Which anti-depressant?

[2Shy]

I've been on Paxil, Celexa and now Zoloft. The Zoloft is not working for me. Doc changed me off of Paxil for same reasons and because one of the side effects is weight gain. Celexa was okay, but my insurance didn't cover it. Anyway, I will probably up the dosage on the Zoloft and see if that helps any.

So, I was curious about others experiences. What's worked best for you?

 

[FitFossil]

I've been on Prozac, Celexa, and now Lexapro. I've had great results with all of them, but Lexapro is the best as far as no side effects. Celexa worked well but made me extremely sleepy. It also had bad sexual side effects. Prozac worked as well as Celexa, and sides were much less. These are in the same anti-depressant family as Paxil (famous for weight gain) and Zoloft. They're all SSRI's - selective serotonin reuptake inhibitors, that work on the brain chemical serotonin.

If upping the Zoloft doesn't help, ask your doctor about the other classes of anti-depressants that work on different brain chemicals, such as Wellbutrin or Effexor.

 

[makedah]

2Shy - what's your diagnosis? I ask because anti-depressants get prescribed for stuff other than depression.

 

[2Shy]

I take it for depression. I have all the classic symptoms. Took me years and a good friend pushing me to force me to get the diagnosis. Now I appreciate what the meds can do for me.

 

[Temple]

Prozac worked very well for me. It did have sexual sides but so did being depressed

 

[Torchy]

I have taken celexa, zoloft, and wellbutrin. The celxa made me very forgetful. I had to start writing things down for I would forget in the middle of a sentence. God forbid I had to remember to tell someone something. The zoloft was terrible for me as it produced more sides of anger and just didn't work with me well. The wellbutrin did nothing either except give me boughts of anger and made me extremely hormonal.

The celexa worked the best, but I could not deal with the memory loss and lack of sexual inhibition.

 

[takniteasy]

I have used effexor xr and would not recommend it. It supposedly works with the epinephrine and it is one anti-d that you cannot just decide to quit taking (like I did). I found that it was effective for a short period, I did experience some weight gain (not good) and when I forgot to take it I experienced extreme dizziness and what can only be described as a bad druggy feeling. I still get the dizziness now after weaning off about 6 weeks ago and from what I have learned this may go on for up to another year. Additionally, this anti-d was originally formulated for short term treatment and the docs are now prescribing it for anywhere from 18 months to 3 years. Personally that is not something I want to do.

 

[BigEasy]

Did any of you experience initial sickness with the ssri's? My last client is struggling with this side and trying to keep from losing any more weight, or else they will change her class.

 

[Torchy]

No sickness, BigEasy. I actually really liked the celexa, if it wasn't for those terrible sides,lol...Now that I re-read my post, seems like i have a problem with anger and anti-d's

 

[2Shy]

The drugs I've taken have never made me feel physically ill. I can't recall whether that's a side effect of any of the three I've taken. I just know first hand about Paxil's weight increases and the general tendencies of many SSRIs to lessen sexual desire. Is your client taking other meds? Maybe it's a combo problem.

It seemed to me the Celexa didn't work as well as the Paxil. Of the three I've tried, I'd say the Paxil worked the best for the longest. Since I struggle with my weight, it is just not a good choice for me. And, like I said, it stopped being as effective.

 

[makedah]

I take it for depression. I have all the classic symptoms. Took me years and a good friend pushing me to force me to get the diagnosis. Now I appreciate what the meds can do for me.

Glad you're getting help, 2Shy. I was just wondering b/c for my condition (anxiety) SSRIs are also an option but I chose the anti-anxiety meds.

 

[2Shy]

I used to have panic attacks and the Paxil helped those, but I have not had problems with those in ages. I think they stemmed from short-term anxiety.

 

[srblan]

Lexapro! Yes, I am male, and yes I may not have the same issues with SSRI's as others would, but I have found that to be the best by far. I take a small dose of Serzone at night, which helps a bit more. So far, I have taken Celexa, Serzone, Wellbutrin, and now Lexapro, and I have found that Lexapro has been the best. Celexa totally shut me down sexually, and Wellbutrin made me feel like crap.

