Anti-depressants and Increased Apnea

Im2tired · Post by **Im2tired** » Sun Mar 11, 2007 8:42 pm

Has anyone else started antidepressants and noticed an increase in AHI?

Background:
6/2004 - DX with sleep apnea at age 46 after snoring loudly since my 20's and being extremely sleepy for about 2 years before that. Start CPAP therapy without much success due to congestion caused by allergies.
11/2005 - Still very tired. Had nasal procedure to zap my turbinates plus happen to start Effexor for mild depression. Fatigue continues
End of 01/2006 - felt much less tired for about 2 weeks.
02/2007 - took Levaquin (antibiotic) for 2 weeks and realized that I was much more alert and able to function the very next day and for the entire time I was taking it. Checked my RX records and found out that I was on Levaquin at the end of Jan. 2006

I had been suspicious that the Effexor was causing me to be tired and thought perhaps there was something about taking it with Levaquin that made it not work as effectively and not make me tired. I asked the pharmacist and he said No, there was no documented relationship with Levaquin and Effexor. I asked my rheumatologist and she thought I was right because both are processed by the liver. She suggested taking it every other day to see if there was a difference. I tried it and there was a definite difference plus when I checked my EncorePro results the AHI for the 2 days I didn't take Effexor were 4.2 and 4.4 which is considerably better than the 8 - 12 range that I usually have. And that was with lower pressure too.

Has anyone else had a similar experience while on Levaquin or more importantly noticed an impact on AHI when on Effexor? If so can anyone recommend an antidepressant that won't make me sleepy or increase my AHI.

I have a lot of conditions and I'm on a lot of medicine so realize I may react differently than others. I know I need to get off the Effexor ASAP and switch to something else that won't make me sleepy or gain weight and it has to be gluten free - not too much to ask

Thanks for any feedback.

Laurie

rachael778 · Post by **rachael778** » Sun Mar 11, 2007 10:31 pm

Hi Laurie,

I don't know if this anti-depressant will work for you, but I started taking Bupropion (Wellbutrin) and it doesn't make me sleepy; also am losing weight. Since I started taking this anti-dep. at about the same time I started x-pap therapy, I'm unable to let you know if it affected my apnea, which is severe.

I'm now taking Bupropion 2x daily at 150 mg. I was on Effexor for quite a long time, but the side effects were awful, and the depression didn't really subside much.

StillAnotherGuest · Post by **StillAnotherGuest** » Mon Mar 12, 2007 5:53 am

Im2tired wrote:I have a lot of conditions and I'm on a lot of medicine so realize I may react differently than others. I know I need to get off the Effexor ASAP and switch to something else...

Also to consider is the dosage and type (extended release or not) of Effexor.

Suddenly stopping SSRIs can generate the SSRI Discontinuation Syndrome, and Effexor's arguably the worst (or the best, depending on how you interpret that) so you really should have a supervised plan if you wanna go that route.

My guess in the pool would be that your AHI (apnea-hypopnea index) has not changed, but rather your AI (arousal index) has changed, and the APAP is unable to distinguish that. Again, without PSG we're unable to tell for sure.
SAG

Im2tired · Post by **Im2tired** » Mon Mar 12, 2007 8:25 am

Thanks for the feedback. I see my doctor today so I'll mention the Wellbutrin.

I have researched going off Effexor and I know it could be challenging and that you need to wean yourself slowly. I'm assuming that's why my doctor wanted me to come into the office rather than just calling in a new RX. The Effexor has worked for me and other than the sleepiness which I didn't even realize since I was sleepy to begin with, I haven't had any side-effect. I was thinking that maybe I didn't need another antidepressant but on the days I didn't take Effexor I did feel irritable and cried a couple of times which I have not done much of since I've been on this med.

