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Running out of options, feeling really depressed


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Hello,

I have depression, ocd and GAD. I have already tried most of the antidepressants. There really isn't much left and this drags me down.

I tried:

Escitalopram 20mg for 4 months, didn't really do anything

Remeron 30mg for 3 months, didn't work

Wellbutrin 300mg for 2 months also didn't do anything

Agomelatine, useless!

Tianeptine 37,5mg for a few weeks, felt like it made me feel worse

Clomipramine/Anafranil: couldn't deal with the side effects, it made my heart race (doctor said if I cannot tolerate the typical TCA side effects then trying other TCAs makes no sense, this means

that TCAs are out of the game)

Brintellix/vortioxetine 20mg for 3 months, not sure if it did something but definitely not much

Mematine 10mg: I tried it for ocd but i felt like it made my memory worse and then stopped it

Sertraline: also didn't work and I got off it when going on Lamotrigine cause there is a drug interaction between these 2 drugs

Cymbalta: I went up to 120mg and it didn't do anything

Effexor: went up to 250mg. The side effects were unacceptable and I also felt no benefits.

 

Currently I am on 250mg Lamotrgine but I cannot say if it does anything. My ocd, depression and anxiety are really strong due to external things which happened. I noticed that if things happen

which scare me then my overall anxiety and ocd also get much worse!

 

The problem is that I also have ADD which I take dextroamphetamine for. This means that basically MAOI and also Moclobemide (Reversible MAOI) are also out of the game!

I know some people mix amphetamines with MAOI and still live but my doctor would never allow this and I will not do any experiments on my own.

 

What do I do now? If I feel like there are no drugs left to try then it makes me feel even worse.

 

Edited by regis
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There's a ton of variation between TCAs, so I wouldn't dismiss the whole class based on just one example.  You don't seem to have tried augmenting an AD with either an AP or Lithium, which are both possibilities.  

I have OCD and ADD with a depressive jag every now and then.  What's ended up working best for me is Wellbutrin + stimulants and then an AP and Luvox to keep the other half from making my OCD worse.  This is after over 20 years of trial and error.  I've been on everything you listed and a bunch more.  Nothing ever really worked without making other stuff worse until I was mixing at least 4 drugs at a time.  It's not a lot of fun, but once you figure out no single drug is going to work for you, you start looking for creative cocktails.  

Frankly, if you're diagnosed with multiple psych conditions, why does it make any sense to think that just one or two meds at a time will work for everything?

 

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Have you tried Abilify? It has made all the difference in the world to me. Also, Tegretol works for me by stopping me from becoming suicidally depressed and by serving as general brain glue. Abilify, Tegretol, and citalopram form the backbone of my cocktail.

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I've seen some people do better on the "flipped" isomer variant of a medication. You stated Escitalopram "didn't really do anything" so, I'm guessing it did something, even if minor. Have you taken Celexa? I also don't see Trazodone on that list. I've provided a link that compares side effects and receptor affinities. You don't need to be a member to see it.

https://www.scribd.com/doc/19985485/Antidepressant-Comparison-Chart

Strattera's indication was supposed to be for depression but they found it worked better for inattentive/hyperactive symptoms so it became an ADHD med. You mentioned you have ADD, it might be a good one to suggest to your pdoc.

Edited by Persona_Is_Life
Fragmented sentence.
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  • 4 months later...

An interaction checker didn't like Strattera and Moclobemide any better than it liked Moclobemide with a stimulant. RxList and Drugs.com wouldn't let me enter Moclobemide, so I went to RxIsk.org (based in Canada or Wales?) and this is what it said:

"MAO Inhibitors may enhance the neurotoxic (central) effect of Atomoxetine."

For Ritalin, Adderall, and Desoxyn combined with Moclobemide, it was about hypertension.

In the really long Brintellix thread, people who took it with Wellbutrin, despite the seizure warning, were the ones who stuck with it and said it helped. "Brintellix- Is anyone else actually taking this?" It's discussed towards the end, so I linked to the last page.

Here's an blog post that covers some of the research on combining stimulants with various antidepressants, that might have some useful ideas. Probably worth checking the references, since it isn't a peer-reviewed journal article. http://mentalhealthdaily.com/2014/03/13/taking-adderall-for-treatment-resistant-depression/

Finally just to test the idea that the dextroamphetamine could be a culprit, I searched the web using dextroamphetamine makes me depressed and found that some people do say that:

 

Screen Shot 2016-05-09 at 1.27.42 PM.png

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