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Hi, Have any of you had or have read of gabapentin being of use as an adjunctive therapy for people with treatment resistant depression/anxiety/bipolar? I have been doing research and some sources say it helps, others say there is no strong clinical proof. I think a lot of the conflicting reports I have seen has to do with it simply not being studied en mass. Any advice/experiences regarding this? If so, what was your dosing? Thank you! troop

So for seventeen years I've had pain depression. It especially feels like it's squeezing my heart. It hasn't historically been *about* anything. I've just chalked it up to biochemistry, heredity. And I've thought about suicide, most days, for at least fifteen years - because pain sucks. Ups-and-downs. Roller-coasters. Probably every person on here has done time at the worst torture theme park in the world. Two years ago, my cocktail started working. There was some CBT and DBT in the mix too. I decreased my daily Ativan from 3mg to 2mg. Plus 20mg Latuda, 300mg Sertraline, 100mg Topamax. I actually felt happy, for about two years, until this October. Then it stopped working. And I stopped working. I work in a level I trauma center, where I identify cancer, anemia, and the effects of the coronavirus on the human body. I feel like I have a front row seat to human suffering, without being empowered to ameliorate it, and it's another kind of torture. I am very tired of fighting. If there was a euthanasia travel agency, where I could just walk in, plan my funeral and end-of-life arrangements, plan my ideal death, and just call this thing at 38, that would be a somewhat attractive option (not telling, The Tallest Man on Earth, flaming-Viking-burial-at-sea.) I'm tired of fighting this disease, personally. And I'm tired of coming up against the tsunami of "world suck" (H/T Vlog Brothers) which seems to be hate-fucking itself ad astra. So the strain theory, which I haven't read much on yet, is that we consider the termination of our lives when under one or more types of strain. I personally find this theory hopeful, as targeting the sources of strain, i.e. "world stuck," could reduce the inducements to terminate one's life. The General Strain Theory, according to one Wik I. Pedia cites loss of positive stimuli, addition of negative stimuli, or the inability to reach a desired goal, as three possible sources of strain. I will follow up on this with my tdoc on Wednesday. I think work is introducing negative stimuli, and I have a shit ton of unreached goals, but am starting to care about goals less and less. Basically, it pisses me off that I've had to dramatically reduce my goals due to my diseases, and it's kind of tempting to just leave the party. Please feel free to weigh in if you have personal and or academic experience with this. I'm also meeting virtually with my pdoc tomorrow... to tweak the cocktail. Would love recommendations. My current rx mix, dxs and rx, failures are in my signature. Lamictal induces hives and vomiting. Depakote causes dyskinesia. Lithium ruined the thyroid and causes acute renal failure. Medicine. Ha ha. Organ roulette. So the observation about different species of depression is that while for a decade-and-a-half I experienced what seemed like purely biochemical, chains-around-my-heart, tar-and-shark-filled, basements-beneath-basements depression. This feels more like a rational(?) depression, which has me concerned about whether it will be responsive to biochemical therapy.

https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/clomipramine-tryptophan-and-lithium-in-combination-for-resistant-endogenous-depression-seven-case-studies/F3A1B19433959744DCF32C36C7B4A28F# Unquestionably an extreme combination, but it seems to exhibit powerful antidepressant effects. Clomipramine on its own is regarded by many as maybe the most powerful non-MAOI antidepressant, at least in clinical practice and inpatient care, although the side effects can be quite rough, but combined with Tryptophan and Lithium it seems to be further boosted in its effect size and response rate. Maybe worth trying before hopping on ECT / MAOIs... One has to be careful because it is a small sample case "study", but nonetheless quite interesting to read. I encourage all those who have a view or experience to share it with us, regarding the aforementioned medications and especially the combination. Greetings!

