Welcome to Depression Regimens

As soon as I do something like going for some beers with my friends, doing sports or see a girl I'm happy. , I suggest activities myself, I'm just often a bit tired.

As soon as I'm active I feel pretty good... But it only takes one day at home for me to become depressed: I stay in bed for 12 hours listening to music, I procrastinate to the point of missing meals, I don't take care of my hygiene, I'm crying everyday (Whereas before 2024 I had never cried)... But with Parnate (80mg) I feel fine, even when I'm crying.

The problem is that it's then hard to get out of this situation (well, I need hiking for a day or clubbing all night but I usually say no to my friends because I have no energy).

At the moment I should be revising and I've turned down a vacation because of it, but I'm doing NOTHING. I could have seen my family and that saddens me enormously.

Here what I'm taking :

• 80mg of Parnate, I feel so tired 2 hours after dosing... And all the day
• Modafinil : 400mg, I can sometimes feel it if I take 2 pills at the same times. Today I took Guaranna, coffee et 400mg of Modafinil then I slept all the day
• (don't take anymore) Concerta 36mg : that is great but no stock and no prescription since I went to another city, it gived me energy and I was really happy but I wasn't more productive...
• (don't take anymore) Bupropion : really good for remediation cognitive, focus and maybe et bit more productive. Effects are coming after like 5 weeks and I bought it again, I will try 450mg
• (don't take anymore) Strattera : maybe the best for cognitive and procrastination but it can knock me out, it was a bad experience, even after 4 weeks)

What I tried :

• (A hated SSRIs : Anhedonia was the worst part, duloxetine, venlafaxine, prozac, brintellix...)
• (Amitryptiline : wow day 1 I had no more anxiety ! Problem is fatigue (they said I had mononucleosis so I didn't change my treatment). For 1 year I was flat, not good (my sister said I was more fun before lol) but I did not suffuring anymore.
• I took Kratom for studying : only thing that worked against procrastination, wtf
• At the begining of 2024 my prescription was : Brintellix, Amitryptiline, Quetiapine and Valium. I was so tired... After all that shit I've decided to self-medicate.

Self medication (since feb 2024) :

• I started with Parnate. It was really good at the begining but it fade out so I upped the dosage to 100mg. For the first time since 2021 I could really feel happy at some moment... And sad sometimes. Best med for anhedonia (but no improvement in motivation to do thing, I could just feel the moment).

• At the summer I did not received my indian order... And it was juste the worst week of my life. Horrible, I can't describe it. After 3 horrible days I took some Tryptophan (they also gived me Valium) and... OMG the effect were so powerful it alleviate like 50% of my withdrawal (obviously it wasn't enough but a guys from reddit sold me parnate and with 40mg/day and, I was crying when I received it, I know it was the end of this hell.

• I started Concerta, 18 mg on august and 36 mg in september. I felt good but people said I was weird, in fact it was the Tryptophan, I took to much. If we forget a difficult breakup (even with my sister and my best friend...), it felt good lol.

• September : 36 mg concerta + 60mg Parnate + 10mg Valium + Bupropion SR 150mg I felt wonderful but I slept like 3 to 4 hours every days.

• October : 400mg modafinil, 80mg Parnate, 20mg Valium... It was a bad month. Hypersomia and dificult to go out of bed. I tried Atomoxetine, just no.

My english is so bad but I really need help, I don't know what to do because here I can't see a a psychiatrist before months. however I could use video to have prescription.

I have been on this med for over a year and It has worked quite well for me until now when I noticed this week that I started getting adverse effects from it again. It has started giving me heart palpitations, chest pain, extreme headaches, tingling feeling all over my body, muscle aches, dizzines that makes it hard to stand up and extreme dehydration to the point of feeling dehydrated all the time. It doesn't matter how much water I drink now I feel dehydrated all the time and my mouth feels so dry. I usually have electrolytes when I feel dehydrated from this med but not even electrolytes have worked this week. How can this med give me adverse effects despite being on it for over a year now? If this is going continue I think I would need to stop taking it because I can't handle this. I don't know what has happened but everything suddenly started to change now and I don't feel good because of these adverse effects because they are really bothering me.

I hear hydroxyzine can have a dementia risk but I’m also not sure if that’s true. I know depression and anxiety in themselves can have a risk

I've been on Wellbutrin before, but was drinking a lot at the time so wasn't really able to give it a fair shot in hindsight.

