After an initial few months of positive improvements in every sector, my guy started into a mental health/cognitive decline to the point where he is now dependent on gabapentin he takes for other reasons in order to maintain any emotional stability. He says his short term memory is also getting worse again, as it was when he was on the lupron. He has become very reactive to incidents that would not have caused such reactivity in the past.
Has anyone else had emotional/mental health/cognitive decline after stopping the ADT drugs? If so, how has he approached getting a handle on this? I would add in that I think he is also carrying at least a moderate depression, but it is hard to tease out exactly what is going on from my perspective and pushing too hard for answers isn't the best strategy until I know what I am asking and why, and choose to fight that battle.
Do any docs or psychiatrists specialize in post-treatment mental health management?
thx.
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lss65
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I'm very supportive of psychotherapy and psych meds. I never heard of this kind of rebound effect, but it is very common for a cancer diagnosis to cause anxiety and depression. I wish that love were enough, but it isn't.
I too am having mental issues with my treatment. Being a prideful, "macho" man I was hesitant to take drugs for my mental state until one of my female friends said "you are miserable, take the meds because that's what you would tell me" My life is back in order again
he is undetectable and has been for 2 years. Thank you for focusing me on the depression - I think you are right, that is the culprit creating this other residue of instability. his testosterone is building back up, he can see evidence, but doesn't know his level. the other huge issue is that he has a lot of life problems he now has to face that he was able to ignore while in heavy treatment - and he doesn't have the kind of skills necessary for handling some of them. I hadn't thought about being overwhelmed with these life issues leading to a depression - but yes that makes perfect sense. thank you for this. I think if he gets medication help for depression he then may be willing to talk with someone, but where his mood currently is, he couldn't make use of it, and wouldn't motivate to go.
and to mrscruffy, yes he would tell me to take meds if I needed to. hadn't thought about it from that angle before.
thank you for bringing it up - he was using it for pain, and I think has stopped, but still uses CBD oil to keep gout at bay. I will ask him what is going on with the cannabis. he knows I'm not generally a fan of it, so tries not to use it in my presence, even when its medically related.
i think he smoked it, and puts the cbd oil in food (cannabutter). he's been having a lot of pain from neuralgia secondary to shingles, and it could be when the gabapentin isn't sufficient he goes to cannabis. I'll explore. thx.
we had a very good summer, but then he started unraveling in September. He has been using a lot of herbals that have helped his fatigue, but was worried that his adrenal function didn't seem to be coming back enough for him to be able to handle the stresses that unfortunately got heaped on top of him. I do think the depression is maybe the biggest issue right now, and I hadn't focused on that. That and recognizing his ability to handle as much as he used to do just won't be coming back, and he'll have to make accommodations for that.
It sounds like the a lot of possible culprits here--depression, various substances (either their use or stopping their use), etc. For example Gabapentin can cause irritability or contribute to memory loss. But I'm no doctor. And it is also possible that something completely unrelated to the cancer or its treatment could be causing or contributing to these problems. You ask if any psychiatrists specialize in post-treatment problems like this. That would be a good question to ask your clinic or a mental health specialist. Sometimes "specialties" like that aren't formal, but some counselors or psychiatrists will have practices concentrating on certain kinds of experiences or problems because of their own interests, skills, or experience much as, for example, some have more experience or interest in helping with grief. Ask around.
There's a lot going on. He might be expecting to be better than it is. I've been off Eligard ADT for a year. I'm better but nowhere near my old self. I am also of the opinion that, no matter what, it takes a year. A year to recover from surgery. Plan on staying on an antidepressant for at least a year. He does sound depressed and would benefit from seeing a psychiatrist. Re: gabapentin. It is a weird drug. Dose is very person dependent. Some people fall asleep on 100 mg; others only get benefits from 3200 mg. It can make a person seem demented with bad memory. It can help with pain but more isn't necessarily better. Some antidepressants also help with pain- duloxetine aka Cymbalta. As my uro pointed out ADT does to the brain what it does to the body. It's a hard road no matter how far we go. Best wishes to you both. Mike
I did the treatment for two years my wife left me about a year and a half in I couldn't drive anymore because I'd stop at the stoplight not know why I was there hardest two years of my life. And I honestly can't remember most of those two years and that was two years ago when I finished but I got two years of no PSA now after a year off I am back on zytiga The quality of life is starting to be a problem and there for a while you just get tired I think the treatment is not for children I'll tell you that much I wish him the best but it is very hard
Isnt that memmory loss strange i have same prob.....can remember years ago...but ive told my wife that its as if the adf make evrything in the present....and even hrs after ....cannot recall ....and it aint" youre getting old"..... i dont think im a danger to society yet....but i do add to lifes amusement......
I went on antidepressants 23 months after ADT was over, because I was still horribly depressed. I'm much better now, but I still cry far more than I did before. As you said, it's hard to "tease out" the emotional lability from the hardcore depression.
My point is that, for me at least, this particular SE of ADT appears to be permanent.
Sometimes it can be the effects of the drugs or procedures. Sometimes it's just realizing as each day goes by we are closer to using up our options.
It's often necessary to live in denial a part of the time to be able to fight off depression and carry on.
The effects of the drugs on our body, mind, and memory are often depressing.
Realizing the effects stack up one upon another becomes depressing.
Sometimes I got angry when my wife assumed I'm always confused, but I'm getting it right sometimes and sometimes she wrong. And we fight over who's right. I guess you call that being treated more like a child.
Cost and finances can become very depressing, and constantly fighting with the insurance company for coverage, fighting denials, their phone systems, not returning calls and ignoring you, being on hold forever and then being hung up on.
Sometimes it's just realizing the insurance companies don't give a damn about your health, and would rather you die quietly.
Sometimes is realizing your state legislatures pass laws against consumers preventing you from getting fair compensation. If you were the victim of mal practice.
Perhaps it's feeling you have no option but to work through the cancer when you want to try to salvage your remaining time and live your remaining years differently.
There are lots of reason to be upset or depressed. But perhaps having control over how you spend that remaining time is what is often needed.
Cognitive changes have been reported in primary adrenal insufficiency/Addison's. This does raise the possibility of continued absence of full adrenal recovery from the Abiraterone. You may want to discuss endocrine evaluation with you primary care or medical oncologist.
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