are antidepressants a bad idea?

[martifer]

My depression (not hhpd related) has gotten so bad lately that i'm considering dropping out of school. just started seeing a therapist who reccomends meds, because that seems like the only thing that will keep me functioning. ive had mild hppd for about 9 months and have had short episodes of dp, so im afraid meds might make it worse.

im conflicted. have there been any depression meds that work for you guys and dont make things worse? i dont know what to do.

[mgrade]

I've had to drop out of school from HPP and depression and dp and anxiety--------that;s never good-----try not to quit and get on some meds maybe------i can only tell you about the drugs i am on Wellbutrin xl and Lexapro

[miketusa]

Sorry to hear that man. Have you tried St. John's Wort yet? It is an SSRI but as far as HPPD goes, it doesn't seem to affect it negatively for anyone, that I have heard. It really helped me trudge through those dark periods when HPPD got me down.

[martifer]

I've had to drop out of school from HPP and depression and dp and anxiety--------that;s never good-----try not to quit and get on some meds maybe------i can only tell you about the drugs i am on Wellbutrin xl and Lexapro

how's that going for you? hasn't made hppd or dp get worse?

Sorry to hear that man. Have you tried St. John's Wort yet? It is an SSRI but as far as HPPD goes, it doesn't seem to affect it negatively for anyone, that I have heard. It really helped me trudge through those dark periods when HPPD got me down.

no i havent, but thanks for bringing that to my attention. is it over the counter or prescribed? ill ask my doc about it. im willing to give some meds a try (carefully)

[Jay1]

5HTP and Inositol are other supplements worth looking into.... as with anything, it might not be for you.... but for me, it was fine and definitely help my depression and anxiety.

Lamictal is also quite good, if SSRIs make you feel worse.

[VisualDude]

My depression (not hhpd related) has gotten so bad lately that i'm considering dropping out of school. just started seeing a therapist who reccomends meds, because that seems like the only thing that will keep me functioning. ive had mild hppd for about 9 months and have had short episodes of dp, so im afraid meds might make it worse.

im conflicted. have there been any depression meds that work for you guys and dont make things worse? i dont know what to do.

Working with a therapist is statistically the most helpful thing one can do for anxiety and/or depression. SSRI's are 8% better than placebo. Tricyclics are 12% better than placebo. Just take the placebo, lol !!!

Since you have HPPD as well, then there is probably some 'brain issue' involved. Try not to drop out (that just aggravates depression) though you could reduce your work load. If you do try a med, older, unpopular meds are often useful. I can feel better with a single dose of Imipramine or Wellbutrin. Meds that take months to kick in are suspicious IMO. With HPPD you are more likely to be sensitive to meds. In general, SSRIs and SNRIs can backfire. However some feel better with no or little worsening of HPPD symptoms.

Do you have ideas why you feel depressed? For example, struggling with HPPD, DP and DR? (these would depress anyone).

[rollingregret]

Visual, I think to a large extent, depression is an actual symptom of HPPD for many people, same as anxiety, same as visual disturbances. I would imagine it's linked to an alteration of serotonergic neurons (some get hyperexcited, some might do the opposite). From reading the boards, I know that anti-depressants have helped a subset of people, not surprisingly those who suffered clinical depression, which might be too powerful for therapy alone. I would explore them if depression is a major symptoms the same way exploring benzos is an option for those with anxiety-related problems. For many of us, it's a chemical imbalance that can't be corrected fully by therapy. Those are some scary stats on the efficacy of SSRIs! Are they really that ineffective? How are they even approved for use then?

[mgrade]

New data seems to suggest that SSRIs are very prone to the placebo-effect for people with mild depression. Of course that isn't considering all the other people who they seem to help. The antidepressants of the last 10 years are the best there have ever been. Your brain is a fragile thing. I wouldn't make soup with ground beef and chicken, but chicken, parsnip and carrots might work.

Not all drugs are for everyone though. I just took about 1/64 of a mg of Klonopin because i was feeling slightly agitated (and i never fully, ever, got along with Klon.) and I feel like sht now. Some people are poor metabolizers of drugs.

