Antidepressant users - Rate the effectiveness of the antidepressant(s) you've used

Tryptamine*Dreamer

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A lot of us here have trouble with depression or bipolar disorder. I have either major depression or bipolar II disorder (diagnosed as the latter, but they may have been wrong). I have been on many antidepressants and combos of antidepressants and other psych meds. Some were prescribed by doctors; others I tested on myself. None have been highly effective, but I have found two drugs that work better than any others I have used(tianeptine and selegiline). They also work better combined, but are still not nearly as good as I would like.

I am trying to see if anyone here has found a med or combo that works really well. I will rate my meds first. You can use whatever rating system you want. I'm going to rate mine on a -5 to +5 scale with negative numbers indicating a worsening of symptoms (-5 would be attempting suicide or becoming homicidal when you were not previously suicidal or homicidal) and side effects rated 0 to 5 with 0 being no side effects, 3 being severe enough that you'd probably quit using it even if it is working well for your depression and 5 as life threatening side effects.

The first number is the effectiveness and second is side effects. I'll make a short description of effects after rating. I am trying to rate the effectiveness of the drugs on improving overall mood for depression and not for other positive effects such as on anxiety or insomnia. Some of the meds would get much better ratings if I included that.
If you want to rate your experiences, you can respond with a simple numeric rating or go in depth about the positives and/or negatives of the drug or combo of drugs. I’m really just wanting to find out what works best for others.
Paroxetine/Paxil: -3,2
This induced an unpleasant state which continued to get worse over the 2-3 weeks I was on it. Anxiety levels went up and I developed severe insomnia. The depression seemed to increase some and I had more mood swings. I felt tense all the time and had a feeling of inner turmoil that sometimes led me to scream into the air and hit, bite, or even stab myself with shards of glass. It increased suicidal ideation to the point that I was making plans to do it. It also caused nausea the whole time and daily headaches but those symptoms may have been improving when I quit. The exacerbation of symptoms subsided within a short time of quitting.

Fluoxetine/Prozac: -1,1
Caused insomnia and anxiety without affecting my depression. Caused nausea at times and increased headache frequency.

Venlafaxine/Effexor: -3,3
This caused much of the same effects as Paxil/Paroxetine but there was also a feeling of being too energized in a bad way. I lost the ability to focus on anything and all kinds of bad thoughts kept running through my head constantly. The thoughts made even watching TV impossible, they were obtrusive and impossible to ignore. I had near constant anxiety. I felt like I was losing my mind by the time I quit and I was probably more depressed at that point. I only stayed on it for two weeks because the physical side effects were too bad and judging from the mental effects up to that point, it would probably not have worked even if I had stayed on it for the 4-8 weeks it takes these meds to produce maximum benefits. Side effects were persistent nausea with occasional vomiting, headache, dizziness, tachycardia (heart rate stayed above 100 the whole two weeks, sometimes 130+bpm), hypertension (as high as 190/120), and excessive sweating.

Trazadone: 1,1
Seems to help my anxiety. May have helped some with the depression but probably because it helped me sleep. Now I take it just as a sleep aid on occasion or a small 50-100mg dose for anxiety attacks with a benzo. It increases the effectiveness of benzos and makes them work with less. After breaks in use, I can still get weak AD effects but can only use it 2 or 3 weeks at a time for that. The only side effects are drowsiness/sedation (desired by me) and dry mouth. Not very good as an antidepressant, somewhat effective for acute anxiety, and moderately effective for insomnia when used for two weeks or less.

Sertraline/Zoloft: 0.75,1.5
My depression may have improved slightly but if so it did not seem to last. I was very suicidal shortly before getting it prescribed. I was on a lower dose which had no effect. I had to be hospitalized due to my suicidality. After they doubled the dose, I was feeling less suicidal after about a week and was discharged after two weeks, though only because I exaggerated the improvements. This medication initially caused severe insomnia and after 10 days with maybe 3 or 4 hours of sleep for all nights combined I started feeling delusional and having hallucinations. I knew it was lack of sleep so I did not tell anyone about it. The insomnia subsided almost completely within 3 weeks. For the first week of treatment, I developed extreme anger to the point of rage, yelling, screaming, and saying horrible things to employees of the institution. I had a reason to be angry though, they would not give me anything for insomnia even knowing that I had been awake all but 4 or 5 hours of the last 11 days and would not do anything about my severe panic attacks. Benefits were modest and seemed to either be temporary or it only helped part of the time. I quit using it due to lack of effects.

