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Toblerone

Suggestions for new meds

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Hello,

I'm new to the boards and could use some suggestions. 

15 years ago I was diagnosed by my PCP with generalized anxiety and depression. Although I've been this way as long as I could remember. My anxiety causes my depression. I originally was started on Paxil, which turned me into a zombie. Then I was on Celexa, for a number of years, as it stopped working, my dosage was upped each time until my Dr said I was at the highest dose. So she changed me to Lexapro  w/ Buspar, the Lexapro worked for awhile, but I had to drop the Buspar as it made my bruxism worse when I slept. Eventually the Lexapro stopped working. 

I switched from my PCP to a Psychiatrist, in hopes of getting more targeted care. The first one misdiagnosed me and was insistent that I was Bipolar and prescribed me Latuda. I took it because I thought, "Well....what If he's right?" Which was a nightmare. Not only was I not able to stay awake during the day, but it put me in a manic state which I had never experienced before.

I again, switched psychiatrists, this one prescribed me Wellbutrin + Zoloft. I was on it for a month. And was not feeling any relief. So she tapered me off the Zoloft. So now I'm just on the Wellbutrin. And not only is my anxiety through the roof, it makes me jittery and edgy. And the last three weeks, I've cried every day. Although the crying is over a breakup, I'm positive that my meds are not helping. throughout all of this...all of these drugs have zapped my libido. It's a catch 22. Do I want to feel normal and not have any interest in having sex? Or do I want to be anxious and depressed all the time and not feel like having sex? 

I've taken the GeneSight test in hopes the results would tell me what would work best...But it just breaks the drugs down by categories of Use as directed, Moderate gene-drug interaction, and Significant gene-drug interaction. In which nothing fell into the last category. 

I hoped that it would narrow it down so I wouldn't have to keep this trial and error up. I don't want to take anything for anxiety that I could become addicted to (Benzos). And as far as antidepressants, I'm running out of options. 

I've thought of trying Celexa again to see if it would work. It worked last time for 5 years before I had to increase it. It does fall into the moderate gene-drug interaction column on my report for "Genotype may impact drug mechanism of action and result in reduced efficacy."

As far as antidepressants listed as suggested, I've tried Wellbutrin, which clearly isn't working.

Then there's Pristiq, Fetzima, Emsam, and Vibryd. Which I have not tried yet. 

Any suggestions on which one I should try next? Hopefully something that doesn't make me a zombie, cause increased anxiety, or make me cry every day, or zap my entire sex drive? I know. I'm asking a lot. 

Also noted, I have started DBT in hopes that it will help as well. Hopefully, one day, I can be med free. (A girl can dream.) 

 

 

 

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This is what I would do. I can't tell you what to do because I'm not a doctor. I would want to try the Celexa again just because it helps me very much with anxiety. It's a really good med except for the apathy. If that didn;'t work out, I'd try Effexor which is the parent drug of Pristiq.

Wellbutrin is not the best AD for someone with anxiety. I can't understand why your doctor prescribed it.

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12 hours ago, Toblerone said:

 Any suggestions on which one I should try next? 

In addition to what @jt07 suggested above, I think Remeron (mirtazapine) might be another possibility....

It is an antidepressant that helps with anxiety as well........ https://en.wikipedia.org/wiki/Mirtazapine

In general, it is more sedating at lower doses, especially when you first start it....Takes a little while to get used to it, but it works well for some folks here.

Edited by CrazyRedhead

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I'm sure there was a good reason at the time, but I'm a little surprised a pdoc would leave you on the Swellbutrin and ditch the sertraline (Zoloft) if your primary concern is anxiety.

Have you tried sertraline on its own?

Also, physical activity and CBT (if you can tolerate it) or ACT are good choices for non-pharm interventions as well as the DBT. DBT will help you learn a bunch of skills. CBT helps you retool your thoughts, and ACT is good for learning how to "do it anyway" (ie committed action consistent with your values and mindful acceptance of difficult emotions and thoughts).

 

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15 hours ago, Toblerone said:

And as far as antidepressants, I'm running out of options.

No way, you still have plenty of options. You still have the SNRIs, SARIs, SMSs, TCAs, TeCAs, and MAOIs to try.

15 hours ago, Toblerone said:

Then there's Pristiq, Fetzima, Emsam, and Vibryd. Which I have not tried yet.

If it were me in your situation, being that you've tried three SSRIs already, I personally would try a first-line med from another class, like an SNRI. I personally loved Cymbalta, while it worked for me, and it has an indication for GAD. I think Effexor XR does too. But that doesn't mean you can't try Pristiq or Fetzima too (which only have indications for MDD). Viibryd might also be a good choice with a relatively lower incidence of side effects (for most people, except GI side effects, which tends to be a problem with many people), which I think is a second-line med. the TCAs might be in your near future if you don't respond to the SNRIs. Emsam is an MAOI which is kinda on the second-line or third-line row of meds, depending on how you look at it, but it's a pretty easy and safe MAOI to take compared to Nardil, Marplan, and Parnate.

Good luck finding something! Hope you get the help you need!

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You could also try adding an adjunct AP...rexulti is very rarely sedating and is indicated for add on depression. I agree with all that Wellbutrin is a weird choice I know it only made me anxious and upset kind of like your describing 

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@Toblerone

Hi there! 

I personally took effexor xr (an SNRI I believe) for a while for anxiety only as one hospital Dr put it. But it wasn't good for the bipolar part of my illness in the long run so I had to ditch it. I have found I cannot tolerate any antidepressants because of manic tendencies. (Zoloft sent me through the roof)

Anyway, I have tried wellbutrin too. But I got the same side effects from it that you are having. IME it's not a great med for my severe anxiety disorder. And it seems like you are having the same problem. 

You aren't alone! And I agree that there are so many more options you can try! Everyone has listed so many good options. I hope you find some relief soon. Anxiety really sucks. 

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