Antidepressants

[Smeraldina Rima]

I've not been very happy with fluoxetine recently[nb]I actually warmed to it because it seemed to be making me thinner initially, which isn't really the right reason to keep taking it I know, but then the brand changed and so did that side effect - or that's how it seemed to me, don't know if that's plausible.[/nb] or others in the past. I think I know how worthwhile seeking amateur medical advice is, but I'm not very good at getting helpful professional advice. Has anyone had a good experience with a drug that relieves anxiety and helps you get on with things without making you more stupid, overenthusiastic, fat, sweaty or sleepy?

[buttgammon]

If SSRIs aren't so great, SNRIs are usually the next port of call. They still work on serotonin, but they also work on norepinephrine, so it's possible to switch over to them quickly without withdrawals or anything Side effects can be really variable from person to person but with venlafaxine at least, the main one is sweating, which is annoying but arguably not as unpleasant as the other things you've listed.

[Kankurette]

Venlafaxine also has withdrawal symptoms from hell. I've had symptoms similar to cold turkey when I've missed doses. It's a horrible drug, and I'm glad I'm off it. I'm on Sertraline now. Citalopram also made me fat. I gained a ton of weight on it and it hasn't all come off.

[buttgammon]

Venlafaxine also has withdrawal symptoms from hell. I've had symptoms similar to cold turkey when I've missed doses. It's a horrible drug, and I'm glad I'm off it. I'm on Sertraline now. Citalopram also made me fat. I gained a ton of weight on it and it hasn't all come off.

That's true. My partner had a bad experience coming off it and people who've taken both have said it's worse than coming off heroin; I forgot to mention that bit!

[TrenterPercenter]

I'm just going to throw this out there but CBT has been found to be as effective as SSRI use.  SSRIs are a great bit of technology but they are crude drugs and aren't really suited for longterm use (they are not very effective for longterm depression).  This isn't to say CBT is a panacea either; but a lot people get locked into the idea about SSRIs in that they will sort the brain chemistry out and efforts to psychologically manage depression move into the background (this isn't any finger wagging; this is a failure of service and short-term cost effective success of SSRIs).

[Theremin]

I'm just going to throw this out there but CBT has been found to be as effective as SSRI use.

Cock and Ball Torture?

[Theremin]

I'll have the pills

[imitationleather]

Venlafaxine does indeed have very bad withdrawals, but on the other side of the coin it's enabled me to live a somewhat normal life in a way no other medication has managed.

[buttgammon]

Venlafaxine does indeed have very bad withdrawals, but on the other side of the coin it's enabled me to live a somewhat normal life in a way no other medication has managed.

Yes, and that's the trade-off with venlafaxine. It sounds like a nightmare to come off, but it can also be a very effective medication.

[El Unicornio, mang]

Citalopram also made me fat. I gained a ton of weight on it and it hasn't all come off.

It never made me fat but just made me lethargic and lacking in emotion (either negative or positive) and made ejaculating take forever.

I think any antidepressants are going to have some side effects, I quit them about 10 years ago and would only get back on them if I found myself in a desperate mental health situation where I was unable to eat/function properly.

[Kankurette]

Sertraline killed my libido the first time, and - sorry for TMI - it's given me a complex about not being a proper bisexual because I never had sex with my girlfriend at the time, and part of it was because the Sertraline made me asexual. I couldn't even wank on it. It's not like that now though.

Venlafaxine also made me have panic attacks. I've had a few since coming off it but it's not as bad as it used to be.

[TrenterPercenter]

I'll have the pills

But the great thing about psychology is you only have to imagine the cock and ball torture in your minds eye.

[Sonny_Jim]

Citalopram gave me terrible diarrhea when I took it for a bit.  I'm not quite sure how shooting streams of muddy piss out of my arsehole was supposed to cheer me up.

[TrenterPercenter]

Citalopram gave me terrible diarrhea when I took it for a bit.  I'm not sure how shooting streams of muddy piss out of your arsehole was supposed to cheer you up.

Have you spoken to machotrouts recently?

[chocolate teapot]

The best antidepressant I ever tried which I had to stop because of very bad dry mouth which might not be such a big issue for you as it was for me is Clomipramine. I don't recall any other downsides unfortunately, wish I could have stayed on it.

[Smeraldina Rima]

If SSRIs aren't so great, SNRIs are usually the next port of call. They still work on serotonin, but they also work on norepinephrine, so it's possible to switch over to them quickly without withdrawals or anything Side effects can be really variable from person to person but with venlafaxine at least, the main one is sweating, which is annoying but arguably not as unpleasant as the other things you've listed.

