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276730 tn?1327962946

Nightmares

I know there is no answer for what Im going thru..at least I dont think there is. Im 10 months post tx now and regaining my life back. So far so good. Everything has gotten better although still have TOO MUCH hand and knee pain.
Im happy, and grateful Im SVR after 9 months post tx.

Howevr before tx I have never suffered nightmares, there isnt one night that has gone by since I started tx up until last night ( and last night was a doozy)!! that I havent had a BAD nightmare and I mean bad.

Has anyone heard of interferon doing this? I really cant handle it anymore.
its to the point I dont want to  go into bed at night. And I mean bad!

Charm
:{
36 Responses
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476246 tn?1418870914
I had no sexual problems with Celexa. (Meki would have said crazy good monkey sex... Gosh do we miss her!)

It definitely proves that people react different to meds.

Helpful - 0
475300 tn?1312423126
I have always been told by doctors that every AD is not for every person, sometimes it takes a trial and error period until the person finds the one that works for THEM. JMHO

Denise
Helpful - 0
Avatar universal
While Wellbutrin is generally used to manage severely depressed patients I don't see how that has anything to do with it's appropriateness for use in an interferon patient.
Apparently, according to your story, Wellbutrin wasn't the right drug for your mood disorder. And that's OK and believable. Maybe you weren't "severely depressed and didn't need to be jazzed up just to get moving". And exactly how does that relate how to your premise that "Wellbutrin is the wrong drug in an interferon patient"?
Had you said that it was the wrong drug for YOU, I would not have commented. It was your statement that Wellbutrin was the wrong drug for an interferon patient. I posted 4 articles which state that Wellbutrin is an appropriate drug in an HCV treatment setting and you have posted none to the contrary. Your bare assertion that Wellbutrin is the wrong drug is not sufficient. You haven't provided a scintilla of supportive documentation.
Mike
Helpful - 0
717272 tn?1277590780
I actually tried welbutrin because a not-too-bright PA prescribed it when I complained about lousy sex on celexa.  She apparently got it off of the internet by googling antidepressants and sex.  After I'd been on it for almost 2 weeks with only an hour of sleep a night and was starting to melt down, I went to a real shrink and she said I should never have been put on one of the dopamine group of AD's because they were for people who were severely depressed and needed to be jazzed up just to get moving.  Good sex is not a good reason to use an inappropriate AD and I hope no one takes it because you like the idea of it or it 'might have potential benefit'.   TX is hard enough.
Helpful - 0
476246 tn?1418870914
It took me about two weeks. But really, I didn't listen to my doc, who told me to start weening myself off around 1 month after tx. But then again, I was on that stuff only for around 32 weeks, as I started taking it in my second week of tx.

I went after my instinct and couldn't wait to get off all meds as fast as possible.

I would not advise anyone to do it that fast. But I would definitely advise reducing little by little. And to go slowly with it. Maybe a tiny dose reduction every week, and just as much so that the body doesn't notice that it is getting a little less.
Helpful - 0
Avatar universal
For the sake of accuracy:

Wellbutrin is considered an appropriate treatment for interferon/ribavirin induced or exacerbated depression. It is not, as was stated above, "the wrong drug for an interferon patient...".

Below are a few citations that suggest that Wellbutrin (bupropion) is appropriate during TX

CONCLUSIONS: Sustained-release bupropion might be of potential benefit in patients with interferon-induced depression.
See: http://www.theannals.com/cgi/content/abstract/38/7/1202

Slight depression occurs commonly with interferon therapy, and Dr. Maddrey said selective serotonin reuptake inhibitors (SSRIs) and Wellbutrin (bupropion) are antidepressants that are safe for the liver.
See: http://www.medpagetoday.com/MeetingCoverage/ACP/3776