Long story short, since leaving my job months ago after it got super toxic and high risk for my future (they were getting into bank fraud and other totally unethical things), I've just been struggling with slumping motivation. I'm not feeling depressed, I just don't have a lot of hope and find myself quick to give up. I've made progress in fixing this via therapy and positive activities like volunteering to bring my self worth back up, but I keep thinking I could use a bandaid to help while I do the hard work. Wellbutrin is especially appealing as I've been struggling with quitting vaping nicotine.

I do struggle with anxiety, but it's normally not crippling. I know Wellbutrin normally doesn't help in that department. But usually when I feel confident, energetic, and productive, my anxiety drops. Like modafinil used to help with my anxiety somewhat.

Have you found Wellbutrin to be effective for lack of motivation? I have so much I want to do, but I just keep avoiding it for a myriad of reasons.

Or, what else have you found helpful?

I am diagnosed bipolar II and take lamotrigine for it, but I have learned I have to be careful with antidepressants. I was extremely motivated on Nardil, but after I stopped, I realized it was pushing me to the edge of mania. Nefazodone worked great for me, but my psych took me off it as he thought it was destabilizing me. I was going through a rough period several months into treatment then started drinking a lot, and I think it was more that. But also I am mostly outside of the US now, and Nefazodone isn't available in other countries.

I found this very interesting study from 2020: Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study - PMC

Is anybody on this kind of regimen and do you feel it's effective?

I don't think i can manage to get an approval from my psychiatrist as many doctors are very worried about serotonin syndrome but in the study it was safe and effective...

Does anyone have experience with this combination? If so, what dosage did you find most effective?

I have an appointment with my doctor soon and I’m at a loss as of what to do.

Most days, I can barely get out of bed to eat or shower. I haven’t left the house other than briefly to get prescriptions or food in months. All I want to do is sleep. I despise every moment of being awake.

I’m currently on escitalopram. This med has provided very little help for me (unless I don’t take it and end up crying for hours on end).

I have no idea what to even ask for anymore. Ive been self medicating with kratom for energy and motivation and it’s just enough to do the bare minimum for taking care of myself. If i don’t take it I can sleep for days.

Does anyone have recommendations for a med switch? Any anti depressants that helped with mood and motivation without subsequently increasing anxiety (I can’t even have coffee because of anxiety and heart palpitations).

I know my life style plays a large role in how badly I’m doing (no exercise, socialization, sunlight etc). Is there a med that could make these even seem like a possibility for me? As I am I just cannot motivate myself to do anything. If I didn’t take kratom I wouldn’t even be able to be writing this post.

Any suggestions are welcome.

Hello, I have been on Paroxitne 20mg for 4 months now and it's working Ok, but recently my IBS-D have been much worse and the doctor added Amitriptyline 25mg daily before sleep and it works for the IBS.

After 2 weeks of use I have a very bad fatigue, no power to do anything, no motivation at all I fight to get up and very bad dreams.

Right now I don't know any alternative for the Amitriptyline that can help the IBS.

Any suggestions to change Amitriptyline with other medications?

Hello!! Those of you who take lithium, how long did it take for you to notice a difference? I am taking for SI along with prozac. I have been on 300mg for 10 days now and still really struggling :/

Hi everyone, I started Pramipexole for severe depression about five days ago. My depression completely lifted right away, however, I am experiencing severe fatigue. My doctor is having me take it three times per day, but I have read that taking it only at night can help reduce the fatigue. I am so relieved and grateful that the depression is gone, but the fatigue is oppressive. In fact, I am having to take Adderall just to function! Does anyone have experience with the fatigue eventually wearing off, or is this a symptom that stays? Thanks!

I' m a combo of meds for TRD. I respond great to Vyvance, it basically takes my depression away but tolerance builds very fast end after about 10 days i seems to end up feeling worst. So i'm interested in the options of meds that work on dopamine. I will list some that i already tried: -Wellbutrin(3 times)

• Stimulants like Concerta and Vyvance.

-low dose of Abilify -MAOI like Nardil and i'm still on Parnate.

So i'm interested in other dopaminergic meds or supplements that i didn't try like Pramipexole but i known side effects can be severe and irreversible. Do you have any other options i didn't mention that could be interesting? Thanks

For a long time now I’ve wanted to try Pramipexole (D2/D3 agonist) after hearing alot of success stories related to it (especially for anhedonia and motivation issues). What’s stopping me sadly is the possibility of DAWS after stopping or the emergence of impulsive behavior (especially since I’m already impulsive). Now I’ve had an idea which might give me a better and safer result. What if I combine Aripiprazole (which is a D2/D3 partial agonist) with low dose Amisulpride (which will act as a selective presynaptic D2/D3 antagonist)? Since Aripiprazole will also give me unwanted partial agonism at the D2/D3 presynaptic receptor (which will reduce dopamine) I can easily counter it with low dose Amisulpride’s selective D2/D3 full antagonism at the presynaptic receptors. This will hopefully give me partial agonism at the D2/D3 postsynaptic receptors and therefore boost dopamine without causing the same issues that come with full D2/D3 agonism such as impulsivity during treatment and DAWS after cessation. This will also hopefully prevent akathisa and tardive dyskinesia from occurring. Is my logic right and is my idea worth a shot? Did anyone try this before and have success with it?

