Anti depressant drugs

Are there any anti depressant drugs an ITP patient can safely take?

Any drug has the potential to cause a platelet drop. That doesn't mean that it will. Many people here have taken anti-depressants without a problem. There have also been some newly diagnosed people who thought that an anti-depressant was the cause of their ITP. Unfortunately, you won't know until you try and even then, a drop could just be a coincidence.

Have you discussed this with your hematologist?

Yes, he suggested I see the psychiatrist but when I asked him which drugs are safe he said it was out of his realm of expertise!!!
The psychiatrist is doing some research before prescribing something. Someone I know with ITP is currently taking viibryd?. And having success.

Celexa seems to be the most used anti-depressant here, but you should use the one that will work the best for you.

Thrombocytopenia is listed as a side effect for most drugs, so no one can really predict what will happen. I just looked up Celexa and thrombocytopenia is listed, but I took it with no problems and others have also. Ha, I'm not pushing Celexa, just using it as an example.

Thanks Sandy. I am just struggling right now. I was diagnosed in September and my mental state seems to be getting worse each month. Finished a rituxan treatment at end of January and platelets have been fluctuating between 120,000 and 150,000. Last check I was at 119,000. Nervous wreck everytime to get checked.

Your counts are great! Spending time talking here might help more than an anti-depressant would. Most people calm down and feel much better once they learn more about ITP and the experiences of others.

119's not going to kill you.
even 50 is not likely to kill you.

i've went about my normal daily routine at 2 and 3 and 5. (i don't have a physically demanding job, so that helps.)
tired, yes, but no bleeding other than petechia.
if the doc would let me, i'd hang out at 30 instead of going back up on the pred.

Your counts are right where mine have been for years. My hematologist ignores me these days and my primary care physician just shrugs at my numbers, saying they're good for me and I don't have to do anything about them. I rarely think about my platelets when the count is above 100.

A psychiatrist friend told me that while a long list of meds can possibly reduce platelet counts, some psychiatric meds are more problematic/risky. He mentioned tricyclics in general and valproic acid in particular as ones he pays closer attention to. He also said that with some of the SSRIs and SNRIs, routine blood work is part of the monitoring that he performs with all his patients. That said, he's never seen a patient experience a platelet crash and has only seen the rash associated with Steven-Johnson syndrome a couple of times. I hope this bit of info helps.

Aoi wrote: That said, he's never seen a patient experience a platelet crash and has only seen the rash associated with Steven-Johnson syndrome a couple of times.

OMGoodness. I'd much rather have ITP than Steven-Johnson Syndrome any day! That's scary!

You know, some ITP treatments even list thrombocytopenia as a side effect. Platelet transfusions can cause post-transfusion purpura. Antibiotics can cause platelet crashes. While it's wise to investigate, it's best not to worry too much about it. Avoiding drugs as much as possible is the best bet, but sometimes you have to do what you have to do.

Rituxan is good for remissions if a person responds to it, so your counts might be good for a while.

Jcallahan I was shocked by what your hematologist told you - he is your specialist, he should help you even if he says: "I don't know but I will look into some of the meds and get back to you soon" Shame on him!

Did you need an anti-depressant before ITP or is this since ITP? You have not been diagnosed for very long - and it is a load to carry. You are not alone - we're here. And we have stories we love to tell I was diagnosed in 1989 and shortly after that we moved to Tokyo while I was on 60mg of prednisone and not knowing if I'd get a hematologist there [did get one and he was THE best].

How did you meet the person you know with ITP? When I was diagnosed I found out our son's orthodontist was an ITPer. Later when we moved back from overseas there was a group of ITPers who met every few months but we don't any longer, I miss that.

Your platelets seem to be doing well - 119,000-150,000 - great counts. After prednisone I was in a "remission" with counts ranging from 85,000-125,000 for about 9-10 years.

I hope Rituxan will keep your numbers good for a long time to come. Know an ITPer who had Rituxan probably about 2007 (2009?) and is still doing well. So send some positive vibes to your body! I used to say, and some others did too, 'I have ITP, ITP doesn't have me" - good way to think.

Keep us posted!

