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    Old 11-06-2008, 06:53 PM   #1
    randuh's Avatar
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    Question regarding antidepressants and addisons

    My grandmother has been dealing with this illness for many years now. In 76' she was diagnosed with cushings and had both adrenalin glands removed at UTMB in Galveston, TX. about 14 years ago they discovered a tumor in hare putitory gland which was also removed again in Galveston. She takes Cortef and Flourinef every day in order to function. She also has a heart condition called hyprothropiccardiomyopathy (which is causing the walls of her heart to harden) and they have exhausted all treatments to repair damage. Needless to say her life is very difficult at times. For the last 30 years she has been a smoker and believes that the cigarettes are the only thing that can help her nerves. The smoking is making her heart condition worse and also contributing to her allergies and lung function.

    So what I am asking is this... Does anyone here who has addison's take antidepressants? If so what seems to work best for you? She said that she tried taking them not too long after the cushings surgery, and they made her feel worse, but that was a LONG time ago and antidepressants have come a long way in the last 20 years.

    I feel if we can get her stress levels under control and find something to help her mood levels she may consider quitting smoking. Every time anyone even suggests that she quit she bursts into tears. She knows it is bad for her but she won't quit. Even if she doesn't quit, I just really want her to feel better. I love her so much and want to keep her with us as long as possible.

    Thanks in advance

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    Old 11-10-2008, 06:12 AM   #2
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    Re: Question regarding antidepressants and addisons

    I don't have addisons, but have a degree of secondary insufficiency along with hypothyroidism. I have struggled to be properly treated to allieviate my physical and mental symptoms. Prior to these diagnoses, I was suffering from anxiety and depression and was put on psych meds. These meds have an effect on the endocrine system, and there is a lot of literature out there.

    From what I understand, the action of an SSRI anti depressant is to raise the HPA axis, and as a result an important action in this respect is to raise cortisol levels. Of course, it is well known that they also have actions on nuerotransmitters, esp serotonin, and depending on the SSRI, Norepinephrine.

    I don't feel great on my antidepressant, but have to stay on it for the time being as I cannot tolerate thyroid meds, and my cortisol is low, and I had a bad expereince with HC. I am on a low dose of Lexparo at 7.5 mg. Treatment ranges from 10 -30.

    I do recall hearing about Wellbutrin which was later also sold under the name Zyban, an anti-smoking aid.

    I would only caution that some people have trouble with antidepressants because some of them have short half lives, that is, a person may feel "withdrawal" in the middle of the day. It is usually better to stick to one that has a longer half life. Wellbutrin is one of the longer ones, at 26 hrs. The longest one is prozac at one week, but most of the longer acting ones range from 25-40 hrs. The shortest half life SSRI is Effexor at 5 hrs.

    I wonder why you think an antidepressant is the solution, however. I smoke and I have never been able to stop becasue I felt "better" on an antidepressant. Unless she is seriously depressed and anxious, I would try an less invasive method, even something like hyposnosis.

    These medications have unseen side effects, and I might add also reduce circulating thyroid hormones in some people. My brother in laws mother has addisons and suffers from anxiety, she takes one ativan per day. It is not a great solution, but keeps her going.

    But, in my estimation, psych meds are a choice of last resort.

    Hope this helps. Best of luck with your grandmother

    Old 11-10-2008, 07:29 AM   #3
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    Re: Question regarding antidepressants and addisons

    I maily hope that anitidepressants will help because she says the only reason she smokes is because she is depressed or stressed out. Like I said everytime a doctor or a family member asks her to quit she bursts into tears and says she isn't good for anything and she wishes we would just let her die. Even if she doesn't quit, I know she needs something to help her feel less depressed because obviously the cigarettes aren't doing what she says they are.

    Old 11-25-2008, 10:51 PM   #4
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    Re: Question regarding antidepressants and addisons

    The answer to your question is yes. I hope you try welbutrin. Other than the smoking and heart problems, I am in the same boat as your grandmother. If there is a medication out there that helps stop the depression, I know she will do better. I don't know how old she is but The only thing I would worry about is the possable onset of dementia and the interaction of any meds for that with the antidepressant. Keep a close eye on med interactions for her as they tend to overmedicate seniors.

    I wish you the best

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