Best SSRI, SNRI, DRI, NRI for PAWS? I'm going on one..

[Bojangles69]

Ok so I'm addressing this a bit more logically this time.
All I can say, is last time I got off opiates I went straight on lexapro, and do NOT remember even the littlest bit of paws at all. Lex was extremely easy for me to get off of, but I'm thinking about trying effexor or wellbutrin. Well I WILL be going on one of them soon I've made up my mind.

Today was fine, I didn't panic on campus. I was able to keep my anxiety down. But walking around I noticed how heavy I felt, how slow I was walking, how cloudy my mind was, and how I'm still having hot flashes, goosebumps, and insomnia most days/nights. Its just tons of little sensations I get 24/7 through my body, and I feel like its about as bad as paws can get right now.

I think because I used sub for the end of the taper I created a weird sort of delayed PAWs process. What I mean is the first week off sub I actually felt great (which I posted on here of course). And I think my body was more or less confused about what to do with itself. Its now after 2+ weeks that I notice the paws has actually intensified, and I believe this could be the peak, but I can't be too sure that its gonna end soon. I have too much stuff to get done these next few months, and I just need some energy and motivation, and a bit of a better mindset.

I have the pick of whatever med I need (don't ask) but I wanna go with 1 of the 2 I mentioned.

My main worry is side effects.

Does wellbutrin/effexor make you apathetic?
Does either give you insomnia (if wellbutrin is giving people energy I would assume it also causes insomnia somewhat)
Does wellbutrin make you shakey? Effexor? Do you ever feel stimulated on it?
I don't give a shit about the sexual sides.. last thing on my mind is sex right now lol.
I just need energy/motivation, w/out taking something that will stimulate me. Caffiene sometimes triggers panic attacks, and anything thats mildy stimulating can aggravate it.

So for anyone whos tried one of these meds, which would you recommend? I'm putting in the order tommorow I've said fuck it at this point. I AM going to relapse eventually if I have to deal with 3-6 more months of this shit. I've done much harder things in my life but theres simply no reason to be dealing with this shit especially after my last experience with lex. Lexapro helped a TON last and I'm even considering that again (cause it helped with sleep too plus gave me a nice boost of happiness and energy). But I'm more interested in something different, that might be more suitable to paws.

Thank you so much.

 

[Ixchellian]

I went with welbutrin & lyrica. I'm familiar enough with them to differentiate the effects while taken simultaneously.

The welbutrin only made my jittery and mildly energetic when i first started taking them orally. if I did a rail or two, I'd get pretty tweaked. But by itself (as prescribed), it's done a really good job of curtailing the stupid "paws".... along with forcing me to quit smoking.
It doesn't negatively impact sexual function in any way, and made me a little randy besides.

I've tried effexor in the past and it didn't do shit for my mood, just made me a little sleepy sometimes..... and made it hard to get it up.

But what helped more than anything.... with the acute withdrawals, "paws", and chronic pain.... has been the pregabalin.
As for sexual function; it's hard to reach orgasm on lyrica, and with the welbutrin i really doubt i'd be leaving some poor girl all frustrated cause i got done too quickly..

I do get really energetic on the combination, but nothing like drinking too much coffee or doing too much coke. So if I need to sleep, I use either promethazine (anti-nausea) or trazodone to knock me out. with both of those, it normally only takes 1/2 a pill.

I've also been taking a lot of vitamins, melatonin, 5-HTP, and L-Tyrosine to help things along. These have made me feel noticably better, just on a really subtle level, and everything in conjunction has worked excellently to alleviate acute & post-acute w/d.

I've been taking lyrica for almost 6 months now, and I decided to see how bad the withrawals would be since there's some rumblings about terrible w/ds from lyrica. I stopped taking it suddenly for the past three days (2mo clean no opiates), and felt just a little moody. my pain came back full force, but that's not a result of pregabalin w/d's.

I think it's a pretty safe bet to use welbutrin and pregabalin to zap the dreaded "paws". But just taken on it's own.... i think welbutrin can help a bit more and with fewer side effects & interactions than SSRI's or MAOI's.

