How should I think about antidepressants?

[sunshinelover]

Hi!

My eyes turned so bad again last week and I quckly became very depressed, could hardly sleep or get out of bed in the morning. The pain, couldn´t work, my vision was all blurry, cancelling my long anticipated vacation activities (for examples a week on a friends boat out in the archipelago visiting partying spots - doesn´t work with this condition) . My doc (not eye doc) prescribed antidepressants and wanted me to start ASAP. However, I am too afraid of the sideeffect to get MORE dry eyes - the cause of my depression! In panic I once again went to the eye emergeny room and came out with steroid drops and anibiotics. After a couple of days on this everything again became so much better! NO PAIN, sometimes almost normal eyes and no need for lubricants except a few times a day. Now, after a week my vision is also back to normal!! And - as a consequence my depression and anxiety is also gone. I have a life again.
However, I know this is only temporarily, I need to stop the steriod drops soon, and in a couple of weeks if not sooner I will be back in pain and discomfort again. 'But should I then eat Antidepressents for the rest of my life to be able to deal with this? My biggest fear is that my eyes would be damaged PERMANENTLY by the antidepressants - so that the situation becomes even worse! Or - is it always the case the the sideeffect disappear if I stop taking the drug ( if I decide to start)? How should I think? Anyone who has experience with this - I have got Citalopram.

By the way, i nstead of vaction boat trip I will that week try acupuncture instead.

[PotatoCakes]

It appears that most (all?) antidepressants have a temporary affect on tear production, not permanent. In other words, if you stop using them, your tear production will resume like normal. I'm not familiar with Citalopram but if you are really as depressed as you say, I would take it, or at least ask your doctor how strong the prescription is and if you could take a lower dose (for instance, some people take 10mg of Prozac daily, others take 200mg -- there's a big difference and if 10mg works for you, it will likely have fewer side effects and really, there's no reason to take more). If you start on the lowest dose and handle it will but need more oomph, you could ask your doctor for a higher dose and see if that makes a difference.

Chronic diseases can be extremely difficult emotionally and I think it's easy to fall into a sort of paralysis about how to help yourself (diets, drugs, exercise, even leaving the house) out of fear the problem will become worse. That leads to a bigger problem, though, IMO... if you are hiding from life, what's the point? The key is to find the balance between your disease and your ability to live life. Your life may not be the way it was but it still can be pretty fabulous once you have the tools and support to cope with the symptoms of your disease. Yes, there will be tough days but you'll know there's a way out. If your doctor wants you to start the anti-depressants ASAP, I'm guessing he's pretty worried about you. Keep in mind, you may not need to take them forever, you may need to take them just long enough that you can get out of the hole you've fallen into. Once you can get yourself out of that hole, you can begin to find ways to manage your symptoms in a way that allows you to live.

Keep in mind that depression can also increase symptoms of a chronic disease so not only are you feeling depressed but, your depression is making your eyes drier and pain more pronounced. It's a vicious circle and if taking an anti-depressant can get you off that loop, it's worth it.

[icycarol]

What I think (only the opinion from myself) is that if you keep worrying about that the antidepressant might get your dry eye worse, then you may be in a panic even when you take those antidepressant.
Maybe you can try to exercise more to help you to deal with the depression ? Or try other thing which may make you happier ?

I take lorazepam and stilnox for sleep(lorazepam to help with anxiety and sleep, stilnox is also for sleep), my eye become very dry after taking stilnox for two days, and lorazepam seems make my eye dry, too(but much more slower.)
And my eyes are very dry now even I quit for about 2 weeks. I would never try them again !

Maybe it is case by case, but I think you should try something else to make yourself happier, if it not work, then you turn to the drug !

