I can only speak from my personal experience. I have taken Paxil and Trazodone for a number of years and do 250-350 dives a year. My doctor, who knows how actively I dive, has never advised against it.
Can I Take Antidepressants and Dive?
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fisherdvm
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My guess is, if diving is therapeutic for your depression, your doctor would advise it.
As long as you stay in the recreational limit, and do only non-deco dives, I can not see why it would pose a risk.
I would see it contraindicated if their is a large component of anxiety in your depression. But for most people, it is mostly depression.
After my divorce 10 years ago, I was on Paxil. It slowed down my thoughs tremendously, and I was fearful it would impact my work - but it didn't.
Paxil dried up my sinuses, and my mouth. I didn't dive while I was on Paxil, but my guess is it wouldn't have impacted it much.
As long as you stay in the recreational limit, and do only non-deco dives, I can not see why it would pose a risk.
I would see it contraindicated if their is a large component of anxiety in your depression. But for most people, it is mostly depression.
After my divorce 10 years ago, I was on Paxil. It slowed down my thoughs tremendously, and I was fearful it would impact my work - but it didn't.
Paxil dried up my sinuses, and my mouth. I didn't dive while I was on Paxil, but my guess is it wouldn't have impacted it much.
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This is a very complex subject and IMHO statements such as, "As long as you stay in the recreational limit, and do only non-deco dives, I can not see why it would pose a risk," are simplistic and potentially dangerous.
A more thorough treatment of this topic can be found in the following "Alert Diver" article:
Depression & Diving: Part II
Making the Call on Recreational Diving
http://www.awoosh.com/Doc Vikingo's Resource Page/Depression_&_Diving.htm
Regards,
DocVikingo
A more thorough treatment of this topic can be found in the following "Alert Diver" article:
Depression & Diving: Part II
Making the Call on Recreational Diving
http://www.awoosh.com/Doc Vikingo's Resource Page/Depression_&_Diving.htm
Regards,
DocVikingo
fisherdvm
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Thanks for pointing out the article. I will mention it to my niece, who was planning to start scuba. I think she is on some type of SSRI.
It is certainly a gray zone, and most FP's and internist probably would have cleared her for diving. Who's got the time to evaluate risks now a day?
It is certainly a gray zone, and most FP's and internist probably would have cleared her for diving. Who's got the time to evaluate risks now a day?
fisherdvm:
Gee it sounds like you know my Dr.
My Dr. who is a diver, suggested I try diving as I had always wanted to try it and that it could help with my depression. I think it has and I've met a couple other divers who have depression and take medication for it and none of us have had any ill effects.
That being said and not being a Dr. I'm sure it's best to first talk to a Dr. before diving just in case, but I think that pretty much goes for any medical condition or when you're on medications.
fisherdvm
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There is very few medications I prescribe without some risks. To expect a doctor to "clear" you for diving is often to ask them to put their license on the line (their malpractice insurance premium, actually!).
I think a patient can chose to take a risk, even risks as high as 5% on certain medications.
Let's say that your risk of seizure with wellbutrin is 0.4%, and lets say that you push your DCS risk to the limit. Well, that 0.4% risk could be 10% .... Just don't sue your doctor if you wanted to dive if you had a seizure.
But lets say that you are conservative, and do no more than 1 or 2 dives a day, at no more than 40ft..... My guess is, it is an acceptable risk for a person to take. There are enough risks with diving, even when you are not taking medicines. Getting run over by a boat, equipment malfunction, getting hit on the head by the ladder, etc. We all take these risks when we rent equipment, or get on a boat during rough weather.
However, one should check with their life insurance policy. Alot of us do not know that diving is not a covered entity. Alot of us do not know that flying in a private plane or helicopter is also an exclusion.
I think I'd take my chance with a dive buddy who is on an antidepressant over one who a risk taker. I appreciate Doc Viking's research into the topic.
I think a patient can chose to take a risk, even risks as high as 5% on certain medications.
Let's say that your risk of seizure with wellbutrin is 0.4%, and lets say that you push your DCS risk to the limit. Well, that 0.4% risk could be 10% .... Just don't sue your doctor if you wanted to dive if you had a seizure.
But lets say that you are conservative, and do no more than 1 or 2 dives a day, at no more than 40ft..... My guess is, it is an acceptable risk for a person to take. There are enough risks with diving, even when you are not taking medicines. Getting run over by a boat, equipment malfunction, getting hit on the head by the ladder, etc. We all take these risks when we rent equipment, or get on a boat during rough weather.
However, one should check with their life insurance policy. Alot of us do not know that diving is not a covered entity. Alot of us do not know that flying in a private plane or helicopter is also an exclusion.
I think I'd take my chance with a dive buddy who is on an antidepressant over one who a risk taker. I appreciate Doc Viking's research into the topic.
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Hi fisherdvm,
I quite agree with you that, "There are enough risks with diving, even when you are not taking medicines. Getting run over by a boat, equipment malfunction, getting hit on the head by the ladder, etc. We all take these risks when we rent equipment, or get on a boat during rough weather."
As such, it ill behooves medical professionals to be cavalier about added risks such as those imposed by a psychiatric disorder and drugs used to treat it, which can involve: lethargy, decreased vigilance, reduced concentration and decision-making efficiency, impaired cognitive functions, irritability and suicidal preoccupation, among other features.
