SSRI Drugs and Depression

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compiler
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Date Joined Nov 2009
Total Posts : 7269
   Posted 3/21/2011 8:40 PM (GMT -6)   
A friend of mine is a retired physician. I've indicated to him that this PC crap is depressing.
 
He made the statement that many cancer patients are on SSRI drugs (I guess they are a type of anti-depressant). He feels they are very helpful.
 
His last statement was to the effect that probably many folks in the support group are on these medications and I should ask about them.
 
You know, we talk a lot about a lot of sensitive issues here on HW. Heck, ED, penis size, orgasms, whatever.
 
But I don't see much talk about dealing with depression. I think we are still hesitant to admit that maybe we have some emotions where it is difficult to "snap out of it."
 
Personally, I am finding this to be true in my case, after getting my last shocking PSA that brought home the fact that I do NOT have an indolent PC, to say the least. My upcoming SRT will remind me of this every day (along with the possible SE), as if I need reminding.
 
Oddly enough, I hardly think about this at work. It remains joyous for me. But at all other times, this current situation is not easy. As I said awhile ago somewhere, my PC dx. was a body blow. I was sent reeling but I did the research, made a decision, had the surgery, and moved on. This second body blow seems to be worse than the first.
 
I know about exercise, etc. That helps.
 
But, back to the subject: Have any of you tried some of these drugs and have they been helpful
 
Mel (who usually eschews/hates taking any drugs!)
 
 
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/21/2011 8:58 PM (GMT -6)   
I, among others, have tried to bring up the subject of cancer and depression on several threads in the past, seems that the threads don't get too far. When I recently learned of my SRT failure, at the pressing of my nurse/wife, I talked to my GP about it, and he was surprised that I wasn't on something with all I had endured the past 2 years.

After a long talk, he wrote me a script for Lexapro, and gave me a few weeks samples to start, so far, I still haven't taken any at all or filled the script. Knowing I have it if I need it helps.

Was on Lexapro for about 5 years or so, more than 4 years ago, and what I didnt like about being on it, it killed all sexual interest (not ability) and it pretty well flat lined my personality and imagination and creativity. My adult children all noticed the last parts.

Its a trade off. So far, I have dealt with all that this nasty PC has slung at me, and I still bounce up. We will see what the future brings.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 3/21/2011 9:06 PM (GMT -6)   
David:
 
Thanks for the response.
 
I would not want any kind of zombie effect. Heck, at work I am enthusiastic and animated enough.
 
But at other times I have found (since the last PSA) that I am moping too much. It is basically a lack of enthusiasm.
 
Wife: "Do you want to go out to eat?"
 
Me: "Oh, I don't know."
 
Wife: "Hey shall we visit our grandchildren this weekend."
Me: "I guess"
 
I think you get the picture. That is not me. I am waiting to rebound and it hasn't happened.
 
Somehow, being zombified by the medication would exacerbate the problem.
 
Mel

Paralleli
Regular Member


Date Joined Jul 2008
Total Posts : 123
   Posted 3/21/2011 9:20 PM (GMT -6)   
Mel-

I've never taken any sort of anti-depressant myself, but know folks who do. I've never noticed any "flat lined my personality and imagination and creativity" or "being zombified" on their part. Quite the opposite, actually. Please talk to an MD in more depth about this issue if you think you need some help.
IMRT 1/07 - Doing well.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3987
   Posted 3/21/2011 9:33 PM (GMT -6)   
>>I would not want any kind of zombie effect. Heck, at work I am enthusiastic and animated enough.<
 
Mel --  i take 20 mg of celexa and it's been great for me. it beats the hell out of feeling like you are going to die all the time and not being able to talk without crying. there was a flattening of emotions for awhile that felt a bit unnatural but it passed, and i'm sure you know that doctors can regulate the doseage or switch drugs if the need arises.
 
ed

age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 3/21/2011 9:35 PM (GMT -6)   
I have mentioned an integrative approach to oncology before and this reminds of a good application of it. I believe that having a strong oncologist includes having a captain that can address these issues. This is an area I see lacking in the training of many urologic oncologists and radiation oncologists. Depression is a very real side effect not just with the ED or incontinence but as we move along in our therapies sometimes it just gets frustrating. i probably would have never seen myself going to a psychologist before I was diagnosed but if things get depressing from where I sit I won't hesitate. I do have other ways of dealing with depression and it has worked well for me.

Mel, I hope you feel better along the way. I think your on the right track in addressing this...