Antidepressants called SSRIs (selective serotonin reuptake inhibitors) are commonly used for treating depression. The medications currently in this class include Prozac, Paxil, Zoloft, Celexa, and Lexapro. They are generally well-tolerated medications; side effects that can occur are stomach upset, diarrhea (which is usually brief), and problems with sexual interest or orgasm. Another medication, Wellbutrin, works on depression by increasing chemicals other than serotonin (dopamine and norepinephine, the brain?s adrenaline). Some people have insomnia or get a little anxious on this medication, and it may not be the best choice for a patient with both anxiety and depression. However, the medication has the benefit of not causing sexual problems in most people.
See: http://www.texasliver.org/Guest_Column_/p2_articleid/29

During short-term treatment, IFN-alpha appears to act as a dopaminergic agonist, although after prolonged administration it binds to opiate receptors that seem to modulate presynaptic dopamine release, thereby eliciting a decrease in central dopaminergic activity.21 Thus, deficiencies of serotonin, norepinephrine, and dopamine may all occur in IFN-alpha–induced depression. This supports a role for SSRIs, bupropion, and other antidepressants that enhance norepinephrine and dopamine in the treatment of this adverse effect. Clinicians prescribing IFN-alpha should be aware of its potential for precipitating depression and of the utility of the various antidepressants described here in the amelioration of this adverse effect.
See: http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=778

Mike
Helpful - 0
717272 tn?1277590780
Another comment about reductions: I took 5mg lexapro for TX management by cutting in half 10mg tabs.  When I decided to start reducing I asked for 5mg tabs, thinking it would be easier to cut them.  They cost exactly the same as the 10's ($50!) and to my surprise were extremely tiny, like the little saccharine tabs that were around when I was a kid. No easier to cut than the 10's, maybe even a little harder to cut because the itty bitties skittered off into space when I applied pressure with the knife.  

Cutting up pills every week for the smaller doses became my new post-tx ritual and made me feel like I was still doing something that mattered.

Last comment: I think some people panic when they go off of AD's because they are no longer used to "reacting".  Remember that it's okay to feel sad if something sad happens.   I don't mean uncontrollable weeping or anything like that.  You know what I mean.
Helpful - 0
Avatar universal
Charm, insightful seeing this thread develop...you started out saying there's 'no answer' to your problem, then speculated it's interferon-induced, then the discussion took an important turn suggesting you take a closer look at the mood drug you're taking. Complicated topic and great brainstorming.

It sounds to me like it's really worth cutting the pills in bits (nuisance) rather than alternating days. (I tried alternating days with my blood pressure pills and it sure rebounded and backfired. I'm getting better results emptying the capsules on a paper towel and dividing the contents.)

Epi once provided a link for tapering sleeping pills and AD's and it also confirms what others mentioned, that the ideal taper is reducing the dose daily rather than alternating. It says to alternate only if the optimal route is not possible:

http://www.benzo.org.uk/manual/bzsched.htm#s13

------------------------------------------------------------------------------------------------------------------------
And here's what Epi added in that post:

"Also a couple of notes from the schedule as follows:

1. Make each dose reduction as small as possible, e.g. by halving the tablets or using a liquid preparation.

2. If smaller doses are not available, reduce by taking a tablet every other day, then every third day, etc. ........

4. If withdrawal symptoms are severe (Chapter 3, Table 2) increase the dosage slightly (e.g. to the dose at your last reduction). When symptoms have settled, resume withdrawal at a slower rate.

Withdrawals are horrible, truly feels like you are losing your mind and your control over your body."
------------------------------------------------------------------------------------------------------------------------  

I don't know what's behind your nightmares but it may provide some comfort that there is something you can at least try TODAY to see if the culprit is the mood drug.

Also, I'm wondering about your taking a bit of Benadryl before you go to sleep? Does anyone know?  I noticed the pharmacist recommended this for tapering Effexor on MedHelp's Pharmacists' Expert Forum.

Sleep tight,
Susan



Helpful - 0
475300 tn?1312423126
Charm, I have to agree with Marcia.  In my honest opinion every other day & then every third day is just too far apart.  

