Anti-depressants

Amy -- i took celexa to combat lupron side effects and to help with the worst anxiety i've ever experienced.  it worked great for me.  i have since weaned myself off.  smart move!  hoping for the best for both of you!

ed

This is a VERY appropriate topic for all of us.

I personally have been struggling with depression as a result of every PSA result being a kick in the gut.

In particular, when I started truly realizing that HT was in my immediate future, I also realized that this depression is significant. Since I got my slight reprieve (testing again in 2 months) my depression has lessened for now.

I did finally discuss the issue with my family doctor, who I greatly respect. He asked me a series of questions and the conclusion was that in his opinion I'm close to the trigger point (for an anti-depressant) but I should wait and see how my spirits do, since I have been much better.

Frankly, I will be on enough medications. But I will certainly seriously consider getting on such a drug if (when) things go south again.

Mel

I agree with everything said.
Choosing which antidepressant, depending on the patient's history, is also very important. For example, certain antidepressants, when given in men with severe BPH, may further compromise urine flow (example amitriptyline, Cymbalta). Certain antidepressants (ex. amitriptyline, imipramine) will further exacerbate blood-pressure changes associated with changes in posture, when combined with alpha-blockers (Flomax, Uroxatrol). It may make pharmacological sense in these 2 types of patients to use Lexapro, Celexa or Zoloft as viable choices. If an antidepressant is indicated in men receiving hormonal therapy, possibly Effexor, Paxil or Zoloft may be preferred to concomitantly reduce the hot flashes seen with anti-androgen treatment. Lexapro/Celexa or Cymbalta may reduce hot flashes, but I am not aware of studies validating that.
Men receiving radiation that are experiencing fatique may not want to be on the more sedating drugs such as Paxil, amitriptyline or trazodone. Effexor or Cymbalta may be less sedating.
The above are not absolutes. For example, I know of many patients who have BPH, that do very well on Cymbalta. Others, such as myself, don't.
Men with neurogenic pain associated with their cancer and are depressed, would probably benefit more from Cymbalta, Effexor, or amitriptyline. All 3 have considerable documentation in the pain literature. Bronson is correct in saying that many times it comes down to trial and error. Finally, it may take a few weeks to months to get use to certain side effects (for example:change in cognition, lack of energy, "feeling strange").

Paul