Hyperactivity and a question about ADs

[WriteItDown]

Is this a common side effect?  My husband just started week 4  (of what we hope is triple therapy with a new PI, but is at least peg and riba), and he's doing pretty well, but we both think he's on the manic side.  It's fine, he feels okay, he's getting a lot of work done, and we've laughed about it a bit.  He has the tendency toward this anyway in "real life."

And this leads me to my second question: are there any treatment-related mood disturbances other than depression for which one would take SSRIs?  He is not at all depressed, but when he told one of his nurses he was a tad hyper, she asked him if he wanted them.  This confused me, since he's pretty cheerful.  

Thanks!

[FlGuy]

I'm wondering if you are newlyweds.  A long time ago my realized that she should never interfere with those too-far-in-between bouts of productivity in me. If he feels 'okay', 'doing pretty well' , 'getting a lot of work done' and 'pretty cheerful' maybe let well enough alone and let it run its course.  Some people have found marijuana to been an effective adjunct to treatment.

[nygirl7]

Yes definitely I would let it alone too!  After only 4 weeks on treatment you have a whole road ahead to avoid the lethargy and depression that can sneak up on most of us.

Why TRY and make him tired, angry, grouchy and unproductive?

Also keep an eye on his hemoglobin and other levels though - while it's very early in treatment generally the ribavirin causes some anemia and lethargy and while that sounds like a bad bad thing it sort of means that you are getting the optimum dosage of the riba into your blood serum.  It's not a definite but is generally a good predictor. Feeling "too" good and "too" hyper could mean he's not getting enough.

Otherwise.................enjoy it cause it certainly wasn't the case for most of us!  :)

[HCA]

Since there is virtually no data on side effects from this particular triple therapy it is impossible for anyone to say whether 'hyperactivity' is common,rare,or unknown..
Ignore the nurses' comment,she probably misunderstood.
The nearest indication for SSRIs to anything remotely similar is for Obsessive Compulsive Disorder.

[FlGuy]

Feeling "too" good and "too" hyper could mean he's not getting enough.

Yeah, that part of life too!

[WriteItDown]

Hi, I think you all may have misunderstood me: I'm not trying to "fix" his being a bit hyper, I was just curious if it's a known sx.  I certainly don't want him to take ADs (or any other med for that matter) unless he really needs to, so I was confused by the nurse -- that's why I asked.

FIGuy, no, we are not newlyweds, LOL, we've been together many years.  I do leave him alone when he's working!  I am dumb, but not THAT dumb. But no Maryjane for him, thanks, unless he really cannot eat or needs it for a medical reason.  We are sticking with the less-is-more philosophy when it comes to medicating, especially self-medicating.  

"Feeling "too" good and "too" hyper could mean he's not getting enough."  Actually, when he's not getting enough he tends to get grumpy.... Oh wait, you meant MEDS :)

NYGirl, his Hgb level fell about 1 1/2 g in the first two weeks.  He does feel it and is more fatigued than usual.  I hope this means he's getting enough.  He does not feel 100% fine; he has some flu-like symptoms, some headaches, slight insomnia, very slight bit nausea, feels "funny," and just this morning began to itch a bit. So he definitely is feeling it, but he can still work, is optimistic, and usually feels pretty much okay.

HCA, I know you are right about this being a new PI and hence having unknown sx. I thought perhaps the hyperactivity could be attributable to SOC.  In fact it seems to me that most of the sx attributed to Telaprevir and Boceprevir, excepting the rash, are also possible sx from SOC, so it does get confusing.  And, of course, we don't know what arm he's in.

[jdwithhcv]

"Actually, when he's not getting enough he tends to get grumpy.... "

hahahahaha!  Me too!!!

[justme53]

I've had a couple of episodes of "mania" (my label) on tx. I felt great for a while, then so "great" I started planning major life changes in the midst of tx...to the point, I was ready to quit my job and find a new one, move to another city, buy a house......I started eyeing my Cd's in the bank as disposable income, but never cashed them in, thank goodness. In this case, when the house was sold before I could bid, I fell into depression. My Dr. advised Celexa for me and it's helped in my case. I still bet these upswings, but catch them sooner and have a couple close friends keep tabs on me if I start talking weird. In retrospct, it was a scary scenario.

I've wondered too if I was a bit bipolar before and that tx has amplified it.

[WriteItDown]

Thanks, justme53, I will keep my eye open for truly manic symptoms.  Right now it's more in the realm of him feeling hyped up -- but it's good to be alert.

[nygirl7]

"Actually, when he's not getting enough he tends to get grumpy.... "


Gosh you guys are making me jealous I don't even remember when that's all it took to get me grumpy it's been so long ;^\

Well I don't even remember how long it's supposed to be either I need help!  ;)

[WriteItDown]

Haha, NYGirl... I could well be in your boat soon enough, since I've heard treatment doesn't exactly have an aphrodisiac effect!

I am betting you are going to meet someone grand and be getting enough *meds* sometime soon.  ;)

[Lynno711]

I too became Manic at the beginning of tx. nothing really crazy, but terrible insommnia, leg cramps gabbing and posting endlessly.  

Dr. put me on Lithium thought I may be Manic Depressive.  Couldn't handle the Lithium so now I'm on 1/2 mg. of risperidone/day.  I've finished tx now and he will lower it to 2.5 mgs./day.

I seemed to have calmed down a lot, maybe it was the Meds. or just the psychologocial effects of just being on them.

Good Luck - Lynne

[newleaf09]

Ribavirin does make the patient a little hyper.  That's why many people try to take it at 5 or so; so it won't interfere with falling asleep later.  There are 2 potential mood disturbances caused by interferon: depression and irritability (anger).  What the SSRI's do is even those 2 out.  It may not even take a full dose of the SSRI to do the job.  I used a half dose (5mg.) of Lexapro to keep me from yelling at my husband and others I came in contact with.

