Anti Depressants?

[cindyg1947]

I am just curious if any of you caregivers have ever thought maybe your survivor is on the wrong meds. My husband is on Zoloft and I don't think it is doing him any good. I have asked his Dr. and he said it's fine. It is a good drug for him. well, he's always angry and mean and yelling 24/7. Have any of you ever had your meds changed and have it be for the better? I know he has alot to be angry about but he takes it out on every around him and it's getting old now. He is almost 2 years post stroke now and getting worse every day. Any input would be appreciated...............

[kanderson]

hi cindy, i was on paxil cr right after my stroke but then switched to zoloft and it does work better for me than the paxil. i'm sorry your hubby is not doing well on his med. i think i would try another doctor if his is unwilling to change it, there are so many of them out there for depression. i do hope you find a find a solution for your hubby soon to make him happier. good luck

[dstraugh]

Cindy,

 

I was never on Zoloft or Paxil as my insurance would not cover. I agree with Kim and change his doc if need be. Or maybe dosage needs adjusted.

[bstockman]

I was on Zoloft and it seemed to quit working or? I was changed to Cymbalta, and have been on it about a yr.. doing much better since we changed.

[Lee Kenaga]

I don't take any medication for depression, though I get rather down in the dumps because it is

tough to get up and get dressed to face yet another day barely able to stand up in the bathroom

to wash my hand and have to sit down to dry them because my legs give out. I don't look fotward

to using a walker to make my way to my wheelchair and just sitting all day. I already take 16

pills a day and I don't look favorly on taking a pill for depression as I've heard of all kinds of trouble

of folks that take them. I am 85 years old and I suffered my stroke on June 5, two years ago.

Today my wife---my caregiver---we celebrate our 59th wedding anniversary today, the 11th of

September! A very tragic day 6 years ago!

[lisas]

Rachel takes a low dose of Celexa everyday and it seems to be working quite well. Good luck on finding the right one. Sometimes it's a lot of trial and error on finding the right medication.

[Mema]

I think I would look into seeing another doctor. This doesn't sound good. My caregiver says to look at the adverse side effects of Zoloft. They can be different than the common side effects.

 

Good luck in finding a solution.

 

Vi

[cindyg1947]

I thank you all very much for your replys. We have a great Dr. but I think it is time for another sit down with him and I to see what can change.

 

To LEE----------Happy Aniversary!!

 

Thanks to you all...........cindy

[scrapdoo]

Cindy,

 

My first thought is how long has he been on this med? Has the doctor tried increasing the dose on this med or has the dose stayed the same?

 

I would suggest scheduling another appt. with your Dr. Keep a diary until then so you can give your Dr. specifics as to your husband's day. Try to be specific including lengths of time his anger is and quotes of language if this would help. Try to be a reporter and just state facts kinda like a news reporter. Continue to keep that journal throughout his trials of meds.

 

Be firm about your wanting to try a different med. or maybe talk about having your husband see a psychiatrist. A Psychiatrist is a specialist for ant-depressant medications and might be able to determine a medication that would work better for him.

 

I wish you the best of luck.

[cindyg1947]

Thank you for your suggestions. He has been on it since Jan.1, 06 and has had it increased twice. We had a psychiatrist come to the house and he told her NOT to let the door hit her in the A_ _ on the way out. Our Dr. said most of this is his new personality and he can controll it if he wants to but chooses to be this way. I agree with him to a point. He has no patience any more and had almost none before stroke. He feels that everyone in the house should be waiting on him hand and foot and he should not have to try to do anything on his own. My Dr. told me to go out as often as I can to make him do a few things for himself and he gets SOOOOOOOOOOOOOOOOOOOO mad when I do that. I know alot of it is his personality shinning through and untill he stops feeling sorry for himself and starts to help himself I don't think things will change. I will talk to his Dr. again when he comes back from vacation.........Have a nice day

[ksaul]

hi cindy,

just wanted to add my bit here - i agree with the idea of seeing a different doctor. my sister is a nurse and she told me that most primary care doc tend to give anti-depressants they are familar with or that the drug rep has just dropped samples off. she told me to see a psychiatist who speciality is brain issues. it took me several tries and dosage adjusments but it was worth the effort. each od us are so different.

i hope whatever you decide you stand firm in your decision that a change is needed. docs only see us for a few minutes and you know what each day is like. take care = kathy

[cindyg1947]

Thank you all for you help. I have decidded to make an appointment with a Nurological Dr. He hasn't seen one in a while. I will tell him what is going on and see what he thinks. A psychiatist is totally out of the question. He refusses to see another one so I'll hope the Dr can come up with something. Something has to change that's for sure!

