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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Jaynee on August 5, 2002, at 15:33:06
I haven't had any success with finding any research material with regards to this.
Since cutting back on my Celexa, from 20mg to 10mg. I am experiencing some very frightening(what I feel are blood sugar related) experiences. I am getting so if I have to much caffine or sugar or if I don't eat every 1 to 2 hours, I get so I almost pass out. I start to shake, and break out into a cold sweat, I feel so weak, it is very scary.
When I was on 20mg I could go almost all day with not eating, and I wouldn't get that shaky weak feeling I always used to get if I didn't eat. Now that I cut back I am a frigin mess. I am feeling like I am becoming a diabetic. This is getting really bad.
Any input on any research into this would be appreciated.
Posted by katekite on August 5, 2002, at 18:58:14
In reply to Do AD's mess with your blood sugar levels?, posted by Jaynee on August 5, 2002, at 15:33:06
Well you made me curious. It looks like most ssris reduce (too high) blood glucose in diabetic patients. ie that they may make the insulin-glucose system work better. The few reports I could find did not suggest they reduced glucose levels in non-diabetics. So if you are at all prone to insulin/glucose problems and went down on your ssri it makes sense that your insulin-glucose regulation would be doing less well. Hopefully its an effect limited to withdrawal! But if it goes on at all maybe would be enough reason to ask your doc about testing for some pre-diabetic type condition. -- kate
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Ann Clin Psychiatry 2001 Mar;13(1):31-41 Related Articles, Books, LinkOut
Use of antidepressants in treatment of comorbid diabetes mellitus and depression as well as in diabetic neuropathy.Goodnick PJ.
Department of Psychiatry, University of Miami School of Medicine, Florida 33136, USA. goodnick@aol.com
After a brief review of epidemiology, the focus is on biochemistry of diabetes. Animal and human studies are reviewed in terms of the impact of alterations in catecholamines and serotonin (5-hydroxytryptamine, 5HT) on glucose utilization. Then, the implications of these experimental results for the choice of antidepressant in comorbid diabetes mellitus and depression as well as in diabetic neuropathy are discussed. Results of clinical investigations are then reviewed in terms of the above hypotheses. An Index Medicus Search for the past 10 years was supplemented by references from previous related reviews of the topic as well as by pending results, where available, not previously published. The range of prevalence of depression in diabetic patients has been 8-27%, depending on study criteria and procedures. An increase of catecholamines appears to increase glucose while both reducing insulin release and reducing sensitivity to insulin that is available. In contrast, increases in serotonergic function by increased precursor, increased release, or blocked metabolism and blocked reuptake in contrast seem to increase sensitivity to insulin and reduce plasma glucose. There have been six studies of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), at a dose of 60 mg/day pursued up to 12 months that have demonstrated that medication's usefulness in diabetic patients, with reductions in weight (to 9.3 kg), in FPG (to 45 mg%), and in HbA1c (to 2.5%). In studies in comorbid diabetes mellitus and depression, nortriptyline, a norepinephrine reuptake inhibitor that produces increased synaptic catechols, has led to worsening of indices of glucose control. However, fluoxetine and sertraline, both selective serotonin reuptake inhibitors, in the same patient group, have produced results consistent with reductions in glucose levels. In diabetic neuropathy, perhaps due to the fact that catecholamines and serotonin may both be implicated in pain pathways, dual-action antidepressants appear more effective at lower doses than do specific serotonergic agents. The tricyclic antidepressants (TCA) (66.7%) have had success in double-blind studies, particularly imipramine, with a 81% response rate. Yet, there are positive reports concerning the SSRIs (paroxetine, citalopram, sertraline), as well as nefazodone, that focus on serotonin selectivity. CONCLUSIONS: In comorbid diabetes mellitus and depression, most evidence supports the use of fluoxetine in control of glucose handling. Other characteristics in terms dosing, drug interactions, cognition, and sleep make sertraline an attractive alternative agent. In diabetic neuropathy without depression, the best choices among non-TCAs may include sertraline, citalopram, and perhaps, venlafaxine, since the TCAs appear to increase cravings and increase FBG levels.
