Anti-depressants - what do people recommend?

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nessa238
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27 May 2012, 6:59 am

Hi I am due to ask my Dr to put me on a different anti-depressant as I can't tolerate the side effects of Effexor/Venlafaxine any longer - this is the anti-depressant I've taken the longest but the excessive feelings of tiredness all the time, sickness and sexual dysfunction mean I don't want to take it any more.

I have been researching alternatives and have come across Reboxetine/Edronax, which is a Norepinephine reuptake inhibitor - it doesn't act on Serotonin.

Does anyone have any experience of taking this medication?



spudboy
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27 May 2012, 7:20 am

Haven't used that one. I was on venlafaxine for a couple of years and found it very unpleasant - be warned also, withdrawal is a b***h. The problem seems to be in its short half life and that it works as a serotonin, norrpinephrine and dopamine reuptake inhibitor at different points. However I tolerated escitalopram (Lexapro) much better, maybe it might be better for you. Your GP might be able to advise you.


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nessa238
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27 May 2012, 8:24 am

spudboy wrote:
Haven't used that one. I was on venlafaxine for a couple of years and found it very unpleasant - be warned also, withdrawal is a b***h. The problem seems to be in its short half life and that it works as a serotonin, norrpinephrine and dopamine reuptake inhibitor at different points. However I tolerated escitalopram (Lexapro) much better, maybe it might be better for you. Your GP might be able to advise you.


I know about the Venlafaxine withdrawal and agree it's horrible. I'm not on anything now though and only took it for short periods when tried to get back on it - not long enough to cause withdrawal when stopped taking it.

I have tried Citalopram in past and it didn't work for me - will look into Lexapro though.

Did you find Lexapro affected your ability to orgasm? (apologies if this question is too overt)



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27 May 2012, 8:27 am

From memory, I found it delayed it somewhat. This effect lessened over the time I was on the drug.


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27 May 2012, 8:44 am

Over the past 12 years I've been on and off Venlafaxine, fluoxetine and Citalopram. The only one I had side effects on was venlafaxine (which made me very physically unwell). I did not get any effect, beneficial or otherwise, from any of them, so I don't recommend any of them.

Turns out, according to my psychiatrist that I am not depressed (though my GP believes I am) but rather I 'just' have a huge problem with my emotional regulation and also some anxiety. I'm now on a mood stabiliser (lamotrigine) and a low dose antipsychotic (amisulpride) and although I'm still having a lot of problems I am doing much better than I have over the last 12 years.

If you have tried several antidepressants and they don't seem to help then it might be time to try something else.


I wish you luck I finding an antidepressant (or other medication) that helps you and doesn't give you side effects you can't cope with.


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nessa238
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27 May 2012, 9:02 am

spudboy wrote:
From memory, I found it delayed it somewhat. This effect lessened over the time I was on the drug.


Yes I remember being able to overcome the effect to a certain extent but it was hard work and nowhere near as good as not being on it.



nessa238
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27 May 2012, 9:29 am

YellowBanana wrote:
Over the past 12 years I've been on and off Venlafaxine, fluoxetine and Citalopram. The only one I had side effects on was venlafaxine (which made me very physically unwell). I did not get any effect, beneficial or otherwise, from any of them, so I don't recommend any of them.

Turns out, according to my psychiatrist that I am not depressed (though my GP believes I am) but rather I 'just' have a huge problem with my emotional regulation and also some anxiety. I'm now on a mood stabiliser (lamotrigine) and a low dose antipsychotic (amisulpride) and although I'm still having a lot of problems I am doing much better than I have over the last 12 years.

If you have tried several antidepressants and they don't seem to help then it might be time to try something else.


I wish you luck I finding an antidepressant (or other medication) that helps you and doesn't give you side effects you can't cope with.


I definitely have a problem with emotional regulation too - particularly impulse control in that if something upsets me too much I can have outbursts - it's like I reach a point of no return and can't put things in perspective and also my self-esteem seems to vanish very easily; it's almost totally reliant on how other people react to me - a positive interaction and Im ok, a negative one and it vanishes!

I can't maintain a stable sense of self on my own - I need medication to provide a safety net so I don't keep dropping lower and lower.



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27 May 2012, 9:51 am

I've had good results with fluoxetine because it doesn't have that sedating effect you mentioned--at least not for me. Plus, it's relatively cheap and it's been on the market for a long time so there's a lot of research that's been done on it.

Is your doctor asking you to do some research as well? That sounds like a particularly decent sort of thing for a doctor to do, knowing that the patient is an Aspie and needs to understand everything around them.

Oh, you might want to visit this site--
http://crazymeds.us
Which basically gives a lot of information in laymen's terms about medication options and the possible effects, usually from the perspectives of people who've taken those meds.

rxlist.com has the more technical information.


