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Experiences with antidepressants pro/con


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I'm generally pro but will balance it out with the biggest con of all, which is they just don't work at all for some people. That's only really a problem if support is hyper-focused on meds. Eggs, basket etc. Can improve function without resolving cause. 

Another con - getting off meds later can be difficult. 

More minor cons - weight gain, acne, libido loss (prob for older, relationship firming teens) - mitigated with awareness of side effects, changing meds. 

In general, the pros outweigh the cons.

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3 hours ago, gardenmom5 said:

the one dudeling's ND uses is much more complex, and as far as I know from previously looking into it - it's not available on the open market, only providers.

If you get a name, I'd love to check it out. Usually they'll have a website, provider locators, etc. etc.

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7 minutes ago, PeterPan said:

If you get a name, I'd love to check it out. Usually they'll have a website, provider locators, etc. etc.

His next appointment is in april.

 

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9 hours ago, PeterPan said:

But it made the comment that if you're asking about the side effects, you're not yet ready for the meds. It's a line I think about a lot and the answer changes for us at times.

Perhaps it's because the quote is out of context, but this makes no sense to me. You should ask about the side effects of every medication that goes into your body. 

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39 minutes ago, katilac said:

Perhaps it's because the quote is out of context, but this makes no sense to me. You should ask about the side effects of every medication that goes into your body. 

It was in a chapter discussing the side effects of the meds, and they were exploring questions like whether you could take the dose down to minimize side effects but still get the benefits, were the side effects worth it, etc. And we've had times where, with the balance we had, the question of side effects didn't matter. We trusted the doctor would suggest something as safe as possible, but it really HAD to be done, kwim? And right now, with our current mix, we're close enough that we're questioning it. So it's something that helps me think through when I know it's time to take the plunge, because my gut is assessing it HAS to be done.

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I know you asked for advice for people that have been there with children, but I'll weigh in with my personal experience and you can use or not use it. As an adult in 2017 I finally decided to give an SSRI a try. I had put it off for a couple of reasons (one of which had been breastfeeding prior to that). I've been evaluated two two pyschs and it was totally different. First one made me answer a billion questions for her intake form. Then came back with a diagnosis of depression and generalized anxiety. I told her I thought I had OCD but she didn't classify me as having it. Fast foward. I went to another psychiatrist and he said he doesn't do intake forms. He just talks to you and gets info without a specific form. He said based on my info the SSRI would be used to address depression, anxiety and OCD. I also complained of a few panic attacks so it was kind of a catch all for all the things. First one I tried worked immediately (I was having suicidal thoughts just before I began it) but I was SUPER tied on that one. We tinkered with the dose a few times but ultimately switched to Celexa (well, the knock off version). Overall I've been decent with celexa. It's a little less intense so not affecting fatigue to the same degree. My follow ups now are usually every few months but if things are extra crazy sometimes I'm seen more frequently. Right now everything is a telehealth appt. In the beginning I'd rattle on (like I'm doing here!) for a while but now we usually just talk like 10 min lol. Basically, "how are you, is the dose still good?" If you want talk therapy or something along those lines, seek an additional therapist. I usually go to two. 

They may not advertise it, but you can cut pills. I cut mine which is a huge PITA but it was the only way I could get the right dose. So they prescribe me 1.5/day and I actually take 1.25. My prescription lasts a bit over a month before I need the refill. I basically had to ask the dr if it was okay to cut them because he could not prescribe them that way (they come as a 10 or 20 mg. At one point I took 10, another point 20, another point I think 30... and now my dose is 25mg). Just be prepared for it to take a while to adjust doses and there may be side effects. 

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1 hour ago, katilac said:

Perhaps it's because the quote is out of context, but this makes no sense to me. You should ask about the side effects of every medication that goes into your body. 

there are common side effects, and there are more rare side-effects.  sorry I don't remember the drug  - or the side effect, but it wasn't in the literature that came with the drug.  I had to search through multiple "side effects of drugs" sites to find the side effect I was having.  It was bad enough I needed a change of medication, but rare enough it was rarely mentioned.

Drs rarely know a full list of side effects of the drugs they prescribe - so dont' count on your dr knowing them.  Pharmacists know more about the drugs and their effects (they spend two more years in classes on drugs than medical students do), but there are still a lot out there.

