Scared

[cdawn97]

I hope someone can tell me I am not alone in this. Whenever my Phenytoin levels are "normal", my depression worsens to suicidal thoughts and cutting. I thought I had that all under control and have a good job - I am finding myself getting so mad about stupid offences that cutting seems the only release. I have resisted this time (it has been years), but I'm afraid that if I don't give in I will respond in a non-professional manner.

 

[N Sperlo]

Hi, Cdawn.

If you are afraid you will respond in that manner, its beyond time to see the doctor. Go do it now. They are the only that can help you right now.

I wish you the best.

 

[cdawn97]

It Is not like I have been ignoring it, it came back up suddenly after my neurologist increased my meds. I am not in here to draw on people (I generally deal with my problems internally), I just want to know if anyone else had had this reaction to an increase in Phenytoin. I don't feel like my Neuro listens all of the time and I would like some backup to take to him. The only thing scarier than dealing with this is having him shrug it off as a separate mental health issue that I need to talk to someone else about.

 

[N Sperlo]

Right. It is a reaction to the meds. I've never dealt with anything like that, but people I love have. I know I would want the people I love to go see A doctor. Doesn't have to be your neurologist, but they need to see a mental health professional irregardless of the cause.

 

[Cint]

It Is not like I have been ignoring it, it came back up suddenly after my neurologist increased my meds. I am not in here to draw on people (I generally deal with my problems internally), I just want to know if anyone else had had this reaction to an increase in Phenytoin. I don't feel like my Neuro listens all of the time and I would like some backup to take to him. The only thing scarier than dealing with this is having him shrug it off as a separate mental health issue that I need to talk to someone else about.

I've had the problem of depression for years as have many others with TLE. This can be a side effect from the medication or it could be a change in seizure activity. Has the dr. checked your blood levels? Have you had your hormone levels checked? This increase in medication could also interfere with your thyroid, which could make a person depressed.

And, your dr. does need to check the side effects of Dilantin because according to the FDA it can cause suicidal ideation:

http://www.drugs.com/pro/dilantin.html

Suicidal Behavior and Ideation

Antiepileptic drugs (AEDs), including Dilantin, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.


The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age (5–100 years) in the clinical trials analyzed.

Anyone considering prescribing Dilantin or any other AED must balance the risk of suicidal thoughts or behavior with the risk of untreated illness. Epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Should suicidal thoughts and behavior emerge during treatment, the prescriber needs to consider whether the emergence of these symptoms in any given patient may be related to the illness being treated.

Patients, their caregivers, and families should be informed that AEDs increase the risk of suicidal thoughts and behavior and should be advised of the need to be alert for the emergence or worsening of the signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Behaviors of concern should be reported immediately to healthcare providers.

 

[cdawn97]

Thanks for the information. Now I just need to figure out which doctor to talk to. Some have asked me at some point if I had been dealing with depression and I lied before I could decide what to say. I just don't want another stupid pill to take - especially another one to mess with my brain. I take way too many already. And if I am correct and the dilantin is causing this, therapy will not do me any good.

 

[dbrim]

I had the same thing with ethosuximide, mine came on suddenly with dose increases and was really scary because I didn't connect the two until it had gotten really bad! I went to my doc next day and said I wanted off!! I don't think he had much experience with aed's because he said ok let's deal with your 'mental health issues' first the. Worry about the meds. It took me a good hour to convince him it was the meds making me feel this way, even after that I got a phonecall every day until my next appointment to make sure I didn't hurt myself...
Not nice to go through buy you need to make yourself heard and see someone ASAP!

 

[cdawn97]

Thanks dbrim. That was what I was hoping to hear. Your doctor took some convincing, and you had to deal with the calls. At least you got through to him/her and weren't placed somewhere - I guess that is my real concern right now.

 

[dbrim]

No problem. You know your body and mind better than any doctor, it's just that they have the tools to help you. I think my reasoning with my doc was... Give me 2 weeks off these meds or at least on a lower dose, worst that could happen is I'm wrong and you are right... Then if it doesn't change we can deal with my mental health issues... I fel better literally the next day after coming off those nasty meds.