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

diamonds3
Regular Member


Date Joined Jan 2011
Total Posts : 112
   Posted 3/21/2011 9:41 PM (GMT -6)   
Dear Compiler,
 
 A doctor will adjust your medication or change the medication if it is not right for you but the patient must continue to try and stay the course. I know that welbutrin is often given with zoloft to counteract some of the loss of sexual drive. Sometimes it is very difficult to dig oneself out of a hole without help. Ultimately, we owe it to ourselves and our loved ones to be the best that we can be given our circumstances.

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 3/21/2011 9:42 PM (GMT -6)   
Mel, I just wanted to add that a member of my family has taken Lexapro for a few years with none of the side effects David experienced. It is different for each individual, and can be a positive experience as well. Also, another family member took an SSRI for several months after losing his wife and then stopped. They can be used short term.

I'm not recommending it one way or another except to say that depression can be so horrible and so unrelenting that the use of medication can be a blessing.

Wishing you the best as you begin your radiation treatments....

Juliet

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7080
   Posted 3/21/2011 9:48 PM (GMT -6)   
Mel,
 
If you think it will help, talk to the doc. I haven't asked for/used anything, so I can't speak to it.

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 3/21/2011 10:10 PM (GMT -6)   
Some people close to me are taking SSRI's. The results are good, side effects are sometimes rough at first, but within a few weeks, it tapers off. I remember my dad being somewhat depressed, I think AD's would have helped him...I didn't even think about it, until I read this thread.

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 3/21/2011 10:12 PM (GMT -6)   
Oh, just wanted to add, if those around you feel you're "zombied" then you need to adjust the dosage or medication. The purpose of anti-depressants is NOT to make you feel "zombied" but to make you feel more like your old self.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/21/2011 10:45 PM (GMT -6)   
I never said or used the term "zombied". Lexapro is the newer and improved version of celexa. celexa is now generic and cheap, whereby lexapro is still on its patent. i have been on both, and after a while, i just never thought about having or wanting sex, once engaged in the act - all systems would work fine, though there was sometimes a lack of ability to climax, you could keep going forever, but never be able to ejaculate (back when I still had a prostate).

its important to note, that everyone reacts differently to meds, so there is no right or wrong, or any absolutes, I think that needs to be made clear.

In the fall of 2006 (2 years before my PC dx, and with everything seemingly going well in my life) I was dx as Major Depressive Disorder) and was pretty close to doing what we can't talk about here. The right medications at the time in the right doses saved my life, so I am not trying to discourage anyone from taking anti-depressents. Mel asked, and I told him my experience only. Not meant to be advice to anyone else.

My creativity is one of the most importatn facets of whom I am, and that's one Quality of Life Issue I am not willing to compromise on again.

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 3/21/2011 11:33 PM (GMT -6)   
Thanks for the input. Food for thought, anyway.
 
Mel

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6067
   Posted 3/22/2011 12:34 AM (GMT -6)   
It's a fight Mel, I deal with it at times, oddly, enough it is not related to PCA. I'm not going to die from this and neither are you. Look I had no pos margin, but my path has some scary stuff. hey I dont like the ED, but whatta ya gonna do? But in my case it is usually brought on by my actions, smoking, not exercising etc. I had this problem prior to diagnosis. I've never taken any anti-depression medicine. Mainly be cause when I stop doing things that i Know are harmful to myself it goes away. Dont not take them for some macho reason, but try all other avenues first. Consistent and vigorous cardio exercise , reletive to age, really is a powerful mood enhancer. It gives you a sense of control and power knowing that your mind at least, in this instance, controls the body. IMO, we are here, to overcome, not be overcome, Heck we are all going to die some time, but not today. Much aloha to you both!
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 447
   Posted 3/22/2011 3:08 AM (GMT -6)   
Hello All,
 
I started on SSRI's before I had PCA...   Brought on by a broken marraige and divorce...  Got better,  re-married,  and got PCA...   Jeesh...   back to depression again... 
 
Anyway,  I learned a lot of info over the last 8 years and in dealing with depression...
 
1. It is REAL...   Once the depression is strong enough and the brain chemistry gets out of whack...  You do need professional help.   It is not something you can just buck up with and get over.   Not if you are in a serious clinical depression and your brain nuerotransmitter chemicals are messed up....  serotonin, norepinephrine, dopamine...
 
2. Family doctors do not cut it.   The depression field, medications, and treatment methods are too complicated for a general family doctor to keep up with.   Find a competent psychiatrist...  One who knows brain chemistry and is uptodate on current treatment philosophies. 
 
3. Family history and heridity are important...  There can be borderline brain chemistries that are more susceptable to clinical depression than others.
 
