Taking Antidepressants post transplant

[GardnerADK]

My spouse is 5.5 years post transplant and his depression has worsened alot since covid19 arrived March 2020. Curious if anyone is taking any kind of medication for depression. Thanks for responding. Be specific if you would. I've done my own medical journal reading research and many anti depressant medications interact in a negative way with antirejection medications.

[PostivelyJo]

if after feedback you feel that antidepressants might add to the burden of drugs or side effects I would suggest movement through exercise dance walking etc as hugely beneficial for emotional well being .

I’ve been on antidepressants , prior to transplant, for a brief spell of 6 months. It did give my mind a (synthetic I felt) rest from repeated negative thought but wasn’t a long term solution (for me ) and it came with unexpected side effects ( for me ) of weight gain and loss of sex drive . It also takes time to taper off the drug which can be alarming …

So … from my experience exercise , diet and a good therapy have had better far reaching long term benefits..

Kind regards

[Gardner-NY in reply to PostivelyJo]

Thanks for writing me back your life experience and your honesty. Since the 11/2018 transplant for 14 months my spouse had so many serious problems with the transplant and Jan 2020 received his first good blood chemistry labs. By then he was almost a couch potato due to all the serious problems and major hemoglobin problems that took a long time to resolve with injections I gave him. He tells me now , he never recovered from all that. He has never taken up an exercise program even with my gentle encouragement. Then covid19 arrived 6 wks after his first good blood lab and seeing any doctor was not possible except through a phone. Long story short here, the new issue is now with his diabetic problems and new insulins being pushed on him when the prior ones worked great. Now he's having side effects with the new one he was forced to use. It is like since the surgery of transplant he has yet to have a 'normal' healthy day to feel good. I could go on, but my prior posts on this topic are on HealthUnlocked. I appreciate your writing me.

[Winner76]

Hi,

I’m on anti depressants a long time now. My anxiety got out of hand after a failed transplant in 2016. I had a successful transplant in 2020. My doctor actually said he doesn’t know many patients going through dialysis , transplants that are not on anti depressants. He could start with a low dose and go from there .he needs to stick with them and take them every day he should see a change in a couple of weeks.

Good luck

[Gardner-NY in reply to Winner76]

Thanks for writing me Winner76. From my research on anti depressants and taking anti rejection medications, the depressant drugs often cause problems with the rejection meds and how they work in the body. My spouse with kidney transplant 11/2018 does not have anxiety or panic episodes. I read many medical journal articles from my online university library about this and to find answers to other questions; and finding that many people that need an organ transplant or obtain one are depressed often for assorted reasons. Thanks for sharing your story and glad you are doing so well now.

[LisaSnow in reply to Gardner-NY]

Antidepressants and transplant immunosuppressants do not have adverse interactions. Importantly, if depression is not treated, the transplant patients are far less likely to recover to a pre-ESRD state, both in physical and in mental health.

[GardnerADK]

Thanks for writing me about this topic LisaSnow.

[ShyeLoverDoctor]

It must be very difficult to see your spouse suffering. I’m sorry to hear it.

I’ve been on anti-depressants since I was 18 years old. I’m on a 4 med combination that took years to get right. I’d rather not share the brand names since everyone is different, but I can tell you none of them changed since the transplant, I assure you.

I attend a weekly post-transplant support group online which is enormously helpful. Please see if your hospital does this.

Depression is treatable. And even a short ten minute walk can help boost mood.

You don’t need an “exercise program” all you have to do is walk. Walk, that’s it. Go for a walk together!

And, while it’s lovely that we have the internet to do research - back away from Dr. Google and take your spouse to a psychiatrist and ask to sit in on the appointment. Enough. Let the doctor make that call about interactions. Bring a list of current meds to the appointment.

There are a lot of meds that can be tried. Don’t get caught up in “this might cause that” and use it as an excuse not to try. No one should be suffering from treatable depression and not taking medication if it might be helpful to them and they are willing.

I’m a little puzzled by this change in diabetes medication. Usually insurance companies prefer the older cheaper drugs. I know there have been drug shortages. Go see the doctor and ask them to explain their reasoning. Change doctors if you have to. Or file an appeal with the insurance company to get the old drug , or have the doctor file it. Sometimes insurance companies make you “fail” at one drug before granting approval for another.

[GardnerADK in reply to ShyeLoverDoctor]

Hi , Thanks so much for your caring spirits. The diabetic medication is no longer manufactured any more that he took 12 yrs and it worked great. The new one he's taking (he takes a different insulin shot before meals, which is fine), but this long time last of the day before bedtime one is not working well. That's a recent find and I'm sure he'll get it figured out with his dr. WE still live isolated like March 2020 and take it seriously. He has no immunity from covid19 and people I know let me know they have it recently or just go over it, it is not 'gone' like the general public thinks. My spouse is anti counselor and anti taking "another" medication to try. He's on 15 a day already, 4X a day most of them.

