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#511556 - 06/30/15 02:23 PM Humira and depression
mooman Offline
Second_Degree_AS_Kicker

Registered: 03/13/09
Posts: 206
So switched from 4 years on enbrel to humira 3 months ago, now am experiencing some heavy depression especially in the few days before I inject. Never had anything like this before, feels like I'm numb don't care don't want to do anything and don't have any ideas. Normally I'm a day dreamer and an idea machine of note. Now I don't know how this drug really and I stress really works. No rheumy, no internet can really say so. I would love to name been a fly on the wall when they were testing this just to see how all the side effects match up. I see depression as a side effect as common but I wonder how as I read in latest new scientist (magazine in the UK) that they are treating depression with anti tnf drugs because on increased studies showing increased cytokine production in people that have committed suicide, on a side note no one can tell me why humira is more effective than enbrel when treating uveitis? OK I digress I been drinking cos I couldn't stand the numbness of this depression. Doesn't make anything I said less real as I have only had 2. I have kept a diary and depression seems to spike same days prior to injection time. Answers if anyone has any, that I would like are. Have you noticed depression as a side effect of humira and if so did it go away with time (I put the 2nd bit in as I had injection site issues with enbrel that went away over time) thanks in advance.

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#511669 - 07/08/15 10:05 AM Re: Humira and depression [Re: mooman]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 21298
Loc: Upstate NY
Actually, just the opposite.

I didn't realize that one of my spondy flare symptoms was/is mild depression. Before humira, i did cycle between very happy and kinda flat, but just thought that was my normal.

I had noticed that methylpred made me very happy.....i called them "my magic happy pills".....i just thought that was normal for steroids.

then when i started humira, just prior to that, i was going into a bit of a funk...the sky just wasn't as blue, the music just wasn't as upbeat, etc.

then i got my first humira shot, and it made me as happy as the steroids always had.

and its not the pain that was causing my funk, because once my rheumy got me better between flares, i could tell the development of a flare...it always STARTED with the mild depression, needing more sleep, etc....then pain and other spondy symptoms would develop.

Maybe you just never noticed that your spondy was causing depression? But now maybe the humira is making you feel so much better, that you only notice the difference....that's how it was for me....i didn't notice the flares were causing depression, til i saw the sharp difference with humira.

or,

we're all different and the humira could be causing that in you.

but the fact that you only notice it when its time for more humira, could be the disease causing the depression, and the humira is actually lifting it.

that's what happens for me.
_________________________


sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

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#511768 - 07/17/15 11:42 AM Re: Humira and depression [Re: mooman]
mooman Offline
Second_Degree_AS_Kicker

Registered: 03/13/09
Posts: 206
Thanks for the reply. It is still odd I am not sure. I was on Enbrel for about 4 years and never depressed or fatigued or fatigued before that. Now since changing to Humira it just feels weird. Things are not right. Could be how it works. about 4 days before I am due to inject things really start going downhill. I could last about 3 days over on Enbrel. I wonder if my body is still trying to get used to every 2 weeks after 4 years of 1 week shots ? I'm just guessing that is for sure. I have no answers only that things are odd I am also experiencing tingling and numbness in my hand and around the elbow it shoots down to the pinky and the finger next to it. First thought it was RSI or something but I have been resting it and its not going away and now the other hand is starting up. Does not seem to be a flare up end of the day I am probably over reacting but the reason I have to react at all is because I am off work because of it and my GP is useless. If there was no time limit I could patiently work this out but lately I just keep getting kicked down. It all seems like Pre Enbrel days? Anyway thanks for the reply I will continue to monitor it and I will let you know if its me or the drug smile

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#511785 - 07/19/15 07:17 AM Re: Humira and depression [Re: mooman]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 21298
Loc: Upstate NY
i will also tell you that humira didn't last me 14 days, so my rheumy got me approved for weekly, but said try to take it every 10-14 days. Often I can push it to 14 days, even though i go downhill those last few days, but other times, like this past time, i was pretty good for almost a week, then couldn't wait for day 10 to come. its that time a year that i flare big. i see the rheumy in about 10 days; will ask him if occasionally i can take it at day 7? he just doesn't want my immune system to be so pushed down by the biologic that i get sick (infections).

but for me, humira doesn't last 14 days, or even 10 days really. It seems to be best the first 3-5 days, pretty good for 7 days, ok for 10 days, but no way can i make 14 days most of the time.

