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.
I was prescribed Vraylar as a mood stabilizer for MDD, which I have been diagnosed with for 20 years, along with ADHD and social anxiety. Until I Vraylar gave me an acute manic episode for over a year, which I hid from my doctor because it was so much better than being depressed. But then I came clean and we realized I actually had hypomanic episodes about 2ce a year, but didn’t realize it, I just thought I had some energy. Anyway, I was wondering if anyone else has had this reaction to Vraylar?
Hey guys, long time lurker here, and I'd really like your input on something. I'm a bit stuck when it comes to treatment, and I'd like to hear some peoples' opinions, as I wont be able to see my doctor to talk about it for a little while.
I’m currently diagnosed as having GAD and MDD, but I’m starting to think I have a bipolar spectrum disorder. Here are some points:
Failed multiple antidepressants (Zoloft, Lexapro, Prozac, Viibryd, Pristiq). Failed and/or had too many side effects Had side effects on every serotogenic antidepressant, even while augmenting (Wellbutrin, Buspar) like sexual dysfunction and extreme fatigue Atypical depression — BP Depression has excessive sleeping with a lot of daytime fatigue and an increased appetite, opposite of MDD Very anxious — BP much more likely to be accompanied by stronger anxiety symptoms The fact that “If all the treatments don’t work, maybe you’re treating the wrong thing” Excessive nighttime eating (seen in BP Depression vs unipolar) Racing thoughts Earliness of first depressive episode (age 19 at the LATEST), and research shows it’s very likely to be bipolar disorder if before the age of 18/20/25 (experts disagree on the age) My anxiety symptoms could actually equate to mixed state Losing and regaining interest in hobbies (I’ll enjoy my “typical” hobbies one day and then later, zero interest / motivation) Cousin has BPII (I know immediate relatives are the key, but still, a data point) Online shopping addiction (computer, iPad, something new in the mail every day)
The fact that Bipolar Spectrum Disorder doesn’t require mania/hypomania, just multiple non-manic markers of bipolar (see links below for source) The odds that I have treatment-resistant depression coupled with very prominent anxiety, and considering my episodes of depression aren’t THAT bad that they would be so hard to treat So, what do you guys think? For me, it would be a big relief to get a diagnosis as somewhere on the bipolar spectrum, as I've tried so many meds already, and I just wanna feel better If anyone is curious as to my regiment and past meds, I'd be happy to post that as well.
Thank you all so much for taking the time to read and respond! It means a lot!
The med tinkering is driving me nuts. Anyone with me here? Sigh. I have had depression and major depressive episodes for the past 20 years, but I have only been doing the med thing for the past three years. I feel like I get so close to finding a combo that works, albeit with some intolerable side effect... and then I try to get the combo better and wind up making it worse. My latest foray brought back my PMDD crying/depression/irritability for the past week and I'm just at a loss of what to do next. My psychiatric nurse is pretty much up for whatever I want to try, but I don't know what to do anymore. Maybe you all have some ideas?
Here's what I'm on right now: Lamictal 200mg (for MDD; *supposed* to be my main antidepressant), Wellbutrin XL 150mg (for giving me more energy and helping with my sex drive), and Lexapro 2.5mg (I had been up to 15mg, but completely lost my ability to orgasm and decided to go off it; hence going on Lamictal).
Dx: MDD, PMDD, Primary Insomnia (which may or may not be related to my depression)
Antidepressants I've been on:
1) Prozac: numbed me to the point of apathy, caused periodic limb movement disorder at night, sedated me
2) Zoloft 75mg: improvement over Prozac! actually helped me sleep through the night! Yay! Killed my ability to orgasm. Boooo! ... until I added Wellbutrin, then WOW! Sedated me so badly that I only survived on caffeine pills that I had to carefully time through the day, at 100mg every four hours. I hated the sedation (as in I would fall asleep wherever I was multiple times a day if I ran low or out of caffeine), so decided to try something else...
3) Wellbutrin 150mg: Added to help give me my sex drive back. Worked wonderfully! Love this one! Wish it still worked with Lexapro...
4) Lexapro 15mg: Swapped out the side effects. Caused periodic limb movement disorder like Prozac, but NO SEDATION! :-). Sadly, killed my ability to orgasm so completely that not even 300mg Wellbutrin could touch it. I could say that I could live with this, but the endless frustration in my relationship has made me want to pursue another option.
5) Lamictal 200mg: I started this in January of this year, for the purpose of getting off Lexapro, and have been titrating up ever since! Holy crap; it's been forever. Within that seven months, I tried to go off the Lexapro three times. The first two times, my Lamictal was at 100mg and I got down to 7.5mg of Lexapro before having a return of depressive symptoms. This past attempt at going off Lexapro, Lamictal was brought up to 200mg for two weeks before attempting to titrate down on the Lexapro. I titrated by 2.5mg every 5 days and I got down to 2.5mg before having discontinuation symptoms, including depressive symptoms along with headache, irritability, and nausea.