Good Luck.
-srblan

 

[Ulter]

My suggestion is that you drop all that stuff and try P Seven. It's only $24 a bottle and it WILL improve your mood.
It's at the AF Store. www.anabolicfitness.net/shop

 

[FitFossil]

Did any of you experience initial sickness with the ssri's? My last client is struggling with this side and trying to keep from losing any more weight, or else they will change her class.

They made me somewhat nauseated for the first week or so, but not so much that I vomited. Also for me they really reined in my carb/sweet cravings. Some people though seem to get increased cravings which doesn't make sense.

 

[wilson6]

Did any of you ever sit back and consider what in your life is causing the depression, anxiety, panic attacks, etc.? and start working on the root of the problem vs treating the symptoms?

Just a thought.

W6

 

[MS]

"Did any of you ever sit back and consider what in your life is causing the depression, anxiety, panic attacks, etc.? and
start working on the root of the problem vs treating the symptoms? "


TOO HARD

 

[makedah]

Did any of you ever sit back and consider what in your life is causing the depression, anxiety, panic attacks, etc.? and start working on the root of the problem vs treating the symptoms?

Just a thought.

W6

I'm sure you and MS are not trying to be nasty, but I bristle at this kind of stuff. For years I resisted medication for anxiety. I succumbed and got on the meds and its a whole new world. But I know better than to just pop a pill and continue with business as usual. I see a therapist to help me work through my issues. As you know, there are "hard-wiring" problems and life history problems. I'm trying to deal with both - and yes, it IS hard.

 

[2Shy]

What makes you think that some of us aren't following a two-pronged approach? I would agree that meds alone will not solve the problem.

 

[FitFossil]

Did any of you ever sit back and consider what in your life is causing the depression, anxiety, panic attacks, etc.? and start working on the root of the problem vs treating the symptoms?

Just a thought.

W6

Quite a lot, thank you very much. If there's one thing that people with OCD (obsessive compulsive disorder) do a lot is ponder things over and over. Considering that my OCD symptoms first showed up when I was 4 years old, not too much had happened in my life to blame it on.

I was in formal therapy for several years before trying Prozac, and the difference was like night and day. Not to say I didn't benefit a lot from therapy, but for me the medication really is the missing link. OCD is caused by a chemical imbalance of serotonin. I continued with therapy for awhile while on medication, because the medication removed my mental roadblock, and I was much more receptive to therapy. Supplements like 5-HTP or whatever don't work for me like the SSRI's. I'm reminded of this every time I've gone off my med for any length of time. I'd much prefer not to be paying for or possibly poisoning myself with these drugs, but for now they allow me to live a normal life. For some people, things like stress, diet, etc. can cause a temporary chemical imbalance, that improves when their situation improves. Then there are those like me who, in spite of a great life, still have weird brain chemistry.

I agree that people and doctors are too quick to use drugs for a quick fix rather than looking for the cause. It is especially alarming when general doctors experiment on their patients with different psychiatric drugs instead of referring such cases to an actual psychiatrist. Same with people who try to diagnose and dose themselves.

 

[MS]

"OCD is caused by a chemical imbalance of serotonin"

OCD is caused by a society where this kind of thought process is no longer considered normal or acceptable. There is splendid evidence that our hunter/hunted forebearers benefitted (from a survival point of view) from mild to moderate OCD and anxiety, only then it wasn't called OCD and anxiety disorders. Anyway, that doesn't help FitFossil or anyone else trying to 'fit in' in todays world.

In other words, if our ancestors had run around in a serotonergic state of relative bliss they almost certainly would not have been the lean, mean hunting and surviving machines that could successfully pass on their genes. Remember it's dopamine/noradrenaline that keeps us alert, motivated, lean and sexually fit. The liberal prescribing of SSRIs is, IMHO, a little too much like trying to keep the masses fat and docile.