Quietiapine/Seroquel: 1,1
This is not an antidepressant but is used in treatment of depression. After the Zoloft had seemed to quit working, this was added and it produced a small but noticeable mood lift that did not seem to go away with time. It is immediately effective as well. It seems more useful in decreasing frequency of panic attacks. It also helps with insomnia but not as much as trazadone and only for a week or two before it loses effectiveness. The only bothersome side effect for me has been occasional dry mouth but some report really bad side effects.
Divalproex Sodium/Depakote: 0.5,0
Did little to improve mood, but it is a mood stabilizer, not an antidepressant. It helped with mood swings and I did not get suicidal as often while on it. I also stopped burning myself while I was on it. It increased my energy level some and kept me from sleeping if I took it at night. Taken in the morning, this was a good thing. No side effects that I noticed other than insomnia when I was taking it at night. It helped me when I was on it, just not much for the depression.

Selegiline: 1.5/2
This one works very well for a mood and energy lift when taken occasionally as needed and would get a higher rating if I could take it more than a couple of days per week. Unfortunately, it causes severe insomnia with near complete lack of sleep by the second or third night along with increasing anxiety. I have been unable to use it long enough to find out if the side effects may ease with longer treatment. It is useful when used a couple of times per week without significant side effects. This could be a wonder drug for me if I not for the insomnia. I will be trying to take it for a longer time again later to see if that side effect might subside.

Bupropion/Wellbutrin: 1.5,2.5
This medication works well for energy without major side effects for 2-3 days and provides slight mood improvement. Side effects increase rapidly after that with severe insomnia and blood pressure elevation. Forced to stay on it in a mental hospital, the side effects started decreasing again after a week or so but blood pressure had risen to near 200/120 before that happened and was >175/100 for three days straight. Within a little over a week, my mood had become very elevated to hypomania from a suicidal state. Unfortunately, it seemed to completely stop working within a couple of months and I eventually stopped using it because it was still causing frequent insomnia and increased anxiety.

Tianeptine/Stablon: 1.75,0.5
Has had a modest but long lasting benefit on mood. Slight mood lift and an improved ability to feel good things. It is the latter effect that has seemed persistent with the mood improvement at best a part time effect. Slightly improved motivation. This med has quite noticeably decreased anxiety and panic attacks. It has produced a lasting decrease in insomnia, at times I have even slept more than normal on this. There are episodes on this med where it seems to barely do anything for mood, but these episodes tend to last only a month or so at most. Other meds I have used seem to lose effectiveness and only work again after prolonged abstinence and without many of the benefits that this med has. Side effects for first two weeks are persistent headache and slight-moderate decrease in blood pressure. It seems to have produced a lasting small decrease in blood pressure. The only bothersome side effect is the occasional oversleeping. Also, running out caused severe, persistent anxiety and a complete inability to sleep that lasted about ten days and did not respond to treatment even with a combo of benzos, Phenobarbital, trazadone, and Seroquel.


Now I will write about a couple of combos that seemed better than any med on its own. I am going to leave out the meds that did not seem to have lasting effects.

Trazadone+Seroquel: 1.5,1
This combo had me feeling better than either med alone. The seroquel has a lasting positive effect on mood. The trazadone will work a couple of weeks and then I need a break to get it working again. I can only use this part time.

Tianeptine+Seroquel+Trazadone: 2,1
My mood seems to be best when I am using all three of these. On all three of these, I probably have less than half as many panic attacks than I would with just Tianeptine or just the Trazadone+Seroquel combo. Increased benefit on mood when not anxious is harder to distinguish and could be imagined although decreased anxiety tends to occur with improved mood.

The hypomanic episode with Wellbutrin occurred while also on Zoloft, Trazadone, and Seroquel. The Zoloft had already seemed to stop working months prior to starting Wellbutrin and this combo seemed to stop working after a while too. I am pretty sure neither wellbutrin or Zoloft were helping after a while because I dropped the Zoloft first without worsening my condition after maybe two weeks off. After quitting the Wellbutrin after that, my mood improved almost immediately, probably because I could sleep better and was less anxious. Restarting Zoloft later did not cause any meaningful change and I quit it again after a while. Stopping the Seroquel and Trazadone made me feel more depressed and greatly increased my anxiety.