Hi, all. I feel like a newb oldie: been on here a while, still feel dumb as shit with all the o chem breakdowns and acronyms. Anyway- I've been maxed out on effexor xr for years now. I've taken it pretty consistently for...12 years? with a few breaks to try something new. There aren't many details I can remember well (always had a bad memory, now it's basically a vestigial feature), but here's what I've garnered: *SSRIs and i seem to not mix. Not just some side effects, but all the side effects, and no or negative improvement. *wellbutrin did nothing for me. Not good, not bad- just nothing. *Effexor was good- great, even- before I tapped out. I've just been staying with it till I can figure something out. *currently, I take 225 mg Effexor (and several doctors have told me now that they flat out won't go above that), 150 lamictal, and klonopin and Ambien as needed. (And as I've been mightily depressed lately...I've been "as needing" them a lot more.) I've been wanting to change for a while now, and I've been studying up to see what might be some better options, but haven't had a tdoc or pdoc in the meantime. I'm meeting new ones shortly and I want to take some suggestions to them. Problem is that I'm allergic to a few things, with varying degrees of severity and type of allergic reactions. Any suggestions of SNRIs, TCAs, or MAOIs that aren't: *sulfa-meds (full body hives. Like...full body- between my toes, in my buttcrack...😬) *compazine (difficult breathing, light anaphylaxis.) *darvocet, Vicodin (full-blown anaphylaxis.) I have been given morphine with no reaction (so, what- does this mean that synethics cause issues, but cleaner natural versions don't?), and take imitrex regularly. I'm not smart enough to understand all of the individual components, and too ADD to have the patience to learn which causes what. I feel like it's got be something pretty potent, since I've been middling- to severely-depressed pretty constantly (easily 8 out those 12 years), but I also don't need anything that's going to make me lethargic. Apathetic, fine- just please, no serious drowsiness. I defer to you guys and gals and pals for what your thoughts are on what might be most effective, but also won't send me to the ER.

Any success or failures with rtms, tms, deep brain stimulation? Meds just don't seem to work well for me. My depression is chronic with dips and peaks and my cognition is impaired heavily. I do remember being knocked out violently at 5yo and 8yo, not sure if that caused some sort of brain damage. Ugh another day if this shit...

Second post on crazy boards. In short I have tried many different classes of Ad's with little help. I am copying my maoi proposal to my pdoc below. I apologize for length, this proposal should cover everything. --------------------------------------------------------------------------------- I have been on Zoloft, Cymbalta, Strattera, Wellbutrin, remeron, fetzima, viibryd, deplin, Lamictal, Abilify, and Nuvigil with moderate to little help. Some boosts and stabilization here and there I will give credit for. Particularly Zoloft for anxiety, Cymbalta for uplifting feeling, Strattera short term for depression, Abilify possibly for irritation, and Nuvigil as a sort of stimulant with little to no crash. This being said my depression just feels very weighted, and dark. I can say for certain my depression has gotten much heavier and darker from 14 to 22. Both in a physical sense and in a mental sense. Suicidal ideations (not induced by medications.) have unfortunately become almost daily recently, now the act of suicide I would definitely be too scared to act out, but it's the thought process that scares me. Doing anything ranging from brushing my teeth to getting to work is more than just a chore, it's painful. My depression feels like a constant itch you cannot scratch, and over the years the itch has grown. My anxiety though not as severe as my Lethargy or depression is still very bad. My motivation is also very lacking in my life which is probably due to my depression. I find myself wanting to cry to get some relief but often cannot. I am getting increasingly tired of trying new meds without the benefit I need. I truly believe atleast 65% of my depression is biological and out of my control which is why I'm searching for a medicine that can allow me to more easily fulfill the other 35% or so treatable with cbt. Why I'm suggesting an irreversible maoi is for the following reasons. I believe have atypical depression sleepiness or excessive sleep, marked fatigue or weakness, moods that are strongly reactive to environmental circumstances, and feeling extremely sensitive to rejection. I have tried various classes of antidepressants and augmentations with little benefit My depression is extremely Lethargic/low energy. The maoi scare was overhyped I can follow dietary restrictions I could care less about sexual side effects or weight gain by this point in my life. Maoi’s are a powerful and underutilized tool in the psychiatric world. I understand the 2 week grace period that's required. Psychiatric times states that TCAs were found to be most effective in severe depression, especially with melancholic features. MAOIs, on the other hand, were more effective in less severe, chronic depression with prominent anxiety, without melancholic features, and often in the presence of reversed vegetative symptoms.35,36 *nardil had a change In formulation in 2003 so maybe parnate might be a better fit. User reports also show parnate might be more energizing than nardil. *Emsam might be good as is a topical patch with less diet complications. Would reboxetine be useful to take with an maoi? Can I still take abilify with an maoi? --------------------------------------------------------------------------------- I have ruled out thyroid issues and sleep apnea with my internal medicine doctor. I am seeing him again August 6 2018 to see if there are any other reasons besides a biochemical deficit that can be causing my extreme fatigue and oversleeping. My question to you guys is if you have had success with maoi's where as other antidepressants have failed? Thank you in advance for taking the time to read my post.