I just started on Enbrel for my rheumatoid arthritis a few weeks ago. My rheumatologist wanted me to wait about a month to see if that helps my fatigue since uncontrolled RA can make you tired too. But I'm sure the Effexor is at least part of the problem and I have too much to do at work to be so sleepy that I can't connect thoughts. I've spent the lat 3 - 4 years in a zombie state. Three years ago I was dx'd with celiac disease and I thought that was the cause of my tiredness. Then 8 months later came the dx of rheumatoid arthritis and finally a year later the Apnea was discoverd. This is on top of the Type 1 diabetes and hypothroidism that I've had since I was 16. So I realize that I'm lucky that I was dx'd with the apnea since it would have been easy for my doctors to blame the fatigue on my other conditions.

Thanks again for the advise.

Laurie

Wistful · Post by **Wistful** » Mon Mar 12, 2007 9:39 am

Studies have actually found the opposite to be true - that anti-depressants may help with Sleep Apnea.
Effexor can be very helpful, so if it's working for you and the Dr. doesn't think it is the cause of sleepiness, I'd stick with it. Getting off it can be very very hard - I've done it, Dr.s need to prescribe an antidepressant to take with it that has a longer half life as you go off.

There are many things besides apnea that cause sleepiness - hopefully you and your Dr can come up with a plan to treat all of you, rather than each problem separately.

Good luck!
Wistful

Excusame · Post by **Excusame** » Mon Mar 12, 2007 9:57 am

[quote="Im2tired"]
Has anyone else had a similar experience while on Levaquin or more importantly noticed an impact on AHI when on Effexor? If so can anyone recommend an antidepressant that won't make me sleepy or increase my AHI.
____

Great question! I was on Levaquin for a week and it had NO impact on my apnea. Additionally, I have been using Zoloft as a anti-depressant for a number of years, both before and after beginning cpap therapy and my sleepiness was caused by the apnea, not the medication. I am still using Zoloft and several diabetic medications and feel great.....good luck!

Rich

Guest · Post by **Guest** » Mon Mar 12, 2007 10:20 am

Im2tired wrote:I have too much to do at work to be so sleepy that I can't connect thoughts.

Not connecting thoughts is a classic symptom of depression. So is feeling tired. Effexor should make things better. (I thought my lack of concentration was sleep related. It wasn't. It was caused by depression.) Effexor has made a huge improvement. Talk to your doctor, but by not taking Effexor you may be making things much worse.

Im2tired · Post by **Im2tired** » Mon Mar 12, 2007 6:57 pm

I saw my internist today and she suggested Prozac. I have read that Prozac is a good one to switch to because Effexor has a short life and Prozac is one of the ones that stays in your system for awhile. It also is a SSRI. She also gave me some lower dosage Effexor if I need it but she thought since I felt OK when I skipped a day, I might not need it.

I never planned on just stopping. Effexor can cause sleepiness. One of my friends was on it and when she switched to Prozac she was much less tired. She felt that the Prozac gave her more energy.

I know there are a lot of things that can cause fatigue - I have several of them! I'm pretty convinced that it's the Effexor and I'm willing to try anything at this point. If I'm still tired or the Prozac doesn't work, I'll try something else. I just can't continue like this and drag myself to work everyday.

Laurie

Wistful · Post by **Wistful** » Mon Mar 12, 2007 7:24 pm

I have lots of things that cause sleepiness too; apnea, depression, pernicious anemia, sometimes I think it's a miracle that I can stay awake at all

Your Dr. is very wise to prescribe you prozac. I have a cousin who is a well recognized psychopharmacologist who chastised me for not keeping him advised that my Doctor was weaning me off of Effexor without putting me on Prozac.

Please know that my reccomendations were not because I thought you would do differently, I just didn't want you to go through an even harder time if you didn't have to.

I wish you well!
Wistful

Im2tired · Post by **Im2tired** » Mon Mar 12, 2007 8:40 pm

Wistful - thanks for telling me that you cousin recommends Prozac for people going off Effexor. I'm sorry you had such a hard time. I really do trust my doctor. It always seems like she has carefully evaluated the situation before she prescribes something. And I'm a complicated case!

Laurie

Anti-depressants and Increased Apnea

Anti-depressants and Increased Apnea

Anti-depressants

Anti-depressants and Increased AHI (Or AI?)

Re: Anti-depressants and Increased Apnea