Yes, I wondered the same as you Tig. Drugs are hard on a liver, period. But then there are the competing issues too.

Perhap testing the benefits versus non-benefits of being on both eff and pax has gudied the decisions to ramp the eff downward.

It's so hard to say from here.

But on principal, treatment via medications does have to be weighed and followed very well.

When you get a chnace Phyllis, it would be inetrstign to know how your ALT/AST have been before and now.

Yes, I agree do keep all your docs informed of what your on and how you are feeling. Opinions may differ but all should be valued and considered.  C.

The combination of medication concerns me. We are all different and certain situations require different measures, but their consequences can be substantial. Doctors must start comparing notes and breaking out the PDR when dealing with competing health issues. I would request a thorough review of your medications. My Hepatologist gave me specific instructions to not take Effexor. It's hard on the liver and there are other medications less harsh. This is my opinion only.

I'm including a link to the Effexor data, review the side effects profile, many of your complaints are mentioned. When they start combining multiple medications, some adverse effects are amplified. I encourage you to ask your doctors to review your case and help you get things back on track. 

Effexor

Hey thanks for sharing Phyllis,

That helps, at least to know there was a history of battling this prior in your family, and that it was not completely out of the blue - certainly does not make it ANY easier, I wish it would behave for you. Very well worth doing everything you can think of, and trying everything they can think of to attempt an alleviation of it, control it and make your life better. Good you have attention of and the benefit of these docs to try to help. I am guessing these are fairly tried and true large dosages they "ramped" you up on, from 75 to 300 mg of effexor, and the 40 of paxil is also a fairly big dose. I have read about this before, where both effexor and paxil are given for basically the same reasons, but each having their own dif means/particular mechanisms of acheiving this - so I guess they think it is well  worth the try, if one drug alone alone is not doing it, the 2 together may be better. I am also glad to hear he is trying to ramp you down on one of them (effexor) as this is another thing they have found, that sometimes the two drugs together or perhaps at too high a dose of one or the other when taken in tandem, can have the opposite or a counter-productive effect. Worth the experimentation to ramp dosages downward, as well, to see if they can effect a better result! Maybe that will help (reducing the effexor dose) finding the "goldilocks" level, not too much, not too little - just right?

You did not mention how much you take of the clonazepam tho, have you been on that as long as the other effexor and paxil??

All I know is that sudden complete cessation of any of these is not a good idea, when you are well used to being on them, so do not let them suddenly discontinue the drugs without them ramping them downward first - that is my understanding of them anyway, i don't think your doc would anyway - they do not want to see you see-saw either in the effect of the drugs I am sure. They and you I am sure hope to find that sweet spot of just right dosing. I beleive the theory is all about finding what works, period, and then, the balancing act, the teeter-tottering of the dosages for the max. benefit you can glean from them.

Keep trying dear, in whatever you think would help, do keep trying all the other non-medication type things you can think of to help. You will certainly have our sympathy with this and our support. Keep us posted how you are doing and your responses to this effexor decrease. Maybe this new decrease/balance WILL help. I hope so!

ONLY one yearish after finishing cruel riba, and after harbouring this damaging hitch-hiking virus for 4 decades, you have to allow more time for liver and body recovery, I am hopeful you WILL see the improvements you hope and wait for, with more time. I am very glad you were not/are not cirrhotic. 

What are some of your pre- and post treatment ALT's and AST's? I am so glad you have beat this HCV, you will conquer this too!.  C.

BWT - let me get this right ... you were on celexa long-term, until you had a sudden exacerbation/melt-down you called it, at 2 months into HCV treatment, which at that point they took you off celexa and started you on the new regimes? Also, at what point did they try this unsucessful trial of lithium? 

PS - I like hearing all the wisdom, experience, info and thinking everyone has brought to this thread!!

Thank you all for your responses. Canuck I'm going to try to answer your questions.  l did not have cirrhosis.  Contracted in 1973  And I had been on celexa for about 14 years Before I started treatment for HCV. I'm afraid depression runs in my family. 

My psychiatrist took me off celexa and started Paxil. 40 mg a day. Then added 75 mg Effexor, then gradually up to 300 mg. I tried lithium and at first 30 mg it worked then it was bad.i was kind of hallucinating.  So off all lithium. Then doc Lowered Effexor dose to 225 mg. that is when I started feeling normal again. So today I called his office. It's been a really bad week. He said to lower Effexor to 150 mg now. So I will Cut down tomorrow. 

Thank you so much for your support. 

may I also add that in those 14 years on celexa I didn't have depressions  I was sad sometimes but it was a Normal sad response. Not this bog of depression.