I know of no other topic that can get people more riled up. But anti-depressants have the highest placebo response, and lowest real response of any drug that's prescribed. Add to this the fact that it is precribed to folks that aren't even clinically depressed, or who suffer only mild depressive symptoms, and you have one of the biggest scams around. Obviously these drugs help some people, but the vast majority of people who take them do not get any benefit (above placebo), but everyone gets side effects! And the long term use of drugs that moderate neurochemical balance leads to long term changes in the brain that make it very hard for a lot of people to ever get permanently off the drugs. SSRIs should not be the most commonly prescribed drugs on the planet. Wine, play time, exercise, sunshine and good friendships with a healthy diet should should be all that most folks need prescribing for mental health. But it's TOO HARD. I was not being facetious or nasty or picking on anyone. I am just being a realist that knows the majority of people will not be compliant with my prescription! Most of us are stuck, one way or another, in a rat-race that we can't see our way clear of

 

[wilson6]

If you have hard wiring problems that began at age 4, then that is one thing. Not using meds to fix an intrinsic neurotransmitter problem is like telling a guy that has very low test or is a diabetic to see a shrink and take prozac to make him fell better rather than giving him test or insulin to solve the underlying problem. However, there are too many people that just need to learn to deal with life. When I hear someone say I wish I didn't have to work, or I wish I was rich, or I can't deal with my boss, significant other or parents, whine, whine, whine and go on to say how they need prozac to solve their woes, then there's a problem. Likewise, there are those that take on way too much in life, then need meds to fix their central burnout. That's what I'm talking about here. Just seems to me like a lot of folks are on meds to make them happier, just makes me wonder considering the meds in some cases just cause additional problems.

W6

 

[wilson6]

Along those same lines, I also wonder what role diet plays here. Getting back to that old question of what are good fats and bad fats?

There is mounting evidence that an imbalance in the omega-6 to omega-3 ratio may be involved with major depression and the increased production of inflammatory cytokines and eicosanoids found in that illness. There is also some suggestion that this may play a role in ADD. External stressors, even mental ones can increase the production of IL-6, TNF-alpha and IFN-gamma; and serum PUFA levels predict the response of proinflammatory cytokines to psychological stress.

Given the bizarre diets I read about on this board, I also wonder about the role of diet, heavy training, constant worrying about workouts, bodyfat, etc. and how that plays into many of the psych issues people talk about.

Many things to consider.

W6

 

[MS]

Agreed, there is mounting evidence that an imbalance of EFAs causes a lot of psychiatric (and somatic!!) disease. It's often hard to blame just one component of lifestyle though. Insulin and leptin resistance, wacky hormones from obesity and lack of exercise and possibly mineral imbalances can all lead to an organism that is less 'robust' or less capable of dealing with stress. Those same inflammatory cytokines that are elevated from external stress are also intimately tied up with diabetes, heart disease and cancer. Lifestyle changes sure could fix or prevent a lot of problems all at once!

 

[wilson6]

Yup. The depression-heart disease and/or depression-lupus seem to go hand in hand and are all linked to an inflammatory response.

W6

 

[sexymeli]

Hi... well i have been on every medication there is out there... paxil, celexa, zoloft, xanax, trileptal and wellburtin and remoron.. i would definitly suggest taking remoron... its not a sedative.. and will help you with your sleeping too at night... and plus it makes you feel more alive when you wake up... i would definitly reccomend it.. its an anti depressant and sleep aid... you will love it.. and if not... try wellbutrin.. its an anti depressant and a mood stabalizer... so it will also help you with your high and lows...

 

[takniteasy]

I was originally prescribed Effexor because my regular physician dx me as moderately depressed. I felt there was a hormone issue, as I had other "symptoms " of perimenopause. However, he was stubborn and not open to the possibility of me experiencing early menopause (I am only 38). Anyways, I chose to trust his medical judgement which was a mistake. Sure there were times when I felt "normal" as in not moody but for the most part the medication was useless and as I said before, I now have a problem with dizziness which I attribute to the chemical imbalance caused by the Effexor .I do agree with W6 and MS that anti-d's are prescribed way too often and for the wrong reasons. Too many people want an easy way out instead of dealing with everyday life, and too many doctors are not willing to investigate further as to the actual cause of a person's depression, anxiety, emotional disorder, etc.

 

[MS]

Or how about some good old fashioned high protein/high DHA/EPA fish?? Everyday!

 

[FitFossil]

I use Udo's oil - would fish oil be better? Can anyone recommend a brand that won't give me fish burps?

