any info on this subject please? How do they work in the very low stages of predisolone. Had a disturbing panic attack in the night and think the time has come!!
antidepressants: any info on this subject please... - PMRGCAuk
antidepressants
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Bedwell
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I have been on my full dose of antidepressants throughout taking steroids — prednisone and methylprednisolone without any difficulty. ( nine months.) I wouldn’t worry unless your particular body protests, recognizing we are all different. Best wishes.
Thought I’d answered you but where has it gone.? Could you recommend what works fir you please. ? Not very knowledgeable as usually an alternative remedy user!!! Apart from pred of course!!
Deep slow breathing exercises are very good for panic attacks.Discuss the problem with your Dr as you don't want to take another pill unnecessarily.
The Drs love dishing out pills and sending us off happily (or unhappily). I know antidepressants don't suit everyone.
Thanks yes do a lot of deep breathing in my yoga class.
Was woken up in a panic.. frightened! Which was a shock?!?!
Very scary. Perhaps you had a nasty dream. 2 paracetamols help things calm down. I find them relaxing and sleep inducing too. Good for you doing Yoga 👍
Woke up very frightened remembering the scariest happening when I was 20 and a burglar broke into our basement and came into my room and stood over my bed!!!! Ouch!!I also kept saying. Unresolved traumas .. repeatedly.
What other medications are you on or health conditions do you have ? That info would help people with replies because it does make a difference to which options of prescribed medications or natural alternatives people could recommend safely.
Depending on all your health issues there are a number of different options out there . Just remember to request to start on a dose lower than your will eventually end up on so you can get your body used to the new medication with less chance of side effects.
Just have 1 Zapain and gabapentin at night for pain from throbbing feet at night. Also 10 temazapam per month. The rest are supplements.. vitamins etc. knees arthritic.. otherwise 85 year old fatigue.. hearing probs etc
Do you take Temazepan to help with sleep / insomnia? Dud you take it prior to the Prednisolone or was it prescribed for sleep problems on higher doses?
Which dose of prednisolone are you on at the moment?
It's important to know whether your Depression or Panic Attacks have only begun since you began steroids and whether it's a short term side effect of higher doses or it has another cause.
It's worth considering this and discussing that with the GP.
Often , if you were not already being treated for mental health issues before steroid treatment Tricyclic antidepressants are not recommended because they can cause other side effects and don't make much difference to steroid induced mental health symptoms.
Although some people can have mental health side effects on steroids of any dose , some people find that they only have occasional problems or mood swings on higher doses and that they go as the dose reduces. Often these can be controlled with breathing and CBT or a change in sleep medications that they are also using.
The Temazepan, Zapain and Garbapentin are the medications which will also limit the options of antidepressants available for you to use.
So you may need to change Temazepan as an insomnia treatment at the least and find an antidepressant option through trial and error with your GP that could help both your sleep problems and reduce anxiety attacks.
Using these medications concurrently with various classes of antidepressant isn't recommended because they can increase the levels of each drug in the bloodstream and cause daytime drowsiness and imbalance in serotonin. So what might be ok to use with Prednisolone may not be recommended with Temazepan, and so on , and so on.
Your options will eventually come down to which drug is suitable for your symptoms and doesn't interact with the medications you are on now and need to keep using , or which antidepressant can be used if you alter the use of other drugs like Temazepan and Zapain.
Which supplements or herbal products do you take?
These can also limit your prescribed drug options or you may need to change or stop taking them to be able to take a prescribed antidepressant.
On the other hand , you may also be able to improve your mental health and night time pain symptoms by altering what supplements you take , and when , and by making changes in your diet and types of activity. Which may also help reduce your need for Temazepan and Zapain.
It's a complex combination so it really requires professional supervision and support.
Hope you find a combination that works for you soon , Bee
Thankyou fir your very comprehensive reply! I had a breakdown when my mum got Alzheimer’s when I was in my 50s and have had a tendency for anxiety and depression since!!I have temazapam .. a half.. by my bed if I have real trouble sleeping . 10 tablets a month.. yes I am addicted.. but am 85 and it works for me.!
