As predicted yesterday, my doctor gave me anti-depressants today.
I can't imagine how they will change my existance, but he assures
me they will do me, and more importantly--to my mind--my family,
good, so I will take them faithfully.

The anti-depressant is 10mg escitalopram.

I am also on 200ug Levaxine (synthetic crap, although I seem to
respond nicely to it).

Does anyone here know of any problems taking the two kinds of
medicine together?
--
SRH

http://www.rxlist.com/cgi/generic/lexapro_ad.htm
The most commonly observed adverse events in LEXAPRO patients (incidence of
approximately 5% or greater and approximately twice the incidence in placebo
patients) were nausea, ejaculation disorder (primarily ejaculatory delay),
insomnia, fatigue, decreased libido, and anorgasmia (see TABLE 2).

Side effects (I'm only listing frequent, but my family frequently seems to get
the infrequent side effects of meds too.


http://www.rxlist.com/cgi/generic/lexapro_ad.htm
Cardiovascular – Frequent: palpitation, hypertension.
Central and Peripheral Nervous System Disorders - Frequent: light-headed
feeling, migraine.
Gastrointestinal Disorders - Frequent: heartburn, abdominal cramp,
gastroenteritis.
General – Frequent: allergy, pain in limb, fever, hot flushes, chest pain.
Metabolic and Nutritional Disorders - Frequent: increased weight.
Musculoskeletal System Disorders – Frequent: arthralgia, myalgia
Psychiatric Disorders – Frequent: appetite increased, lethargy,
irritability, concentration impaired.
Reproductive Disorders/Female* - Frequent: menstrual cramps, menstrual disorder
Respiratory System Disorders - Frequent: bronchitis, sinus congestion,
coughing, nasal congestion, sinus headache.
Skin and Appendages Disorders - Frequent: rash
Special Senses - Frequent: vision blurred, tinnitus.
Urinary System Disorders - Frequent: urinary frequency, urinary tract
infection.
***********

Doesn't appear to be a prohibition against taking thyroid meds with
escitalopram. However, there's a long listing of drugs not to take it with
(including Nsaids, aspirin, and alcohol.)

My family always seems to get side effects from drugs, so even though the above
list only happens to 1 / 100 patients, if you're observant you'll probably see
some. However, you have to weigh the side effects against the benefit for you.

They did say, "Clinical experience with LEXAPRO in patients with certain
concomitant systemic illnesses is limited. Caution is advisable in using
LEXAPRO in patients with diseases or conditions that produce altered metabolism
or hemodynamic responses."

As far as I'm concerned thyroid = metabolism which means you have "altered
metabolism" but not everyone feels that way.

Skipper

Skipperbeers skrev:


Well, my metabolism is fine as long as I take my Levaxin, so I
wonder if it's altered or was-altered-but-is-now-normal-again.

Thanks for doing the leg-work. What I was really after, however,
is a problems of taking the tablets at the same time. Iron
preparations, for example, should be taken not earlier than 2
hours after thyroid meds. It's that kind of thing, I wonder
about.

I start the medication tomorrow (I had a lone beer in the
fridge), and will take it after breakfast. I take my thyroid
medicine half and hour to an hour before I eat breakfast.
--
SRH

Hi SRH,
Escitalopram (Lexapro) is an SSRI Antidepressant (AD). I haven't located
any scientific study that specifically discusses SSRIs and thyroid hormone
replacement supplements yet (doesn't mean it has been addressed). If anyone
has, please post ;o) TIA -- see also footnote.

There are contradications between lithium as it blocks thyroid hormone and
presumably thyroid hormone supplements????

The following:
http://ajp.psychiatryonline.org/cgi/...ct/158/10/1617
is a meta-anaylis of thyroid hormone replacements and tricyclic ADs. Sorry
not to be much help but one would need to know how SSRIs differ from
the tricyclic ADs. If you can't access this link FYI this study concludes:

quote from American Journal Psychiatry:
"...This meta-analysis supports the efficacy of T3 in accelerating clinical
response to tricyclic antidepressants in patients with nonrefractory
depression. Furthermore, women may be more likely than men to benefit from
this intervention. "

So it is the t3 that helps? What a surprise! Would your doctor consider
adding synthetic t3 to your mix for your depression instead of the ADs?
There is ample evidence emerging that supports t3 supplements help depressed
individuals.