[VisualDude]

Visual, I think to a large extent, depression is an actual symptom of HPPD for many people, same as anxiety, same as visual disturbances. I would imagine it's linked to an alteration of serotonergic neurons (some get hyperexcited, some might do the opposite). From reading the boards, I know that anti-depressants have helped a subset of people, not surprisingly those who suffered clinical depression, which might be too powerful for therapy alone. I would explore them if depression is a major symptoms the same way exploring benzos is an option for those with anxiety-related problems. For many of us, it's a chemical imbalance that can't be corrected fully by therapy. Those are some scary stats on the efficacy of SSRIs! Are they really that ineffective? How are they even approved for use then?

Yes, depression and anxiety can be 'neurological' in origin. And according to brain studies (dicecting and how they cause depression in animals), depression IS a form of anxiety ... hyperactivity in certain areas with long term causing shrinkage (loss of neurons).

Neurology aside, just getting HPPD is STRESSFUL. And when it persists you have to get used to chronic illness ... including going through grief, resentment, anger, ...

When it is out-of-control so that you can't work/function, then meds are a sensible thing the get you on your feet. The biggest problem with SSRIs is that they become a crutch (easy fix) instead of being an intervention ... with long term social complications. Prozac is a BIG marriage breaker. But in fairness, so is chronic illness.

The stats on SSRIs are scary. The first, Prozac was actually approved with VERY FEW patient trials. And it was a missreading (perhaps serendipitous) of a paper, The Serotonin Hypothesis. Nevertheless it is here and many people initially feel better on it. As they say, if it feels good do it. But 'cause and effect' still rule. Cocaine feels good but it can leave a lasting affect that is not good.

People here should not be afraid to try things. IMO just start with very low amounts. It symptoms start to worsen, then seek something else. If you communicate with your doc that, yea anxiety was better but vision is worse, he may be willing to try something else.

It is more complicated with HPPD because, IMO we are dealing with a very mild brain injury. The docs who are most useful are those experienced with successfully treating brain injury (which is largely "management").

Being calm, careful and patient, each of us should be able to come up with some help and see improvement. Time, healthy living, and support for nerve healing are the tickets to get better - partial or sometimes complete.

[rollingregret]

Interesting points, Visual.

What do you think of the treatment that is used by some of using an SSRI+wellebutrin XL (I have no experience with these) to try to affect symptoms of anxiety. I mention this because, as my recovery from a benzo cut has been slow and is yet far from complete, Dr. A suggested I try that route. It seems that ADs have some anxiolytic properties. I'm scared as shit about them due to their side effects! Being that I'm on klonopin (and a pretty high dose), I don't think there's going to be any nerve healing since I think you need to be completely off the drug to allow receptor upregulation to start. That said, I have to be on it (as a crutch) due to the severity of my HPPD. I literally can't function without it (went a year of HPPD before getting on klonopin, 2006-2007), my life fell apart. Right now I'm trying to let my body adjust to a shaken up GABA system that may or may not have developed some kind of tolerance. Dr. A. (although not believing in benzo wd syndrome, let alone protracted symptoms) has advocated using additional treatments to make up for whatever ground needs to be covered.

Some have told me from their experience that when they've made a bad cut and reversed it, it took 3-4 months to get back to homeostasis. I REALLY waited too long to reverse the cut (5 months) so I'm not sure if it's possible to restore the same efficacy. I have taken every measure possible to reduce anxiety (I have physical symptoms), but I'm still far from where I was before the cut. I guess you're saying that I should stay far away from the AD route. An added problem is that it's almost impossible to find or have access to pdocs where I am and where I might be going (unless that' Boston -- Dr. A.) It's a complex problem and requires someone with a keen and open mind.

I would add that with ADs, the problem is that they are supposed to make you feel worse before they make you feel better, clouding your judgement of whether they are helping.

[VisualDude]

SSRI+wellebutrin XL

I've used small amounts (< 75mg / day) of Wellbutrin SR. It works very well except I don't tollerate some side effects, namely eye pain, aggitation, and migraines. I would guess that Dr A would have in mind possible cognitive help with norepinephreine. Hard to say with SSRI's.

I would add that with ADs, the problem is that they are supposed to make you feel worse before they make you feel better, clouding your judgement of whether they are helping.

This does complicate things. Then, if you don't like the effects after a few months, most people suffer discontinuance problems - some for a very long time.

Overall, it would make sense to try the things Dr A suggested. He seems most experienced with HPPD and medication responses.

Dr. A. ... has advocated using additional treatments to make up for whatever ground needs to be covered.