The taking a walk with me is complicated and he won't do it. Too long of a story to explain, just believe me. WE 've been married over 45 yrs and the past 5.5 yrs have been extremely difficult. He had cancer 35 yrs ago and chemo 9 months long and he tells his dr that journey was a picnic compared to all he's endured with transplant problems. He has many side effects from the antirejection meds too and they have been changed and doseages changed too without success. The organ works well and that is the focus for the doctors, not the 'entire person'. He is just exhausted with all he's endured. Anyway, thanks alot for writing. It means alot.

[ShyeLoverDoctor in reply to GardnerADK]

What rotten luck they stopped making that medicine!

I was sad when I walked into the blood draw lab today and all the free masks were gone and no sign saying masks required. At least my doctor’s office still has it.

transplant is supposed to improve our lives but of course there’s a chance it does not.

I’m sorry he is anti-therapy. I sometimes give people this book who might consider therapy.

Are you in the US? There’s a new long acting monoclonal antibody called pemgarda supposed to provide some immunity to covid-19 for people with moderate to severely immuncompromised systems. I want it really badly but no one has it.

It is sad when some chronically ill people just give up on trying something new that it might help, I know two other people like this.

Book by Collette Dowling “You mean I don’t have to feel this way?_

[GardnerADK in reply to ShyeLoverDoctor]

Thanks for your caring spirit and this book. My spouse journey about 2 months after the transplant surgery and lasted 14 months was assorted serious problems 'medically' including a rejection of organ, hemoglobin not being produced in body so I had to give him a shot 3X a week for 8 months, and CMV virus to deal with. Jan 21,2020 his blood labs were good for the first time ever and covid19 arrived around 6 wks later. During the 14 months, he was close to being a couch potato due to all the problems, drug changes, and more. Now it is Jun 2024 and he tells me the hemoglobin causing severe energy issues he really never got over that. His body took a beating physically and emotionally. Now we see the meds he takes for antirejection that have been tweaked in doseage and type for the first 2 yrs we think is the main issue for how he feels so fatigued, depression, mood swings to name a few. We both feel we were not told that a low %, but some people choosing the path of kidney transplant, have ongoing for years bad side effects from the drugs stay with them. I work at a college and keep up on using their online library to read medical journals to my questions and one recent one was about fatigue. The article was 2021 and basically it said that there are too many people after kidney transplant that have fatigue and depression and the medical community has not done enough research on this to find out what the patient's body will be challenged with after transplant is done due to years of what their body went through before the surgery. I agree with this after seeing how my spouse has been doing the past over 5 yrs. The drug "Pemgarda" FDa approved in March 2024 for a monoclonal for covid19 : I did my own research and the number of people in the study was not high enough for my /our comfort and the infusion sessions every 3 months side effects for some was allergic reaction quite severe . I spouse and I were dismayed at the very low number of people in the study; also it is difficult to locate the medication for people desiring to try it. So we just prefer to not go down this road. We are both exhausted emotionally over the transplant results of quality of life he did not receive and more. I appreciate your writing though. I wish you all the best in life.

[littlelinda50]

The immune suppressant can cause depression and if you had depression before being on them it can make it worse. What you have to do is find what works for your spouse. The best thing is that your spouse has you to be there but having a therapist can help too. Someone to tell all the things going on because sometimes having someone outside your circle to talk to helps a lot. Taking walks can actually help a lot, writing things down, and listening to music. There is way to get back to normal or a new normal just sometimes to get there the road has a lot of twists and turns. Good luck and big hugs

[GardnerADK]

Thanks for all you wrote which we already know about. Thanks for caring. He refuses to see a counselor for anything the past over 40 yrs of marriage including now. I could write more, but prefer not to. Thanks for caring. gina

[PKDPostXplant2020]

I was already on fluoxetine for seasonal depression for a few years prior to transplant. The immunosuppressants DEFINITELY caused serious depression for me, which KNOWING it was the meds helped me work through it until I could find a viable answer. I added Vraylar every other night, which is one of the fairly new "add on" meds. It's actually made a HUGE difference for myself. I think of the Vraylar as the "icing on the cake"! The fluoxetine was definitely helping me, but not enough. It's really about finding something that works and you're comfortable with. Hang in there and I think most of the "SSRI" type antidepressants and the likes are safe with the meds we already take, so there are plenty of options your provider can help you with. 🙏🏼💚

[GardnerADK in reply to PKDPostXplant2020]

Thanks for writing about your experience.