Increased depression and smoking cessation

I have been on antidepressants for about 5 years now.  I am currently taking Paxil (20mg/day).  I was taking Elavil (75mg at bedtime) The elavil was prescribed to me for fibromyalgia.  I no longer see a psychiatrist.  All of my meds are being handled by a doctor I see at a pain management clinic.  The took me off of elavil.  I am also attempting to quit smoking.  I have noticed my depression increasing (today, I didn't get a shower & dressed until after 4:00).  Even though the elavil was used in a low dose, directed to fibromyalgia symtoms (symptoms), do you think this could cause the problem or is it common to happen when trying to quit smoking?

[HFHS M.D.-SW]

Dear Suzanne,

I am unsure if there is a relationship between smoke cessation and worsening depression.

Your worsening depression may be situational or more likely due to the stopping of the elavil. Elavil is a tricyclic antidepresssant, Paxil is a SSRI. When these two medication are adminstered together, there is a synergist effect.  Simply, they both increase the effect of each other.

I recommend you discuss your concerns with a p[sychiatrist.

Best Wishes,

HFHS M.D.-SW