plumbus-nine
Bluelighter
- Joined
- Apr 4, 2021
- Messages
- 3,653
I am currently on fluoxetine 40mg/d (60 agitate me too much), have been taking it for the last few months after switching from venlafaxine 150mg because that one exacerbated tachycardia. Transition was pretty flawless but I start to be sad and having recurrent thoughts daily again. I was using dissociatives against that but I begin to see that these aren't the solution, too much memory inhibition and mania. Also here where I live atm is medical ketamine probably not available.
Now yesterday I took 75mg venlafaxine on top of the fluoxetine and think I feel better. Slept just a few hours but appear to be fully rested. This was the case in past when either an AD started working or a sign for hypomania, its hard to differentiate but guess I'd be happier with a latency period as hypomania will crash at some point.
Now, 40mg fluoxetine should occupy most (afaik >90% if not 95) of the SERT and combining two SSRIs not do much other than increased side effects and secondary effects. I theorized before that I might have built up tolerance but people say things are different and SERT doesn't upregulate (more of it - sry always confuse) with antagonism.
Then again it's said you shouldn't combine multiple serotonergic agents because of serotonin syndrome risk but in past a doc recommended me exactly that, paroxetine on top of venlafaxine which gave me too much headache to continue.
How common is it to combine two antidepressants? Just know that venlafaxine + mirtazapine is used as 'California rocket fuel' and bupropion is used as an augmentation agent. For me mirtazapine was a hunger inducing failure, after a few nights complete tolerance to the sedative effects, hunger attacks and no benefits up to 90(!) mg. Fluoxetine is certainly stronger at 5ht2c but also I don't get the beneficial effects from a stim from fluoxetine. Unfortunately it's hard to get Vyvanse around here, that was my first thought as am augmentation agent because I have inattentive ADD and amphs tend to help me.
Antipsychotics were tried and failed, all of them feel dysphoric and cognitively limiting (makes some sense in regards to ADD).
Maybe even a tricyclic like amitriptyline plus fluoxetine?
Moclobemid failed too, was on 600mg/d and just felt dumb. MAOIs have potential, experienced this on 4,4'-dimethylaminorex, just here the irreversible ones aren't approved, even selegiline isn't (and 4,4'-DMAR is a triple releaser too).
I will ask a doctor too, just my experiences are that they too can only experiment and the better ones admit that even, and some are open for input if it isn't too far off. For this I'm asking you guys first.
Responses are greatly appreciated!
Now yesterday I took 75mg venlafaxine on top of the fluoxetine and think I feel better. Slept just a few hours but appear to be fully rested. This was the case in past when either an AD started working or a sign for hypomania, its hard to differentiate but guess I'd be happier with a latency period as hypomania will crash at some point.
Now, 40mg fluoxetine should occupy most (afaik >90% if not 95) of the SERT and combining two SSRIs not do much other than increased side effects and secondary effects. I theorized before that I might have built up tolerance but people say things are different and SERT doesn't upregulate (more of it - sry always confuse) with antagonism.
Then again it's said you shouldn't combine multiple serotonergic agents because of serotonin syndrome risk but in past a doc recommended me exactly that, paroxetine on top of venlafaxine which gave me too much headache to continue.
How common is it to combine two antidepressants? Just know that venlafaxine + mirtazapine is used as 'California rocket fuel' and bupropion is used as an augmentation agent. For me mirtazapine was a hunger inducing failure, after a few nights complete tolerance to the sedative effects, hunger attacks and no benefits up to 90(!) mg. Fluoxetine is certainly stronger at 5ht2c but also I don't get the beneficial effects from a stim from fluoxetine. Unfortunately it's hard to get Vyvanse around here, that was my first thought as am augmentation agent because I have inattentive ADD and amphs tend to help me.
Antipsychotics were tried and failed, all of them feel dysphoric and cognitively limiting (makes some sense in regards to ADD).
Maybe even a tricyclic like amitriptyline plus fluoxetine?
Moclobemid failed too, was on 600mg/d and just felt dumb. MAOIs have potential, experienced this on 4,4'-dimethylaminorex, just here the irreversible ones aren't approved, even selegiline isn't (and 4,4'-DMAR is a triple releaser too).
I will ask a doctor too, just my experiences are that they too can only experiment and the better ones admit that even, and some are open for input if it isn't too far off. For this I'm asking you guys first.
Responses are greatly appreciated!