ntt14 Posted June 9, 2011 Report Share Posted June 9, 2011 Is there anyone who knows very much about antidepressants in general or who are taking any of the SNRI group eg. venlafaxine, nefazodone, mirtazapine, bupropion. Sorry this is a bit of a heavy question but I've been researching my options because the way things are going just isn't working. I don't get on with a lot of the SSRI group eg. Citalopram, prozac (they make my anxiety totally out of control) and have tried countless others that don't help at all. I've been on the highest dose of dothiepin (tricyclic) for about 8 years and have just kept on sinking and with anxiety gradually taking over. Trouble is I can't ignore it anymore and hide away. But my doctor is reluctant to change them without me seeing the psychiatrist and the psych is unreachable so I want an idea so that I can be more assertive (ish). SNRI's, I have read are good for anxiety and depression but there doesn't seem to be much info or should I try another tricyclic. Aaaah, not expecting anyone to know the answer to these questions, just wondering if anyone has any experience. Or this would be a good moment for humm__mabbe to pop in with a nice bucket load of info!! Link to comment Share on other sites More sharing options...
ntt14 Posted June 9, 2011 Author Report Share Posted June 9, 2011 Just wanted to add that I do know that counselling, selfhelp and a lot of determination is really the only way to get past a lot of my problems, but I need to be in a place where I can try to get my head to stop spinning long enough to start dealing with it step by step and feel that I care enough to even try. Link to comment Share on other sites More sharing options...
blackdagger82 Posted June 9, 2011 Report Share Posted June 9, 2011 I can't help on the AD front hun but sending lots of great big hugs to you :bigarmhug[1]: Link to comment Share on other sites More sharing options...
pippab Posted June 9, 2011 Report Share Posted June 9, 2011 venlafaxine was one of the first antidepressents i was given and didnt agree with me at all... there are even facebook groups you can read on it if you pop in into the search bar.... you may get some info there... i never joined the groups but you can still read the wall and peoples experiances etc... sorry i couldnt be much more help x Link to comment Share on other sites More sharing options...
Christine001 Posted June 9, 2011 Report Share Posted June 9, 2011 Hi I can only give you my experience, been on venlafazine now for a year, think it is good for anxiety as well as depression. you can started on a small doze and increase if needed. its supposed to be one of the most effective ads, i have looked it up a lot on the internet and the withdrawal can be very difficult. i take mine with another drug and have had a few tries before finding current combination. it is trial and error, with obviuosly dr suppervision, Link to comment Share on other sites More sharing options...
wonderful Posted June 9, 2011 Report Share Posted June 9, 2011 the problem with anti depressants is that everyone is different and what helps someone might not help another... But I was on Citalopram and it didn't quite work for me, I also have anxiety and depression, I have recently changed my meds to Sertraline and so far they seem okay Link to comment Share on other sites More sharing options...
G1rlInterrupted Posted June 9, 2011 Report Share Posted June 9, 2011 I'm on mirtazapine and have been for years. Yes they are more sedating thab prozac etc but you have to way up if the weight gain, sleeping for 11 hours straight is for you. Link to comment Share on other sites More sharing options...
Villan Posted June 9, 2011 Report Share Posted June 9, 2011 i found that the best AD for me was citalopram (SSRI), but it scewed with my sleep and anx and so they also gave me a very low dose of amitrip (a TCA AD) to combat that... taking the SSRI first thing and the TCA in evening... Before everyone jumps and says taht you cant take an SSRI and a TCA together - the TCA was a VERY low dose (and also known to be prescribed as an anxiolytic in low dose) and the combination was ok for me as it was short term thing... but i dont know whether it is OK to take it more long term... But - my point here really is that there are a load of other combinations of meds out there, so maybe if you look to ask about getting on the best AD for you and then maybe getting summat else prescribed for the side effects or other issues (anx) you have, rather than trying to find one drug that works for all... that is if you are OK with taking a combination... hopefully that makes sense... Link to comment Share on other sites More sharing options...
badman Posted June 9, 2011 Report Share Posted June 9, 2011 http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/depression/antidepressants.aspx Was writing to explain that doctors have frontline medications SSRI antidepressants and then move along from there to venlafaxine, mirtazipine. The reason for this is side effects and toxicity in overdosing. Link to comment Share on other sites More sharing options...
