Anti-depressants

DeathDomokun

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What do you guys know about anti-depressants? I'm booked to see a psychiatrist in 2 months, and I'm hoping to get some anti-depressants to start off with.
I'm interested in Tianeptine the most. Followed by Reboxetine, Mirtazapine. I think I'd settle for Bupropion if I don't get prescribed have any of the previous ones.
I was just wondering if anyone had any info (anecdotal is fine) about these. I know they're a personal thing, and my brain may very well differ from yours tremendously, these are the ones I'm most willing to take, so extra info would be good.
 
Ive taken 2 different types, they both cause withdrawals when you stop them.

escitalopram and lexapro

Neither did shit for me, except reduce my sex drive, add another addiction, and possibly other bad things.

But they might work for you, as you said, everyones brain chemistry is different.
 
Which anti-d will work for you depends very much on what form your depression takes. For example, if it's the kind where you're demotivated and lethargic, in a can't be arsed doing anything kinda way something like Prozac can be useful as one of its effects is generally an increase in energy levels. If you're prone to anxiety though Prozac would be the last thing you'd want to take because you don't want additional stimulation ramping that up, and perhaps in that case something like Mirtazapine might be of more use. Almost impossible to advise without more detail as they're all very much horses for courses IME.
 
It's the kind of volatile depression that causes apathy, hopelessness, and yes a lack of motivation and desire with some lethargy. I don't get any anxiety, I have before but that was over a year ago. I honestly couldn't give any less fucks about my energy or motivation though, it's my feelings I care about. I've heard Mirtazapine can cause drowsiness, so it'd be great to be able to sleep in bed all day again. Robxetine and Bupropion inhibit norepenephrine reuptake so they're more likely to increase energy levels, although Mirtazapine also affect norepinephrine transporters. Tianeptine is an SSRE, although it does enhance the release of some Dopamine, although Tianeptine itself has no effect on dopamine transporters. I'm going to take whichever one my psychiatrist prescribes, I guess, so this was pretty futile, but hey, what isn't.
 
The thing with antidepressants is they are very subjective - as you said, it is a personal thing and what works for one person often doesn't work for someone else. I'm currently on venlafaxine, which works really well for me and gives me no side effects apart from in the first few weeks, but has given some people nasty side effects that don't ease up or hasn't worked at all. We can give you our experiences here but ultimately it is between you and your psychiatrist to find the best one for you, and don't be disheartened if the first one you try doesn't work. It did for me though so equally don't worry too much that you will need to try a range to find one that fits. Everyone is different :)

Some antidepressants are more stimulating (SSRIs and SNRIs for example) where as others are sedating (mirtazepine, the tricyclics like amitriptyline and lofepramine). They have differing side effects too - SSRIs can make you feel a bit jittery at first and some can exacerbate anxiety, although others (such as citalopram/escitalopram and sertraline) can actually help with anxiety. SSRIs can also cause sexual dysfunction which can be a big issue for some people. Mirtazepine is sedating and can increase appetite too. The trycyclics have anticholinergic side effects - dry mouth, dizziness and difficulty urinating - but these tend to ease up after a while. Venlafaxine (a SNRI) gave me nausea, insomnia and jitteriness for the first 2-3 weeks but I don't get any side effects now.

I don't know much about bupropion as it isn't really used as an antidepressant in the UK and I hadn't heard of tianeptine! Reboxetine doesn't have a lot of evidence for it's efficacy and appears to not be especially effective looking at some studies, but there may be newer research I am unaware of.

Sorry I don't have any personal experience in the ones you are interested in - I do have a few friends on mirtazepine who have found that it works really well for their depression, and helps them sleep too, but they have noticed an increase in appetite.
 
I've heard Mirtazapine can cause drowsiness, so it'd be great to be able to sleep in bed all day again. Robxetine and Bupropion inhibit norepenephrine reuptake so they're more likely to increase energy levels, although Mirtazapine also affect norepinephrine transporters.

Mirtazapine for me only caused drowsiness at first, maybe a week if that. Given that I'm taking it at night to help me sleep that's not so good! There's no hangover at all into the next morning, what little sedation there is being very short acting: half an hour window tops in which to get to sleep otherwise the effect's gone. Can't comment on drowsiness being an issue if taken in the morning but I would expect the effect to disappear just as quickly. Not noticed a huge increase in energy levels, despite it being as you say noradrenergic as well as serotonergic, any increase in noradrenaline I'd guess tending to just balance out the sedating effects. Not noticed a huge increase in appetite either but my appetite is generally good anyways. The effect may be more pronounced in those whose appetite suffers because of their depression.

