Aa
anti-depressants
Hi All,
My neurologist has mentioned that anti-depressants might alleviate the (undiagnosed) symptoms that bother me the most. I have some questions and thoughts about pros and cons, and would be happy to hear what others think, or may have experience with.
I've been through the standard tests, and I am told that there is no answer for WHY I get tingling/numbness/dull burns, etc, but that anti-depressants may help STOP these things.
Since my little adventure started last fall, I've had periods where my symptoms are VERY mild, and do not interfere/bother me at all. I've also had a period of ~5 weeks NEARLY symptom-free in between two bouts of stronger symptoms. So, it seems that a lot of the time, my symptoms will be under control WITHOUT medication. So might it be better to not take meds? I guess my concern is the idea of taking meds for an unknown problem that may go away on its own seems to be walking straight into the fallacy of confusing cause and effect.
And not to sound paranoid, but I also am weary that this is jut an easy way for the doctor's to placate my concerns, and get me to take anti-depressants even though I do not think I am depressed. I could very well be wrong, but I do not think anti-depressants are approved as treatments for paresthesias, and I think that is the root of my suspicion. On this theme, wouldn't it also make sense to see a therapist if I do start anti-depressants? I thought it was better to be monitored.
Finally, I am worried that anti-depressants might affect me beyond my symptoms. I'm not looking for something to come into my life and change my mood, sleep patterns, concentration, and so on.
I guess the bottom line is that, like anyone, I don't want to be on meds unless I need to be. In this case, evaluating that need seems really complicated.
Thanks as always for reading, and thanks again in advance for feedback to any of my ideas, or please throw in your own ideas and/or experience!
My neurologist has mentioned that anti-depressants might alleviate the (undiagnosed) symptoms that bother me the most. I have some questions and thoughts about pros and cons, and would be happy to hear what others think, or may have experience with.
I've been through the standard tests, and I am told that there is no answer for WHY I get tingling/numbness/dull burns, etc, but that anti-depressants may help STOP these things.
Since my little adventure started last fall, I've had periods where my symptoms are VERY mild, and do not interfere/bother me at all. I've also had a period of ~5 weeks NEARLY symptom-free in between two bouts of stronger symptoms. So, it seems that a lot of the time, my symptoms will be under control WITHOUT medication. So might it be better to not take meds? I guess my concern is the idea of taking meds for an unknown problem that may go away on its own seems to be walking straight into the fallacy of confusing cause and effect.
And not to sound paranoid, but I also am weary that this is jut an easy way for the doctor's to placate my concerns, and get me to take anti-depressants even though I do not think I am depressed. I could very well be wrong, but I do not think anti-depressants are approved as treatments for paresthesias, and I think that is the root of my suspicion. On this theme, wouldn't it also make sense to see a therapist if I do start anti-depressants? I thought it was better to be monitored.
Finally, I am worried that anti-depressants might affect me beyond my symptoms. I'm not looking for something to come into my life and change my mood, sleep patterns, concentration, and so on.
I guess the bottom line is that, like anyone, I don't want to be on meds unless I need to be. In this case, evaluating that need seems really complicated.
Thanks as always for reading, and thanks again in advance for feedback to any of my ideas, or please throw in your own ideas and/or experience!
If a doctor, any doctor, wants you to take an anti-depressant when you are not depressed and seemingly dismisses you current complaints, then it IS time to find someone that is going to take you seriously.
Anti-depressants, certainly have their place and in the right circumstances can be a wonder drug for those that are truly depressed. In some, anti-depressants can help with some of the pain from other causes and sleepless nights.
There are so many anti-depressants on the market today, I am left flabbergasted. If you need to take one, I would recommend one of the older, tried and true anti-depressants, with the least side-effects. If you feel that you are truly NOT depressed, then I would refuse an anti-depressant. Why stick another drug into your body if it is not medically necessary?
The final decision comes down to what YOU think is best for YOU. You are the best judge. Always listen to what YOUR body is telling you, dear. What do YOU think?
Big Hugs,
Heather
Anti-depressants, certainly have their place and in the right circumstances can be a wonder drug for those that are truly depressed. In some, anti-depressants can help with some of the pain from other causes and sleepless nights.
There are so many anti-depressants on the market today, I am left flabbergasted. If you need to take one, I would recommend one of the older, tried and true anti-depressants, with the least side-effects. If you feel that you are truly NOT depressed, then I would refuse an anti-depressant. Why stick another drug into your body if it is not medically necessary?
The final decision comes down to what YOU think is best for YOU. You are the best judge. Always listen to what YOUR body is telling you, dear. What do YOU think?