4. Learn your stressors...   learn your boundaries...   take some cognative therapy also...  Usually recommended with the SSRI's by a psychiatrist who knows his stuff.  I found a great ONLINE cognative therapy workshop supported by the Austrailian government.  http://www.moodgym.anu.edu.au/welcome
 
5. A treatment may initially involve one SSRI at a higher dose or two SSRI's at lower doses.  A lot will depend on initial reactions to first SSRI(s) tried.  The doc will have you come in every one or 2 weeks at the beginning to monitor effectiveness and side effects.   SSRI's used and dosages may change/adjust...   but this is why you have the psy doc and not a family doc.
 
6. You may not see significant effects for 4-8 weeks in some cases.  Also note that many side effects may gradually disappear after 4- 8 weeks also.
 
7. Good sleep is important...   many depression episodes may be kicked off by stressors and  lack of sleep... brain chemistry starts getting out of balance...  serotonin or other chemicals get used up...  and you spiral dooooown....   You may also be given some supplemental pills at the beginning to get normal sleep patterns back.
 
8.  Depending on the depth of your depression, recovery, and other heridity factors,  you may stay on a significant dose for 6 months to a year...   then slowly backed off and monitored.   You may end up on a lifetime small maintainance dose...   or be able to get off them entirely.  But also know the signs when to seek treatment or go back on a small maint dose again.
 
9. A good psy doc can balance medications if sex drive or feeling like a zombie is an issue...  You can be on SSRI's and if managed correctly,  be very creative...  He will get to know you brain chemistry after awhile and be able to tweak things just for you...  A family doc does not spend enough time in the science to understand or keep up with it...  he also does not know all the side effects or synergistic/antagonistic effects between the drugs except for summaries read in a PDR...   and where combination drug treatment options are not considered...
 
10. You may be on full dosages for a year,  and then be able to taper off to either a smaller maint dose on maybe off of all pills altoghether...   It will be determined by your particular brain chemistry, response,  and how you handle stressors and set boundaries to what you can or cannot handle in your current state of mind...   Just like a computer,   your brain can and will crash if it gets too far out of whack...   Your best tool to dealing with depression is to learn the signs of when you are slipping and catch it in the bud before major brain chemistry episodes take over.
 
Long winded,   but I have spent a lot of time there...   and have experience with mutiple episodes with somewhat different treatment scenarios to draw upon...  :-)  
 
I will also answer most any question...   here or private email if you like...
 
Take care and God Bless!

3/2007 - Dx 59 y/o - 12 point biopsy - Left 0/6 Right 1/6 Gleason 3+3 T1c
4/2007 - DaVinci RRP performed - Gleason 6 T2c Nx Mx
PSA 7/07 0.01, 6/08 0.02, 12/08 0.03, 10/09 0.13
11/09 Consult BCR and rec for SRT
1/2010 IMRT SRT - 32 sessions 2 gys for 64 gys total.
6/2010 3 mth PSA post SRT 0.02
1/2011 10 mth PSA 0.01
My Extended Signature

Post Edited (pasayten) : 3/22/2011 2:16:09 AM (GMT-6)


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 3/22/2011 4:05 AM (GMT -6)   
Mel,
From what you say, you have lots of interesting and exciting things to do at work. So you hardly need the drugs there.

But at home, you don't have anything equally interesting and exciting. So is it worth working on that? Something new that you've always wanted to do but haven't got around to -- clubs, hobbies etc? Just a thought...
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but now 0.4, doubling time 7 months
No radiation but ADT coming unless I can slow down the rise...

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 3/22/2011 7:41 AM (GMT -6)   
More Food for thought-> I've had good results from a relationship with my head shrinker aka Doctor Don the Psychologist.
 
I first visited him after a failed relationship. You know – the kind where you lose 30 pounds in six weeks. I was eaten up with stress, anxiety and panic attacks. He helped me deal with – cope with – understand it and more importantly -> “get over it.”
 
The placebo affect commonly found in pharmaceutical clinical studies is a good example of psychology at its best. A percentage of people get better or show improvement by taking a sugar pill. And everyone concerned agrees that its not the sugar that help the participant.
 
“I think I am better – therefore I am better.”  

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 3/22/2011 7:48 AM (GMT -6)   
Mel,
meds are like pinning a tale on a donkey, what works for one might not work for another. Lexapro helps more with depression and OCD and Celexa a lighter form of that better used for depression and some OCD. But there are others and if I felt like I needed it I would take it. Right now just battling thru this and the loss of my parents with exercise, but I have down moments and who wouldnt. best to you.
Michael

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 3/22/2011 10:32 AM (GMT -6)   
Folks:
 
Thank you so much for your responses. As I said, we seem to be willing to talk about everything, except maybe admitting the depression element. It was not easy for me to even post this.
 