BTW - do you mean levoxine (and not Levaxine)

Maybe our resident chemist here could comment - I think he commenteD once on
the AD/thyroid supplement topic, or you could Google...
I hope you feel better very soon. Meanwhile, you could separate the two
pills by a couple of hours if you think there is a negative effect.

Kindest regards,
Diana
PS Does anyone have access to the following, it might shed some light on
the topic:
I. BERLIN and E. CORRUBLE
Thyroid Hormones and Antidepressant Response
Am. J. Psychiatry, August 1, 2002; 159(8): 1441 - 1441.

Cavaliers skrev:

My T3 is nice and high already, which means the cells are getting
theirs. I don't see any reason to add to it. The smooth operation
of my metabolism is one of the reasons the doctor suspects
depression. I think I've probably been depressed for years --
since long before I went hypo. I am willing to trust the doctor
on this. At least as long as the ADs work.

I mean "Levaxin", which is a brand of synthoid in this country.
It gets confusing with all these names.


Good idea. I found this from sci.med

<http://groups.google.com/groups?q=ad+thyroid&hl=no&lr=&ie=UTF-8&oe=UTF-8&selm=michael_gordon.45.03C29CF3%40sunshine.net&r num=2>
=====
There are other conditions such as auto-immune reactions to the
thryoid or subclinical hypothyroidism that can also result in
depressive symptoms, but TSH levels may not be out of normal
range. Therefore, other diagnostic tests for thryoid problems
should be done in addition to TSH. One is an antibody test and
another is a TRH stimulation test. In our experience, anyone
suffering depressive symptoms should have these tests done.
=====

But I've had the anti-body test, and whilst it was high before I
started treatment, it all-but disappeared when my blood levels
began to normalise.

Thanks. So does my wife. I have mixed feelings about it, but I
will take my medicine as I have been instructed, and see what
happens.


Yeah, that's what I'm going to do.

Thanks for your reply.
--
SRH

SRH said...


I'm taking Lexapro 10mg and Synthroid 75mcg. There isn't much
information on interactions between SSRIs and thyroid supplements, but I
have heard that the SSRIs can inhibit the function of thyroid
supplements by a small amount, approximately 10%. The leaflet that came
with my synthroid mentioned to tell your doctor if you are taking
Sertraline (Zoloft) which is actually quite similar to escitalopram
(Lexapro). I find the Lexapro rather sedating, meaning I sleep a lot.
But this was actually a welcome change from the incurable insomnia I
have suffered for so long. Other than that I have had remarkably few
side effects other than some ringing in my ears.

If you're observant you might find a lot of drugs interfere with thyroid meds,
including antibiotics, and it wouldn't surprise me if antidepressants do also.
Personally, I would not take them together, and I would make a good note of how
I feel before and after the anitdepressant. If thyroid symptoms come back,
obviously it's interfering and you need to stop the antidepressant or increase
the thyroid medication as long as that will work. In some cases it won't. The
antidepressant Prozac for example, is known to cause high levels of cortisol
which can negatively affect T4 to T3 conversion, thus making one hypothyroid,
and in a way even harder than normal for doctors to interpret when they get lab
tess. I'm not saying your antidepressant does this, I don't know.

I've taken Cipro and Augmentin and found that regardless of the timing, they
greatly interfered with thyroid medication or function.

Skipper

GT skrev:

That's useful information. My doctor didn't tell me that, but
mentioned the possibility of having to up my dosage. He didn't
explain further when I protested that my blood figures are fine.

I have just (two minutes ago ) taken my first AD. I'll see what
happens.
--
SRH

Hi SRH,

Good news about your t3!

Thanks for clarifying (it's good to know the names of supplements from all countries).

<http://groups.google.com/groups?q=ad...-8&oe=UTF-8&se
lm=michael_gordon.45.03C29CF3%40sunshine.net&rnum= 2

Thanks very much for posting this - the poster was well informed -- what a
coincidence his noted address is 'up the road' from where we live.
Good health to you. Hope the ADs are effective.
Kindest regards,
Diana
A footnote on antibodies - when diagnosed with Graves' eye disease and when
it was at its worst all my antibody tests were negative.