Need advice on what anti-depressants to discuss with my doctor

I'm going to make this kind of short.

I was diagnosed with Crohn's about a year ago and then my gastroenterologist found tumors in my pancreas. They are neuroendocrine tumors. I went for a long time just trying to tough it out with minimal medications.

I finally gave in and went to see a pain management specialist and she has me on 50mcg/hr fentanyl patches for the pain. So the pain is under control and she is also taking care of treating my Panic Disorder. I am taking 1mg Klonopin 3x day and the panic attacks have all but stopped. Also, my overall anxiety/agoraphobia has decrease significantly.

The only major thing now is the depression. I've used Zoloft in the past and I am currently on Celexa 40mg. I don't feel like either one works all that great. Another problem is my BT pain med currently is Tramadol and there are issues with taking Tramadol with both Zoloft and Celexa. Are there any SSRI's that don't have the risk of serotonin syndrome when taken with Tramadol?

What are some med options I can discuss with my primary care doctor since I have an appointment this Thursday? One med I can't take is Wellbutin, I had a lot of side effects from that one. I think I would rather stick with the SSRI class. Thanks for any and all suggestions.

Well here is the list of meds I currently take:

Fentanyl 50mcg/hr patch
Tramadol 50-100mg 3x daily for BT pain
Klonopin 1mg 3x daily
Lomotil 2 tabs 4x daily
Questran Powder 4g 2x daily
Gabapentin 1800mg daily
Atenolol 50mg daily
Celexa 40mg daily
Levsin 0.125mg 3x daily as needed
Zofran 4mg 3x daily as needed

Now I don't feel so alone, somebody who takes as many meds as I do is here. You take a lot, I know the feeling. I use two different pill boxes. Plus I take supplements.

I hope that you find what works for you...

Hugs, Karen...

The Effexor is a good medication but has gone generic now. That is why I switched to pristiq. Sometimes the generics aren't exactly the same as the brand names. And my insurance would of most likely wanted me to switch to generic. They say that they are the same, but I don't think so... Efffexor is a very hard medication to go off of if you don't figure on being on it long term.

My problem with side effects is I don't get them until a month or two later. I will do good on the medication and then all of a sudden the side effects start. And they don't go away... A lot of meds give people side effects but they go away in a couple of months. Not me...

I hope you do find what is going to work best for you...

Hugs, Karen...

I think that is a good idea. Maybe you could take Vicodin or something. It is a narcotic pain med, but that way you can take the antidepressants.

I hope that you feel better soon Markh.

Hugs, Karen...

I do good on oxycodone, though sometimes it makes me sleepy. I tried morphine, it made me very depressed after about a month. But that doesn't mean it will do the same for you. I am taking oxycodone and methadone now, don't know if it will make me depressed or not. Haven't been on it that long.

I hope you have a good day today.

Keep posting Markh...

Hugs, Karen...

I took Effexor xr for 15 years. I did good on it. I hope you do too.

Effexor is an snri. I hope that you feel better soon. I just got up, shouldn't even be on here. I tend to lose train of thought when I first awaken... Have a good day...

Hugs, Karen...

Well I was on that dosage of klonopin for 12 years then I lost my psychiatrist because of insurance reasons. My primary doctor didn't control my panic disorder very well at all for a couple years and now my pain management doctor has it under control again.

Klonopin doesn't seem to be too bad for dependance as meds like Xanax. Be careful how you throw around words like addiction too. There is a huge difference between addiction and physical dependance/tolerance.

When I lost my psychiatrist a couple years ago I went from 1mg klonopin 3x daily to 5mg Valium 1x daily as needed and no W/D's....it just obviously didn't prevent panic attacks and sometimes wouldn't even stop an ongoing panic attack.

I think the tolerance is still there after the 12 years on it even though I wasn't for almost the last 2 years. I don't have any side effects like drowsiness, dizziness, etc....the only side effect I am getting is lower anxiety and no more panic attacks.

Thanks Karen. I really wish I would have accepted referrals to pain management earlier in this illness. I refused a couple referrals because I was afraid of becoming dependent on opioids. It was my family and friends that finally convinced me that something had to be done about my pain symptoms. I guess it was hard for me to realize it, but the pain really had taken total control of my life. Now I'm doing so much better and I feel like I'm not a prisoner of my own home anymore.