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What is a good anti-depressant? Please

If you're going for a combination of drugs to treat your depression, I would suggest aiming use a combination that works on the dopamine, serotonin and norepinephrine neurotransmitter systems. I personally take the following combination of drugs that works synergistically with each other:

* A low dose of amisulpride (50mg/day), which preferentially blocks presynaptic dopamine autoreceptors that control dopamine synthesis and release, which increases dopamine transmission. For this reason, it is used to treat dysthymia (chronic, low grade depression).

* Bupropion, which inhibits the reuptake up noradrenaline and dopamine. It is mildly stimulating and is good for treating depression that is characterised by low energy levels/fatigue etc.

* Mirtazapine, which has a dual mode of action; it is a noradrenergic and specific serotonergic antidepressant (NaSSA) that works by antagonizing the adrenergic alpha2-autoreceptors and alpha2-heteroreceptors and by blocking the 5-HT2 and 5-HT3 receptors. Norepinephrine release and 5-HT1A-mediated serotonergic transmission is therefore enhanced. Mirtazapine also blocks the H1 receptor, causing sedation which is good for insomnia and anxiety, both of which are symptoms of depression. Its dual mode of action probably accounts for its rapid onset of action.

* Lamotrigine, which may work partly by blocking voltage-gated sodium channels and the 5-HT3 receptors. Very little is known about it's mode of action, but it appears to be useful in treating depression (either unipolar, refractory depression or a depressive episode associated with bipolar affective disorder). I have heard many positive reports regarding this drug and from personal experience, would recommend it as it's side-effect profile is quite benign. The only disadvantage of this drug is that it takes a long time to titrate the drug to a theraputic dose, due to the risk of developing Stevens-Johnson syndrome, a potentially life-threatening rash.

So with my combination of drugs, there is a dopamine 'double boost', a serotonin 'single boost' and a noradrenaline (norepinephrine) 'single boost'.

I am trying to get onto buprenorphine maintenance therapy, as there is good evidence that this drug is efficacious in the treatment of major depression.
 
what about these meds will they be safe together,amisulpride,mirtrazipine,and citalopram?
 
Yes. In the US in particular, mirtazapine and an SSRI such as citalopram are frequently combined. The amisulpride is also safe to take with these meds.

What dose of amisulpride are you taking? Is it for psychosis/schizophrenia or is it for dysthymia/social anxiety (or for something else?)?
 
i get the 100mg of amisulpride to chill me out stop me from being violent towards people...! what dose of citalopram and mirtrazipine do you recomend?
 
I would recommend aiming for:

20-40mg citalopram

30-45mg mirtazapine

Maybe you might want to look into either increasing the dose of the amisulpride or trying a mood stabilizer like carbamazepine if agression is your problem.
 
You just have to see what works for you.. it took me like trying 4 different anti depressents to find one that worked for me.. its different for everyone
 
i take 0.4mg of buprenorphine primarily for an antidepressant and anxiolytic effect, dropped down from an initial 4mg like a year ago, and it STILL works for me everyday without fail. its an excellent antidepressant as far as im concerned. i havent noticed ANY decline in effect whatsoever.

i just recently started riding my bicycyle for almost 2 hours everyday, it is amazing how i feel when i get off of it. i seriously feel high. its an awesome feeling. i feel a LOT better from doing this exercise everyday. i work outside so i get plenty of sunlight and exercise at work, but this seriously improves my mood, and gives me time to chill and think. i definetly recommend exercise!!!!

i just started escitalopram 5 days ago and i have started to notice some positive effects already. i have been on citalopram before and can highly recommend that as an antidepressant.

escitalopram and buprenorphine is pretty damn good so far!
 
Get your Thyroid checked. Mine had been offline (Hypothyroidism) for years.
None of my many MD's bothered to check until I demanded the simple test.
Hypothyroid causes depression, annemia, constipation, ..., ...
Bi-polor has large ties to hypothroidism
It takes as much 6 weeks for the medication to kick in but life got a whole lot better.
 
I have struggled with depression for at least 10 years and have tried Zoloft, Prozac, Wellbutrin and Lamictal (which I later found out is an anti-seizure medication for people with epilepsy). All of them made me feel sick and lose my appetite. The only thing that would lessen that naseous feeling was smoking weed. I guess out of all of them, I tolerated Wellbutrin the best, but I'm kind of anti- antidepressants after my experiences with them. I just always felt... medicated (and not in a good way). It wasn't a feeling I liked.