Carol

[Colin P]

Iv'e been on an anti-depressent for a year now after hitting rock bottom, and am now ready to come off them. I noticed NO extra dryness whatsoever, and if anything, my eyes are 10x times better.. I would echo Potato cakes last paragraph about anxiety making things so much worse.
I was actualy admitted to hospital with severe depression, and the doctors in there once they had spoken to me, liased with the pharmacy and found the anti-depressent for me- VENLAFLAXINE.
You start on 35mg, 2 weeks later 75mg, then another 2 weeks later 150mg and stopped at that. There were other patients in there with different issues, and they were on many tablets, some to counteract a side effect of there medication and were on anything upto 350mg.
Myself i ticked all the boxes on the 'possible side effects'? and they are not even a distraction really, the manufacturer by law must list the 'possible side effects'..
Compared to depression,anxiety and dry-eyes, i will gladly accept feeling tired, or an increase in aggression, or even viagra like symptoms !!!...
There are many different brands of anti depressent, and most of the patients in hospital were there till the doctor could find the correct anti-depressent for the individual, if the first brand the patient compalined of, say, headaches, or feeling drowsy? then they were tried on another type.
I know what medication enduced drier-eyes feels like, as i also tried co-codomal but noticed i had drier eyes so took no-more of them, simple as that!, fortunatly the first anti-depressent VENLAFLAXINE was ok with me... My only worry now, is coming off them, i feel perfectly normal my doctor is not pressuring me to come off them (costs) i do hope my eyes do not get drier without the anti-depressent cos either the Venlaflaxine or improved mental state has sorted my eyes out..
Coming off them is the reverse of building yourself up on them 2 weeks of a drop in dosage.

[Rebecca Petris]

Great thread.

In my opinion depression/anxiety ought to always trump dry eye when you're looking at this kind of decision. Why?
1) Depression can kill. Dry eye can't.
2) Depression/anxiety materially interferes with treating dry eye appropriately and with coping and adapting. Treat the depression, so that the rest will come down to a manageable level.
3) Anxiety probably exacerbates and prolongs pain and maybe other dry eye symptoms. Again, treat the depression and maybe you see a benefit overall.

As for the long-term future... no need to live your life that far in advance. Consider depression treatment as the crutches you give yourself some time & room to heal.

[SunshineinCalgary]

Rebecca,

You always have so much wisdom in your words!!!....... Depression can kill. Dry eye can't.

Suhshinelover,
1. On medication: XANAX (the medical name is alprazolam) helps with sleep and anxiety. I don't notice any effects on dry eyes. But then I only take it when I need it, not everyday.
2. ON other ways to help with depression and anxiety - exercise, vitamins (B12), music, sharing, but to me the most important tool that helps me survive all odds is POSITIVE THINKING. If I can survive the last 12 months, I can cope with the future. 'But should I then eat Antidepressents for the rest of my life to be able to deal with this My answer to this is: ONE THING AT A TIME. WE CAN ONLY HANDLE ONE THING AT A TIME!!! Sometimes things will work out on its own if we give it time.
And, I believe in prayers

[Colin P]

Right now, you may not feel it is possible, but the body wants heal itself and yep anti-depressents can be regarded as 'the crutch' or the sticking plaster over a cut, they stop the rot while the body naturaly starts to repair itself. They do-not carry a label saying "may or may not work for you?" if you have a problem with the first attempt? and i emphasise the word "IF" then you try another type, the instructions inside my own particular box, like ALL meds advise of 'POSSIBLE' side-effects, and you get the mandatory 'increase in blood pressure' or 'feeling drowsy' the only mention of possible eye trouble was to exisiting Glaucoma patients (pressure). Virtualy every box of meds ive ever seen carries this as 'possible side effects'?.
They go to work, very deep down inside you, hence the reason for a small dosage start while the body accepts it, they would relax you far to fast if started on, say 75mg and maybe feel sickly? if it was not for the minor side effects i would have said "hey there not working these" no sickly feeling, and no massive shock to the body at all- not for me anyway..

[Andrey]

Hej sunshinelover,

I hear you. I have always been against antidepressents and for so many years I avoided it, until I reached a point when I just had to start with it. Now I really regret that I didn't start any way sooner. I'm also taking Citalopram (30mg, but may go down to 20mg soon). For once, I'm FINALLY waking up totally rested. Be sure to take them in the morning though, because if you take them too late, you will have really wicked dreams from time to time .

