Catastrophizing Issues

[ClassicalBlueKitty]

On Wednesday my doctor changed my medication again to step down to 50 mg of sertraline from 100 and added 150 mg bupropion. I also had a surprise set of blood tests done and everything looked great... except my liver enzymes. Two of them were high and one was low and all were out of range. I don't drink alcohol at all EVER and only take the occasional ibuprofen. I'm kind of freaking out about the enzymes thing and my doctor just told me not to drink or take a few drugs for 30 days and we will test again. I'm super stressed because I don't know why this would be happening and am afraid of my SSRI damaging my liver (But I only take moderate doses usually, not super high ones). I am afraid of stopping SSRIs because my PTSD and anxiety are almost unbearable. I'm prone to health anxiety because I have asthma and a variety of allergies that I kind of need to be vigilant about. How do I make it 30 days without having a clear plan forward? And what do I do if I find out my liver is really experiencing some sort of disease? It can't be viral hepatitis because my immune markers are perfect, but that also means it could be something chronic or serious. Any ideas for coping or has anyone else had a similar experience?

[LTaloha]

some ssri are less damagin to liver. Maybe ask to switch to these.

[Kinlay]

I am so sorry you are dealing with this! Sertraline is know to potentially cause liver injury. I am confused: did he say to not take it at all or go down to 50? I also don't understand why he would switch you to buproprion, as that one is also a high risk for liver injury. You may want to ask if you can switch to fluoxetine, paroxetine, citalopram, or escitalopram, all of which have lower risk of liver problems.

Be aware that quitting your current meds cold turkey will lead to withdrawal issues, so I'd get a new prescription to start on before going off them, or try weaning down slowly (depending on how off your liver numbers are). I will say that my husband's liver numbers have been high before and his doctor has chosen to just keep an eye on them rather than worry seriously, so it can depend on how far off they are. What I'm seeing with a bit of quick research is that elevated levels often return to normal within a few weeks. I'm also seeing that low levels are rarely a concern at all. This may be why your doctor is waiting to see the result from the next tests.

I would definitely reach out to ask about the liver numbers and exactly how high they are and see if they are simply something to watch (mildly elevated) or something to worry about. You can also do some google searches to learn more on your own. .gov and .org sites are usually pretty reliable, but I always look for two sources before I believe what I read. Hope this helps!

[Goldenlover0730]

So I take a LOT of meds that are detrimental to my brain, and liver. And it is not pleasant to think about at all. And I absolutely catastrophize and obsessively ruminate on all of my health problems. So I get it! But as others have said, there are other options. Lexapro is supposed to be a pretty good one. Try to avoid benzos if you can. Liver enzymes do fluctuate and sometimes they're high, sometimes low. I have had to have my blood monitored like every three months at times to monitor my liver. There are supplements out there that are designed for liver health. Liver Sauce, Liver Health, Liver MD, different brands will help protect your liver. If you are seriously concerned, you can have the doctor do an ultrasound or some sort of imaging to assure you that you are not dying, and in need of a transplant or anything. Good luck!

[mizzou7016]

you make it through the next 30 days because YOU WANT/NEED a clear path forward. You follow the current path.....it will lead to findings and determining where the next road leads...I Catastrophize everything.....so I'm not very good at giving answers.....but I feel that very much