Been on it for around 3 or 4 months after previously being on Prozac, and though I've yet to feel a huge lift in mood, mainly because I'm not regimented enough in remembering to take it and still drinking occasionally, I'm a hell of a lot calmer than I was and it's cut a lot of the inwardly directed anger and negative self-talk that fuels my depression and drives the worst of the spiralling down to dark places so there's a marked benefit there. Other than that not a lot I can say for it, and can't comment on the other anti-ds you mentioned at all as never used them.
 
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i was put on prozac for a little while, all i know is that it made me extremely angry and it actually made my depression worse however estitalopram worked wonders for me, within about 3 days my depression was getting a lot better and it also seemed to have some anti-anxiety properties to it. although just remember that these drugs are not a long term answer! you must find the root of your depression and work with it honestly. not sure about the others that you have mentioned however.
 
I have bipolar disorder and i have been on a few anti-depressants but i don't seem to get along with any of them besides bupropion which is the one i have been on for years now. Naturally someone with unipolar depression is going to react alot differently to anti-depressants then someone with bipolar disorder who can't really touch serotonic anti-d's without triggering mania.

In the past i have taken effexor (venlafaxine) a SNRI which gave me the most horrible side effects of any psych med i have ever been on. It made me feel manic as hell and very short fused plus the sexual side effects where awful. I was on it maybe 6 weeks to 2 months (it was about 10 years ago that i was on it) and in that time i think i had maybe 2 orgasms. I could still get it up but getting off was impossible. So between that, the full blown mania it gave me and the awful withdrawals that made coming off dilaudid or morphine look easy i swore never to go back on venlafaxine.

The second anti-depressant i was prescribed was amitriptyline which is a tricyclic anti-depressant that is a serotonin and norepinephrine reuptake inhibitor i was originally prescribed to treat my neuropathic pain. It helped my nerve pain as well as my depression alot at first and it's kinda hard to tell if it messed with my bipolar or not as i was not on a mood stabilizer for the majority of the time i was on it. But it didn't trigger my mania nearly as bad as venlafaxine. It is one of the few psych meds Ive been on that caused me to gain alot of weight though. Also it stopped working on both my neuropathic pain and depression at the same time so i stopped taking it. Thankfully i got no withdrawals at all from it.

I was on remeron (mirtazapine) for awile and i can't really say if it helped my mood much. It was a very fucked up time in my life and due to a idiot shrink i was not on a mood stabilizer with it. I was prescribed 30mg's of mirtazapine and i think 2mg's of risperidone a day and naturally this combo made me abit hazy to say the least. Also mirtazapine is the worst med i have ever taken for making me hungry. It made cannabis look like cocaine and as much of a knockout med as remeron can be my hunger would over ride my need for sleep alot of the time and id end up eating half the food in the fridge before i went to sleep. Also when i am suffering from a depressive episode the last thing i need is a med that makes me sleep more. Though the sedation starts to go away as you increase the dose and the norepinephrine effects start to kick in and override the strong H1 antagonism that makes remeron such a knock out med.

For the past few years i have been on wellbutrin (bupropion) though i sometimes go off it if I'm more on the manic side for a long time then the depressive side of things. It works great for me as i get the sleep all the time, no energy, no pleasure in anything feeling like a sluggish zombie the few hours i am awake type of depression. Also since it doesn't really touch serotonin it does not make me manic at all. It's a dopamine norepinephrine reuptake inhibitor so it's kind of stimulating and can make anxiety worse for some people. Wellbutrin is by far the best anti-depressant i have ever been on with the least amount of side effects by far. It's also about the only anti-depressant that can actually increase your sex drive instead of killing it like alot of SSRI's or SNRI's do so that's another big plus :D

I don't know if these help unipolar depression but i have found lamotrigine which is what i take asa mood stabilizer to help the depression side of things alot. Some people get anti-depressant effects from it at only 25mg's a day which is way under what most people who take it for bipolar take. I also found that adding certain atypical anti-psychotics (namely seroquel) to bupropion helped my depression more then either of them by themselves. Seroquel has it's own anti-depressant effects atleast in some people but it's almost always used as a add on to treat major depression.

The most important thing to remember is that everyone reacts differently to medications. What helps me alot may do nothing for you or even make you worse so i am only giving you my experience with various anti-d's. The only way you can tell how you react to them is to try them really. If your really lucky you may even find something that works on the first try. It took me ages to find the right medications to treat my bipolar disorder so don't get discouraged if the first or second one doesn't work for you.

Good luck :)
 
I've taken both Zoloft, and Lexapro on separate occasions and I can not stress enough how much you should avoid SSRI's.

Both drugs simply blunt your mood, making it a steady medium. I felt no highs, no lows...I just was. Both decreased my sex drive tremendously, so much so I believe it has affected me tremendously even in the year I've quit taking them (I have absolutely no libido, no sexual drive at all since taking SSRI's)

Do not try these drugs. I can't stress this enough. Seriously.
 
