Initially misdiagnosed

General Discussion on any topic relating to CPAP and/or Sleep Apnea.

Where you misdiagnosed and put on psychiatric medications before finding out you had OSA?

Yes, I was on antidepressants, sleeping, anti-anxiety, etc meds
37
57%
No, I was not on any meds before finding out I had OSA
28
43%
 
Total votes: 65

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jskinner
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Post by jskinner » Sun Jun 10, 2007 2:09 pm

socknitster wrote:Did you know that there is a blood test (don't know how widely available it is because I saw it on tv) that can determine which antidepressant will work best for you? I would see a psych and ask about it. It would save a lot of trial and error.
Are you sure about that?

Could you be talking about a P450 metabolism test to make sure your body can actually process certain antidepressants? Doctors have been prescribing antidepressants for years without doing these tests. This is despite the fact some people are physically unable to process certain antidepressants. This has killed a number of people. These tests should be mandatory before putting someone on an SSRI for example (2D6), yet if you where to ask most doctors about it they likely wouldn't even know what you are taking about.

Given that no one knows exactly how antidepressants even work, I very much doubt there is a test to tell you which one will work best for you...
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jennmary
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Post by jennmary » Sun Jun 10, 2007 2:22 pm

Seems we have even more in common Jen.
I have a blood disorder called MTHFR as well as my OSA. MTHFR will cause miscarriage in almost all cases. I lost a baby 6 months before I got pregnant with my daughter. I was almost 5 months along when it happened.
With my daughter I stayed on bed rest and basically laid around all day.....didnt have energy for much else. But I know that the SA had an effect on both pregnancys. I did the same as you....just sat around being pregnant. I left my job so I wouldnt risk loosing her, she was just over 5 weeks early.....but still 6 pounds and healthy.

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Post by jskinner » Sun Jun 10, 2007 2:28 pm

socknitster wrote:
My fear is that all those years of meds starting at such a young age may have permanently messed up the chemical balance in my brain. Guess I will just have to wait and see.
The body is resilient. Don't worry. You will bounce back.
While I certainly agree with being encouraging I don't beleive there is any long term data of the effects of these drugs on the brain. In fact I have only seen evidence to the contrary. The safety of these drugs is usually based on trials only lasting a number of weeks.

If someone was to take cocaine or estacy for years on end most people wouldn't find it hard to believe that there are some long term effects. Antidepressants work via similar mechanisms (Serotonin, norephenephrine, dopamine level manipulation) My personal opnion is that this highly likely that there are lasting effects. (Check out the people suffering from PSSD as one example)

Lets not forget that psychiatrist used to tell us that cocaine and lsd where good treatments...
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cwsanfor
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Post by cwsanfor » Sun Jun 10, 2007 2:44 pm

Sock: can you provide a link to that test?

James: What she's talking about is feasible. For example, there are basically three neurotransmitters that are generally thought to be involved in the treatment of depression: serotonin, norepinephrine, and dopamine. In my case, serotonin was the one that had to be manipulated by an SSRI (Lexapro, earlier Prozac, in the bad old days, Elavil and Triavil, both with less good results). When I took Wellbutrin/Zyban to quit smoking, I became cranky beyond belief: someone would say "Good morning" and I'd be like "What the hell do you mean by that?".

Wellbutrin is an noradrenaline reuptake inhibitor. Apparently I have plenty of noradrenaline/norepinephrine. So despite the fact that antidepressive mechanisms are not well defined, an accurate measurement of which neurotransmitter is out of range might provide better than a guess as to which medication to start with. I just didn't know that the testing methodology had evolved to that level.

To sort of answer your poll question, I was first treated for depression at about 13. Precocious kid. Since then, I have needed occasional medication, typically three months of the year, not every year. I've only been on xPAP for a year, but I have the strong sense that although my depression preceded my apnea, xPAP treatment has and will reduce the frequency and dosage required for me to be normal. I'm not a medical professional, etc., and may be talking crazy, but that's my take on it. My guess is that there are lots of people who are diagnosed with a psychiatric illness when the issue is apnea: I am probably one who has seasonal affective disorder as well as apnea. Treating the apnea can't hurt: I had desats to 64%, and that's got to be depressing.

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socknitster
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Post by socknitster » Sun Jun 10, 2007 2:45 pm

jennmary wrote:Seems we have even more in common Jen.
I have a blood disorder called MTHFR as well as my OSA. MTHFR will cause miscarriage in almost all cases. I lost a baby 6 months before I got pregnant with my daughter. I was almost 5 months along when it happened.
With my daughter I stayed on bed rest and basically laid around all day.....didnt have energy for much else. But I know that the SA had an effect on both pregnancys. I did the same as you....just sat around being pregnant. I left my job so I wouldnt risk loosing her, she was just over 5 weeks early.....but still 6 pounds and healthy.
So interesting! My little guy was a week late and I was induced. He was 10lbs 5.5 oz. How I grew such a big guy with limited oxygen I will never know. I DO KNOW that I was totally paranoid about losing him too and I started sleeping on my left side (the most favorable for O2 to get to the baby) in the first trimester, even though it isn't medically called for until the third. That may be what made it possible to carry him to term. I don't know why I did that, really. Perhaps my subconscious knew more than my conscious mind at that point.