 

[wilson6]

Alright FF,

Time for some student directed learning here as this has been discussed before.

Udo's oil contains a mix of omega-3 (alpha-linolenic) and omega-6 (linoleic).

If it is EPA and DHA (fish oil) that you need, why could Udo's be a problem. Hint: think delta-6 desaturase.

Do a web search and see if you can come up with a basic answer.

W6

 

[wilson6]

Try Fisol from Nature's Way. It is enteric-coated and smaller softgels. No fish burps as it doesn't release in the stomach.

W6

 

[fawnmarie]

Well... I've been off and on wellbutrin for the last couple of months for smoking & depression. It didn't seem to do much for the depression OR the smoking - although it did help with some compulsive shit I was doing when depressed that was starting to become self-mutilation (i.e. compulsive pulling, scratching, etc.).

I came off for a while when it didn't appear to be helping with the smoking much and I was bloody sick of not being able to have a beer when I wanted one. Came off it slow with no problems and only side was headaches, which I got going on and going off (lots and lots and LOTS of water helps, for anyone that's taking it). Took a break over the holidays and enjoyed my booze.

I dealt with the depression by 1) fixing my life (most of my depression was situational) and 2) taking pregnenolone - which I had used before and worked wonderfully.

I went back on the wellbutrin to see if it would help with the smoking under different circumstances. More headaches, more water. Seems to help some now.

ANYWAY - it's a wonderful appetite depressant, since I lost quite a bit of weight on it (was needed and intentional).

Once I was no longer depressed, it helped a lot more with the smoking thing (still haven't quit, but am down from almost two packs a day to about 12 or 15 smokes, so I guess that's progress).

ANYWAY - the only thing I've found that works great for depression is fish oil & pregnenolone. The effects of pregnenolone are almost immediate - i.e. you feel better sometimes as soon as a couple of hours, at least by the next day or two. I use salmon oil - 1 - 2 grams a day, and I get it cheap at Walmart. The pregnenolone is the best, though - absolutely. I take about 30 mgs per day, and cycle off it for a couple of days every two weeks (or I get a kind andro-rage - results vary according to age and hormonal profile).

Perimenopausal depression is probably more appropriately treated with progesterone than antidepressants. Estrogen dominance can cause sleeplessness, moodiness and depression. Progesterone & pregnenolone together work beautifully for me and keep me even keel, happy as a clam, etc.

AD's are fine, but pregnenolone makes me obnoxiously happy, calm and confident. I even get on my own nerves.

Fawn

 

[wilson6]

Better stock up on the pregnenolone. It is likely to be a C-III controlled substance soon.

W6

 

[FitFossil]

Alright FF,

Time for some student directed learning here as this has been discussed before.

Udo's oil contains a mix of omega-3 (alpha-linolenic) and omega-6 (linoleic).

If it is EPA and DHA (fish oil) that you need, why could Udo's be a problem. Hint: think delta-6 desaturase.

Do a web search and see if you can come up with a basic answer.

W6

OK, I'll give it a shot. From my web search, I have learned that delta-6 desaturase (D6D) is an enzyme which metabolizes linoleic acid and alpha-linolenic acid into other fatty acids. So...the Udo's could be a problem for me if my D6D is faulty, preventing me from metabolizing alpha-linolenic acid into EPA and DHA Looks like I'll be trying that Fisol!

Here's one of my sources:
http://www.nutrisana.com/html/engm.html

"In humans D6D is the initial and rate limiting enzyme in both the omega-6 and omega-3 metabolic pathways. Although adequate intakes of both LA and ALA may occur, the body may be unable to utilize these fatty acids due to this impairment....

"Due to the possible impairment of the D6D enzyme, it is necessary that an adequate amount of the "conditionally essential" omega-6 and omega-3 fatty acids, that bypass this limiting D6D enzyme, are consumed. Specifically, GLA, EPA and DHA should be consumed in addition to the "essential fatty acids" LA and ALA."

 

[wilson6]

You got it. delta-6 desaturase also regulates the production of gamma-linolenic. That's why a little borage oil isn't a bad idea either. In addition to intrinsic defects in delta-6 desaturase, age, alcohol, cholesterol and diabetes can reduce its activity. That's why older individuals should consume EPA and DHA directly in addition to gamma-linolenic.

