Welcome to Depression Regimens

Whenever I’m in a depressive episode, I can’t stop researching and ruminating, I’ll sit on my phone for hours searching all different types of medication, therapy, reading people’s stories, etc. idk if this is a helpful thing or is a rumination thing and actually makes things worse since I’m giving it so much focus. Does anyone else do this?

All in all I just want to feel normal lol, I know the feeling so well of feeling normal and I’m longing for it when I’m feeling depressed. I want that normal contentment that people have as they go about their day. Idk how one day the switch flips and randomly I’m depressed? Ugh

Which is worse?

I have autism, severe anxiety, depression, and probably inattentive adhd or OCD. Effexor and Mirtazapine are my first antidepressants ever. I'm the one who suggested them and suggested increasing the dose for both.

I'm currently on Effexor 150 and Mirtazapine 45. I also take risperidone, propranolol, stemetil as needed and anxicalm as needed. Due to having autism, I'm terrible at recognising and explaining symptoms to my doctors, who don't really listen anyway.

Effexor got me out of bed and got rid of a lot of my anxiety and paranoia, but it's also way too overstimulating. My mind races like crazy, and I can feel my brain and heart rate going like crazy.

But it's also made me unable to concentrate on work at all since going up to 150. And I'm even worse since increasing Mirtazapine to 45.

Simultaneously, the Mirtazapine has been great for curing my insomnia. But now I'm super tired in the morning and at night. Very groggy. No way to live at all.

Did these medicines reveal some hidden ADHD or autism complications that I always had? Or am I just suffering from serotonin syndrome? It's crazy that my doctor's haven't recognised this and just brush it off under the umbrella of autism.

Any slightly milder medications to replace effexor and Mirtazapine with? I was thinking cymbalta/sertraline/Prozac/wellbutrin/agomelatin, and quetiapine/pregabalin/hydroxyzine. Obviously I'd only take two, but my doctors are just leaving the decision up to me. So any advice would be most appreciated.

Hey! I have been on a mix of Wellbutrin (was 150 and quickly upped to 300) and Lexapro for going on three years now. Lately I have had absolutely no motivation at all, and have been feeling very depressed and hopeless again. I sleep as much as I can. I’m always psychically and mentally exhausted. I have read that Wellbutrin has a tendency to stop working as well after a while. Has anyone had this problem? Were any other medicines added into the mix?

For background- was so Prozac for probably about 1.5 years, and I felt completely emotionless and robotic. With Lexapro, it decreased my anxiety but my depression/hopeless thoughts were very bad. With Wellbutrin, I was very anxious but not depressed, so taking the two together was perfect, initially.

I am currently on Escitalopram and amphetamine/ dextroamphetamine. I am not consistent with my meds and would like to switch to selegiline transdermal. From looking at it online I am not sure if I can have a adhd med along with this. I would like to do an antidepressant and an adhd med if possible. I take the adhd med as needed.

Hey all, I'm back with my usual medicine ramblings and want some thoughts on what to potentially try next and why.

Background:

• ADHD, depression. Taking 18mg-36mg of Concerta, 3mg of Intuniv. That's been my staple for a long time (5 years). Intuniv for rejection sensitive dysphoria mainly.
• Was on 300mg Wellbutrin for the past 6 months or so
• Recently added 0.75mg of Pramipexole to give me a bit of a boost and there's lots of good literature about it. Still evaluating.

Noticed that I had no motivation to do much outside of work, but luckily I was able to focus on work pretty well. I was doing a good job at work, it was quite nice. But outside of work I just didn't want to do a thing. I didn't want to meet friends, I couldn't bother replying people, I stopped going to the gym (I went every damn day, even when I travelled). I am quite unhappy.

I tapered off the Wellbutrin and now my focus at work is trash. I keep getting distracted and do all kinds of other things. So it definitely worked for making me a good worker bee.