Phyllis

Wow, Scruffy, you could do Tai Chi during tx?  nope not me.

But more importantly Lawmatt, I had the sore quad muscles! 

OMG It lasted for 2 1/2 years post TX but I must add that I developed myositis and lost all my muscles.  I pretty much laid in bed for 48 weeks and ended up in the hospital because of it. That said, last fall 2016 I was determined to find out why my legs hurt. Let me be more specific. It hurt to walk up and down the stairs, it hurt to touch my quads (top and sides) and after all my other muscles recovered the quads would not heal.  So I went to a physiotherapist & he said the muscles were "tight" & referred me to a massage therapist.  Off I went demanding answers and he said my "fascia" was stuck.  He said it happens in cases of extreme over-active athletes and complete lack of exercise. So he massaged my legs and after one treatment my pain has subsided.

I'll take it one step further and explain while I still remember. The fascia is like the silver skin on meat, and it covers the entire body from the tip of the toe and attaches to the back of the eyeball.  It's supposed to glide like oil in a baggie. When it gets stuck there is no movement. You can look up fascia stretches but it is very difficult to stretch the quads yourself. A massage therapist has worked for me and it is painful at first but feels great.  He said that it can work for some people and not for others, it's worth a try. For me the results were instantaneous! Still need to go for more.

I really hope this helps you!

+1 for the qiqong practice. I practiced Tai Chi during treatment and still do. It was probably one of the biggest helps with my 48 week of limbo.

Sorry you're still suffering from depression. Neurotransmitters out of balance.

I have a friend who was part of a university study that ended up 'proving/confirming' that daily meditation is extremely helpful for depression, so I'm glad you have integrated that into your regime.

I'm not at all knowledgeable about the drugs, but I do know that medical cannabis is very useful for anxiety, PTSD and other brain issues.

I also have read a fair number of things about using probiotics and concentrating on 'gut health' to help with depression, anxiety ect.

I practice qigong which helps me balance myself mentally and physically.

take care,

Alison

Hi Phyllis,

From a fellow GT3 a huge congrats from me on killing your virus BTW!! You resolved your HCV, you will resolve this too.

I am sorry to hear about your ongoing symptoms tho. 24 weeks of that sof/riba regime was a long haul enough, and, you did not need the onset of the depression/anxiety to be on board for the duration and now following - really not fair! 

I am glad you and your docs have obviously been trying to address these lingering symptoms.

I am hoping they WILL dissipate (the sooner the better). It has been a long haul for you. Keep trying. I thought maybe your name seems familiar to me but I cannot find any other posts from you at first glance, I was wondering a bit, first and foremost, about the overall condition of your liver and some of your history.

Were you/are you cirrhotic? I was also wondering if your had ever had any inklings of a depressive or anxiety episode in the past before HCV treatment? If you had ever been given any drugs like effexor/paxil/clonazepam before.

They are certainly trying to help you with this 3 drug combo. If you don't mind sharing, can you relay which of the drugs(s) they tried first, which were added and when, and what dosages have been tried as they went along? I am sure all your docs must be monitoring you well, and following your current sypmtoms and keeping an eye on your liver function as well. 

I hope things start going your way soon, and that you might have gained a wee bit of lessenings in some of the symptoms, no matter how small at first, and will start seeing some more significant relief. When you do, and when they start considering removing some of these meds, be sure they DO ramp the dosages down slowly, so there are no abrupt discontinuations.

I am not "up" on these drugs, I am sure you probably know more about them than I do. Of these 3 drugs, which, if any, (if you can tell or guess) might be having any or the greatest effect to the positive??

Can you elaborate and confirm .... did you mean you felt some better (for a couple weeks - just recently?) - but then the symptoms just returned?

Do you have good help and support around you, I hope so. It is good you have the attention of a psychiatrist and an psychologist, do you get to see them frequently to talk it out and talk things over with them?

I am betting on it, and banking on it, that this will pass, it is just taking some time. Good you are meditating and exercising.

I have no idea whether adding marijauna at this point would help, hinder or make no discernable dif. What do your docs say to you, in general, about how you are doing and your progress, they must be giving you ongoing feedback, no??

Hang in there.  C.

Hi Phyllis,

I'm sorry to hear about the anxiety and depression. I am glad that you're seeking help with it. Did you have any problems during treatment? These are powerful medications and they affect people differently sometimes. There have been some complaints of depression and moodiness on these new treatments, but are generally short in duration. HCV is often the culprit and the damage from it will take far longer to resolve. The extremity and associated neuropathy is very common among Hep C patients. The longer the years of chronic disease, the more time to repair it. Don't give up hope, keep up the fight, because it's worth it. Stay determined to improve your life and believe in your efforts. 

