Jump to content


E-Newsletter Signup Like us on Facebook Sign Up For Our e-Newsletter
Photo

anti depressants


  • Please log in to reply
4 replies to this topic

#1 joyfulnoise

joyfulnoise

    Advanced Member

  • Members
  • PipPipPip
  • 32 posts

Posted 14 February 2012 - 03:27 PM

My husband is taking mirapex 3g every day, it has helped with the motor symptoms of PD but not so much with the mood. My question for you, what anti depressant would you recommend to try first paxil or effexor. I know different people react differently and PD itself makes it difficult to treat. I did see dr Irene richards study and it said there was more to come on the recommendation at the end of the year (2011). Wondering if you have any updates on that study also about treating depression in PD.

Thanks for your help

#2 MComes RPH

MComes RPH

    Board Certified Pharmacist

  • Ask the Pharmacist Moderators
  • PipPipPip
  • 1,147 posts

Posted 22 February 2012 - 11:35 AM

First let me say, "Thank you," from all of us with PD. I have always said it is much easier to hqve PD than to take care of someone with PD. I thank you for being so involved with your husband and his condition.
With so many anti-depressants out there, it can seem overwhelming when you see all the ads on TV etc..
I think you have over come the major obsticle, which is admitting depression is there. Unfortunately, it usually comes hand in hand with PD.
The ones that I have seen work best are Celexa, Lexapro, and Effexor. I will explain why:
Depression can cause a variety of other issues other than depressed mood. Depression can bring about pain, sleep issues (too much or not enough), fatigue, anxiety, loss or gain in appetite, loss in pleasurable things, restlesness, agitation, sudden outbursts of anger, slowed thinking or movement (which is difficult to tell in a patient with PD), and an overall feeling of uselessness (due to the depression and inability to do the things he used to be able to do.
Celexa and Lexapro (along with Paxil and Zoloft) are in a class called SSRI's. It seems as if these meds have a tendancy to not only help with depression but also with some of the other effects of depression. I would probably talk to the Dr about Celexa or Paxil, because they do come in generic. Lexapro, as of right now does not. What I have also seen is that if one medication in this class does not seem to get the results expected, a change to a different medication in this class may give the outcomes you are looking for. There is really no explaination for this, it is just one of those odd things.
The Effexor is in a class of SNRI's (along with Cymbalta and Pristiq) is another med that works well with depression and other symptoms of depression, such as pain. I have seen effexor work well in situations where pain or body aches are involved with depression. The best part, out of the 3 meds I mentioned, is that Effexor does come in a generic.
The toughest part about treating depression, in people with or without PD, is the waiting. It can take up to 4-6 weeks to see any effects. This is because the blood levels need to be at a certain level for a length of time in order to work. Anti-depressants are many times like PD meds, where you need to start at a low dose and increase it slowly. I call it the, "Start low and go slow," method. The major reason patients stop taking anti-depressants is because they do not give them enough time to work. Most people these days have they attitude of "i want it to work yesterday!" If you can handle the Mirapex increase schedule, than this should be easy.
Lastly, keep a journal of what types of symptoms he may be experiencing and at what times of the day. This will be a greay help for the Dr in deciding the correct path to go.
Please keep me updated.

My husband is taking mirapex 3g every day, it has helped with the motor symptoms of PD but not so much with the mood. My question for you, what anti depressant would you recommend to try first paxil or effexor. I know different people react differently and PD itself makes it difficult to treat. I did see dr Irene richards study and it said there was more to come on the recommendation at the end of the year (2011). Wondering if you have any updates on that study also about treating depression in PD.

Thanks for your help


Edited by MComes RPH, 22 February 2012 - 11:37 AM.
Needed to add info

Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#3 joyfulnoise

joyfulnoise

    Advanced Member

  • Members
  • PipPipPip
  • 32 posts

Posted 22 February 2012 - 03:58 PM

First let me say, "Thank you," from all of us with PD. I have always said it is much easier to hqve PD than to take care of someone with PD. I thank you for being so involved with your husband and his condition.
With so many anti-depressants out there, it can seem overwhelming when you see all the ads on TV etc..
I think you have over come the major obsticle, which is admitting depression is there. Unfortunately, it usually comes hand in hand with PD.
The ones that I have seen work best are Celexa, Lexapro, and Effexor. I will explain why:
Depression can cause a variety of other issues other than depressed mood. Depression can bring about pain, sleep issues (too much or not enough), fatigue, anxiety, loss or gain in appetite, loss in pleasurable things, restlesness, agitation, sudden outbursts of anger, slowed thinking or movement (which is difficult to tell in a patient with PD), and an overall feeling of uselessness (due to the depression and inability to do the things he used to be able to do.
Celexa and Lexapro (along with Paxil and Zoloft) are in a class called SSRI's. It seems as if these meds have a tendancy to not only help with depression but also with some of the other effects of depression. I would probably talk to the Dr about Celexa or Paxil, because they do come in generic. Lexapro, as of right now does not. What I have also seen is that if one medication in this class does not seem to get the results expected, a change to a different medication in this class may give the outcomes you are looking for. There is really no explaination for this, it is just one of those odd things.
The Effexor is in a class of SNRI's (along with Cymbalta and Pristiq) is another med that works well with depression and other symptoms of depression, such as pain. I have seen effexor work well in situations where pain or body aches are involved with depression. The best part, out of the 3 meds I mentioned, is that Effexor does come in a generic.
The toughest part about treating depression, in people with or without PD, is the waiting. It can take up to 4-6 weeks to see any effects. This is because the blood levels need to be at a certain level for a length of time in order to work. Anti-depressants are many times like PD meds, where you need to start at a low dose and increase it slowly. I call it the, "Start low and go slow," method. The major reason patients stop taking anti-depressants is because they do not give them enough time to work. Most people these days have they attitude of "i want it to work yesterday!" If you can handle the Mirapex increase schedule, than this should be easy.
Lastly, keep a journal of what types of symptoms he may be experiencing and at what times of the day. This will be a greay help for the Dr in deciding the correct path to go.
Please keep me updated.



#4 howietx

howietx

    Member

  • Members
  • PipPip
  • 12 posts

Posted 02 March 2012 - 10:01 PM

Great response . I take mirapex along with Pristiq which works great for me,

#5 MComes RPH

MComes RPH

    Board Certified Pharmacist

  • Ask the Pharmacist Moderators
  • PipPipPip
  • 1,147 posts

Posted 09 March 2012 - 10:49 AM

Thanks for your input. We are all in this to help each other.
Thanks again

Great response . I take mirapex along with Pristiq which works great for me,


Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users