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Is it possible to be depressed while being on 60mg fluoxetine and 54 mg methylphenidate SR


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3 hours ago, the maze runner said:

i spoke to my pdoc and he said antidepressants cannot be increased more than current level. he encouraged me to handle it psychologically.

Do you have a therapist?.....If not, I think that would be a good idea.....A therapist can help you navigate your feelings, and learn some coping strategies for your depression.

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Well humans are complicated and require a lot of things to be happy and not feel glum (a synergy of things). Medications only take you so far.

Some things to look at:

- Social life

- Job or school

- Financial status

- Dating

- Physical activity

This isn't an exhaustive list. But for some, if they aren't active enough in some of these areas, it can make them feel down.

It just depends on the person and what they deem as important.

 

 

 

 

 

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maze runner -

Certainly it's possible to be suffering from depression even though you're taking antidepressants - because those particular antidepressants might not be the ones you need. Fluoxetine was the first antidepressant I tried. It did practically nothing for my depression. Neither, as it turned out, did any of the antidepressants in the Selective Serotonin Reuptake Inhibitor (SSRI) group. Why? Because, evidently, serotonin isn't my problem. After a lot of trial and error with other medicines in other classes, my pdoc and I now believe my depression stems from an issue with dopamine, and therefore I benefit from medications that promote dopamine output and inhibit its reuptake. SSRIs would never have helped me.

What did help me, in the beginning, before I ever tried meds, was therapy. If you're skeptical that therapy is going to cure your depression, you're right. That's not what therapy is for. What therapy does is provide you with cognitive skills to help you leverage the well parts of your mind to stabilize the parts of your consciousness that are not well. It's possible to manage depression with meds alone. It's possible to manage depression with therapy alone. But multiple studies have concluded that following a consistent course of medication along with therapy results in quicker relief, with less difficulty. I experienced this myself when I finally decided that doing it just with therapy was taking too long, and then I thought, "Why in the hell did I wait so long?"

Others above have suggested that you might want to look at circumstantial factors for reasons why you continue to feel depressed. While it is valid to consider external stressors that cause depressed moods and feelings, I think some people too often dismiss depression as "just feeling down" because of transitory things in life and don't realize that Major Depressive Disorder and Bipolar Depression are serious and often chronic illnesses with biological causes, and that the mood states they cause are not necessarily connected to actual events. If you take stock of what's happening in your life and determine that, as you say in your original post, objectively speaking everything is fine, that suggests that the mental condition is indeed the culprit, and that the treatment you are currently on is not working as your doctor anticipated. It sounds like it may be time to discuss a possible change of medication to see if you can get relief using a different med.

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  • 2 weeks later...

@CerberusThanks for the thoughtful response. Recently I have been vacillating between an anxiety state and a depression state. In Jan I left my prev job in software. At that point anxiety was the leading cause of distress. Also my methylphenidate dose was lower then it was 30mg. Then taking the opportunity to have a break I started looking into chess as a career. That was a bad move because I pretty quickly got depressed. Then I started looking for a career in Routing and Switching but when it came time to apply to jobs they wanted people with a lot of experience. So that as well was consigned to the waste basket even though yes I learned some stuff and enjoyed it. Now I am back in the job search. And so it goes.

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Just with a quick Google search, it looks like with fluoxetine alone, you could go up to 80mg/d; but there's a potentially dangerous interaction between it and methylphenidate wherein the methylphenidate may inhibit metabolism, this increasing the likelihood of serotonin syndrome. 

Psychotherapy is definitely an option. Also, maybe adding another weakly- or non-serotonergic medication. 

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  • 2 weeks later...
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