In my life, I have very rarely been depressed. There have been some stressful times where I've been upset for a few days or maybe even a week or two, but then I would just GET OVER IT. That was even true with the PC dx. But this latest setback really does say that I am dealing with such an aggressive PC and that has created emotions that are impacting my life (still, amazingly, not at work).
 
One concern is the side effects of these drugs: by itself, that's okay. But with SRT starting later today, I really don't need a constellation of side effects (and good luck, possibly, sorting out what is causing any individual SE).
 
I'm going to see how things go. Hopefully, I will adjust on my own but if not I will still see my family doctor for starters.
 
Mel

Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2460
   Posted 3/22/2011 11:03 AM (GMT -6)   
Mel,
I have never taken SSRI drugs, lately, I've been experiencing some anxiety that Didn't happen except the week of PSA test. I wake up every morning thinking about PCa and where this journey will take me. I try to keep busy with my vegetable garden, golf, grandchildren, and exercise but PCa is never too far away. I hope that my next PSA test will be still undetectable may be it will bring some comfort otherwise, I may look into the possibility of using SSRI drugs.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18, 21 months) undetectable
Latest PSA test (2 years) <.008 ?

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 3/22/2011 12:24 PM (GMT -6)   
ED C. - head over to one of the Baby Acapulco resturants and grab a cold margarita and a hot co-ed and you'll fell better in no time yeah

Viperguy
Regular Member


Date Joined Nov 2010
Total Posts : 259
   Posted 3/22/2011 12:55 PM (GMT -6)   
I'm glad you folks are discussing depression and anxiety. I was on Zoloft and 1 or 2 Xanax pills per day due to anxiety and depression before all this PCa stuff. These drugs really helped take the edge off. However they kill your sex drive and sometime make you a little sleepy. I never felt like a Zombie or lacked emotion. The drugs allowed me to control emotion better ( and no I'm not Mr. Spock). When the PCa was found my Urologist insisted/demaned I stop all the anti-depresants. "If you want a good outcome with this surgery you must be off all depression meds". WOW! That was very hard for me to do. However I have been off these drugs since 03/05/11, cold turkey (which is not recommended). The Urologist said "Take Xanax and you will always leak". My Uro is not one to mix words and told me to find another Urologist if I can't stop taking these anti depressants.

I really miss taking these meds. They relief anxiety and give me very restful sleep. However i want to be normal again particullary with this leakage issue. I tried to google anti depression meds and incontinance but could not find any coorelation.
2009 PSA 2.2
2010 PSA 3.2
Biopsy 24 cores 3 positive
Gleason 3 plus 3
Robotic Surgery March 3, 2011 @ 6 am
At home recovering
Cath removal scheduled 3/17/11
Pathological report confusing, no seminal invasion Gleason 6 but margins not completely clear.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 3/22/2011 10:19 PM (GMT -6)   
Is Xanax one of the SSRI's?
 
Mel

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 3/23/2011 12:02 AM (GMT -6)   
I'm curious why being on a/d's would affect the outcome of prostate surgery.

pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 447
   Posted 3/23/2011 12:21 AM (GMT -6)   
I would have found a different Uro from one who just blankly said get off all antidepresant meds... He is negligent in seeking the best overall treatment for his patient which should include both physical and mental health aspects. I would find a Uro that would work with a Psy Doc for the best overall management of medications and their potential side effects for somebody that was going to be treated for PCa....

Mel, Xanax is not a SSRI, but a central nervous system (CNS) acting medication... More to control anxiety aspects... Concern could be for contenance aspects... I imagine it could cause relaxing of muscles that could lead too leaking urine? Or influence the muscle communications between bladder and control valves/muscles? Would have to ask a psy doc.

For the SSRI's, a concern might be their potential side effects with sexual drive and performance aspects since ED is such a concern after PCa treatment.

With a good psy doc, I believe a balance could be found... They found a balance for me.

pasayten
3/2007 - Dx 59 y/o - 12 point biopsy - Left 0/6 Right 1/6 Gleason 3+3 T1c
4/2007 - DaVinci RRP performed - Gleason 6 T2c Nx Mx
PSA 7/07 0.01, 6/08 0.02, 12/08 0.03, 10/09 0.13
11/09 Consult BCR and rec for SRT
1/2010 IMRT SRT - 32 sessions 2 gys for 64 gys total.
6/2010 3 mth PSA post SRT 0.02
1/2011 10 mth PSA 0.01
My Extended Signature
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