Anti-depressants, bladder incontinence and CCSVI

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Anti-depressants, bladder incontinence and CCSVI

Postby hoodyup » Wed Mar 03, 2010 11:52 am

Need a little advice from those who have had the procedure. We have an appointment with a vascular surgeon to scan my wife for CCSVI on March 18. It is all I can do to keep from pacing my way around the globe to speed up the time (like Superman). In the meantime, my wife's spirit is deteriorating as is her health. A social worker came to visit us after a home health nurse saw what immense suffering she was enduring and how much stress I am under trying to keep it together for the both of us. Both the nurse and the social worker immediately saw that my wife is extremely depressed and she will cry at the drop of a hat. They both recommended she get a doc to prescribe anti-depressants.

She is against them for the following reasons:

1. She has seen "loopy" friends who have no motivation to help themselves become even loopier and not care about improving their lives (like vacuuming once in a while).
2. She is afraid of side effects. If it has 'em, she'll get 'em.
3. She feels that she will be zombified and not care if she wets herself or showers or anything. She has been the most resilient person for the last 5-1/2 years since diagnosis. However, in the last few months she is falling apart emotionally and physically. She sleeps most of the time and rarely gets out of bed. Her disability level is about 8.5, meaning that she can barely get out of bed to transfer to a wheelchair. I believe she has more right than anyone to feel depressed, I just don't want to see her get so despondent that she is in misery 24/7. Anyone know of any contraindications with starting an anti-depressant prior to having the procedure done? She is looking for any reason not to take these things. Anyone taking one, and if so which one and does it have side effects?

Also, anyone know of anything to help with urinary incontinence? It has gotten really bad in the last 2 weeks. It isn't a bladder infection, and it will come and go in 3 hour windows. I am hoping the procedure (if she has one) will help even just one or two of her symptoms and make her a happier person. It's just that all this waiting is not helping her and she is progressing fast. I read this forum all the time and sometimes it is all that keeps me from losing hope altogether.

Thank you all. Andrew
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Postby Cece » Wed Mar 03, 2010 12:56 pm

I have not had the procedure so I can't help with that. What a tough situation you both are in. I've never heard of antidepressants being contraindicated for people who are having angioplasty for heart reasons or elsewhere in the body. I would think she could try the antidepressants and if she has side effects or feels loopy she could always go off them or switch to a different one. I suppose starting them so soon to having the procedure could mean that you wouldn't be able to tell what effects are the result of the surgery and what are the result of the antidepressants (which can take six weeks to take full effect)...but since both are likely to have positive effects, why worry? For my husband the main side effect of antidepressants has been weight gain and he is currently on one that does not seem as effective as his previous ones...it can be trial and error to find which one is best.
"However, the truth in science ultimately emerges, although sometimes it takes a very long time," Arthur Silverstein, Autoimmunity: A History of the Early Struggle for Recognition
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Postby MaggieMae » Wed Mar 03, 2010 1:28 pm

My husband had Botox shots for the bladder issue. Really made a difference. My thoughts are with you both.
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Postby Johnnymac » Wed Mar 03, 2010 3:37 pm

Hi Andrew, sorry to hear your wife is having a hard time, but its very good news that her scan is already scheduled!

Depression is s tough one. My wife has tried a couple of different anti-depressants in the past but nothing really did much for her, but everyone seems to respond differently. I can say that marijuana helps tremendously. Not only with spasms, but with stress (which I think is a HUGE thing), and hey, it helps her laugh at little things which I also think helps quite a bit. PM me if you have any specific questions on how to go about getting some if you are unsure how.

Currently my wife takes Desmopressin for her bladder problems (she's tried a handful of meds for bladder control) and it seems to work pretty well, not sure if its applicable to your exact situation but may be something to look into.

Best of luck, tell your wife we're wishing her well and I hope she can get some relief soon!
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Postby Rokkit » Wed Mar 03, 2010 4:09 pm

When I began to be aware of what was wrong with me, I got extremely depressed, couldn't function at all. Anti-depressants brought me back from the brink in a matter of days. My advice would be to try it. If you don't like the way they make you feel you can stop. But they literally saved my life. I'm not on them any more. Just needed it for a few months so I could get my wits about me.
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Postby dunkempt » Wed Mar 03, 2010 6:17 pm

Anti-depressants brought me back from the brink in a matter of days. My advice would be to try it. If you don't like the way they make you feel you can stop. But they literally saved my life.


Yes. This is true for many, many people. I resisted even the *idea* of anti-depressants for a long time. But the "won't bother vacuuming" apathy you see in some people on anti-depressants is more like depression itself than a side-effect.

I have been on 5 (so far), and sometimes things change or side-effects develop, but when you're on one that is working what happens is just that *you don't feel depressed*: You feel normal.

You are sad about things because they are sad, not because everything makes you sad. Not weird, not loopy - and not necessarily happy either. Because the opposite of depressed is none of those things - it is NOT DEPRESSED.

A pathologist I knew in college felt that they were actually the most *under* prescribed drugs. Because they have a high success rate and because they do literally save people's lives. So I bore people talking about mine all the time (sorry).