So now I'm at 2.5mg of Lexapro and have been holding there, afraid to go off it completely and afraid to go back up. Clearly the 200mg of Lamictal, plus 150mg Wellbutrin are not enough to deal with my depression, particularly the menstrual/hormonal version of it. I was at 200mg of Lamictal for 7 weeks before this last period hit, so I know that there was plenty of time for it to work. If I increase the Lexapro, it defeats the purpose of why I went on the Lamictal. I've never had good anti-depressant results from Wellbutrin, only increased energy, so no reason to go up on that. I am disappointed at the possibility that I've given Lamictal this entire year to work and I don't know if it is marginally working, or not really at all. I'd like to think that the reason I was able to get down to 2.5mg of Lexapro without return of symptoms this time means that the Lamictal is doing *something.*
Do I ask to increase the Lamictal? Go up to 300mg?
Do I add a different SSRI and go off Lexapro completely? Pdoc thinks I should try Zoloft again. Aaack! Must I live in a sedated state for the rest of my life?! I don't know if there is even the possibility that another SSRI would be better than Lexapro with the side effect profile. But maybe try Celexa and hope for the best?
Do I add an antidepressant that is not an SSRI, like Strattera, Abilify, etc....
Since I know y'all are going to ask, I have tried Mirena and Nuva Ring to control the hormone influenced depression and it has been a crap shoot. Mirena turned me into a raging bitch for months and I bled and bled for weeks at a time. So I had that taken out, needless to say. Nuva Ring caused weight gain, pimples, break through bleeding, and did not seem to make any difference with the hormonal depression. So I went off that too.
Talk to me, people. Lend me your ideas.
Short story - MDD d/x'd 3 years ago with EDNOS (eating disorder not otherwise specified - i.e. I restrict, but I'm not thin, I used to purge, but not too much). I also self-harm and have situational anxiety and chronic insomnia. Current meds: 50 mg Pristiq, 450 mg Wellbutrin XR, 2 mg Klonopin (1 at 5:30p, 1 at 8:30p, occasionally 1 as needed), and 10mg Ambien. I've been on the klonopin/ambien combo for a long time and it works pretty well for my sleep. I've been through most of the SSRIs with limited success or horrible side effects, only to find out via a recent GeneSight test that I don't have the whatever/enzymes to process SSRIs (and SNRIs) correctly. Only Pristiq and Fetzima are in the "green column" for me. Meds I've tried - Celexa (worked for a while and then nada), Lexapro (similar), Zoloft (horrible reactions), Paxil (little effect), Brintellix (not enough and bad side effects), Wellbutrin solo (worked for awhile, but then became not enough), Abilify (gained 20 lbs in one month with little effect), Risperadol (no impact), and I'm sure other combos I can't think of.
We went up to 100mg of Pristiq but I felt like I was in a fugue and would lose all sense of time, so we backed it down. I'd like to go up to 600 on my Wellbutrin as it works well for me but my pdoc won't even though I've been purge-free for 13 months. My eating disorder is ok - my weight is stabilized and I'm not restricting or binging. I'm in therapy regularly and see my nutritionist every other week. But I am exhausted all of the time. It is difficult for me to get out of bed, it's impossible for me to do anything. I have no memory, and it is a struggle for me to think, let alone work (I'm a professor). With the Vyvanse, I'm sometimes able to get out of bed. I can feel my brain "knit" together and kick on, and even have started writing again. I still can't bring myself to get things done or to exercise or even get outside unless I must.
The problem with the Vyvanse is that it wears off pretty quickly for me. If I take a dose at 6:30a, by 11:30p I'm scattered, can't think straight, and feel lost. I take a second dose at noon but it barely holds me to 4. Then my brain is gone. I am still exhausted, and then I can't really think at all in the late afternoon/evening. I'm completely distracted.
I have a call with my pdoc this week and I'm considering asking her to switch the vyvanse to adderall because it has an XR, and the up and down with vyvanse is shitty. I'm really reluctant to switch from the Pristiq since the worst of my depressive symptoms (hopelessness, sadness, flatness, isolation) are better. I like that the vyvanse cuts the cravings so I don't turn to sugar to try to help with the lack of energy because that worsens my ED. I can't take anything that will cause weight gain, or anything that increases appetite. I'm on a meal plan, I'm not losing weight, but I can't take aggravating my ED on top of the shit I'm dealing with.
Does Adderall XL last longer for depression-related ADD symptoms? Does it cause jitters or increased hunger? Anyone use it as an add-on to antidepressants?