Hi there zzz101, there are many, many ssri/snri's on the market right now; they are the decades "wonder drug", after all, and are being pushed heavily by the pharm companies. I've no idea the difference between SSRI and SNRI drugs, but I've been on SSRI's for six years now, and they're excellent for depression, and I mean great.
I was originaly taking Citralopram, but they made me restless and it was hard to sleep on them. I now take mirtazipine, they are a relatively poweful sedative, and also an appetite enhancer. (I've gained weight!)
None of these drugs (ssri's at least) kick in instantly; it can take quite a long time for the brain to regulate it's serotonin to normal levels, even with ssri assistance)For me, it took around 6 weeks, but the effects can last months, even if you stop taking the drug, so it's not vital you take it every day.
My first SNRI was Effexor, It took effect pretty quick but my system had to get used to it. The first few days i felt like I took a very low dose MDMA I even had dilated pupils, which was awkward as people around me started to notice and thought I was also more customer friendly than usual =)
After a few weeks it evened out and worked great especially at dosage above 150mg (aditional norepenephrine action i believe)
BUT... Forget a daily dose and expect to pay the price, instant withdrawal syndrome resulting in freaky brain-zaps, some head aches and an overall hung over miserable feeling.
I have ADD and during this time I was also taking Concerta (Methylphenidate) during this period of about 8 years.
If I took my meds and made sure to have my precription renewed in time, (weekends without Effexor are hell and I also remember raising hell at the pharmacy when my script wasn't ready too)
I was on top of the world. Things were going better and better.
Only...eventually after a year or so, my girlfriend started complaining I was losing interest in her.. Although this had multiple reasons... decreased libido was part of it.
I figured what the hell everything is going super smooth, it's time to quit and get on with business, so I did. A week taper halving my dose and then a few days prozac. I was my usual self and behaving like the old dog again, gf didn't complain neither did anyone else.
Things seemed fine. In hind sight they were not.
Depression and social anxiety slowly crept back in and I became less confident, this combined with a fresh coke habit which made me a bit paranoid, I fucked up at a lot of things while still riding the wave to sucess that had already lost momentum.
Anyway...almost back on topic guys...
I figured I made a bad desicion so started Citalopram an SSRI my doc said would probably keep my libido intact..It did but didn't do anything else either, thinking it might take some time again I stayed on it for quite a while, but eventually I was still not the vibrant and more confident me and was dissatisfied with the results I got from Citalopram.(except the nice vivid dreams)
As I was no longer with my girlfriend I decided to give Effexor another go as I was desperate to get out of this hole I had further dug for myself and I had become quite lethargic. I hadn't been this depressed before and Effexor certainly didn't have the same effectiveness as the first time I was on It. (this seems to happen when people have quit Effexor before)
Also I thought my levels of Serotonin were either too low or not having much effect due to a more pronounced depression and lack of sleep. Also, when I would take melatonin, I still couldn't sleep well, only briefly to wake up extremely foggy headed. A visit to a sun tan fixed this. I stopped using Melatonin with Effexor after that, but when I was off I tried again, with the same result: dull headed when waking up, tanning studio worked better than coffee.
So I started reading in to my meds and the first thing I discovered were articles regarding up-regulation of receptors and that long term Methylphenidate causes upregulation of dopamine receptors causing basic reward stimuli no longer being experienced as such but more or less only triggering fight or flight response resulting in fear and apathy in general, because one is no longer rewarded accordingly...
Could this percieved shortage or loss of effectiveness and longer discontinuation syndrome be caused by up-regulation by k-Opiod receptors?
These detect abnormally high levels of neurotransmitters and kind of make receptors less sesitive to protect the brain from posible toxic high levels. Down regulation on the other hand is painfully slow...Perhaps long term SNRI use also triggers adjustment in sensitivity?
More research seems being done now and it seems a more logical aproach to modify KOR instead of the underlying mechanism. From what I understand with the little knowledge of neurology I have gathered in the last few months SSRI's, SNRI's, and to an extent all medication that chronically create a surplus of a neurotransmitter will (with extended use?) cause the k-Opiod system to upregulate the relevant receptors, causing misery down the (longer) road.
Are there exeptions or has modern medicine been prodding away in our mysterious skulls once again, just to learn they almost got it but not quite?
For ones who like to experiment:
Sub perceptual micro-doses (2 dried leaves 0.5 gr) or if you like the effect a lager dose of Salvia Divinorum seem to have a long lasting antidepressent and anxiolytic effect (a few days to a week) due to k-opiod agonism.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721268/
Anyway I stopped taking Concerta and Effexor and after a more prolonged and nasty withdrawl from the latter (brain zaps for 3 weeks tried suplementing with 5-htp at first (when off for a few days) with little effect, so after that didnt work, the next day and after that took 5 mg Citalopram when they got really annoying It has been 3.5 weeks now it used to last only a few days last time. But it seems my mind is almost back to normal and feel much better now and I look forward to experiencing some fun times again!
But finally back on topic:
How does Pyrazolam's withdrawl potential compare to Etizolam?
As I felt like crap today: lack of apetite, nausia, insomnia, just blegh.. You know.
But these symptoms could be very well related to the stuff mentioned above or does a general nasty wheezy stale feeling sound familiar? Would you say i'm having withdrawal of the soul shattering type or the 'you probably shouldn't take 3 or 4 in one go kid' kind? XD
I have been nibling a couple now an then (2mg at night to get some sleep) for the last 2 months maybe 50-60 intas in total although I am a bit surprised at the amount, I hardly munched a strip at a time.. All super responsive a few days on then a few days off etc.. I rarely If ever take more than 3 days in a row as I also have other things to take, do.
-How close to trouble am I walking Is there still hope for me?
-Do I need to get all drastic and taper or just take a few weeks off?
Update:
I brazenly took 1mg Etizolam around 04:00 and I felt slightly better, but not much.
I didn't want to take more as it might be better not to, and at some point one must go to sleep without the aid of mental lubricants.
(I mainly use them for sleeping and 1mg of Pyrazolam also did the job just fine probably even better as I woke up with a clear head, would switching up have aditional benefits regarding dependency/half life/side effects?)
I will probably stay awake and try to have a good early sleep tonight to get back into the groove.
Hell maybe I have some totally unrelated funky ailment and I'm posting for all the wrong reasons, but I think I already feel an improvement underway.
(If this was too much of topic. I apologize feel free to move when needed)