Well, eight months into ADT after SRT, and I am finally confronting the need to hit the Prozac.
A number of years back I went through an extended period of testing circumstances and ended up using Prozac because my GP made the very sensible point that I had a lot of decisions to make and I needed to be in as good a frame of mind as possible to make them. Aside from a bit of weight gain, there were no negatives, and I found them easy to put down when the stressors were past.
I really thought I was coping with the ADT, but my wife tells me i’m not - and she’s right. I honestly don’t recall the last time I was happy, despite having so much ro be grateful for - and I really miss having any joy of living.
There’s no shame in going back to those little aqua capsules - but I would like to know if many of you have needed this assist with ADT too ... those who have effortlessly upped their exercise quotient and sailed through, pls do try to keep the self congratulatory tone to a dull roar... i’m not doing so well on that front lately....
Stuart
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Blackpatch
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Anti depressant meds are VERY effective in lifting mood and give more energy and motivation which can translate into good night time sleep and increased physical activity during daytime. They also give a sense of wellbeing.
However, I would avoid Prozac due to more drug interactions and opt for another serotonin booster such as Escitalopram .
Also If Zytiga is on board, will try to avoid Effexor (venlafaxine) as both Zytiga and Effexor are likely to increase blood pressure. Zoloft, citalopram are also good choices.
Please discuss with your doctor pros and cons of each serotonin boosting anti depressant.
I can't say enough good things about bupropion. It's stimulating and that helps combat fatigue. Studies are showing that it (and other antidepressants) improve survival as a bonus. More at healthunlocked.com/advanced...
Use anything that makes you feel better, my doctor put me on Effexor for the depression and hot flashes. Better but not cured. Live your life the best you can 😀😀🙏
I am in a similar place to you in that I've had past depressive illness and have been on various medications prior to the ravages of androgen deprivation therapy.
I have been exercising very frequently and vigourously and this has kept away most of the black moods and the evidence for exercise is better than the evidence for any of the antidepressants.
I ride a road bike about 160 Km per week , swim 1 to 2 km per week and do 2 to 3 gym sessions per week.
The difference between Prozac and other SSRIs is minimal but they do have some difference in interactions and slight changes in side-effect profiles.
If Prozac doesn't work to help you then it is unlikely that any of the other SSRIs will either.
I believe that some of the feelings that we get without testosterone are not classic depression but can masquerade as such.
I notice for instance that I don't think I'm depressed but I cannot feel the exquisite joy that I used to feel with contact with my loved ones.
I am enjoying life mostly and I am able to laugh and have a joke and get on with things but that intense exquisite joy that I used to experience, for instance hugging my children, or their partners just doesn't work.
I get a tiny flash of it and then it disappears. I am attempting to see if there are medications that will bring it back at the suggestion of a psychiatrist who agrees that I'm not depressed so I am trying an unusual antidepressant.
I think it has helped me sleep a little better because my sleep has been completely disrupted with the sweats and body clock changes that go with ADT.
I am not convinced yet that the medication has worked to make me experience that joy again but I will persist.
Agomelatine is the medication and I have increased it at the advice of my psychiatrist to the maximum dose, that is two 25mg tablets a day.
It can cause liver problems but hasn't for me.
If the effect on my depletion of joy is a direct effect of ADT that means it's a chemical affect so therefore maybe it can be reversed with another chemical.
I miss testosterone so much and I would much prefer the side effects of chemo or Lutemium PSMA which I have had.
No testosterone is so life altering and in my view under acknowledged in its devastating effects on quality of life.
Thank you for your thoughtful reply, and indeed to all the others that have replied.
I agree that this is not classic depression - i’m not sure i’ve really ever been depressed in a clinical sense. My previous episode was just a rational response to a massive impost - too complex to describe here, but it crossed several continents and cost me five years of my life and many millions of dollars - but I did manage to come out on top in the end, and the ability to enjoy life that i’d lost as a result of what honestly felt like physical hammer blows, returned.
In the current situation, I am again suffering the loss of “joy” - and it just has to be the ADT. Sure, PCa is no fun, but I have it on the run - the problem is much more chemical than it is a stress response.
Regrettably, Prozac is my only choice - almost every other anti-depressant has been shown to have some impact on platelet levels - even the non-SSRI types. Prozac drops my platelets too, but not by much. They went down to 9 when I started taking it some years ago but gradually equilibrated back up to around 20... and that’s about where they’re sitting with the impact of the Zytiga and statins I’m taking, so even the Prozac will be a risk.
Metungboy, it’s a while since you posted - how are you doing these days? Maybe we should form an Australian chapter of this thing and hold a local get together one of these days..... would be good to actually meet some of these weird names IRL...
I tried an antidepressant for the hot flashes only, the side effects was worse from the meds so I stopped. The only side effect from ADT is the hot flashes, I still work part time, walk daily for excercise, energy level is normal and feel good. Not depressed about the lupron, thank God every day for it as it has stopped the cancer and will give me years, a small price is the hot flashes . A co worker jokes about putting a heater/ac around my neck so I can regulate the temperature. Live on and strong.