I am reducing very gradually.. 3/3/2.5 fir another month before I go to 2.5 daily. Am speaking to my therapist today.
Think that frightening in the night was such a shock. I overreacted. I do a wonderful gentle yoga class .. calked breathe and be still. ! Lying down mostly.
Onwards!!!
Thorough advice? Bleary.
PMRproAmbassador
It really is something to discuss with your GP. These days they do like to look at talking therapies and CBT and not immediately throw pills at everything.
I did reply to this but can’t see it! I have tried cbd but didn’t seem to help. Have good therapist who I see on zoom.
Do you mean you have tried CBD or CBT?Pro and I suggested CBT , which is Cognitive Behavioural Therapy, basically relaxation , thinking and breathing techniques to reduce symptoms and distract the brain.
CBD , is the cannabis derived supplements.
CBD products aren't generally significantly useful for depression or recommended to use if you are on steroid medications because they are processed by the same pathway in the liver as the prednisolone and can cause a increase of the Pred in the bloodstream which can cause side effects.
CBT is definitely a useful mental health tool to use if you get fast mood changes or mental health issues on medications.
CBD products aren't usually successful for medication induced mental health side effects .
Thanks! Yes a bit of brain fog I’m afraid.
"CBD products aren't usually successful for medication induced mental health side effects "
In fact - probably make them worse ...
I was already taking prescription meds for chronic pain and depression before being struck down with poly myalgia.The antidepressant I was taking is citalopran.The addition of steroid to my drugs had no adverse affect ,just successfully treated the p.m.r.Of course this prescribing and treatment was done by qualified medical professional-my G.P.I also ditched all supplements I had self medicated with( with no real benefit in hindsight) just took prescribed calcium and vitamin d supplement.please discuss your problems with your doctor,you may not need antidepressant therapy but another treatment.Best wishes!
I assume you didn't mean the reply for me but Bedwell? She will see it as author of the thread but not realise it was meant for her.
Oh dear,do I need to do anything? It’s a general sort of message.
Not really - it is just you replied to me in a thread within the main thread. If you want to make a general point it is better to reply to the author of the thread.
Thankyou.
Thanks for that.I did take citalopram in the past. Once! And benefited I think! Long time ago!. As I have now posted.. I had a very good zoom with my therapist and won’t take another drug for the moment. I had a wonderful 9 hour sleep last night. Must “question my expectations” as to tonight’s sleep . That is one of his phrases I think I should pin to the wall!! Very helpful !
Thanks all again !!
Best wishes!
Quite possibly. I had a sudden light bulb moment on this earlier too.Bedwell mentioned that she is also reducing the amount of Temazepan she is taking.
Acute episodes of nightmare or panic are actually common as part of withdrawal of Temazepan, so the event may have been because of that.
If that is the case CBT practice to reduce PTSD and return to good sleep would probably be more useful than anything else.
I didn’t mean to indicate I was reducing temazapam.. I just always take a very small amount when I wake and can’t go back to sleep. Works out at about 10 tablets a month.. which gp seems to think ok. Sometimes take a little more if under pressure. To reduce at the same time as reducing pred would be asking for trouble ! What does PDST stand for please?
And I feel blearyeyed most mornings by the way!!!
Oh that's ok, what dose of Pred are you on a the moment?It's not actually uncommon to have the occasional lucid dream on the higher doses and if you had had a stressful day or felt anxious it's not surprising that it was more like a nightmare.
PTSD is post traumatic stress disorder.
Anyone can suffer it.
It can be caused by any bad life event that happens to you which had a big impact on your feelings and insecurity.
It is basically mental and physical symptoms of distress which get triggered by things that you may come into contact with that remind the brain of the previous trauma.
How are you feeling now?
I’m on 3/3/2.5 mgs and I take a quarter of a 10 mg tablet of temazapam when essential.. have been doing so for years! Basically I’m an alternative remedy person. Hate drugs but needs must. I started at 15mgs 2 and half years ago and have been on this website for at least a year! Am 85. Am sure you’ve seen all this before. !! Staying on this regime for another month. Rheumy happy with that! Have a very good therapist who I’m now talking to regularly. Such a help. Thanks!!
