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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by CK1 on May 1, 2005, at 11:05:15
Hi all,
I am a college student and was on Paxil (10mg) for 3 years and it worked great until January when it lost it's effectiveness. Since then, I have tried Effexor, Zoloft, and now am on Lamictal (25mg) and Prozac (10mg), but still not feeling like I did on Paxil (when it worked). BTW, 20mg of Prozac made me worse and 50mg of Lamictal made me aggressive, so higher doses are not an option for me.
I have been on Advair (250/50) for VERY mild asthma since January (when my depression started AND when Paxil lost it's effectiveness) and just read an article in a magazine about Asthma Meds (corticosteroids and serevent) worsening depression and anxiety. The packaging of this product looks harmless so I never suspected this "steroid" to have any serious side effects. After reading the article, I did a search on the internet and found over 100 posts of people experiencing depression after starting Advair. It is also listed in the side effect chart of the med. ALSO, I read posts where patients antidepressants suddenly didn't work anymore after starting a corticosteroid like Advair?! I'm 21, in good shape, and work out 5 times a week, but, since I started Advair, my muscles hurt all the time, I have pain/numbness on the left side of my face, and nothing is touching my depression/anxiety. I am normally NOT a hypochondriac and I strongly think this Advair b#@sh#! is causing these unexplainable problems. I know SSRI's stop working after awhile and I know I had anxiety before starting Advair, but I'm wondering if this has complicated things and potentially "worsened" my condition. Also, I know Pregnisone (steroid) caused my aunt to go crazy until she got off. Advair IS a steroid like Pregnisone although at a much lower dose, but they still cause problems.I'm getting off this stuff and seeing what happens. Anyone else with similar experiences?
Posted by Larry Hoover on May 1, 2005, at 12:41:25
In reply to Asthma meds known to worsen depression?, posted by CK1 on May 1, 2005, at 11:05:15
I'm 21, in good shape, and work out 5 times a week, but, since I started Advair, my muscles hurt all the time, I have pain/numbness on the left side of my face, and nothing is touching my depression/anxiety. I am normally NOT a hypochondriac and I strongly think this Advair b#@sh#! is causing these unexplainable problems.
The steroid in question here, fluticasone, is extremely potent (3 X the binding of budesonide, for example). It also is absorbed systemically, at highly variable rates, in different individuals.
Musculoskeletal pain and cramping are associated with this drug, as are adverse psych effects. You may have adrenal/hypothalamic suppression from the steroid effects remote from the target tissue, which is the lung. The kidneys may also be affected, increasing mineral loss in urine.
This may sound far-fetched to you, but adjusting your nutrient intake might help both the anxiety and the asthma. You mention being in college, so I know you're stressed. You also work out all the time. Your body may simply be running low on certain enzyme cofactors, as your intake might not be meeting demand. The deficiency presents as anxiety and asthma.
A B-complex tablet, and multi-mineral, would provide a good basic supply of nutrients, but you can then target the specific symptoms you describe here. You should see a benefit of a magnesium supp (helps with anxiety, asthma and cramping). You should target 500-1000 mg/day, in divided doses, with meals. You may get some diarrhea, if your body is not accustomed to the magnesium intake level. If that happens, reduce the dose to a comfortable level, and then increase it gradually again. Your body will compensate.
The other thing is niacinamide. It's a specific form of vitamin B3. Make sure it's the one that ends in the suffix -AMIDE.
Individual dosing varies, but you can take from 100-500 mg at a time, total daily maximum of 2000 mg. Only take the niacinamide if you also take a B-complex, as you can induce other disturbances if you don't supply all the B-vitamins together. They work as a team.
Both niacinamide and magnesium can be sedating, so you need to take that into account.
Best,
Lar
Posted by Phillipa on May 1, 2005, at 17:57:53
In reply to Re: Asthma meds known to worsen depression?, posted by Larry Hoover on May 1, 2005, at 12:41:25
Cortisone killed my mother. She was taking it for psoriasisin the 50's when it first came out. She became a raving lunetic. Threw things at me, said I was the one to make her sick, etc. My life as a child was a nightmare. Unfortunately they didn't know what they know today about the side effects. Do I think your use of steroid meds could be affecting your moods and med tolerance. Yes! I'm terrified of them myself. I know they cause mood swings. If you want good supplements that will get shipped to your door, and contain no harmful chemicals contact me CKl. Fondly, Phillipa
Posted by Maxime on May 3, 2005, at 9:00:01
In reply to Re: Asthma meds known to worsen depression?, posted by Phillipa on May 1, 2005, at 17:57:53
I take Advair. I have been taking it for a long time, only I wasn't taking it. But my allergies and asthma got worse, so I have been taking it for the past 4 months. I wonder if that is what has made my depression worse. Things really started to crumble about 4 months ago.
Yay, one more thing to throw into the soup!
Sigh.
Maxime
Posted by Maxime on May 3, 2005, at 9:07:25
In reply to Re: Asthma meds known to worsen depression?, posted by Maxime on May 3, 2005, at 9:00:01
And I thought all the muscle etc. had to do with my thyroid ... maybe it does. At this point who knows what is causing what.
