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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Jenny on April 13, 2000, at 9:31:02
I am on Serzone and doing reasonably well with it. I got bronchitis. The doctor (regular doctor, doesn't know me, I told him I'm on Serzone) put me on Ceftin (antibiotic) and Claritin-D (decongestant). I spent the next week unable to sleep and when I did a little I had nightmarish dreams. In the daytime I grew very sad, very irritable and had a lot of very negative, distorted thoughts. I felt like I was falling fast into a very deep agitated, paranoid sort of depression. I got that feeling of being in this deep, dark place I'd never get out of. I didn't know if it was fatigue from the bronchitis (I foolishly kept going to work through this) or the medications, or the medications interacting with my Serzone. I stopped the claritin-D and though I remained fatigued, my sleep and mood eased improved. I have now finished the antiobiotic, though the bronchitis is lingering and I still wheeze. My question is does Claritin-D and decongestants in general bring on depression in people prone to it? I'm reading a book called "A Mood Apart" by Peter Whybrow about mood disorders and a doctor friend of his in there talks about managing his own bipolar disorder (I'm not bipolar) and he says he knows to avoid triggers by making sure he sleeps enough and avoiding cold medications. So is there a known link here between cold medicines/decongestants/antihistamines and triggering depression? Thanks for any responses.
Posted by saint james on April 13, 2000, at 10:53:13
In reply to Decongestant drug interaction?, posted by Jenny on April 13, 2000, at 9:31:02
> I am on Serzone and doing reasonably well with it. I got bronchitis. The doctor (regular doctor, doesn't know me, I told him I'm on Serzone) put me on Ceftin (antibiotic) and Claritin-D (decongestant).
James here....
It was the D in Claritin-D that made you feel funny. Yes this is a side effect, decongestants do have this effect on some people.
james
Posted by Fran on April 13, 2000, at 14:12:42
In reply to Re: Decongestant drug interaction?, posted by saint james on April 13, 2000, at 10:53:13
> > I am on Serzone and doing reasonably well with it. I got bronchitis. The doctor (regular doctor, doesn't know me, I told him I'm on Serzone) put me on Ceftin (antibiotic) and Claritin-D (decongestant).
>
> James here....
>
> It was the D in Claritin-D that made you feel funny. Yes this is a side effect, decongestants do have this effect on some people.
>
> jamesDecongestants are not the only thing to watch out for. I did a lot of research on prednisone when my daughter sustained an injury that caused her to have Bell's Palsy before Christmas. The doctor told us the prednisone could either cause her a high or a real low. My oldest son had taken it for Cystic Fibrosis and hated the way it made him feel and the come down after. I ran searches on Medline and found that taking prednisone (steroid) can induce depression. After reconciling the fact that the doctor had said that it might not do the Bell's any good anyway and the fact that my daughter had been free of depression almost two years, we decieded not to take the risk. I had reminded him she had had depression before and he dismissed the connection and was willing for her to take the risk. We were not.
As an informed client we did not take the prednisone, researched Bell's Palsy, got feedback from folks on a depression med board and made what was ultimately a good decision. Typically, Bell's Palsy resolves itself if not a symptom of some other condition, it did for her and she is fine now.
I think that with the resources available via the net we can be more aware of the concepts of meds and principles of "disease" if not the complex chemical processes we are made of. Seeking out med books/journals slowed me down before. Being an informed and involved patient is touted as the ideal these days but in fact is not always welcomed. I believe in the concept, find the information helpful and will continue to learn about "what ailes me"!This site is great, by the way, and a good place to start.
Fran
Posted by saint james on April 13, 2000, at 16:30:17
In reply to Re: Decongestant drug interaction?, posted by Fran on April 13, 2000, at 14:12:42
> Decongestants are not the only thing to watch out for. I did a lot of research on prednisone when my daughter sustained an injury that caused her to have Bell's Palsy before Christmas.James here...
We have discussed prednisone here b4, I have taken it for years off and on as needed and sometimes at high doses while living in the south
with no problems. I used prednisone many years prior to going on AD's so I was comfortable with it and really needed to use it for bad allergies.
