I recently learned that I have microscopic colitis, specifically collagenous colitis. Upon doing some research into the subject, it seems that SSRIs and SNRIs might aggravate and possible even be a causative factor of this inflammatory bowel disease. Over the years I have taken SSRIs and SNRIs to help combat depression, with the SNRIs proving most effective, along with the atypical Remeron. Right now I’m on a relatively low dose of Cymbalta. I think it helps with my mood but wouldn’t be enough by itself to stop me from descending into the stygian depths. But it does double-duty, helping with the muscle and joint pains of fibromyalgia. And it does these things very effectively, with little side effects. To keep me stable and from severe depression, I rely upon Remeron, an atypical anti-depressant. This helps me sleep and provides the heavy duty lift that Cymbalta can’t. I ‘ve been on it for several years and keep my fingers crossed that it will continue to work, b/c it is THE “go-to” medication for severe and recalcitrant depression, which mine was. This regimen is my maintenance and my lifeline. I remember what life used to be before I found meds that worked, and it was literally a life not worth living. Every day I wanted to die. I would have killed myself, but that required more effort that I could muster, one, and two, I felt sure that I was so stupid I would bungle the job and be left in a state even worse than the one I was currently in. This was despite the efforts of excellent psychiatrists (back when psychiatrists still did therapy) and eventually even ECT. The ECT made me forget for a while, but the depression returned again and again. I was put on a stronger drug regimen, had hospitalizations, felt hopeless. Then something changed. Perhaps it was the right combination of meds, I don’t know. For the first time in my life, color appeared. Where the world had been only hues of gray, I started to notice small details, like red birds in the trees, the taste of food, and the love of my dog (actually a big thing). I got a new psychiatrist (old-school) who listened to me, knew her meds, and gradually helped me reduce the number of psych meds I was I was on. I saw a difference at work-I actually talked to my colleagues now, rather than going immediately into the stacks as had been my wont. I started being more social (on the internet) and going to the local farmers market, out to dinner, and attending fests and plays . In short, I gained a life.
This is the reason why, even should my gastroenterologist tell conclusively that I need to discontinue the Cymbalta, that I would tell him no. I would rather deal with symptoms of a physical illness any day than return to the devastating effects of depression. I’m doing, to use the words of Peter D. Kramer, “ordinarily well” and am stable, functioning at a high degree (except for the colitis), and want to keep it that way. So no tinkering with my psych meds!