Posted by awake at last on August 6, 2002, at 10:17:28
In reply to Do AD's mess with your blood sugar levels?, posted by Jaynee on August 5, 2002, at 15:33:06
> I haven't had any success with finding any research material with regards to this.
>
> Since cutting back on my Celexa, from 20mg to 10mg. I am experiencing some very frightening(what I feel are blood sugar related) experiences. I am getting so if I have to much caffine or sugar or if I don't eat every 1 to 2 hours, I get so I almost pass out. I start to shake, and break out into a cold sweat, I feel so weak, it is very scary.
>
> When I was on 20mg I could go almost all day with not eating, and I wouldn't get that shaky weak feeling I always used to get if I didn't eat. Now that I cut back I am a frigin mess. I am feeling like I am becoming a diabetic. This is getting really bad.
>
> Any input on any research into this would be appreciated.
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Yes, some of them do, though I can't say I found where Celexa was specifically mentioned. They tend to decrease the blood sugar level. Probably what you are experiencing is more of a hypoglycemic reaction than a diabetic one. If so your blood sugar is dropping below 70. (You might want to purchase a glucometer and test yours for a while to see. You can get them at any pharmacy, Wal-mart, grocery store etc. They run about $60 for the tester kit w/50 strips). It should tell you pretty quickly if your sugar levels are dropping. Just check it when you are feeling weak or shakey.
I am hypoglycemic, and have taken Celexa in the past, I don't know that I could tell you if it made my condition worse or not - I never really thought about it then. I just always monitor my problem and eat accordingly.
P.S. I found an interesting site regarding depression medications and interactions
http://holisticonline.com/remedies/depression/dep_interactions_SSRI.htm
Posted by hildi on August 6, 2002, at 19:03:29
In reply to Do AD's mess with your blood sugar levels - YES » Jaynee, posted by awake at last on August 6, 2002, at 10:17:28
I have been complaining about this very thing to my dr. and he says 'so what'-he makes me so mad!
What I experienced was extreme and what sent me to the dr. for blood tests to see if I was OK (and I NEVER go to a dr-that is how bad it was) . .
After being on zoloft 8 yrs i started feeling more and more hypoglycemic, then it got extreme- even to the point where food or juice wouldn't help and I couldn't even drink coffee without getting sick. I was constantly feeling sick, weak, shaky and trembly and on the verge of passing out. Nothing I did food, sleep or drink-wise seemed to affect this, so I sensed it was the meds.
I went to the dr. for various blood tests and they said nothing was really wrong with me.
Well, I haven't taken zoloft for a couple months now and I haven't really been that bad feeling-except of course for anxiety and depression(!!) because I'm trying out various other meds and there is nothing I like yet.
But I knew it couldn't be just me feeling this, and I knew it wasn't just in my head (This is something I think my dr. believes).
I don't know what kind of AD to go on now- I don't want this physical thing to happen again. I thought it might just be SSRI's, but celexa is not an ssri, is it?
Hildi
Posted by Jaynee on August 6, 2002, at 19:47:02
In reply to Do AD's mess with your blood sugar levels - YES » Jaynee, posted by awake at last on August 6, 2002, at 10:17:28
Thanks for the info. I finally found some studies on mice with regard to SSRI's and blood sugar levels, and yes they do mess things up or fix things, depending on which study you read. I think I am starting to level out, but I have really been watching what I have been eating today. I don't know if I explain myself well enough though, being on Celexa I felt fine with regards to blood sugar, actually better than before. But since cutting back to 10mg I have been experiencing the "shakes" a lot. I even thought that maybe the Celexa slowed my metabolism down, and now my metabolsim is starting to increase, and this is why my blood sugar levels are off, and I am so hungry. Who knows, but it will be interesting to see what happens when I am off Celexa completely.
Thanks again.
Posted by katekite on August 7, 2002, at 21:09:33
In reply to They do? I thought so!!, posted by hildi on August 6, 2002, at 19:03:29
The following drugs are 'standard' ssris: Celexa, Prozac, Paxil, Zoloft, Luvox, Lexapro.
Serzone and Effexor both also are ssris (although they both also do other things too so they are not always called ssris).
Drugs that are not ssris are: Remeron, Wellbutrin, and the older ones: some tricyclic antidepressants and the maois.
This is the end of the thread.
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