Sounds good.I was just trying to work out which end of the steroid symptoms you were dealing with at the moment .
At 3/3.5 you are having to tackle the Adrenal Phase aren't you and waiting for the Adrenals to wake up and do their job better again. Lots of Fatigue and I did have the odd bad dream if I had a hard day .
Like my body telling the brain it had done too much and felt under attack but the brain would then confuse the message and think it needed to give me a dream shock to wake me up .
When, in reality , the best thing it could have done was give me a nice long sleep.
As my steroid reduced my chronic pain from EDS and Fibromyalgia was more noticeable so I had to increase my dose of Pregabalin ( which I take instead of Garbapentin because the side effects are less , especially on the stomach) .
Did your therapist suggest any techniques to help ?
Maybe they could suggest an antidepressant that you can use with your other meds , not for now , but if you feel you need one in the future you would know which type to ask the doctor for, just a thought.
Take care , Bee
The synacthen test came back normal! Whatever that mean? Yes am doing 2 days at 3 and one at 2.5 and I am struggling! Never know how I’m going to feel! Tends to be a bad day after the lower dose. The next day. But yesterday was exhausting. The 2.5 day. And am praying I’ll have more energy tomorrow.. family lunch at mine. Daughters very present.. but I pulled the curtain out of the wall yesterday! And only slept 5 or 6 hours last night .. so LIFE not easy!
So much to be grateful for. !!! Great granddaughter.. 2 wonderful daughters.. darling dog.. disabled badge for parking!
thanks for all this information. I've just started using CBD oil but maybe it's not such a good thing. Certainly very expensive. Had read about high doses and liver problems but keep myself within the latest recommendations. Maybe it's not such a good idea?
The dose size is important for anyone , but the doses recommended may also be too high when you are also on steroids as they are both processed via the same pathway in the liver.Therefore it can reduce how well the liver processes steroids for you and can cause and increase of both steroids and CBD in the bloodstream . They basically have an interaction .
Plus , even the more expensive CBD over the counter is not well quality controlled so the amount of active ingredient in them can be next to nothing.
If you continue , just take care, Bee
The CBD oil has been dumped! Thank you very much for your advice, and also all the info from Dorset Lady, where would we be without this info source. CBD was recommended to me by a Paramedic I met who swears by it but doesn't have PMR.
It is the trouble with recommendations I'm afraid , even from medically qualified people.They forget to tell people that they should always double check whether it's possible to take a medication or alternative supplement alongside other medications they need to take or with other illnesses you may have.
It's why we always remind people to check if it's suitable for them to use on this forum all the time.
What's a cure for one can be a curse to another depending on your personal medical history.
What might be a miracle for a generally healthy person in no Medication might be murder to a person on certain medications or with certain chronic health issues.
Most people whom give you recommendations in daily life don't consider the real facts that herbal or alternative remedies and supplements are still chemical or drugs and can have as many side effects as prescribed medications. Just because the are classed as natural or come from a health food shop over the counter everyone assumes they are safe. When , in fact , in some cases the opposite is true and they can be dangerous
I actually advised someone on another forum recently whom had an awful day of heart symptoms and it turned out that the Pharmacy had suggested her Kalms because in their words, " they had no bad side effects" .
They actually contain active ingredients that can make certain heart conditions worse, interact with some medications , and cause increased tachycardia, which is what happened to that person.
The chemist clearly hadn't read the papers specific to Kalms side effects for people with AF and Hypertension, they'd only checked if it could be used with her medications , which is the norm .
So , it's always a good idea to do a bit of your own research before you start a recommendation, even from a Medical professional, but especially from a health or lifestyle website .
Personally, I think they should be putting health warnings about the adverse effects of CBD for people on certain medications or with certain health problems of the heart , kidney or liver to check at the bottom of the screen ; telling them to see a GP first. The advertising about these products and promotion by celebrity online influencers is very irresponsible in my opinion.
