Anti depressants and ADEM recovery


I was wondering if anyone could share their experiences with the use of anti depressants while recovering from ADEM. My best friend was diagnosed in February this year. She is 42. She is not able to communicate or move very much (the odd hand/arm and head movement only) she is awake and alert. I am concerned that she may be very depressed due to her awareness of her situation but cannot communicate this obviously to us in any way.

Any information would be greatly welcome on this subject.
Thank you very much.

My son is on an antidepressant Cyprexa but they are in the process of weaning him off Cyprexa and putting him on Wellbutrin. But we only started the depression medication when he went to the cognitive rehab facility. He was hospitalised for about 4 months then moved to the cognitive rehab facility. At this point he was able to walk and talk a little. They decided on the depression medication when he got visibly upset a few times. The neurologist said it was a good sign that he was getting better because he became more aware. The problem with psychiatric drugs is it trail and error till you get the right drug. The side effects can create problems of its own. He had hallucinations and became very violent. He was on 3 antidepressants at one time which was prescribed by the rehab psychiatrist. He had multiple episodes where he had to be restrained
because he continually wanted to run away and was injured in the process. Long story short he was finally taken off all the drugs and is now only on one anti-depressant, Ritalin because he struggles to focus garbapentin an anti seizure medication and melatonin because sometimes he would only go to sleep at 4 am in the morning and we have a stronger sleep medication if that does not work. But anti-depressants is a slippery slope because you have to find the right drug because every individual is different in addition to that the neurologist says that as the brain heals the anti-depressants have to be changed.

Thank you Sarah, this helps a little to gauge what could be a potential slippery slope indeed. As she is not currently able to communicate with us or walk or move, apart for some very small hand and head movements, we are gauging her mental state only by what we can see in the way she “projects”, if that makes any sense?.. It would be understandable to wait until maybe she can communicate better and the doctors can really assess her properly… I just worry that by the time she does convey any depressed feelings clearly by voicing them she may be so far down that road that getting her back could prove a very hard task indeed. I totally believe in the " first do no harm" stance but the question is what would do the most harm? Waiting OR trying to potentially alleviate her situation now rather than later. What is potentially doing the most harm?
I also understand that anti depressants take a while to kick in so there lies another concern.
It is so hard to know what would be the right choice…
Ultimately the doctors will the ones to decide the best course but I do feel I want to understand better this type of treatment and any consequences, good and bad.
Again many thanks for sharing with me.

In the meantime while you wait on the doctors let her listen to the music she loved listening too. My son would sometimes cry even though he is on anti-depressants and I normally lifts his spirits up by letting him listen to the music he listened too before he became ill. He is able to walk now so we dance as well. When he was unable to walk we would let him click his fingers to the beat of the music. Music apparently stimulates a certain part of the brain. Nutritionist also believe that cashew nuts is a great mood enhancer. There is a documentary I watched “Food Matters” where they say cashew nuts is a natural anti-depressant. Two handfuls is equivalent to one dose of prozac. My son only started the anti-depressants when the Psychiatrist at the rehab center suggest it but the neurologist eventually took over that function because of the episodes we had with multiple anti-depressants that were prescribed. Just hang in there she will recover. I know it is difficult and at times we become despondent but we see very slight improvements in my son on a weekly basis. Our neurologist made this analogy he said for my sons case it was a entire forest that was destroyed and now everything has to start regrowing tree by tree but eventually the forest will grow back but it is just going to take a long time. My thoughts and prayers are with you, your friend and the family.