Aticaprant

Navacaprant

Gepirone

Triple reuptake inhibitor

I've been taking it daily for two weeks. Doses between 3.75mg and 7.5mg. Prescribed for sleeping difficulties. I have noticed a change in my mood and anxiety over the last few days. I feel down, with too many racing thoughts in my head, anxious and indecisive. Is it possible that zopiclone causes or worsens depression and anxiety?

I feel like every little bit of stress and every impending decision throws me off track.

I need to get off that stuff asap.

I regularly take 7.5mg escitalopram for anxiety and depression.

My doctor prescribed Caplyta 42 mg and I haven't started it yet. Is it safer than other atypical antipsychotics? I try to avoid taking those because I've dealt with weight gain on them, plus I'm worried about tardive dyskinesia

I've also never been diagnosed with bipolar depression, just depression in general.

Major depression, social anxiety disorder, CPTSD and Anhedonia. My ADHD is managed extremely well with dexamphetamine, but that’s only the ADHD part. I have tried so, so, so many different things to treat my severe social anxiety and depression, nothing has worked, except a Russian anti anxiety that I’m not sure I’m allowed to mention here, but that cannot be used often due to severe withdrawal and rebound effects when you’re not taking it.

So far I have tried: Ketamine, Zoloft, Prozac, WellButrin, Vyvanse, Methylphenidate, Seroquel, Ketamine, Semax, Selank, Buspar, Valium, Clonazepam, Mirtazapine, Doxepin, Effexor, Luvox, Cymbalta, Pristiq, Paroxetine, moving states, therapy, light exposure, exposure therapy, MTHFR refining, genetic testing, NOTHING HAS WORKED! I am stuck, at my whits end.

I abused opioids for 12 months, went on buorenorphine for three months and I believe that after buprenorphine left my system, the anhedonia effects have never left me. It’s been over 12 months since I last had an opioid in my system. I am so, so lost.

Had a QEEG Scan done and it showed my brain was extremely over activated, even though I feel constant brain fog and fatigue, especially during the day, my doc did mention there was a small area near the front of my brain that was slightly under active, possible to do with my dopamine system? I have spent thousands on nootropics and supplements to no avail.

I am currently on: Duloxetine 30mg (stuck on this due to hellish withdrawals and in no mental state to go through that at the moment, have tried three times already) Luvox 100mg and Dexamphetamine 30mg daily.

Does anybody have some experience with a Vagal Nerve Stimulator implant for depression? How much is your quality of live improved with this device?

SSRIs improve depression in as many as 50-60% of patients, but their side effects often limit the therapeutic response. The main side effects - fatigue, sexual dysfunction, reduced motivation, akathisia, motor coordination deficits - seem to be related to a decrease in dopamine signaling, which is mediated by excessive activation of 5-HT2C receptors by the increased serotonin levels.^[1][2]

Mirtazapine is a tetracyclic antidepressant that doesn't affect monoamine reuptake, but acts at several receptors. It is especially known for its potent antagonism or inverse agonism of 5-HT2A and 5-HT2C serotonin receptors.

If Mirtazapine blocks 5-HT2C receptors, and 5-HT2C receptors are responsible for dopamine blunting by SSRIs, it sounds like Mirtazapine should help attenuate the dopamine blunting caused by SSRIs.

Notably, Mirtazapine may induce fatigue through Histamine H1 antagonism, but this is not a concern, since tolerance builds rapidly to the sedative effects of H1 antagonism (7-10 days at most) - so its sedative effects fade quickly with daily use.

Unlike H1 receptors, however, 5-HT2C receptors don't seem to get desensitized with chronic SSRI use, which is seemingly why SSRIs cause motivation and fatigue issues even after years of use (no tolerance to that effect of theirs), so antagonism of 5-HT2C by Mirtazapine shouldn't necessarily cause upregulation of them, either.