This is generally what is done (somewhat unfortunately). Finding ways to patch life together ... first to function (work), then hopefully some happiness.

Overall with meds (all the more so when taken for a while) the brain adjusts. When you stop, it is like the brain has been pushing against what you have been doing (which it has in an attempt to balance).

Don't worry about not having nerve healing. As long as a neuron is alive, reasonably healthy, and hooked up with other active neurons - plasticity is possible.

I wish there was an easy answer. But as you know from your own troubles, its a pain in the rear...

[martifer]

Alot of this stuff is over my head, but im glad i got a discussion going. I personally have had mild depression for years, even before hppd. It's school stress, pre-existing depression, and anxiety/panic attacks that started with hppd, that have sent me into a deeper depression now.

I'm going to talk to my doc and give meds a try, but im definitely gonna handle them cautiously. I'm not looking at them as a long term solution but more of a jump-start into changing the way im thinking and combat the anxiety.

And although i dont feel DP'd on a regular basis, i just feel a little dumber than before. Anyone get that?

Bah anyway, this little chit chat helped. thanks.

[mgrade]

I think Wellbutrin SR is ok but XL is probably better----and the regular stuff is like borderline garbage. ...........It depends on what is really the problem though. Do you feel depressed? Can't concentrate? or Do you have a lot of anxiety?

Or All of these things?

Based on what you are telling me, it seem to me you need to be on Lexapro.

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I know about feeling dumb. I feel dumb right now. That to me was the worst thing about this disorder.

[cs1234]

Everybody talks a lot about strong, prescription ssris, but how would, say, a weak sri affect my hppd?

[mgrade]

probably help.........listen i'm on the ssri, but im on 5 mg [virtually nothing] ...............justa sri? ..........let me look into it............. sri? as in sri lanka? .....hahaha j/k

[cs1234]

hahaha well I've been pretty sick lately so I was just wondering if all the benadryl and dxm I've been taking is bad for my hppd. wikipedia says they're both weak sris.

[mgrade]

here's the scoop cs1234: There must be some wicked colds your way ......i was in DC visiting my family and i got my cold from my 7 year old nephew......anyway benadryl is ok (i used it once) if used moderately but.........now it has solidified (the fluid) in my irritated eustachian making it hard to drain my ears and now i may get a infection potentially. So that is your main concern now IMO.

I think benadryl works on the adrenaline/noradrenaline routes mainly, not sure.

[cs1234]

I know man what's happening over here? Everybody's got it...i hope your case doesn't turn into an infection though!

I mean I don't know much about these drugs but wikipedia says one of the functions is as a weak sri. At first I had a really bad cold for a week and now I have a bad cough but now it's getting better. I haven't noticed any worsening symptoms yet after about 2 weeks of repeated use of both of them.

[mgrade]

Dude we have the same cold guaranteed. Maybe it would start with a runny nose; then it was upper respiratory and sore throat and congestion, one day of low grade fever, spittin' up some real stuff, then congestion. I'm getting better now though.

[VisualDude]

Here is an old fashioned time tested cold and flu treatment. Can remove toxins ... wonder if it would help HPPD and/or depression?

http://en.wikipedia.org/wiki/Enema

http://www.diaryofavegan.com/2011/04/make-friends-with-enemas/

[martifer]

I was just prescribed Wellbutrin XL. We'll see how this goes. I completely forgot to talk to the doc about how this would affect depersonalization, which ive had in the past. Kinda scared to take it for that reason as well.

[mgrade]

I looked back at my initial thought as to what drug i thought would be most beneficial to you and in that post I said it would be:

Lexapro. I think that would be better esp. for depersonalization. But Wellbutrin should help as well. Let me know how it turns out. .........They got you on the 150's right?............What's the drug company maker of the pills you received from the pharmacy?

[mgrade]

Look at it like this: Wellbutrin is to Lexapro as Mocha-Coffee Ice cream is to Chocolate-Chip Cookie Dough Ice cream. ....lol

[martifer]

yeah, 150s. it says bupropion hcl xl on the pill bottle. think i should go back and talk about dp?

[mgrade]

ok 150's .....um.........Tell me what the pill says on it and describe size and what it looks like. And see if it says a drug company on the bottle.

....You should be ok.........see if you like bupropion first..........if you don't for some reason, you could look into adding an SSRI such as Lexapro, or just taking only an SSRI on its own.