Sedatives/Anti-Depressants

[jmjm530]

Looking for some collective wisdom here.

As you probably know if you've been reading my posts, one of my worst side effects on treatment is reflux. The traditional medicines (PPI's, H2's, Antacids) are only helping marginally. Same with diet changes (lived on rice gruel and boiled chicken for a month. UGGGH! and still only a little relief)

A few days ago I decided to approach the problem differently. Like many, the riba puts me under a lot of physical and mental stress. When I'm alone (most of the time these days LOL) it's really not so bad. But most real life interactions are magnified. If I'm talking on the phone with a friend or relative that I don't quite get along with, things are like 100 per cent worse than they used to be pre-treatment.)

Anyway, my new approach is to try to reduce my stress level which hopefully will help reduce the reflux. This is not a novel approach as many have linked stress and reflux.

After trying meditation, Alexander technique, breathing exercises, massage, etc, I've come to the conclusion that for now MS Riba is stronger mistress than I can handle on my own. So...I've turned to some drugs for help.

(RAN OUT OF ROOM SO I'LL CONTINUE BY ANSWERING MY OWN POST)


(ran o

[Forseegood]

Good to see you guys here as well. Although I'm soooo inquisitive about everything I should do to prepare, you might regret your welcome, ha! I know I can't control everything, (drat!) so I'm just now seeing what I can control. I'm getting a referral to an opthamologist. My teeth worry me because we only have so many, but hopefully I'll still have a few in my head when all is said and done. Just seen too many people fall through the cracks cause docs didn't follow up or conduct the right tests, etc. so I'm hoping to avoid that. You guys have a great weekend!

[cuteus]

not a bad idea to have the echo, the ones you had should be ok still. you could also get the cryoglobulins test, other than that I can't remember any more. My eyes got iffy on tx, but after tx the prescription was still the same, so I guess the changes were not measurable.
you will be fine, it seems.

[doll face]

I was just thinking about you the other day. It is good to see your name here. Welcome. Like i said above I had tried many ADs and the remeron seems to work the best for me. Plus it helps me to sleep. Good luck.

[Califia]

Duh!  I said workup because I forgot the word for the actual test.  Yes, me.   It frequently happens.  As my partner says, it's really not such a big deal.  You just have to learn to speak elliptical...

so that was just me being respectably "elliptical."   (Mierda de toro, anyone?)

What I really should have said was "EKG."   It's no biggie at all, so take heart.   I mention it because many hepatologists forget about the impact of their prescriptions on other organs, so you might want to lean on your internist to order this one.    

Free association here, but make sure you have good air conditioning in place before you start.  Heat sensitivity really goes up at the beginning of tx.  Can you get someone to lend you their sweet little ocean side studio for a couple of months?    (I strongly believe that everyone on tx should have the keys issued to such a place, along with their potions and pills. )

[jmjm530]

Thanks everyone for your support and suggestions.

The Xanax seems to be helping with the reflux but it's brought my enenergy level from low to LOW.

The new plan is to try an SSRI. I've had 10mg samples of Lexipro lying around for a few months. Spoke to my shrink today and we decided I should take half a pill (5mg) a day. Hopefully, it will help the reflux without too many sides.

Laika mentioned taking Lexipro 5mg/day. Anyone else on Lexipro and what dosage do you take? Also, how long until it starts working? Can you take it on an empty stomach or with food? Do you take it the same time each day, or doesn't it really matter?

Not crazy about taking another drug, but as I explained to my shrink today, it's not like life's a bowl of cherries -- although I[d love to eat a bowl of cherries -- darn reflux. LOL.

[cuteus]

yes, I remember you mentioning the teeth thing, but don't get me started, it is the source of much pain; two fractures before tx and two during, it is a disaster in need of a miracle cure.
check these threads if they are still around;
What Questions to Ask - sunshine143: 06/29/2005
HCV resources? - wantalivlong: 06/23/2005
To treat or not to treat - wantalivlong: 06/20/2005

med help and its members have  been a source of information and comfort since I was dx in 2003, I hope you find it useful.
take care

[jmjm530]

Didn't try a joint -- and the reflux still isn't gone -- but between yesterday's valium, today's Xanax and Lexipro, I'm not sure I care as much. LOL.

[Forseegood]

Thanks, yeah, my ekg was normal. Would like to do some more tests, anything to keep the actual tx process at bay! ha! That's why I didn't want to start tx in the summer, the summer makes me feel like it's its own tx nowadays. Glad that you seem to be doing okay, youre almost through as I recall. Also glad to see you are not crawling to the finish line, you sound good. Lets hope we all get some relief soon. Any additional comments or suggestions would be really appreciated from this newbie, in terms of teeth stories, and any and all tests, etc that would be helpful.. thanks.

[Califia]

Well,  it's probably good to get a baseline on as many physical functions as possible.  Starting at the top and working down: definitely get an eye exam, the aforementioned thyroid tests, and cardiac workup.   Might also be good to know how you're doing w/ calcium levels and bone density before you start tx.  I'm sure I've forgotten something...anyone else want to add to this list?  And best of luck to you!

