Depression Depression and loss of motivation - considering ketamine and/or agomelatine...cost in Australia?

[Flynnal]

I'm thinking seriously of starting a new A/D medication, and I've been looking into the new SSRIs, along with even newer treatment options. I won't touch SSRI/SNRIs due to their impotence/anorgasmia inducing side effects, so I've decided to try something different.

I am hesitant to start mirtazapine again despite the improvement in sexual function, because of both the weight gain and, mostly, because it makes me mean and nasty...I have two dogs now, and whilst I was on mirtazapine there was occasionally the temptation to lash out at them both verbally and physically (luckily it was only verbal, I'd never forgive myself if I hit any of my fur babies), hence why I quickly decided to finish the taper because I didn't like this particular effect. I didn't care nearly as much about the weight gain as I did about this strange anger problem. And of course, sexual function isn't nearly as good without the mirtazapine, but at this point I don't care, I'd much rather not have to deal with the anger, so I ditched it.

So I've looked into agomelatine, and ketamine, to see how these would work. I am aware that the TGA hasn't put agomelatine on the PBS, so I'm looking at $50/month to cover the single dose version. The double dose version is about $90/month which is getting expensive.

Then there is ketamine...but what forms does it come in? Is it covered under the PBS at all? Is there a nasal spray that can be given in Australia? I have no idea, but I'm fed up with not feeling good, and not having any hope for the future. It's as though the last couple of months I've really gone downhill. My sexual function has literally dropped off a cliff, there is just no feeling at all. I know it's depression due to stress (and perhaps a nerve/hormone problem).

If I go back on the mirtazapine I could go through those nasty "mean" spells again and I'm not having any of it. I hate that feeling, my heart starts pounding and I get super angry for seemingly no reason, and something that irritates me can result in objects flying across the room, usually balls or soft items, but occasionally a fragile object has been destroyed in a fit of rage. So going back on the mirt is...NOT...an option.

 

[l41n]

have you tried snri’s?

it’s harder to orgasm but not rlly hard

ssri sexual dysfunction is a lot worse from my experience.

also wellbutrin isn’t cheap but it’s sure as fuck cheaper than K

iv tried agomelatine and it did squat for me

wellbutrin pairs well with pristiq if the snri isn’t fully alleviating the depression.

okbye

edit: i think i read you say that you have sexual dysfunction when not on an AD.

so i’d recommend to try wellbutrin at 150mg and taper up to 300mg after a week if 150mg isn’t cutting it.

forget the snri suggestion..

 

[Flynnal]

My sexual dysfunction is caused by God knows what, but I suspect that the hydrochlorothiazide diuretic that I used to treat my Menieres might have had something to do with it.

LOL. Try to solve one problem and definitely create another. Great. Oh, and my hearing is still fucked AND now I have either primary or secondary anorgasmia. The way shit is headed I doubt I'll be around for much longer. This is a sad story with a sad ending both for me and anyone who cares about me. I'm just totally, totally fed up. Antidepressants won't do anything because they don't address the root of the problem.

 

[OceansState]

I dont have much experience with antidepressants so im not much help.

I was recently prescribed Wellbutrin because I've felt extremely sad/depressed that started 4 weeks ago. Wake up feelings of despair, no reason to live etc. Ive been taking 150mg XL daily for 11 days now and I feel better, haven't cried since on it, I do have negative thoughts but im quickly able to stop and think about something else, its like im focusing on what im doing at the moment is how ill explain it.

As far as sexual side effects I have no trouble getting it up, im actually waking in the morning aroused which previously I wouldn't. I do seem to have odd sexual thoughts, can be a negative or a positive depending how you look at it. Id say if your into watching porn its probably a good thing.

I recently tapered and stopped taking high doses of Loperamide which is probably why depression set it.

 

[Man67]

I'm thinking seriously of starting a new A/D medication, and I've been looking into the new SSRIs, along with even newer treatment options. I won't touch SSRI/SNRIs due to their impotence/anorgasmia inducing side effects, so I've decided to try something different.

I am hesitant to start mirtazapine again despite the improvement in sexual function, because of both the weight gain and, mostly, because it makes me mean and nasty...I have two dogs now, and whilst I was on mirtazapine there was occasionally the temptation to lash out at them both verbally and physically (luckily it was only verbal, I'd never forgive myself if I hit any of my fur babies), hence why I quickly decided to finish the taper because I didn't like this particular effect. I didn't care nearly as much about the weight gain as I did about this strange anger problem. And of course, sexual function isn't nearly as good without the mirtazapine, but at this point I don't care, I'd much rather not have to deal with the anger, so I ditched it.

So I've looked into agomelatine, and ketamine, to see how these would work. I am aware that the TGA hasn't put agomelatine on the PBS, so I'm looking at $50/month to cover the single dose version. The double dose version is about $90/month which is getting expensive.

Then there is ketamine...but what forms does it come in? Is it covered under the PBS at all? Is there a nasal spray that can be given in Australia? I have no idea, but I'm fed up with not feeling good, and not having any hope for the future. It's as though the last couple of months I've really gone downhill. My sexual function has literally dropped off a cliff, there is just no feeling at all. I know it's depression due to stress (and perhaps a nerve/hormone problem).

If I go back on the mirtazapine I could go through those nasty "mean" spells again and I'm not having any of it. I hate that feeling, my heart starts pounding and I get super angry for seemingly no reason, and something that irritates me can result in objects flying across the room, usually balls or soft items, but occasionally a fragile object has been destroyed in a fit of rage. So going back on the mirt is...NOT...an option.

I just got a prescription for agomelatine ($50 at Chemist Warehouse) and wandering how long before it starts working and is it working? Any serious side effects? Regarding ketamine Medicare doesn't cover it so nasal spray Spravato costs around $800 per treatment and you need one every week. IV Ketamine is more than $2000 per (weekly) treatment.

 

[Flynnal]

I can't believe you can't get Spravato on the PBS. I think the PBS wants to stick to stuff that no one can sell. SSRIs are a fine example - they screw up your sex life but because there cheap, they just want you to get them instead, and not the stuff that doesn't cause PSSD.