Depression & Anxiety

[deeplyset]

My doctor has been pushing me to take Depression/Anxiety medication for a really long time. Not that she found out that I have POTS she is even more adamant about it because of the difficultly I am unable to manage any amount of STRESS very well. Which in turn threws me into Anxiety and Panic attacks and of course makes it hard to breathe on the already difficult time breathing.

Because of POTS, coming on Suddenly I have found that which all the life changes it I have come in and out of mild depression also.

SO, my question is are there other people out their that have experienced this and is taking medication to help okay? Are there cautions I should watch out for? Are there other options? If so, what? How important (among all the other stuff) is this?

[MomtoGiuliana]

Many POTS patients (according to my specialist at least 50%) see improvement in their POTS symptoms with a low dose SSRI, a type of anti-depressant. It would be worth a try for that reason, if your doctor is recommending it. I would just suggest asking your doctor if you can start with a very small starting dose (smaller than the usual) since many of us tend to have a very difficult adjustment period with SSRIs. If you do try it, try to stick with it for six weeks--it takes that long to start seeing benefits and for side-effects to wear off. However, SSRIs do cause side-effects that may not wear off and may be intolerable for you. There is not a way to know until you try, unfortunately.

I take a low dose SSRI and it has changed my life and the course of this condition for me.

Katherine

[mom4cem]

Hi,

I am also heading in the SSRI area for anxiety. I am a bit leary, but from what I hear from everyone it might well be a risk worth taking.(with side effects I mean). Which one is your Dr. giving you?

[calypso]

I have taken SSRIs on and off for about 10 years. I took Zoloft for panic disorder from age 18-26, then went off of it for a pregnancy. This was all pre-POTS. Then I developed POTS postpartum, and at first, my doctors thought I just had a recurrence of panic attacks and anxiety. But I continued to get weird symptoms that didn't fit in, and POTS was diagnosed. I was put on Lexapro, but after four months, I decided to stop taking it because it wasn't helping me at all. Then, just a few months ago, I started Effexor. The only thing this drug does for me is prevent POTS "attacks" of adrenaline rushes. Otherwise it just makes me thirsty. But the attacks really are scary, and I like that I don't have to have them.

I am not a big fan of antidepressants. I don't like the fact that no doctor or scientist really truly understands how they work, but I also know that if I didn't take Zoloft during my college days, I would have been virtually unable to function. Zoloft gave me my life back.

I would urge you to read "Listening to Prozac" and also anything by Dr. Andrew Weil to get two completely different perspectives on these drugs. Ultimately, you should try to deal with the underlying cause of your depression and anxiety. But if you try that and therapy, etc., isn't working, these kinds of drugs may help you become functional again. Good luck with your decision, and keep us posted.

Amy

[Sunfish]

just b/c it hasn't been mentioned specifically in this thread, some folks with various dysautonomias have had success with SSRIs for symptoms other than depression/anxiety too. i have been on them at times (celexa or lexapro) & believe that they have been of help, but find it hard to "track" over time b/c of the fact that they take a long time to get both in & out of your system. at different times i have been on them for different reasons (at one point mood/depression while recovering from eating disorder& at other points as a combo of dysautonomia meds.)

good luck with whatever you decide!

:-)melissa

[ramakentesh]

My doctor goes the opposite way - he thinks that POTS patients have bodies that are heavily under stress from a constant surge in autonomic nerve activity from hyper adrenal responses to orthostatic stress. We exhibit symptoms similar to patients that are under real external stress because they and POTS patients both have high levels of adrenaline and noradrenaline in their systems.

This ofcourse, leads to anxiety and panic - when i was really bad, and my symptoms were at their worst and my noradrenaline levels were described as highly excessive from orthostatic stress, i couldnt handle any stress without shaking, and was VERY jumpy about things - easily panicked.

This was quite normal and from a physical manifestation of pots rather than a psychological disturbance.

I get moody much more often since pots and occasionaly depression - my doctor says that you would expect this from the excessive nervous system overactivity as you would similarly from a thyroid overactivity.

[deeplyset]

The drug is called Effexor XR. I committed to just trying it for a month. She has been really persistant that I need to just try it. I'm thinking short term... I hope to doesn't mean long because I'm already uncomfortable with it. I took the first does yesterday and felt like I could crawl out of my skin. She said that INCREASED anxiety for the first week is normal.

