Using Anti-Depressants After TBI?

 

Is it safe to take an anti-depressant after a brain injury? My wife never took them before her brain injury. Her depression is a result of her injury, it seems, and she just can't seem to kick it. It's been more than a year now. I'm wondering about their effectiveness and safety after a brain injury.

 
Depression is a huge issue after a traumatic brain injury. We know that depression itself in general is caused by changing chemicals in the brain. We know that people after traumatic brain injury have a changed brain and changed chemicals in their brain. After traumatic brain injury, your risk of depression is probably about doubled. Somewhere between 40 and 60 percent are the numbers that you'd see over time. And this can be very disabling for people after traumatic brain injury to be suffering depression. Certainly when you're looking at the treatment of depression after traumatic brain injury, you want to make sure to look at both counseling, which can play an important part, and also medications. Medications can be effective in treating depression, definitely so. Obviously, people need to be closely monitored by their doctor for their medications. There are antidepressant medications that should be used cautiously or even avoided in people with traumatic brain injury. These are some of the older medications which are usually placed under the category of the tricyclic antidepressants. Examples of these include amitriptyline, which is also called Elavil, and these can actually have negative effects on people's memory and can have a lot of side effects and should be used cautiously. Some of the newer antidepressants like Paxil or Prozac or Celexa have a lower side effect profile and probably would be more effective and more appropriate in the treatment of someone with a traumatic brain injury.
Posted on BrainLine August 30, 2011.

Comments (1)

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My TBI, which turned out to be Diffuse Axonal Injury, led to changes in my brain & subsequent depression. I’ve been on antidepressants for the most part of the 18 years since.

Depression was especially bad after I was told I could go back to work (7 months after the DAI), which I found highly stressful. Not surprising, considering I had forgotten how to teach, felt exhausted most of the time & couldn’t find words, remember anything, multitask, plan or organize.

I was put on Citalopram at a low dose & given Xanax to help with sleep. The latter didn’t work when I was at my worst & I used Stilnox which finally worked.

I still suffered from anxiety and I tried various other antidepressants which didn’t work for me (Mirtazapine, which increased my anxiety; & Sertraline, which seemed to have no effect; Xanax which helped in the early days but didn’t relieve the immense anxiety I was feeling).

Finally, I drove to a psychiatric hospital in tears, where I had a long interview with a doctor & nurse. The doctor prescribed Paroxetine 20mg which I am still taking and Xanax .5mg which had an immediate effect.
The latest psychiatrist I have been seeing for around a year prescribed Trazadone as I often suffered from insomnia.  It really did the trick at 100mg! The slow-acting Retard version at 150mg meant I didn’t really wake up during the day & had terrible trouble with aphasia, memory & concentration.

In my opinion, there is a place for antidepressants in the treatment of TBI/DAI survivors. The correct medication has to be found & this is hard to go through.

I have tried to reduce my need for them by using mindfulness, meditation & yoga to keep myself calm, but I am still taking them.