About 10 years ago I was on Celexa for depression (I was also on prednisone - see the connection?!!) At the same time I was taking cognitive therapy. Once I learnt that I was able to wean off Celexa. I am no longer on pred, but when feeling depressed, I use the skills learnt in therapy. BTW I have been doing Tai Chi once a week for 8yrs and that certainly helps.

That sounds like a good plan for the present. ITP may take some getting used to, but you'll find plenty of people here who rapidly adapted to having the disorder and now engage in a lot of monitoring or watchful waiting in case something happens. Fortunately, it rarely does. Most of us just go about life and double-check platelet counts once or twice a year.

I have had the same pharmacist for more years than I remember and found he was a wonderful resource re: anti depressant drugs.

I have been meaning to thank you all for your responses here. As of now I haven't started the anti depressant. While my numbers have bee steady around 120,000 to 150,000 since rituxan, I am still pretty anxious waiting for the other shoe to drop.
Would love to hear more success stories to keep my hope and spirit going.

Those are great numbers. I'm usually in the 110s or a bit lower, and my hematologist and primary care doc both agree that's nothing to be concerned about. In other words, no footwear is falling around here.

Joanne:

I'm going to tell you what I think. I have been tracking Rituxan users on here since 2004. What I have seen in all that time is that if a person has counts like yours after the treatments, they tend to have a remission that lasts about a year, give or take. That is the average. I have also seen the occasional person drop a few months later, and I have seen people have much longer remissions. I think your chances are good.

Now, if the other shoe were to drop (and someday it might), you will have to treat again. If that happens, it's not the end of the world. It's just an inconvenience in your life that will pass like this one will. You got through this. You can do it again. ITP will only rule your life if you let it. I had a trick that worked for me and it has worked for others. Whenever I got a good count, I would pretend that my count stayed until I heard differently. I never worried until the next count because in my head, I was at 120k until they told me otherwise. It worked and I never felt anxious or scared. If I had symptoms and knew my count was down, I took a breath and told myself that I could manage it. And I did. Every time. I had up and down counts for 8 years before I went into this last remission (2005). Looking back, it was not the worst time of my life, but I thought it was at the time. You can waste your time worrying about that other shoe, but it may never drop and you will waste your time worrying. If it does drop, you'll pick it up.

You want success stories but 'success' is different for everyone. Ultimately, success is having normal counts and never having to treat again. Not everyone gets that lucky. You might. Some people get breaks from treatments and that is good enough for them. Some people hover in the 50's and 60's and that is good enough for them. Success is in the eye of the beholder. I have seen people live with counts under 5k for many years because they had no choice. Nothing worked. It didn't stop them from living. ITP is something that you get used to and your fear will subside. You will eventually put it on the back burner and focus more on what is up front. You're going to be okay.

thank you sandy. This has been hard on me. I really appreciate your input, honesty and advice. Much appreciated.

I know. It's normal to freak out at first. You're not alone there.

Yes like Sandi says, success is different for everyone.

Three weeks ago I was at 1000 platelet count. I was totally fine- my hemo also trusts that I am fine- having the doctor on my side is so encouraging. The drugs failed but somehow my body compensates for the low platelets.? Don't know what happens, but when my counts get that low, my bruises go away and I have no symptoms. Very mysterious but it inspires me to trust that my body is somehow handling it. That is success for me.

My Nplate was increased and counts went up- that also is success for me. I guess my success story consists of little successes along the way. My goal is to lightly manage ITP in the best way I know how- I still have my spleen and that also is success for me.

When I was first diagnosed they said it could be HIV or leukemia or some other blood disorder. I knew I didn't have HIV so I thought leukemia. It took 2 full weeks to get the blood work results back and during that time I was quite panic stricken. I was an unemployed single mother with a young child.

When I found out that all I had was this quirky auto-immune disorder, I was absolutely delighted. I laughed so hard when I got out of the doctors office, I felt like the luckiest person alive. So its all very relative. I go to the cancer clinic every week for Nplate injections and believe me I know it could be so much worse. good luck to you!

Poseymint how are you doing now? Did your numbers go up on N plate?

I am a Psychiatric Nurse Practionier and have ITP. I will not prescribe SSRI for patients with low platelet counts. I myself take Wellbutrin SR and have had no problems with it effecting my platelet count .
Elaine