maybe enbrel lasted 7 days and humira doesn't last 14 days for you. See if the doctor will increase the frequency with which you take humira? or maybe another biologic would be better for you?

as for numbness down the arm: that can be classic nerve compression. The lower cervical nerves: c6, c7 can cause that. i have nerve compression higher up: my numbness is in my left jaw, left side of face, behind the left ear and my muscle spasms are in the neck, upper back, head, and the pain is in the neck at c2-c3 and c3-c4. currently, yearly, i get cortisone injections there and it helps. too, i can't sit (and thus don't sit) in most chairs, sleep in my recliner, drive an old car with 250,000 miles cause can't find a new car i can sit in, use ice packs to drive anywhere even in my old car, etc. its constant vigilance to keep my neck happy. the symptoms start though with numbness in my jaw due to the higher up nerve compression. more typical is what you describe.

but as you said, monitor, and keep a symptom diary. i have a calendar on my fridge where i track not only when i get the humira shot, but also track my symptoms....its a great thing to have.
_________________________


sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

Top
#513074 - 10/29/15 02:48 AM Re: Humira and depression [Re: mooman]
mooman Offline
Second_Degree_AS_Kicker

Registered: 03/13/09
Posts: 206
Thanks Sue,

Your posts always help smile

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#513178 - 11/07/15 08:48 AM Re: Humira and depression [Re: mooman]
Sue22 Offline
Very_Addicted_to_AS_Kickin

Registered: 01/13/08
Posts: 21298
Loc: Upstate NY
Originally Posted By mooman
Thanks Sue,

Your posts always help smile


That's nice to hear smile

Glad I could help smile
_________________________


sue

Spondyloarthropathy, HLAB27 negative
Humira (still methylprednisone for flares, just not as often. Aleve if needed, rarely.)
LDN/zanaflex/flector patches over SI/ice
vits C, D. probiotics. hyaluronic acid. CoQ, Mg, Ca, K.
chiro
walk, bike
no dairy (casein sensitivity), limited eggs, limited yeast (bread)

Top
#513183 - 11/08/15 12:41 AM Re: Humira and depression [Re: mooman]
MikeGinnyMD Offline
Active_Member

Registered: 01/24/09
Posts: 71
Loc: SF Bay Area, CA, USA
I'm not aware of any published link between TNF inhibition and depression. In fact, I found one study (1) that suggests that there should be no link and another one (2) that suggests the opposite of what you claim (that TNF inhibition should IMPROVE depression), and current research suggests that this may be the case in AS.(3)

I'm not saying that you're nuts. You say that this symptom is WORSE just before you inject. Given my findings in the paragraph, I suspect that the drug may be dropping to subtherapeutic levels in those few days. We call that a "trough effect" in medicine.

But also, depression is common and, as the links I posted above show, it's even more common in people with AS. So given that you have AS, it's hardly unlikely that you have concurrent depression.

You could look to switching to a TNFi with a longer half-life. Both golimumab (SIMPONI) and certolizumab pegol (CIMZIA) have longer published serum half-lives than adalimumab (HUMIRA).(4)(5)(6) You could also look into getting primary therapy for the depression, which is most effective when cognitive-behavioral therapy is combined with anti-depressants. I know that neither of these are easy choices to make and that both approaches are fraught with risks and pitfalls. That's life with this disease, I've learned. A lot of taking of chances and a lot of meds.

(1)http://www.ncbi.nlm.nih.gov/pubmed/26453249
(2) http://www.ncbi.nlm.nih.gov/pubmed/26453249
(3) http://www.ncbi.nlm.nih.gov/pubmed/25193010
(4) SIMPONI prescribing information
(5) CIMZIA prescribing information
(6) HUMIRA prescribing information


Edited by MikeGinnyMD (11/08/15 12:43 AM)

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#513577 - 12/23/15 01:38 PM Re: Humira and depression [Re: mooman]
mooman Offline
Second_Degree_AS_Kicker

Registered: 03/13/09
Posts: 206
Yeah I agree with you. In the end a few months later and I realise that HUMIRA is not working as well as ENBREL did (minus the iritis ) Some slight stiffness appeared where there was none and the ulner nerve problem for 6 months and now the common peroneal nerve issue all points to the drug switch. So I think you are right about that trough affect but since then I have broken in the drug as such and everything seems to be improving except for the nerve problems. I might actually go off the meds till I see my rheumatologist in March as I am worried that the HUMIRA is the cause and its listed in the side effects.

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