Where next - continued depression or Prozac?

[formulaic]

Hi,

I'm new here and would like to give my complete (don't worry I'll keep it brief) history of anxiety and depression and then would like to seek advice from those who know. Hopefully some of you here do.

I took quite a lot (I guess between 50 and 200 pills) of recreational ecstasy (and speed, acid tabs and quite a lot of weed) in University (from age 17 to 20). For the most part this was great fun, however I did have a couple of nights where the e made me feel like I was going to die (paranoia/anxiety). These I later realised were my first panic attacks. Also my comedowns seemed to always be worse than others lasting two to three days. I also drank quite heavily from 17 onwards, binge drinking in true British style but also liking to buy a few cans or bottles on nights in as well. On my graduation day after getting drunk the night before, I had my first panic attack while sober, which saw me in the nurses office before the ceremony being calmed down. After University I pretty much stopped taking drugs but continued drinking on a regular basis (not quite daily, but still a lot of binge drinking). Around 22 years old I noticed my hangovers were getting worse, taking two days to get over them, where before I only had a bad headache for half of the next day. I also noticed that during these hangovers I would become very anxious. As social binge drinking was a big part of my life I went to see a psychiatrist who put me on escitalopram. Upon taking the first pill I could immediately feel it's benefits (it was like low level speed) my mood improved quickly and I found my hangovers were now wholly manageable. So I spent the next ten years continuing to binge drink.

By the end of these ten years however I was again experiencing crippling hangovers which were filled with anxiety and panic attacks and would last up to two days. My love of drinking had led me to beating these hangovers by drinking four of five beers - just enough to stave off the anxiety but not enough to give a repeat hangover the next day. After a few years of this type of drinking I realised this was no way to live, so I managed to reduce my binge drinking, started getting more exercise and took less xanax to control the hangover induced anxiety.

After one year of this relatively sober lifestyle - I still binge drank but only very occasionally - I decided there was no need to be on escitalopram anymore as I felt pretty good and my anxiety levels were very low. So I tapered off it slowly over six months and have now been off it for one year. I exercise fairly regularly and have a pretty good life, but depression is a constant and whenever I drink too much and get a hangover my anxiety levels go through the roof.

I also tried being completely sober for three months while exercising daily thinking that if this made me feel much better then I would quit drinking completely, however after 3 months my depression and anxiety levels were much the same, so i returned to social drinking.

Where I'm at now is that I am coping without any meds, but I feel after one year of being off escitalopram that I feel worse on a daily basis. I am pretty sure my depression is caused by seretonin depletion from e usage, and that my anxiety comes from this too coupled with a family history of such. So it seems to me the only way to enjoy a good mood on a daily basis is to take something to lift my seretonin levels.

From reading this site people are suggesting things like St John's Wort and 5HTP, however I live in China so getting hold of these kind of things is hard. Prozac however is easy (more so than escitalopram), so I'm thinking of taking a daily 20mg dose of Prozac - the lowest dose of escitalopram worked well for me - to treat my depression.

My doctor seems to think my self diagnosis is pretty accurate and my suggested remedy is apt too, but I'd like to get a second opinion from users of this site. Taking prozac forever isn't something I want to do (and I'm fearful that it could lead to very negative consequences in the future - increased risk of althzeimers etc) however living with constant depression that has not lifted following periods of clean living seems unnecessary if Prozac can lift my mood.

Thanks for any advice,
Ben

 

[suessmayr]

I'm pretty sure that you could get alot more than Prozac even in China. Is there any reason in particular why you think Prozac would be good for you? If you benefited from Lexapro why not just go back to that?

I think that benzos should really just be saved for extremely stressful situations; otherwise they just produce rebound anxiety worse than the original anxiety.

I've been on alot of AD's and Prozac was pretty good. Unless I'm wrong, it's not quite as selective as other SSRI's like Zoloft and works instead in a very broad way. If your depression, however, is lethargic and if you suffer from low energy, Prozac may not be ideal. There are other, way more 'activating' AD's like (notably) Zoloft. Also, some of them are specifically indicated for anxiety, and have been proven to be particuarly beneficial in anxious patients (like Paroxetine or the Tricyclic-antidepressants).

 

[Legerity]

^That's a good point. If you've already benefited from Lexapro, it may make sense to go for that if you can get it again. Medications are pretty hit or miss in their effectiveness so if you've already found one that works, it can save months of experimenting with other ones.

And maybe try not to convince yourself too much that you will always need something to raise serotonin levels. I notice that a lot of people doing MDMA in particular are extremely focused on neurotransmitters. Way more than any other substance. I've rarely heard any other substance where people are worried about having permanently altered their brain chemistry from a single use. The brain is more malleable than we might expect and can recover nicely if treat it well

Take care of yourself

 

[Cohesion]

SSRI helped me get out of my rut.

The withdrawl was awful, but at the time it was a fine compromise.
Best to you.

 

[formulaic]

Thanks for your advice and suggestions.

There was a St John's Wort product called Karma on offer in the shops so I've bought a 2 month supply of it and will give it a try. If that fails I have some Prozac but will seek out the escitalopram I took before or Zoloft. My problem with escitlopram is that it is very hard to come off it however I succeeded before by reducing it very slowly over six months. But as now that I've been off it for a year and I feel I need to be back on it I think that is not a big concern.

It's interesting to read how others have used SSRI's to get through depression and are now off them. My sister is the same. The fact that I am not feeling fine without them, suggests to me that a permanent imbalance exists in my brain and that my Ecstasy filled university life was the culprit.