Wondering if anyone has any good news to share about finding remission from refractory depression! Whether you've been partially or fully successful at getting your life back, please share your story

Hi, I have depression,anxiety,ocd,anhedonia,adhd. I have already tried many ADs and nothing seems to work at all! I am running out of options. 1 psych already gave up on me telling me he cannot do anything for me anymore. This makes me feel even worse. I don't know what the heck is going on. I mean something is clearly wrong. This is not just psychological. I already had OCD as a child and anxiety, too. I have tried without success: Lexapro 20mg 5 months (no effect) Anafranil 75mg 1 month (couldnt stand side effects, also no antidepressant effect in this time) Wellbutrin 300mg 8 weeks (no effect) Tianeptine (37mg 4 weeks, no effect, maybe felt even worse) Valdoxan (did nothing) Ritalin 5mg-30mg (doesnt work for adhd, also not for depression) memantine 20mg (didnt really do much) Remeron 30mg 8 weeks Currently I am taking 60mg Cymbalta. When I went on Cymbalta the first 5 days I felt like there was an effect. After that nothing! I am on 60mg now and I feel as crappy as always. I don't understand this. This wasn't placebo. I really felt like it was working from day 1. But then after a few days it was gone. I cant make sense of this. Anyway, there isn't much left now. MAOI are way too scary for me. Moclobemid would be an option but it read it sucks and I also couldnt take any stimulants while on it. This is a disadvantage. The ritalin is still like a crutch. Trying other SSRI doesnt make much sense to me. Trying other TCA also doesn't make much sense cause they have the same sides as Anafranil which I couldn't tolerate. What do I do now? I know that there are drugs which are used off label against depression but the problem is convincing my doc to prescribe them and the even bigger problem is that the insurance will probably refuse to pay them if they are not for depression.

I'm just wondering if Lithium is an option as an add-on to antidepressant for depression? My depression is usually mild-moderate and chronic, but lately I'm going through quite a severe dip that has been going on some months now. I've tried so many antidepressants and while the one I am on at the moment is somewhat helpful, I am still struggling to function day to day and a lot of 'dark' thoughts too. I have not asked my family doctor to send me to a Pdoc because I fear they will just try and dope me up on AAPs or take me off my antidepressant/benzo and start me on the SSRI merry-go-round again. I really don't want to take AAPs. I stumbled across Lithium as a potential augment and it sounds less scary than antipsychotics. Should I ask my doctor about it or is it mainly for bipolar?

Gah, I wanted to write this all day yesterday but I was so tired and wired and the words disappeared. Once again, the meds I've been on haven't gotten me/kept me stable. Years and years and years I've been trying. And years. This time, I'm back in a mixed state, and the psychotic symptoms jumped on me so fast. Well, I guess they are never really gone, but full blown auditory hallucinations, confusion, fear, visual disturbances, etc., all sort of out of the blue. I feel so defeated. I'm really getting scared that I will get sicker and sicker and eventually not be able to care for my children (who really need me now, because their dad's house is getting to be untenable). I was told years ago that my prognosis isn't good-- that due to various factors, it was likely I would continue to deteriorate. Has anyone else been told the same thing? Did that happen to you? So I went to see my pdoc yesterday, and he agreed that I'm destabilizing (I wasn't really stable, but about as close as I've ever gotten). He and I decided a long time ago to stop trying antipsychotics, because my response has been extremely bad for one reason or another. But at this point we've run out of other options, run through all the meds, tried so many combinations. I kind of thought he would up my lithium, but he is worried about my brain fog, my thyroid, my depression, so didn't want to. Then he suggested an antipsychotic. Fuck. So he searched through his vast med memory (he's like a frickin' computer) and we settled on Stelazine (trifluoperazine). Though it's a typical, it isn't sedating, he has only seen one case of TD from it, it isn't terrible for weight gain and it might help dampen the mania while helping me to organize my thoughts. He is starting me on a teeny, tiny dose because I am so sensitive to meds (maybe one day we will do testing to see if I am a slow metabolizer, but in the meantime, he is exceedingly cautious about dosages). (Sorry for how parenthetical this post is. Brain jumpy.) Have any of you tried it? I know that the older APs aren't that popular, but we weighed all the options and I decided that I prefer TD over diabetes. I'm already fat from the lithium & nortriptyline and adding more weight with the higher chance of diabetes from the AAPs scares me. My ex-partner got diabetes from Zyprexa, so it sketches me out. Also, I have tried almost every single AAP with no success, but have not tried the old school APs until now. I'm starting it tonight, titrating slowly over the next week to see if it works. If any of you have any insight about that med or my fear of ending up entirely stark raving mad, homeless on the streets, I would appreciate it. I'd rather not hear too many horror stories about AP/AAPs, because I've lived most of them. Bleagh. Feeling sorry for myself and really scared. On a slightly lighter note, I found this link to a webpage of old advertisements about Stelazine. Very funny. And oddly reassuring. Marvelous Mental Medicine: Stelazine straitjacket