Hep C Discussion Forum

Hi Judy-OMG you have been through a lot...Bri too!!!

Not sure what you can take while on treatment but B complex and Flax oil work pretty well for mild depression/anxiety-were recommended many years ago by my doc in lieu of allopathic drugs.  I know many people taking Flax Oil for depression and rave about the results...  

You are sure in need of brighter days...wishing you many to come.

Judy, are you the strongest person on eath? I think you are. And Bri is running a close second. You two amaze me. Good call on the ADs. Just do what makes the most sense to you. You are getting pretty good at this. I know you listen to your doctor. We all do. But you are also starting to make up your own mind, based on all the things you know. This is the best treatment of all.

Alan

This tx (treatment) is pure hell, but together with the Paxil my dr put me on, I have been nearly suicidal.  If I didn't have Bri to care for, there's no telling what I may have done; it's been maddening and PURE HELL.

 I had a basic understanding of how ADs (antidepressants) affect the Serotonin receptors in the brain.  From the moment I started Paxil 2 weeks ago, I developed SEVERE anxiety, insomnia, nausea, uncontrollable body movements, tremors, restlessness, a severe inability to sit, stand, or lay still.  I was going CRAZY.  I couldn't eat and eventually couldn't walk or breathe properly; I ended up in the hospital for the day again via ambulance on Aug 4.

 My dr reduced my Paxil dose to half, 1 week ago (hospital day when I nearly quit tx) to wean me off.  I have stopped completely on Saturday (2 days ago).

Not wanting to be ignorant about things I don't fully understand, I did more Paxil research to educate myself better.  I'm glad I did.  MANY patients have the SAME reaction to Paxil and any ADs.  Here is why:

 Please know that many people have this reaction to SSRIs when they first start them. The digestive tract has more serotonin receptors than anywhere else in the body (even the brain), so many people feel nauseous when they first start them, since the receptors are dealing with more serotonin than normal.

The reason you feel anxious (tremors, insomnia, restlessness) when starting them is as follows: the theory is that those with depression (and possibly anxiety) have smaller amounts of serotonin circulating in the brain. Because of that, the brain has, over time, increased it's numbers of receptors, hoping to mop-up all available serotonin it can find.

When you start taking SSRIs, the medication increases the amount of serotonin available to the receptors. This wouldn't be so bad if you had a normal number of receptors, but if you have a huge number, your system is suddenly flooded with serotonin. In normal doses, serotonin "activates you" and makes you feel good (hence people with depression feel lethargic and inactive). In too high doses, it "over-activates" you - the symptoms you describe.

Two things to note: 1) the symptoms go away after a short while - say, a week or two after beginning the drug. This is how long it takes the number of receptors to down-regulate to a normal number. 2) the ironic thing is that people who get this reaction may be exactly the people who NEED it most, for the reasons outlined above.

It's a shame, I agree, because the side effects are miserable. Even though I'm a doctor, I'm on an SSRI, too (for anxiety), and I had the same reaction when I first started. (So, just so you know, doctors don't only prescribe these meds, we take them, too!)

My own doctor put me on a low-dose benzo for the first week, and also had the pharmacy compound down the drug so that each pill contained only a very small amount - eg. instead of starting with 10 mg of Celexa, I started with 2 mg, then increased to 4 mg, then to 6 mg, until I worked up to 20 mg. Ask your doctor to try this for you.

Unfortunately, I'm not sure you'll notice much difference in side effects between the different SSRIs. As I said, the side effects are actually a sign the drug is working, and despite the different names, they all work more-or-less the same.

The withdrawal side effects are true with regard to Paxil (though I've had patients comment on similar withdrawal from Celexa and Effexor - it may be the same for all of the SSRIs). The drug companies call it a "discontinuance syndrome" as opposed to withdrawal, but whatever you call it, it's miserable. I've missed a few pills now and again, and I know what you're talking about.