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Depression with Gleevec?

Hello, I was diagnosed with CML in 2009 when I was 14. I have been on Gleevec (400 mg.) ever since. I am currently in remission and have been since 2011. Also, I am still on Gleevec(400 mg). Within the first few months of taking this medication the side affects were constant. My doctor said that over time those side affects would subside. I still get nausea and heart palpations from time to time, but that's okay with me. From taking this medication, I noticed that my moods have changed quite a lot. I feel depressed and tired all of the time and I'm not really sure why. No matter how long I sleep throughout the night, within a couple of hours of being awake, my energy level goes completely back down. I sleep a lot.

Does Gleevec cause these two symptoms? or could it be sorting else?
Thanks,
Chad Chinavare.

Hello Chad,

It is possible Gleevec is causing or contributing to your symptoms. I suffered with some mild depression last year and it took some determined steps to improve my mental state. My advice to anyone on TKIs is the following:

1. Exercise. As counter-intuitive as it may seem I find brisk exercise helps raise my energy levels. I know it's hard if you're feeling tired, but it works for me and I know of others this helps too. I have a friend in the USA with CML on gleevec and he swears by exercise every morning. It doesn't have to be anything excessive, just a 20-30 minute walk which raises your heart rate is a good start.

2. Diet. I believe a good balanced diet is essential in everyday life and even more important when you have CML. get lots of greens and fruit if you can. If you eat crap then you'll feel like crap.

3. Meaning. I listened to a well respected CML specialist in the USA a few years ago and his view was very much 'it's easier to cope with CML when you have meaningful purpose to your day'. Ensure you have meaningful relationships and hobbies/interests that you enjoy. It's easier said than done to find work you enjoy, but concentrate on hobbies you're good at that make you tick.

This advice helped me shake the depression monkey off my back and I'm feeling better for it this year. If you still have no changes following lifestyle steps then it may be worth having a chat with your doc about alternative TKIs which might not impact your mood and energy as much.

Chris

Hi Chad,
I think that everything that Chris has suggested would help. As humans we are designed to move and even though it may be difficult to start with, if you try a little walking exercise in the open air every day you will find you will be able to do more and go further each day. After my stem cell transplant I was really tired- for months- and really did not feel like going out. However, my partner encouraged me to try walking. It worked faster than I would have believed possible.

I also agree that to have something you enjoy to focus on (whether that is a job, an interest or hobby) will help too.

Like all of us, you have been unlucky to develop CML... and especially at such a young age. Young people have a lot to deal with just growing up! and need more a lot more sleep than adults. Add to this the need to take a TKI - in your case imatinib- that can also cause extra fatigue in some people, then it is not surprising that you are feeling pretty low most of the time.
It may be a good idea to change your diet as Chris has suggested and make sure you have enough magnesium too. You can try to supplement this important mineral by using Magnesium oil or cream. Just by rubbing a couple of teaspoons of cream into your skin every day can raise cell levels of magnesium to where it should be. This will certainly help with the palpitations you are experiencing. I too suffered from this which is quite disturbing- especially at night on lying down. A week or so after I added magnesium cream to my daily routine this disappeared and has not returned. I make sure I remember to use magnesium supplementation every day.
It will also help you sleep better. There is some evidence that it helps alleviate feelings of depression and anxiety.

I do hope you can find a way to deal with these issues- it might well be that you need a change of TKI.

Best wishes,
Sandy