I'm not anti CBD , I'm anti taking any herbal product without checking it won't upset you first. Take care , Bee
i take the generics for lexipro and welbutrin.
but everyone reacts differently to various antidepressants. i have been on many different ones since ‘91.
A single panic attack, horrible as they are, doesn’t really warrant another complex drug. This could be part of coming off Pred and maybe Adrenal recovery too. I have found that a vitamin B12 supplement has a calming effect. Interesting that your panic attack revisited an old trauma. A therapist would be happy to explore this with you. I hope it was just a strange one off. As others have said, speak to your doctor if you are struggling.
I had something similar and I must admit it frightened the life out of me. Early Saturday morning I woke in a panic - although I don't know why. I couldn't breath and because I couldn't catch my breath I panicked more, I was hammering on the wall for my neighbour which she appreciated at 3 am! But then all of a sudden one big inhalation of breath and I was back to breathing normally. I can't tell you how much it frightened me I thought I had reached the end. I had been taking Sertraline for about 5 months and must admit I think it was just beginning to do me some good then my wonderful (not) Neurologist changed them to Duloxetine which I didn't get on with at all. I explained to the Doctor and next week I'm back on the Sertraline. But I don't know what caused my attack and I'm frightened of it happening again, someone said it was sleep apnoea? Any idea anyone?
Thanks. Yes I’m not someone that takes a drug easily.. and have resisted friends advice about anti depressants so far!! Interesting to see what therapist has to say later on today. Had such a wonderful peaceful night last night.
Good luck 🍀
I do not fully understand why you would want antidepressent for a single eppideode of nightmare and consequent panic. However it could be a side effect Gabapentine. In the Product Information it is written: Common side effects: Hostility, confusion and emotional lability, depression, anxiety, nervousness, thinking abnormal.
I had Panic disorder when I was young, so I understand your distress, but more medication may not be the answer here.
I would see a doctor to find a good way forward.
It wasn’t just that incident…which was a shock! but I do get days of feeling quite depressed.. however.. had a wonderful 9 hours sleep last night so the picture looks different ! And am speaking to my therapist midday.
Thanks to all fir your immediate input. Will answer to you separately later on!!
Hi Bedwell. I have had generalized anxiety since I was a teen. Over the last many years I have been on an anxiety med, clonazepam. No one can address this unless they've experienced a full- blown axiety attack, night or day, when it feels like you're about to die. The one thing that has helped is a distraction. Word games work for me...or calling my daughter and just talking. The clonazepam is now helping with the muscle spasms caused by 8 fragility fractures in my spine. The pills relax the muscles. So, combined with paracetamol, works. Neurologist refilled my prescription yesterday for this reason. I'm on a high blood pressure pill, so can no longer take ibuprofen which really helped. Talk with your GP who may be reluctant to describe benzodiazapenes. It can be found when reading that "clonazepam is often used in the post operative treatment of muscle spasms after vertebroplasties", which is what I had about a month ago. Very low dose of .5 mg. I said to my NP "if it's not broke, why fix it?" My anxiety is controlled at this very low dose. I also am glad to be getting off the co-codemol and back to plain paracetamol. For me, this is a win. I am not depressed, so why go on sertraline. To get these muscle spasms under control is another win and means more mobility. All the best..
.
Hi Missus. I also take Clonazapam for many years and I do not plan to stop. You are right: if you have not had panic attacks over and over again, it is difficult for others to understand. I am 65. I was brought up in a household of tremendous child abuse. There is a new category of PTSD. It is C-PTSD. C being Complex. Which my counselor has assured me I’m in the group.
The reason I am compelled to respond is because there exists a severe prejudice against benzodiazepines even in the medical community. The Clonazapam also helps my spinal muscles where I had 2 surgeries relax. I am also a master at deep breathing for 30 years. For those reading this I want you to understand that severe trauma changes the neural pathways of the brain. Forever. This is why certain antidepressants combined with other medicines help people like me and people with panic attacks. I’m very happy for the invention of these meds! Every drug has side effects. For me, if the quality of my life is improved, I’m all in. BTW I have lupus SLE and other autoimmune goodies. 