Of everything I have tried, Tianeptine seems to be a lot better than the others especially when its anxiolytic effects are also considered. It is unique among them in that it increased my ability to feel positive emotions and that it still works after probably near a year on it, though it lost some of its effectiveness after the first couple of months.
 
Effexor (venlafaxine):

It literally drove me nut's and had the worst side effects of almost any drug Ive tried. Not to mention that the wd is hell on earth. I am bipolar though and this was before i was diagnosed as having bipolar so going crazy manic on this drug was pretty much inevitable. This drug turned me off any psych meds except benzos for years because i was so afraid of going through any effexor type withdrawals.

Amitriptyline:

I was prescribed this for neuropathic pain originally but it did help with the depression. It's hard to tell how much or at all if it fucked with my bipolar because i was not diagnosed before i went on it. It did work good as a anti-depressant until it crapped out and it is hands down the best sleep aid by far. It also gave me no withdrawals at all. The weight gain can be a bitch but it's nowhere near as bad as say remeron.

Wellbutrin (bupropion):

The best anti-depressant Ive tried and has he least amount of side effects. It helps my depressive episodes alot without making me manic. It's almost as if my brain wakes up about a week after taking it.

Remeron (mirtazapine):

I took this drug along with risperidone to help my bipolar as i was going through a real rough patch. I was not on any mood stabilizers at the time just 30mg's of remeron a night and 2mg's of risperdal every day. All it seemed to do was make me so hungry that i wouldn't go to sleep until i had eaten half the food in the fridge. I can easily see someone putting on 50lbs or so in a few months of being on remeron. Also i nearly hung myself one morning in a pit of despair but i have no idea if remeron contributed to that.

Seroquel (quetiapine):

Ok it is a anti-psychotic but it is used as a add on to a anti-depressant for major depression. I found it to have anti-depressant effects of it's own and it works fast for depression for me but since i have bipolar i react abit differently to meds then someone with unipolar depression.

Lamictal (lamotrigine):

One of the only true mood stabilizers the other being lithium of course. Lamictal has literally been a lifesaver for me and it stabilizes me mood pretty good. It works better on the depression side then the manic side so doctors sometimes use it here in treatment resistant depression.

So i vote wellbutrin for the win in my case for actual anti-depressants.
 
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I won't use the rating scale because I find it too subjective to place. I am also going to include more than just anti-depressants, if that's okay. I have been been medicating my depression through official and unofficial means for a long time now.

Paxil (Paroxetine) - I was on 20mg for about 2-3 years as a teenager. Keep in mind that I have a very sensitive constitution so this dose was impacting. It was initially effective but I don't think it was necessary for so long. Later on suicidal ideation became much easier leading two a couple of crisis situations. The drug allowed me to dissociate from the fear and logical recourse of suicide. I also gained a lot of weight - looking back, I looked scarily unlike myself at any other period in my life. When I decided to take myself off of this medication, I suffered horrible withdrawals. Because there was no medical evidence at the time that it caused withdrawals, my doctor claimed it was all in my head, and my parents believed him. Nonetheless, I had to stay in bed for a whole week before I could walk without feeling dizzy, and minor symptoms lasted longer. Two years later the research came out about its addictiveness (which they now quaintly call "SSRI discontinuation syndrome" to differentiate it from street drugs), and my parents apologized.

Effexor (Venlafaxine) - Despite denials that paxil had withdrawal symptoms, my doctor tried switching me to this SSRI to serve as a buffer against the symptoms. I was violently allergic to it and within a few days I started having harsh symptoms. My doctor claimed it was part of the adjustment period, but when I started vomiting and having diarrhea, cold sweats, bad shakes, delerium, and borderline anaphylaxis I stopped it myself. Fucking moron.

Ketamine - During my raving days I discovered ketamine to be an excellent mood modulator and I went through a stint of 5-6 months of doing small amounts weekly. I of course would do more, and with other drugs, if I was partying; but outside of parties I did K independently once a week and it helped. Unfortunately my supplier disappeared along with my source of income, so I didn't have a chance to take it again. Probably for the best though. This analysis is not objective though as I was doing a lot of E at the time and we all know what that does to the serotonin system.

