What do you take for Depression and Anxiety?

[SKL]

Haven't used either myself or on patients (I don't see in my role really any uncomplicated cases with a sole diagnosis of depression/anxiety) but the pharmacology seems promising


standard disclaimer not medical advice etc.

 

[belfort]

cannabis and exercise

i hear and see so many people recommend cannabis to someone with anxiety..i think much of the time it backfires on a person and makes them much more anxious and paranoid overall.. it might help a small % but not most just from what ive seen..

OP, if you are drinking energy drinks or coffee, anything with caffeine in it, throw it away asap!this will help your anxiety right away..

tightlywound- u might want to reconsider welbutrin..for someone with bad anxiety and sleep issues welbutrin is a bad choice..i know from experience..sure, it helped mood and motivation but made my anxiety much worse, anything that messes with dopamine will..

an hour of intense exercise every day will help anxiety too..u seem to want a medication for every asp[ect of your life though(mood, sleep, anxiety) etc and this is the wrong way to go about it imo as every medication will bring side effects..

 

[SKL]

^excellent points overall

i hear and see so many people recommend cannabis to someone with anxiety..i think much of the time it backfires on a person and makes them much more anxious and paranoid overall.. it might help a small % but not most just from what ive seen..

a hundred times yes
I don't understand potheads who think it helps with anxiety
or at least for the average person
maybe for potheads
maybe it's withdrawal anxiety OTOH

OP, if you are drinking energy drinks or coffee, anything with caffeine in it, throw it away asap!this will help your anxiety right away..

yes

tightlywound- u might want to reconsider welbutrin..for someone with bad anxiety and sleep issues welbutrin is a bad choice..i know from experience..sure, it helped mood and motivation but made my anxiety much worse, anything that messes with dopamine will..

maybe. venturing into polypharmacy if you want to go down that road wellbutrin as an adjunct to a SSRI and possibly plus an atypical, BZD or other anxiety might really help on the depression side if that's is also an issue

an hour of intense exercise every day will help anxiety too..u seem to want a medication for every asp[ect of your life though(mood, sleep, anxiety) etc and this is the wrong way to go about it imo as every medication will bring side effects..

yes

standard disclaimer not medical advice etc.

 

[sigmond]

op:clonazepam for anxiety - the only class of drugs that worked for my depression were opioids; of course - not prescribed.

quick question:what traditionally prescribed antidepressants besides wellbutrin have 'stimulant' like qualities?

appreciate any response

 

[SKL]

op:clonazepam for anxiety - the only class of drugs that worked for my depression were opioids; of course - not prescribed.

quick question:what traditionally prescribed antidepressants besides wellbutrin have 'stimulant' like qualities?

appreciate any response

1. a Suboxone like drug but with total mu receptor blockade (i.e. no fun/analgesia; it's bupe/naltrexone IIRC instead of bupe/naloxone which makes it active po/sl/etc) is actually in the pipeline for depression; who knows if it'll be worth a damn
2. SNRIs and possibly the aforementioned Brintillex; also some tricyclics little used anymore and triple reuptake inhibitors which are also rarely used in clincial practice and most of which are very obscure (i.e. Mazindole which is C-IV and not approved for depression)

standard disclaimer not medical advice etc

 

[sigmond]

thanks

i was reading certain MAOI's like parnate or phenelzine are possibilities.

 

[SKL]

that too, sort of I guess, for more or less the same reasons as triple reuptake inhibitors, but they are problematic in a lot of ways, I'd consider them on par with ECT in terms of number of times removed from first line treatment

standard disclaimer not medical advice etc

 

[TheTwighlight]

I am on Effexor XR 300mg/day & gabapentin 800mg 4x/day. Venlafaxine is the only antidepressant that has ever worked for me, and I've been on everything. I've been on antidepressants since I was 8 years old, and I'm 31 now. Soon enough weed will be legal, and that shit works, too. I'm also on that.

 

[Keif' Richards]

I second this for the depression. Would not start at those exact dosages but escitalopram has the fewest side effects of SSRIs and the aripirazole will boost it and may stop some of those racing thoughts. Prozac may be worth looking into as well, as while generally SSRIs are said to be equally effective, Prozac can stimulate one when initiating therapy, which may help get you out of the funk. Careful though, could also worsen anxiety.

I personally feel that Escitalopram (Lexapro) and to a lesser degree the racemic Citalopram (Selexa) have all of the positives of older SSRI's like Fluoxetine (Prozac), while cutting out a lot of the negatives. In my experience, Fluoxetine caused pretty significant sexual dysfunction. It's a cool novelty being able to last a long time, but when you are completely apathetic toward sex in general, it's kind of a moot point.

Aripiprazole (Abilify) has made a noticeable difference in my "thought process". I notice I am able to sense, for lack of a better word, when I am moving into depressive/anxious territory and can in some ways, I can actually divert myself. The term anti-psychotic has always scared me, but with all of the weight that comes with the term "psychotic", my experience with the atypicals like Quetiapine (Seroquel) or Aripiprazole have been no more intense than that of SSRI's...

 

[Kittycat5]

1. a Suboxone like drug but with total mu receptor blockade (i.e. no fun/analgesia; it's bupe/naltrexone IIRC instead of bupe/naloxone which makes it active po/sl/etc) is actually in the pipeline for depression; who knows if it'll be worth a damn
2. SNRIs and possibly the aforementioned Brintillex; also some tricyclics little used anymore and triple reuptake inhibitors which are also rarely used in clincial practice and most of which are very obscure (i.e. Mazindole which is C-IV and not approved for depression)

standard disclaimer not medical advice etc

Mazindol, where the hell you pull that from? No one would use, like you said though. Think it may be orphan drug now.

 

[SKL]

wiki tbh, wasn't really aware of any approved pharmaceuticals in that class, went looking
SNDRIs interest me though
a few of the substituted cathinones which were less than successful as recreational drugs might make decent antidepressants at a dose an order of magnitude or so lower than what people were taking trying to get high.
mazindol analogs might be the next RC fad, who knows, there are shittons of potential substittions

 

[sigmond]

1. a Suboxone like drug but with total mu receptor blockade (i.e. no fun/analgesia; it's bupe/naltrexone IIRC instead of bupe/naloxone which makes it active po/sl/etc) is actually in the pipeline for depression; who knows if it'll be worth a damn

I read about ALKS-5461- Buprenorphine/samidorphan

I am not familiar with samidorphan but seemingly it has a blockade effect which is nearly equivalent to naltrexone. when i first read about the drug i considered trying to invest in Alkermes but considering how things are going its probably better that i didn't

 

[Phil.McKeer]

The ALKS-XXX whatever samidorphan/buprenorphine combo has actually showed promise in the trials. I haven't kept up with it but they're either in Trial III or done and trying to get FDA approval at this stage.

I ALWAYS recommend low dose buprenorphine for depression (and it just so happens to alleviate anxiety too).

Many disagree, often vehemently, but I've found it to work very well in my experience. I have pre-existing refractory depression and so long as I take my sub dose every day that black cloud over my head disperses.

Low dose in this context means <0.25mg/day. That's 250 micrograms, which can later be tapered down to, say, 50 micrograms, so there is little to no w/d syndrome.