Denise
Helpful - 0
Avatar universal
I wrote;
"If the nightmares go away then you know the cause.  You will have to do a slower taper, you may have to take a smaller and smaller dose PER night instead of going cold turkey at longer intervals."
---------------------------------------------------
and so I think I agree with Marcia.  I think it comes closer to actual tapering than, no dose, no dose, big dose, no dose, no dose big dose.  I think there would be fewer peaks and valleys, but of course what do i know?  You could ask them if Marcia's method would be acceptable.  

also.....

http://bipolar.about.com/cs/antidep/a/0207_ssridisc2.htm

http://www.antidepressantsfacts.com/taper.htm

Some light reading.  Once again, I'm not suggesting a course of action but often doctors may not be as up on tapering as others.  Further, there is a range of reaction.  You may be a tad more sensitive.... but I wonder if a better taper method might yield better results.

best,
Willy
Helpful - 0
717272 tn?1277590780
I agree that it's the mood drugs that cause bizarre, vivid dreams.  I only really had them when I was trying welbutrin, which was the wrong drug for an interferon patient, anyway.

I ended up on Lexapro (a sister drug to Celexa).  They started me on 10 but I immediately went from 10 to 5mg, which I used for much of TX (had the same effect with the 5, so stuck with that).  When I started getting off it a month after EOT, I halved the pill to 2.5 and took for a week. Then I cut that little bit of pill again and was on about 1 mg for a week, then spent a week taking it every other day.  Would have gone to taking the sliver every 3 days but I only did that once and then just forgot to take it again, with no ill effects. I guess it took me about 3 weeks all told to get off of 5 mg of Celexa.

Doctors took my mom off 10mg cold turkey and sure enough, about a week later she had 2 very weepy days when I had to talk to her a lot and remind her that it was just backlash from cold turkey .

I think all of us who remain on meds that alter consciousness, like AD's and sleep meds, have side effects that we end up blaming on IFN.  I know I thought that I had a permanent personality change of being over obnoxious and overly talkative, that ended up being a side effect of Ambien CR.  It went away within a week of stopping the Ambien.
Helpful - 0
276730 tn?1327962946
Thanks much for telling me that....What length of time did it take you to be off of them completely ??

I was told a few months...did it take you that long?

Again, thanks
Charm
Helpful - 0
476246 tn?1418870914
Hi Charm,

Sorry to hear you are having such a hard time. I have no idea about nightmares, but wanted to say something about the tapering.

I tapered in a totally different manner. I kept on taking it every day, but lessened the dose.

I ended up breaking the meds into little bits and pieces. My doctor had told me to go from 20 to 10 and then to stop after a while.

Going from 20 to 10 was no good, as it was too drastic. I was not feeling good. So I decided to do it my own way. When I was going from 10 to 0, I did it slowly, breaking the pill into 4 pieces, so that it was 7.5 then 5 and the 2.5 and then stopped. I just went with how I felt.
Helpful - 0
276730 tn?1327962946
Thanks WIlly! I  spoke to a pharmacist and he suggested (dont know if its the correct thing to do) to keep on tapering like Im doing. When I get down to 1 20mg. every 4 days stay on  that for approx. 3 weeks then go to 5 days. etc. As far as asking my doctor he was useless, I asked him last month and my PCP replied "just taper off slowly" thats when I called the pharmacist and he suggested doing what Im doing.
He just said whatever I do dont stop cold turky all at once. Which I knew.

Thanks alot for your advice.
Hoping you can sleep!!
Charm :}
Helpful - 0
Avatar universal
I just saw; you are still up.  : 0

Am I wrong?  Couldn't you test the hypothesis and stop tapering?

IF that "cures" you then you know exactly the cause of the nightmare issue.

I don't think there will be a cure before there is a diagnosis.  You might be able to easily prove this by UN-tapering.  

If the nightmares go away then you know the cause.  You will have to do a slower taper, you may have to take a smaller and smaller dose PER night instead of going cold turkey at longer intervals.

I'm not telling you how to do it.  I'm sure that there may be other methods such as substituting a different drug or adding yet another.  

IF you are having the serious kind of sides you describe it suggests that a good doctor or pharmacist may be of help.  Make no mistake; some people just do it by the seat of their pants but that doesn't mean it's the best or safest.

Sorry you are up so late.  I think that you'll work out a solution soon.

