kalex
01-19-2010, 03:53 AM
My GP is overseas until mid February.
I cannot get a referral to a psychiatrist until she returns.
I am providing detailed background so a medical person can provide useful advice while I am waiting. (See QUESTIONS at the end for my specific concerns)
BACKGROUND
I am female and was diagnosed with depression in about 1988, after suffering undiagnosed for at least 5 years.
I was treated by a psychiatrist, and we tried various antidepressants with cognitive therapy.
Depression was diagnosed by several psychiatrists as severe and endogenous, and did not respond to cog therapy alone. All antidepressants we tried caused deterioration of my depression, or no change, until 1993 when fluoxetine was first prescribed. FLuoxetine was the first drug that helped me.
In the following 5 years under psychiatric supervision I tried several times to stop taking fluoxetine, but on all occasions severe and life threatening depression returned.
In about 1994 my psychiatrist referred me back to my GP stating that my depression should continue to be managed with fluoxetine and that psychiatric counselling was of no furtehr benefit.
Since then I have continued to take fluoxetine daily and my depression has been well managed, enabling me to have a career and live a relatively normal life.
HYPERPROLACTINEMIA
During a specialist consultation this week for a physical condition unrelated to depression, the specialist observed that some of my symptoms could be explained (or may be exacerbated) by abnormal prolactin levels.
He has ordered blood tests (awaiting results) and will refer me to the relevant specialist if necessary. Meanwhile he is continuing to investigate the original condition. He is unable to provide more information as it is not his area of expertise (anyway, he has other things to worry about for me!).
When I got home I looked up prolactin because I didn;t know what it was.
I found several references to antidepressants causing hyperprolactinemia. The symptoms of hyperprolactinemia do indeed reflect some of the symptoms I am experiencing.
QUESTIONS/ CONCERNS
My concerns relate to whether I will have to stop taking my antidepressants in order to be treated for hyperprolactinemia, AND whether drug treatment for hyperprolactinemia is likely to aggravate my depression (cause a relapse).
Would I have to stop taking antidepressants during the treatment?
Could I take fluoxetine again afterwards?
DO the anti-hyperprolactinemia drugs aggravate or increase the risk of a depressive episode?
Are there new drugs (since 1993) that might effectively treat my depression wuithout causing hyperprolactinemia ? (I believe I had tried all available antidepressants before having success with fluoxetine).
I am terrified of returning to a depressed state - my depression was severe and life threatening, and the prolactin-related symptoms are far preferable. However, I understand that if the prolactin problem is not treated it could cause more serious problems later.
I would appreciate reliable references for further reading or treatment options for hyperprolactinemia in chronically depressed patients at risk of relapse.
Thanks
I cannot get a referral to a psychiatrist until she returns.
I am providing detailed background so a medical person can provide useful advice while I am waiting. (See QUESTIONS at the end for my specific concerns)
BACKGROUND
I am female and was diagnosed with depression in about 1988, after suffering undiagnosed for at least 5 years.
I was treated by a psychiatrist, and we tried various antidepressants with cognitive therapy.
Depression was diagnosed by several psychiatrists as severe and endogenous, and did not respond to cog therapy alone. All antidepressants we tried caused deterioration of my depression, or no change, until 1993 when fluoxetine was first prescribed. FLuoxetine was the first drug that helped me.
In the following 5 years under psychiatric supervision I tried several times to stop taking fluoxetine, but on all occasions severe and life threatening depression returned.
In about 1994 my psychiatrist referred me back to my GP stating that my depression should continue to be managed with fluoxetine and that psychiatric counselling was of no furtehr benefit.
Since then I have continued to take fluoxetine daily and my depression has been well managed, enabling me to have a career and live a relatively normal life.
HYPERPROLACTINEMIA
During a specialist consultation this week for a physical condition unrelated to depression, the specialist observed that some of my symptoms could be explained (or may be exacerbated) by abnormal prolactin levels.
He has ordered blood tests (awaiting results) and will refer me to the relevant specialist if necessary. Meanwhile he is continuing to investigate the original condition. He is unable to provide more information as it is not his area of expertise (anyway, he has other things to worry about for me!).
When I got home I looked up prolactin because I didn;t know what it was.
I found several references to antidepressants causing hyperprolactinemia. The symptoms of hyperprolactinemia do indeed reflect some of the symptoms I am experiencing.
QUESTIONS/ CONCERNS
My concerns relate to whether I will have to stop taking my antidepressants in order to be treated for hyperprolactinemia, AND whether drug treatment for hyperprolactinemia is likely to aggravate my depression (cause a relapse).
Would I have to stop taking antidepressants during the treatment?
Could I take fluoxetine again afterwards?
DO the anti-hyperprolactinemia drugs aggravate or increase the risk of a depressive episode?
Are there new drugs (since 1993) that might effectively treat my depression wuithout causing hyperprolactinemia ? (I believe I had tried all available antidepressants before having success with fluoxetine).
I am terrified of returning to a depressed state - my depression was severe and life threatening, and the prolactin-related symptoms are far preferable. However, I understand that if the prolactin problem is not treated it could cause more serious problems later.
I would appreciate reliable references for further reading or treatment options for hyperprolactinemia in chronically depressed patients at risk of relapse.
Thanks