My first depression

[Virusbuster]

I'm in my fourth week, and it seems all of the well known side effects of the treatment are parading along one  after another. First it was feeling flu-ish. Then lack of appetite. Nausea. All seasoned with fatigue. But also hyperactive on the good days. It all constitutes a rollercoaster, but only one thing was missing up to this weekend. Depression. The rollercoaster is complete now. Sure, there is room for more, My outlook is a treatement of 72 weeks, since I started with a viral load of almost 14 million copies per mm3. I'm not counting on becoming undetectable in the 12th week. But am I going to put up with this another 68 weeks? Not to mention the withdrawl effects that may occor after that period? Does this justify the less than 50% chance of success? It it really worthwhile to virtually not have a life? I can't plan a thing, I don't have a clue  how I will feel the next day.

Don't get me wrong. I count my blessings. I live a good life in a wealthy country with good health care. I don't have to worry about paying for my treatemet, being fired, or being cut on my salary if I can't work enough. I have friends who care about me. But when I feel depressed as I do now, it all seems so utterly meaningless. Yesterday and today I cried several times, out of desperation. I simply want to get out of this rollercoaster. Tonight, while I forced myself to get out and buy some food at supermarket, I wondered how it would be to jump into the river and let myself float calmly  in the cold water towards the sea. Not that I actually considered doing so. Just the idea felt oddly peaceful to me. It should have scared me, but it didn't. I can't trust my feelings anymore...

[newleaf09]

You are just about on time for the mood side-effects.  People refer to 'riba rage' but iritabliity and anger, or depression are caused by the interferon and affects about half of those on it.  I had the anger thing, starting 4-6 weeks in.  I went through 5 antidepressants before I found one I could take for the irritability.  Zoloft and Wellbutrin acted as methampetamines on me.  If a new one has that effect, don't keep trying it and thinking it will get better...you are not suited to that one and you need your sleep with this serious illness and chemo treatment.  I take a half dose of lexipro (5mg) and it does the trick.  I feel normal, not sedated or overly agreeable.  Without it, mean things just fell out of my brain and onto my tongue and I wanted to keep working and stay married.

[jdwithhcv]

Sending you a pm.

[Virusbuster]

I saw my doc today. Firstly, my VL at 4 weeks hadn't dropped very much (14 to 8 million, see my other posting http://www.medhelp.org/posts/Hepatitis-C/From-14-to-8-million-after-4-weeks-is-there-any-hope/show/919375 ). That was a dissappointed.

Regarding the depression I suffered last week, she suggested to start Citalopram and have me talk to a psychiater. Last Friday I was emotionally so numb and tired that I thougt that I better take the ADs (that was when I had arranged this extra meeting with my doc). But over the weekend I started to have my doubts again. Perhaps this was only initially this bad (like it seems like with many of my other side effects)? Nor do I like the idea of taking yet another drug unless really nessesary (I am already taking 5 now!). Also the most common side effects of this AD proposed didn't really 'tickly my belly',

"Decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; increased sweating; lightheadedness when you stand or sit up; loss of appetite; nausea; stuffy nose; tirednes."

Hence, i was really indecided, and therefor decided to post-pone the decision, at least for a week.

[powerbuilt]

This trip is like a rollercoaster, up and down like a yoyoo,one day you feel like hidding in a corner the next day everything seems normal again.... you have to take the good with the bad and keep looking for the end of the tunnel and dont look back.....

[alijee]

i dont know much about viral load things but it is true that high viral load does not mean 12 week result will +.  

During tx first attack of depression i faced on week 6. I tried AD but they made me so confused and sick. But after all, doc gave me Escitalaporam 5mg (half doze) per day at night and this was i needed. AD made my tx easy and times started passing very fast.

Now im on 3 week post tx. Last week i tried to tapper off AD but failed becuase as i started tapering it off i faced IBS (Diarrhoe) problem (which is my old problem and gets worst when im depressed).

[nygirl7]

I hope that you've spoken to the doc and got a good antidepressent, my doctor started me on one four weeks BEFORE treatment and I found it to be a great help.