🙌🙌🙌
Been on clonazepam for many years as well. Same with the child abuse. Sexual around 6 yrs old. Then Mum was quite abusive by today's standards. Then a life time of abusive relationships. Until the last one died in 2009. I'm now 73, so probably CPTSD. Also a deep breathing master. QOL is very important to me. It's sad we have to explain ourselves for, not abusing, but needing a medication that works for our particular affliction. Sometimes we're made to feel like drug addicts. Neurologist did not question it at all. One doctor refused to be my doctor because he did not believe in clonazepam. Walked out of the office on me. I have PMR and osteoporosis. Great combo for pain. My current temp NP does not believe in it either. Neuro is going to have a talk with her. Thank you for your response and the validation, which, by the way shouldn't be needed...but is appreciated.🌷
I share your experience although I was slightly older when my Uncle abused me and it was dealt with swiftly. Unfortunately, my father then died when I was 11 and my Mother had her own demons and I had to deal with her physically violent mood swings until I left for University. I was also raped on the way home from work in my 20's.I think anyone whom suffers these types of trauma suffer form a lifetime of C-PTSD to some level . Trauma , especially at an early age, affects the way we react to the World and traces patterns through the way we react to life events , even in mild and unnoticeable ways. I think , from my own experience, it is part and parcel of becoming a survivor and finding the tools we need to maintain our strength against the odds.
I feel strongly about the way people are judged for requiring prescribed medication to help with their mental health issues. There should be no stigma for getting antidepressants for a mental health illness just as there should be none for getting medicine for a physical illness. Actually acknowledging the problem and finding a way to proactively deal with it with all the means available should be seen as a huge achievement not a fault.
As I often say when discussing steroids and other medicines , you wouldn't shame someone for needing to use an asthma pump or a crutches to help them walk so why should anyone feel ashamed to take a prescribed drug to support their quality of life and manage their long term health condition , even if it isn't visible to the naked eye.
I feel equally annoyed for people being made to feel scared or reluctant to take antidepressants for chronic pain or nerve conditions because of the stigma Society mistakenly tie to these vital medications.
This stigma that people put on these drugs, including doctors at one time , hampers people's road to recovery for lots of illnesses . These medications are used as often to help various physical conditions as often as mental ones these days but people often put themselves through delays and excessive pain just because they see the medication being offered has the term antidepressants or anticonvulsant attached.
I feel for people like Bedwell , and anyone, whom needs to get drug treatment for both mental and physical health issues at once because often it is so complicated to find the right medications that will work harmoniously together to treat both problems.
Often doctors and other sufferers of the physical illness don't understand that the effect of drugs like high dose steroids ( especially if they are taken alongside other strong neuro medications ). You may have much stronger mental side effects on them than most people can understand. These people deserve more support for their effects not being made to feel like they are some sort of failure to treatment or aren't doing enough to help themselves.
Thanks to you , and to Mrs Marigold , for including your experience and helping me to share my own.
You've actually inspired me to go searching through the research archives and see if there has been any work done to see if patients with previous mental health problems or trauma get worse mental health side effects on drugs like steroids that others may not get. Whether the trauma adds to the woes. If I find anything I will share in a post just in case people with these conflicting needs need it to help to speak to their doctors about their needs , and especially if that research includes any advice about which treatments work best together.
Take care , Bee
Well said , thanks for sharing , I've included a reply to Missus 835 which is also for you if you want to read it, take care and stay strong , Bee
This just MIGHT help. As you probably know, panic attacks happen when the mind/body thinks it’s under attack. So, if I get a panic attack - quite rare now I’m pleased to say - I just quietly say to myself “thank you body for trying to protect me but I’m really doing OK anyway”. It seems a strange thing to do but it was suggested to me by an excellent therapist many years ago and, for me, it works!!
Again! Thought I had poste
I had a very good zoom with my therapist this morning and feel much better… so for the time being I won’t embark on another drug!!!
Thank you again for all your replies !
