Please help my depressed friend! ADs question

[aloha]

I have a good friend who is a single parent with no contact or help from her son's father. She's really struggling with depression (and exhaustion if you ask me) and has got worse lately. I'm really worried about her. She has been to see her GP about anti-depressants, but says that they make her very nauseous (which she finds hard to cope with as she has a phobia about vomiting which gets worse when she is depressed - catch22) and stop her sleeping.
Can anyone help by recommending ADs without these side-effects or ways of minimising the side effects. She's a lovely person but struggling so hard at the moment bringing up her lively nearly-three year old on her own.

[Kayleigh]

Your poor friend. What has she taken aloha ?
I take prozac with no side-effects whatsoever. But everyone is different and I know people who have had problems with prozac.
Took something before (Liofapramine sp?) which I wasn't really happy on. Felt a bit spaced out with it.

[aloha]

I'm sure it was Prozac. Will call her later to ask more.

[spacemonkey]

I think finding the right AD is a trial-and-error process (according to my GP anyway). The reaction to different ADs varies from person to person. Your friend's GP should be able to help her find the right medication for her. Trouble is, it does take a while for the SSRI type ADs to work, so no quick fixes

If she can afford it, has she considered homeopathy as an option? I know several people for whom it has been v effective in combatting depression.

So sorry to hear what a struggle things are for her - it's so bloody tough doing the parent thing on your own

[aloha]

I will mention homeopathy to her. There is a place near us. Trouble is she hasn't got much money due to her situation. I don't think her GP is very good at helping her find an AD to suit her. Is the nausea a very common side effect with all types?

[layla]

Aloha,I can recommend effexor XL which other name is venlafaxine-has no side effects it's brilliant.

[Blu]

Is Cipralex is one of the newest? I think the thing with ADs is that any side-effects only last a couple of days, and you have to tough it out a bit until the side-effects (v minor...a bit of wakefulness and in my case v slight nausea) wear off and the effect begins to work. I'm on Cipralex and the nausea lasted about a day and a half, but felt the benefit within one day.

[aloha]

Blu, it's hard for her because she has a severe phobia about vomiting which gets worse the more depressed she is. The sensation of nausea provokes frightening panic attacks I'm really worried about her. Have been doing research on the net (pharmacists' site) though and it seems you can use Motilum (Mears' beloved Domperidone!) as an anti-emetic with SSRIs without side effects or interaction so am recommending that. Any pharmacists online who can confirm? Susammt, could you check with your dh please? Also will talk to her about Effexor. I'm seriously worried about her.

[aloha]

Blu, it's hard for her because she has a severe phobia about vomiting which gets worse the more depressed she is. The sensation of nausea provokes frightening panic attacks I'm really worried about her. Have been doing research on the net (pharmacists' site) though and it seems you can use Motilum (Mears' beloved Domperidone!) as an anti-emetic with SSRIs without side effects or interaction so am recommending that. Any pharmacists online who can confirm? Susammt, could you check with your dh please? Also will talk to her about Effexor. I'm seriously worried about her.

[WideWebWitch]

Aloha, I'm sure you're right and she does need anti depressants but are there other things too that might help her? I was on my own when ds was 3 and it was so bloody hard, it really was, so I feel for your friend. Has she got a computer? Can you send her here? Does she have other single mum friends? Could they take turns giving each other a break? God, I do think being on your own + lively boy + little money is almost bound to = being down or depressed. Poor her. For me, fear of the side effects stopped me getting anti depressants: I almost think that can be part of the depression iykwim - fear of side effects and actually taking them. I had panic attacks too, not often but scary all the same. Might she go for yoga if you were to suggest it? It's incredibly relaxing and helps with breathing which is good if you're trying to stop a panic attack. I'll post again if I think of anything.

[shanequa]

i've just had a baby and i'm suffering with pnd, i also have a phobia of vomiting. i went to see my doctor today but she didn't want to put me on anti depressants as they can sometimes create problems of there own. though i've heard there are some natural ones about without side effects.

[unicorn]

aloha- has your friends doctor recommended counselling- if she has a phobia as well as being depressed it sounds like she could do with talking it out a bit (unless she doesn't agree with this type of therapy?)

[aloha]

WWW, she is on a waiting list for CBT on the NHS, but it might be six months! I've suggested she goes back to her gp and talks to them about how desperate she is - she looks so lovely and glam that I think she comes accross as more OK than she is. She stays at her parents a lot but they don't understand really. I have offered to have her ds but she finds it hard to accept help. If I send her here (which is a good idea actually) I will have to get this thread deleted I think! She's a fantastic person but in such a spiral of gloom and panic and overwhelming anxiety about her phobia...

