. Surviving Your Antidepressants
The major advantage an SSRI has over its tricyclic counterpart is a much shorter rap sheet related to side effects, thus ensuring far greater compliance and eventual recovery, right?
Wrong. A study published in the American Journal of Psychiatry has found that there are “no significant differences” in compliance between the SSRI Prozac and the TCA doxepin (Sinequan), this despite “marked differences in side effect profile.”
But wait. How “markedly different” are these “marked differences,” anyway? I recall the first time I dropped an antidepressant into my brain, and all I can think of is that movie Das Boot and the entombed U-boat crew riding out a depth-charge attack. Eventually, my psyche righted and stabilized, if you don’t count the 30 pounds of ballast I took on and some minor malfunctioning in the bow torpedoes.
Needless to say, these unpleasantries tend to get swept under the carpet. A Brigham and Women’s Hospital study recently uncovered major discrepancies between the number of drug complications their patients reported to doctors and the figures that eventually appeared on the medical charts. According to Tejal Gandhi MD, who led the study: “Physicians often take these types of reactions for granted in the course of medical therapy. However, it is important to realize that these events are not minor to patients …”
One doctor has finally come clean on the issue. In the Feb 29, 2000 Washington Post, Robert Hedaya MD, Professor of Psychiatry at Georgetown University, has written: “Sadly, some doctors do not appreciate, or may even dismiss, their patients’ complaints about side effects … This all-too-common response by physicians not only lacks compassion, it’s also bad medicine. By dismissing antidepressants’ side effects as something patients must learn to live with, doctors are forfeiting their patients’ chances for full recovery.”
Dr Hedaya found himself treating his patients for depression, only to discover their progress sabotaged by a whole new set of problems:
“They gained weight – sometimes so much that they resigned themselves to the sidelines of social life. Their sex drives deserted them – love relationships and marriages foundered amid sexual apathy and dysfunction. Most critically, they lacked the energy to keep up with their jobs and fully engage the everyday challenges of life. Over and over again, patients told me that although their depression was controlled, they could not fully enjoy life.”
Dr Hedaya believes that we should not have to resign ourselves to half a life simply because of our medication. Now here’s the catch – his prescription amounts to dietetic boot camp. It’s all laid out in “The Antidepressant Survival Program: How to Beat the Side Effects and Enhance the Benefits of Your Medication (Crown Publishers).”
First, toss out that bagel and coffee in the morning, then bid a tender farewell to that Cherry Garcia ice cream. Now say hello to more protein, folates, unrefined foods, and omega-3 fats. Each meal of the day is based on roughly one third protein to two thirds carbohydrates (with fruit and vegetables counting as carbohydrates). A typical dinner might be four ounces of chicken or fish with brown rice and vegetables topped off by fruit and cheese. Breakfast might be based around an egg, and lunch tuna fish.
Call it homage to the pancreas, if you like, which is typically thrown out of whack by sugars and carbohydrates.
Sugar tends to give the body a quick energy rush followed by an inevitable crash, leaving one sluggish and at the mercy of an unrelenting series of compelling sugar cravings. The pancreas is so confused at this stage that it indiscriminately pumps insulin into the system, which brings on a vicious cycle of eating and overeating, with the pounds piling on and the energy dropping off.
Carbohydrates should be seen as slow-acting sugars. That bagel in the morning is going to be converted into sugar, which doesn’t bode well for the rest of your day. Carbohydrate cravings can be as destructive as sugar cravings. True, there is real food value in many carbohydrates, but people taking antidepressants need to be on guard.
Protein, because it digests slowly, has a way of smoothing the system’s highs and lows, and eventually reduces the destructive cravings that leave one feeling fat and sluggish. The ironclad rule here is to have protein with every carbohydrate. Thus, if you are reaching for an English muffin (whole wheat, of course) you should be topping it with tuna or peanut butter or cheese.
Alcohol and tobacco, needless to say, are taboo, and so is caffeine, which triggers the release of adrenaline and signals the liver to release sugar into the bloodstream. Caffeine also stays in the system for two days, which can disrupt sleep.
Tied into the diet is a common sense exercise regime.
Those who try the program may feel headachy and drowsy for the first two or three days, but Dr Hedaya claims an 80 percent success rate for those who stick with it, and that after four or five days, the dreaded sugar and carbohydrate cravings begin dropping off and energy starts returning.
If the program sounds excessively rigid and Spartan, it pays to bear in mind that we are not just fighting our depressions, we are also fighting our antidepressants. Robert Hedaya, it seems, is the first doctor to recognize this critical fact.
SOURCE:- McMan’s Depression and Bipolar Web
SOURCE:- McMan’s Depression and Bipolar Web