With Wellbutrin gone, I am thinking what else I should try or re-evaluate (or just re-add Wellbutrin). I'm a bit all over the place but hope I can get some thoughts here. all of this I am of course also talking with my doc about, but he's more following what I say/request and can't look into my brain. Here's what I am thinking is the most promising:

• Parnate: Worked great, I stopped because again, I didn't want to do much. I was in "sloth mode" as someone on this sub described it, where I just laid around and was happy doing so.
• Moclobemide: Been on and off. It works, it doesn't work. I'm not sure anymore, I have notes from my Moclobemide period that are positive
• Selegiline: Works temporarily (taken orally to stay selective to MAO-B), then stops. Rinse and repeat. Also very hard to get for me because it can't be prescribed with Concerta, and importing it is illegal due to mild amphetamine effects
• Strattera: Been on that a long time before taking Intuniv. My dosage was very high and eventually it gave me abnormal heartrate so I stopped. Recently wondered if re-evaluating it is good given that Wellbutrin (NRI) helped and Strattera is also an NRI. Plus mild effects on serotonin, so I guess a mild SNRI
• Baclofen: GABA-B, Been on my list for a while because Phenibut works so well for me and there are positive reports on it. Tried non-ER version and it made me so tired, bu thaven't properly trialed it.
• Modafinil: Really just an idea to try. Tried instead of Concerta for a while as an experiment with my doctor and it did nothing at all for my ADHD. Just made me very very awake, though my concentrate was still trash. Still maybe could be the kind of slap in the face that gets me out of my hole
• Abilify: Same, tried before, idk if it worked but I felt a bit manic, like I had a tornado in my head, like overthinking but x100000. I was very very restless. I hear good things about it though, but think I may have that angle covered through Pramipexole already

Right now I'm thinking is to re-introduce a bit of strattera (25mg?) to see if that does anything, followed by Baclofen, but a bit more vary about this one. A third is Moclobemide.

Modafinil/Parnate are a bit more powerful so I would need to adjust the other things I'm taking, eg stopping Concerta and gentle reintroducing it (if at all), and maybe getting off the Parmipexole.

Curious what you would do and why? Is there something missing from the list that I haven't thought of yet? So far I'm stayinga way from SSRI/SNRI territory. Brainstormed with ChatGPT and it pointed out Nortriptyline (tricyclic) for it's norepinephrine and dopamine effects, and Bromantane for enhancing dopamine/serotonine synthesis.

200 clomipramine 75 trazodone for sleep

Uhhhh when I am hungover ever since starting clomipramine I get closed eye hallucinations. It has to be binge drinking tho.

It’s nothing crazy kinda like very indistinct staticy faces? Pretty weird and freaky. Made me drink responsibly so thats a positive.

Wondering if there’s a reason or something why doctors don’t seem to have good opinion towards Pristiq. I was on it before and it was always the first to go when talking treatment regime changes despite it not having any side effects or doing noticeably much. When I finally got off and my pharmacist asked if I still take Pristiq vs a few other meds I said no, she said “good for you” specifically in reaction to it 😂 so now I’m curious

any low risk meds that hit all these pretty well? what regimen works for ya? i’ve got pssd? need something with low side effect profile and low long term risk

*EDIT: AND IRRITATION/negative thoughts REGULARLY

Hi all,

Long story short, for around 4-5 years now, I've been suffering with moderate depression, anhedonia, and a lack of motivation. Essentially, I just don't get any buzz or excitement from anything anymore. I very much feel as though I'm just going through the motion of life without anything to look forward to, even though there's so much in theory in my life to be happy about.

The cause is a complete unknown. I have ADHD and have been on SSRIs and Vyvanse in the past, but don't want to go back on SSRIs if I can help it. Vyvanse was great, but the comedowns were too bad. I'm now also struggling with some dissociation which is near constant. I have literally no idea what's made me feel this way - perhaps it's the constant moderate depression that I've been having for a number of years finally catching up with me?

I do pretty much everything for my mental health. I run around 50km a week, I gym 3 days a week, I eat very healthily, I take probiotics, vitamins (because I'm a veggie), creatine, I go on walks twice a day, I don't drink, I don't take any drugs, I have a healthily sleep routine, I do cold water immersion at least 5 days a week and I have a healthy sex life. I've had blood tests done twice in the last 2 years and other than slightly low Vitamin K, all has come back in the normal range. I've also had testosterone testing done as well - that came back absolutely fine. I've done counselling as well, but since my life circumstances are very good and my way of thinking isn't that damaging, it can be hard to really know what to talk about. I'm just 'low' and I have no idea why...

