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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Medication For Depression

Hi ,I am 32 year old married female.I have a 10 and a half year old daughter.In 2007 i was diagnosed with Nephrotic Syndrome.Later kidney biopsy reavealed Glomerulonephritis.At that time i was put on 60 mg prednisolone.But later it was tapered off due to numerous side affects like difficulty in breathing,edema,cramps,insomnia,peptic ulcer etc.After few months of tapering off the steroids I again felt pain in the body ,fatigue and 2+ protein leak from the kidneys.My nephrologist again put me on 7.5 mg of prednisolone ,500 mg of MMF(twice daily)(Mycophenolate Mofetil) HCQS(200Mg)(TWICE DAILY)Shelcal(500 mg twice daily)My doctor suspected Lupus Nephritis.But he said it was not easy to diagnose it as diffferent laboratries showed varied results for ANA.I started taking these drugs in august 2009 and have continuing them since then.I still find it difficult to carry on with my daily activities.Pain and fatigue are still part and parcel of life.Apart from that i struggle from side affects like wheezing ,mental confusion.severe palpitations,bloating,acidity,gas etc.I also take 0.50 thyrox for hypothyroidism.I suffer from clinical depression as well and can't make out of its because of disease or medication or my ownself.Ihave never taken any medication for depression and would like to know how can I carry on without medication for depression.I have been recently diagnosed with spondylitis as well and hampers my daily activities to a major extent. I am a house maker and i work part time for four hours which is not strenuous but does get affected due to neck pains.I try and do light exercises in gym but most of the time i have to give up due to energylessness or neck pains.For the past 1 year i have been observing blood clotting all over my thighs and arms which is painful at touch and disappears on its own after 4 to 5 days.Could be a side affect of any medication or does it need medical attention.I got the following test done for this issue-BTCT.This was normal.Could you suggest something which could improve quality of life and i feel better.Thanx.
Wed, 17 Dec 2014
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Psychiatrist,  's  Response
Hello thanks for asking from HCM

I have read your query and I can understand your concern. There are multiple factors that are increasing the risk of depression in your case-

- One is you have Nephrotic Syndrome. Any chronic illness in a person results in severe stress and this may progress to depression.

- Second is that you have history of clinical depression which is one factor that determines risk of depression.

- You have co-morbid hypothyroidism which is also one factor responsible for depressive symptoms.

- You are on steroids for Nephrotic Syndrome which are the drugs that are known to cause depression.

The symptoms like pains, fatigue, tiredness, confusion, palpitations, multiple somatic symptoms etc all are symptoms of depression. I will advise you to consult a psychiatrist for treatment of depression. You don't want to take medicines then you have to try psychological methods like Cognitive Behaviour Therapy. This therapy helps to improve symptoms of depression. But it has not much usefulness in severe depression. In severe depression medicines are required for treatment. Medicines like SSRIs as Fluoxetine, Paroxetine, Sertraline etc are commonly used. Consult a psychiatrist for evaluation and proper diagnostic work-up.

Thanks, hope this helps you.
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Suggest Medication For Depression

Hello thanks for asking from HCM I have read your query and I can understand your concern. There are multiple factors that are increasing the risk of depression in your case- - One is you have Nephrotic Syndrome. Any chronic illness in a person results in severe stress and this may progress to depression. - Second is that you have history of clinical depression which is one factor that determines risk of depression. - You have co-morbid hypothyroidism which is also one factor responsible for depressive symptoms. - You are on steroids for Nephrotic Syndrome which are the drugs that are known to cause depression. The symptoms like pains, fatigue, tiredness, confusion, palpitations, multiple somatic symptoms etc all are symptoms of depression. I will advise you to consult a psychiatrist for treatment of depression. You don t want to take medicines then you have to try psychological methods like Cognitive Behaviour Therapy. This therapy helps to improve symptoms of depression. But it has not much usefulness in severe depression. In severe depression medicines are required for treatment. Medicines like SSRIs as Fluoxetine, Paroxetine, Sertraline etc are commonly used. Consult a psychiatrist for evaluation and proper diagnostic work-up. Thanks, hope this helps you.