FuzzyWasHe Posted June 9, 2011 Report Share Posted June 9, 2011 Anxiety is harder to treat then depression with SSRIs. I've tried most of them and found the following were good for anxiety: 1) Fluvoxamine (Luvox) Probably the best after it builds up. Does a great job on both dep and anx. An underrated AD IMHO. 2) Paroxetine (Paxil) this is nasty stuff to get off of but does a pretty good job on anx. 3) Lexapro (escitalipram) not as much of a punch for anxiety, but does help and is effective quickly. 4) Effexor (venlafaxine) again, not too big of an effect but did help at higher doses. I tried Buspar and it didn't work for me--works for a few folks though. Some of the antipsychotics did a good job, especially Zyprexa. Heavy guns for anxiety but helped me when I needed it. A lot of anxiety sufferers take benzodiazepines either as needed or regularly under supervision of a doc. Yes, they are addictive, but under a certain dose, not very dangerous (according to my pdoc). They are the gold standard for treating anxiety--sometimes there's nothing else that will do the trick. Some ADs made my symptoms worse: 1) Amitiyptyline (TCA) felt like I wanted to die. There is research supporting the hypothesis it makes BDP symptoms worse--was true for me. Cried in the bathroom for 2 weeks. 2) Zoloft (sertraline) made me shaky and nervous. 3) Prozac (flouxatine) Made me very angry and irritated--hated it. 4) Welbutrin (buproprion) hits dopamine and norepinephrine receptors--very activating. Link to comment Share on other sites More sharing options...
minded Posted June 9, 2011 Report Share Posted June 9, 2011 I hope you find something that will work for you. SNRIs are used to treat both anxiety and depression however can make the anxiety worse initially (for a few weeks). However as with all of the medications the responses and side effects they create will be individual - so it is a case of try and see. There is also the option of combinations, and also the issue of weaning for some of the changes. It sounds like it would be useful to be able to discuss the options that would most suit you with the psychiatrist. I may be reading wrong but it sounds like you're feeling quite urgent for something to change and improve (and I'm sure a lot of us can relate to that). Unfortunately none of the medications will make things improve quickly as it takes time for the effects to begin and to gradually increase doses. Would it be helpful to try and get some extra support in the meantime? Whether that's a counsellor/ CPN/ befriender/ support group? Good luck! Minded Link to comment Share on other sites More sharing options...
ntt14 Posted June 9, 2011 Author Report Share Posted June 9, 2011 Shit, sorry, but I wasn't really expecting much response and now I don't know what to do with all of the information so I need to read through again!! Thanks everyone. Link to comment Share on other sites More sharing options...
G1rlInterrupted Posted June 9, 2011 Report Share Posted June 9, 2011 I've been on both types of anti d, well nearly all anti d's. I never got on with prozac and citalopram didn't touch my depression. In the end they didn't know what to give me or do with me infact so I was refered to a psychiatrist who prescribed mirtazapine as I had anxiety and social anxiety on top of depression. This was years before I was diagnosed with BPD. i was floating around the mental health system for years and know one new what to do with me. Anyhow, I was pescribed the mirtazapine and have been on and off them for years. At first they really shiffted my depression like nothing else and I was severley depressed at the time and hearing voices etc.In a bad way, suicidle. I was put on the lowest dose to start with then up to the top dose which is 45mg. They were a god send to me. The only down side was the intense hunger I felt and the weight gain. Also the fact that I would sleep and sleep for 11-12 hours as they knock you out so you have to take them before bed. The weird thing is the lower dose 15mg knocks you out more than 45mg so when you first start taking them you will sleep all the time but when the get the dose higher this should ease off somewhat. If like you say, you get anxious, you may suit these pills better than the likes of prozac as mirtazapine is sedating where as sssri's are very stimulating in my opinion for someone with anxiety. Also, if you have trouble sleeping mirtazapine will help. Just beware the weight gain and try to eat healthy and exercise. I'm not preaching cos I binge eat due to BPD, just try to make healthy choices if your worried about weight gain. In all honesty mirtazapine helped my depression and general anxiety but it didn't touch my social anxiety at all. If you really want to try these type of anti depressants then talk to your doc again, you have a choice in your treatment you know. After all it's you that has to take them. If the doc still disagree's then ask for a second opinion. Link to comment Share on other sites More sharing options...
ntt14 Posted June 9, 2011 Author Report Share Posted June 9, 2011 venlafaxine was one of the first antidepressents i was given and didnt agree with me at all... there are even facebook groups you can read on it if you pop in into the search bar.... you may get some info there... i never joined the groups but you can still read the wall and peoples experiances etc... sorry i couldnt be much more help x No that actually is a help thanks pippa. I remember your post and that your side effects were similar to mine on the SSRI group and I've read that they are similar drugs so I will need to be a bit wary thank you xx Link to comment Share on other sites More sharing options...
