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    Never used antidepressants, need advice 
    #1
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    I'm going through a period of severe anxiety and depression. I'm facing life and death illness, and for a long time I have been able to stay relatively calm and cope with it; but now that certain realities are here and not some unknown date in the future, I am having mental health challenges.

    My doctor has recommended the lowest dose of citalopram (celexa) to help me chill out, but I don't know if it's going to be good for me or not and I don't want to mess myself up this late in the game.

    Ideally I'd like a clean anxiety/depression med but I don't know what that'd look like. The doctor also discussed mirtazapine but I was concerned about morning grogginess.

    Can anyone speak to either of these drugs and what I should look out for? Any alternatives for anxiety (especially acute attacks with lots of crying) that aren't so long-lasting?
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    #2
    Prozac worked good for me for depression if you don't mind some sexual dysfunction (i.e. kind of crap orgasms). As far as anxiety I think xanax would be the go to for fast acting like in cases of panic attacks, but if it's something daily I'd suggest k-pin.
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    #3
    Celexa worked on me. I also reccomend amiltryptaline. I never got any side-effects except complete sexual dysfunction from them.

    I haven't tried mirtazapine, but it sounds related to amiltryptaline. with amil, i don't get morning grogginess. I actually feel awesome in the mornings when I'm taking the stuff, and it helps sleep.

    My depression was only moderate at its worst. I don't have bad anxiety.

    Most doctors will let you try a variety of medications. That's really the ticket. I've settled on simply amiltryptaline for my depression after trying prozac, celexa, wellbutrin, and venlafaxine.
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    #4
    Your having severe anxiety and depression but are worried about getting drowsy? I have never been so drowsy as when i was too depressed to get out of bed. If you get drowsy and it doesnt ggo away you can stop it.

    Imo using drugs for the acute effects is a bad idea. For example you could take xanax sure. But the difference is the goal should be to create long term stable results.
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    #5
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    Thanks all!
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    #6
    Did not like Celexa at all. Was on Lexapro before that. Say goodbye to any sex drive and be prepared for isolating yourself even more than you did previously to taking the Celexa. At least that's what it did to me. Also gave me extremely restless legs, dry throat, nausea, and brain jolts when I tapered myself off of it. I look at it like a temporary lobotomy personally. Talk to a therapist or psychiatrist to sort out inner turmoil, but don't take their drugs. We're lab rats. SSRIs don't do shit.
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    #7
    Quote Originally Posted by Cudi View Post
    SSRIs don't do shit.
    That's not true. Whether you can tolerate the side effects or not is another question tho.
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    Quote Originally Posted by Foreigner View Post
    Thanks all!
    Howdy Foreigner

    First let me apologize for being a bit flippant in a staff thread a couple months ago. What you're facing is nothing to make jokes about.

    I'll add that an SSRI doesn't make a lot of sense, to me, given they have the lowest success rate of any class (countered with the lowest adverse events) and the amount of time required to have any effect at all, means you'd spend a month to feel relief when you'd feel better in hours with a different medication. It's just my experience, but I think SSRIs don't really treat anxiety so much as they dampen all emotions.

    I don't think there's reason in this situation to avoid benzodiazepines. I think gabapentin is an excellent anxiolytic that you won't just suddenly fall asleep on.

    It's also easier on your GI tract. People forget that SSRIs have strong effects on gut motility, really getting you moving when you first start them (and constipated when you stop).
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    #9
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    Don't get on the Lexapro. It made me put on weight like no tomorrow. Then it was impossible to burn it whilst still taking it. I got on Cymbalta and that was quite good. Had no issues burning weight.
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    #10
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    when it comes to hangoverish feelings from nighttime meds, they usually dissipate or become much more tolerable, if I remember right.
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    #11
    I'm on Wellbutrin XL (Bupropion) but also on Quetiapine (Seroquel), I think that the Quetiapine plays a much more important role on my depression and mood-swings. Wellbutrin is great, specially if you want to feel more "energetic", as it works as a NDRI (Norepinephrine-Dopamine Reuptake Inhibitor) - but it doesn't work with Serotonin (as SSRIs or SNRIs, for example)... Quetiapine, as far as depression is concerned, works with Serotonin (as well as with Dopamine mainly), hence its antidepressant effect. At the begining, when I first started takiing meds, 10 years ago, I didn't want to take an "antipsychotic" just because of the stigma it carries, mainly, I believe, because of its name... You think "I'm not Schizophrenic or Psychotic, so I won't take an antipsychotic", but, as from my experience, Quetiapine was and is the most effective medication for me concerning my depression. Initially you would get the groggy feeling, but with time (a couple of weeks) and with a higher dose this will fade away.
    Last edited by crubsc; 09-07-2018 at 16:40.
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    #12
    Hey there! A little bit about me, I'm diagnosed with RBD, Rem-Sleep Behavior Disorder. Basically, I act out my dreams and can injure myself or others in the process. So I was prescribed clonazapam and was told to take melatonin as well. I also had to stop taking mirtazapine, because that is a drug that is well-known for aggravating RBD. This is not good, because RBD typically eventually turns into a neuro-degenerative disease such as Alzheimer's or Dementia, and taking mirtazapine or venlaxafine can speed up this transition.