Like someone else said here, I haven't felt any dryness from the medicine, and if anything, it's almost better now. But I'm not gonna say that's the way it's gonna be for you, read around some.

Also, with antidepressents being good I mean the easy ones. The ones who won't get you addicted etc.

Really, how many of you have tried Oracea capsules? They are really doing a difference for me.

PMa om du vill prata av dig lite =).

[Andrey]

What I think (only the opinion from myself) is that if you keep worrying about that the antidepressant might get your dry eye worse, then you may be in a panic even when you take those antidepressant.
Maybe you can try to exercise more to help you to deal with the depression ? Or try other thing which may make you happier ?

I take lorazepam and stilnox for sleep(lorazepam to help with anxiety and sleep, stilnox is also for sleep), my eye become very dry after taking stilnox for two days, and lorazepam seems make my eye dry, too(but much more slower.)
And my eyes are very dry now even I quit for about 2 weeks. I would never try them again !

Maybe it is case by case, but I think you should try something else to make yourself happier, if it not work, then you turn to the drug !

Carol

And yea, this. Even though I would GUESS that there's a pretty big difference in side effects between Stillnox and Citalopram, it is not time to "gamble", yet. You should start exercising A LOT, and do it 3-4 hours before you get to bed so hopefully you will have a good sleep.

[sunshinelover]

Hi!
Thank you all so much for your replys! It is woderful with people who truly understand. That is among the worst thing, that there are so many friends that turn away when you cannot participate in the social life and activities anymore - and worst, start comparing with their own trivial (compared to this health issue) problems... So I guess I will have to stop seeing them, since my social life has been very active with single friends. Anyway, after the 10 days on steroid drops my eyes felt so great and my vision was much better. I then went out to an archipelago island cottage where the humidity was 70-80% all week!! Soooo wonderful! I felt almost completely normal!!
But yesterday I started to feel something bad was going on again ( I now recognize the feeling after having been through it a couple of times) - that the eyes dry up, vision goes down etc. And today the eyes have gotten worse and worse as the day has gone by. I am back in town, with humidity 45% - which was rather fine i May!!! So things seems to deteriorate quickly! And this should be the best time of year, so how I will survive another winter beats me. Now my left eye is aching, aching, aching, like there is a big pressure in it - anyone knows what causes this?? And both eyes feel like I have been awake for 3 days without sleep, and as soon as I have written this I will go, lie down and close them for the rest of the day - although it is only 6 pm. Awful!! Drops only help for a few minutes.

aI have started to wonder whether hot compresses is good or bad? I can't see anything coming out from the glands at all when pressing. And the skin underneath my eyes are starting to flake off - i guess from the hot compresses?

Anyway - I am so glad to hear that some of you are getting better. Hope is what we need.
Also, about exercise, I have tried that (normally I exersice a lot) but have felt I have no energy, in fact, after I tried bodypump and spinning (my usual activites) my blood sugar must have dropped so much, as I started to shake!! And then had to lie down a rest for the rest of the day. Not normal for me. While in the archipelago last week I was feeling great and had no truoble bycycling fpr 30 kilometers uphill/downhill...
Well, I also read about the Stilnoct experience Carol, and got scared, since I myself took my two first sleeping pills ever in April ('Stilnoct) after having insomna due to 9 hours jetlag and had to stay with a lot of people to attend my fathers funeral - a stressfulevent in itself - so I borrowed thes pills from a friend and my eyes went SOOO dry, and still are. However, that could have been a co-incidense due to all other events as well.
So - I really hope I will have the courage to try Citalopram soon. Doctor has ordered me to take 10 mg for 5 days, then 20 mg. The ONLY side-effect I am worried about is more dry eyes . The rest, if any, I can certainly cope with.

Nice to know that some of you has actually felt better in your eyes after taking the drug - tell me more!!!

PS. Today was my first acupunture session. Felt a lot of pain around my left eye during it - hope that means something good is happening.