 

[Jabberwocky]

You are probably not likely to make the mistake I did w/ welbutrin but thought I'd throw it out there. I accidentally took a double dose by forgetting I already took one. For me at least misery is 1 extra dose. Therapeutic and toxic are closer together w/ welbutrin than a lot of other agents imo.

Welbutrin has a reputation for not causing ppl prone to mania to go manic as can happen w/ a lot of other ADs.

Google brain zaps or brain shivers along with effexor. A lot of people have prolonged strange symptoms when withdrawing from effexor. I've known a few people who got disturbing jolts or shocks for almost a year after discontinuing effexor. It does happen some w/ other ADs but effexor is kind of notorious.

A) My experience was welbutrin did not produce apathy
B) slightly more insomnia w/ welbutrin but not intolerable
C)welbtrin did not make me shakey except I did tolerate coffee less well. Just did less coffee & was OK

 

[Ixchellian]

For me at least misery is 1 extra dose. Therapeutic and toxic are closer together w/ welbutrin than a lot of other agents imo.

Welbutrin has a reputation for not causing ppl prone to mania to go manic as can happen w/ a lot of other ADs.

I've taken double my daily dose in a single go. That's 600mg (not including the amount I insufflated). I didn't have anything close to seizures or hallucinations; the biggest problem was queasiness, and an overriding compulsion to keep my hands busy.
But when I first started welbutrin, I was a lot more sensitive to it's effect on my stomach and nervousness. that wore off within a week.

I've only heard of buproprion causing overtly manic states in those already being bi-polar or ADHD.

 

[Sweet P]

Effexor (venlafaxine) is supposed to be good for treating PAWS in opiate addicts.

Here's what Wikipedia has to say:

Venlafaxine acts as an agonist at the mu-opioid receptor. It is surprisingly effective in treating depression in heroin and other opioid addicts compared to all other conventional antidepressants.

However, it can cause anxiety in some people - especially in the first few weeks of treatment. I began taking Effexor several weeks ago to treat my depression, but I had to stop after only the first week, as I was finding the anxiety totally unbearable. But of course, different people will respond to it differently. I've also been on Wellbutrin (bupropion) in the past. It's difficult to say whether or not Wellbutrin and Effexor caused any apathy or insomnia, because I'd already been suffering from those for years! Didn't really notice any shakiness or feelings of stimulation.

 

[Bojangles69]

I'm reading that effexor is actually a mu opiates agonist? (eh fuck sweet p beat me to it lol)

It says it right at the top of its wilk page:
"Venlafaxine acts as an agonist at the mu-opioid receptor. [2] [3]It is surprisingly effective in treating depression in heroin and other opioid addicts compared to all other conventional antidepressants"

I'm surprised you didn't have better results on it Ixch and it makes me curious at what the hell effexor actually is. If it really agonizes mu-opiate receptors it almost sounds in a way like an opiate... and the thought of getting off a med like that doesn't sit well with me. But its still largely appealing that they tend to prescribe it to opiate addicts.

And I'm curious about the smoking aspect with wellbutrin. If I smoke cigs on it does it make you sick or something? I don't really care if it does... I mean I'd prefer if it does, losing cigs was always another goal of mine so it helps that would be pretty sweet imo.

Thanks guys!!


and sweet p I am DEFINITELY the type of person to have nervous reactions to meds. I'm worried that effexor might be like zoloft in terms of anxiety the first few weeks. All I know is I was on it a matter of days and had a surge of panic attacks, then wound up flushing them all. Thats basically what I'm' trying to avoid, so maybe wellbutrin may be the better pick here I'm thinking.

 

[villian]

The only AD I have personal experience with is Celexa, and I had a good reaction to it.

I've also heard the Effexor is about the hardest AD to get off next to Paxil..I know a couple people on a benzo board I'm on having a terrible time getting off Effexor.

I have quite a few IRL friends who have had good reactions to Wellbutrin.

 

[Sweet P]

If it really agonizes mu-opiate receptors it almost sounds in a way like an opiate... and the thought of getting off a med like that doesn't sit well with me. But its still largely appealing that they tend to prescribe it to opiate addicts.

