Depression
Can depression in lupus be treated?
Today, effective treatment is available for depressive illness and usually consists of psychotropic medication, psychotherapy and, most often, a combination of both.
Effective treatment requires early diagnosis and early intervention. Fortunately, most episodes of depressive illness in people with lupus subside on their own within a few months. Just as some people with lupus can tolerate a lot of pain, some seem to be able to accept and tolerate major symptoms of depressive illness without complaint.
However, depression is very stressful and anxiety-producing, which may aggravate the lupus activity. Depressive reactions should be treated with the same aggressiveness and persistence that one would use to treat a lupus flare, or any other medical complaint. Naturally, any underlying medical condition that could contribute to the depression must be identified and controlled.
Anti-depressant medications
Anti-depressant medications are the drugs that are most often used to treat depression. The four categories of medications are:
- tricyclics
- newer-generation non-tricyclic anti-depressants called SSRIs-selective serotonin reuptake inhibitors. These are best known by brand name: Prozac, Zoloft, Paxil, etc.
- MAO (monomine oxidase) inhibitors
- lithium.
Other types of anti-depressant medications
- Effexor
- Serzone (nefazodone)
- Wellbutrin
- Remeron
- Desyrel, etc.
Newer, potent anti-anxiety medications are now available and, when used in combination with the anti-depressant medications, offer significant and rapid mood stabilization and anxiety reduction.
Also, newer and safer hypnotics contribute to insomnia relief and offer uninterrupted and longer sleep.
Medication side effects
Anti-depressant medications can have side effects and may intensify various symptoms associated with lupus (e.g., increase in the drying of mucous membranes in Sjogren's Syndrome). When anti-depressant medications are effective, there is a welcome improvement in the individual's sense of well-being and overall attitude and adjustment.
Additional treatment requirements
Adequate and aggressive treatment involves many other components:
- blood tests to determine the appropriate dosages of medication
- open communication between the patient and treatment team
- encouragement, patience, availability and perseverance between patient, physician, family and close friends
- identifying and addressing any underlying medical factors that contribute to the depressive state