Thanks. I think everything I've had has been an SSRI so I'll ask the doc if they could consider SNRIs and then try to get on the Venlafaxine.

Venlafaxine also has withdrawal symptoms from hell. I've had symptoms similar to cold turkey when I've missed doses. It's a horrible drug, and I'm glad I'm off it.

Thanks, I'll steer clear of Venlafaxine. Had some terrible advice about it before from buttgammon.

I'm just going to throw this out there but CBT has been found to be as effective as SSRI use.

I've had quite a lot of CBT before and don't really want to try again until I can see someone in person. Would it make sense to get on a waiting list and then request to hover at the top of the waiting list until that's back on the table? I feel I need the drugs at the moment - and Fluoxetine wasn't helping - but I have been trying to manage my moods in other ways like exercising and considering the lilies.

Venlafaxine does indeed have very bad withdrawals, but on the other side of the coin it's enabled me to live a somewhat normal life in a way no other medication has managed.

Thanks. I'll reconsider asking the doctor about Venlafaxine. Always been a feather in the wind. It's a bit heavy sounding: here's this one drug that might actually work or it could be a catastrophe. I'm hearing the other contestants on Deal or No Deal chanting "Take Venlafaxine" at me.

It [Citalopram] never made me fat but just made me lethargic and lacking in emotion (either negative or positive) and made ejaculating take forever.

I think any antidepressants are going to have some side effects, I quit them about 10 years ago and would only get back on them if I found myself in a desperate mental health situation where I was unable to eat/function properly.

Citalopram did help me a bit once in being more care free I reckon. Paroxetine I found caused the most delayed sexual climax which if I weren't writing in a public forum I would be more likely to admit to having been pleased about.

Thanks all :)

Except not :) but :(

[The Ombudsman]

First time went on Fluoxetine it was great, then kept on needing to increase it until after a long time it did nothing. I then went on a few other and ended up with Venlafaxine for a long old time. I didn't like the fact if I missed a morning dose I got pronounced 'head-zaps' all day and it felt like I was falling over. So back on Fluoxetine which this time did nothing.

I've not been on anything for two-ish years now. I'm trying my best to work on behaviour patterns and diet. Still not that great but for me the drugs were just giving me side effects with no discernible positives. I didn't find CBT sessions helped very much, although some of it stuck I suppose. For me, taking each day as it comes and knowing tomorrow will be a bit better does more than drugs can do. I'm still open to trying them again in the future if needed.

[TrenterPercenter]

I've had quite a lot of CBT before and don't really want to try again until I can see someone in person. Would it make sense to get on a waiting list and then request to hover at the top of the waiting list until that's back on the table? I feel I need the drugs at the moment - and Fluoxetine wasn't helping - but I have been trying to manage my moods in other ways like exercising and considering the lilies.

Yes absolutely; there no reason why you cannot do both CBT should always be offered alongside SSRIs but sadly there just isn't the resources to do this.  Getting on the waiting list means you are in the queue so I would say go for it.  Btw I'm not for a second suggesting to stop or not take SSRIs these drugs are a lifeline for some people; my point was that often people get parked on SSRIs without further support and SSRIs, like most drugs, can become a measure of dependency when depression, whilst likely not completely curable (mental health doesn't have cures), can be manageable without these quite clumsy drugs.

I've had a few people tell me that this book helped them https://www.danaeagle.com/howtobedepressedmobile it's got lots of little exercises in it like a workbook but it doesn't take itself seriously - just an idea as a stop gap.

Wishing you all the best Smeraldina

[bgmnts]

I'm on sertraline and I'm at my fattest and have had to force wanks.

Dont take sertraline folks. Just pull yourself together.

[holyzombiejesus]

Citalopram made me feel fucking awful, just wrong. I remember lying on the floor and just feeling too weird to even move. I liked Prozac though although I think the actual act of taking an anti-depressant made me feel better than the actual drug did.

[Smeraldina Rima]

Cheers Trenter. Yeah, I agree with what you were saying. What I meant was just would you be able to climb the queue and then say no thanks while staying at the top of the list until being offered in person therapy post-covid? Hope that makes sense. I hadn't bothered at all since I didn't want what I thought would be available for the forseeable future. The GP did give me a number for CBT and was a big avocado. He said 'it might seem a bit cheesy but it can really help'.