[chellski]

or you could just follow new sojourns advice and smoke a big fat joint!! lol

[Xenigma]

If you take the Xanax every day,
(Whatever the doc Rx'd you) you will not feel groggy after about a week.  You won't have any anxiety either.  The tiredness sides go away.  I've been taking .025 of Xanax at bedtime with my high blood pressure medicine for 5 years.
I never need to up the dose (I guess since having HCV my liver holds the meds longer)  I'm not worried about being cut off it when the time comes.  But as for now, my blood pressure is good and not much anxiety.  I feel it works better for long term than the Valium.  
If I was you, I would take one Xanax in the morning and one 12 hours later say before bed. You will feel better soon  :-)
Enigma

[doll face]

Just thought I would throw another AD out there for you to look into. I had tried many AD before I found this one. It is called Remeron. I began taking it first as a pill form, but it took a while to work so I was prescribed it as a soltab (water soluble). You take it at night, and it dissolves instantly on your tongue. Within a half hour I was able to sleep and it took away most of the anxiety the next day. I never felt groggy the next day. Just a thought. Sorry I can't help with the reflux as I never had that problem. Good luck to you.

Oh by the way, be careful of most ADs as they can cause dry mouth, which can lead to futher complications.

[cuteus]

WOW! you are starting TX? What motivated you? I know you were not too sure about it, but your biopsy was showing some disturbing stuff if my memory(which I don't trust much) serves me right.  Nothing has gotten worse, I hope?
good luck to you

[Forseegood]

Hi, just reading your post and I thought I'd throw this in re the reflux. Firstly, haven't been on tx, going to start in the fall. I had a few flares up on the hep which were pretty awful. One of the most awful components to these flare ups was the reflux, or intense indigestion for lack of a better description. I'd never experienced it before. It was sometimes accompanied with a little nausea. I did a search on the natural remedies for reflux as I am wont to do, and I came up with Betaine Hydrochloride or tmg. They supposedly have been using it in Europe for years - for this purpose. Then my chiropractor recommended it. It's made from sugar beets for the most part so I figured what the hay, can't be that bad. I take other supplements, but this one worked right away. Feel no indigestion at all with stuff, at all. FYI, that's all. Not recommended for ulcers though, on the bottle. I did a brief search on betaine and treatment and I didn't come up with much. So of course you'd have to ask your doctor about it, most likely he won't know much about it which usually translates to him/her nixing it which is fair enough. Don't know if it agrees with treatment. Oh, and I take the occasional zanax if I need to. Will on tx as well I predict. Good luck to you.

[Forseegood]

Hi, thanks for the tips!, now just working on the pre-treatment jitters. When you say cardiac work-up, do you happen to know what that entails? for you at least? I know some cardiac tests are kind of knarly. I'm wondering if you just mean just say, an ekg and a echocardiagram. Sould I do any others? I know that that would probably depend on the results of those two, when I did those last july they were okay, though I know they don't pick up everything heartwise. It's probably good for a woman in her early 50's to get these done anyway, one should think. I know you know more about the rigors and procedural facets of hep c than many. I'd appreciate any input from anybody, though I feel bad asking questions on someone elses threat, is that okay?. thanks!

[Forseegood]

Hi Cutie. Well one good thing in my favor is bx, which is 1.1
but I am symptomatic, though that's not as bad now. Up and down. Just think it's time, never ruled it out. Don't want to be doing this when I'm 54. I'd figured I'd at least give it a try, might be surprised that it won't be that bad, at least I'm hoping. Trying out a few different anti-ds before I start. That remeron sounds good, if it helps sleep. I have lots of anxiety issues, menopause roars it's head. Trying to deal with those in various ways.. Anyway, this is a good board for gathering info, for sure. In fact, if any of you reading this have some suggestions as to all the different medical tests I should take before starting, and any info about dental issues, I'd appreciate it. I was told that I should maybe get more extensive tests on thyroid, which i'm gonna do. Thanks beforehand for any help. I'm 51 and in relatively good health (except for my teeth, which concerns me) Good to see you!

[Laika]

The Lexapro I have is 10 mg.  I cut them in half because taking whole ones for the first 3 days knocked me on my ass--taking half returned me to a place that could be considered "normal" for being on treatment! Others don't have this experience...you know, we are all individual in our responses to these meds.  I believe most people are less sensitive to meds than I am.

Anti-depressants aren't just anti-depressants.  There has been some talk lately in the news that low dose anti-depressants work better than most meds that are prescribed for sleep.  It seems to work that way for me.  I think they are less addictive than Xanax/Valium, although I don't have enough experience taking them to really know.  I didn't get addicted to Xanax because I liked the way it made me feel (didn't)--I ended up taking more and more to sleep because they become less and less effective over time.  That's the complaint with other sleep meds I hear about too.

Anyway--I think the Lexapro improves your ability to deal with the stress of treatment without the side effect of impairing your functionality.

