Thursday, May 31, 2012

Wednesday, August 13, 2008 Jkiwaha asks

Q: What part does medication play in depression?

I know that Prednesone causes mood swings and other emotional side effects. I am also taking Methotrexate, Arava, Plaquenil, Naproxen, Hodrocodone and I want to know that I am not going crazy and that I have enough control over my emotions to not feel so out of control.

 

Today, my General Practice doctor has me put me on Xanax and Cymbalta, to try and take "the edge off". I've been not so nice to my great family, and not so patient with my 5 year old daughter. After my appointment, I stopped in to see my RA doctor, and was told that everyone goes through this. I'm sure that there are many degrees of depression, but does it intensify because of the meds?

 

If anyone has any suggestions or words of wisdom, I would greatly appreciate your assistance!

 

Thanks,

 

Joli

 

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Answers (2)
Lene Andersen, Health Guide
8/15/08 12:13pm

You're right - medications can mess with your moods. Prednisone is one, hydrocodone another, so it's quite likely that your meds may be contributing to your problems. However, I'm going to throw something else out there. You are on three disease modifying drugs, yet still have enough pain to need an opiate painkiller. Pain makes you irritable and a lot of pain can make you very irritable and inpatient - it takes up so much room in your head and can be so loud that there's not a lot left over to deal with other people. Pain can also make you depressed. I used to see a psychiatrist, but eventually figure it out that my depression was directly connected to very high pain levels. So I went to my rheumatologist, got better meds and since then, as long as I have adequate pain control, my mood is pretty even.


This is where I go out on a limb. Requiring opiates when you are on three DMARDs seems to indicate that your disease may not be controlled as well as you'd like it to be. I'm a little concerned that when you discussed the impact on your personal relationships and parenting, your doctors prescribe more pills or essentially say you just have to live with it. A big part of living with a chronic illness is finding coping techniques that enable you to focus on your life, including relationships, parenting, work, etc., and antidepressants can be a valuable tool. I wonder, though, if it's time to discuss medication options with your doctor - is there a reason why he hasn't suggested one of the biologic drugs for your RA (Enbrel, Remicade, Humira)?


Part of managing a chronic illness is to knowing when to push your doctors. What does your gut tell you - do you feel that your treatments adequately address your problems? Is there a little voice in the back of your head saying 'this isn't right'? You are the expert on your body and its messages, so trust yourself. You're the one who has to decide whether the side effects are worth the positive effect of the drugs. If you're questioning this, maybe it's time for you to go back to your doctor and tell him you want to talk options. On the other hand, if you're satisfied with your current treatments, there are things that you can do to help you cope better. Find a counselor or therapist to help process your feelings about having a chronic illness and develop coping strategies for when things are tough. Meditation or gentle exercise that's a sort of meditation in motion (yoga or tai chi) can do wonders to help you get centered. Developing effective and supportive communication with family is also an important part of emotional health - Christine Miller wrote an excellent article about communication within a marriage (click here) and many of the ideas in the article can be used in all relationships.  HealthCentral's Depression site may also be helpful for you.


Sorry this got a little long. If you have any more questions, please write again.

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9/ 7/08 9:54am

I take Methotrexate and Plaquenil also I take the injection Humira once a wk verses bi-weekly.  I have in the past taken Prednesone and Hodrocodone.  The streoids play a hugh part I believe in depression because the alter your mood.  The Plaquenil I've found finally after years I found out made my skin itch so severely after I showered that I would sit and cry while I could do nothing to make the itching stop.  That in its self is enough to make anyone depressed.

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By Jkiwaha— Last Modified: 11/01/10, First Published: 08/13/08