Willy
Helpful - 0
276730 tn?1327962946
I sure hope so......Its 3:00 am and still up. Insomnia and once I do fall asleep its only for 3-4 hours tops and thats with nightmares.

Im glad Im aware of this thanks to you all....Tomorrow I start one 20mg every 4 days..and hopefully will be weened of  within the nezt two months.

Charm
Helpful - 0
Avatar universal
im sure u will be fine once u have come off your meds,when i was on antidepressants yrs ago my bad dreams went once off meds for a while.
tx still is a culprut though,its brought all my nightmares back and im not on antidepressant etc.but post tx i do not have any clue cos i aint there yet.
gd luck with getting your normal sleep back
Helpful - 0
419309 tn?1326503291
Can't answer your questions, but just wanted to wish you sweet dreams. ~eureka
Helpful - 0
206807 tn?1331936184
I still take Ambein on occasion. I usually can tell if I am going to be able to go to sleep or not before bedtime.
I break them in half and watch something on TV (NO CHANNEL SURFING)
If I am not asleep by 30 minutes. I take the other half. Since I’m through with tx, Usually a half does the trick. If I wake up in 3-4 hours, I will immediately take another half and go back to sleep.
This works well for me because Ambien does not leave me with a hangover.  
Something to think about.
Helpful - 0
276730 tn?1327962946
Thanks for the sugestions..........I will ask my doctor...

I took Ambien while I was txing but for only about a month..It only made me sleep for 3-4 hours top and I was awake the remainder of the evening.

Never had any of these issues till I started tx and taking A/D's.

Im hoping to be OUT of this mode soon as I finish tapering off.
Thank you take care,

Charm
Helpful - 0
148588 tn?1465778809
One option I seldom hear discussed is switching to a different drug of the same class - only one with a longer half-life in order to wean yourself off. It's one of the reasons I usually suggest Prozac/fluoxetine  -  long half-life = easier taper. I had to do this recently with benzo's switching from Ambien to Valium to do a workable taper. I'm not sure if the same holds true with SSRIs, but it may be an option worth exploring with your doc.
Helpful - 0
276730 tn?1327962946
Thanks to the both of you. That is why Im currently on 20 mg. every other day. I know how difficult it is to ween yourself off of this.  My doctor advised me to ween myself off
by slowly taking 20 mg every other day, then every 3rd, 4th so on.
So thats what Im doing......

RIcky- Yep it defintely sounds like my issues...
           Thanks...
Last night I spent it in the NY subway system getting bombed because of Obama!
And my cat was running free! When I got to the body bags and the bomss I said Im never going back in that bed! This has been going on for over a year.....! Plus the German's were there too clanking their shoes!! Scary as @#$%!!
whewww,,,,,,,,thanks so much,
Helpful - 0
206807 tn?1331936184
It could be the Culprit. I searched Celexa Nightmares and found this

http://www.anxiety2calm.com/blogger/2007/02/celexa-and-nightmaresstrange-dreams.html

Just a little extra personal experienced of celexa (citalopram) that came my way. It was reported that after slowly dropping from a standard 20mg dose to a 10mg dose strange things happened during sleep. These consisted of:
· Very vivid and frightening nightmares of the type that leave you in a strange mood all day
· Very vivid dreams which are odd but not necessarily unpleasant
· Feeling very sleepy even after a long nights sleep
· Difficulty getting to sleep despite being too tired to do anything else
· Needing stimulants like coffee to keep you going in the day
All of these tend to effect each other as a vicious circle.
Like all side effects of Citalopram however, sleep disturbances are temporary (It should always be remembered that in a tiny amount of cases people suffer long term effects of SSRI medication).
I think it’s always best to taper slowly!
Other Interesting Articles:
· Celexa / Citalopram
· Withdrawing from Citalopram
· Celexa and weight gain

Helpful - 0
Avatar universal
There are issues with discontinuing anti-depressants too quickly.  Some people have heightened sensitivity where others do not but your symptoms could also relate to discontinuing use.

Once again, research the topic or see that shrink for advice.
http://www.healthyplace.com/depression/antidepressants/getting-off-antidepressants/menu-id-68/

best,
Willy
Helpful - 0
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