Anti depressant question

Hi Guys,
So most of you know that I lost my husband suddenly about 2 years ago. It seems as though the grief has just really started to hit me and I know that I am showing the symptoms of depression.

I had depression for a couple of years about 6 years ago and I feel the same way, feel hopeless, lacking in motivation, not enjoying the things I usually like to do, tearful and very low in mood, zero libido

my question is, do we need a higher dose of anti depressant due to our malabsorption ? I took 4omg prozac before and it worked well with little side effects. As you can imagine I am keen to avoid an anti depressant that increases appetite and causes weight gain or one that has discontinuation problems. I couldnt get a doc's appt till monday afternoon and I'd like to go armed with all the relevant info

Thanks in advance for your advice guys

Yorkie x

 Yorkie 

I recently started back on antidepressants again. I am taking Paxil 10 mg twice a day. My pcp figures that if I have less absorption then it would be smarter to do the same with my Paxil as I do with my calcium and some other vites. 

Thanks Kristina, why didnt I think of that lol

Do you have any side effects with the Paxil?

Yorkie xx

 My only real side affect that I've noticed is a major decrease in appetite. I've been lucky if I get in 1000 calories a day (that's including 2 double scoop protein shakes). I remember last time I took Paxil that the decreased appetite lasted for about 2 months and then my appetite was back to normal. So, I'm not stressed about it. I just remind myself every couple hours I need a protein snack  for now.

For all the lurkers out there, I want to point out that the much more common effect from Paxil is weight gain.  I'm no doctor, but IMHO depressed folks with excess weight shoud try some other antidepressant meds before Paxil.  All the same, I'm glad it's working great for you and you have still lost while on it.

I was on antidepressants before I had my DS and I still take them (20 mgs of Lexapro).  My doctor didn't say anything about having to increase the dose or anything like that.  In fact, it's the same medicine she gives DS'ers right after surger (altho she gives 10 mgs). 

I'm so sorry for your loss.  My thoughts and prayers are with you.  I started battling depression when my father passed away when I was 15.  I didn't realize then that I was depressed.  I just thought I was sad because my dad died.  I let it go and let it go and let it go.  Finally had a breakdown when I was 29 and was diagnosed as clinically depressed.  I'm almost 36 now and not a day goes by that I don't take my "happy pill".  I don't know your feelings about it, but there is certainly no shame in taking medication for depression. When you get a sinus infection...you go to the doctor and get medicine to help you get better.  When you need to lose weight...you go to a surgeon and have the DS!!!  Depression is a medical thing.  It's a chemical imbalance in your brain.  You just need a little help to straighten it all out.  You may only need them for a short while.  My grandma took them for about a year after my dad died.  Or you may need them more long term, like yours truly.  All in all, you deserve to be happy.  I'm a Christian.  I don't believe it's the Lord's will for you to be so down.  He hurts with you now and wants to rejoice with you again.  You're not alone.  Praying for you....

Yorkie - I have struggled with depression for many, many years and have been on many different meds.  I've been working with a psychiatrist (in addition to my therapist) since my surgey in March of this year.  Until a couple of weeks ago, she had me on regular Wellbutrin (twice a day) and Sertraline (Zoloft) once a day.  I had been on Wellbutrin SR before surgery, but she immediately put me on regular due to the malabsorption issue with sustained release.

About a month to 6 weeks ago, I really felt I was in a pretty deep depressive episode and so made arrangements to see my Psychiatrist before my regular appointment.  She brought up the idea of switching to LIQUID Zoloft, rather than the tablet, so malabsorption wouldn't be an issue.  Of course, I won't really begin to feel the effects for 4 to 6 weeks, so I can't tell you if it will work, but I'm optimistic.

She also has me on Adderall to combat the lethargy, with mixed results.

None of these three meds are known to cause weight gain.  At worst, Zoloft is considered weight neutral.

Hope this helps!!

Donna

Thanks, I appreciate the info and you sharing this with me
Yorkie xx

I'll advocate for the Zoloft too, it was the first med my Dr. tried me on when I was diagnosed 10 years ago, exactly because it didn't cause weight gain. It has worked beautifully.

I've had to up my dose from 100mg originally, to 150 right after pregnancy and then 200 now post-DS with all of our hormone issues when losing weight.
 
I may have to add in an anti-anxiety med soon, as my Zoloft alone just isn't cutting it right now.  Tried Klonopin (clonazepam), didn't really work... any recommendations, anyone?

But still, over the years I've tried other meds, because of what insurance would cover, etc, but always returned to Zoloft. And now that I know it comes in liquid form (yay! Thank you so much!), I'll be requesting that from now on, because I believe that part of my problems are also because I'm just not absorbing as much of it as before.

At the end of the day, good luck, feel better, and we love you, Yorkie! Depression sucks monkey balls.

That's cool that 40 mg Prozac worked in the past for you, and it's also good news in that you have room within normal dosing to go up from there.  Plus, doctors who prescribe antidepressants tend to be very comfortable prescribing Prozac.  So, you could try 20 mg for a while, then go up to 40 mg and see how it goes.  If not enough improvement, you could go to 60 mg a day.  It looks like you could even go up to 80 mg.  If that's not enough, they would probably want you to add in another med or switch meds (although, I am on 400 mg of desipramine, when the usual upper limit is 300 mg/day).  I couldn't get a cut & paste to work, but the manufacturer's prescribing guidance for Prozac when used for major depressive disorder is at the beginning of pg 5 of this .pdf pi.lilly.com/us/prozac.pdf .