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What delicious SSRI should I try next?


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Hello, thanks for reading. I'll get to the point. I don't have a regular psychiatrist and the doctor I see is unskilled in the ways of psychiactric medicine leaving me wih little choice but to do my own research. So I need some help. I need to get off Lexapro 20mg and Abilify 5mg. Since i've been on them my life has slowly drained away. I languish in bed day after day, letting the house grow filthy and caring about nothing. The motivation to live life has gone. I used to be on 2.5mg of Abilify and I felt like crap but adjusting the dose highter only made me feel worse, not better. (I know it's just trial dosage still but it's not doing the job and I fear the doctors wont believe me) Anyway, I am stumped as to what to try next.  I was on Zoloft for 5 years prior to this and it worked wonderful for three years of that time. I tried Prozac for a week and it gave me such terrible stomach cramps that I had to switch to Lexapro.  And I've also been on Paxil which had the same effect as Lexapro... like having a thousand leaches attaced to you daily and expected to function.  Soooo, is tere another antidepressant I might try that purhaps is a sister drug of zoloft?  Where should I go from here?  How do you tink he doctor should switch me from one medication to the other?  I most likely will have to tell him what to do.

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There is a reason why family doctors and gdoctors are not supposed to presrcribe psych meds for long term management of anything other than mild mental illnesses. Because psych med prescribing is very complicated and you can't just fluff your way through by googling and asking strangers on the internet. We can advise you on how to communicate better with your gdoc, and how to seek a pdoc to care for you, how to deal with a lack of insurance, but no one here can or should help you prescribe meds for yourself because none of us are qualified doctors.

 

SSRI's have many side effects (I am sure you are aware) and a long list of interactions with other health conditions and other medications. SSRI's are not the only or best anti depressant for many people, look around here and see how many people with depression use mood stabilisers or anti psychotics, or exercise, or diet or all of the above. I for one, cannot take any SSRI but I have found other options helpful.

 

I could recommend some ideas based on what I know, but I am as unqualified as you. I have not seen your history, I haven't seen your medical notes, I don't know anything about your physical health, what good would that do? A better solution is for me to ask 'what 'little option' is there to get a pdoc referral? If you have found a gdoc with a prescription pad who is stupid enough to sign his name to any old idea you suggest to him, you are wasting your time. Why not get access to someone who can treat you with some reason behind it?

 

CB does not encourage drug seeking behaviour or getting advice on how to self medicate rather than seeking a medical opinion.

Edited by Titania
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Why not get access to someone who can treat you with some reason behind it?  Because I don't live in a magical fairy land in which I am able to flit from practice to practice examining the qualifications of each psychiatric physician I see.  Because to do so would mean I would have to attempts suicide, land back in the hospital and go back through our grand county mental health system because that is the only way a person with no money and no insurence can get a doctor in this damn town.  I've been trying to navigate the wonderful world of mental health since I was 14, by myself and I know what my options are and arn't.  At this point I have one clinic with doctors I can make same day appointments with.  My doctor, the one who knows my history is a PA.  He didn't perscribe any of my medications, the county's psychiatrist did before they dropped me because I couldn't afford it.  This clinic I can afford. They charge me fifteen dollars for visits and five for medication.  The price I pay is not having the best of care.  So yeah, I google.  I ask people on the internet.  I make a lot of decision and do a lot of trial and error with medications and my docotrs pretty much just sit back and let me because they don't know what the hell they are doing.  Could it be better? Yeah.  But this is how it is.  So don't come down on me all high and mighty.  I just came looking for advice and didn't see anything in the rules against what I was asking.

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There is a reason why family doctors and gdoctors are not supposed to presrcribe psych meds for long term management of anything other than mild mental illnesses. Because psych med prescribing is very complicated and you can't just fluff your way through by googling and asking strangers on the internet. We can advise you on how to communicate better with your gdoc, and how to seek a pdoc to care for you, how to deal with a lack of insurance, but no one here can or should help you prescribe meds for yourself because none of us are qualified doctors.

 

SSRI's have many side effects (I am sure you are aware) and a long list of interactions with other health conditions and other medications. SSRI's are not the only or best anti depressant for many people, look around here and see how many people with depression use mood stabilisers or anti psychotics, or exercise, or diet or all of the above. I for one, cannot take any SSRI but I have found other options helpful.