Celexa (Citalopram) - I used this during a crisis period in my early 20's or six months, then stopped it on my own. I had stopped raving and doing E for about two years by this point, and IMO part of this crisis was fueled by the damage done by all of my prior E use. It was suggested by my doctor that this SSRI could "chip away" at the serotonin receptors and make them more functional again, but given that I still battle with this issue I feel that was bullshit. But I digress. Of all the SSRIs I've taken, celexa was the least offensive, but I still noticed that as time when on suicidal ideation became easier and this disturbed me greatly, creating increasing levels of anxiety. It was also a very sexually active time in my life and I hated the erectile dysfunction and delayed orgasm with a passion. As a teenager I got used to these side effects because I wasn't getting laid so it didn't matter, but as an adult it was unacceptabe. My doctor gave me cialis to compensate but it didn't agree with me. I also had withdrawal symptoms from stopping celexa but they were more easily mangeable, probably due to the shorter duration of the medication and the fact that I was a regular cannabis user by this point. It's also worth mentioning briefly that after each SSRI I discontinued, I felt a "thawing" of my emotional state as though a full range of being had been restored. It's because of the numbing effect of SSRIs on my intuition and sensitivity to the world that I will never take them again.

Cannabis - I know it's technically a depressant but I went through a period of smoking one to two hit amounts, once a week, and it helped to balance my mood significantly. The downside was that it took a great amount of self-control to not smoke more than this, and I eventually faltered. If I smoke pot chronically it makes my depression worse, but in smaller amounts it makes it better.

Nootropics - I stacked paracetam, vinpocetine, hydergine, selegiline, lily bulb extract, and choline for a period of two months or so, all at low doses. I found that it helped my mental state significantly and my bouts of depression since then have not been as extreme. Unfortunately, I did suffer more intense insomnia during that period, and mild headaches, but the benefits were worth it. It's also fair to mention that I made significant dietary changes during this time that brought amazing results to my life, so it may not have been just the nootropics.

LSD - Most recently (2011-2012) I took 300ug once a month for 6 months in a very controlled environment, with diminishing returns on improvements to mood over these months, eventually leading to a psychotic break. (Honestly, I think I just did it too often for my constitution.) Initially it brought amazing change to my life, and given that it's a serotonin analog I think that might have been part of the reason. The first time I ever did it, I was still taking the nootropics listed above, and it blew my consciousness wide open. LSD has had a strong deconstructive effect when used to think about actual problems in my life; and because I took such a high dose it deconstructed every part of me, including some hidden areas that I had forgotten or repressed. At this point I think it would be more constructive for me to do it rarely (once or twice a year max), otherwise it becomes too catabolic and its deconstructive powers have less mental "content" to work on. In other words, it becomes exhaustingly redundant.

I'm about to start another course of nootropics once I gather them all, as they seem to have the best results out of everything I've tried.
 
Thanks for the replies. It looks like the meds effect everyone quite differently.
I agree that wellbutrin works well, at least initially but I had bad side effects.

I think one reason why the Tianeptine works so well for me while SSRIs have little positive benefits and sometimes severe side effects. Tianeptine is an SSRE (Selective Serotonin Reuptake Enhancer). It increases the reuptake of seratonin instead of decreasing for SSRIs. It seems something like an opposite of SSRIs. If SSRIs fail for you, this is probably a good med to try. It worked quite a lot better for me than any SSRIs. If SSRIs make you feel worse, perhaps tianeptine will work since it does practically the opposite of SSRIs. Effexor/Venlafaxine is and SNRI. That class of meds should not be combined with tianeptine because it would block tianeptine from working right.

I used to get relief for like a month after a heavy dose of most psychedelics but this seems to not work nearly as well as it used to.

For me, SSRIs and SNRIs have bad side effects and/or little or no effectiveness.

Seeing piracetam mentioned did remind me that that generally improved mood and increased my energy. It started causing headaches but they resolved when choline was added.

I think I will try lamotrigine and maybe amitriptyline to see how they work or try the entire nootropic combo that was posted. I am also considering mirtazapine because it has been shown to be effective in some patients who don't respond to other things and it begins working fast

I have also found synthetic cannabinoids to help at first until I start using too much.

Also, I plan on trying to use seligiline this summer to see in the insomnia goes away eventually because this med seemed highly effective for the days I use it.

I was not looking for this info but it did work for me a long time. Small doses of poppies several times per week kept me feeling not bad and sometimes good. Might help but you need the self control to not over do it and become an addict as I have been much of the time since my early use began.
 
The best AD I used untill now is clearly Clomipramine. Although it has plenty of nasty side effects it elevates mood better than any other AD for me. Especially in the beginning (week #3-6) it produces almost amphetamine like energy and body load. The down side is primarily its tendency to produce frequent muscle twitches (or even seizures if combined with other drugs).
 