In another case, I had learned you can buy temporary dental cement OTC in drug stores.   How timely - just in time for a crown to pop off over a four day holiday weekend.  The drug store carried three brands. (don't know why, they were all basically the same.) ONE brand mentioned an allergy warning to eugenol.  both of the other brands contained eugenol, but neither mentioned an allergy warning. . . . . . it turns out, I'm allergic to eugenol.  I was popping Benadryl like mad as I went to my dr because I was having so much trouble breathing.  (fortunately my dentist was open, and my crown came in so he just put the real one on with regular only available to the dentist dental cement.)   If that ONE label hadn't said anything about an allergy warning - I wouldn't have made the connection.  Now, if I pop a crown . . . . I use wax until I can get in to the dentist. . . doesn't last long, I have to do it several times a day, but I can breathe.

 half the adrenal supports on the market contain holy basil leaf.  oh - HBL contains, you guessed it - eugenol.  there are NO warnings.  only one I know of even mentions the supplement contains eugenol (in the form of the HBL.) - no allergy warning.

 

Edited by gardenmom5
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Thank you everyone for your comments. My DH has a psychiatrist whom he trusts a great deal, who isn't prone to overmedicating. So we are going to start with getting an appointment with her. I'm intrigued by the concept of interoception--this dc has a lot of trouble expressing feelings or even recognizing them at all beyond "I wish I were dead," I will get a book about it and see if we can implement.

DH has a constellation of issues including type II bipolar, so we are aware that this may not "merely" be depression and that mood stabilizers may be what's required. DH has been through the wringer and been on many different combinations of meds over many years before finding the right thing. He's frankly more nervous about medicating the DC than I am, because he has personal experience of when meds don't work, and knows how hard it can be to make changes. 

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22 hours ago, PeterPan said:

No, this chart I linked was neurotransmitters, not methylation. Might interest you.

P5P is the form the liver converts the b6 into (from what I understand). So I get why you might say well I take methylb6 and don't need that. Fine. I have both MTHFR and 

I asked for the P5P - that's not what the dr gave me.  So, i just buy it OTC.  - well, Now I just buy a good quality b-complex, and make sure everything is in the most bioavailable form.   I have elevated liver enzymes, but I have also had an active Epstein Barre infection for years.   - we suspect it started when I had my "eye infection from hell", as my health has never been the same.  And a few things my eye dr said..  25 years ago.   (there's a test that can tell if the virus is replicating.  We had to repeat the test because the lab only ran the antibody level - my dr had never had a patient with numbers that high.)

and I'm homozygous for MTHF.

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22 hours ago, PeterPan said:

Reading about your experiences, I'm so glad what you did worked and you're safe and feeling well now!

actually - i had a super weird (super weird) reaction to anesthesia.  that's what set off my pendulum swing self-harm compulsions.   if we're right - it's also about the time I started an Epstein Barre infection.    I've since discussed my reaction with anesthesiologists, and just left them scratching their heads. (I haven't had that reaction again.) But I can definitely pinpoint that is when it started.   So - the prozac was just to stop the pendulum.   

bodies are very complex chemical systems.

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Very positive results with teens and adults in our home. If your teen is engaging in substance abuse, they are likely self-medicating. It is in their best interests to see a psychiatrist. Try to find a specialist in addiction if you can. If your teen is older - say 16 as opposed to 13, then see if you can find someone that sees both teens and adults so that there isn't a transition in adulthood. This has been a long term problem it's my experience that the solution will likely be long term as well. I strongly suggest you don't attach any expectation of a recovery time to your willingness to seek psychiatric help for your teen - I know many people who do this and it has resulted in inconsistencies in treatment and delayed improvements in mental health unnecessarily. It takes as long as it takes and if, like when someone has diabetes, lifetime medication is required, so be it. That's what you do to maintain health.

You might find the information for families & caregivers from National Alliance on Mental Illness (NAMI) helpful - they are a valuable educational resource. Be sure to look at all of the sidebars menus also.

 

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1 hour ago, gardenmom5 said:

actually - i had a super weird (super weird) reaction to anesthesia.  that's what set off my pendulum swing self-harm compulsions.   if we're right - it's also about the time I started an Epstein Barre infection.    I've since discussed my reaction with anesthesiologists, and just left them scratching their heads. (I haven't had that reaction again.) But I can definitely pinpoint that is when it started.   So - the prozac was just to stop the pendulum.   

bodies are very complex chemical systems.

Is anesthesia more likely to react with MTHFR problems?

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2 hours ago, PeterPan said:

Is anesthesia more likely to react with MTHFR problems?

It's the only time I've had issues, and i'm homozygous.  I think there were other things - at that time -  that made it more complex, and put me at greater risk.

dudeling's ND freaked out when I said the dentist gave him nitrous oxide to have a tooth pulled.  the risk is anesthesia can shut down the methylation cycle.

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5 hours ago, egao_gakari said:

Thank you everyone for your comments. My DH has a psychiatrist whom he trusts a great deal, who isn't prone to overmedicating. So we are going to start with getting an appointment with her. I'm intrigued by the concept of interoception--this dc has a lot of trouble expressing feelings or even recognizing them at all beyond "I wish I were dead," I will get a book about it and see if we can implement.