Big Hugs,
Heather
http://www.nlm.nih.gov/medlineplus/news/fullstory_64072.html
Well I still think that my neuro was just dismissing me, I stumbled across this and thought it might be interesting to the forum.
If the link doesn't work, please not that I got it from Medline, a service of the US nat'l library of medicine and the NIH. They have many good pages.
Well I still think that my neuro was just dismissing me, I stumbled across this and thought it might be interesting to the forum.
If the link doesn't work, please not that I got it from Medline, a service of the US nat'l library of medicine and the NIH. They have many good pages.
For me the biggest aspect of depression is being tired. Fatigue for me is not solved by anti-depressents. Rather, it is enhanced and ends up making more depressed. I have be told similair things as your neurologist has suggested. The actuallity had been to increase my symptoms because of the added stress of the increased fatigue.
More of my symptoms were relieved by taking amantadine to relive much of the fatigue and decreasing my stress do to being too tired to produce.
More of my symptoms were relieved by taking amantadine to relive much of the fatigue and decreasing my stress do to being too tired to produce.
Thank you so much for such thoughtful replies!
Soonermom, I am really impressed you made it that far in my time line without falling asleep. I do find that such a log is personally useful for keeping track of how and when events related to this adventure occur.
All, a lot of you suggest I find a new neuro. Well I did not mention it before to (try and) simplify the post, I actually did see two neurologists. Of course, they sounded so much alike, it is hard to tell them apart.
The bottom line from both is that my neurological exam is normal and my MRI's are clear, so I should "not worry about this." As my symptoms tend to come and go, and thankfully are waning this week, I think it may be best to just watch and wait. I think I will continue to use journals and even this wonderful forum to keep track. Overall I think my good fortune of getting the green light from the doctors outweighs my frustration, so I try to look at this from that angle.
I think in the last few days I have felt a bit depressed, but only because of the confusion these symptoms give me. I think I can manage that depression without medications, though I will keep a watchful eye on myself. I agree with many of the posts here that I may further confuse my body by taking medications. Instead I am going to try to continue to improve my health in more common sense ways. For example, my little adventure has lead me to quit smoking, and I am slowly but surely working on breaking/correcting bad habits like too much coffee, not enough fresh food, stressing out over work, etc.
I see my neuro again later this month, he wants to do a 2nd EMG. At that time, I think I will discuss with him that I will just wait and see for now, and ask if he will be available for follow-ups just in case the disappearing/reappearing act comes back to town.
Thanks again for all of the supportive, thoughtful replies.
Soonermom, I am really impressed you made it that far in my time line without falling asleep. I do find that such a log is personally useful for keeping track of how and when events related to this adventure occur.
All, a lot of you suggest I find a new neuro. Well I did not mention it before to (try and) simplify the post, I actually did see two neurologists. Of course, they sounded so much alike, it is hard to tell them apart.
The bottom line from both is that my neurological exam is normal and my MRI's are clear, so I should "not worry about this." As my symptoms tend to come and go, and thankfully are waning this week, I think it may be best to just watch and wait. I think I will continue to use journals and even this wonderful forum to keep track. Overall I think my good fortune of getting the green light from the doctors outweighs my frustration, so I try to look at this from that angle.
I think in the last few days I have felt a bit depressed, but only because of the confusion these symptoms give me. I think I can manage that depression without medications, though I will keep a watchful eye on myself. I agree with many of the posts here that I may further confuse my body by taking medications. Instead I am going to try to continue to improve my health in more common sense ways. For example, my little adventure has lead me to quit smoking, and I am slowly but surely working on breaking/correcting bad habits like too much coffee, not enough fresh food, stressing out over work, etc.
I see my neuro again later this month, he wants to do a 2nd EMG. At that time, I think I will discuss with him that I will just wait and see for now, and ask if he will be available for follow-ups just in case the disappearing/reappearing act comes back to town.
Thanks again for all of the supportive, thoughtful replies.
My ex-Internal Medicine dr told me my symptoms were all in my head, and put me on anti-depressants. I did take them for awhile, but my symptoms still got worse and worse. I quit taking them, but each new dr....and I've seen a lot of them, still see in my chart that I was given anti-depressants. It can follow you around for a long time. That said, they can be helpful for some symptoms other then just being depressed.
You don't sound depressed enough to need them, I think you need a new neuro instead..Maggie
You don't sound depressed enough to need them, I think you need a new neuro instead..Maggie
I have taken antidepressant several times, first for depression. I had nasty side effects from just about everyone I tried, though the Prozac kicked me out of the depression, but the way the therapist's worked, they kept trying me on others. I finally took some classes and saw a therapist, and learned skills to avoid depression.
