Depressed husband who had a kidney transplant

Question
My husband has some issues with anger and Depression- however if you met him you would think that he is the happiest person in the word- therefore his doctors think that I am nuts when telling them that he needs to be on some kind of antidepressant or other medication. I take zoloft and have started giving him half of my pill everyday. He has had a kidney transplant and I just read on line that you shouldn't take zoloft! What should I do and What can he take? Please help


Answer
Hi Kathi,



Thanks for asking my help on "Allexperts".



Following transplantation, concerns about potential drug-to-drug interactions become a greater focus. This is especially true when patients are either on cyclosporine (CsA) or tacrolimus (TAC)for immunosuppression, both of which are metabolized by CYP3A4. Drug-to-drug interactions leading to unexpected elevation or reduction in the levels of CsA or TAC can result in organ rejection or drug toxicity.



Mirtazapine, venlafaxine, bupropion, duloxetine, and psychostimulants (ie, methylphenidate, dextroamphetamine) are reasonable alternatives, although stimulants are not typically used for longer-term treatment. Use of psychotherapy should also be considered.



Sincerely,



Dr. Shah