At the end of the pregnancy I had pregnancy induced high blood pressure (or so they thought, I'm sure apnea played a large role there) but never developed diabetes, though they watched my blood sugar like a hawk because I was a little overweight at the time.

I have since had another miscarriage and then a few months later my diagnosis of osa. We had already been trying to get pregnant again and decided to put it on hold until my osa is under control. Both miscarriages were very early. I was completely devastated. I don't know what I would have done if I had gotten to 5 months and then lost it. That is rough.

You know, it is hard enough to be diagnosed with osa, but to also be the "bearer of life" puts an extra hard spin on the diagnosis that no man could ever understand. It is hard not to feel a little guilt for those miscarriages and for not figuring out what my true diagnosis was sooner. For a man, having osa only affects him and perhaps his mood or state of mind affects another person. For a potential mother, osa affects her ability to even bring the next generation to bear. And that is mind-blowing to the woman involved.

Anyway, all anyone can do at this point is move forward with the knowledge we have now. There is no sense in looking back and saying what if, what if, because we can't change that. I can only make my tomorrows better. At any rate, I will be very interested to see what a normal pregnancy feels like!

Congrats to both of us for defying the odds and producing healthy children!

Jen

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socknitster
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Post by socknitster » Sun Jun 10, 2007 2:52 pm

cwsanfor wrote:
Sock: can you provide a link to that test?
All I know is I saw a blurb at the end of the news or some such. You know, the last 5 mins of the local news they put a "health watch" news report or some such. It wasn't that long ago. I wish I knew more. Maybe I'll take the time to do a google search later. I remember thinking, wow that is interesting, if I need to I might do that someday. But my number one goal (after I become xpap compliant) right now is to get off prozac altogether.

It is certainly worth researching about!

And yes, I specifically remember that the test was to see which drug you metabolized the best to avoid the long trial and error so many go through trying to find the best drug. They talked to a woman who had been on and off ad's and after the test finally found one that worked for her. I wouldn't misunderstand an important detail like that. And I didn't imagine it either.

Jen

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socknitster
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Post by socknitster » Sun Jun 10, 2007 3:08 pm

jsckinner wrote:
While I certainly agree with being encouraging I don't beleive there is any long term data of the effects of these drugs on the brain. In fact I have only seen evidence to the contrary. The safety of these drugs is usually based on trials only lasting a number of weeks.

If someone was to take cocaine or estacy for years on end most people wouldn't find it hard to believe that there are some long term effects. Antidepressants work via similar mechanisms (Serotonin, norephenephrine, dopamine level manipulation) My personal opnion is that this highly likely that there are lasting effects. (Check out the people suffering from PSSD as one example)

Lets not forget that psychiatrist used to tell us that cocaine and lsd where good treatments...
You must have had a REALLY bad experience with antidepressants to be the bearer of such gloom and doom. I hardly think you can put lsd and cocaine in the same class as ssri's.

You know, people are just getting by trying to do the best they can. I've said it before: if you are faced with living a life in a comatose state or dead, you are better off with antidepressants and living another day--maybe in that new day you will find out your true diagnosis.

The real take home message here is: if you are unsure if depression is your true diagnosis, keep looking for answers until you find out what is. But until then, do what you have to do to be sane and a productive member of your family. I doubt my husband and I would still be together if I hadn't taken antidepressants. Then how many people would have had to be casualties of my undiagnosed osa? Him, my son, and myself.

And I also believe people can recover from being on antidepressants--fully. THat is what the "brain zaps" of lexapro discontinuation are probably about--your brain is jump starting production of something it hasn't made on its own in a while and it is happening in fits and starts--especially since the half-life of lexapro is so short. Once that smooths out, you should be fine. I have known lots of people who were on ad's at one time who aren't anymore and are just fine. Including members of my own family.

I refuse to let you make me feel guilty for trying to be the best I could be. And, no, I'm not offended--just have strong opinions too!

Jen

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Post by jennmary » Sun Jun 10, 2007 3:31 pm

Yeah, I was doing the left side sleeping also. It was thought that part of the reason for my preterm labor was pregnancy induced high blood pressure.
26 hours of labor. I remember getting the epidural not because I was in so much pain.....but because I was just so tired. I thought that if I got it I might be able to sleep a little. lol Pregancy and labor is hard enought without adding OSA to the mix. I know I would love to know what it is like to have a more normal pregnancy.
Good luck to you on your treatment and on adding to your family.
I agree with you on that added burdon. Plus what really sent me looking for help was that I found myself unable to do things that I felt a mother should be able to do with her child. My 2 year old daughter has never been to a park, or gone for a walk with me. I would come home from work and have no energy for her, and I hated myself for it. It is hard trying to mother a small child when you feel like you cant even take care of yourself half the time.
I am so glad I I figured out what was wrong with me....now I can look forward to my daughters first trip to the park.