When pain started being a major factor in my life, I was prescribed low doses of antidepressants, and once again had annoying side effects, like rashes, shaky nervousness, sun sensitivity, etc.
I tried Wellbutrin recently, to give it one more try. I spent two days hardly able to move. My PCP said that was a really atypical reaction.
It is your choice as to whether or not to try antidepressants. You do need to take them on an ongoing basis, not just when you have symptoms. Neurontin or Lyrica may do the job better, but you can't take those just as-needed, either. Either way, you would need to have regular follow-ups, with a primary care doc, probably, unless you feel that a therapist would be helpful. I'm considering a few visits, myself. All this stuff can really get to me, you know?
I wish you the best,
Kathy
When pain started being a major factor in my life, I was prescribed low doses of antidepressants, and once again had annoying side effects, like rashes, shaky nervousness, sun sensitivity, etc.
I tried Wellbutrin recently, to give it one more try. I spent two days hardly able to move. My PCP said that was a really atypical reaction.
It is your choice as to whether or not to try antidepressants. You do need to take them on an ongoing basis, not just when you have symptoms. Neurontin or Lyrica may do the job better, but you can't take those just as-needed, either. Either way, you would need to have regular follow-ups, with a primary care doc, probably, unless you feel that a therapist would be helpful. I'm considering a few visits, myself. All this stuff can really get to me, you know?
I wish you the best,
Kathy
I have been on an SSRI for 15 years, and I have had bouts of depression mostly after each of my son's were born which was when they first started the Zoloft. I also have a panic disorder that I am pretty sure was inherited from my dad. I do have to have the meds because I truly do have these problems and have struggled with them for most of my life. I am also on a very low dose of Xanax .25mg three times a day and this is for the anxiety and panic attacks. Now having told you my history of these medicines I will now tell you what happened to me. Six weeks prior to this onset of neurological/ vision dysfunction I was jerked off of both the Zoloft and Xanax without a taper and put on Paroxetine(generic Paxil) the very next day. Like I said this was six weeks prior to the onset of this attack. I had been on Zoloft for all of these years and had not had any depression for 10 years and the only reason this doctor switched my meds was because he didn't want to give me the low dose of xanax, said it could be habit forming. I agree, because it can be, but not if you are taking it for what it is perscribed for, anxiety and panic disorder, and if you take it right,which I do! As soon as I went to the ER for the sudden onset of vision dysturbance the ER doctor horned in on the fact that I had been on antidepressants for years and totally dismissed the reason that I came to the ER in the first place, SUDDEN VISION DYSTURBANCES, and sent me to the phyc. floor. This little dismissal prolonged my medical care for six months as it took me that long to convince the eye doctors that I couldn't see right, eventhough I had 20/20 vision. They finally done a visual field test and found the visual field defect and then believed me and got me to a neurologist who done the MRI of the brain and found the 10 lessions in the white matter. These doctors did tag me as being on antidepressants, and because of thier ignorance I didn't receive the steriod treatment in time and have suffered two years of eye and head pain and vision loss that may have been shortned had they treated the medical symptoms I had and not focused in on the SSRI that I was on. And still there is the question of what happened to me. Was it the first attack of MS, or ADEM as my neuro thinks, or was it the effects of all of the jerking around of these medicines that work in the brain? This is the questions and the situation that is my reality two years after this SSRI change that was definately not monitored for side effects! Having said that I must say that I was on the Zoloft for 13 years before this onset of neurological symptoms and never had any neurological problems that I was aware of. So what do all of you think? Was it the drastic switch without a taper or monitoring that triggered this attack? Your oppinions are welcome, and I would like your input and opinions on the situation, since my neuro seems to be sitting on the fence on this one for now!
Santana
Santana
I can definitely understand your concerns. I'll tell you a bit about my experiences.
I went into my neuro looking for some answers about a constant headache and some tingling in my pinky/ring fingers. After a negative c-spine MRI, I had an abnormal brain MRI.
Never suspecting MS at all, I entered limbo land as my neuro suspected it based on 3 lesions. All of my repeat testing since then has been negative. I have "minor" Sx.
After hearing "possible MS" and researching on the internet, I began having other MS-type Sx. I was very upset and my neuro gave me a script for Xanax to help with my anxiety. The Xanax did wonders and even alleviated my fine bilateral hand tremors.
Thinking that my anxiety was causing additional Sx, I asked my neuro for a script for something that I could take long term. He never volunteering it. I was hoping that the SSRI would actually take away some of my Sx that appeared after my brain MRI, because at that point, I didn't know what was a real Sx and what was an Sx caused by anxiety of obsessing with MS.