W6

 

[circusgirl]

I've been on Paxil, Celexa and now Zoloft. The Zoloft is not working for me. Doc changed me off of Paxil for same reasons and because one of the side effects is weight gain. Celexa was okay, but my insurance didn't cover it. Anyway, I will probably up the dosage on the Zoloft and see if that helps any.

So, I was curious about others experiences. What's worked best for you?

Sorry to be so late replying to this but I've been wawy from the women's board for a few days...

I was tried on numerous SSRIs and they didn't do a thing for me. I would suggest trying either Reboxetine or Venlafaxine. The Reboxetine works on noradrenaline instead of serotonin, and the Venlafaxine is an SSRI that at higher doses also has a noradrenaline effect.

Serotonin and noradrenaline are the two chemicals you need to function normally, the absence of which result in depression.

The side effcets of venlafaxine for me are pretty much a tendency towards mild orthostatic hypotension (ie feeling dizzier longer when you stand up), slightly reduced thermoregulation abilities, ie I sweat a lot more a lot more quickly, like a guy lol. But I always had less than perfect thermoregulation anyway. Oh, and you will be constipated for the first few days, ouch. DIg out the fibre cereal...

Get your doc to try this or Reboxetine but be warned if uninsured they cost $$$$.

 

[circusgirl]

Did any of you ever sit back and consider what in your life is causing the depression, anxiety, panic attacks, etc.? and start working on the root of the problem vs treating the symptoms?

Just a thought.

W6

yup. I had plenty of time sitting on my ass in a locked psych ward to think about that stuff.

Manic depression is a fairly organic illness though, it's got a strong inherited streak. And then was heaps of shit on top of that that was making me more depressed than manic all the time. Made the illness a lot worse I think, as the mania I suffer is pretty mild, just mild to medium hypomania only, but the depressions was very bad.

I got counselling, help etc but what helped me be happy, as opposed to not ill, was getting all the toxic people out of my life and out of my head. And realising that just because someone says something nasty to you, doesn't mean they are right about you. Oh, and sports and a better diet. Don't underestimate these two - but since you pot on elite, you already work out, right? .

 

[MS]

Yeah, it's a funny thing depression. It seems the first couple of times someone gets depressed, it's often just a mild and transient reaction to perceived or real stress. But there are some folks who get into a groove (analogous to migraine sufferers) where their body/brain 'learns' to get depressed as a coping mechanism. Unlearning this method of coping is not easy, but almost inevitably involves getting toxic people and lifestyle factors out of your life, and practice at not taking things so personally. It often also requires reinstilling a sense of control or power to the sufferer.

In any event, it is not a forgone conclusion that an absolute lack of neurotransmitters is at fault. There is the other (compelling) point of view that reacting to stress chronically (stress here is anything that elevates cortisol and can include poor diet, obesity and personality type) actualy raises neurotransmitters to a high levels, which leads to down regulation of receptor numbers or sensitivity (just like in insulin resistance). If this is the case, then the antidepressants are really just propping up a faulty feedback system and are not a cure in the sense that many people may get 'stuck' on them for life. This theory fits particularly well with the observation that the increase in depression and obesity both correlate highly with increased consumption of toxic high carb diets...which leads to elevated serotonin.....which leads to receptor downregulation and desensitization to the serotonin signal......which leads to more carb carvings....and so on in a viscious spiral. SSRIs are a patch for this syndrome. Likewise all the neurotransmitters do a lot of 'cross-talking' with each other's receptors to the extent that there is no such thing as a drug which affects ONLY serotonin, or ONLY norepinephrine or ONLY dopamine.

From a purely holistic perspective, it is preferable to identify the cause of the stressors in your life and eliminate them or refuse to react to them in a stressful way. This requires time, patience, social support and many other things that are rare and lacking in modern societies. Lacking these resources, antidepressant drugs are a very poor second choice line of therapy
All drugs have side effects. A healthy lifestyle has no negative side effects!

 

[NubianBeauty]

This is a GREAT thread! Alot of good info!