I've taken a wide range of medications and supplements in the past with limited success - the closest I got to being 'cured' was St John's Wort back in November, but had to stop that due to risks to eye healthy which I read up on. Even then, the effects were short lived.

What do you guys think I could do extra? What am I missing?

How’s it working for you?

I’m wondering what people’s experiences were withdrawing from Effexor!I took Effexor for 8 years, the last 3 or so I was taking 300mg a day (the max dose is 225, but my doctor prescribed more). I spent the last 7ish weeks cross tapering with Wellbutrin and now have been completely Effexor free for 9 days.

The first 5 days the brain zaps, nausea and exhaustion/physical pain were brutal and my appetite sucked. Now my zaps are way more mild, and the rest of the symptoms are pretty much gone but I keep crying uncontrollably—has this happened for anyone? I’ve never been a crier so I’m pretty alarmed that I’m just losing it everyday

FYI: the actual cross tapering was great, I’m doing well with Wellbutrin. All of this came on AFTER I fully stopped

Please give tips

Does anyone cycle through their rescue meds so that they don’t gain a tolerance? Like say day 1 pregabalin, day 2 benzo, day 3 medicinal cannabis then repeat, taking sober days whenever your depression isn’t that bad. With this method, meds are never increasing in dose. Is there any harm in doing this when ssris don’t work?

Hello,

I have been on Trintellix 10 mg for exactly a month so far. The medication is barely working compared to when I tried it a year ago.

There are a bunch of side effects that are not improving and I want to understand how they arise pharmacologically. These are:

• Dry Mouth
• Constipation
• GERD/stomach pain
• Nasal congestion

The last two arise probably because of the increase in histamine that the medication is causing, and me having already predisposition to nasal allergies and GERD to begin with (Histamine Intolerance). My doctor suggested adding Mirtazapine 7.5 mg a night to improve these two, which it did. However, it has not helped with the first two: dry mouth and constipation. Does anyone have some sort of an explanation of how the first two side effects actually arise? I do not think it's the excess histamine as the latter two. I was thinking maybe the increase in norepinephrine or acetylcholine?

Thanks.

I am currently taking Wellbutrin XL(150mg a day) and Modafinil(100mg a day) for increasing daytime alertness and energy.But I still suffer from very low motivation and some sadness.I was not able to tolerate 300mg of the Wellbutrin. Tried Prozac at 20mg a day and it caused only emotional blunting and sexual dysfunction. I would like to know if I should increase the dosage of Modafinil to 200mg,add duloxetine,duloxetine + mirtazapine,mirtazapine or pramipexole. Which advice would you give?

I’ve been suffering from PSSD for years now. I’m completely numb to all emotions, even alcohol / nicotine. I’m so desperate to just feel a little bit of something at this point. I’m looking for medication suggestions to hopefully improve emotional blunting. I don’t care about the sexual symptoms anymore.

can it cause it?

I've never had a steady circle of friends. I never felt like I fit in from an early age. I have great social skills so I don't stand out negatively, but I've been alone for years now.

I'm aware that having good social connections is important to sustain mental health, but being in the depth of depression, anyone who I try to forge some kind of relationship with, I just feel compelled to talk to about my problems as that's what's most prevalent for me in my life right now.

With that in mind, I know I can't forge proper relationships this way as its a selfish thing for me to do (nor would they want to spend time with me). I've no interest in anything at the moment, so "joining a club" etc is a fruitless strategy for now.

I don't know how to approach this.

Hi everyone. Dealing with depression (mostly presenting as complete lack of motivation and energy as well as pretty severe irritability) and (mostly social) anxiety. Also it seems I’ve developed OCD in the last few years. Was prescribed Zoloft 5 years ago, took it for 8 weeks (even upped the dose to 100 mg without consulting the doctor because I was getting frustrated lol), didn’t do anything for either anxiety or depression.

A year ago I’ve decided to give SSRIs another chance: this time with fluoxetine. Started with 20 mg and upped it to 40 and then maybe even 60, don’t even remember now. Either way, same thing happened, 8 weeks, no improvement, no side effects.