Good days come and good days go.  Sides come and sides go.  It's best to have something on board to keep you level all of the time, it really does help.

And listen - sometimes people with LOW viral loads have a much harder time than people with huge viral loads.  I did 72 weeks and started out with only 568,000.  A few of my close friends in here as well did NOT start with high vl's.

It's all how your body and immune sytem work with the meds - nothing to do with what seems to be a giant number.  Get the PCRs and dont' sweat it until you hear otherwise. Really.  If it were that way I would have thought I would only have had to do 24 weeks - and been pretty surprised when I found out otherwise.

Good luck.

[kittyface]

I forgot to recommend Reglan for nausea.  It's cheap with no sx.  I know you probably don't want to add more drugs but this tx can be brutal and the helper drugs will increase your chances of sticking with it.   You don't have to suffer with everything.

Kittyface

[kittyface]

Antidepressants are your friends while on this tx.  You may feel good now but it's highly likely you'll have more depressive episodes.  They take a while to work so please consider starting them.  You probably won't even notice any AD side effects because the tx sx are so bad.

I only did 48 weeks with a much higher vl than you, over 50 million, and geno 1 also.  I cleared at week 9 and will do a 12 week post tx test in 2 months.  As others have stated, monitor your viral load decline frequently.  You may clear sooner than you think and may not be staring 72 weeks in the face.

Drink lots of water!!  This can't be overstated enough.

I wish you the best,

Kittyface

[jdwithhcv]

I'm glad to hear you are feeling better.  Like you, I had good days following shot days.  Two or three days post shot were when I got hit hard by side effects.  I hope your PCR comes back soon and that the news is good.

jd

[Virusbuster]

I talked to my doc today, and she also told me that ADs are an option for me to consider. Update: Today was a really great day. My depression has tapered off the past days, and it's fully gone now. Hence, before I start any ADs I prefer to see how this will hold. However, if it happens again, I think I will start taking them.

Funny, looking back at my first five shots, the day after the shot was usually one of the better ones.

[Magnum]

After 4 failed treatment attempts, I consider myself very lucky not to have had depression. However, I had rage and uncontrolled anger at times. What I did then, is to be think of the fact that I was thankful I was being treated. If you think of the alternative and not do anything, to me that's more of a concern than depression. That line of thinking got me through some very brutal times. So brutal I eventually couldn't get out of bed. At that point, I knew I had had enough...

Obviously you will know when you've had enough, but if you can overcome the hump and get into the groove of treatment (although it may be nasty), the reward could very well be clearance. I hope for the best for you...

Magnum

[Rain6866]

I knew myself to well before I started tx. I read and read on this board and learned many things. I was put on Celexa a couple months before I started treatment. I had been diagnosed with depression before. It takes a few weeks for some ADs to actually start working so I suggest you talk to your doc asap.
I am on shot #4 on Tuesday. This was a hard week, last week was easy so Im not quiet sure which way I am heading but I know that my AD is with me. A lot of people are scared of ADs but prior use assured me that theres no harm there. I see an AD as a rescue drug for depression. Just do a  lot of reading and trust in anything Bill has to say lol..

Good luck with Tx and SX Im right on your heels!!

[jankar]

Yes, it can vary from day to day but it might not go away and then things could get bad .  I didn't want to take AD's either, I was scared but the drugs we are on are pretty ehavy duty and take a lot out of us physically and mentally. - I have never really been depressed in my life so couldn't believe that could happen to me.

Now at Week 26 my mood is usually good but the anxiety can get me if I have any extra stressors, so I keep them to a minimum. If I can - sometimes I cannot control the external ones.

The meltdown - I was never suicidal but had really weird mood things that I didn't understand, extreme anxiety, heavy limbs, noise seemed extreme, crying at work in a meeting and with my boss in a very weird way that was unreasonable.  I was sent to a psychiatrist and he said it was the beginning of a mood disorder caused by the medication. He said it wasn't yet really bad but it felt awful to me and he prescribed Citilopram and Lorazapam.

