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Allergic responses to SSRIs; any good choices left?
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Allergic responses to SSRIs; any good choices left?


Posted by Jean on August 11, 1999 at 10:58:15
I am a 50-year-old white female with a history of major depression beginning at age 10. I have been treated successfully with Prozac, Zoloft and Celexa at different times over the past 6 years. However, after months (2 years in the case of Prozac) on these drugs I developed a dose-related skin rash covering buttocks, hips, upper arms and the backs of my legs. This rash is worsened by heat. My board-certified psychiatrist now says I am apparently allergic to all SSRIs, and has suggested MAO inhibiters. I am unwilling to take these because of side effects. A dermatologist biopsied the Prozac rash and the path reports showed "no evidence of allergic reaction" but some sort of chemical interaction was obviously going on, as my psychiatrist agrees.
I took Welbutrin for about 8 weeks in 1996 and found it did not help depression.
Am I out of options here? For the moment I am controlling my depressive feelings with Valium and anger and have not yet loaded the .38 revolver I keep in my closet. However, my knowledge of my psychiatric history makes me feel the clock is ticking down to that inevitable conclusion.
jean
Posted by HFHS.MD-AJ on August 14, 1999 at 16:15:27
Jean,
The incidence of rash caused by SSRIs is about 2-6%. I am sorry to hear that you had to discontinue these medications that you otherwise found beneficial in treating your depression. You also state that you did not find Wellbutrin helpful. Your psychiatrist may want to consider a trial of other antidepressants such as Effexor, Remeron, Serzone, or tricyclic antidepressants, as well as referral for cognitive-behavioral or interpersonal therapy. Elecroconvulsive therapy (ECT) is another safe and effective treatment for major depression, in those patients who have failed adequate antidepressant trials, are unable to tolerate antidepressants, or are acutely suicidal. It is imperative that you inform your psychiatrist immediately about any suicidal ideation, and to remove any guns from your home.  
This response is provided for general information only. Always consult your physician for any health concerns.


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