    About mirtazapine: if I didn't have RBD, I would be taking it right now. I have tried several anti-depressants and similar drugs to help with depression and anxiety, and mirtazapine was my favorite of those drugs. It DID make me groggy in the morning, particularly in the first week that I took it. By week four I would still be groggy in the morning, but not nearly as much as in week one. This medication was the only medication prescribed to me for depression that really helped my depression. It also helped my anxiety. There are a couple of interesting facts about this drug. For one, a very noticeable side effect other than morning grogginess and general mild sedation throughout the day was appetite. This is a drug to be taken at night. I have severe insomnia and this drug almost seems better than xanax at knocking me out. That was my favorite effect of the drug. But, back to the appetite comment... when I took this drug at night, about thirty minutes after taking it, I would get fairly severe munchies. Because of this, most people who take this drug gain weight. An interesting fact about this drug is that most users report that they get more sedation from this drug at lower levels, like 15mg or 7.5mg. At 30mg mirtazapine is not nearly as sedating, but it becomes a more effective anti-depressant drug at high dosages. The sedative effects of this drug take effect from day 1, but like most anti-depressants, the anti-depressant part of this drug is not immediate. I believe it takes a month to be in full effect.


    A few people mentioned the use of benzos for anxiety. Like I said, I'm prescribed clonazapam and will most likely have to take it for my entire life. I have no problem with that, because this drug is very pleasant. And unlike xanax, it doesn't bring about quick and uncomfortable withdrawals. I mean, the withdrawals can be very uncomfortable, but you'd have to not take clonazapam for at least a week for the withdraw to kick in, so there's usually no reason to worry about clonazapam withdrawals. It is also a drug that works from day 1. It doesn't have to build up in your system. Someone else suggested gabapentin. I'm also prescribed this medication, for restless leg syndrome. This drug helps me with much more than restless leg syndrome, however. It helps greatly with anxiety and depression, and it's sedating but not overpoweringly so like mirtazapine. Btw, IME clonazapam is only mildly sedating. Like gabapentin, the sedation is not overpowering.
    Last edited by encyklonopin; 12-08-2018 at 18:29.
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    #13
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    Quote Originally Posted by Foreigner View Post
    My doctor has recommended the lowest dose of citalopram (celexa) to help me chill out, but I don't know if it's going to be good for me or not and I don't want to mess myself up this late in the game.

    Ideally I'd like a clean anxiety/depression med but I don't know what that'd look like. The doctor also discussed mirtazapine but I was concerned about morning grogginess.

    Can anyone speak to either of these drugs and what I should look out for? Any alternatives for anxiety (especially acute attacks with lots of crying) that aren't so long-lasting?
    Celexa was a miracle drug for me, but unfortunately, the only way to find out if an AD works for you is to try it for a few weeks. When you say lowest dose, I'm assuming 10mg? If your depression or anxiety is causing you insomnia, mirtazapine is not a bad option, but mirtazapine is one of those drugs where more is less sedating. The doc in rehab put me on 7.5mg and it absolutely zombified me. But at 15mg, it wasn't so bad. There are a ton of SSRIs and SNRIs (i.e. Effexor) and they all work a little differently, so a little trial and error is necessary.

    IME, for acute situations, a therapeutic dose of a benzo is best, and personally, I would recommend anything with a intermediate to long half-life, in other words, not Xanax. But Ativan and Klonopin are good alternatives. Ativan kicks in only just a little more slowly than Xanax but has a longer half-life so frequent redosing isn't needed.
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    #14
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    Hi Foreigner, I don't have any experience to share with you (with the drugs) but I am curious to know whether you are also utilizing talk therapy as well? I know that for my husband this was not an option as he had bad experiences with simple-minded (simplistic) therapists in the past and he wasn't up for giving it another try. But then he ended up in a medical marijuana collective that functioned a lot like a therapy group once a week as most there were dealing with life threatening as well as life ending illness. It was really good for him to explore his intellectual ideas as well as his emotions about his own impending death with others that were facing the same thing. We also talked a lot about it for the past 6 years.
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    #15
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    Hi Foreinger.

    It's hard to give advice on stuff like this, even more so with the limited info you've provided but what came to my mind when reading your post is the drug Tianeptine. I haven't tried it my self (yet) but many people have found it to be a great antidepressant and anxiolytic without being as dulling (emotional wise) as Benzodiazepines and the likes. That is at therapeutic dosage levels though. It'll definately numb you out if you take enough/too much (it's a full agonist at the μ-opiod receptor). If you've been addicted to opioids in the past when please do not use Tianeptine unless you know for certain that your time is running out soon. In that case I suppose you might as well just go ahead and do whatever makes you feel better.

    I wish you the best and btw, I really enjoy reading your posts.
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