I've been on my SSRI for since last August. I am now planning on tapering off in a week. I have gained a lot of weight and I have recently had a bout with galactorrhea, which I believe is possibly caused by the SSRI (I've run through tests and nothing abnormal has been found to cause it). I don't think the drug has ever "masked" any of my previous Sx, just added new ones.
I also have been wondering what Sx I'm left with after I taper off the drug. Sometimes I'm a bit "spacy" and I wasn't before starting it.
I'm not saying that your Sx are imagined, nor am I saying that you should stay off of an anti-depressant. There are some people who need the drug and it does wonders for them. At the time I asked for this Rx, I felt that I needed it. Now, I feel that I don't.
Just sharing my experiences.
I hope you find some answers soon!
Take care, Pat :)
I went into my neuro looking for some answers about a constant headache and some tingling in my pinky/ring fingers. After a negative c-spine MRI, I had an abnormal brain MRI.
Never suspecting MS at all, I entered limbo land as my neuro suspected it based on 3 lesions. All of my repeat testing since then has been negative. I have "minor" Sx.
After hearing "possible MS" and researching on the internet, I began having other MS-type Sx. I was very upset and my neuro gave me a script for Xanax to help with my anxiety. The Xanax did wonders and even alleviated my fine bilateral hand tremors.
Thinking that my anxiety was causing additional Sx, I asked my neuro for a script for something that I could take long term. He never volunteering it. I was hoping that the SSRI would actually take away some of my Sx that appeared after my brain MRI, because at that point, I didn't know what was a real Sx and what was an Sx caused by anxiety of obsessing with MS.
I've been on my SSRI for since last August. I am now planning on tapering off in a week. I have gained a lot of weight and I have recently had a bout with galactorrhea, which I believe is possibly caused by the SSRI (I've run through tests and nothing abnormal has been found to cause it). I don't think the drug has ever "masked" any of my previous Sx, just added new ones.
I also have been wondering what Sx I'm left with after I taper off the drug. Sometimes I'm a bit "spacy" and I wasn't before starting it.
I'm not saying that your Sx are imagined, nor am I saying that you should stay off of an anti-depressant. There are some people who need the drug and it does wonders for them. At the time I asked for this Rx, I felt that I needed it. Now, I feel that I don't.
Just sharing my experiences.
I hope you find some answers soon!
Take care, Pat :)
I am so sorry you were treated like that but be thankful. This awful doctor will not be treating your precious body by his/her low and bad standards. and we know his knowledge is below standard. Don't give up and there are good doctors out there. So far.....I believe I have a good Nuro.maggiesue
Dr. possibly could be right about anti-depressants taking away most of the symptoms, but doesn't mean it is worth the riskof them. And if it did take away the symptoms, how would you know if other meds are working or not, or if you are having a "flare up" or not. I don't agree with masking symptoms just so you don't bother your doc with finding out why they are there. I personally just stopped taking anti-depressants which I was taking for post-partum depression. Most of my symptoms didn't start until the med was out of my system, but I need to know what is going on with my body so I will not start taking them just to "mask the symptoms". Don't know if I was any help, sorry.
This is from your timeline:
March 26 08: Feeling better, but still some residual tingling/numbness, and still confused. See neurologist. He tells me "you think you have a disease, but you do not." He tells me not to follow up with him, eve if my symptoms recur/progress. He recommends Prozac.
I would find another neurologist that will take you seriously (including ruling out MS mimics) WHY do they think people would make this up?? This is the kind of attitude that I was referring to.
Give me a break,
Stacey
March 26 08: Feeling better, but still some residual tingling/numbness, and still confused. See neurologist. He tells me "you think you have a disease, but you do not." He tells me not to follow up with him, eve if my symptoms recur/progress. He recommends Prozac.
I would find another neurologist that will take you seriously (including ruling out MS mimics) WHY do they think people would make this up?? This is the kind of attitude that I was referring to.
Give me a break,
Stacey
I understand your skepticism towards your doctor's advice, and I too would be hesitant to take anti-depressants when I'm not depressed. However I don't think he's on the wrong track, or necessarily trying to placate you with a prescription. I have a few books on MS that talk about the use of tricyclic anti-depressants (ie; Elavil, Triavil) to treat paresthesias and dysethesia. My concern with starting an anti-depressant med would be the long list of side effects, and as you point out, the possibility that side effects might get confused with other symptoms and sidetrack the diagnostic process.
The symptom of numbness is very hard to treat and in fact I don't know that there are any meds that really help with that.