It was good going to the psychiatrist because he told me I wasn't going mad, it was just the medication, which relieved me a lot. It took two weeks to start to feel better and 6 to 8 weeks to feel good.  It also helped relieve the sx of the medication as they can seem somewhat similar - tired, heavy limbs.

Please go to see your dr asap as they really can help.  I am happy to hear your HIV results - must make you want to continue, getting good results like that.  Those are the sort of things that keep us all going.

[Virusbuster]

I just got up and my depression seems to have faded overnight. Is it normal that it comes and goes like that? I hear all you guys about AD's, and I will discuss it with my doc, but it feels like a big step to me.

Yes, the interferon is helpful to suppress my HIV, in fact, it was one of the reasons to start. It was hard to push my HIV to undetectable with my current meds (Truvada + Kaletra), and the interferon gave the extra push needed. At 2 weeks my HIV was UND already (it was at 340 copies/mm3 at T = 0w).  Of course, that was very good news for me.

If I may ask, how bad was your meltdown at week 10?

[jankar]

Take the AD's - they will really help.  I should have started taking them about Week 4 and waited until I had a meltdown in Week 10.  Don't do that to yourself - it was ugly.  I am still on AD's, have Lorazapam when things are really tough that I don't really need much and also take Zoplicone to sleep.  I am Week 26 of 48 and would not have come this far without the help of these meds. My mood remains quite good now although I do have a tendency to get stressed and anxious but I am managing quite well with the meds. I had horrible symptoms for the first 12 weeks but feeling a lot better now - it did seem to get better with me.  It is worth doing what you can to keep on treating because it is the only type of effective treatment you can do and treating the HCV will help with the HIV, in my opinion although I am not a doctor.  Your odds get better the longer you can manage the treatment.  I drink lots of water - about 3 litres a day. Take care and best of luck.

[Virusbuster]

Do note, I'm also have HIV, and the protocol is taylored to HIV and HCV co-infection. Oh, did I mention earlier that my chance of success was 50%?  My memory is playing tricks, for genotype 1 HCV/HIV co-infected people it's a lousy 30% successrate.

[Virusbuster]

I will definately discuss it with my doc. And yes, I feel very welcome. Thank you guys, it does make a difference.

[FlGuy]

It's good that you have such a schedule. And although I'm a proponent of aggressive treatment once the comittment is made, I'm curious about the 'if not zero by week 4 do 72'.  I could more easily understand at week 8 and very much so at week 12.  Good luck.

[Virusbuster]

Thanks for sharing, jd. I'll post the result as soon as I get it.

[Bill1954]

Hello, Buster;

Sorry to hear about the depression you’re experiencing. Please consider antidepressants as others advise; they can make a big difference in your treatment success. Welcome to the forum—

Bill

[jdwithhcv]

I had 1a.  Best of luck on that pcr.  I'll be watching for the result.

jd

[Virusbuster]

My first VL test is scheduled for Wed (at T = 4 weeks). That should give an indication. Then the next are at T=8 and T=12. I just checked my treatement protocol, I remembered it wrongly. My test next week will determine if I need 48 or 72 weeks (depending if it's UND or not). The test at T =12 weeks determines if I should continue at all (depending if the VL dropped 2 logs, i.e. by 99%).

[Virusbuster]

It's good to hear that with a VL of 6 million you managed UND at 4 weeks. Which genotype did you have? I have 1.

[Trinity4]

Consider starting on an anti-depressant as soon as possible.  They take a while to become effective and many people could not continue tx without them.  Try not to put the cart before the horse when it comes to treatment duration.  A high viral load doesn't mean you will not UND by twelve weeks and you should only cross that bridge if you come to it.  
Treatment can very difficult and you must do everything you can to help yourself get through it.  If you are having suicidal ideation this early in treatment you really need to talk with your treating physician now so he can prescribe medication or refer you to someone in the psychiatric community that can provide counsel and medication.

A certain percentage of people who treat are pulled off treatment due to psychotic episodes and depression due to the medications.  These are very powerful drugs and have mind altering properties.  Please seek help.

Trinity