Larry, do a lot of people suffer ill side effect from Advair or Flovent?
My GP will not give me much Ventolin. She is very against it. She believes in treating asthma with steroids such as Advair (which has some Ventolin in it) and Ventolin. Could it cause me to be so volatile?
Maxime
> I take Advair. I have been taking it for a long time, only I wasn't taking it. But my allergies and asthma got worse, so I have been taking it for the past 4 months. I wonder if that is what has made my depression worse. Things really started to crumble about 4 months ago.
>
> Yay, one more thing to throw into the soup!
>
> Sigh.
>
> Maxime
Posted by Maxime on May 3, 2005, at 12:38:36
In reply to Re: Asthma meds known to worsen depression?, posted by Maxime on May 3, 2005, at 9:00:01
Hi me again.
I have another question I hope someone will answer. I have heard of people taking steroids/cortisone and it causing mania. So if the Advair is causing my worsened state of depression, and my aggression will it go away once I stop the Advair? Or has it changed anything. I have heard some people say they were never the same afterwards.
I am really going to pursue because the time frame fits. And with the muscles I have been having as well.
Problem is I have very bad asthma, and I don't know how to control it without something like Advair or Flovent. Plus my doctor won't be much help in that area. I am going to do a trial with no Advair. Obviously if my asthma gets really bad, I will have to use it.
My mood has lifted just a little after seeing CK1's post and Larry's response ... so thank you. :-)
Maxime
Posted by Maxime on May 3, 2005, at 13:02:25
In reply to Re: Asthma meds known to worsen depression?, posted by Maxime on May 3, 2005, at 9:00:01
I also wasn't able to tolerate the Parnate when I restarted it in February. I know there is a warning about using the inhaler with MAOI (mainly because the inhaler makes your heart race a little from the ventolin that is in it).
I hope I am solving a mystery and not on a wild goose chase.
Maxime
Posted by CK1 on May 3, 2005, at 15:42:12
In reply to Re: Asthma meds known to worsen depression?, posted by Maxime on May 3, 2005, at 12:38:36
Maxime,
Check out http://www.medications.com/go/se/Advair and read the postings about Advair. It "could" be making your depression/muscle aches worse. I gave up Advair today and going to see how it goes. I also reduced my dose of Allegra from 180mg to 60mg. Ask your doctor about Pulmicort, which is less likely to be adsorbed and doesn't contain serevent or Singulair, which works in some people but doesn't do a thing in others.
It's something to look into! If you had your thyroid checked and the levels are normal, like I said before, it "might" be something else....maybe Advair?? You won't know until you get off and/or try something else if your asthma gets worse.
Posted by Maxime on May 3, 2005, at 19:15:54
In reply to Re: Asthma meds known to worsen depression?, posted by CK1 on May 3, 2005, at 15:42:12
Cool site. I am going to give it shot. Because what have I got to lose. I will chart my mood and compare. I can get either of those meds in Canada (yay!). It's my agression that is really bad too. Usually I am not agressive and well I have been a bitch from hell for month now ... since I restarted the Advair.
Thanks! I will keep you posted and you let me know how it goes for you!
Maxime
> Maxime,
>
> Check out http://www.medications.com/go/se/Advair and read the postings about Advair. It "could" be making your depression/muscle aches worse. I gave up Advair today and going to see how it goes. I also reduced my dose of Allegra from 180mg to 60mg. Ask your doctor about Pulmicort, which is less likely to be adsorbed and doesn't contain serevent or Singulair, which works in some people but doesn't do a thing in others.
> It's something to look into! If you had your thyroid checked and the levels are normal, like I said before, it "might" be something else....maybe Advair?? You won't know until you get off and/or try something else if your asthma gets worse.
Posted by Larry Hoover on May 8, 2005, at 11:42:08
In reply to Re: Larry, posted by Maxime on May 3, 2005, at 9:07:25
> And I thought all the muscle etc. had to do with my thyroid ... maybe it does. At this point who knows what is causing what.
>
> Larry, do a lot of people suffer ill side effect from Advair or Flovent?
>
> My GP will not give me much Ventolin. She is very against it. She believes in treating asthma with steroids such as Advair (which has some Ventolin in it) and Ventolin. Could it cause me to be so volatile?
>
> MaximeYes. It is possible.
Have you tried Singulair (montelukast)? It is a direct inhibitor of one specific leukotriene.....the signalling compound that causes the inflammation from asthma/allergies.
Lar
Posted by Larry Hoover on May 8, 2005, at 11:43:40
In reply to Re: Asthma meds known to worsen depression?, posted by CK1 on May 3, 2005, at 15:42:12
> Ask your doctor about Pulmicort, which is less likely to be adsorbed and doesn't contain serevent or Singulair, which works in some people but doesn't do a thing in others.
I agree. Pulmicort has less systemic effect. Singulair is an excellent alternative, for some people.
Lar
This is the end of the thread.
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