[ksaul]

cindy,

best of luck with the doctor appointment. just a quick thought - write down all your concerns before you go and take the list with you so you won't forget anything important. a friend suggested i do that cause i always get a bit sidetracked or forget to mention something important during the visit. please keep us posted on the outcome. kathy

[2ndChance]

Get to a physiatrist or a NEUROpsychiatrist and ask them about adding on a mild anti-seizure med - they boost the effectiveness of ant-depressants and stop emotional outbursts.

 

[arogers]

Hi Cindy,

 

Your husband may not want to see a psychiatrist because feels like he 'isn't nuts, just had a stroke'...It will take some prsuading on your point to help him understand that you don't think he's nuts, and a psychiatrist is just another doctor who specializes in the brain. But, I do think he needs to be evaluated by a psychiatrist to deal with his anger issues since those issues aren't really new - he went into the stroke with them. It sounds as though the stroke has added to a pre-existing condition. I've heard about a drug being a "nice drug" too, and just because it is a "nice drug" for one person doesn't mean it will be for the next!!! The Neurologist may have a suggestion, but I'm not sure it will be much more than the primary care phsician since they don't specialize in emotional conditions. I remember when my husband became thoroughly convinced about a conspiracy regarding his care the doctor quickly called for a psychiatric evaluation.

 

I can tell you that although I empathize, I don't live with the physical results of the stroke as my husband does. I know there are countless of opportunities for anger. I also know that since I am closest to him it is natural that I will be the target of the anger since I am that "safe place" for those emotions to be released. Since this is the case, I also need to be involved in psychiatric appointments or the doctor isn't going to know what is going on with him - especially since his short term memory was profoundly affected. Even if your husband's memory wasn't affected, I would suggest the same would be true for you as his caregiver. His continual anger issues need to be addressed since they aren't improving with time and his current medication.

 

Incidentally, a psychiatrist will certainly recoginze and understand the anger and your husband's attitude won't be something new. You do have to protect yourself though. You don't have to be the emotional punching bag because he doesn't like the sound of the word "psychiatrist". (Unfortunately I have some experience with a person who refused help because he "wasn't crazy - but that's another story.) There are lots of medications out there to help him cope and that's the way the whole situation should be approached. Different doctors have different specialties. Celexa, Cymablta, Lexapro, Zoloft, Prozac, Paxil to name a few all have their place and a specialist will be able to help determine which would benefit him the most.

[Da Ole Guy]

This topic has been a concern of mine even pre-stroke. Today I think far too many anti-depressants are used. Not blowing ahorn, but I am degreed in Behavioural Psych (circa 1969) and have never condoned pharmacological treatment of certain physical conditions. I don't practice by choice. I was just curious about the mind and wanted to learn. Today it seems that just not dealing with the patients real issues is easier via meds for the caregivers. Cindy I am in no way saying you. I am saying physicians.

 

In sessions with my therapist this has come up a few times. My arguement against has that in a cse of head trauma, like stroke, the emotional imbalance is not inherent, but resultant. Medicating a brain attemting to resolve physical (note I said physical) trauma is not a situation in which induced feelings of wellness via mediaction is good. The person knows damned well the blew a gasket and things aren't physically right at the moment. Sedating that healing brain is the worst in my opinion to do to it. My therapist agrees in context with me.

 

Okay now real life background here. For over 13 years I have been a caregiver to a very dear person who suffers from acute depression. Her's was resultant to years of harsh behavior interfence, psychological abuse with physical reenforcement. Her anti depressant meds are a means of helping her to controll unreal threats she feels direct to her. She is aware of this and actually says they help. Look at Brooke Shields with Post Partum. Pysch Meds do help in some cases.

 

Head trauma, stroke, is a completely different animal. The survivor knows they have suffered a physical event. They are generally aware something REAL physically beyond their apparent control bit them. The anger, grief, nonacceptance of the event is irrelevant to them, it is happening. Yes they are ticked off. I know I was and still am over mine. I know prior to it I was able to capably function in society and without a drug to make it work. MY God I wnat a clear mind to beat this thing as best as it can be, not a drugged tool to try to fix itself.