I have never been suicidal - but my depression has been bad enough that I have literally felt like a life that would always be that miserable *wasn't worth living*. (Best not to find out what the next stage is, I think.)

So I've been on Wellbutrin for almost a decade. It's the one that actually has a happy face on it! Which is funny and stupid and wicked, if you like. And Wellbutrin tends to make you a bit jumpy and maybe lose weight (both of which side effects eventually wore off, sadly). But it brought me back from that place - so I smile back at it.

-d
dx rrms august 2009 (dx CFS spring 1988) off avonex after 3 months
treated katowice 24-25 march 2010 - best thing that ever happened - check tracking thread
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Postby facetspera » Wed Mar 03, 2010 6:48 pm

Hi, sorry to hear you are both having a difficult time.
I have not had the procedure, and like Cece have not heard of any contraindications of antidepressents and the procedure.
Some personal experience:
- I've been on anti-depressents for a while. They don't make me loopy (ier). There are a bunch of different types of a.d. and it takes a while to find the right one, and the right dose. At first my gp gave me a prescription. I found when I saw a psychiatrist who had pharmacological experience it was way better. They were able to slowly adjust me to the right level, and depending on side effects, make adjustments. So I'd reccomend you just find someone who has experience with a.d who can help you find the right one. If that is the route that you choose
For a long time I battled against taking anything, thinking I just "needed to get my act together". When I was on the proper type and dose, I found that my quality of life changed. It didn't make living with MS fun but I was able to be more constructive about things. Before I'd just sink into feeling so badly that nothing felt worthwhile and I let MS totally control my whole life and felt too hopeless and helpless. So I certainly believe they have a place.
As a note, one neuro-psychiatrist said that MS lessions could be in areas that affect mood. It made my, then husband, more supportive of anti-depressants. He was one of those "just suck it up and get on with life" kind of people. But I digress.
With bladder, my doctor said drug options depended on whether the problem is incomplete voiding (the bladder doesn't completely empty when you pee, so you have to go again in a short time) With this type, bladder drugs cause infections because they slow down the bladder and the urine that hasn't been voided can cause infections. I found accupunture usuful for me. I was in a study for it with MS bladder problems and while the results of the whole study were inconclusive - accupunture worked for me.
Anyway, good luck. I'm glad you have an appointment this month. Being in limbo is horrid (I think)
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Postby Rose2 » Wed Mar 03, 2010 6:49 pm

Andrew,
I am so sorry to hear how things are going for you both. I wish you a nice spring day SOON! ;)
I have had the procedure, with stents and have had great results.
I have also taken an antidepressant for years, and this is before I was was ever diagnosed with MS.
I have taken a few thru the years as new ones come and the MD changes me.
I see a psychiatrist for my meds. He doesn't do counseling, just meds and he is really good at it.
MS REALLY put my depression into overdrive. I don't know if it is the MS physically or just dealing with the whole issue. I believe MS to be so overwhelming that it is easy to get out of control depressed.
I strongly recommend your wife to see a psychiatrist (get a referral from a doctor you like) and try what he would recommend for her.
I have been taking Pristiq for quite a while now and it works very well.
I have gone thru stages where I try to go without it because I don't WANT to take any more meds, but it always comes back to my quality of life.
I cannot get things done or function as well physically if I am depressed so I would hope that the anti-depressants would also help your wife in more than a few ways.
So, no I did not stop my anti-depressant for any of the CCSVI testing or procedure. Because I have been on it for years, I can say that all my improvement is not related to the medication one way or another.
I do not see any reason to wait before your wife tries medication to help her with the heavy grief she is dealing with.
Depression is painful and heavy just by itself. It can feel like drowning.
It is hard to fight and then throw some MS on top. yes, she is really rowing upstream.
I hope this helps. I know she will feel better if treated. The problems she saw in her friends behavior on meds sounds like they were not properly medicated, but the fact that she is already aware of that and what she doesn't want to feel will help keep her in control. They are not sedating and they actually lift you up and get you going. or at least for me.
Sincerely, Rose ;))
My diagnosing MS MD in 2001 told me he has very few MS patients who do NOT use an anti-depressant. Depression and MS seem to be very smoothly aligned.
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small study finds prozac may slow MS

Postby ThisIsMA » Wed Mar 03, 2010 8:19 pm

With respect to antidepressants, I found this small study with intriguing results! Here's a link to an article about the study:

http://www.medicalnewstoday.com/articles/106150.php

Here's an excerpt from the above article on the study:

Of the 40 initial patients, 19 participants in each group finished the study. The main finding was that the patients who were treated with Prozac had fewer new areas of inflammation than those treated with placebo. The researchers were able to detect the effects just after eight weeks - the same amount of time that it takes for selective serotonin reuptake inhibitor (SSRI) drugs such as Prozac to begin relieving depression.

Specifically, the group given placebo had an average of over five new areas affected with inflammation compared to just less than two areas in the Prozac group. Twenty-five percent of scans from Prozac-treated patients and forty percent of placebo-treated patients depicted new areas of inflammation. Almost two out of three patients in the Prozac group had no new inflammation areas during the last 16 weeks of treatment, whereas only about 25% of patients in the placebo group had no new areas.


