What's a good antidepressant for me

[Flowerchild700]

I'm a 61 year old woman. I have HCV, stage 3-4 cirrhosis of the liver and a bunch other stuff that goes alone with it. They want me on antidepressants. But, around 6 or 7 years ago I took Cymbalta. I ended up in the hospital with a stomach bleed. Then this year they started me Effixer. I had a few bruises pop out and nose bleeds but I didn't think anything about it, I'd had bruises pop out before and nose bleeds, too.. Until they increased the dose. I broke out in big black bruises everywhere. I told my doctor he told me to reduce the dose back down. Then I started bleeding from my cervix  and my rectum. I even started bleeding under m toe nails. I told one of my doctors I didn't want to take any more Effixer. So, she started me on Celexa. My bleeding didn't stop. So, I winged my self off the Celexa, and guess what, yep the bleeding stopped and I'm nearly bruise free. So, what kind of antidepressant should I take... They want me on antidepressant because there going to start me on a new treatment soon.

[Flowerchild700]

Thank you, both, for answering my post. I hope I can find a psychiatrist, that knowledgeable about treating someone with my issues. Maybe, I should just wait until I talk to my PA, that in caring for my Hep C, again. But, she wanted me to get on something before I start treatment next time she sees me.

[HectorSF]

There is no one antidepressant that works best for all people. Everyone is an individual. Different types of clinical depression warrant different treatments. In addition you have chronic liver disease with either advance fibrosis or cirrhosis which will impact what antidepressants are safe to take.

For example Cymbalta is contraindicated in those with chronic liver disease so I am not sure why you were prescribed it.

"Because it is possible that Cymbalta/duloxetine and alcohol may interact to cause liver injury or that Cymbalta/duloxetine may aggravate pre-existing liver disease, Cymbalta should not be prescribed to patients with substantial alcohol use or evidence of chronic liver disease."

"Then this year they started me Effixer..."

Effexor is known to increase the risk of bleeding. If you have cirrhosis and portal hypertension you are already at an increased risk for bleeding.

Abnormal Bleeding

"SSRIs and SNRIs, including Effexor, may increase the risk of bleeding events. Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs, warfarin, and other anti-coagulants may add to this risk. Case reports and epidemiological studies (case-control and cohort design) have demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleeding. Bleeding events related to SSRIs and SNRIs use have ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.

Patients should be cautioned about the risk of bleeding associated with the concomitant use of Effexor and NSAIDs, aspirin, or other drugs that affect coagulation."

"Use in Patients with Concomitant Illness

Clinical experience with Effexor in patients with concomitant systemic illness is limited. Caution is advised in administering Effexor to patients with diseases or conditions that could affect hemodynamic responses or metabolism."
Such as cirrhosis and portal hypertension.

Perhaps you should find a doctor who is aware of the interaction between hepatitis C caused liver disease and the use of certain antidepressants before treating and possibly doing more harm than good?

Do you know the underlying cause of your bleeding issues?
Is it liver related or another medical issue?

Bleeding issues are often seen in patients with cirrhosis and portal hypertension and why cirrhotics are advised to avoid NSAIDs and other drugs that can lead to internal bleeding.
Have your doctors addressed this issue?
Do you have a low platelet count and a high INR blood level common with cirrhosis?

I would suggest finding a doctor who is knowledgeable and experienced in treating someone with your multiple issues. A hepatologist would be the most knowledgeable and experienced in the areas of hepatitis C treatment, advanced liver disease, and their management.

Good luck.
Hector

[Sovaldi13Newbie]

This is really a question for a good psychiatrist with a fix on your particular issues, as our circumstances are not the same. You're issues are too important to go by what a laymen says, I just wanted to give you some feedback. I ended up doing what I always do to fight depression...guided meditation tapes and yoga. That works for me but we're different people. Just my thoughts...Best of luck to you!