Janet (name changed for privacy), aged 60, had suffered from depression for 31 years when she came to see me. Prior to that, she had suffered from social anxiety. Janet had been on a high dose of Pristiq for three decades.
Pristiq is one of drugs commonly used for treating major depressive disorder. It is in the class of SNRI (Serotonin noradrenaline reuptake inhibitor) drugs. These prevent the neurotransmitters (brain chemicals) serotonin and noradrenaline (or norepinephrine) from leaving the brain so fast for excretion or recycling, giving it more time to act. Effexor and Cymbalta are identical drugs, and Zoloft, Prozac and Paxil have closely related mechanisms.
Ten years earlier Janet had tried to reduce her Pristiq dosage and ended up in hospital from a failed suicide attempt. Now she was understandably terrified at reducing the drug again but hated taking it as she no longer felt great happiness – or sadness. In her words, “All was ‘grey’”.
My goal was to lower inflammation in the many areas it showed up in her body. This is because hundreds of studies, such as <this one>, are now pointing to the idea that depression, like most chronic diseases, is actually caused by inflammation.
Janet also had fibromyalgia and chronic fatigue, so it was clear to me the source of the inflammation. Over several months we worked on getting inflammation down; we measured our success by her energy levels going up and her fibromyalgia pain going down. Then she discussed tapering off Pristiq with her primary care doctor. He advised on how fast to go off it and cautions. She continued working with him on this. I prescribed some supplements beneficial when reducing psychiatric medications.
In another five months, she had reduced the drug by ⅔ and told me when she woke each morning, the world seemed coloured again, she felt happiness and could cope with sadness better. Janet went on over the next year to get off the drug completely and eventually get off the supplements too.
She went off happily with her husband to do overseas charity work – which had previously been out of reach for them both because of her various conditions.
Read more about now nutrition helps depression at my <blog post>.
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