Is there a point in trying fluoxetine again, but this time at the highest dose (80 mg)? Or is it safe to assume I’m one of those people who simply don’t respond to SSRIs (due to either being a rapid metabolizer of certain enzymes or because my issues aren’t connected to serotonin)?

I’m getting a bit desperate as I live in Russia and nothing besides SSRIs, SNRIs and some tricyclic antidepressants is available and, most importantly, legal here. I also can’t afford therapy because I can’t hold down a job, so yeah…

I have problems falling asleep. As soon as I fall asleep, I sleep well through the night.

Classic antihistamines such as mirtazapine, nortriptyline and promethazine are too sedating for me. I feel heavy and sleepy the next morning. Benzoes and Z-Drugs come with the risk of addiction.

I am looking for a light sleep aid that lets me fall asleep quickly so that I feel fit again the next morning without feeling weighed down.

So there is an old thread on this sub about the horror story of David Foster Wallece, the writer, coming off Parnate after 20 years only to find himself stuck with TRD with Parnate not working anymore when he wanted to go back and taking his life a year later. Same thing seems to have happened to me with Escitalopram. I also got PSSD on the way and now I don't tolerate, don't profit from any psy drugs at all, they only make me worse. How is this such a rare phenomenon that I bearly read about it, appart from the well known tardive dysphoria paper and Fava's work about oppositional tolerance? I have to add that I stupidly messed around going on and off this shit multiple times during the last decade. Now I feel like I'm done for I only wonder how that phenomenon is so rare that I never seem to hear or read about it happening to anyone else..

Hello! for some background nausea has always been the norm for me, when I'm not on certain medications I avoid a lot of food that makes me feel worse. I was taking taking Mirtazapine for a few months and my nausea was completely gone, I could literally eat anything and i wouldn't feel sick afterwards. I recently had to stop taking it because It stopped working and I have been struggling, to the point I'm thinking about just going back on It because of how amazing it was. I can't even go on long car rides because I get motion sickness. I've been trying to look for new medications that will be like Mirtazapine but I'm scared it won't help/ make It worse. If anyone has any insight It would be very appreciated!

Right now I'm just feeling the urge to cry and go back to my depressive (natural) state. I've been taking tramadol for pain without abusing ikt, strictly for pain and it helped my depression and anxiety, I've felt like I never did for a good time, but right now I feel depressed, drained, irritated and I just want to cry till I fall asleep Edit: it was just a bpd mood shift. I had nothing to cry for but I did it, usually I can't cry like that. Then I felt better and next day without any negative symptoms besides my physical pain

How long do you give an antidepressant to work when trying one or increasing the dose for the first time?

I know most drugs take weeks or months to work but my body is so sensitive that I can usually tell in the first few days or a week if a med is going to work or agree with me.

Just curious what the rest of you are like.

I just don't think anything lasts for very long. Im In therapy. I did tell my doctor no more atypical antipsychotics. On bupropion, sertraline, lamitrogine.

I’m rather new to Parnate (20 mg) and have been playing around with the timing of my daily dose(s) to see how it affects my insomnia (side effect from the medication). Right now I’m taking the full dose at night.

To switch back to a twice-daily routine, should I skip a day and resume as normal or return to usual the day after a night’s full dose? I’m a bit worried the latter option might be too soon/dangerous as far as doses go. But I also don’t want to miss a day of medication.

What do you think? I reached out to my doctor, but I’m not certain he’ll reply before the weekend. Thank you.

Hello all, could you please share your experiences with bupropion?

Three weeks ago, my depression started to say hello again because an event triggered it. It was horrible, I always wish I had the kind of depression that makes you stop eating, and then I had it. Food was my number one source of numbness when depressed, take it out of the equation and it's just "hello darkness, my old friend".

After two weeks and no sign of recovery, I called my doctor and she bumped the dosage of bupropion. It was less than one week ago, I know it takes some time to see improvements, but I feel weird. The depression is pretty much here and I feel sick all the time. I don't know if it's the bumping in the dosage or just me being depressed in a different manner.

Before, I would be depressed just with a complete lack of motivation, zero feelings, and lots of binge episodes. Now I am functional, because I have to be, but barely functional. My brain is often blurry, my back is always heavy, and my belly/stomach are just weird, kind of like butterflies in your stomach, but wasps instead of butterflies.