Bupropion is a way better alternative to SSRI's. Listen to J. Wallace. Zoloft definitely blunted my mood - "I just was" is a good way to put it.

I had a sex drive on Zoloft but it'd take me an unreasonable number of hours to achieve orgasm.
 
Thanks for the input guys, I appreciate it. I don't plan on taking SSRI's unless I've exhausted everything else. I don't know how I'd react to feeling empty. Feeling empty seems pretty good to me, but if it's emptiness from which no other emotions can sprout from, then count me out.
I'm a bit iffy about Reboxetine, an SNRI, although I'd be willing to try it if that's what I'm prescribed.
I have a strong history of bipolar on my fathers side. 2 of my uncles have had severe manic episodes that ended not so pleasantly, and my grandmother became delusional after she gave birth to my uncle, and unfortunately had to endure ECT..
I know that I don't have the typical melancholic unipolar depression, but I don't think I'm bi-polar either.
I'll report back to this thread once I've had an appointment/been prescribed an anti-depressant, and then again to share my experience with it.
Also, just on a side note, do you think it's strange requesting certain anti-depressants? I'm going to irrespective, so I guess it doesn't matter, I just hope this guy is better than the last psychiatrist I saw..
 
ive tried tons of antidepressants from ssris to tricyclics to moais in a bid to help my depression but none of them did anything at all except stop me getting a boner and some other weird stuff. i dont know if they really work for other people or if its just a giant multi billion dollar pharmaceutical company scam.
 
Glad to hear you decided to try other options first. No study, nothing, has every concluded that SSRI's help in the long run. In fact, they are quite bad for you. Tons of side effects, plus the effect it has in the long run on you're serotonin receptors is not something I'm very fond of.

It's very much a feeling of emptiness. Sure, you don't feel depressed and like shit...but you don't feel happy and estastic either. As someone who goes through high and lows similar to Bi-Polar, I came to the conclusion a long time ago I'd rather feel like shit followed by manic happiness rather than feel nothing at any given time.
 
True J Wallace but some people feel like shit all the time, with very little manic highs. Iv gone through a good number of drugs, but i think MDMA just put me over the edge with negative thoughts and depression. This is the first SSRI iv tried which is zoloft, and i don't know if its fully kicked in yet (3 weeks?) but i feel better than before. I use to smoke weed 4-5 times a day, because of how shitty i felt but now i rarely smoke (maybe 2 hits in a day). That has to say something right there, my mood is over all is just stable. No real highs, or lows but i would rather have this than a lot of lows if you get me. Things still get me happy , don't get me wrong but yea anyways i know this isn't a long term solution i am just seeing where it takes me atm.

So yea in the end, it depends how bad your depression is. If it has stuck around for many years, and SSRI might help you get back on track with positive thoughts and such. It is in no way a happy glow though, your not gonna be smiling all the time or anything. Give it a shot i guess, if you really thing the depression is getting a hold of you. And btw i went in to try to get benzos, but they wouldn't prescribe them and they said the SSRI will help for anxiety. W.e we'll see how it goes
 
I've dealt with depression my whole life. I honestly think I have some form of Bi-Polar and ADHD fused with constant anxiety. I'm always anxious, even when I'm relaxing. It's weird, and frustrating because it prevents me from enjoying a lot of things. I tried SSRI's for 2 years, and while they helped the first few months, inevitably you're body will develop a tolerance and you'll have to raise the dosage by doctor's orders.

In my experience, SSRI's are a temporary solution, and one that to me does not outweigh the negatives with the positives. It's affected me in ways I wish never had, for example I have no sex drive since taking them. I know, this may be mental...but before I took them I had a sex drive, I'd fuck my girlfriend 3 maybe 4 times a day. Now, I can't even get fully hard, nor can I get an erection as easily as before. I have no desire for sex. I do, but it's because of the emotional aspects that come with it, the physical aspect isn't there for me because I don't "feel" anything in my body that drives me to it. I'm only 20 years old, I should have at the very least a decent sex drive considering my age. But nope, not since SSRI's.

And I know, this may be all in my head, but it's a big coincidence and one I can't turn my head to. I'm truly saddened to think of all the people out there put on SSRI's that use it to help them, and expect to use it the rest of their lives. We can't rely on a medication to fix us, that only masks the issue. Just like we can't use drugs to make us feel better. A solution must be found within to find true and pure happiness.

If somebody needs a temporary fix for depression, I'd imagine Benzo's to be a more effective route. Their used more often for Anxiety, but it certainly helps depression. Of course, they can be abused much much more than an SSRI can, so it's a more risky route if you have an addictive personality, but the long term effects won't be so terrible. I'm not a doctor though, so do not take my advice as professional by any means, it's just my personal view on it because I'd rather use a Benzo temporarily than an SSRI.
 
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