Disclaimer: I'm not a medical professional, nor am I giving out advice, I'm just a person with M.S. who is always looking for more options...
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Postby hoodyup » Thu Mar 04, 2010 4:58 pm

Thanks guys and gals for all your kind thoughts and suggestions. Since yesterday Sharon feels a lot better due to, in her words "taking a big ol' dump". Her constipation also affects her bladder control, so when she can't go, she goes. It is a strange beast she is fighting. Her emotional state is much improved as well. I know she is a fighter and was down but not out. She said she will consider anti-depressants after the procedure (if she gets one). She wants to know what, if any, benefits will come from the procedure alone (in the name of Science). I know, too, that it is a matter of pride with her. The fact that she still has this pride tells me that she hasn't hit the bottom yet. I would have given in a long time ago and said "gimmie whatever ya got".

The consensus seems to be that anti-depressants are pretty benign and do not pose much of a threat, if any, to the surgery. Thank you all for sharing your experiences and opening up of yourselves. Sharon is a complex person and with her there is no "one size fits all" solution.

Unfortunately, the social worker who was here the other day said the only service that we qualify for is Rusty the companion dog. While I'm sure he is a lovely Weiner Dog, it doesn't do dishes, cook or clean.

Thank you all,
Andrew
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Postby mrsilkykat » Thu Mar 04, 2010 7:12 pm

Hello,

I've been on anti-depressants for 6.5 of the 7 years of my MS. I'm happy with them. I started on Celexa and am now on Cymbalta, which can be paticularly good for the brain of MSers.

My main absolute, hard advice GET A PRESCRIPTION FROM A PSYCHIATRIST. Gp's, neurologists and others are NOT qualified to prescribe anti-depressants even though they do so regularly. It is not their specialty. These are wonderful drugs if utilized properly. There are many different kinds. New ones are constantly being developed. Regular doctors do not keep up with the developments. Talk to a shrink for one or two sessions (even if you have to pay for it yourself) and you will get a good script from someone who deals with them and the side effects EVERY DAY.

Prescribing meds is mostly what shrinks do these days. Sometimes they talk with you in addition and sometimes not. Just depends. But if you are new to these things, you need proper supervision to get the right one with the right action.

I'm sorry the two of you are suffering with so many difficulties. Depression may be one burden you can let go of. Trying to fight it is exhausting and futile.

My best to you both.
Kat
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Postby Rose2 » Thu Mar 04, 2010 9:21 pm

Hi!
Sharon I am glad you feel better!! Goody!
I highly recommend Miralax for constipation. Over the counter, not a prescription.
They used it when I was in the hospital and the GI MD said it is good for kids, also.
It does not work like a laxative, but draws fluid into the bowels.
The Miralax brand is a little pricey but all pharmacies seem to have a generic exactly the same.
I have used it regularly since I was in the hospital and I have felt great.
I hope it helps. It really is good stuff.
Sincerely, Rose ;))
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Postby zinamaria » Fri Mar 05, 2010 12:31 pm

Oh Sharon and Andrew, hang in there.

I have not had the procedure nor have I taken any medications for depression. But depression I have had and do have at times, as I think so many of us do, especially facing MS.
My first instinct is spiritual, not as in a traditional religious sense, although the framework of traditions are helpful to some, but my first thought on reading, Sharon, about your hesitancy to taking meds and yet your deep suffering and sadness is this: start a journal, if you can write or type, either way, start writing daily, whatever comes to mind, no deleting, write down everything that comes to mind.

I tend to think any person suffering from depression has a buried artist beneath the weight of their lives and perhaps your spirit is crying for artistic expression in some form. Andrew mentioned you are a complex person...writing can free the complexities, sometimes our trapped voices need form, even painting...perhaps a small watercolor set and some sheets of paper just to play around and see color, bright colors, so you can bring the sun into your eyes. Activities like these where you are tapping the imagination can also give you a great chunk of time away from the immediate problems in the mind and body and often act as a catalyst for suffering.

Maybe it's something you could both do, like write daily journals privately and then share them, or not. But I find that 'expression' is so important for sensitive souls and I think anyone suffering depression is supremely sensitive.

Just so you all know I am not here to contradict anyone's valuable input and important suggestions regarding medication for although I have chosen other ways to deal, I understand and respect everyone's individual path in making choices that best suit them.

And by the way, my bladder is totally out of control so I will check out some of the approaches I read on this post.
I said to my companion recently, after wetting my pants spontaneously, 'Now I know why no one talks about MS, it can be so humiliating and ungraceful' because in that moment I smelled like a urinal. I'm so gratified to have found this community of such caring and loving people who CAN talk about it.
Oh, and magnesium powder dissolved in a small amount of water taken at night relieves constipation beautifully, I have found.

With care and thoughts to you both,
Zina
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Postby zinamaria » Fri Mar 05, 2010 12:38 pm

Natural Vitality makes a product called 'Calm', can even get it off Amazon, or a health food store, a little goes a long way and I have found it to be a high quality product to relieve constipation and also helps 'calm' my nerves to get a good night sleep.

peace,
zina
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