Mental Health About to start taking antidepressants - have had side effect problems in past

[bluesteyes]

In late July I am going to be seeing a new psychiatrist who is known for his work with chronic pain patients. He's also generally considered to be the best overall psychiatrist in our area. I currently suffer from fibromyalgia and interstitial cystitis. I also have a minor bulging disc in my neck and retrolithesis in the C4/C5 area of my neck. As I have been documenting in the Other Drugs forum, I am currently tapering off of Percocets and OxyContin.

I also suffer from acute generalized anxiety disorder as well as depression (which has worsened since I developed chronic pain 3 years ago).

One of the treatments that I know the psychiatrist is going to want to put me on is an antidepressant. The problem is that I have tried a variety of antidepressants in the past ranging from Effexor to Paxil to Lexapro to Viibyrd, and all of them make me feel as though I am on 10 doses of Sudafed. I feel absolutely wired as if I am on speed. I will never forget taking Viibyrd a few years ago and not being able to sleep for 48 hours. I took the lowest dosage possible. I recently took 5mg of Lexapro, and I was still so wired after 3 hours that I had to take a couple of Benadryl to calm down. I get tightness in the chest area, and just feel incredibly anxious.

As a side note, these medications also have a habit of stripping saliva from my mouth. I'm not talking about dry mouth symptoms. I am talking about zero saliva.....that kind of dry mouth conditions that can lead to dental problems.

None of the members of my medical team believe I am bi polar manic depressant. I don't believe I am either. I know it is common for bi polar manic depressants to go into mania with they take SSRI's and other antidepressants. There is also the whole thing with serotonin syndrome, but I don't know if I have it.

Has anybody else on this board experienced similar side effects when using antidepressants in the past? I know that experiencing anxiety and insomnia are common side effects, but I feel my side effect reaction to these medications is kind of extreme. I mean, Lexapro is an antidepressant with a low side effect profile that isn't known for being very stimulating.

I am going to ask the psychiatrist about the possibility of taking Lyrica along with the antidepressant he is likely to choose for me. I need to be on some kind of pain med that is non-opiate based. It is my feeling that the sedating qualities of Lyrica might slow down the stimulating effects of the antidepressant, and that the stimulating effect of the antidepressant might slow down the sedating effects of Lyrica. In other words, the two meds would cancel each other out to some degree.

I should note that I take Lorazepam right now: 1mg, 3x per day. It doesn't really help me unless I take a 2mg dose. I have been taking it a long time.

I would appreciate any input and advice. Thanks.

 

[Rybee]

Hey Buddy - really sorry to hear about your problems, chronic pain is as, if not - more, mentally challenging as it is physically challenging. I too suffer from chronic sciatica so I really feel for you.

I used to suffer from bad GAD and MDD and experienced similar side-effects on the SSRI front. Celexa (Citalopram) / Effexor (Venlafaxine) / Prozac (Fluoxetine) / Cymbalta (Duloxetine) etc... all made me feel doped out with cotton mouth (had to chew so much gum to stimulate my saliva glands), loss of libido, retarded ejaculation. I was generally on the maximum prescribed dose of each though - and it the side-effects were directly proportional to the dosage in my experience.

Tricyclic antidepressants tended to give me less side effects overall, but made me hella drowsy. Though they tended to be pretty useful for the neuropathic pain, particuarly Nortriptyline. I found it to be a more refined version of Amitriptlyine, as its' somewhat more specific in it's serotonergic inhibition.

Pregabalin was really good for my anxiety but only as a result of making me absolutely spaced out. It really affected my short term memory, which is massively reported. I was doing my bachelors degree (Law) at the time and I had real issues recalling information. I also suffered massive withdrawals from it if I was to forget my dose. It has a pretty short half life so I had to dose twice daily. If I forgot my morning dose, by lunchtime I'd lose touch with reality and feel like I had the flu. Like yourself I had pretty bad sciatica so the Pregabalin worked a dime for that too.

A bit of a wild card but in light of the issues with SSRIs/SNRIs/SRIs, my psych tried me on a novel melatonergic antidepressant' called Valdoxan (Agomelatine) as it had a completely different mechanism. Though only annoying side affect was pretty sever night-sweats and horrific nightmares. Otherwise it was spot on. It's pretty new so fairly expensive, but have a read up on it, as an alternative. Had no effect for the pain, though.

Best of luck, please keep us updated

 

[bluesteyes]

It's too bad that Valdoxan has been found to be no better than a placebo when it comes to handling GAD. I really hope for the day when big pharma comes up with an antidepressant that helps depression and GAD without major side effects. There is always going to be side effects.....but it would be nice if they could severely reduce them.

 

[Rybee]

Worked really well for me, though more on the depression from than anxiety, admittedly. Though my GAD scores still decreased notably.

 

[bluesteyes]

There are a lot of recent studies which say that Lyrica is really good for slow wave sleep and building sleep architecture. It helps with night time awakenings.

 

[almostoptimistic]

A relatively new AD is brintellix/trintellix. People either love or hate it, but it seems to often work for people who have had no success withSSRIs/SNRIs. There is little downside to trying buspar, although it does not work consistently it has an extremely good side effect profile.

 

[cr33py]

Has your doc tried you on any TCAs or anticonvulsants? hypomania on antidepressants is not always indicative of bipolar but if there are other bipolar symptoms your doc might bring it up. Usually if you went to a doc asking about meds for pain + anxiety the first things youd hear about were gabapentin and carbamazepine.

 

[Mmp85]

Some of the antideppressants you've been taking are definitely ones known for feeling like speed, especially effexor.
I get dry mouth from my meds and I started using special toothpaste, mouthwash, and mouth spray and it's helped a lot.
I still take old fashioned prozac but I'm bipolar and its mixed with mood stabilizers. So I can't really say how it works on its own but I do take it at night because it makes me sleepy.