Hi Janann. Your suggestion is wise of course. And significant to Cognitive Behavioral Therapy. I have my own mantra that I learned to use and it helps. However,
Without the extra help of some medicine, my mind is unable to focus enough on organic healing/helping methods. This is because it is like I have “brain damage” and it is well documented in the books on mental health. I no longer need therapy. It was a long road. Interestingly enough, my siblings are taking similar medications with the same results: we are happy functioning adults who can say : I survived and now I live!! Best to you.
Thanks all. Glad were able to share. Also happy no panic attacks for awhile, although I do get a little wound up about the outcomes of this osteoporosis and thank God for pred which is keeping the PMR, GCA or lupus at bay. We are all survivors, a very positive outcome in spite of our past lives. Cheers!
How awful! So glad you had a good chat with your therapist AND a good night’s sleep.
I understand where you’re coming from having had PTSD for 8 years after hearing stories of sexual harm from social work clients for 18 years. Many nights I experienced night terrors. Talk therapy and EMDR helped significantly however as long as I continued to work and hear stories of sexual trauma, I continued to struggle. My employer was extremely supportive but in the end I decided to end my career that I loved. It was a sacrifice I made for my mental health. Moving to a small town made me feel safer as did living with my husband and his dad. Glad to report I’ve not had night terrors since (but PMR emerged 18 days after my early retirement at age 55). The body bears the burden and I don’t think it’s a coincidence that I developed an AI condition after several years of living in a /flight/fight/flee mindset constantly triggering cortisol to be released. The stress and paranoia took its toll.
I sending you healing vibes and hoping you have better nights moving forward. Do what you feel you need to while going through this frightening time…extra appointments with your therapist may help.
In my training as a nurse, anesthetist benzodiazepines are not recommended for the elderly. They have been implicated in falls, depression, and dementia.
My mom was on Valium for many years – along with her wine. She became quite depressed. She stopped the wine continued with the benzodiazepines and was still depressed. When I took her to the doctor he asked Me(!) - I guessed based on my training- what he should give her. I said to him what do you usually use for your pati his answer was Remeron a SSRI antidepressant.. I only suggested the lowest dose because of my mom’s age; she was 82 at the time. She did very well on that medication. She took it at bedtime and slept very well. Cognition was sharp as a tack - far better than when she was on a benzodiazepine/wine. She lived to 93 with excellent cognition.
My sister-in-law was recently given Valium, because she was dizzy. Well, along with her wine, she fell into the bathtub and hit her head. She is 82. If it were me and exercise, and other things didn’t work, I personally would take the Remeron.
Hi Karinjaninaz. I didn’t think I would jump in on this thread again but here I am. You are right: it is concerning to grow older and be on benzodiazepines. The medical literature proves this I know. Combining it with wine or any alcohol is a road to disaster. I do not drink for this very reason. I also want to point out that here in USA where I live our state has very strict guidelines for benzodiazepines. We are drug tested every 5 months for other substances ( in our urine). But what I wanted to say is I do not take Clonazapam for sleep. It is for anxiety and muscle pain due to 2 cervical spine surgeries. I also take very low dose Remeron for sleep! It is wonderful. At higher doses it is used for clinically depressed people. Tiny dose acts as an antihistamine and fosters sleep. For those of us with PTSD; a valuable quality of life medication. And I acknowledge that everyone reacts differently to medications. These are my experiences. The abuse I lived with growing up happened at night. I believe brutal memories, stored in our bodies; our very cells, remain forever. Again I remain grateful for medication that helps alongside mindfulness practices. And I’m also aware that some medications will have to be altered as I age(ugh!aging😂)Your post is very informative especially for anyone combining benzodiazepines and alcohol.
Be aware that any benzodiazepine cannot be stopped suddenly for any reason; it will result in seizures as benzodiazepines are also used for seizures.
An acquaintance was taking Xanax for scoliotic back pain several times a day before corrective surgery. When asked how much she took she said “ as needed” which really was several times a day. Then she was scheduled for corrective surgery and did not take her Xanax . She had the surgery and all of a sudden she had seizures. The doctors had no clue until she came clean with her doses. They put her through all kinds of brain imaging until they gave her benzodiazepines. It takes a year of slow tapering( sound familiar) to come off this class of drugs under medical supervision.
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