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  1. @mikl_pls I am also into pharmacology, more so when I am unbalanced and more ocd-ish. Risperidone is an inverse agonist of Histamine H1 but with lower affinity than to dopamine/serotonin. I guess that with higher doses this becomes sedating in a more pronounced way. I really liked this one, changed to Abilify because of high blood cholesterol levels, which turned out to be unrelated. Trying to change back did not work as expected. FWIW, Lamictal is a miracle drug for me.
  2. Welcome to the forum. My story is very similar to yours, except that I was not diagnosed at the age of 14 but carried on my grey life till I was 25 and at a point where I was not suicidal but couldn't care less if I were to suddenly get hit by a car. Same thing about depression and anxiety, everything is an effort... To the point: I have no experience on Fetzima but have been on Milnacipran (Fetzima's parent drug). It was the exact opposite of sedating - the most activating/energizing med I have ever been on, including Wellbutrin+stimulants combined. Frankly, it was too much for me but it definitely helped with depression. Generally I found SNRI+low dose AAP to be effective. Higher doses of AAP can cause a flat affect (i.e. "greying out"). If you are looking for a different AAP: Amisulpride (Solian), if available, can be an effective one with minor side effect profile Risperidone is sedating above 1mg, but 0.5 was very effective for me when I've been on it. Stimulants like Ritalin can be useful for the lack of energy. I would also not rule out Prozac. It is an SSRI with 5HT2C antagonist property, which means it indirectly increases norepinephrine/dopamine. ... and yes, this effect is noticable. Please update.
  3. Updates: Effexor 225 - Depression & anxiety Abilify 5 ->7.5->5->2.5 - OCD & tics Ritalin 30 - ADHD Reducing Abilify made me feel more alive and less flat. It also improved the notorious side effect of SNRIs (apologies to Cymbalta for blaming it on that)... Anxiety and restlessness was still an issue. My pdoc suggested switching to a different AAP (Amisulpride) or try a mood stabilizer. I chose the second option, so: Added Lamictal 25->50 (soon: ->100->200) - Magic powder. Lamictal is amazing! I didn't believe it could be this effective at 25mg, thought it was the placebo effect. It's been a month, now at 50mg. OCD is pretty much vanished, tics almost disappeared, feeling calmer, sharper and more balanced than before. I don't even need Ritalin to stay focused (maybe once a week). Took me a long time to find this combo and still naturally skeptical. Never give up.
  4. In case of overdose it might be, so it is less "safe" than newer meds.
  5. Switching from Lexapro to a different SSRI should be much easier in terms of side effects than changing from SNRI to SSRI and “removing” the norepinephrine effect. I have changed from one SSRI to another without withdrawl symptoms at all. Stopping Cymbalta (twice) was a whole different story.
  6. My dx is OCD (pure-o)/depression/anxiety. Not bipolar, never have been anywhere close to mania. I have tried different SSRIs/SNRIs/NDRI with AAPs and they had partial results. Recently I was perscribed Lamictal. 2 hours after the first tiny dose my symptoms disappeared for almost a day later. I am still on 25mg, on my way to the target of 200. It may have been the placebo effect, but given past experience I have a good feeling about this one.
  7. waking up trembling?

    Sometimes antidepressants make you feel worse at first before they actually work. But even with that in mind, 2.5 mg of Trintellix may be too low for you. If I remember correctly the minimum effective dose is supposed to be 5mg. Trintellix is (mostly) an SSRI, but some of its specific properties may actually decrease serotonin in low doses, thus causing even more depression/anxiety.
  8. Seroquel is also an AAP. It may work for you, just note that it is considered one of the more sedating of AAPs and you mentioned that you have a problem of becoming too sleepy from meds. (In my pdoc's words, when I asked about it: "you will sleep all day") Anyway, if it were me I would first get to the right dose of current meds before adding others. Otherwise it may be harder to know which of them did what.
  9. Based on your description and my experience... and only that: Lexapro (pure SSRI) - doesn't work Prozac (SSRI with 5HT2C antagonizm) - weight gain. 5HT2C antagonism is generally good for mood, but increases appetite. Pristiq/Effexor (SNRI) - anxiety. How much Effexor were you on? It tends to have a stronger effect on norepinephrine above ~200mg, which can sometimes cause more anxiety. A low dose antipsychotic may allow reducing the dose the antidepressant and improve anxiety on its own. I had good experience (anxiety-wise) with Risperidone and with Abilify. The latter has less side effects. My 2 cents
  10. Nortriptyline is closest to a SNRI than to anything else, but has more affinity to N transporter than to the S one. Fluoxetine is an SSRI. Changing the ratio between them can create sort of a custom-made balanced SNRI. Because both of them have serotonin reuptake inhibition they can potentially cause serotonin syndrome. That's what the internet would say
  11. Not bipolar myself, but taking Abilify as augmentation. I found it more activating at lower doses, going higher is more “stabilizing”.
  12. Fetzima is Levomilnacipran. I've been on Milnacipran. It has more effect on norepinephrine reuptake than on serotonin, so if SSRI/Pristiq didn't work for you this one might. In my experience it is very activating and gives a great energy and motivation boost if that is what you need. Have you tried augmentation to SSRI? A low dose AAP may make the difference. After Prozac (SSRI) was too weak for me, my pdoc added a sub-minimal dose of Risperidone (AAP) with good results... and it is not bad for sleep either. edit: Just saw you said that you have tried AAPs on the first post. with or without antidepressant?
  13. This is what I feel everytime when meds start to work but not “there yet”. I think that this is the exact feeling because of which psych meds come with a risk-of-suicide warning. Still searching for the right combination, but I have been balanced for enough time to know that it does get better. It takes time, research, trial and error but it is worth it. Can't say that Trintellix worked for me, but it had no side effects even at max dose and was really easy to stop.
  14. Don't be afraid to try a different SSRI. I've never been on Lexapro, but have have been on (and off) Zoloft and Prozac - above the recommended max dose. Both were good for my anxiety/depression, had no side effects at all and no discontinuation issues when switching. Eventually, SNRIs were better for me, so even if a different SSRI doesn't work you still have other options. Good luck!
  15. I've been on Prozac in the past (80mg at morning). It is more of an "upper" than other SSRIs. Technically it is classified as SSRI, but it does have direct and indirect effects on noradrenaline and dopamine as well. Not as much as SNRIs, but enough to make a difference.