Ramakentest - my doctor not knowing much about POTS kinda took the approach that you are saying... She said that if my body is not being able to handle things itself and therefore allowing me to easily go into overdrive then I should treat it just like I treat a thyriod. Helping it out in a sense and giving it a boost. She doesn't view it as NORMAL for POTS though she just thinks that I if we can help any aspect of the symptoms by "fixing" them we should. That makes me uncomfortable in a way because I'm concerned it will mask important things my body is trying to tell me...

Calypso - I would like to hear more about your experience with this drug... Collasping is what happens to me mainly and if this could help that in a sense I'm very interested... I have seen a phsycologist for over a year and dealt with everything I could image. Every time I go into a mild depression I go in and out of it in less then a month. I have my days of up and down, happy and sad, over all I would say I'm doing pretty good concerning the circumstances. The main problem is the Anxiety, occasional Panic Attacks, and inability to manage stress. Which is turn cause breathing problems on the already hard time with the tachycardia. Suggestions???

What does SSRI stand for???

Thank you all for your help and support.

[Sunfish]

SSRI = Selective Seretonin Reuptake Inhibitor

good luck with the new med. it is true that many meds have accompanying side-effects that pass after a few days. hope you get some relief...

:-)melissa

[MomtoGiuliana]

deeplyset

I hope this medication helps you. SSRI's seem to help "calm" the autonomic nervous system. It won't cure you, but may help you to be far more functional. That in turn, has positive health benefits--such as the ability to exercise, not to mention, just be able to get through the day doing "normal" things.

Yes, I would expect you will experience side effects such as anxiety with this drug as you begin it. It can be pretty severe and uncomfortable--that was my experience. I rode it out--it was a very bumpy ride--and in the end it really helped me tremendously.

Did you ask your doctor about using a dose lower than the typical starting dose--since we POTS patients tend to be highly sensitive to meds? I have no idea if that is possible with Effexor, but it is worth asking.

Katherine

[calypso]

Deeplyset,

I don't collapse (I assume you mean fainting?), but I do suffer from anxiety, panic attacks, tachycardia, shortness of breath (chronic, like you describe) and occasional spaciness/dizziness. I only see improvements in the area of panic attacks and anxiety from this drug. I have not had a panic attack since starting it. However, I do still have a generalized feeling of anxiety that hasn't been eliminated by the drug. And I also take 0.25 mg Klonopin every day.

I did experience a worsening of anxiety for the first 10 days. This is common. Beyond that, I started to feel fatigued. But it gets better with time.

I would stay committed to trying this drug for 2-4 months to see if you experience relief. It often takes that long to start working. Don't quit too soon, or you may not find out whether this drug is helpful to you. You can always stop it later if you don't like it.

Feel free to ask any more questions.

Amy

[BuddyLeesWife]

My husband has taken Effexor XR for the past 2.5 years for NCS and it has worked well for him. He was allowed to ramp up on the medication slowly. Every time he increased the dose, he would have about 2 days of slight but annoying gastro problems so he always started the increased dose on a Friday so that the problems occurred on the weekend when his schedule was more flexible.

I hope it works for you.

[Ling]

I am on a anti-depressant at the moment. I was at the point in my life where I thought I was going to have to stop working and land up in bed. My Cardiologist recommend a new doctor and he immediately said I have a seritonium deficiency. Apparently pots patients often suffer from seritonium (spelling) deficiencies. I am not funny about anti-depressants and will try anything that improves my life. Within 4 days of starting my medication I was a different person. I can?t tell you what a difference it has made in my life. I can hold a cup in my hand again. I can read and concentrate. I am working again at home and work. I am so happy. I don?t have depression but a seriatim deficiency. Try it, IT HAS CHANGED MY LIFE like you can?t believe. I just accept that my body can?t do anything normal including this. Plus I don?t have horrible headaches any more. I had such bad head aches that I though my head was going to explode.