Mirtazapine has effects at some other receptors, like 5-HT2A, 5-HT3 and alpha receptors, but I'm not sure about the significance of those.^[3]

What does everyone here think? Can Mirtazapine be taken together with a SSRI to attenuate the anti-dopaminergic effect of the SSRI?

I started pramipexole maybe 2 months ago. The extended release and am at 2.625 mg daily at night. I’ve been on 2.625 for 3 weeks now and it’s weird because every week my symptoms just get worse. I’m now dealing with some of the worst apathy I’ve dealt with in a long long time and just overall annoyed mood. My libido and enjoyment and interest in anything has gone to almost 0 where nothing even stimulates my boredom. It’s not like the pramipexole isn’t doing anything at all because it’s definitely 100% the pramipexole that has made me worse over the last 2-3weeks, especially this last week was pretty bad. I’m just lost at when you’re supposed to see a positive change? Some people have said it took them just a few days which I legit don’t understand how that really works for some and not others? A lot of post I see where the med didnt work is they felt no side affects at all or the side affects where to strong on a small dose. I just need some input on what you guys think I should do?

I've had symptoms of brain fog, general fatigue, and insomnia since I was about 17-18 years old.

I've been researching various concepts and trying to combat CFS, but I'm surprised to learn that so many different diseases can cause these symptoms (brain fog and general fatigue).

I've had brain damage since birth, and a doctor has diagnosed me with intracranial instability (I heard this from my mother).

Maybe because of that, I had symptoms that seemed to be obsessive-compulsive disorder or organic brain problems even before I developed brain fog.

And antidepressants are effective against my brain fog (but they seem to stop working after a certain period of time. It's very sad).

I also have CFS and ADHD, but methylphenidate doesn't work at all (in fact, it makes my hyperactivity worse), and antidepressants work for my ADHD.

In this case, what is the real problem behind CFS? I don't need to narrow it down to one thing, but I'd like to know what common (and often overlooked) factors you think are causing chronic fatigue.

Hypothyroidism, Lyme disease, mold exposure, MCAS, methylation issues... it seems like brain fog can be caused by a variety of things. I don't know where to start. I'm really tired of life.

I mainly suffer from brain fog and general fatigue, but when I take antidepressants, these symptoms disappear immediately.

However, both Cymbalta and Effexor worked for the first month, but the effect soon wore off.

On the other hand, tricyclic antidepressants (especially Nortriptyline) are excellent at eliminating brain fog and the effect lasts a long time.

However, there is one thing that is very inconvenient for me, and that is that my QT is abnormally prolonged when I take tricyclic antidepressants. After taking 10 mg of Nortriptyline for just 5 days, my QT was so prolonged that I had to stop taking the medication.

So, my question is,

①Are there any tricyclic antidepressants that are less likely to cause QT prolongation? (Nortriptyline extended my QT tremendously, but I'm wondering how much it affects QT with drugs like clomipramine.)

② When I take drugs that act on noradrenaline, my brain fog disappears, but on the other hand, when I take drugs that increase noradrenaline, I get strong side effects on my heart. Are there any good methods or drugs to resolve this dilemma?

③ I have the type of CFS that is particularly effective with antidepressants, but is there anything else I should try besides antidepressants? Nutritional therapy and Chinese medicine didn't work very well. The drug that worked best for me was Nortriptyline, but when I take it, I can't use it because of heart problems, which is really sad. Should I try drugs that don't seem to be related to noradrenaline, such as memantine? ?

I take duloxetine 120mg, fluoxetine 40 mg, olanzapine 5 mg, clonazepam 2x2 mg, nothing seems to work. I am extremly angry and iritable nothing like this i had in my years of treating my TRD and anxiety.

