DHEA and antidepressants

[sunny1018]

I recently saw a holistic doc for my anxiety because it has been out of control for over a year despite various meds and CBT.  She ran some hormone tests and my DHEA and cortisol were fairly low.  She says it's probably due to long term stress.  She wants me to take a DHEA supplement.  Problem is I've read on some sites that it's not wise to mix that with antidepressants or benzos.  I'm currently on 20 mg Escitalopram and .75 mg clonazepam.  I called my shrink to ask about interactions and his nurse said as long as the other doc knows what else I'm on he doesn't care if I take it.  That says to me he doesn't know.  Has anyone here tried it?

[sunny1018]

He also suggested antipsychotics which in the beginning he said he never would.  My last shrink recommended that too, hence I found a new one.  I just have anxiety.  Those meds hardly seem worth the risk to me.

[Paxiled]

I think, first, you need a new psychiatrist.  Everyone knows meds poop out.  The people who make them know they poop out.  It's true they don't poop out for everyone, but they make the brain work artificially and eventually the brain can get used to this.  If it were you just being anxious, well, duh, wouldn't that mean the medication wasn't working, since you were still that anxious?  I agree about antipsychotics, they go there when they don't have a good alternative.  As for weaning off the klonopin, I was also put on klonopin a long long time ago without anyone telling me it was addictive and hard to stop taking.  This can take a very long time (or no time at all) to stop taking, and I wouldn't feel confident if I were you doing it with this particular psychiatrist.  As for ashwagandha, that would have been a better choice than DHEA.  I have never heard of that being used for anxiety before, but ashwagandha is.  I don't see any real conflict with the meds you're taking, as it's main effect is on the adrenals, not the neurotransmitters the drugs are targeting.  But alone, it probably won't do that much -- natural medicine requires a regimen, not usually one substance, and lifestyle changes and therapy and the whole ball of wax.  You might ask your DO where she got her training in natural medicine and how much of it she got -- a lot of DOs and chiropractors claim to be expert in this, but usually aren't.  Some are.  It just depends on how much study and experience they have in it.  I wouldn't have much confidence in any natural practitioner, however, who just told me to take one thing.  They usually work with formulas that target different parts of the body involved in the problem, which is why it's so hard to do if you're also on medication -- you have to avoid targeting the same neurotransmitters.  At any rate, good luck.

[sunny1018]

She is a DO who practices integrated medicine.  She first recommended ashwagandha but I was scared it would interact with my meds so she suggested DHEA.  My testosterone levels were ok, along with progesterone and estrogen.  Thyroid is ok too.  She did say too watch for increasing anxiety on DHEA.  My morning and late evening cortisol levels were low.  I am looking to wean off the Klonopin as I feel it doesn't help.  Of course my shrink says I'll fall apart without it.  His weaning schedule seemed a bit quick for my comfort.  The DO put me in touch with a compounding pharmacy who will help me with a slower wean.  No meds have helped much since my lexapro first started to poop out in December 2014.  My current shrink says he doesn't believe in poop out.  It's just your anxiety gets worse as you age.  He told me it's probably me talking myself out of anything working because I'm so frustrated with these meds.  I have tried effexor, zoloft, Celexa and now back to lexapro.  I could kick myself for ever letting them talk me into Klonopin.  I used to take an occasional Ativan but was told KPin would help so much.  Not so.  I've been on it 7 months now.  I did try cutting it by a quarter several months ago and that caused terrible anxiety.  Shrink says that's how I should do it.

[Paxiled]

What kind of holistic doc did you see?  An MD who practices integrated medicine?  A naturopath?  I ask because given you suffer from chronic anxiety of course you're under long-term stress, but anxiety sufferers overproduce cortisol when they're suffering a panic attack -- that's in fact the biological way a panic attack is manifested.  Cortisol is released by the adrenal glands and is considered the flight or fight substance, and is probably sent in response to a signal from the amygdyla in the primitive brain that a great danger is present.  Of course, with those of us who suffer anxiety, no great danger is actually present, so our system is messed up.  But you definitely don't want to increase cortisol production if you suffer anxiety attacks -- this is what taking cortico-steroids does to many people.  So sure, you probably do have some depletion, but the way to work on that would be to relax your adrenals through the use of adaptogenic herbs such as holy basil or ashwagandha, not by increasing it.  As for DHEA, this is a precursor hormone that then manufactures our sexual hormones.  Some women -- and I'm assuming you're a woman as your profile says you are -- take this in order to control their hormonal fluctuations better, as it makes testosterone.  Some men take it to get bigger muscles and more energy.  But you're doing all this medication to relax your system, and it's doing its job, depressing your energy as it does it.  You might in fact be deficient in testosterone, but do you want more energizing?  It's very difficult to treat anxiety naturally if you're on medication -- it's difficult to treat anything naturally if you're on medication for the same problem -- but I'd think about this before I'd take this particular substance.  You can try it and see, and if you get more anxious, then stop taking it.  You might also stop taking it if you notice hair growing in places you don't want it, say, your chin, as that can happen when a woman increases testosterone.  So while I wouldn't say it's a terrible idea, I'd say I'd be vigilant about how you feel if you do try it.

[mikegbuf]

I happen to be a natural health practitioner, DHEA is there to support the adrenals once it creates too much Cortisol during stress, and then get exhausted and can't make anymore.  Thought I'd clear up that confusion.  

[JustHelp123]

I am not sure about DHEA at all, but it is alarming that they are so passive about mixing different substances.  Pharmacists tend to know a lot, but not sure if they are familiar with the DHEA as much as other typical medications.  Every form I fill out with medical records indicates that I should list absolutely everything I put into my body, for good reason.  Just because something is more holistic or natural, it doesn't mean it will interact well with other medications.  Good example is grapefruit juice, which intensifies medications to the point it can be dangerous.  For what it's worth, I am a firm believer in CBT and REBT (which now I have applied more easily into my life) and I take Buspar.  My mood stabilizer (for bipolar) Lamictal probably fills in some areas, thus I don't take a large dosage of Buspar.  I hope you find relief and what you are looking for.  Have you tried other pharma meds? - Brett