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Post by jskinner » Sun Jun 10, 2007 4:01 pm

cwsanfor wrote:James: What she's talking about is feasible.
When trying to figure out what was wrong with me before being diagnosed with OSA I had my neurotransmitters levels checked. As far as I know there are currently three methods for doing so plasma, platelet, and urine. See top chart for my results:

http://james.istop.com/metalife/

As you can see my platelet norepinephrine was low. Despite this psychiatrists kept wanting to put me on SSRIs (because they said they didnt' believe neurotransmitter tests where accurate).
cwsanfor wrote:For example, there are basically three neurotransmitters that are generally thought to be involved in the treatment of depression: serotonin, norepinephrine, and dopamine.
Yes I agree that those neurotransmitters are the ones mostly targeted in the treatment of depression. Clearly all three play a role in mood. However if you raise one and it makes you feel better I still don't think you can imply that it was a low level of that neurotransmitter that was the root of problem.
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Post by jskinner » Sun Jun 10, 2007 4:22 pm

socknitster wrote:I refuse to let you make me feel guilty for trying to be the best I could be.
I was not trying to make you feel guilty. I apologize if you felt I was.

The point I was trying to make is that I felt depression is a symptom not a disease or diagnosis. Of course thats doesn't feel well into the current popular thinking.

Anyway I don't think my input into this tread is going anywhere positive so despite wanting to debate it more I'll try to resist. I'll try to stick to less controversial threads such as EP and EPA
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Post by socknitster » Sun Jun 10, 2007 4:50 pm

I hope you aren't going away all mad. . .

I do agree with you that docs tend to slap the label "depression" on you and stop looking for a cause when the depression itself in most cases is probably a symptom of some other underlying condition that has gone undiagnosed. Sadly, it isn't a perfect world. Maybe in 10 years things will be better? I haven't had a chance to discuss this yet with my bil who is just out of med school. It would be interesting to hear what his thoughts are on the whole debacle.

See, we can agree on something!

I could just kiss my gp for uttering the words sleep apnea, even if he was just thinking aloud. Once I had those two words in my brain--i could DO something about it. Research. Being a bad ass bitch to anyone who tried to hold me back from trying to find out what was really worng with me. It worked and here I am.


Jen

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Post by jskinner » Sun Jun 10, 2007 9:46 pm

socknitster wrote:I hope you aren't going away all mad. . .
Nope. I'm just tired and irritable lately due to no CPAP so I should try to stay out of debates

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Re: Initially misdiagnosed

Post by Breathe Jimbo » Tue Sep 14, 2010 5:56 pm

I would not say "misdiagnosed." My wife never mentioned that my breathing sounded "horrible" until recently. When I mentioned that and my "horrible" snoring to an internist she agreed with my wife that I should have a sleep test. The internist (who is now my primary) tried to sell me on the benefits of CPAP, to encourage compliance, during the same consultation when I mentioned my horrible breathing. From that point everything moved quickly to the sleep test, severe OSA diagnosis, and CPAP therapy (4 nights now). I am hopeful that the CPAP treatment will allow me to reduce or eliminate some of my current meds for depression and high blood pressure over time, but I am trying not to rush things. One exception is a med (Trileptal) recently added to deal with "agitation" (road rage at work), which I have unilaterally halved due to its sedative properties while awaiting my shrink's thoughts on stopping it altogether. (When he returns to the office where I see him, he will find about 20 pages of materials on his fax machine warning that, in general, sedatives, tranquilizers, and anti-convulsants are a bad idea for anyone who has severe OSA because those meds may relax the tissues involved in OSA.)

Only time will tell whether CPAP "cures" my depression or depression-like symptoms.

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Re: Initially misdiagnosed

Post by elena88 » Tue Sep 14, 2010 6:14 pm

Oh my.. quite the go around...

Well, a lot of people who found out they had osa, had a lot of their contributing health problems improve or disappear, so lets hope you
are one of them!


I was on no meds before being diagnosed.

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Re: Initially misdiagnosed

Post by SleepingUgly » Tue Sep 14, 2010 9:16 pm

One can have symptoms of depression as a consequence of having their quality of life tank thanks to a sleep disorder. Or depression can cause weight gain due to overeating or medication, and that can cause OSA. Or the disorders can co-exist. (Or... Or...) Being diagnosed with OSA does not mean that the depression diagnosis was incorrect. And, in all fairness to the docs, sleep problems are a symptom of depression. If every disorder that could possibly cause symptoms of depression was ruled out, a person would die of old age (or suicide?) before they'd all been ruled out. I'm not saying that doctors shouldn't inquire about possible symptoms of apnea, because they should. But short of someone describing "classic" apnea symptoms such as snoring, cessation of breathing, etc., it is understandable that it can go undiagnosed. Until it's diagnosed. And, IMHO, once it is diagnosed, one should not waste another minute of one's life by ruminating over the "lost years". I know it's easy to do... I lost a couple of decades myself. But given that I haven't resolved all my issues now, I think I'd better focus on that rather than what went awry in getting me to this point.

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