Question for the med gurus out there!!

[Benjammin69]

Hi all

Quick one - my normal meds are Mirtazapine 30mg (reduced from 45 3 weeks ago) quetiapine xr 300mg and 10mg diazepam as and when.. maybe 1 or 2 a week....anyway I have been doing great lately really well. Socialising, backat work and genuinely enjoying life again....

Unfortunately I have had another bout of tonsillitis which was quite severe so they gave me penicillin (2000mg a day), naproxen (750mg per day) and ondansetron (4mg average a day)...

Anyway so it's quite a bit of medication I'm taking but last few days I feel I'm slipping back in to that slope... I have been great on the mirt, quetiapine and diazepam and was finally stable does anyone know if any of the other meds Can set off a blip? And how can I stop it being a full blown relapse this would be my 3rd relapse since august 2016!!

Any advice much appreciated?


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[panic_down_under]

Anyway so it's quite a bit of medication I'm taking but last few days I feel I'm slipping back in to that slope... I have been great on the mirt, quetiapine and diazepam and was finally stable does anyone know if any of the other meds Can set off a blip?

I think it is more the infection than the extra meds which are causing it. An immune system in overdrive can trigger or worsen anxiety and depression as in several respects anxiety and depression are immune system disorders (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002174/). People on immune system boosting meds like interferon (http://www.hepmag.com/articles/hepatitis_interferon_depression_2501_22378.shtml) to treat viral diseases and cancers are now often also prescribed a SSRI because of this. Immune system proteins may also reduce the effectiveness (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337012/) of antidepressants.

Why were you prescribed ondansetron for tonsillitis? It is mostly prescribed for chemo/radiation therapy induced nausea. It is also supposedly a very effective anti anxiety med, btw.

[MyNameIsTerry]

Anxiety can be worsened by certain infections e.g. strep throat. Then when the infection goes, the anxiety rebalances.

The same with antibiotics, they kill healthy bacteria too and can spike anxiety. This can be lessened with some probiotic self care at least.

When the immune system is reduced, the symptoms of depression can be felt. You will find articles/journals discussing that.

[Benjammin69]

Thanks lads was looking for some positive reinforcement as last time I felt like this I went straight to doctor and got myself out in citalopram which I had a bad response to and ended off sick from work for another 2 months. Dare I say it I actually feel better today :-)


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---------- Post added at 06:06 ---------- Previous post was at 05:29 ----------


I think it is more the infection than the extra meds which are causing it. An immune system in overdrive can trigger or worsen anxiety and depression as in several respects anxiety and depression are immune system disorders (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002174/). People on immune system boosting meds like interferon (http://www.hepmag.com/articles/hepatitis_interferon_depression_2501_22378.shtml) to treat viral diseases and cancers are now often also prescribed a SSRI because of this. Immune system proteins may also reduce the effectiveness (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337012/) of antidepressants.



Why were you prescribed ondansetron for tonsillitis? It is mostly prescribed for chemo/radiation therapy induced nausea. It is also supposedly a very effective anti anxiety med, btw.



Thanks PDU always spot on with your responses.

Cause the ondansetron be causing the slight depression? I had it prescribed due to nausea from my tonsils as metoclopramide (Reglan) can cause depression and prochlorezapine( stemetil) is anti psychotic and I am already on quetiapine.


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[panic_down_under]

Cause the ondansetron be causing the slight depression?

While there are a few case reports of it triggering depression these have all been in patient's taking the med after major surgery, or chemo/radiation therapy for cancer so the more likely explanation is they became depressed in response to their medical issues. It isn't a listed side-effect.

I'm pretty sure the depression is due to the infection and maybe also the antibiotic. It should clear once the immune system calms down after the bugs exit stage left.

[Benjammin69]

While there are a few case reports of it triggering depression these have all been in patient's taking the med after major surgery, or chemo/radiation therapy for cancer so the more likely explanation is they became depressed in response to their medical issues. It isn't a listed side-effect.



I'm pretty sure the depression is due to the infection and maybe also the antibiotic. It should clear once the immune system calms down after the bugs exit stage left.



Ah thanks PDU, I have today requested a med review to throw out some of these point less meds like hydroxyzine and ondansetron... there just too many in the mix.

I'm looking to settle on 30mg mirt and look to reduce that to 15mg in a month. Remain on 300mg quetiapine and 10mg diazepam as a PRN which is an average of once a week at moment. Got therapy every Tuesday too so that helps.


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[panic_down_under]

I have today requested a med review to throw out some of these point less meds like hydroxyzine and ondansetron

The irony is that of all the meds you're taking, ondansetron could be by far the most effective for anxiety. It was originally developed for anxiety/panic and seemed to be as good as the benzodiazepines without their dependence and tolerance issues. But then GSK discovered it was also a potent anti-emetic, especially for chemo and radiation therapy induced nausea and vomiting, and as this was a more profitable field to target, work on getting it approved for anxiety stopped.

Unfortunately, it may still be too expensive and I'm guessing NHS GPs aren't allowed to prescribe it for anxiety. :(