DH has a constellation of issues including type II bipolar, so we are aware that this may not "merely" be depression and that mood stabilizers may be what's required. DH has been through the wringer and been on many different combinations of meds over many years before finding the right thing. He's frankly more nervous about medicating the DC than I am, because he has personal experience of when meds don't work, and knows how hard it can be to make changes. 

The other thing to think about, when you have time, is CBT therapy.  DC is working through Mind Over Mood: Change How You Feel by Changing the Way You Think right now in therapy.

The advantage you have is that if DH has medications that work, a psychiatrist may try those or similar medications first.  My sister is bipolar, so we tried medications that were part of her combination first.  My DC takes the same NDRI, and the same mood stabilizer.  My sister takes a high dose anticonvulsant and my DC takes an atypical antipsychotic.

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7 hours ago, egao_gakari said:

I'm intrigued by the concept of interoception--this dc has a lot of trouble expressing feelings or even recognizing them at all beyond "I wish I were dead," I will get a book about it and see if we can implement.

https://www.kelly-mahler.com/product/the-interoception-curriculum-a-step-bystep-guide-to-developing-mindful-self-regulation/  Easy to implement curriculum.

https://www.kelly-mahler.com/product/three-steps-to-improving-interoception/  She has two online recorded courses, but if money isn't holding you back this is the one to do.

She has a book, but I wouldn't bother with it. She wrote it before the full curriculum came out, and you'll be much happier with the recorded course and the curriculum. 

I've got her assessment btw. You can buy it from AAPC. The price has gone up, but it's very interesting. That would be an if money is no object. It's not standardized (they're working on a version that will be) but it is quite revelatory and would show both you AND HER if this is actually an issue or not.

https://www.aapcautismbooks.com/products/interoception-assessment-forms?_pos=1&_sid=c84d484d3&_ss=r

 

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7 hours ago, egao_gakari said:

constellation of issues

You could run genetics. There may be parts that would be treatable based on the genetics. For instance, some people have a VDR defect (vitamin D receptor) and find vitamin D stabilizing. Simple thing, can be good results. It takes lot a lot of sleuthing, but might be worth the effort. It's sort of what I do sometimes, going through looking for more explanations to get my extremely volatile ds stabilized. You could also look at methylation. Methyl levels are strongly implicated and sometimes *food* is aggravating it. 

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2 hours ago, gardenmom5 said:

the risk is anesthesia can shut down the methylation cycle.

Interesting. I got busy the first time I heard people being anathema on nitrous. We've done it on ds multiple times, nary a problem, but he's straight COMT with zero MTHFR defect. So shutting down his methyl production a bit would be good, lol. But me, I think I had gas in college for my wisdom teeth and yeah I was exceptionally affected. Might explain why. But for ds it never seems to have been a problem. We do it because calm experiences with the dentist trump a lot. But sounds like we'd know by know if it was hurting him. 

I guess it's the only benefit of having a really awful chemistry mix. He can breathe nitrous and not get sick. Mercy.

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43 minutes ago, PeterPan said:

Interesting. I got busy the first time I heard people being anathema on nitrous. We've done it on ds multiple times, nary a problem, but he's straight COMT with zero MTHFR defect. So shutting down his methyl production a bit would be good, lol. But me, I think I had gas in college for my wisdom teeth and yeah I was exceptionally affected. Might explain why. But for ds it never seems to have been a problem. We do it because calm experiences with the dentist trump a lot. But sounds like we'd know by know if it was hurting him. 

I guess it's the only benefit of having a really awful chemistry mix. He can breathe nitrous and not get sick. Mercy.

One ND who specializes in MTHF had a patient who could drink, a lot, and not feel affected.  It was how his mutation affected him.  Put him no MTHFR . . . He could have one drink.  He wasn't happy about it either.  I think she said after complaining about it to her, he didn't come back.

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1 hour ago, PeterPan said:

You could run genetics. There may be parts that would be treatable based on the genetics. For instance, some people have a VDR defect (vitamin D receptor) and find vitamin D stabilizing. Simple thing, can be good results. It takes lot a lot of sleuthing, but might be worth the effort. It's sort of what I do sometimes, going through looking for more explanations to get my extremely volatile ds stabilized. You could also look at methylation. Methyl levels are strongly implicated and sometimes *food* is aggravating it. 

I'm not sure what this means--like, too much methyl in the diet or too little? The only place I've heard of methyl is that my vitamins have methylfolate in them 🙂 

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49 minutes ago, egao_gakari said:

I'm not sure what this means--like, too much methyl in the diet or too little? The only place I've heard of methyl is that my vitamins have methylfolate in them 🙂 

careful what you ask - you might get information overload.  MTHF mutations inhibit methylation.  This is what it's supposed to do.