And I'm curious about the smoking aspect with wellbutrin. If I smoke cigs on it does it make you sick or something? I don't really care if it does... I mean I'd prefer if it does, losing cigs was always another goal of mine so it helps that would be pretty sweet imo.

Thanks guys!!

Effexor isn't an opiate (it's an SNRI), but it does have a similar chemical structure to Tramadol. When I started taking Wellbutrin (150mg's a day), cigarettes began to taste disgusting. It didn't make me sick when I smoked, but it definitely make smoking less enjoyable. However, I continued smoking (I wasn't ready to quit the ciggies yet!) and eventually the taste returned to normal.

 

[Ixchellian]

I dunno why the effexor didn't do anything for me..... never improved my mood or withdrawal symptoms even after taking it for a while.

I've read that any anti-depressant that affects serotonin reuptake or production is a bitch to come off of. I've never heard of any issues with coming off welbutrin long-term.

When I started taking Wellbutrin cigarettes began to taste disgusting. It didn't make me sick when I smoked, but it definitely make smoking less enjoyable.

Exactly.

I also stopped having cravings/nic-fits within 3-5 days of taking it regularly.

 

[bben]

tramadol is the best, it does have very slight opiod effects though. Its not quite accepted in the psych community though so you cant get it scripted. However if one were to have lower back pain its easily available at a doctors office.

Its and ssri, snri, atypical opiod, nmda antagonist, 5htp 3c antagonist. Hands down the best antidepressant especially for opiate usrs.

 

[fermi]

tianeptine may be worth trying, just don't IV it.

 

[Sweet P]

tramadol is the best, it does have very slight opiod effects though. Its not quite accepted in the psych community though so you cant get it scripted. However if one were to have lower back pain its easily available at a doctors office.

Its and ssri, snri, atypical opiod, nmda antagonist, 5htp 3c antagonist. Hands down the best antidepressant especially for opiate usrs.

Tramadol is prescribed mostly to treat pain. It could help with depression in some cases, but it isn't endorsed as an anti-depressant, and I doubt any doctor would prescribe it for depression. It is also addictive, and can lead to physical dependency. Withdrawals from tramadol are very opiate-like.

 

[Mariposa]

tianeptine may be worth trying, just don't IV it.

Not available in North America. Believe me, I have checked.

I haven't taken Effexor.

Wellbutrin (which I start again at 150 mg SR tomorrow) did a lot for my mood. No real shakiness, no mania (peppiness, not outright mania), just watch your alcohol intake (if any) and the grapefruit juice interaction is not a joke.

Absolutely no flatness or apathy.

If you smoke cigarettes, you will want to less or not at all.

Totally not abusable; don't even try.

 

[Bojangles69]

Ok great guys it seems like wellbutrin is definitely getting the most recommendations hands down.
I was mostly worried about that shakiness/stimulated feeling just from my experience with zoloft. What a terrible fucking med that was how anxious I got.

I was just reading (after seeing the responses here) that wellbutrin gives cigs a metallic type of taste, and thats pretty freakn cool imo. I'm glad it does just that and doesn't make you sick, cause thats definitely enough to help me get off the cigs. I notice I'm also a lot calmer when I don't smoke, but I've been going strong now with the habit for 4 years so we'll see how it goes.

I'm about 90% sure at this point that wellbutrin will be it. I'm gonna do a bit more research tonight and put the order in for it tommorow. It'll make me feel a lot better just knowing SOMETHING is coming that might alleviate some paws. And I think paxil is suppose to be the worst ssri to get off of, it was truely a nightmare when I did it. But every ssri I've taken after that was relatively easy to get off of. I mean it sucks for 4 weeks but its relatively minor and goes away pretty fast.. nothing at all like this shitty paws.

And another reason besides paws that I want to do this is I was officially accepted to run a suicide hotline for my internship. I'm in no mental spot to really be motivating people not to kill themself lol (somedays I'm in the same boat as them with these paws), so it worries me that my ability to help them will be compromised. And I think if I'm in the right headspace this intership can actually do a lot of good for my own life. So I'm crossing my fingers and hoping everything works out here. Thanks everyone!

