Hi and thanks for your welcome.
I quit alcohol at the age of 42 and went back onto it at 44, but as I said, at a much reduced amount. There's simply no way I could tolerate 21 drinks every night now, and I don't know how I did it back then. My stomach would not take that amount now, for one thing, and my brain would be utterly fogged out.
I tried all the antidepressants for my depression. I tried the SSRIs fluoxetine, fluvoxamine, sertraline, paroxetine, citalopram, and escitalopram. With some SSRIs I experienced a lot of initial anxiety, irritability, and insomnia, and that caused me to quit them. I managed to stay on escitalopram but it didn't help. I tried the SNRI venlafaxine and it helped a lot at the start but then seemed to do nothing. I tried the TCAs amitriptyline, desipramine, imipramine, dothiepin, and nortriptyline. Dothiepin and amitriptyline did absolutely nothing to help, I had trouble tolerating desipramine and imipramine (for similar reasons to SSRIs), and I was allergic to nortriptyline, which was a shame as it seemed to help quite a lot to begin with, even though antidepressants are not supposed to help at all until 2-8 weeks on them. I tried the reversible MAOI moclobemide, which is available here in Australia, and the melatonergic antidepressant agomelatine, also available here, but neither helped. I found I was unable to tolerate mirtazapine and mianserin due to restless legs syndrome, so I don't know how I would have gone with them. The NDRI bupropion is only available here as Zyban, a quit-smoking application, and as such you only get a couple of boxes of it. Finally I tried the MAOI tranylcypromine (Parnate) and it did help for a while, but I became irritable and agitated on it and had to quit once, and am now in the process of getting off it a second time (a hard drug to get off due to withdrawals). I have also tried trazodone but only for sleep at a small dose of 100 mg. I tried nefazodone (Serzone) when it was still available and it helped at the start but not in the long run. I tried the new antidepressant vortioxetine but was allergic to it too. There are a couple I haven't tried but I doubt they would help any more than the ones I have tried. I have always wondered about the TCA clomipramine but it is such a powerful serotonin drug that I fear its side effects and emotional blunting. I also tried lithium but I think it dulls my emotions, although it does reduce suicidal thoughts. I tried CBT but found it totally useless, and the same for behavioural activation (BA). I think psychodynamic therapy would help me a lot but it takes so long and would cost thousands of dollars. I have also had numerous counsellors over the years and it has been good to have someone to talk to but it hasn't really helped my depression. I have to say that I am reappraising the rTMS treatment I had, as my mood does seem to have improved and I seem to have more energy and enthusiasm for things now that the treatment has finished. It took a few days to a week after treatment to notice these benefits. I have never tried ECT. Good luck in finding something that can ease your depression - I still have to try ketamine, esketamine nasal spray, and psilocybin therapy and I think these sound a lot more promising that all of the useless antidepressants the pharmaceutical industry has stuck us with over the past 30 years. These have recently been introduced to Australia.
Do you mind me asking what level your drinking is at? Even if it is "only" 10-12 units a day you could require benzodiazepine-assisted detoxification. I found benzo detox to be easy and pleasant, and a welcome relief of withdrawals. I have developed my own diazepam detox method, although I don't need it anymore. I found that, for me, 5 mg of diazepam was equivalent to 1 standard drink/unit on the first day during detox, although doctors would probably say that you should use less. Using 5 mg per standard drink on the first day resulted in a detox that was comfortable while not being over-sedated. On Days 2-5 I halved the diazepam dose each day until I was down to zero. As an example, if detoxing from 12 standard drinks per day I would take 60 mg diazepam on Day 1, 30 mg on Day 2, 15 mg on Day 3, 7.5 mg on Day 4, and 2.5-5 mg on Day 5, with zero on Day 6. I found that only the 5 mg tablets were any good for the first phase of detox, as you simply need far too many 2 mg tablets. In fact I have found the 2 mg tablets to be useless for anxiety too, unless I take 3-5 tablets at a time.