[peanutbutter]

My doctor prescribed me lexapro (escitalopram) when I was like 18 and it was shite, in retrospect the main issue was probably that the patent hadn't expired yet so I was paying something nuts (think it was 80 pound a month... as a fucking 18 year old full time student...). Main memory of it was just feeling very very flat, like if my lows are -1 and my highs are +0.5, it was leaving me at about -0.5 and I'd rather at least have to occasional burst of something positive.

Venlafaxine was great but there wasn't enough going on in my life for it to help much.  I think my best approach with these things would be to take them for a while when I've got a lot of stuff coming up that will be good but I'm highly likely to get disenchanted with and bail on but not stick with long term.
RE: Withdrawals, I used to get really nauseoous and headaches the day after any day where I missed a dosage. The actual withdrawalls of coming off permanently weren't that much worse though.



Right now there's def an argument I could do with being on something again after 18 months of becoming massively defeated, but i think it probably makes more sense to first push with finding out about ADHD stuff and having some fun doing things I probably can't do if I start on antidepressants (psychedelics and party drugs, basically).

[Zetetic]

in retrospect the main issue was probably that the patent hadn't expired yet

And more broadly that Lundbeck was allowed to patent escitalopram at all or convince anyone to prescribe it in preference to citalopram.

[chocolate teapot]

That's interesting, my mh nurse told me escitalopram was a bit different to ciralopram and is more selective when it comes to the serotonin part and more up to date, is that bollocks?

[Zetetic]

It's more modern, because it was pursued by Lundbeck - the inventors of citalopram and escitalopram - in large part as a way of extending the profitability of citalopram after the patent on the latter ran out. (Other tactics included an arrangement with generics manufacturers of paying them not to produce citalopram. This eventually earned Lundbeck them a massive fine from the EU.)

Citalopram is 50% escitalopram. The other 50% of citalopram is a slightly differently shaped version of the same chemical that doesn't have the same effects on the nervous system.[nb]Escitalopram is the "left-handed stereoisomer" of citalopram, or citalopram is the "racemic mixture".[/nb]

In theory, this might have interesting effects on how quickly your body processes the 'active' chemical. In theory, the other version of the chemical in citalopram might produce substantial side-effects that escitalopram avoids.

Are these things the case? Lundbeck certainly spent a lot of money trying to show that the two were substantially different, and in the case of their American partner this seems to have extended to kickbacks for doctors who prescribed it to children.

If you get on better with escitalopram over citalopram, fair enough. Edit: Some people certainly seem to, and I'd like to believe this is the case.

Edit: I think I should be clear that citalopram is an extremely safe and - for many people - extremely helpful drug, and escitalopram is at least as (and maybe more) safe, tolerable and helpful. (Lundbeck wouldn't have bothered trying to hold on to exclusivity for so long if wasn't a good drug, bluntly.)

[Zetetic]

On what I'm sure is a completely unrelated note to their history of illegal cartel practices, multiple generics manufacturers had problems supplying sertraline last year resulting in a 7x price increase and the NHSs' spend on antidepressants doubling from one month to the next. (English NHS spend went from about £17m to more than £34m per month, for example).

(Edit: Feel I should confess that my antidepressant still costs several times more than sertaline did at its 2020 peak...)

[monkfromhavana]

I'm on sertraline and have grown fat but can still shoot sex wee out of my penis within an acceptable timeframe.

[TrenterPercenter]

Cheers Trenter. Yeah, I agree with what you were saying. What I meant was just would you be able to climb the queue and then say no thanks while staying at the top of the list until being offered in person therapy post-covid? Hope that makes sense. I hadn't bothered at all since I didn't want what I thought would be available for the forseeable future. The GP did give me a number for CBT and was a big avocado. He said 'it might seem a bit cheesy but it can really help'.

Ah I think I know what you mean now so you want actual face-to-face but at the moment you are only being offered a waiting list for a online session; hmmm tricky as I wouldn't like to guess when you would be able to get actual face-to-face treatment.  It also difficult because different trusts have different policies most places have a PALs service which might be good place to contact and enquire; just state that you struggle with online and would like to mark you name in the queue for when a in-person session is available.

Sorry I'm not much help here I'm afraid; give online a go though if you've not tried it - really suits some people (but I'm guessing you not wanting this is from experience).

[Smeraldina Rima]

just state that you struggle with online and would like to mark you name in the queue for when a in-person session is available.

Thanks - just the sort of sensible thing I never think of.

[idunnosomename]

Sertaline just makes me sweat at night really which can be a bit annoying but whatever