Issues with Metabolizing Antidepressants

Posted by Postcovidblues @bmspector, Mar 11 12:20pm

Has anyone found that they now metabolize antidepressants differently? If so, have you found a way to explain this to a psychiatrist or other doctor?

Specifically, my psychiatrist decided I was on too many meds and has been tapering me off several that I was on before I got COVID and subsequently Long COVID, which from a depression standpoint has been so-so, but I found that I started having severe reactions to antidepressant withdrawal that I previously never had. For example, I went off Seroquel and I wound up not being able to walk straight, and then got a six-day long migraine. However, I started feeling noticeably better after that got out of my system, so I stayed off it. I’ve had similar reactions to stopping two others she wanted to stop, including SSRIs (which aren’t supposed to be as severe as SNRIs). I haven’t regained my appetite fully, but my energy and strength have gotten better. Prior to COVID, whenever I stopped a med or changed from one to another, I only felt off and had those weird brain zaps, but never the nausea, migraines, etc. I read a publication about a patient at UCLA that developed serotonin syndrome following a COVID infection although the patients meds didn’t change, but that patient was so sick that he had to go to the ER and I never got there.

Thoughts or similar experience?

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I did a gene test....Not sure if my body changed but took Zoloft for over 20yrs for depression and after getting Covid it stopped working and i had bad anxiety which i never had prior.
After my gene test they narrowed possible meds for me down and one is off label because of my test results.
I am no doctor but it has helped a lot.
Maybe this link will help or be a place to start.
https://www.mayoclinic.org/tests-procedures/cyp450-test/about/pac-20393711

REPLY

This is totally off the topic....but related. Has your medication changed as far as the color or a different pharmaceutical company? That makes a difference. I have taking Ceftin in the past for sinus infections...it never bothered me. Ceftin comes in a white tablet. I was given Ceftin for a sinus infection a couple of years ago and it was a blue tablet. I woke up with terrible itching and rash.

I'm wondering if there's been a change in the color of your meds or pharmaceutical company with fillers in the medicine and you are reacting to them. Just a thought. Praying for you.

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@covidstinks2023

This is totally off the topic....but related. Has your medication changed as far as the color or a different pharmaceutical company? That makes a difference. I have taking Ceftin in the past for sinus infections...it never bothered me. Ceftin comes in a white tablet. I was given Ceftin for a sinus infection a couple of years ago and it was a blue tablet. I woke up with terrible itching and rash.

I'm wondering if there's been a change in the color of your meds or pharmaceutical company with fillers in the medicine and you are reacting to them. Just a thought. Praying for you.

Jump to this post

That is a good question....I am not the OP but to piggy back on that.....I was afraid to sound stupid but i swear when my Clonazepam is pink they work better than when they are refilled with the yellow ones.
Maybe it's just me? And i only take 0.5 MG at bedtime and as needed (Which is rarely)
Is it all in my head or is there a difference?

REPLY
@da69

That is a good question....I am not the OP but to piggy back on that.....I was afraid to sound stupid but i swear when my Clonazepam is pink they work better than when they are refilled with the yellow ones.
Maybe it's just me? And i only take 0.5 MG at bedtime and as needed (Which is rarely)
Is it all in my head or is there a difference?

Jump to this post

It is not all in your head and you do not sound stupid....yes, there is a difference. Example, I have been on Protonix for years for GERD (Acid Reflux). The Teva brand works the best. They are the yellow Protonix. The other white Protonix simply do not work as well. My doctor believed me and wrote a new prescription and he put Teva Brand preferred on it. That worked great for a while, but, now I can no longer get the Teva brand. I guess they are more expensive.

Sometimes too, you have to go with the brand name vs the generic to get the full benefits. A fine example of that is Synthroid. Levothyroxine (generic) does not work as well as Synthroid for a lot of folks with thyroid disease. You pay more, but, get better results.

Also, some pharmaceutical companies have stopped manufacturing some of the medications that we all take and another pharmaceutical company has taken over.

I recently asked my pharmacist about one of my meds. The blue tablet worked best. The white tablet did not work as well. He told me, pharmacists cannot request certain medications from certain companies anymore due to cost effectiveness and have to accept what they are sent. How sad for the consumer.