[susanmt]

hi aloha!
dh says that Cipralex would be a good option as the side effects are less, or the one I am on, sertraline (Lustral). Prozac is actually one of the worst of the SSRI's for side effects in most people (mainly because it was the first to be made).
She could also try one of the tricyclic antidepressants, the older ones. They're just as effective as the newer ones but they are more dangerous in overdose and they have a wider range of side effects which can be quite unpleasant such as dry mouth, blurred vision, vertigo (though not normally nausea). If she has this severe phobia then they could be a good option. They do make you a bit spaced out though.
The other option is to take an anti-emetic alongside the ad for a few days. Something like Buccastem, whic you put under your tongue, would be good. He also says if it were him he would give her a very low dose of diazepam to take in case she had panic reaction, not enough to make her dopey, just enough to have a couple to calm her down as aniety reactions are so distressing for the patient and he hates to see people unable to take medication because of that - he's got a patient who used depo-provera but is afraid of needles so she comes in half an hour before her injection every 3 months and has a little diazepam first. It's not a problem as long as you don't use it regularly, he would give her 5 to have in case she did get nauseous and panic, until someone could get there to see her.

As someone else said, he would also advise CBT or some other form of psychotherapy, not only for the depression but also for the phobia, as it seems to be quite crippling for her. If she was his patient he would probably be referring to the psychiatrists for this, but that's here, where you can see a psychiatrist next week or even sooner if you need to.

Don't know if any of this is any help. He says just ask if there's anything else you want to know, he'll try to help.

[aloha]

Thank you so much Susanmt. I'm really grateful to you and your dh. Would it be safe to take Motilium with a SSRI if her gp continues to refuse to prescribe an anti-emetic? I don't think her GP 'gets it' in the same way your dh does. I have suggested she pushes her gp to get a quicker appointment, but I think there is a lot of demand around here. He's right, the phobia is crippling her. She can't sleep, is obssessed with handwashing and is genuinely desperate.
She has just been prescribed Lustral so I hope she can take it.
Thanks again.

[NancyKominsky]

Has she considered Seroxat? I know it has had a really bad press but a friend of mine who had almost identical sounding phobia/anxieties used it and had fab results - she had no problems coming off either, but took it VERY sloooowly, took her 6 months to wean off but no side effects.

I also agree with www - she sounds under tremendous stress and strain and would benefit by looking for ways to make life a little bit easier on herself.

[WideWebWitch]

Aloha, I really feel for her. I looked quite glam and together too but I was permanently crying inside at the time. Can you go to the GP with her? Getting this thread deleted and sending her here might help - a lot of people have said this site saved them or just helped them when they were depressed. I wish I'd have known about it back then.

[susanmt]

aloha, no problem. SHould be OK to take that combination (she says sneakying a look in dh's bnf).

www - I always thought you sounded quite glam, and now you ave confirmed it!

[aloha]

Hi and thanks all. I persuaded her to go back to her gp and she has finally agreed to prescribe an anti-emetic - hooray - and so my friend is now going to take the ADs. Sadly, she has a very unsupportive family but we had a nice day today with our lads and am hoping to persuade her to let me look after him the odd afternoon and maybe even overnight so she can have more of a break. She has also gone back to the gp to try and get higher up the list for counselling. I hope all this will work. Thanks for your help. I think I will talk to her about Mumsnet and try to persuade her to log on. Thanks again - esp Susanmt and her dh - I read her your post over the phone and it was the trigger that persuaded her to go back to her gp.

[essbee]

Message withdrawn

[kizzie]

Aloha - im really glad your friend is getting proper help now. Just to confirm what others have said - even if she does get some nausea it usually only lasts a few days (the worst Ive heard of is someone who really did get it bad and it lasted a maximum of 10 days.) A know at the time this must have seemed never ending but at least you should be able to reassure her that it will go away.

Also apart from the Motilium all the things that help with morning sickness tend to help a bit (ginger, 'trying' to eat something plain every couple of hours etc etc.)

Hope shes feeling loads better soon.
Kizziex

[susanmt]

Aloha, glad we could help. I know dh is a good doctor and wish everyone elses GPs (including my own) were like him!
So glad to hear she is getting the help she needs. I'm glad to hear you will try to persuade her on mumsnet too, honestly it has been the most reassuring thing for my parenting and especially for my depression!

[aloha]

Thanks everyone