Antidepressants - getting the balance right

[Hetty56]

My son (aged 23) has been on antidepressants for about a year (his tbi happened 18 months ago). His GP is wonderful but has struggled to find antidepressants that do their job without huge side effects. He’s been taking Mirtazapine and Citalopram which seemed to be having the desired effect but cause extreme fatigue. Because of this he’s decided to cut down not only on one but on both and this is not working. He has a doctors appointment next Friday so could any of you lovely people tell me what you take, about whether they work and the side effects. I’m really concerned that by cutting everything out he’s going to undo all the good work he’s done so far

[Hidden]

We never found Citolopram caused fatigue. The fatigue could just be part of his bi, not the pills?

[cat3]

Hetty, the fatigue (as mentioned by Jan) is more than likely a result of your son's BI ; it's the most commonplace after-effect of brain injury and an indication of the brain's need for slowing down, especially in the first couple of years.

The effects of antidepressants are notoriously difficult to predict on any particular person owing to everyone's unique brain chemistry, so what works for one can be ineffective for another. Same with side-effects ; I tried many different ones over a period of 12 months with some horrible and persistent symptoms such as severe dizziness, rattling noises in the head and severe light phobia.

But after starting on Seroxat (Paroxetine) I was free of symptoms within only a few days and haven't looked back ; that was 30 years ago. My daughter was prescribed them after chronic post natal depression and but could hardly function for several weeks 'til she finally had them changed to Citalopram...……...one of the ones I'd tried and which gave me none-stop violent headaches ! ……….so you see my point...😕

So I'm afraid it's trial & error, and it can be a lengthy business when each one needs perseverance for several weeks to give the assimilation process chance to work....or not. Is it possible that your son needs to lower his expectations energy-wise and accept the new limitations of his injured brain. It's one of the hardest challenges, but something we've all managed to make the mistake of underestimating one way or another.

I hope your son can 'tailor' both his meds and expectations and reach a (reasonably) happy medium. It might help a little if he takes the ADs at bedtime ? Best wishes to you both.... Cat x

[Hetty56 in reply to cat3]

Thank you Cat x we need to be aware of what you and Jan said about the fatigue being as a result of his BI - it’s always easy to forget about that. Thinking of it though he was very fatigued in the early days so it would make sense that it still has an impact - luckily it’s not as bad as in the early days though.

It’s good to hear your own experience but being an impetuous 23 year old Sam just wants to get on with life - in the past he’s tried different meds and given up on them after a short period of time. I always tell him to read my posts and the replies - thank you for your advice yet again

Xx

[cat3 in reply to Hetty56]

Yes I can understand how frustrating it must be for someone so young to be told they need to accept limitations ; it's upsetting enough for seniors who've lived previously active/productive lives.

But it needs to be treated as a grieving process of which there are many stages...….disbelief, anger, heartache and, hopefully/finally adaptation and a new will to find fulfillment in a different but still worthwhile way of life.

Good luck to your son in reaching his personal equilibrium, and all best wishes to you both Hetty. x

[neilhapgood]

Hi hetty,

I tried fluoxetine for a while, whilst it did give me longer spells of feeling 'good' I was aware it was never getting to the root of the problem and giving me back a sense of self which was what I so desperately wanted, in fact I thought it was hindering this as I wanted some cause and effect in terms of how I reacted to situations where as the anti depressants would cause me to have spikes of happiness out of proportion to the situation.

after some time I learned that the root of a lot of my issues were related to trauma so I found some ways of addressing this. I put some info into a website that may be of interest. Www.braininjuryftp.com.

I really wish you all the best, I had my brain injury at 32, I can't imagine how tough it must be at 23, your personality is still developing at that age.

Thinking of you both

Neil

[Hetty56 in reply to neilhapgood]

Bless you and thank you - I’m definitely going to look st your website xx

[Danger19]

Hello my lovely,

I was diagnosed with Bipolar Affective Disorder in 2011. I’ll be honest, there is not a lot of antidepressants that I have not been on at one point or another. Not every medication had the desired effect but I don’t know what life would be like without the medication I have now. I have been taking my current antidepressants for five years and I would rather die than change what I currently take.

I take 150mg Lamotrigine, 120mgs Duloxetine, 45mg Mitazipine and I also take 300mgs Pregablin. Pregablin is for Neropathic pain but is good for anxiety, it is commonly used to combat symptoms of depression. I do not experience any side effects from my medication before or after my traumatic brain injury.

I really hope I have been of help and I sincerely hope your son is eventually given a medication that works for him without any negative side effects. Ensure that he knows he is not alone, there are plenty of people that understand what he is going through, especially me!

I wish you all peace, happiness, good health and a whole lot of luck,

Vikki

[Hetty56 in reply to Danger19]

Thank you Vikki - for your advice and your good wishes. I hope you continue to do well.

Heather x

[pinkvision]

Hi Hetty 56

I was wondering why your son is on antidepressants so I read your other posts. Is your son still working a full time job and doing all the other activities? It could be that he is doing too much and needs to slow down or stop for a while and try to recover from the brain injury. He may not be depressed at all and the anti-depressants are just making everything worse.

Is he depressed because the brain injury symptoms are getting in the way of life?

This may sound a bit harsh but I think he needs to focus on the brain injury issues before taking anti-depressants.

Understand how the brain injury works first, accept it and adapt.

[Hetty56 in reply to pinkvision]

That’s really interesting and something to think about and discuss with Sam. Thank you x

[Irmina1983]

Everyone reacts different to the medicines. I take Venlafaxine 75ER. And it works for me without any side effects but how I said everyone is different

[Richdp]

Hi Hetty, my tbi was eight years ago and I'm still on antidepressants. In fact I was taking antidepressants prior to my tbi, so I've been prone to depression anyway. citalopram was what I was taking a couple of years prior to my injury and I had no side effects of fatigue back then. I was also taking citalopram after my tbi and then something called ecitalopram, which is a bit stronger than citalopram. So as exausted wife says, brain injuries carry the side effect of fatigue/chronic fatigue! For this reason my neuropyciatrist tried me on something called Venlaflaxin which I've been on ever since. It gives a bit of a boost against the fatigue. Maybe you should ask your son's doctor about that,

I hope your son finds something that's suited to him. Best of luck!

[Hmc94]

Those are the go to ones to be honest. Fluoxetine is another one, for the first 2 weeks it can make your mood lower but my advice is to persevere because it’s worth it after 4-6 weeks x

[Hetty56 in reply to Hmc94]

Thank you x