A lot of our meds come from other countries and I pray one day they all will be manufactured in the U.S. I had rather pay a little more and get a purer more effective medication, hadn't you?

I believe you my friend. If you have an old bottle of the Clonazepam in pink, look and see who the manufacturer (Pharmaceutical Company) was and check around to see who has it.

I pray you feel better soon. Keep me posted. I care.

REPLY
@covidstinks2023

This is totally off the topic....but related. Has your medication changed as far as the color or a different pharmaceutical company? That makes a difference. I have taking Ceftin in the past for sinus infections...it never bothered me. Ceftin comes in a white tablet. I was given Ceftin for a sinus infection a couple of years ago and it was a blue tablet. I woke up with terrible itching and rash.

I'm wondering if there's been a change in the color of your meds or pharmaceutical company with fillers in the medicine and you are reacting to them. Just a thought. Praying for you.

Jump to this post

Naw, it’s more the withdrawal being so severe that is my concern. It makes me think about the serotonin gap that Yale identified, but I wondered if others who had LC had dealt with it too.

REPLY
@bmspector

Naw, it’s more the withdrawal being so severe that is my concern. It makes me think about the serotonin gap that Yale identified, but I wondered if others who had LC had dealt with it too.

Jump to this post

My tolerance for meds has also changed dramatically with LC.
Would you mind providing more details for both the studies you mention, please? (Possibly links?) The UCLA studie on serotonin syndrome and the YALE one on the serotonin gap?
Thanks!

REPLY
@covidstinks2023

It is not all in your head and you do not sound stupid....yes, there is a difference. Example, I have been on Protonix for years for GERD (Acid Reflux). The Teva brand works the best. They are the yellow Protonix. The other white Protonix simply do not work as well. My doctor believed me and wrote a new prescription and he put Teva Brand preferred on it. That worked great for a while, but, now I can no longer get the Teva brand. I guess they are more expensive.

Sometimes too, you have to go with the brand name vs the generic to get the full benefits. A fine example of that is Synthroid. Levothyroxine (generic) does not work as well as Synthroid for a lot of folks with thyroid disease. You pay more, but, get better results.

Also, some pharmaceutical companies have stopped manufacturing some of the medications that we all take and another pharmaceutical company has taken over.

I recently asked my pharmacist about one of my meds. The blue tablet worked best. The white tablet did not work as well. He told me, pharmacists cannot request certain medications from certain companies anymore due to cost effectiveness and have to accept what they are sent. How sad for the consumer.

A lot of our meds come from other countries and I pray one day they all will be manufactured in the U.S. I had rather pay a little more and get a purer more effective medication, hadn't you?

I believe you my friend. If you have an old bottle of the Clonazepam in pink, look and see who the manufacturer (Pharmaceutical Company) was and check around to see who has it.

I pray you feel better soon. Keep me posted. I care.

Jump to this post

I will check that out...Thank you.
I have gotten the pink ones mostly but every once in awhile they give me the yellow ones.

REPLY
@gerdi

My tolerance for meds has also changed dramatically with LC.
Would you mind providing more details for both the studies you mention, please? (Possibly links?) The UCLA studie on serotonin syndrome and the YALE one on the serotonin gap?
Thanks!

Jump to this post

REPLY
@da69

I did a gene test....Not sure if my body changed but took Zoloft for over 20yrs for depression and after getting Covid it stopped working and i had bad anxiety which i never had prior.
After my gene test they narrowed possible meds for me down and one is off label because of my test results.
I am no doctor but it has helped a lot.
Maybe this link will help or be a place to start.
https://www.mayoclinic.org/tests-procedures/cyp450-test/about/pac-20393711

Jump to this post

Thanks for this! I actually had this done at Mayo, but my prior psychiatrist wouldn’t read it after (and assumingly resented being told what to think), unfortunately. Mayo also found that my meds were “appropriate” but were wrong about that (as well as some other things). I was frankly disappointed that after 21 years of psychiatric care, that I’d actually be able to meet with a psychiatrist at Mayo because I’m well aware of how the meds typically worked in me, but, alas, all they would give me is a LP, DO. I’m hoping my new psychiatrist is more knowledgeable 🤞🏻, although she is also not an MD.

REPLY
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