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YellowBanana
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27 May 2012, 10:14 am

nessa238 wrote:
YellowBanana wrote:
Over the past 12 years I've been on and off Venlafaxine, fluoxetine and Citalopram. The only one I had side effects on was venlafaxine (which made me very physically unwell). I did not get any effect, beneficial or otherwise, from any of them, so I don't recommend any of them.

Turns out, according to my psychiatrist that I am not depressed (though my GP believes I am) but rather I 'just' have a huge problem with my emotional regulation and also some anxiety. I'm now on a mood stabiliser (lamotrigine) and a low dose antipsychotic (amisulpride) and although I'm still having a lot of problems I am doing much better than I have over the last 12 years.

If you have tried several antidepressants and they don't seem to help then it might be time to try something else.


I wish you luck I finding an antidepressant (or other medication) that helps you and doesn't give you side effects you can't cope with.


I definitely have a problem with emotional regulation too - particularly impulse control in that if something upsets me too much I can have outbursts - it's like I reach a point of no return and can't put things in perspective and also my self-esteem seems to vanish very easily; it's almost totally reliant on how other people react to me - a positive interaction and Im ok, a negative one and it vanishes!

I can't maintain a stable sense of self on my own - I need medication to provide a safety net so I don't keep dropping lower and lower.


Honestly that sounds so much like me it's a bit scary! You recognise this in yourself (which is more than I was able to do - I had to have it pointed out to me and then I couldn't understand how I hadn't seen it!) and it sounds like this is also still present when you are taking antidepressants. It might be worth thinking about a mood stabiliser - I don't think a UK GP can start such a treatment but if you are seeing a psychiatrist it might be worth discussing it. Mood stabilisers are often combined with an antidepressant if it is felt necessary.


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Mootoo
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27 May 2012, 10:18 am

Ecstasy baby. :D

But seriously, entactogens in general (a family of drugs, like SSRIs, which MDMA is part of) affect both serotonin and dopamine... and might even help with socialization.

Otherwise, how exactly do you experiment with pharmaceuticals? Do you try them for six months and if they don't work you try another? So hopeless...



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27 May 2012, 11:51 am

Ketogenic paleo diet....carbs are bastards for messing your moods around.

Takes a couple of weeks before things settle when you stop carbs though, as there is a brief carb withdrawal period to work through! I am still trundling through it slightly as carbs were the last thing to go (quit smoking and antidepressants simultaneously a month before, 2 weeks later dropped grains and dairy and now its the turn of carbohydrates).

I dropped the antidepressants in favour of more natural techniques so that my brain chemistry could rebalance itself back into a natural state minus drugs etc. So I stopped smoking, don't drink, don't take antidepressants, don't eat grains, don't consume dairy, don't eat anything processed and certainly don't consume processed sugars or artificial sweeteners. This should allow my body to clean itself out and for my brain chemistry to reach a more natural state.

First month or so is rough, but things are settling down now, slowly (ie more good days than bad ones)

Plus paleo diet is very dense nutrition wise and provides the body with all the nutrients it needs to make the right level of neurotransmitters. With the poor diets most people eat, loaded with carbs (that give a mood high then a crash) it's no surprise depression is on the increase amongst the population. Without good nutrition they body cannot make the neurotransmitters etc that it needs to function at optimal levels.

Would you expect a car to run efficiently on dirty fuel or without fuel at all? Then don't expect the human brain to!

Which reminds me, there is a bit of brain fog with carb withdrawal initially as although the body adapts to ketones quickly the brain can lag behind a little...however this does wear off and it's debatable that glucose is the brains preferred energy source. Ketones are the bodies preferred energy source and the liver is capable of converting ketones into glucose anyway...It just takes a while for the body to become efficient at it after years of being run on high levels of carbs.



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27 May 2012, 1:43 pm

bumble wrote:
Ketogenic paleo diet....carbs are bastards for messing your moods around.

Takes a couple of weeks before things settle when you stop carbs though, as there is a brief carb withdrawal period to work through! I am still trundling through it slightly as carbs were the last thing to go (quit smoking and antidepressants simultaneously a month before, 2 weeks later dropped grains and dairy and now its the turn of carbohydrates).

I dropped the antidepressants in favour of more natural techniques so that my brain chemistry could rebalance itself back into a natural state minus drugs etc. So I stopped smoking, don't drink, don't take antidepressants, don't eat grains, don't consume dairy, don't eat anything processed and certainly don't consume processed sugars or artificial sweeteners. This should allow my body to clean itself out and for my brain chemistry to reach a more natural state.

