SSRI'S + AAS

[humongous]

i've been considering going back on effexor to combat my chronic low grade depression. i've taken it in the past sucessfully by itself. i'm wondering if there's any negative effects when you mix SSRI's with steroids.
p.s. my depression is due to a chemical imbalance that's part genetic (my mother also suffers this) and part due to my crappy childhood. i enjoy my life and i have great relationships. i'm just unhappy because of the imbalance.

 

[iprimate]

i've been considering going back on effexor to combat my chronic low grade depression. i've taken it in the past sucessfully by itself. i'm wondering if there's any negative effects when you mix SSRI's with steroids.
p.s. my depression is due to a chemical imbalance that's part genetic (my mother also suffers this) and part due to my crappy childhood. i enjoy my life and i have great relationships. i'm just unhappy because of the imbalance.

There have been some reports of elevated liver enzymes from Effexor but this isn't the case for everyone. You should be ok using injectable AAS and SSRI/SNRIs but go easy with the oral AAS. If you want to be careful, get your liver panel before starting AAS or Effexor to get a baseline. Then start the Effexor and after four weeks get the liver panel again. If the AST/ALT are unchanged then your liver is coping well with the Effexor and you can use orals safely. If your AST\ALT is elevated from the Effexor then either avoid oral AAS altogether or use for no more than 4 weeks and take some liver support.

 

[humongous]

There have been some reports of elevated liver enzymes from Effexor but this isn't the case for everyone. You should be ok using injectable AAS and SSRI/SNRIs but go easy with the oral AAS. If you want to be careful, get your liver panel before starting AAS or Effexor to get a baseline. Then start the Effexor and after four weeks get the liver panel again. If the AST/ALT are unchanged then your liver is coping well with the Effexor and you can use orals safely. If your AST\ALT is elevated from the Effexor then either avoid oral AAS altogether or use for no more than 4 weeks and take some liver support.

great. thanks. so liver values are all i need to be concerned about? there's no other nasty interactions i need to keep an eye out for?

 

[iprimate]

great. thanks. so liver values are all i need to be concerned about? there's no other nasty interactions i need to keep an eye out for?

Sorry for the delay in replying.

Yep. No interactions. Effexor raises blood pressure in some people as do AAS so you should also check your BP before starting Effexor and after starting Effexor. Then check it after starting the AAS. If you are getting hypertensive it would be wise to take an antihypertensive.

 

[OuchThatHurts]

Chronic low grade depression? There is no such thing. I'm going to assume you meant "acute" depression.

What sort of chemical imbalance? Overdosing on male hormones and testosterone analogues is also an imbalance of sorts (although self-inflicted). So then you have two known imbalances.

With an unknown existing existing chronic condition or chemical imbalance, I think it may be less than ethical to advise that any individual add an additional variable to his/her equation. What I'm saying is that while the two drugs are not generally contraindicated in healthy adults, you still risk a reaction inside your own body that could make the two drugs contraindicated in you specifically because of your existing condition(s).

If it were me, I would approach this with extreme caution or not at all.

 

[iprimate]

Chronic low grade depression? There is no such thing. I'm going to assume you meant "acute" depression.

There is such a thing as "chronic low level depression". He means his depression is low-moderate and constant. In terns of DSM-IV-TR jargon his condition would be described as a Depressive Disorder that doesn't meet the criteria for Major Depressive Disorder. Dysthymic Disorder is one such Depressive Disorder.

What sort of chemical imbalance? Overdosing on male hormones and testosterone analogues is also an imbalance of sorts (although self-inflicted). So then you have two known imbalances.

By referring to a "chemical imbalance" he was trying to say (in lay terms) that his depressive illness is not due to exogenous factors and very likely due to a genetic presisposition. He is saying his chronic low mood isn't because he is unemployed, divorced, lonely etc.

With an unknown existing existing chronic condition or chemical imbalance, I think it may be less than ethical to advise that any individual add an additional variable to his/her equation.

If he is on venlafaxine it means his depressive illness has received a diagnosis and that he is under the management of at least his primary care physician. If the depressive illness is entirely endogenous in origin -- as the OP has indicated -- then nothing more can be done, counselling is not indicated. There is no "blood test" for depressive illness so I am unsure what your point is.

Further, I didn't advise the use of AAS I simply made a factual (as opposed to a normative) statement regarding the pharmacology of AAS and venlafaxine so your point about ethics is irrelevant.

What I'm saying is that while the two drugs are not generally contraindicated in healthy adults, you still risk a reaction inside your own body that could make the two drugs contraindicated in you specifically because of your existing condition(s).

This is just empty speculation. If anything being on gear will lift a low-level depression.

If it were me, I would approach this with extreme caution or not at all.

It isn't as if the OP is making a non-redemptive decision. For the sake of argument, lets say he has a adverse reaction to AAS. Then what? Simply stop taking the AAS. I don't understand your fatalistic conception of the matter.

 

[OuchThatHurts]

There is such a thing as "chronic low level depression". He means his depression is low-moderate and constant. In terns of DSM-IV-TR jargon his condition would be described as a Depressive Disorder that doesn't meet the criteria for Major Depressive Disorder. Dysthymic Disorder is one such Depressive Disorder.

By referring to a "chemical imbalance" he was trying to say (in lay terms) that his depressive illness is not due to exogenous factors and very likely due to a genetic presisposition. He is saying his chronic low mood isn't because he is unemployed, divorced, lonely etc.

If he is on venlafaxine it means his depressive illness has received a diagnosis and that he is under the management of at least his primary care physician. If the depressive illness is entirely endogenous in origin -- as the OP has indicated -- then nothing more can be done, counselling is not indicated. There is no "blood test" for depressive illness so I am unsure what your point is.

Further, I didn't advise the use of AAS I simply made a factual (as opposed to a normative) statement regarding the pharmacology of AAS and venlafaxine so your point about ethics is irrelevant.

This is just empty speculation. If anything being on gear will lift a low-level depression.

It isn't as if the OP is making a non-redemptive decision. For the sake of argument, lets say he has a adverse reaction to AAS. Then what? Simply stop taking the AAS. I don't understand your fatalistic conception of the matter.

This was a well-thought-out and articulate response to my difference in opinion. The problem is this: you did not listen to what humongous originally said before you gave your hasty and reckless affirmative approval of his situation. "He means", "He meant", "He was trying to say"... You appear to know exactly what he is saying although you missed the most important point of his original post which is that he is already using AAS and considering adding the SNRI you dope! And then you waste my time with this itemized retort that makes little or no sense whatsoever.

Humongous, I'm curious. You mentioned in your original post that you enjoy your life and have great relationships. If this is so then why are you considering going back on your medication? Is there something else? Did you discontinue your Effexor before or after you started using AAS or were you using AAS all along? I suggest you seek counseling before starting on your Effexor if your lifestyle has changed. This could be something as simple as being overtrained to something as severe as a worsening of your previously diagnosed condition (although unlikely) - Whatever the case, you should not be trying to decide whether or not to go on or off your medications completely on your own. Get some professional advice my friend. Don't do this on your own.

p.s. iPrimate, I know your intentions are good. But we do not advise members to change, discontinue, add, or in ANY way whatsoever interfere with a member's psychotropic medications or other therapy whether they ask or not. If you want to stay on the board, please refer all such inquiries to the user's physician or local emergency room (depending on the severity). If you want to help, be a friend. No practice target-shooting on the membership.