 

Sorry I am adamant on anti-depressant use and abuse. Supplying a medication to create a false sense of wellness when you aren't and know it is a cop out. The goal is to give the patient every tool available to recover, not inhibit or distort the process. Now think of this. Today they have found many anti-depressants actually create suicidal manifestation contrary to the indicated positive effects. I am not suididal in the least. But give me a drug known to create that idea as a solution and I may as think it is an option to healing.

 

Stroke recovery, actually any brain\physical injury, is a hard road for anyone to walk. We walk it alone. I have seen first hand as a caregiver for a depression patient sometime simply a smile or a pat on the back recognizing the struggle they are fighting is far better than sedating the situation until tomorrow. It is today, not tomorrow. Things will not be better in the morning by simply hampering the person recovering from clearly trying to do the task.

 

Those of you caregivers actually forcing your loved one to strive to better themselves on their own are the best meds. I am thankfully not restricted physially from communicating, but I will say that Debbie forcing me to say applesauce and not pudding to use with my meds is great (I mentioned elsewhere here I confuse names). I tend to mix the words up. I sense those of us that cannot verbalize and try prefer the assurance and faith a loved one has they can do it is far better than providing a medium granting a false feeling of accomplishment. I thank Deb for making me change the word use. It might be a small thing, but I really feel good I did it. See little things on our own really mean a lot.

 

Survival is a very strong drive. Don't for once imagine we stroke survivors don't know that. Consider this. Many of us have been the rock of a relationship in the past or an equal part in its success. Losing that seat is hell. Our, or at least mine, is to recover my abilities to be there again. The last thing I need is a drug fooling me I am getting there. Caregivers, god bless. Cindy I am gald you are concerned on this topic. I mean sometimes "Tuff Love" is a better prescription. I prefer it!

 

Sorry folks I am at times very outspoken.

 

AJ

[JohnI]

I am just curious if any of you caregivers have ever thought maybe your survivor is on the wrong meds. My husband is on Zoloft and I don't think it is doing him any good. I have asked his Dr. and he said it's fine. It is a good drug for him. well, he's always angry and mean and yelling 24/7. Have any of you ever had your meds changed and have it be for the better? I know he has alot to be angry about but he takes it out on every around him and it's getting old now. He is almost 2 years post stroke now and getting worse every day. Any input would be appreciated...............

 

Wow! YES! I got off Lexapro about 3 months ago, it was the best thing ever! Before I was angry, crying and over reacting a lot. Now it happens rarely, so much better without that, plus it was causing ED, which is a real bad thing for most men and enough to make you angry by itself!!

-JohnI

[cindyg1947]

I thank all of you so much for your advise and sharring stories of good news in your recovery. A quick description of what life has been like for the last 2 years. One week before my husband had his stroke, he got the promotion he was waiting for for 2 years and a very nice raise. Then BAM. Now he will never do that work again. His company would hire him back in a heart beat if he could return there. I know he has alot to be angry over and I know it's the people closest to him he takes his anger out on. In our case it's me and our youngest daughter because we are the two that inforce tough love. He was a Marine Gunny Sgt in the Corps for 12 years and if any of you know one it's true once a Marine always a Marine and being a Marines wife is the hardest job there is. I have been hit, kicked, and pinched, had things thrown at me and called every name in the book. I have Diverticulitus and IBS and so when stress hits me I run right to the bathroom. I came down with this horrid sore rash on my side and went to the Dr. He told me I have maximized my stress level and had to have treatment for the Shingles!! This has been a tough time for all of us. My kids want there Dad back and he will never be back. Not what he was anyway. If meds can help keep his anger down than that's what has to be. I'd hate to see what it would be like without any. I think I'd want to choke him. He never in his life had a challenge he could not over come. He never gave up untill he could get it done. He was our handyman. He fixed the plumbing, wirring, carpentry, cars, everything. Now he can't even stand alone or use his right hand. He is right handded. I had a phyc. nurse come here one time and he told her NOT to let the door hit her in the ass on the way out!! The Marine in him I guess, LOL. But it was a bad scene here that day. I am taking him to see a Nuero Dr. in a few weeks and hopefully he can come up with something. He really feels that by sitting in his reclinner he will get better even though all the Dr's have told him different. They have all told him that repetition is what rewires the brain and he just refusses to believe that. SO...........I am at my wits end here as to how to help him any more. We tell him every day he needs to do more if he wants to get better. It's like he just don't care any more. He really feels a miricle will happen and one day he will stand and walk again. It's not going to happen like that! Being his caregiver, I had to quit my job to stay here with him. Be the one to fight for everything he has. I am the one who had to go from 2 good paychecks to living on almost nothing and so far I have survived. ................SO I guess all I can say right now is thank you to all of you. You are all so carring and helpfull. I know I would have been a basket case if it weren't for finding this place so long ago. It has helped me accept his stroke and most important makes me know that I am not alone in this battle...............Thank you all for carring and all of your suggestions...........HUGS to everyone of you.....