That said, I agree with Rev and others who say "take whatever you need to get thru this that is not going to hurt your liver or interfere with your treatment."  For myself, I've taken meds for anxiety, for pain and for itching and had relief.  The most unrelenting symptoms for me are fatigue and fog.  For me, Xanax and Valium would only make that worse.

It's just one more thing to try, to see if it works for you.

Good luck,
Laika

[honey1616]

I have to totally agree with Willing's post.  You need to make your life as simple as possible for the duration of your tx.  And I can relate so well to someone calling whether family member or not that kinda sorta even before tx,,,,hit a nerve,,,,and then tx seems to intensify our feelings and seems like at that point agitation can hit many a raw nerve.  Honestly,,,I didn't always get my phone.  Answer machines work great and if it is someone needing something,,,,they will usually leave a message and then you can mull it over and on your own sweet time....decide when you want to return the call. Alot of people said that I didn't call as much and acted kinda weird at times,,,,haha I wonder why???  Hey,,,that is fine,,,I kept my life as stress free as possible and didn't use ads.  Now,,,I'm not saying not using them is the answer but tone down what is going on first as far as the stress and then you could maybe work on not using a AD everyday.  Because it is true,,,when getting off tx,,,,you will be working on any extra meds you accumulated so make it light.  Coming here and bitching can also be a great stress relief when your days on tx are not the greatest!  Best Wishes to many a stress free day!

[willing]

sorry the tx grind is starting to wear - it will do that. I had pretty sharp  suicidal tendencies when I was a teen, but survived that and made it to the ripe old age of 50 with no major depression problems until I started the combo meds. By the 12th week, the thought of having to keep doing all that breathing seemed  just too much to ask for. Then I started on lexapro, and other than an occasional trip to the gun shop ( never ended up buying one : I was just too depressed to deal with all the gun-registration paperwork) I made it through the rest of ny 48 weeks. So my experience is that the ADs helped a lot. But probably more important is tossing every single item of unneccesary baggage out of your life for the duration of this trip : ie if those phone calls are giving you grief, rip out the phone and smile. No one other than those going through tx at the same time as you are will have a clue what you're going through. At some point, regardless of what happend with the virus, you've got to dig back out (get your energy level back, stop the ADs, etc. ). This takes a (surprisingly long) while, and the less chemicals you have to "undo" the better, so it's probably better to strip your life to the bare minimum than it is to take more meds in order to keep coping...all the best.

[jmjm530]

I've been thinking of trying Lexapro myself, especially if I remain groggy with the xanax. I know its considered an anti-depressive, but do you think it will help conteract the physical stress my body feels from the ribavin? Also, when you say you took a half dose, how many mg was that. Thanks.

[Laika]

My experience...I've had some depression & anxiety issues prior to treatment--nothing too huge.  I never took xanax or valium for anything but sleep because they made me too groggy, tired.  Xanax was a regular sleep medication for me for years.  After I was diagnosed with hepC, I decided to quit taking them and re-learn how to sleep on my own.  I later came to feel that Xanax hung me over, gave me a "bad day" the next day...depressed for no reason.  So I'm not really a big fan of Xanax.  Not to mention the fact that my #1 complaint on treatment is fatigue--I would not do ANYTHING to make that worse!

I started taking an AD, Lexapro, about the 4th wk of treatment, for anxiety--I usually only take a half-dose a day.  At night, if I'm feeling edgy, I'll take another half, but generally I have not had sleeping problems on treatment. The Lexapro has definitely helped me to get thru this treatment, and I believe it is a better first choice than Xanax or Valium.  I am not aware of any side effects from it.  

Hope this helps,
Laika

[jmjm530]

"The only thing I would like to add is to never take Valium and Xanax together."
-----------------------

WHOOPS! Read this post a little too late. LOL. As part of my experiment, I took a dose of each today about six hours apart. (2.5mg valium and .25 mg xanax) And, yes, I do feel a little sicker than usual. Thanks for the heads up.

Question--even with the small doses of xanax by itself, I've felt pretty out out it for a couple of days. Groggy and a bit off balance. Does this disappear with time?

[Xenigma]

The only thing I would like to add is to never take Valium and Xanax together.  It can make you very sick.  If taking the Xanax makes you feel better while on treatment then take it.  Your Doc will cut you down slowly when it is time to stop (Usually over 4-6 weeks)so you won't feel too badly.
Just no Xanax and Valium together.  Wait at least 12 hours (or more) before switching from one to the other, and stay with that one. Using both from day to day is not good.
Feel better  :-)
Enigma

[chellski]

i was being treated for depression even before tx....the doctor had me switch from wellbutrin to zoloft (wellbutrin is not liver friendly).  I take zoloft daily which helps 85%with depression; and i also take klonopin for anxiety/nerves.  I don't care what tom cruise says - i've tried everything natural to deal with depression NOTHING has helped but medication...
everything was kind of changed to go with my new tx...i still get sad; but i don't want to not feel at all....it seems to be working for me...
good luck
and be well...
<3 michelle