Sri, Ssri, Snri Adaptation?

[Barberian]

I've been prescribed most of the above three that are on the market over the last several years at one time or another. With EVERY one my body has adapted to them within two to three months and they lose their effectiveness. They start out great, then.... not so much. Then, why am I wasting my time with these.

It isn't the "oh I feel good so I'll stop" effect. It's the "I feel like crap again, so why bother"? They have modified the dosage, but usually by the time my body has adapted, simply upping the dose doesn't do anything noticeable.

Anybody else have this problem?

 

[joeylittle]

With EVERY one my body has adapted to them within two to three months and they lose their effectiveness.

Yep. That's called being 'treatment resistant' or 'treatment refractory'. It means either that you are an Ultrarapid Metabolizer, so your body learns how to process and push the meds through, and you can't dose high enough to get a sustained benefit. If you found that you were having continual side effects but no psychological benefit, you'd be whats known as a Poor Metabolizer.

I'm treatment-resistant. Things just quit on me. It's frustrating. If you keep hopscotching around, you can usually get a few months of relief before it starts to dissipate (as you've noticed).

Mood stabilizers will not have quite the same issue, so if you needed help cutting off the extreme bottom of lows, then you would want to look into those. Lithium also does not have the same problems, and is successful for many people. Those are all the drugs that alter your metabolism - you'll gain weight, but your body will slow down the processing enough for the drugs to work.

Have you been through all the SNRIs? Some of them really are better than others, for ultrarapid metabolizers.

 

[Barberian]

I've been through most of them. I don't know the complete list, but I've had discussions with my psychiatrist, (who changes on a yearly rotational basis in the VA). They have expressed frustration because I've been on most and they don't know what to do with me.

I started a mood stabilizer depakote a month or so ago. Not sure if it is helping any. The doc is still upping the med to find the "magic" dosage.

 

[joeylittle]

The doc is still upping the med to find the "magic" dosage.

Yeah, that's normal. A very slow titration up. I hope that helps. If not, I might suggest just making sure you've tried effexor.(SNRI) - and you can also look into abilify and latuda. Abilify is hard to get off of and you will gain weight - but, it's a very effective medication. It never quit on me, I had to quit on it. Latuda is newly re-classified for a lot more issues,. including depression. It was doing OK for me at the 6 month mark, but then I started with the weight gain on it and had to stop.

I really feel for you. It's a horrible struggle to deal with.

 

[Barberian]

Been on effexor, and most of the other meds, same story. 'bout two to three months, then useless.

I had a small prescription for Abilify over 10 yrs ago or so. It worked great for me, loved it. Can't remember what it was prescribed for, or why it was stopped. It was before PTSD and it's friends struck full force.

Doc won't give me Abilify or other sleep aid because I'm on clonazepam or something like that (cousin of valium). He's afraid they will have a synergistic effect instead of an additive effect. He told me to just take the clonazepam for a sleep aid. I really don't like that idea because I have a phobia of becoming addicted to medication. I'm trying to take the clonazepam as little as possible unless I'm just exhausted from fighting anxiety and need a short vacation from it. I also do take it if I am in danger of having a panic attack, or I'm going to a place or event that I know I will or probably will have difficulty with.

If it comes down to it, and I NEED to sleep, I'll take it. Chronic sleep deprivation... well, I'm sure most of us have been there at one point or another.

As far as being a fast metabolizer or the other. Mentally they do their thing for a few months then lose effectiveness. About the only thing that continues on as long as I'm on the med is sexual dysfunction or impediment. My body adjusts partially to it, but not completely. When I start the med, it's a no go. Then after a few weeks I can get the job done, but it takes forever and I have to be so... enthusiastic I risk injury (been over 6 yrs since wife helped, so it's a solo thing). Forever might sound like a good thing, but every time? It gets old. I just want the job done sometimes, 'Ya know what I mean? :cool:

Edit:
I'm on Busiprone (for generalized anxiety disorder)
Divalproex (Mood stabilizer)
Prozosin (Anxiety, PTSD, and panic disorder)
Amitriptyline (lots of stuff, major depressive disorder, anxiety, ADHD, bipolar. The last two I'm not full blown, but have traits thereof).

Recently taken off of Pristiq the last SNRI that failed. Doc is taking a "wait and see" how these meds do because, like I said, most if not all of the SRI, SSRI, and SNRI have been tried on me.

 

[joeylittle]

Doc won't give me Abilify or other sleep aid because I'm on clonazepam or something like that (cousin of valium). He's afraid they will have a synergistic effect instead of an additive effect.

Interesting. I'm not aware of Abilify being used for sleep. It's generally an adjunct medication, also used on its own, and yeah - I'm glad you at least have tried it and it worked. I don't know nearly enough about how all those things on your list combine.

The only thing that restored my libido, ever, was wellbutrin (buproprion). I've taken it as an adjunct for a number of years now, and it does an excellent job of counteracting the droopy effects one gets with many of the SNRIs (no pun intended).

Something else that I tried that did help, and insurance companies are picking it up now, was TMS. You can google it up. It's meant for people like us who are treatment-resistant.

 

[Barberian]

Sorry, I got abilify and ambien mixed up.