[bstockman]

Hi Cindy, I am glad to hear you have an appointment soon. All i can "guess" is the "motivation" .. self starting part of his brain has been damaged.

 

You are sooo right.. sitting in his recliner all day is NOT going to help. and repetition is the key and the ONLY way I know of to make any progress.

 

I was so Scared when I couldn't walk, but I had this Determination that I would walk again.

 

I hope the new Dr can help.. and somehow convince him .. he needs to be Pro active in his recovery...

 

(hugs)))))))))) to you. my husband also pushes ...sometimes. most of the time it is when i need it. Or he reminds me of things needing done.

 

i try to have a little routine each day, I take a Lot of breaks as I get tired very easy. but I do feel happy when I finish a task ..

[lisas]

We are in the procees of stopping Rachel's Celexa right now. She has been on it since her stroke 1 1/2 years ago. We spoke to the doctor about this and he said by all means let's try and get her off of it. After all, it's one less drug to take. :laughbounce:

 

We weined her off slowly, cutting down to 10mg daily instead of 20mg for one week ,then taking one every other day, then every couple of days. Now we just stopped the last one about 4 days ago. It seemed kind of rough at first. She was crying more but we are starting to see her level out. RAchel of course had been sick with pnuemonia so she really didn't notice the change too much. We're hoping we can keep her off but we will see what happens.

 

Always get the advice from your doctor. I agree that anti-depressants may not always be the answer, but I will say the sure helped Rachel cope with her stroke in the beginning.

[Guest lwisman]

Lisa. et al,

 

I was also weaned off of antidepressants -- in my case about 15 months after the stroke. The doctor told me it is very important not to go cold turkey. It has to be a gradual pull back. My family said it took about a month before I was able to get control of my emotions.

 

One thing I found really helpful was to use music composed for healing. My research says that healing music is most effective with ear phones (apparently the vibrations are part of the healing), in a quiet room with no distractions. I found it really helped me. I still use it some times, but not as often. There are a number of options out there, but I like the music by Steven Halpern the best. He has been doing this for 20 years. The music is also really helpful when one has an event to go to where there will be chaos -- which is difficult for most stroke survivors to handle. I listen for an hour before the going to the event.

[swilkinson]

Cindy, I don't know if this is a stupid question:"Is there a kind of personality profile for a Marine?" If there is I wonder if you need to find someone who is familiar with this personality type to work out how to motivate someone using this profile?

 

I deal with Ray who is unmotivated to exercise. I act like his coach and say:"Half an hour to lunch gives you 20 minutes to exercise." or something similar, I might get away with that twice a week. By himself he would sit all day and do find-a-word puzzles and basically daydream the days away.

 

I tend to agree that anti-depressants are not the answer, but change of lifestyle is, healthy eating, as much exercise as you can manage and social interaction. Socal interaction is a big deal for Ray as he is far more charming, alert, motivated with people around him so I use as much social interaction as I can to improve our life together.

 

I am afraid I would not put up with verbal abuse. I used to say to the boys when they were teens and argumentative:"I am walking away now. Stay where you are and think about what you have been doing." It is a timeout strategy and a much needed one. You may be able to think of ways to minimise the angry contact you are not enjoying with your husband. With or without mdication I guess it is true he knows it is wrong and may be able to minimise it if he wished to.

 

I am sending you big (((HUGS))) as you are the person on the spot dealing with the problem and we are only the hope-to-help advisors.

 

Sue.