antidepressants - some better than others?

[plumeria]

Hello,

I am relatively new to the IC world and I have a question. Elavil seems to be the recommented antidepressant for IC. Are there other antidepressants that are effective as well? I am looking for depression relief as well as pain relief.
plumeria

[poetgirl]

Hi Plumeria,

Elavil is an older tricyclic antidepressant usually prescribed for IC patients for pain relief, because it helps block nerve pain and calms bladder spasming. It is not usually prescribed at the dosage necessary for treating depression. Instead, doctors may prescribe a SSRIs (Prozac, Zoloft, Paxil) for the treatment of depression. For example, I take both Elavil and Zoloft.

However, I will caution that care must be taken when you're simultaneously taking a tricyclic antidepressant and SSRIs. The SSRI dosage should be very low to start (less than 25 mg) or you may experience very unpleasant drug interactions. The following is from www.rxlist.com describing possible interactions between Zoloft (for example) and TCAs:

"Tricyclic Antidepressants (TCAs): The extent to which SSRI TCA interactions may pose clinical problems will depend on the degree of inhibition and the pharmacokinetics of the SSRI involved. Nevertheless, caution is indicated in the co-administration of TCAs with sertraline HCl, because sertraline HCl may inhibit TCA metabolism. Plasma TCA concentrations may need to be monitored, and the dose of TCA may need to be reduced, if a TCA is co-administered with sertraline HCl"

I have been taking 25 mg of Elavil since last June, and started on 25 mg of Zoloft about a month ago. I found that I had to cut the dosage of Zoloft in half because it was impossible for me to function. This is not to scare you away -- I'm doing fine now and feeling less depressed/anxious. If you are experiencing depression and pain, you should definitely get medical attention, but it's important to understand how TCAs and SSRIs are used in the treatment of IC and depression/anxiety.

Good luck!

[plumeria]

Thanks for your reply - I guess I will have to discuss this with my Dr. I am also taking celebrex 2xdaily and vistaril at bedtime. I have dealt with depression on and off all my life I have been taking SAM-E but feel it is just not doing the job, I find myself getting more and more discouraged by the on and off again pain of the IC. I am currently trying to get Elmiron from the drug co low cost/free program. But it hasn't come thru yet.
I also take 1/2 vicodin when the pain exceeds my "threshold" of tolerable.

Thanks again!

[Dixiefireball]

i take lexapro but trying to come off it again its not that i don't like it or it doesnt help its just that i hate the thought of taking more meds.
i'm praying after my surgery on may the 19 to have my hunner removed from my bladder I will come off most of my medicine inclueing my pain meds i'm so sick of taking pills. i pray and hope after my surgery and i have healed up i will go down to nothing but maybe a klonopin when needed and a dmso treatment which i do at home.
I hope you find something you like soon.
sending you hugs and prayers
Rhonda.
Oh BTW welcome to the icn family.

[Lyn40]

Rhonda, good luck with your surgery. I hope you can get off those meds.

Poetgirl, thank you for posting all the info. That is good info that we should all be aware of.

Lyn

[ICNDonna]

It's not possible to know which antidepressant would be best for any one individual. Many ICers do take low dose elavil --- my system didn't like even the tiniest dose of it so I had to stop taking it. There are many different antidepressants available; it may take a little while to find exactly which is best for you.

Warm healing thoughts,
Donna

[Iris]

I know it took a while for me to find the right meds, I am on Elavil and Effexor XR, and so far so good. I also have pain medication when needed. It took a while to find the right combination. Take care and hugs Iris.

[Christa]

Hi

Consider imipramine. It works for nerve pain and the side effects are minimal.

Christa

[Sue]

I think. I was on imipramine it worked well for me.