 

 

April-Ward-Hauge-Yasko-Methylation-Cycle.jpgepar

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48 minutes ago, gardenmom5 said:

careful what you ask - you might get information overload.  MTHF mutations inhibit methylation.  This is what it's supposed to do.

 

 

April-Ward-Hauge-Yasko-Methylation-Cycle.jpgepar

That's not very easy to interpret 😛 Is this something that can be treated with vitamins if we choose the right ones? During my research a while ago I did see that often depression can be a sign of B-complex deficiencies as well as vitamin D deficiency, so I started both kids and DH on multivitamins recently. I've always been the vitamin person but never really made the rest of them take them.

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36 minutes ago, gardenmom5 said:

careful what you ask - you might get information overload.

:biggrin:LOL :biggrin:

1 hour ago, egao_gakari said:

I'm not sure what this means--like, too much methyl in the diet or too little? The only place I've heard of methyl is that my vitamins have methylfolate in them 🙂 

Well start by googling methyls and bipolar and you'll find a lot. 

11 minutes ago, egao_gakari said:

vitamin D deficiency,

Yes, D can help stabilize mood. It pulls the methyls off the methycobalamin, helping process B vitamins. 

11 minutes ago, egao_gakari said:

B-complex deficiencies

There's some research on it but it would make more sense to me to drive those questions with genetics rather than a DSM label, only because people could be grouped together under a label who don't all have that issue.

https://www.reliasmedia.com/articles/141976-l-methylfolate-for-bipolar-disorder

You could google for methyl donor foods and see if any of them tend to exacerbate symptoms for your people.

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23 minutes ago, egao_gakari said:

That's not very easy to interpret 😛 Is this something that can be treated with vitamins if we choose the right ones? During my research a while ago I did see that often depression can be a sign of B-complex deficiencies as well as vitamin D deficiency, so I started both kids and DH on multivitamins recently. I've always been the vitamin person but never really made the rest of them take them.

Not all b-vitamins are created equal.  There are many molecular forms on the market - you want the most bioavailable because you loose some in the conversion process.

I took a mid-range drug store brand for years.  If I didn't take it for a week - I could feel myself slide backwards.  Then (I had more money to spend) I switched to a good (not the best) quality b-complex.  Three days later . ... It was like someone turned on the light.  - and that was despite taking a double dose of a drug store mega B stress complex for several years.

D3 is easy to supplement - the biggest variation between d3 vitamins is the oil the use as a base (do NOT bother with a solid d3, you want oil based.), and whether it has K2 or not.  (it can be beneficial.)  It's being reclassified as a hormone (came up in some of 2dd's classes) due to how it is made, and how many body processes it is required for function.   they really haven't changed the suggested RDA much since it was thought D3 was all about bones and teeth . . . . for perspective, a d3 level of 7 is about where you start to find rickets.  Now - a baseline D3 level of 50 is considered a minimum for good health.  (one oncologist said she'd never had a patient with a d3 level >30.)  I take 5,000 IUs a day.  It still only climbed about 9pts in a year.

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I use bloodwork and keep my d in the top end of the normal range. I use it with K2 to make sure it absorbs well. I take 10k IU during the summer and 15k IU during the winter. I definitely feel the difference when my D levels are lower.

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I have a son with depression. Thankfully his doctor is holistic, so although he is being treated successfully for depression with a 5htp and ashwagandha combo, we are also working on finding root causes. DS ran out of the above supplements unbeknownst to me and came to me recently and asked me to purchase more because he's been feeling sad and struggling with depression again. This was about 5 days post running out of his supplements.

I would suggest that you have your doctor do a MTHFR test on your DS because if he has a genetic mutation, a good b complex can make a huge difference for mental health. A poster here just shared on another topic that her son's psych ran a MTHFR test that was positive and that supplementing is helping. Bravo to that doctor. 

What we've just started doing is a carefully orchestrated supplement regime to see if DS can successfully wean of meds (though absolutely no biggie if not and he continues to need them) is:

Triple strength fish oil

Metabolically active B complex or multivitamin with metabolically active Bs

400-600 mg highly absorbable magnesium

10,000 IU Vitamin D

100-200 mg Vitamin K2 if not in multi (the above multi has K2)

I'm on a similar regime. We shall see how it helps. DS and I are feeling really great on this both physically and mentally, but it's early days and we haven't tried any weaning off of meds.

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6 hours ago, IfIOnly said:

wean of meds

There’s a supplement to do this, don’t remember the name. Look for it. Helps system get back in gear.

Fish oil tolerance is genetic.

Have you run bloodwork on the D and s?

 

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