[nygirl7]

I could well be in your boat soon enough, since I've heard treatment doesn't exactly have an aphrodisiac effect! "


Start taking Rockers mushroom / blue algae / wildbark / blueberry concentrate right now it just might save the day!!!!!!!!!!!!!!!!!!  ;^0

That's why many people try to take it at 5 or so; so it won't interfere with falling asleep later.  "

Nah doesn't really make one whit of difference.  The goal is to make sure you build up the serum level in your blood so after a few weeks it really doesn't make any difference when you take what.  That's when the sleep problems really get pretty exacerbated and the anemia usually kicks in pretty good.  Watch out yowza then you REALLY won't be in the mood although you'll certainly have the time!!!!!!!!!!  ;)

[WriteItDown]

Tonight hubby's getting mushroom-algae surprise for dinner, with a dessert of blueberry leaves in puff pastry!

No but seriously....  whaddaya think of the 1.5g drop in 2 weeks?  That should be enough, right?

[WriteItDown]

Thanks to you both for the comments -- he isn't angry or depressed and I don't think he's manic.... so I guess he'll wait and see if any ADs become necessary.

[Isobella]

Omgoodness.....I had to laugh reading this, sorry, but it reminded me of my first weeks of tx.  Especially the first 4.  Every night I was up re-arranging furniture, refinishing furniture...doing all sorts of stuff with furniture.

It got to the point that my husband would ask me "where's the tv?"  I was sooooo focused-even at work and school.  I felt like an ADD kid that was on Ritilin for the first time.  It was actually kinda nice.

At week 7, I looked at myself in the mirror and started crying.  Whoa...it hit me that quickly.  I started Zoloft that day.

The drugs are doing their thing--even when we feel kinda ok. I felt kinda ok most of the time and was RVR.   What were his numbers on his hgb?  Mine went from 14.4 to 10.1 in 7 weeks and I have been told that was a sufficient drop to indicate the meds were "working"

And I, too got grumpy when I wasn't getting enough on tx.....but then other times I got grumpy because I'd gotten too much.

Tx is like the weather here in FL.....if you don;t like it, wait 15 minutes and it will change, lol!!

He's lucky to have you watching his back.  I wish you both the best and few sx.

Isobella

[WriteItDown]

Thank you, Isobella!  He hasn't gone for the furniture yet, but he's been going gangbusters with work, and talking more than usual.  He seems to be all hyper and then he crashes at night and goes to bed early.  But I'll try to be alert to any mood change -- if he gets depressed we'll do the ADs.

His Hgb went from about 16 1/2 to about 15 in the first two weeks. That's the latest result we have, but I feel he seems a bit more tired this week.

I'm so glad you got SVR -- it's encouraging to hear the good stories.

[Bill1954]

For what it’s worth, I experienced a little mania the day after shot day; that was when I’d do housework, take care of chores etc. It would generally last for about 18 hours or so; then I tended to crash and sleep. Nothing to worry about in my case; in fact, I welcomed it.

Bill

[Trish77]

If he was later on in treatment, I'd ask about his thyroid but seems a little too soon to be having thyroid issues.  Just the same, keep an eye on his TSH throughout.  I went hyper also but later on in treatment and while it was great to have an energy boost at that point in treatment, it was also manic and I couldn't sleep at all, only a few hours a night. Your husband sounds like he's sleeping just fine.  The doc put me on a very mild bi-polar med so that I could sleep and I went on beta-blockers for the hyperthyroid condition.  Things settled out after the hyperthyroid situation switched to hypothyroid and the bi-polar meds were no longer needed.  

Sounds like the other comments are more applicable to your husband's situation, particularly if he tends to be like this anyway.  

[Isobella]

I think my experience followed Bill's and possibly your hubby's.   I ran pretty hard when I was in the hyper phase....and then when I went down, I went out.  Like a light.  No insomnia here, for sure.  For me, things did level out after that first 12 week honeymoon phase.  

Defo keep an eye on all his levels. Being aware and staying on top puts you ahead of the game.  It won't stop things from happening, but at least there will be fewer surprises along the way.

[nygirl7]

1.5 log drop in two weeks?  Seems like he's REALLY going gangbusters to me on all fronts huh?  :)

Just like Trish I went from hyper to hypo on treatment, I think it USUALLY happens to women and she's right it seems pretty early but of course it's something to keep an eye on for sure if it doesn't calm down.

More likely though...He'll get pooped out and turn into a couch potato cabbage brain like most of us do........so you might get some sleep eventually...that is depending on how the mushroom algae works or not ;)

[WriteItDown]

Haha, NYGirl, I am getting sleep, except for every time he tosses and turns (he's definitely sleeping more restlessly) I wake up all worried. Then I realize he's going back to sleep so I do, too.

Yeah, I don't think he's really manic, he's just keyed up, and he has definitely been crashing and then is able to sleep, despite the restlessness.

I'm glad if you think that drop is good -- I am very very hopeful that he will be RVR and that this tx will be a one-time thing.  I am also very hopeful he's getting the protease inhibitor, since I seem to notice he more often complains of feeling "weird" in the morning when he takes the mystery pills (only 1x a day for those.)

In terms of fewer surprises, I have to say how much you guys have already helped me!  Seriously, a lot!  When he mentions something he's feeling I am usually able to say, "Yeah, that's common, you can try this" that I've gotten from the board.  We already have a good supply of anti-itch lotions and the minute he started to itch he was putting some on.... it does make me feel better, and I hope him, too, so THANKS!  

Hopefully we'll repay the debt of gratitude with him being a successful guinea pig and there will be another good tx option soon....