Head Meds
It's no secret that I have been on and off meds for depression for most of my adult life. My latest iteration is Zoloft, which has been working very well for me for the past couple of years. I was scheduled to taper off this summer, but my doc felt that I should stay on while I was going through surgery and treatments. You know, stressful stuff. I kind of wish I would have tapered off so I would have had some sort of baseline. It's going to be difficult to isolate how I am when dealing with the other drugs coursing through my system.
In our independent research Dan and I discovered that certain SSRI meds are contraindicated with tamoxifen, which is the follow-up treatment I'll have when the chemo is done. It's an oral hormonal treatment that I will have to take for five years. It comes with its own set of side effects, which I'll get into a little later. Zoloft is one of the anti depressants that per certain studies lowered the efficacy of tamoxifen by half. Recurrence occurred in the test group at a rate of 16% as compared to the control group at 7%. Those results are quite compelling. I mentioned it to Dr. Kimo before my last treatment and he was in agreement that I should probably get off of the Zoloft.
I saw Dr. T a couple of weeks to discuss this (not Dr. Kimo, since the Zoloft is not his prescription,) and she put me on a completely different class of antidepressant. I have been on a tricyclic before, with fair results. Doc T felt we could kill two birds with one stone as the main side effect of the tricyclic is sleepiness, which I've been missing. (Sleepiness, not fatigue... got tons of that.). So the past couple of weeks I've been sleeping more and more and needing more and more sleep. I've been tapering off the Zoloft and I'm not happy with the results. I've developed an anger management problem. Not cool. I've also developed a propensity for late night snacking, which is extremely out of character for me. I cannot remember the last time I had something to eat after dinner previous to the past week and a half. Now it's a bowl of ice cream before bed, whether I need it or not. I don't even like ice cream.
So now I have another appointment with Doc T later this week to try to see if we can figure out something different. I'm tempted to stop the head meds altogether and just get my chemo done and out of my system, then start on the tamoxifen and get stabilized on that. If I need to add a depression med once I've been on the tamoxifen for a couple of months, I can start with one of the SSRIs that are not contraindicated. (Although I've been on two of the three with only fair results.) I sense this is going to be a balancing act - what side effects can I live with, what behavior can I and those around me tolerate, what risk factors are acceptable.
It's no secret that I have been on and off meds for depression for most of my adult life. My latest iteration is Zoloft, which has been working very well for me for the past couple of years. I was scheduled to taper off this summer, but my doc felt that I should stay on while I was going through surgery and treatments. You know, stressful stuff. I kind of wish I would have tapered off so I would have had some sort of baseline. It's going to be difficult to isolate how I am when dealing with the other drugs coursing through my system. 
In our independent research Dan and I discovered that certain SSRI meds are contraindicated with tamoxifen, which is the follow-up treatment I'll have when the chemo is done. It's an oral hormonal treatment that I will have to take for five years. It comes with its own set of side effects, which I'll get into a little later. Zoloft is one of the anti depressants that per certain studies lowered the efficacy of tamoxifen by half. Recurrence occurred in the test group at a rate of 16% as compared to the control group at 7%. Those results are quite compelling. I mentioned it to Dr. Kimo before my last treatment and he was in agreement that I should probably get off of the Zoloft. 
I saw Dr. T a couple of weeks to discuss this (not Dr. Kimo, since the Zoloft is not his prescription,) and she put me on a completely different class of antidepressant. I have been on a tricyclic before, with fair results. Doc T felt we could kill two birds with one stone as the main side effect of the tricyclic is sleepiness, which I've been missing. (Sleepiness, not fatigue... got tons of that.). So the past couple of weeks I've been sleeping more and more and needing more and more sleep. I've been tapering off the Zoloft and I'm not happy with the results. I've developed an anger management problem. Not cool. I've also developed a propensity for late night snacking, which is extremely out of character for me. I cannot remember the last time I had something to eat after dinner previous to the past week and a half. Now it's a bowl of ice cream before bed, whether I need it or not. I don't even like ice cream.
So now I have another appointment with Doc T later this week to try to see if we can figure out something different. I'm tempted to stop the head meds altogether and just get my chemo done and out of my system, then start on the tamoxifen and get stabilized on that. If I need to add a depression med once I've been on the tamoxifen for a couple of months, I can start with one of the SSRIs that are not contraindicated. (Although I've been on two of the three with only fair results.) I sense this is going to be a balancing act - what side effects can I live with, what behavior can I and those around me tolerate, what risk factors are acceptable. 
No comments:
Post a Comment
Feel free to send positive feedback. That is all I'm accepting right now. If you don't like my blog, try one of the other 300 million out there.