As was said, this a very complex issue which requires careful consideration of the specifics of each case.
Regards,
DocVikingo
I quite agree with you that, "There are enough risks with diving, even when you are not taking medicines. Getting run over by a boat, equipment malfunction, getting hit on the head by the ladder, etc. We all take these risks when we rent equipment, or get on a boat during rough weather."
As such, it ill behooves medical professionals to be cavalier about added risks such as those imposed by a psychiatric disorder and drugs used to treat it, which can involve: lethargy, decreased vigilance, reduced concentration and decision-making efficiency, impaired cognitive functions, irritability and suicidal preoccupation, among other features.
As was said, this a very complex issue which requires careful consideration of the specifics of each case.
Regards,
DocVikingo
Meds like Wellbutrin need to be monitored very carefully. Subclinical doses don't do much but when the dose gets high enought to help pull someone out of clinical depression it usually will cause issues of anxiety and in some cases panic. Psychopharmacology is a delicate balance. It's not uncommon for those on high doses of Wellbutrin to also be buffering the upside of it with something like Ativan, Librium, Ambien or Klonopin (anti-convulsant).
Other meds like Paxil and Zoloft have visual side effects. Some have reported "night vision" problems which can also show up with diving in limited visiblity where using lights is important.
In the early/mid 1990s clinical sociologis Dr. Jennifer Hunt conducted a study on techincal divers (among other high risk sports) and found an overwhelming percentage of the participants suffered from mania, depression and many were also classic Bi-polar subjects. Those who were manic had fear of nothing and could exhibit delusions of grandure, which might pose significant problems. Those who were suffering from depression would have it exacerbated by deep air diving (where information processing slows down) and yet those who were bi-polar would experience the rush of the diving process but be left feeling anti-climactic after it was over. It was an interesting study resulting in an article in the now defunct aquaCorps magazine.
Never-the-less, emotional stablity is critical for diving. Well managed depression or bi-polar disorder should not pose a problem for regular diving. But one should discuss it with both their psycopharmacologist and therapist.
Cheers
Other meds like Paxil and Zoloft have visual side effects. Some have reported "night vision" problems which can also show up with diving in limited visiblity where using lights is important.
In the early/mid 1990s clinical sociologis Dr. Jennifer Hunt conducted a study on techincal divers (among other high risk sports) and found an overwhelming percentage of the participants suffered from mania, depression and many were also classic Bi-polar subjects. Those who were manic had fear of nothing and could exhibit delusions of grandure, which might pose significant problems. Those who were suffering from depression would have it exacerbated by deep air diving (where information processing slows down) and yet those who were bi-polar would experience the rush of the diving process but be left feeling anti-climactic after it was over. It was an interesting study resulting in an article in the now defunct aquaCorps magazine.
Never-the-less, emotional stablity is critical for diving. Well managed depression or bi-polar disorder should not pose a problem for regular diving. But one should discuss it with both their psycopharmacologist and therapist.
Cheers
drrich2
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I just found this old thread, & it'll save me starting a new one.
Someone I care about dives & takes Wellbutrin XL, a slower-release form of Wellbutrin than even SR. Has dived with air with no problems. Plans to dive with nitrox. At issue: making this as safe as practical.
It's my understanding that about 1% of the general population has epilepsy, but that about 5% of people have at least 1 seizure at some point in life (did some Web searching at various sites to come up with those figures).
So, EVERYBODY has a seizure risk of some degree over some set period of time. Then again, seizures underwater have a nasty way of being fatal.
It seems to me that diving with a full face mask would be a very good risk reducer. You could still seize, run out of air & suffocate while unconsious, but diving with a buddy & not letting your air get too low should at least help you get past the 'seize, pass out, spit out your regulator, inhale water & die within minutes' concern.
It's even mentioned in the PADI Encyclopedia of Recreational Scuba Diving, 3'rd Ed., Page 3-10 -"In rec diving, you may want to use a fullface mask for breathing hyperoxic (high oxygen) gases underwater." It goes on to say that risks of aggressive tec diving include oxygen toxicity seizure, which is "relatively harmless" except for losing your mouth piece & drowning, & that a FFM can reduce that risk somewhat.
What say you, guys?
Richard.
Someone I care about dives & takes Wellbutrin XL, a slower-release form of Wellbutrin than even SR. Has dived with air with no problems. Plans to dive with nitrox. At issue: making this as safe as practical.
It's my understanding that about 1% of the general population has epilepsy, but that about 5% of people have at least 1 seizure at some point in life (did some Web searching at various sites to come up with those figures).
So, EVERYBODY has a seizure risk of some degree over some set period of time. Then again, seizures underwater have a nasty way of being fatal.
It seems to me that diving with a full face mask would be a very good risk reducer. You could still seize, run out of air & suffocate while unconsious, but diving with a buddy & not letting your air get too low should at least help you get past the 'seize, pass out, spit out your regulator, inhale water & die within minutes' concern.
It's even mentioned in the PADI Encyclopedia of Recreational Scuba Diving, 3'rd Ed., Page 3-10 -"In rec diving, you may want to use a fullface mask for breathing hyperoxic (high oxygen) gases underwater." It goes on to say that risks of aggressive tec diving include oxygen toxicity seizure, which is "relatively harmless" except for losing your mouth piece & drowning, & that a FFM can reduce that risk somewhat.
What say you, guys?
Richard.
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