 

[Ixchellian]

tramadol is the best, it does have very slight opiod effects though. Its not quite accepted in the psych community though so you cant xget it scripted. However if one were to have lower back pain its easily available at a doctors office.

Its and ssri, snri, atypical opiod, nmda antagonist, 5htp 3c antagonist. Hands down the best antidepressant especially for opiate usrs.

ultram has very strong opiate effects when taken to excess, and a horrible withdrawal even when taken as prescribed for an extended period.
of course tramadol is an anti-depressant for people quitting opiates.... because for all intents and purposes it *is* an opiate. if you're dope-sick and you take any opiate, of course it's gonna make you happier. and one that note, any opiate could be considered an antidepressant, because they make yeh feel good, period.

I don't know any psychologist would prescribe tramadol for depression, because it does lead to physical and psychological dependence.

tramadol isnt related to the antidepressants being compared here or indicated for the same problems.

 

[Ixchellian]

not smoking helps with detox & depression in the long run too.

welbutrin inhibits nicotine somehow or blocks the nicotine receptors, IIRC. why it causes there to be a metallic taste with smokng, I dunno. that ones weird.

 

[Jabberwocky]

I've taken double my daily dose in a single go. That's 600mg (not including the amount I insufflated). I didn't have anything close to seizures or hallucinations; the biggest problem was queasiness, and an overriding compulsion to keep my hands busy.
But when I first started welbutrin, I was a lot more sensitive to it's effect on my stomach and nervousness. that wore off within a week.

For me it was a narrowed field of vision like some get with migraines, nausea, and a feeling of impending doom, which was way different than effects from ordinary dose which was general well being. Welbutrin does increase libido for me quite a bit, which sucks because when I invite people to come over and play naked , crisco, twister everyone always makes excuses to not attend

 

[HamClamp]

Hang in there Bo. It sure as hell ain't easy. Looking back the taper and jump was the easy part- it's the staying clean and slogging through the depression, anxiety, and lethargy that is the ass kicker for sure.

I've been having amazingly good results with the supplements. Frankly I'm kind of blown away at how good this stuff is working.

I've been taking L-tyrosine w/B6 in the morning, 5htp in the afternoon, and a combo capsule designed for anxiety (not sure if I can post brand names) that contains a handful of goodies including kava, mulungu, red sage, honokiol, and magnalol (sp?). It's not effective for treating an anxiety attack but it sure as hell prevents them. Two caps morning and evening and I can't induce anxiety if I try. And yeah- I'm weird like that: I tried.

No doubt the expense adds up but I don't have health insurance right now and I'm not only unable to source pharms but they scare the hell out of me. In my limited experience head pharms make me more anxious, suicidal, and/or angry. These herbs and supplements have been a freakin' miracle for me.

Hope school went well for you today, man, and I hope you're hanging tough.

Hang in there Bo.

Peace.

 

[molly897]

I've taken 300mg of wellbutrin (bupropian) for a week with no effects whatsoever. i lost my sex drive on lexapro, experienced hand zaps from pristiq, and will not be trying anymore anti depressants

I prolly should have kept taking the wellbutrin as it has little side effects but eh. Live and learn I guess. my friend is on Effexor, he says he feels like a slug if he goes a day without it. and he gained like 35 lbs

 

[sid3]

So are you going to consider giving the Lex another shot seeing that it worked so well for you in the past. Wellbutrin made me manic after a week and I ended up calling my Dr in panic mode, beyond hopelessly depressed. I could tell he didn't appreciate my calling on a memorial day weekend. Needless to say I fired his ass yet he still sent me a reminder that my 'conditon' required further treatment, what a chode! Hopefully you get a good Dr, that is willing to listen. They're out there. I wonder if bio feed back is available at your campus's pysch dept. If not maybe there's a univeristy close by that has it. Good luck with geting a med that works from the start, you're positive outlook and willingness to short shyt out is really going to work to your advantage IMO