Medication For Depression, Question.

[Panda Bear]

@Lotis

Anti-depressants are a HUGE NO NO for me! I've tried many and had very dangerous side effects. Wellbutrin included, which I had severe and adverse reactions too. Never, ever again.

My psychiatrist won't even consider them, after what has happened.

 

[Sideways]

@Panda Bear - have you tried MAOIs? I had a lot of success with Parnate for quite a long time, it's an old school one. They warn you about certain foods that you can't eat, but they weren't foods I usually ate anyway, and he evidence is mounting that the food warnings are way excessive anyway.

Parnate didn't seem to have any side effects for me, and maois work completely differently to the other classes of anti-depressants...

 

[Panda Bear]

She may have dismissed it because Zoloft is in the same class? And I had, again....very dangerous side effects from Zoloft. :(

She mentioned the possibility of working with NMDAs like amantadine. But I'm very unfamiliar with them. She is thinking.

 

[joeylittle]

She may have dismissed it because Zoloft is in the same class?

No, I don't think that's right - zoloft isn't an MAOI.

Have you ever tried Lithium?

 

[Panda Bear]

@joeylittle No we haven't tried Lithium and it hasn't come up yet either. I'm not bipolar....though in the loose sense, I could possibly be? But the PTSD is so strong, it's hard to tell?

She's considering doing some sort of genetic test for medications? She's avoided it until now, but I've had so many adverse reactions to meds. I am tolerating the Abilify at 1mg, but she's not sure it'll tackle the seasonal depression.

It's all a guessing game. This has proven to be very hard.

 

[Friday]

Straterra (Atomoxetine) is an easy one to try. As there's no lead time necessary for it / It has a super short half life / but no history of discontinuation syndrome (which makes it's very strange in the land of re uptake inhibitors. Most either take a month to start working, or are strongly addictive, or both). To find the best dosage people usually step it up (10mg-160mg-10mg), and the. Back off until they're at the right dose for them... but it works on Day 1. And can be stopped at any time.

It's an SNRI - Selective Norepinephrine (no serotonin / not an SSNRI) Reuptake Inhibitor labeled for ADHD... But also used off-label for Anorexia & Depression.

I am ADHD, which is both how/why I was Rx'd it, but also why I can't take SSRIs SSNRIs etc. They make me seriously effing crazy. As in psychotic & suicidal. So when people sat they can't do SSRIs / SSNRIs, I usually like to point them at this med for a look-see.

 

[joeylittle]

No we haven't tried Lithium and it hasn't come up yet either. I'm not bipolar....though in the loose sense, I could possibly be?

It's also used for depression; lower dosage than what's used in bipolar. Lithium is one of those very old, very reliable medications. People often don't think of it because it requires some regular testing while titrating up on it. But once it's stabilized, a lot of people swear by it. I'm not suggesting you switch, just that it might be worth bringing up.

She's considering doing some sort of genetic test for medications?

Yep. What this will do is tell you what kind of metabolizer you are. That information, in turn, can help steer you towards certain things or away from certain things. It can also be a decent predictor of what you will and will not respond to. Whether it's right or not, that's still trial and error. But, how your body will break it down and absorb it, they can figure out. It's apparently a pretty common test now.

Straterra (Atomoxetine) is an easy one to try.

Now, there's a drug I haven't thought about in awhile :) Nice to hear a positive recommendation for it in re: depression. I've never really talked with anyone who has gotten that benefit. On paper it looks like a really interesting (unique mechanism) ADHD drug.

 

[Friday]

@joeylittle Last I was keeping up on it, it seems the anorexia benefit fits most people / it's becoming really popular in ED circles around here... But the depression benefit is extremely limited. Tends to only help people who are med resistant. Which makes me wonder about base physiology.

But it's actually the anorexia benefit that makes me really curious about seeing a clinical trial for PTSD... As it works on anorexia -anecdotally- in a similar way it works for ADHD, for non-ADHD peeps; tones down the hypervig / overly aware of ones own body at all times, and removes the revulsion component? As well as intrusive thoughts, adds a layer of control to impulsiveness / compulsiveness. IDK. It's a very very quirky drug. Acts like a stimulant for ADHD folk, but not for neurotypical folk? Shares results? That's just strange.

My experience with it is very biased, as I am ADHD. It's hearing all the reports from non-ADHD folk using it in disordered eating that mirrors my own experience with it that just kind of blows my mind. I reeeeeally wanna see some trials done on it!

 

[Sideways]

Zoloft is another SSRI. Maois don't seem to be nearly as common, probably because of all the diet restrictions they used to have.

 

[ms spock]

David Burns' book "Feeling Good" has a great few chapters on medication - you might find them of use @Panda Bear. I was rereading them last night.

 

[Panda Bear]

Thanks @Ms Spock. I'll see if my husband can find it for me. I'm a little dense when it comes to medication.

 

[ms spock]

Aren't we all @Panda Bear? I am not a psychiatrist with 7 years training either! This book has quite a few chapters which are really good. The whole book is brilliant and Burns breaks medication down really, really well. I have really struggled with medication over the years. I have really struggled with it a lot.