Just wanted to take a minute to talk about anti-depressants, especially the SSRIs. These are the most commonly prescribed anti-depressants these days. In this group are: Prozac, Paxil, Zoloft, Luvox, Effexor, etc. All of these work on the Serotonin system in your brain and all can be very effective to treat depression, some anxiety problems and disorders like OCD (Obsessive Compulsive Disorder). Some work better for some types of problems; some just work better for individuals. A lot of the time it is trial and error to determine which one will work for you. 

Big on the problem list with all of these drugs is sexual dysfunction. Probably the main reason people come off of them ! I wonder, Mag, was your doctor surprised about the side effect for you or that you had a sex life? <grin> I've run into that with my patients sometimes - the attitude that sexuality disappears if you have a chronic physical or mental health problem. So stupid!!

Re suicide : I don't believe these drugs in and of themselves cause an increased risk of suicide. They have just discovered a gene for suicidal behaviour in some families (ie the Hemmingways). But aside from genetics, people who are depressed are at increased risk for suicide. As they start to improve on the medication there is a period of increased energy sometimes prior to a corresponding lift in mood. In theses situations, a person who still feels hopeless and / or worthless may still wish to end their life and now have the drive to act on that wish. 

Re the spasticity issue: Most of this group of drugs list side effects (in small numbers of patients) of: "abnormal gait, ataxia, hypertonia (increased tone), inco-ordination, extra pyramidal syndrome (among other things - stiffness, dystonia, swallowing problems), myoclonus..." Any of these sound familiar? 
:-)   And these side effects are documented in non-CPers, so of course if you have CP you would likely be more susceptible. Also, given that a CP brain has already suffered some damage to begin with, it would make sense that the CP brain would be more sensitive to drugs in general- anything that may upset the balance, so to speak. This could also make some people more susceptible to depression itself (organic versus situational depression). The good news is that if you can't take one of these drugs, chances are a different one may be okay. And there are always new ones coming on the market.

Robin mentioned Cogentin (Benztropine). This is a drug we use when people experience extra pyramidal syndrome (dystonia, primarily) as a side effect of their medication. It can be very useful but can have nasty side effects of its own (dry mouth, blurred vision, etc.). There are other options for this as well.

As Carla mentioned there are lots of alternatives to anti-depressants out there too. I personally have been taking St. John's Wort with good results - I'm sleeping better and feeling more rested and less stressed. Virtually no side effects either! Just a note of caution, herbals and vitamin preparations are not always benign. Always consult with someone who knows about the preparations you are looking at taking. Dosage recommendations and preparation types may vary considerably and these preparations are not regulated the same as prescription and over-the-counter drugs are. Many herbals should not be taken at the same time as you take prescription drugs. (ie. Never take St. John's Wort with an anti-depressant unless the combination is prescribed by a doctor).

Not to knock family doctors (many are great) but if you believe you are clinically depressed you probably should at least have a consultation with a psychiatrist (especially one who specializes in Mood Disorders). They are the experts in the drugs available and are much more likely to be up on the latest info on dosing, precautions, side effects. A pharmacist is a great resource for drug interactions and side effects - a greatly under-used source of knowledge, IMHO.  And, of course there's always NURSES!!!!  :-P


Hope this helps. Taking off professional hat again.  :-)

Yvonne