Whether medical marijuana, oils, etc. will help you is one of those unknowns. There is certainly enough literature out there to make a person curious. Use our search function above to see some of the discussions on the forum.

Hello Matt.  EOT for me was in May 2015.  I am still having depression and anxiety problems. i felt "normal" for a couple of weeks. I was so thankful. Then on Saturday it started back. I keep working with a psychiatrist and a psychologist. I'm on efflexor, Paxil and clonozapam.  i would like to know if medical marijuana helps or hurts. 

Phyllis

Hi Matt

Give yourself a little more time. Don't forget it takes 6 months for the riba to clear maybe longer in some people. I'm a little over 1 1/2 years post treatment and things are pretty good considering I just turned 63. Nurse told me we were on one of the if not the hardest hep c treatments. It will pass give yourself a pat on the back.

Keep your head up the worse is over.

thankyou Bassar that gives me hope i have never experienced depression before maybe a bad day at times but nothing the intense it is only early days for me so i guess more patience 

great heads up thanks again to all 

hi matt.can relate to most of your post tx probs.the depression being the hardest to deal with.i had low times in my life as everyone does.but this post tx depression was vile.i am in know doubt that this was due to meds.am now 14months poet tx still svr and the deep depression has eased right off.so its the time thing matt.i wish you well in your recovery                                                                                                                                                                                                                                                            william

Hi Matt,

Glad you dropped in and let us know what's going on in your world. Doesn't sound like you're feeling too well at all and I'm sorry to hear that. I'm experiencing many of the same things you just mentioned and I didn't have most of them before treatment either. Interferon alone is hard on the body and mind, add to that Ribavirin and whatever else was the flavor of the month at the time. It's hard to stay on top of all the advances in treatment. Just 3 years ago there were a couple of options and that was it. They all included Interferon and Ribavirin. It has been a trade off in some cases for sure. I'm hoping that there will be continued improvement, but that's hard to determine really. I'm soon to be 60, so I know that liver disease won't kill me or disable me in the future. There's a lot of comfort in that thought. We have picked up some lingering side effects and I hope that we'll both see some improvement. Keep thinking that way if you can. Just keep looking for answers and solutions for these new maladies, even if it's just enough to calm them down. One day a time...

Hi Matt,

I can't speak for the interferon, I'm sure Tig or others can and will ...

... I have little doubt many if not all of the symptoms you are experiencing are due to the meds.

I would be hopefull that time away from the drugs will help some, more time, better yet.

I was going to suggest dealing with some of the sides you are experiencing with nutrition.

It's not a cure-all but it can help a lot. It can certainly make you regular to avoid any additional stress and perhaps help to heal some of the damage done by some very potent drugs.

You might hit the Smoothie thread, there's some joking around but also the start of a very useful collection of diet tips and tricks.

I'm on Tx right now and it seems to be helping a LOT with many of the sides of Ribavirin ...

... I can't really speak for the Depression, I've been experiencing some (at least Mood Swings) from the Riba and I've got an appointment with my PCP regarding re-assessing current meds, one of which is for sleep and depression (Trazodone).

Oh, CONGRATS! on the SVR ... good job and that must at least help get you through but my bet is some diet changes along with a visit with your Doctor to assess the depression may help. If one doctor doesn't help, you can always get a second opinion. I know how REAL and troubling feeling depressed can be ... one good thing is that we live in an age where there are lots of options for depression.

As for the teeth, no doubt it's from the Interferon (which I have not had the dis-pleasure of taking) but I know when I've had some tooth issues previously I use a "Sensitive" toothpaste and it REALLY helped.

I sure wish you the best and I'm sure others will be along to offer some more information and help.

Dave 

i have a question for all if i may i am 7 months out of treatment and cured SVR and stoked ,

These are the thing i struggle with day to day 

Linering depression i mean like once a week major breakdown and exausted i am on treatment and talking with the relavent people 

side of quad muscles top of legs always sore like brussed

teeth very sensative to hot or cold water and ache often

developed a hiatus hernia which i believe could be from toilet straining during treatment 

chest pain with required aniogram, ECG and no apparent reason for it nothing found 

never experienced any of those sorts of symtoms before and am advised very astutley by my liver specialist that is has nothing to do with interferon which i dont believe at all

Just letting you all know about this to find if anyone else has experienced similar 

i do realise that age is a contribution to diferent thing needing attention just wished i can live without these after effects as i am only 1 year older 

thanks to all Peace Matt