safest anti-depressants for liver/prozac info needed too

[julie9536]

Hi...
I am wondering which are the safest antidepressants for the liver...does anybody know?
I am looking specifically into taking Prozac, because research shows it helps those suffering from bulimia as well, which I'm dealing with, in addition to the depression.
Any help, suggestions, anything...would be greatly appreciated.
I was on Prozac 20mg sometime ago, and looking back I'm not sure if it helped or not. I am thinking perhaps the dosage needed to be higher, more like 40mg, but I'm concerned about the liver side effects.

[dusti13]

I am so sorry to hear about your wife. I am 58 and i am going through the same exact thing as your wife did. i have been on anit depressants for almost 35 years.  I had a gastric bypass in 2002. My liver enymes were elevated for I dont know for how many years. Now i am off the anti depressant and they are normal. All my mri's , ultrasounds, and cat scans show normal and even had a liver biopsy last year but I am sick as a dog. I am in pain, I cant eat, weight loss, plus I can go on and on with symtoms. I just hope one of these doctors have some sense to find out what this problem is

[JMAR7238]

My wife died 3 months ago at the age of 52.  Doctors did not know the cause.  She took a variety of antidepressant over 20 years.  She also had a gastric bypass in 2001.   Her autopsy indicated non alcoholic hepatitis (cirrhosis of the liver).  She also took medication for psychosis that required periodic blood tests.  Two months before she died a Doctor John Becker indicated that her liver looked normal on the screens and that a Biopsy of the liver would not be indicated.  What do you think?  Tests do not indicate everything but my family told the Doctors that her symptoms indicated liver  problems, but who listens to the layman.  Obviously Doctors don't.

[Diane12855]

I took Prozac long before I knew I had hep c, and then I changed to Effexor because it works better for me.

Depression will make your eating disorder worse just because it is caused by your emotional health, not your hunger, so find a good doctor and get that taken care of.

Are you on treatment yet?

Diane

[HectorSF]

Julie -

You are correct, I don't think there are many anti-depressants that come in patch form.
I use the EMSAM (selegiline transdermal system).
http://www.emsam.com/
I take the lowest dose. 6 mg/24hr. It is a MAOI. A very old type of anti-depressant. By putting it in patch form, the drug manufacturer is able to have exclusive rights to the med and charge a lot of money for the new technology. Generic MAOIs are very inexpensive. My co-pay for EMSAM higher than any of my other meds.

MAOIs: If you take a higher dose you need to watch your diet, as certain foods can interact with the med and cause high blood pressure. This can in the extreme cases cause blood vessels in the brain to burst! So MAOI are not commonly used anymore. Obviously! Because I suffer from "atypical depression" the only anti-depressants that work for me are MAOIs. So since I need to take an MAOI I use the patch which is "easy" on my liver since I have advanced cirrhosis and want to have as little stress on my liver as possible. If you don't have cirrhosis of the liver or even if you do but have compensated cirrhosis any oral anti-depressant will be handled easily by your liver so I won't worry about it. Just let your doctor know that you have HCV so they are aware of it.

Emsam is used to treat "atypical depression", which is not alleviated by the more commonly used selective serotonin reuptake inhibitors (SSRIs), dual serotonin and norepinephrine reupatake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). "Atypical depressions" are characterized by an increased need for sleep, increased appetite, and increased severity of depressive symptoms towards the end of the day.

The key is finding an anti-depressant that works for you. Different people respond to different anti-depressants. This is where you need to work with your doctor. You may have to try several before finding one that works. Most people suffering with depression will be given the newer, cleaner meds (IE Prozac, Wellbutrin, etc.) which are targeted to act on particular neurotransmitters.

Hope this helps.

Hectorsf

[julie9536]

Thank you...what is the patch anti depressant you are using? Never heard of anything like that before.

[HectorSF]

First, you have to find an anti-depressant that works for you. Some work for some people while others don't. If the medicine is working for you and you are depressed you should feel different once the medicine is working. This typically takes 4-6 weeks. If you don't feel different (relief from depressive symptoms) then the medicine probably doesn't work for you. You should then try another antidepressant.

Second, your psychiatrist should know which meds are less stressful on your liver as a description of how they are processed in the body comes with each medicine. How much is processed through liver, how much is processed through kidneys, etc.

I use a patch form of an anti-depressant. (Most people don't use a MAOI med as they have their own problems. But it works for me and they come in patch form.) The med is absorbed through the skin instead of being digested like most meds the come in pill form. But I have advanced cirrhosis.

Note: The impact of an anti-depressant on your liver should not be an issue for you, unless you have very advanced liver disease.

Good luck.
Hectorsf