G1rlInterrupted Posted June 9, 2011 Report Share Posted June 9, 2011 Just wanted to add that I also have valium for anxiety but have found this just a quick fix. Docs are very strict about prescribing them so only do it as a last resort. My doc prescribed them to me as I was literally climbing the walls in the docs office and I was prescribed beta blockers but I have asthma so I can't take them. It's really trial and error to be honest. Different people react in different ways to meds. There's no one size fits all so unfortunately alot of us have to be ginuea pigs and test out different pills and different combo's. It also helps if you have a good doc. I never have. Mine gave up on me due to my BPD and when I go in now he asks what I would like to happen and what pills do I want. Its disgusting really. Link to comment Share on other sites More sharing options...
badman Posted June 9, 2011 Report Share Posted June 9, 2011 Mine gave up on me due to my BPD and when I go in now he asks what I would like to happen and what pills do I want. Its disgusting really. This sounds like misconduct have you spoken with the practise manager? Could this potentially be a dangerous situation if you are not able to manage the medication? Link to comment Share on other sites More sharing options...
G1rlInterrupted Posted June 9, 2011 Report Share Posted June 9, 2011 I haven't made a complaint. Again my BPD causes me not too as I worry about moaning and feel shit and guilty about it. Put it this way, in my home I have mirtazapine, prozac, valium, and beta blockers. When I go in there they haven't a clue how to handle me and just chuck pills at me. When they dont work, they just shrug at me and are like, well what do you want us to do? and then I feel like I am being a burden. Link to comment Share on other sites More sharing options...
ntt14 Posted June 9, 2011 Author Report Share Posted June 9, 2011 Thank you everyone for taking the time to read and reply. This is a kind of general reply to everyone so might go on a bit, so feel free to get bored, nod off etc. I know medication is a totally individual thing but I'm feeling a bit lost so was just looking for some general advice and other's experiences. In an ideal world my doctor would refer me to the psychiatrist who would try all of these AD and combinations to find the right one for me, but that option doesn't appear to be available. I've had depression and been on and off countless AD for 20 years and also counselling and CBT. About 8 years ago, my doctor referred me to the psychiatrist who prescribed Lithium. But then another psych took me off everything. Then the original one put me on Dothiepin because it was the only medication that has had any effect without extreme side effects and that was that. My doctor referred me back to the psychiatrist a few months ago but I saw a psych nurse and I really tried to get it all out but I'm just not very good with words. But he told me they would look at medication and come up with a plan for therapy etc. but then sent a letter to doctor saying there's nothing they can do and referred me back for CBT for social anxiety. You're right Minded, I do feel a little desperate. I know treatment takes a while and the AD take a long time to kick in, but if I knew I was on the right track I would feel a little stronger and have a bit of hope. But, to be totally bleak, the bad days are getting too hard to get through. I started researching thinking I could find an answer and kind of insist on the help but I've gone round in circles today and come back down again. But I do appreciate all of the help thank you. Link to comment Share on other sites More sharing options...
hummm_mabbe Posted June 9, 2011 Report Share Posted June 9, 2011 On the SNRI / Nassa / NARI front, I have tried effexor, reboxetine and mirtazapine. ffexor was good, the others were pants. Have also tried a number of SSRI's and so on, none really that great. For me all my change and progress has come from therapy. From my own experience I would say that recovery from personality disorder is measured in years, possibly in the region of 5-10 for real personal (not just clinical) recovery. I have had many types of therapy and my philosophy is just keep trying everything you can. Do CBT or DBT, then do something else, then something else. Each one gives you a little bit. Sadly it may be that nothing is going to move you quickly to a place of recovery though, its just get on board that slow train and keep riding it. Link to comment Share on other sites More sharing options...
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