 

I could recommend some ideas based on what I know, but I am as unqualified as you. I have not seen your history, I haven't seen your medical notes, I don't know anything about your physical health, what good would that do? A better solution is for me to ask 'what 'little option' is there to get a pdoc referral? If you have found a gdoc with a prescription pad who is stupid enough to sign his name to any old idea you suggest to him, you are wasting your time. Why not get access to someone who can treat you with some reason behind it?

 

CB does not encourage drug seeking behaviour or getting advice on how to self medicate rather than seeking a medical opinion.

I think this is a bit harsh.

 

Sometimes a doctor will give the patient a choice because all the options are equally preferable. I was given a choice of mood stabiliser when I was diagnosed with BP. Choosing an antidepressant is often just trial and error. If there are comorbid illnesses, that can dictate which ones will be prescribed. If not, there aren't any tests to show which will work best. There's not much for the physician to base the decision on. I don't see a doctor being open to suggestions as inappropriate. 

 

It is not the same thing as self-medicating or drug-seeking. The patient suggests the med to the doc and the doc decides whether it is appropriate. The doc will still be assessing if it is safe and a suitable choice etc. If a patient has chosen the med they are more likely to feel positive about it and more likely to be compliant. I don't think it's right to attack the OP and call them a drug-seeker. That is rude, aggressive and uncalled for.

Edited by mcjimjam
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My reply would have been different if the OP had actually given a reason why he wasn't seeking a psychiatrists input. Many people do try and manage with a gdoc prescribing and some people do that because they aren't willing to engage with treatment, I felt it was a fair question to ask why the OP had ruled out getting a;pdoc And it's still a huge risk to be getting meds from someone who not only isn't really qualified to manage a complex case, but who will prescribe what is suggested, that sounds like someone who can't deal with a crisis when they meds they prescribe cause issues. The OP said 

'I most likely will have to tell him what to do'

Which didn't really read to me like he was giving to gdoc ideas as much as asking for a specific med.

 

As for the OP, I am sorry if what I said came off harsh, I can see why my tone read that way and I apologize. I am also sorry to read that you have been struggling this way for a long time. I can see if I can get some members who know a lot about accessing funds and county care to pitch in with any suggestions more relevant at this point.

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It sounds like you're b/t a rock and hard place with finding good psychiatric care.

 

I often use this website: http://www.psycom.net/depression.central.html  when I want to do a little research on meds and other things relating to MI.   I hope you and your gdoc are able to come up with a good SSRI or other anti-depressant.

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SSRIs, while not identical, are very similar in terms of side effects. It really is trial and error to find the med that works for you. I've taken all the SSRIs except Viibryd and Luvox, and citalopram is the only one that works for me. But we all react to meds differently so no one can really tell you which med to try. It really depends on what you and your doctor agree upon and your particular brain chemistry.

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Sorry, I got a little defensive and snarky.  I'm a bit, well, defensive and snarky.  I actually went to the doctors yesterday to ask whether they had mental health capabilities at their clinic because I'd heard rumor of such things in the past.  They referred me back to my doctor and said we can fit you in at 4:25.  I was not prepared but I figured I could atleast tell my doctor the lexapro was not doing its job and see if he had any ideas.  So eventually I got in and told the nurse what was what and the doctor knocked on the door, or so I thought, and in came some completely other guy.  A doctor training with my doctor who is himself a PA.  I don't really get that but okay.  So I told this stranger how I was feeling and in the span of ten minutes tried to recap a lifetime of mental illness and my medical history, including all the drugs I had taken in the past.  He listened and was very polite then excused himself to discuss his treatment ideas with my actual doctor.  A few seconds later he skipped back in and proclaimed I would be going off of lexapro, cutting it in half and taking it nightly for a week then taking it every other day for a week, while simultaniously starting Wellbutrin.  So that is where I am now.  I haven't done much research on Wellburin, but I work in a library so research in the easiest thing in the world, but I have heard that some users complain of feeling irritable and angry on it.  This is my biggest fear as I am already irritable and angry when unmedicated.  Hopefully though it will all work out.

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I know I was a bitch, I'm having a shit time with my mental health and I do tend to go off on one. But I truly am happy to see this new development for you. I am glad things are moving again and I hope that Wellbutrin helps.

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