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Frustrated with finding the right med

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Posted 12/9/2021 12:20 PM (GMT -7)
Hi there,
So I've been on and off anti-depressants for years, have had mild to moderate success with SSRI's. Earlier this year went back on medication and tried Cymbalta, I have some chronic pain issues and I guess the doc was hoping this would help that as well -- apparently Cymbalta (generic: Duloxetine) can work for pain as well. At first it actually did but that benefit petered out after a few weeks. This drug is an SNRI not an SSRI -- however like most anti-depressants aimed at targeting Seratonin that still brings some side effects... for me anyways it's always mainly loss of sexual drive, also this med seemed to mess with my sleep patterns and at times gave me extra weird dreams, even nightmares at times. Also similar to SSRI's I've tried it ends up creating a huge sense of apathy/emotional numbing within myself; I guess you could say that's an anti-anxiety like effect but when you feel so hopeless from apathy that pretty well negates the anti-depression effect this med is supposed to have in my opinion, just doesn't make sense. I did stick with it for a few months but got sick of it as it still wasn't touching the depression and still barely a libido.

Talked to my doc and tapered off Cymbalta and went on Wellbutrin, tried this med before and I do like it as it has no effect on libido (actually increased it for me) and seems to help depression especially "seasonal affective disorder" like effects, not that I've been diagnosed with that but I do get quite down when days are cloudy, cold and dark; this med helps that big time. Also great for energy and focus, sure got me thru some work shifts nicely. I don't drink coffee but it sure feels like I'm loaded on caffeine when I take Welbutrin. Now onto the main side effect with this for me... not good for anxiety! However every time I've tried this med maybe I don't give it enough time and give it up due to the extra induced anxiety. Does this side effect ever go away? I've heard that it can actually help some people with anxiety, although I think that's rare.

Just tired of dealing with all the pros and cons of these medications. Some days just wanna throw my hands up in the air and say "enough with these!" arggh!

So can anyone relate? Similar experience? Thoughts? Advice?
Thanks!!

Post Edited (skytop1) : 12/9/2021 12:23:11 PM (GMT-7)

Posted 12/9/2021 4:37 PM (GMT -7)
Hi Skytop,

Welcome to the depression support forum. Have you tried effexor or pristiq? They are both SNRI's I believe. I took effexor for many years and it didn't effect my libido one bit. I take pristiq now. Just thought I would throw it out there incase. Though if cymbalta effected you negatively maybe your doctor feels effexor or pristiq would do the same. I don't know. But it may be worth a try. I hope that you find what works for you.

Have a good night or day depending on where you are.

Take care,

Hugs, Karen...
Posted 12/9/2021 6:08 PM (GMT -7)
Hi Skytop -- I was prescribed SSRIs years ago, but they didn't work very well. The effects were along the lines of your description, except on steroids (i.e., couldn't take the extra anxiety and sleeplessness at some point, especially with everything else just numbed down and not really fixed).

I've read good things about ketamine on this forum and elsewhere. It's relatively new, but may be one way to go, especially as it's claimed to work in hours or days instead of weeks. I've yet to give it a try and would be interested if anyone has any experience there.
Posted 1/6/2022 8:35 PM (GMT -7)
Look up Remeron. Works quickly, is activating at higher doses (since it will increase dopamine and norepinephrine), good for insomnia (makes you tired when dosing), blocks serotonin 2a and 2c receptors, which contribute to SSRI side effects.

Works quickly, with same-day benefits.

Combined with SNRIs in a combo called "California rocket fuel".

I think the combination is supposed to be synergistic through blocking of the negative effects of enhanced serotonin transmission via 5ht2a and 2c receptors. Bombarding 2a and 2c receptors causes anxiety, and zombie effects. Serotonin hitting 2c receptors inhibits dopamine and norepinephrine release.

The issue is it'd probably be a difficult combination to get off of, but if you're backed into a corner, maybe it's the answer.


Otherwise:

Magnesium glycinate, or malate (400mg+/ day)
Vitamin D3 (2000iu+/day)
High quality fish oil
Neurotransmitter precursor amino acids
Eliminating inflammatory foods
Sunlight (even light lamp)
Ample hydration
Posted 1/6/2022 8:54 PM (GMT -7)
maybe an old school style of med might help a
mono amine oxidise inhibitor.
when ssri snri don't work, maybe a maoi might.

Just throwing it out there. HT
Posted 1/7/2022 9:12 AM (GMT -7)
Welcome Quantumsurge.
And Skytop.
Some meds take longer to kick in then other meds
Unfortunately meds can be a try and go thru process of eliminating
I had to through this

Hard. But well worth it in the end
Stay well
Posted 1/7/2022 9:51 AM (GMT -7)
Tricks with meds... fun times!

After 7 months, I seem to be developing an allergy to Lyrica. So have to slowly cut back on it, supplement with a Prednisone dose pack while that's happening, and hope to end up in a better place.

Not really expecting much, but trying to cling to hope. What's the alternative? lol
Posted 1/7/2022 12:41 PM (GMT -7)
You said you are now on Welbutrin antidepressant, but noted, "Now onto the main side effect with this for me... not good for anxiety!"

I agree with the poster above who said "Look up Remeron...good for insomnia (makes you tired when dosing)."

I've taken Remeron (I call it Mirtazapine) for the past 5 or more years for bipolar, along with Lithium, and I'm not anxious or depressed. Web.md says, "Mirtazapine is used to treat depression. It improves mood and feelings of well-being."

As for Remeron's (Mirtazapine's) help with anxiety, www.nhs.uk says:
"Mirtazapine is an antidepressant medicine. It's used to treat depression and sometimes obsessive compulsive disorder and anxiety disorders."

One of the side-affects is "weight gain." However, webmd also says: "Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects."
Posted 1/7/2022 6:22 PM (GMT -7)
Mirtazapine munchies!
Yes, i have severe insomnia, and use it as a settler at night.
Yes TT, spot on with last paragraph. HT
Posted 1/8/2022 4:14 PM (GMT -7)
I’m feeling the same as you. Have been trying for 3 years and no success. I was on Pristiq for many years and did pretty well on it until my Dr. thought it was time to try something else. She put me in Cymbalta but it caused me to form gluten sensitivity and eventually sensitivity to all grains. It only worked for me at the highest dose. We tried going back to Pristiq, but it didn’t work when u went back to it. I now discovered that once I stop a medication and eventually go back on, it either doesn’t work or it works maybe half as good as before. Then we switched to Zoloft and Wellbutrin now Lexapro with Wellbutrin. Still depressed. I went off Wellbutrin for some time and my Dr had mr go back on it. I don’t think it’s helping much at all but she wants me to keep taking it. She doesn’t seem to believe me that I can’t go on the same antidepressant more than once bc it doesn’t work second time around. Oh, went on Trintellix too and felt relief but copay was $250. So I stopped. Don’t know what yo do at this point. It doesn’t help that I have Lyme which causes depression.
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