First month or so is rough, but things are settling down now, slowly (ie more good days than bad ones)

Plus paleo diet is very dense nutrition wise and provides the body with all the nutrients it needs to make the right level of neurotransmitters. With the poor diets most people eat, loaded with carbs (that give a mood high then a crash) it's no surprise depression is on the increase amongst the population. Without good nutrition they body cannot make the neurotransmitters etc that it needs to function at optimal levels.

Would you expect a car to run efficiently on dirty fuel or without fuel at all? Then don't expect the human brain to!

Which reminds me, there is a bit of brain fog with carb withdrawal initially as although the body adapts to ketones quickly the brain can lag behind a little...however this does wear off and it's debatable that glucose is the brains preferred energy source. Ketones are the bodies preferred energy source and the liver is capable of converting ketones into glucose anyway...It just takes a while for the body to become efficient at it after years of being run on high levels of carbs.


Where to you get a healthy amount of fiber if you're cutting out carbohydrates from your diet? And are you exercising? A diet without carbohydrates would put a lot of strain on the body to give you fast energy if you were to do any intense cardiovascular activity.



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27 May 2012, 1:50 pm

Another question regarding that diet is fatty liver problems. Is that a potential problem also?

Just thought of another. Is it even possible for a diabetic to switch over to that type of diet (type 1 or 2)?

I don't mean to knock your diet or turn into an interrogator. I just haven't heard of that diet before (it sounds similar to Adkins). I definitely consume too many simple carbohydrates and I do crave them (even brown rice) when I'm feeling glum, but I did really well mentally when I was vegan for a few years and eating whole grains, fruits, LOTS of vegetables, and legumes, and few simple sugars like white flour or table sugar.



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27 May 2012, 2:34 pm

Senath wrote:
Another question regarding that diet is fatty liver problems. Is that a potential problem also?

Just thought of another. Is it even possible for a diabetic to switch over to that type of diet (type 1 or 2)?

I don't mean to knock your diet or turn into an interrogator. I just haven't heard of that diet before (it sounds similar to Adkins). I definitely consume too many simple carbohydrates and I do crave them (even brown rice) when I'm feeling glum, but I did really well mentally when I was vegan for a few years and eating whole grains, fruits, LOTS of vegetables, and legumes, and few simple sugars like white flour or table sugar.


My dad controlled his Type2 diabetes very effectively with the Protien Power diet. I've found I do best balancing about 2 gram of carbs with 1 gram of protein. If I go below 1 gram of carb per protein I get a liver dump (liver dumps glucose, either stored or manufactured, into bloodstream), if I go above 3 grams, I'm more likely to go high from that.

Type 1 is lack of insulin -- although controlling carbs will likely help, it isn't a complete fix

Type2 is more likely to be insulin resistance -- reducing carbs so that insulin levels decline, can only help. Anything that increases insulin sensitivity would also be a tremendous help. When LEF started recommending Metformin for it's life extension properties, I went ahead and asked for a prescription.



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27 May 2012, 5:57 pm

Callista wrote:
I've had good results with fluoxetine because it doesn't have that sedating effect you mentioned--at least not for me. Plus, it's relatively cheap and it's been on the market for a long time so there's a lot of research that's been done on it.

Is your doctor asking you to do some research as well? That sounds like a particularly decent sort of thing for a doctor to do, knowing that the patient is an Aspie and needs to understand everything around them.

Oh, you might want to visit this site--
http://crazymeds.us
Which basically gives a lot of information in laymen's terms about medication options and the possible effects, usually from the perspectives of people who've taken those meds.

rxlist.com has the more technical information.


Agree, crazymeds is the best site for learning about pysch meds. It really comes down to which is worse, medication effects or ones mental illness.



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27 May 2012, 10:39 pm

Lithium!! ! Primarily used in bipolar disorder, but they prevent psycotic episodes. I judge it to be the only one save for use with AS.

I was on Cipralex (may only be the danish brandname), when I got misdiagnosed with depression. And I developed Schizophrenia and paranoia while on them. Honestly it was the most scary thing I've ever tried (and I suffer from major anxiety, and that's saying something). I don't remember much from the month while the experience lasted. But what I remember was scary as s**t. I was even willing to kill my roommate because I, suddenly remember that I had a roommate and then he just invaded my space. Understand that he was one of my best friends.

And if Lithium doesn't work, I'll drop the antidepressant and try and find something else. Personally I went on a weed binge for 6 month and then I was all better. (Warning: Might not work for you)

Was later put on Lithium, when I suspected Bi-polar disorder (was before I got my diagnosis), but has a good psychiatrist who allowed me to choose my own meds. It gave me an internal balance (zen state, like feeling in balance with one self. It even killed my anxiety), unlike anything I've ever tried.


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