Centrals and Antidepressants

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jipavl
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Centrals and Antidepressants

Post by jipavl » Wed Apr 18, 2018 4:45 am

Hi,

I've been on CPAP for about two months now. My AHI were in the 2-4 area, most of them centrals according to Sleepyhead.

I have also been on taking antidepressants for the last 5 years. Since my symptoms were not improving with CPAP I decided to try to stop antidepressants. I stopped gradually and ceased taking them completely about a week ago.

The last week my centrals dropped considerably and my AHIs are now 0-2. So antidepressants definitely have negative effect on sleep quality.

Unfortunately, I still don't feel any better, but I'll see where I'll be in couple of weeks time.

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Julie
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Re: Centrals and Antidepressants

Post by Julie » Wed Apr 18, 2018 4:52 am

Good idea - it can take a long time for meds to leave your system, especially ones affecting you neurologically.

prodigyplace
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Re: Centrals and Antidepressants

Post by prodigyplace » Wed Apr 18, 2018 5:10 am

Hmm. Curious.

i started using an anti-depressant a couple of months ago. I thought my AHI was getting a little high. I wondered if the issue was pollens & sinus issues.

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Arlene1963
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Re: Centrals and Antidepressants

Post by Arlene1963 » Wed Apr 18, 2018 5:38 am

I was recently prescribed low dose amitriptyline for chronic pain and when I take a tablet at night (10mg dose) my centrals go quite high, as many as 4 per hour. I've taken about 15 tablets over about 2 months and noticed this on each of the nights I've taken them. On the nights I don't take the medication my AHI goes back to normal. I haven't looked at my data in SH (getting a bit lazy!) so can't determine if the events are SWJ or the real deal, but anyway, whatever is going on, the medication definitely affects my sleep and breathing.

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Julie
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Re: Centrals and Antidepressants

Post by Julie » Wed Apr 18, 2018 5:41 am

Amitryptiline (Elavil) has been known to cause depression in some people... just something to keep in mind, maybe consider another answer for your problem.

Arlene1963
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Re: Centrals and Antidepressants

Post by Arlene1963 » Wed Apr 18, 2018 5:54 am

Thanks Julie.

When I read up on the side effects I didn't particularly like what I saw, also some user forums where people reported a lot of weight gain, and difficulties getting off this med ... so I haven't been taking them. I have to admit though that it really does help with pain at night because it knocks me out.

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Pugsy
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Re: Centrals and Antidepressants

Post by Pugsy » Wed Apr 18, 2018 6:20 am

Arlene1963 wrote:
Wed Apr 18, 2018 5:54 am
When I read up on the side effects I didn't particularly like what I saw, also some user forums where people reported a lot of weight gain, and difficulties getting off this med ... so I haven't been taking them. I have to admit though that it really does help with pain at night because it knocks me out.
Of those kinds of meds Elavil is probably the one with the least amount of scary side effects...when compared to some of the other SSRI meds. Not saying it doesn't have it's share of bad side effects...just that compared to the others the list isn't quite as long. :lol:
All meds come with baggage. We just have to figure out which baggage is easier to carry.

You said low dose....how low? And how often?

I have taken it myself for pain management but only at bedtime. I decided to quit last fall for various reasons but I had no issues just stopping it but then the dose I was taking was so tiny. Of course this is another one of those YMMV things.
Didn't cause weight gain either at least for me.
I never had any problem with my AHI in any category when I took it. Certainly didn't seem to cause centrals in my case.
It did help with the frequent wake ups from pain which is why I took it. So I could "sleep through the pain" probably...sleep a little deeper and sleeping better could maybe thus allow more REM to happen and in a round about way increase apnea events in REM if someone had their OSA worse in REM just because more chance of it happening.

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Arlene1963
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Re: Centrals and Antidepressants

Post by Arlene1963 » Wed Apr 18, 2018 6:36 am

Hi Pugsy,

Thanks for your comments!

I started taking 25mg but cut the dose down to 10mg because 25mg just knocked me out for days. I was like a zombie.

My current prescription is for 10mg nightly. I must admit that from day 1 it helped with the pain which is odd because my NP told me it would take weeks for it to kick in and help with the pain. (unless it was placebo effect?)

I took the 10mg dose for about 10 days at first, no breaks, and gained over a kilogram during that time. I weigh myself every day and so this was definitely a side effect for me, my weight is usually very stable, slight variations from day to day but this was different. I guess I am one of those who puts on weight with this med, unfortunately.

How to proceed? Not sure, will be speaking to my NP about this. I stopped it after the weight gain, and also after scaring myself with reading the online forums!

As for the centrals ... who knows, but certainly for me I noticed an uptick but honestly it doesn't actually bother me because I slept very well and felt quite well during the day on the 10mg dose, so it was more of a curiosity than anything. I didn't even bother to check it in SH! (I almost never have any obstructives or hypopneas, 90% of my AHI is central as reported by SH. I tend not to worry about those anymore, unless they creep up over 5 per hour, which they almost did some nights on this med, but not quite.)

I take the odd dose now and then when I feel like the pain is too much and I need a deep night's sleep. It seems to help me cope better with tolerating the chronic pain.

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Pugsy
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Re: Centrals and Antidepressants

Post by Pugsy » Wed Apr 18, 2018 6:48 am

Arlene1963 wrote:
Wed Apr 18, 2018 6:36 am
I take the odd dose now and then when I feel like the pain is too much and I need a deep night's sleep. It seems to help me cope better with tolerating the chronic pain.
That might work out to be a suitable compromise for you... it's what I eventually ended up doing for years. Didn't take them every night...maybe 3 out of 7 nights.
Also..they come in 10 mg pills...you might try that dose and or cut in half and see what happens.

All meds come with baggage and we just have to decide if the baggage is worth carrying or not.
For me even 10 mg caused some morning hangover effect...groggy a bit kind of thing. I had to sit back and decide if the hangover from the meds was worse than the hangover from crappy sleep from frequent awakenings due to the pain which is what I had without the medication. It was like I knew I was going to get a hangover effect...either from the meds or the poor sleep...and I had to decide which was worse. Damned if you do and damned if you don't.
For me...the meds hangover went away quicker than the crappy sleep hangover which is why I took it for so long (but more prn than nightly). It was an evil but the lesser of 2 evils at least for me.

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