I am currently taking Neurontin, which happens to be an anti-convulsant med, to treat the burning/tightness sensations in my left hand and arm. These sensations have been constant for the past month, since the onset of my last flare. I tried to wean off of the med this week because I didn't think it was helping me, but I guess it was, because I am much worse on the lower dose. So I'm staying at my current 3 doses per day (200mg/200mg/ 300mg) for now. Initially, I was very reluctant to go on it, but decided finally to do so because this sensation has become a daily thing; not sporadic like it was previously, or as sounds like the case with you. I am concerned about side effects but so far have had none, and my neurologist indicates he rarely sees any problems with this med, even in those who must take it long term. I remain hopeful that the persistent pain will pass and I can go off it eventually.
Neurontin also seems to have alleviated my Lhermitte's, which is not so bad that I would take meds just for that. Having said that, this symptom comes and goes, so who knows if it is the med, or if it just remitted on its own?
I agree with yourself and the others here, that if you can live without meds, it's preferable to do that. It is when your symptoms begin to really interfere with your day to day functioning, that they can and should be considered. Then you are faced with the decision of which is the lesser of two evils. This is such an individual decision, depending on one's sensitivities to meds; one's individual pain threshold; other health conditions or meds that may be impacted; etc. etc.
db
The symptom of numbness is very hard to treat and in fact I don't know that there are any meds that really help with that.
I am currently taking Neurontin, which happens to be an anti-convulsant med, to treat the burning/tightness sensations in my left hand and arm. These sensations have been constant for the past month, since the onset of my last flare. I tried to wean off of the med this week because I didn't think it was helping me, but I guess it was, because I am much worse on the lower dose. So I'm staying at my current 3 doses per day (200mg/200mg/ 300mg) for now. Initially, I was very reluctant to go on it, but decided finally to do so because this sensation has become a daily thing; not sporadic like it was previously, or as sounds like the case with you. I am concerned about side effects but so far have had none, and my neurologist indicates he rarely sees any problems with this med, even in those who must take it long term. I remain hopeful that the persistent pain will pass and I can go off it eventually.
Neurontin also seems to have alleviated my Lhermitte's, which is not so bad that I would take meds just for that. Having said that, this symptom comes and goes, so who knows if it is the med, or if it just remitted on its own?
I agree with yourself and the others here, that if you can live without meds, it's preferable to do that. It is when your symptoms begin to really interfere with your day to day functioning, that they can and should be considered. Then you are faced with the decision of which is the lesser of two evils. This is such an individual decision, depending on one's sensitivities to meds; one's individual pain threshold; other health conditions or meds that may be impacted; etc. etc.
db
Wobbly is right about the side effects of medication getting confused as new symptoms. I was put on low dose nortriptyline for migraine and it also helped with all the paresthesias (some of which were getting painful) that I was having in my face. I was glad to be on it at first, but it eventually started causing urinary retention and when I recognized that it was a side effect and not a new symptom, my doctor told me to discontinue it.
If your numbness/paresthesias are not that painful or bothersome I would personally not take anything for it. I have gotten use to all of that now. I think you are wise to really second guess this suggestion. Another thought that I have is when/if you do go to another doctor for a 2nd opinion, they MIGHT look at your case differently if you are on an antidepressant. I'm not saying that they SHOULD here--but we all know how some doctors can be!!!! If you are depressed and need it, that is one thing....but you don't sound like you are.
just my 2 cents here,
Stacey
If your numbness/paresthesias are not that painful or bothersome I would personally not take anything for it. I have gotten use to all of that now. I think you are wise to really second guess this suggestion. Another thought that I have is when/if you do go to another doctor for a 2nd opinion, they MIGHT look at your case differently if you are on an antidepressant. I'm not saying that they SHOULD here--but we all know how some doctors can be!!!! If you are depressed and need it, that is one thing....but you don't sound like you are.
just my 2 cents here,
Stacey
Just my opinion.... I agree that I would not want to start taking meds that are not necessary and could give you side effects that would confuse what is going on with you.....
But I'm not a Dr, and who is to say the Dr would be correct in giving you that advise?
Just my opinion. I have enough symptoms going on that I wouldn't want to confuse myself anymore then I have already...If you know what I mean.
If you do not feel depressed" why" and maybe seeing a therapist wouldn't hurt if you think you might start taking some meds....just to keep tabs on your side effects?
Good luck and stay in touch
andie
But I'm not a Dr, and who is to say the Dr would be correct in giving you that advise?
Just my opinion. I have enough symptoms going on that I wouldn't want to confuse myself anymore then I have already...If you know what I mean.
If you do not feel depressed" why" and maybe seeing a therapist wouldn't hurt if you think you might start taking some meds....just to keep tabs on your side effects?
Good luck and stay in touch
andie
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