LSD - Most recently (2011-2012) I took 300ug once a month for 6 months in a very controlled environment, with diminishing returns on improvements to mood over these months, eventually leading to a psychotic break. (Honestly, I think I just did it too often for my constitution.) Initially it brought amazing change to my life, and given that it's a serotonin analog I think that might have been part of the reason. The first time I ever did it, I was still taking the nootropics listed above, and it blew my consciousness wide open. LSD has had a strong deconstructive effect when used to think about actual problems in my life; and because I took such a high dose it deconstructed every part of me, including some hidden areas that I had forgotten or repressed. At this point I think it would be more constructive for me to do it rarely (once or twice a year max), otherwise it becomes too catabolic and its deconstructive powers have less mental "content" to work on. In other words, it becomes exhaustingly redundant.

I'm about to start another course of nootropics once I gather them all, as they seem to have the best results out of everything I've tried.

Fascinating. I was doing a similar thing with psilocybin and had a similar experience. How long did it take for your psychosis to resolve itself (of course I know it's hard to tell such things because in some ways you were psychotic at birth and in some ways you still are psychotic, if that makes sense to you as it does to me, but a rough estimate of when you stopped having serious delusions/hallucinations would be fine). And did you need antipsychotics?
 
I've been on 2 antidepressants, Citalopram and Wellbutrin.
Citalopram didnt really work very well for me, and it made me unable to preform sexually. at all. I hated it, and asked my psych to switch me.
I was put on wellbutrin, which i still take. I don't notice any difference and still am depressed as hell, but friends and family say they notice a difference in me when I stop taking it, even if I don't. It doesnt cause me any increased anxiety, but I do notice its hard to fall asleep at night, and for that I'm perscribed ambien. I take propranolol for anxiety, psych wouldnt script me a benzo due to the fact that I would just end up abusing it.
 
When I saw my shrink, she told me to try to take the citalopram for a few more days but call right away if the depression got worse. It stayed about the same severity for the next three days or so and then began rapidly improving. I would say my mood has been completely normal for the last 3 or 4 days, not depressed at all and my mood may still be getting better.

I don't know if it is the citalopram or not though. I think it is likely that it has improved at this time merely by chance. I will keep taking it for the near-medium future because I don't want to risk going back into the same hell I was in 7-10 days ago or so.
 
None of them have ever done anything for me. They just made me more violent and homicidal. Which lead to a transfer from Bipolar Disorder NOS to ASPD.
 
I've been on 2 antidepressants, Citalopram and Wellbutrin.
Citalopram didnt really work very well for me, and it made me unable to preform sexually. at all. I hated it, and asked my psych to switch me.

^This. I tried both Citalopram and Escitalopram over the course of a year or so and found them both to be worse than useless for me. Switched to them from Prozac which seemed to be ramping up my anxiety and causing sleep disturbances and constant head zaps so the doc suggested Citalopram first as something more calming. Side-effects the first week were pretty unpleasant, just really doped-up and spaced-out wanting to sleep all day but not being able to cos of pretty severe gastro-intestinal problems. Settled down by week two but found rather than lifting my mood it pretty much just switched my emotions off altogether, completely flat-lined, so while I was no longer in the very darkest pit of despair I could not be said to be any happier as a result. No pleasure in anything, just totally blah and meh. Did absolutely nothing for motivation or energy levels either, so was just drifitng along in a state of absolute don't-give-a-fuckness getting nothing done. That certainly contributed to my being as actively suicidal at this point as I've ever been, came very close to throwing in the towel altogether. Switched to Escitalopram around 6 months in and found that to be pretty much the same. Completely pointless, verging psychologically damaging, which ain't what you want from an anti-d really, is it?

Tried Prozac again in recent years, not much success, which was disappointing cos the first time I went on it in my 20s it really was the sunshine drug everyone claimed it to be back then, 6 weeks in and all of a sudden it was like a little light went on in my head and the world was suddenly a brighter place. It's stopped doing that for some reason, not sure why? Been using Mirtazapine most recently which seems to be pretty effective at lifting my mood I think and no side-effects to speak of, none that I'm aware of anyways. It's stopped having any effect as an aid to sleep but my sleeping pattern's more normal and not nearly as disturbed as it was so no worries, all gravy.
 
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