Remitting long-standing major depression in a multiple sclerosis patient with several concurrent conditions

• Main Authors: Sachinvala ND, Stergiou A, Haines DE
• Format: Article
• Language: English
• Published: Dove Medical Press 2018-10-01
• Series: Neuropsychiatric Disease and Treatment
• Subjects: Major depression; multiple sclerosis; craniopharyngioma; euthymia; dimethyl fumarate; bupropion; S-adenosylmethionine; vitamin D3
• Online Access: https://www.dovepress.com/remitting-long-standing-major-depression-in-a-multiple-sclerosis-patie-peer-reviewed-article-NDT

Navzer D Sachinvala,1 Angeline Stergiou,2 Duane E Haines3,4 1Retired, US Department of Agriculture-Agricultural Research Service, New Orleans, LA 70124, USA; 2Department of Medicine, Fairfield Medical Center, Lancaster, OH 43130, USA; 3Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; 4Department of Neurobiology and Anatomy, The University of Mississippi Medical Center, Jackson, MS 39216, USA Abstract: In this report, we discuss the case of an multiple sclerosis (MS) patient, age 62, who learned to attain and sustain euthymia despite his ailments. He has Ehlers Danlos Syndrome (EDS), asthma, MS, urticaria, and major depression (MD). Despite thriving limitations, the patient is an accomplished scientist, who struggled for > twelve years to emerge from being confined to bed and wheel chair with MS, to walking with crutches, scuba diving, writing manuscripts, and living a positive life. Through former educators, he reacquired problem-solving habits to study the literature on his illnesses; keep records; try new therapies; and use pharmaceutical, nutritional, physical, and psychological methods to attain euthymia. With this inculcation, years later, he discovered that dimethyl fumarate (DMF) suppressed inflammation, cramping, urticaria, and asthma; and the combination of bupropion, S-adenosylmethionine (SAMe), vitamin-D3 (vit-D3), yoga, and self-hypnosis relieved MD. Then, after a 14-month respite, the patient, discovered that he had adult onset craniopharyngioma: a benign, recurring, epithelial tumor that grows from vestigial embryonic tissue (Rathke’s pouch) which formed the anterior pituitary. The tumor grows aggressively and causes surrounding tissue and function losses. It caused headaches, disorientation, bitemporal vision loss, among other problems. To emerge from this conundrum, the patient employed his relearned habits; the above antidepressant cocktail (bupropion, SAMe, and vit-D3); and with 30 fractionated stereotactic radiation treatments shrank his tumor and gained relief. This is a single case, and methods we discovered serendipitously may not work for other chronically ill patients. Consequently, we want to encourage such patients and their physicians to discuss their experiences in peer-reviewed domains so readers may acquire new perspectives that help individualize their care, and have productive contented lives. Keywords: craniopharyngioma, euthymia, dimethyl fumarate, bupropion, S-adenosylmethionine, vitamin D3