I've seen and printed several studies and articles that shows how Pramipexole can be very effective for TRD, the stats has a adjunct seems to be better then anything else. I'm on a combo of meds, probably too much but just want to mention i'm on PARNATE for about the last year. I precise that because often people will say did you tried PARNATE because of it's effect on Dopamine. I tried for dopamine Nardil, Wellbutrin, low dose of Abilify, they didn't work, and about 40 different meds over the years I'm also on 175mgs of SEROQUEL( maybe my base meds), i hate that meds because of it's side effects especially the exhaustion in the morning that can stay for a good 3 hours after i wake up even if i slept a good 8-10 hours. I known it also blocks dopamine at higher dosage. So i wake up completly not functionnal, i just go and make myself a coffee and return to my room because i just can't speack to nobody, i'm so short temper, basically i'm so tired i just lay in bed, not able to sleep just waiting for it to get better after about 3 hours. So i'm still dealing with important residual symptoms of depression. The main ones are fatigue, very low motivation and without any motivation it affects all the aspect of your life and create anxiety and depression. So lately we tried stimulants, VYVANCE doest a great job, i wake up, take 1 and after half an hour i'm up, very social, in a good mood and ready to be productive. It basically takes my depression away. Only big problem, tolerance builds very fast for me, in about 10-15 days it doesn't work anymore and i'm getting probably even worse depression after and i have to take a breack or tried to reset my tolerance( probably 5-7 days) or swiching to CONCERTA but it's not that good for me. So i feel stimulants are a double edged-sword and i think it potentially make more harm then good in the long run when use for depression. You get that big spike of dopamine and probably when the effects goes, my already low dopamine baseline even drops lower so i'm really not sure the trade off is worth it, 10 good days vs 7 bad days. So i'm thinking if i respond that good to stimulants that a dopaminergic agent like Pramipexole could possibly work great for me. My psy even precibed me PRAMIPEXOLE a few days ago without knowning anything about it for TRD, she has about 10 patients on it for RLS but the protocol for TRD is very different. I even printed all the studies, highlighted all the important points of doctor Fawcett article. So i done the hardest part, research, print and then identified the major points and she didn't even take 5 minutes to check it out and just gave me a prescription and said i will print it and take a look at it later. So i have the prescription but didn't go get it because of the major possible side effects like addictions and DAWS syndrome, so i still didn't make my mind on it yet.

My dr refuses to give me wellbutrin because im underweight i am currently on zoloft and found no relief i feel like my issue is dopamine and not serotonin as i was also diagnosed with adhd before my brain feels asleep

if i respond extremely poorly to basically every ssri/anti except for pristiq (which didn’t help me) is nefazadone worth looking into? i’ve tried maois, ssris/snris, stimulant medication, wellbutrin, auvelity and ketamine and i have not had any response with my depression or anxiety. i know nefazadone is an sndri so in theory it should have a better side effect profile than regular ssris. is it worth the liver risk to try this?

How frequently are these two medications prescribed together? I’m currently in the psych ward and got prescribed venlafaxine on top of my 20mg escitalopram and 5mg abilify. Is there any benefit to talking both instead of just switch in to the SNRI?

My psychiatrist is away for the weekend and the psych nurses didn’t know.

I’m just worried about being on too many medications.

I’ve tried: Mirtazapine Prozac Zoloft Abilify Seroquel Lamictal

When all that didn’t work I did the following on my own, either to try to cure myself or just to cope:

Ketamine (made me process trauma, helped with PTSD a LOT)

LSD (made me a bit more optimistic and insightful, no significant change)

Xanax (no effect, used it to numb myself)

Cocaine (relief, don’t enjoy it that much anymore)

I haven’t felt a significant change with any of those for depression. Do therapy and it doesn’t work. I feel like just giving up and just doing drugs.

https://youtu.be/UT0lqCCx5BA Leo (rip) goes on about how some people are naturally resistant to their own thyroid hormones. T3 also upregulates 5ht1a and 5ht2a serotonin receptors.

It makes sense that if you’re fat and have a slow metabolism that you probably feel depressed. I am not fat however and have a not a very slow metabolism either. Did anyone try T3 here?

While it may sound like I want to take it recreationally, I actually have a PDD with anhedonia and low libido. No I don't have a life threatening condition, history of drug abuse or taking other antidepressants, I'm healthy and live a stressless life. with regular sex, it's just about me not enjoying life, having troubles with sleep, energy and motivation.

I had hopes on Wellbutrin but my doc said it is withdrawn in EU so we'd liked to try Prami.

Searching Prami experience on Reddit I have found a lot of positive in r/sexondrugs where many people say that even a tiny dose of less than 0.2mg taken once make them crave for sex all the day.

Yesterday I have taken my first pill (dosages are strange 0.18mg) in the morning and very soon I wanted to return to bed. Not a single sexual thought during the day.

Question 1: why some people get such a strong boost from drugs? I had been taking proviron, tried Cabergoline, lots of food supplements, and while I see the effects they do (confirmed with bloodwork, testicles enlarging etc) libido boost (or any other sexual performance changes) is not among them. Even PDE5i (Viagra Cialis) stopped working for me (not gradually, but in a short period of time). I tried marijuana several times in my life and it also almost did nothing for my brain.

Question 2: considering my symptoms and my goals, what may be a good regimen and results with Prami? Looks like I'm gonna take it in the evening and slowly increasing the dose. But definitely not up to 1-2mg? Is there a chance libido will be higher in the long run?