Posted by cellular on January 21, 2013, at 21:01:29
In reply to Re: Corticosteroids and Relief from Depression, posted by linkadge on January 21, 2013, at 19:34:26
Thank you for replying, Linkadge.
> Prednisone can have a stimulant like effect - releasing dopamine and norepinephrine.
That I didn't know, and I'll try to find out more about its dopamine- and norepinephrine-releasing effects.
> It appears your depression symptoms are atypical. The combination of an SSRI and antipsychotic may not be the best for you at this time. SSRIs alone can induce fatigue, apathy. Antipsychotics might increase this.
Part of the intended or side effects of the SSRI sertraline though is a certain kind of apathy which has been freeing my mind from suicidal thoughts for over ten years now. Sertraline saved my life, literally, so I can't do without it.
> Some ideas / options:
> - switch to (or add) something more stimulating (wellbutrin, desipramine, clomipramine)Adding something stimulating would most probably result in me being more irritable and susceptible to the debilitating effects of over-sensitivity when buying groceries or having to go somewhere else with people around me. My anxiety level already rises when I'm fit enough to leave my apartment and decide to go outside.
What might be suitable is a stimulating med that leads to short-term (daily) relief when I'm at home, so that I can skip that med whenever I need to leave home.> - check vitamin D and b12 status
Definitely no problem, since I've been taking both D and a vitamin B-complex for many years.
> - add some chromium (good for atypical depression)
Chromium being a trace mineral, I'm reluctant to think about taking a daily supplement of it. My diet is relatively well-balanced and I doubt that extra chromium is necessary.
> - caffiene augmentationI use caffeine every day, but it doesn't have the sort of antidepressant effect that prednisolone provides.
> - ditch the antipsychotic if the depression is not psychotic (add a 'Z' drug if sleep is the issue)
I do have a psychotic-related diagnosis, but typically I believe that what I hear (insults and negative comments when people are around me) is actual and relates to me, and I don't accept it as a form of delusion which my pdoc seems to imply that it is.
> -switch the zoloft to imipramine or fluvoxamine (these drugs have partial glucocorticoid agonist activity)
That's certainly interesting, and I'll look into that option.
> - bright morning light
That certainly helps, but most of the time I don't even have the drive to go outside at all, let alone in the morning when I usually sleep best.
> - partial sleep deprivation
Tried it, but doesn't work for me.
> Linkadge
Thank you once more for your suggestions and I'll do some research on two of your tips.
cellular
poster:cellular
thread:1036019
URL: http://www.dr-bob.org/babble/20130112/msgs/1036030.html