I decided to stop taking medication about 6 months ago and I feel better now than I have in years, but that's probably because of other factors too.

But anyway, I have gone through so much regarding depression, if anyone wants to discuss it then drop me a line. I know how hard it is. Hang in there.
 
patte4dm said:
I'm currently taking lexapro and I think that it has improved my life alot
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Lexapro (escitalopram) didn't do shit to me... (I took it for like 4 months, 10 mg a day)
 
Fuzati said:
Lexapro (escitalopram) didn't do shit to me... (I took it for like 4 months, 10 mg a day)
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Well that's the minimum therapeutic dose that is recommended. You could go up to 20mg if need be.
 
Buprenorphine.

First anti-depressant that has ever actually worked for me. I take 0.3-0.5mg in the AM and the same dose after dinner and I am happy, energetic, motivated, comfortable, and most importantly i feel NORMAL!

bupe saved my life.. i've been on over a dozen "tradition" anti-d's: lexapro, prozac, paxil, wellbutrin, st. john's wort, tofranil, cymbalta, etc. nothing works anywhere near as well as bupe. not even recreational opiates (oxycodone, hydrocodone, etc) with those tolerance builds up quickly and you start to feel like total shit very quickly whenever you're not on them and when you're on them you only feel halfway normal... bupe when your not on it you feel good and when your on it you feel normal and human again.

its wonderful. but i'd only recommend it to people abusing opiates.
 
black peter said:
I'm not sure if anyone has mentioned Lamictal... I have been on it for about a month and definately notice an improvement in my moods, with no bad side effects. at this point i'm optimistic about what it can possibly do for me long-term.

as for Suboxone... please please dont try and get this for depression! It does feel good at first, yes, all opiates do. but in the long run, you'll regret it, i think. I recently got a script for my opiate addiction and am struggling to find an appropriate daily dose. If i take even 1 or 2 mgs too much I get sick as fuck. miserably sick. disfunctionally sick.
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so wouldn't common sense tell you to take less of a dose than you're taking so you DONT get sick? how bad was your opiate addiction? if i were you i'd take 0.5mg / day until you find the right dose.
 
enoughorangejuice? said:
Best antidepressant is oxycodone.
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^and now suboxone? see what i mean? you gotta be careful with opiates that are supposedly used for depression. it is NOT a long term solution to the problem. still in the 'honeymoon phase'? seeing as this is a harm reduction board, id highly advise on recommending an opiate detox tool as an anti-depressant.

anybody who is NOT an opiate addict but is depressed gets on suboxone i centainly think they would feel better than 'normal'. most people who claim they feel 'normal' on suboxone are those who got it shortly after an addiciton to opiates. and i for one dont want to see anyone who is truly depressed try and detox from ANY kind of opiate.
 
enoughorangejuice? said:
Buprenorphine.

its wonderful. but i'd only recommend it to people abusing opiates.
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i specifically stated it will only be a good idea for people abusing/addicted to opiates!!!
 
enoughorangejuice? said:
Best antidepressant is oxycodone.

But since thats not an option, wellbutrin + cannabis + valium + focalin works for me
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I specifically said oxycodone is NOT an option, even tho it is a good anti-depressant while your on it, its not a realistic option to treat depression which is why i wrote THAT ITS NOT AN OPTION!!!

jeez! and no i'm not still in the honeymoon phase, that ended about 8 or 9 days ago, i just feel normal now, i take ~1.0mg a day. i'd say that's a pretty fucking low dose. and its an anti-depressant, my M.D. even says so, I ADVISE ANYONE ADDICTED/ABUSING OPIATES TO SWITCH TO BUPRENORPHINE TREATMENT IF THEY CANNOT GET OFF OF OPIATES OR STRUGGLE WITH CRAVINGS/DEPRESSION

but i'm not a doctor so LISTEN TO WHAT YOUR DOCTOR SAYS. my advice is bupe for opiate addicts, but thats ADVICE, not directions.
 
I just recently started on Wellbutrin and am very happy with it, snapped me out of a severe depression in which I had no energy to do anything, couldn't take any joy in anything, pushed away friends, etc, etc. I also take Ativan as-needed and Ambien to help my sleep.
 
Tramadol maybe? mu opioid receptor stimulation+ssri+andrenalin

I have loads of 100mg tramadols, I use 3 times a week 50mg, and I feel fine all day (100mg and above and im feeling the high)
 
^^ it does work on serotonin, so it could be a potentially decent anti-d.

does it still work after long term use?
 
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