It can push people right over the edge, the most common being manic or psychotic reactions to it.james
Posted by Cindy W on April 13, 2000, at 21:30:14
In reply to Decongestant drug interaction?, posted by Jenny on April 13, 2000, at 9:31:02
> I am on Serzone and doing reasonably well with it. I got bronchitis. The doctor (regular doctor, doesn't know me, I told him I'm on Serzone) put me on Ceftin (antibiotic) and Claritin-D (decongestant). I spent the next week unable to sleep and when I did a little I had nightmarish dreams. In the daytime I grew very sad, very irritable and had a lot of very negative, distorted thoughts. I felt like I was falling fast into a very deep agitated, paranoid sort of depression. I got that feeling of being in this deep, dark place I'd never get out of. I didn't know if it was fatigue from the bronchitis (I foolishly kept going to work through this) or the medications, or the medications interacting with my Serzone. I stopped the claritin-D and though I remained fatigued, my sleep and mood eased improved. I have now finished the antiobiotic, though the bronchitis is lingering and I still wheeze. My question is does Claritin-D and decongestants in general bring on depression in people prone to it? I'm reading a book called "A Mood Apart" by Peter Whybrow about mood disorders and a doctor friend of his in there talks about managing his own bipolar disorder (I'm not bipolar) and he says he knows to avoid triggers by making sure he sleeps enough and avoiding cold medications. So is there a known link here between cold medicines/decongestants/antihistamines and triggering depression? Thanks for any responses.
Jenny, I've heard that some decongestants can interact badly with AD's. I've taken Entex for at least l0 years, for allergic rhinitis, and have never had problems with it in terms of interactions with AD's (Prozac, imipramine, Luvox, Zoloft, Serzone, or Effexor-XR). But ask the pharmacist or your pdoc before you mix AD's and antihistamines or decongestants.
Posted by Fran on April 17, 2000, at 14:00:36
In reply to Re: Decongestant drug interaction?, posted by Cindy W on April 13, 2000, at 21:30:14
> > Hi Jenny,
My daughter was told not to take Seldane with Effexor a couple of years ago. Wish I knew the chemistry, but do not, but telling the Pdoc what meds and natural substances you are taking is always a must. If you forget something ask the pharmicist. Because each patient's chemestry is different, care should be taken when taking multiple drugs. Keeping notes of how drugs effect you (on a calender or in a journal)is a good idea. Believe me it is so easy to forget even after a few days.
Good luck.
Posted by Cam W. on April 17, 2000, at 19:51:47
In reply to Re: Decongestant drug interaction?, posted by Fran on April 17, 2000, at 14:00:36
> > > Hi Jenny,
> My daughter was told not to take Seldane with Effexor a couple of years ago. Wish I knew the chemistry, but do not, but telling the Pdoc what meds and natural substances you are taking is always a must. If you forget something ask the pharmicist. Because each patient's chemestry is different, care should be taken when taking multiple drugs. Keeping notes of how drugs effect you (on a calender or in a journal)is a good idea. Believe me it is so easy to forget even after a few days.
> Good luck.Fran - You have some good advice about disclosing all medications (prescription, non-prescription and herbal) to both your doctor and pharmacist.
As to your doctor's advice about not combining Effexor with Seldane may be a little overcautious, but not unwarranted. Both of these drugs are metabolized by liver enzymes of the cytochrome family (CYP-3A3/4 to be exact). Effexor only weakly inhibits this system and probably does not affect the metabolism of Seldane that much, if any.
If the the antidepressant were Serzone, Luvox or Prozac and was taken with Seldane, the combination could be deadly. These antidepressants are potent inhibitors of CYP-3A3/4. This means that they stop the body from producing this enzyme and the Seldane would not be metabolized as effectively and blood levels could build up. High blood levels of Seldane can affect the heart (prolongation of the Q-T interval). It is this reason that Seldane was pulled from the OTC market in Canada. When Seldane was taken with Erythromycin (an antibiotic with potent CYP-3A3/4 inhibition) it did cause a few deaths from heart attacks.
Like I said, the chance of this happening with Effexor and Seldane is small, but it would be safer not to take the two together (just in case). I, myself, would not take the combination of Effexor and Seldane because even though the risk of heart problems is small, there is still a risk. Like you said, individual chemistry does figure into the equation.
- Cam W.
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