I had nausea, headache, tiredness, sleepy all day, brain fog and lack of interest in anything. All went away after stopping it, made sure I stopped so I had no withdrawal symptoms as I stopped before system was hooked on it. Was never depressed and can live with the hot flashes.
If it's any help... I'm no stranger to antidepressant meds and I am worried about whether or not I can maintain a reasonable mood when I DO go on ADT... Depression is real and saps the strength you need to get on with the business of living.... In particular it robs mental acuity and leads to poor decisions or putting OFF important decisions... don't hesitate to use them... there is no percentage in "toughing it out" If they helped you in the past the odds are they will help again.
Good morning Blackpatch. Just share with you our experience but I know everyone's different. My husband's prostrate specialist has always been worried about his mental health mainly due to the many traumas and dramas he experienced from November 2015 until January 2018...various problems and complications after his prostrate removal. Also he's a very private person and doesn't volunteer communicaiton so this added to the specialists concerns. His specialist also wouldn't prescribe hormones due to concerns about his mental health. However, he convinced him to start Zoloft (50mg) and I'd have to say he's much better, says he notices the difference and coping very well with Lupron. He probably has far too many wines starting about mid morning but that's his way of managing. He has lost weight thanks to the pre-diabetic tablets (Metaforin...think that's the spelling) and the Lupron Man Plan exercise physiology classes. So from our experience I'd say Zyloft is a great way to see if things seem better even if they aren't in reality. Hope you have a similar success 🙂
In late 2014 I was assigned 24 mos ADT. Physically, I was miserable starting at about the 1-month mark, but I was OK emotionally until about 8 months, at which point I was capable of little else that sitting in my home office with the door shut and crying. I had become so depressed that I desperately wanted to die.
I quit 12 months in, as I was sick of the anger I felt ever morning I woke up and realized I hadn't died in my sleep. My MO tried to talk me out of it, but backed down when he realized I was far more likely to die of a self-inflicted gunshot wound than I was of PCa.
My T came back in about 5 months, but I was still depressed..until about 6 months after that, when I was able to see a psychiatrist in my network who prescribed an antidepressant called Viibryd, and I felt better almost immediately; it was borderline miraculous.
Initially I was reluctant to take a drug, but then I realized that Lupron is a highly toxic chemical, and dealing with it without another chemical is fruitless.
I happened to get a DNA test years later that showed that Viibryd was one of 3 out of about 25 total antidepressants that would be effective given my genetic make-up; in other words, I had simply gotten lucky.
Bottom line: I highly recommend the DNA test and the indicated antidepressant.
Good luck.
Well Sir ! I Read that 1/5 th of Americans are on a mood drugs another 1/5 are on cholesterol meds .
My testosterone just hit 235 after over a year and a half of around 100. In the last two months it went to 165 and this month a big jump to 235. Not a lot of energy but way better than at below 100 level.
• in reply to
3 T for me for over six years ? Ouch . I don’t even know what t is anymore . I’ve followed you since your inception here . Good luck in Omaha!
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I’m not feeling the big move mine has made. Maybe energy doesn’t come back as fast as the T level. Of course now I’m waiting for the psa to start up
Well, I buckled after 8 months of Zytiga but stuck with the Goserelin for the full 12 months - the original plan was 18 - 24 months but I couldn't persuade myself that the minor additional risk reduction justified the extra time. T took 6 months to begin recovering and another three months to get back to full strength. My mood started recovering soon after the last ADT shot wore off and I think it's fair to say that as things stand today, I'm about as "happy" as I have ever been. The PCa is in abeyance, but my extra-high Decipher score and pT3b pathology tells me that in all likelihood it will return some day.
As I read about others on this site, almost all of whom have more advanced disease than me, I am constantly reminded that PCa strikes most of us fairly late in life (I was 61 when diagnosed four years ago) so there are often other health- and life-issues happening anyway - I think ADT significantly impacts our ability to cope with the non-PCa stuff. In my own case, as a result of PCa-related scans, I discovered that I have fibrosis in my lungs - this usually kills you within a few years but having discovered it early, I am on a drug that is supposed to slow progression - I feel fine, but it's another thing hanging over me.
And since I'm being honest, I guess I have also had to confront weaknesses in my marriage that PCa has exposed - I read about men whose wives are their reason for going on, and indeed many of those posting here are those wives - in my case, PCa has damaged our relationship and I am gradually coming to resent the lack of support.
So, in answer to your question... I'm doing fine, but would really like to be 20 years younger and dealing with all the issues life throws at younger men, rather than having to cope with health and relationship stuff... but I'll get through...
Since I am new to this site I kinda like to see how things are with people… some have been doing well for years… while others are no longer with us…glad you are hanging in there…
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