[avais1]

Hello,

Sorry I am late in responding on this one. I just want to reiterate what MomtoJulianna said, SSRI's for me have helped tremendously. I suffer from hyperadrenergic POTS, which means I "spillover" norepinepherine (adrenaline) about three times as much as a normal person. Needless to say, when I panic, it is MAJOR, meaning I can panic myself into incapacitation due to all of the lovely norepinepherine I can generate Anyway, I started Lexapro 5 mg and have been on it for two years. Getting on it was one of the worst hells of my life, for two weeks, I was a mess. But after that, I was able to get some of my life back. If you do start one, try to stick it out, no matter how hard. It had helped me tremendously. Good luck to you, and know that you aren't alone on this one.

[becky]

hi,

Pre pots i took prozac for depression and i found that i couldn't function properly, i felt like i wasn't running my life and hated being on it.

My cardiologist suggested that i try an ssri to stop me from collapsing as often, i was reluctant because of my history with prozac but i decided to give it a try.

I now take paroxetine as well as florinef, and i have found that it has helped with the collapsing but not with anyother symptoms, i still get chest pains and breathlessness and i am succeptible to mild bouts of depression but i'm not fainting as often and that was definitely worth taking it for. Give it a try, for about six weeks so it's in your system, if you don't like it stop, there are loads of SSRI's on the market.

[deeplyset]

I tried the Effexor for about the first three days. I stopped it because I was have almost all the side effects even the unusal ones (i felt like I was going mad!). I called my doctor and she said it was a good idea. She is going to try a SSRI now. Thanks for the suggestions! I'm still nervous ESPECIALLY after this experience. But I'm learning more and more to accept the fact that I have been having an Anxiety probably that is really making life hard. And until I do something about it I'll never know what it's like to be "normal" and then be able to learn a balance by myself without medication. Also, who knows maybe I'll be a blessed one like many of you and it stop or at least minimize the collasping!

Thanks again everyone.

hi,

Pre pots i took prozac for depression and i found that i couldn't function properly, i felt like i wasn't running my life and hated being on it.

My cardiologist suggested that i try an ssri to stop me from collapsing as often, i was reluctant because of my history with prozac but i decided to give it a try.

I now take paroxetine as well as florinef, and i have found that it has helped with the collapsing but not with anyother symptoms, i still get chest pains and breathlessness and i am succeptible to mild bouts of depression but i'm not fainting as often and that was definitely worth taking it for. Give it a try, for about six weeks so it's in your system, if you don't like it stop, there are loads of SSRI's on the market. 

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[mehganb81]

I too take a low dose of Effexor, which has helped my symptoms. Effexor affects both serotonin and norepinephrine. I was skeptical at first but am glad that I decided to follow their advice. My one suggestion is to have a psychcologist manage the dosing. They have much more experience with this class of drugs and have an extended knowledge of possible side effects. My psych doctor checks in with me every 3-4 weeks to check on me, it is very nice. I also see a Liscensed clinical social worker every month for an hour to talk about my illness, its effects on my relationships, and sacrifices I have had to make. I think this has also been very helpful to have someone to talk to. She has experience with dealing with clients who have chronic illnesses and has had many helpful suggestions for learning to live with a chronic illness and coming to terms with the changes I have had to make.

[Madwife]

Hi! I also have been talking Effexor ( Otherwise known as Venlafaxine) for 4 yrs now and if I am even an hour late in taking my dose I notice a big effect in relation to POTS symptoms. It also helps in stabilising mood as I too swing in and out of depressive periods. HOWEVER....be prepared to face even further discrimination though once a medical professional with no knowledege of the condition reads that you are taking an anti-depressant, as that will give them the confirmation they require to convince themselves that our condition is related to psychological / psychaitric issues. At the end of the day the majority of us are going to experience anxiety related symptoms...I'm sure they would aswell if they never knew how long they were going to remain standing and were grieving for the lives we all once had. Edited July 8, 2005 by MightyMouse

[catmcgrath]

Hi, sorry have just seen your post and wanted to say that you must be careful going onto venlafaxine (trade name Effexor). I have been on it for 2 years after suffering a cerebral anuerysmal bleed and having severe depression. It is a drug that is fairly difficult to come off as it has quite bad side effects. I am trying to get off it and it is extremely difficult. Interestingly though my POTS symptoms have got worse as I have decreased my dosage which has intriqued my psychiatrist! I'm not saying don't go on it but please look into the side effects and make an informed decision!

Take care and keep well!

Catherine