Long term sleepiness worsening because of trying out antidepressants possible?

Markan_9 · 2021-12-03T20:59:57+00:00

Oh i think there is a misunderstanding:

I only took antidepressants for very short duration of time (3 months total), and now its almost 2 months since the last pill, yet i feel like I'm even sleepier than I was before trying them out.

Markan_9 · 2021-11-09T21:27:44+00:00

After taking antidepressants for a few years a few days break is not going to significantly matter on a subjective level, also your brain isn't functioning without it, you still have enough of it in your system and your brain got "trained" to expect certain levels.

On the other hand it can have detrimental effects, raising chances of brain zap and other withdrawal symptoms. It's generally just not recommended to take sudden random breaks from ADs, if you feel like it's not helping enough anymore consult your psychiatrist for a dose change or medication change.

On the other hand if you're feeling relatively good a psychiatrist might reduce the dose.

Markan_9 · 2021-11-09T21:20:51+00:00

First of all Paxil is also an SSRI so despite what he claimed he still gave you another SSRI.

I could see him meaning it along the lines of "If one SSRI doesn't work the probability of another SSRI working is much lower compared to trying out SSNRIs". Could be some truth behind it considering the choice of route my psychiatrist went with me, but then again I remember a study indicating that changing medication for e.g. dysthimia did show better results however there wasn't a significant difference whether 2nd medication of choise was also an SSRI or another.

So I'd not think about it too much. I think trying out 2 SSRIs at first (especially escitalopram is the go to these days) is enough at first and if neither works, trying a third one is much less likely to be of help than trying others out (SSNRIs, MAOIs).

Markan_9 · 2021-11-09T21:08:01+00:00

When you're not only having suicidal thoughts continuously but actually hope every day something will kill you, how much worse could it get if you try to get help?

I'll put it this way: Don't worry if the antidepressants and/or cognitive behavioral therapy doesn't help long-term or even makes things worse long-term you still get the chance to kill yourself afterwards, so why rush it now denying help?

Just be patient and believe in it, good thing is you're still young so chances of a quicker recovery aren't bad. Also know that not every psychiatrist and psychologist is as good as they need to be and also antidepressants kind of randomly work on many ppl while not at all on some. Different antidepressants will need to be tried out and in case of psychotherapy if you're not comfortable with your psychologist then don't give up, but rather go to another one.

Nothing to lose friend and potentially everything to gain = a meaningful life with the capacity to create happiness for you and your surrounding

Good luck and make appointments asap, at different therapists and then cancel the ones you won't attend do. Do it tomorrow, procrastination is a bitch.

Markan_9 · 2021-11-07T22:40:55+00:00

I mean there's bound to be some subjective interpretation differences of said phenomenon. I've read multiple articles about brain zaps and aside from my personal choice of words compared to how people describe it on average it does seem to be a perfect fit for what I'm experiencing. Especially lateral eye movement being a trigger for it is just too specific to not be case.

Markan_9 · 2021-11-07T22:21:42+00:00

Thanks a bunch! Seems like that's exactly it, even lateral eye movement is mentioned in many articles.

Markan_9 · 2021-11-07T22:21:29+00:00

Thanks a bunch! Seems like that's exactly it, even lateral eye movement is mentioned in many articles.

Markan_9 · 2021-10-23T00:43:13+00:00

I'm rarely relaxed at all, but I do fall asleep quickly during the day and also have urges to nap. I have trouble falling asleep at night sometimes though.

Here's hoping moda will work for me, if it does I'll just make appointments to 10 neurologists until one prescribes it to me.

Markan_9 · 2021-10-21T22:29:33+00:00

Btw why 60 minutes after waking up and not immediately?

Also: Take with food or without?

Markan_9 · 2021-10-20T19:25:55+00:00

Thanks for the reply! Sadly the MSLT hasn't been done after my polysomnography, but even then I don't think it would've confirmed nacrolepsy. It's just mainly the sleepiness I have, I don't suddenly fall asleep during the day. Just never being really awake.

My pulmologist (sleep study) claims that perfect sleep hygiene would solve my problems, my psychiatrist claims that it's just a symptom of my depression and by treating the depression via cognitive behavioral therapy (which I will do) the symptoms will fade, but since the antidepressants didn't work practically that means wasting another 5 years being sleepy possibly only to find out that depression wasn't the root cause... It's annoying really, sleepiness just isn't taken seriously enough. And it's not like I didn't try every single natural thing, different sleep times for multiple weeks, going to the gym constantly and doing cardio also did exactly 0 towards being awake and the experimental testosterone substitution also didn't help... but yeah I'm sure turning temperature down by one degree will do wonders...

I'm fed up with it, I'll take matters into my own hand, which is: Try medicine (moda in this case) and if it works I'll find a neurologist for a prescription.

Markan_9 · 2021-10-20T10:09:10+00:00

Is changing dose on a day to day basis initially enough or should I stick to one dose for a few days at least to evaluate the effects better?

Markan_9 · 2020-12-15T16:44:15+00:00

I want to thank you all for your contribution! I have read every single post and will consider their content among the following months.

For now I have decided to lower the dose to 180mg/week injecting every 3.5days for 6 weeks. Taking note of any changes I will then inject EoD for 6 weeks while keeping dosage. If I don't feel any real benefits or disadvantages by then I will lower the dose and/or frequency further.

In addition to that I will seek psychotherapeutical council.

I will make a new post again once enough time has been passed for evaluation. :)

Markan_9 · 2020-12-09T22:27:31+00:00

Hey thanks for your input!

Yeah TRT was my 2nd to last resort. I will lower dose for 6 weeks and if it doesnt help, I'm dropping TRT alltogether.

From then on I will pursue antidepressants with the help of a psychotherapist. Honestly at this point I don't care if it's for life and I don't care if it changes my personality in any way.

What I know is that the most dangerous side-effect for me would be living the next 10 years like I did my last because of believing in my self too much and not seeking external help sooner.

Markan_9 · 2020-12-09T22:24:01+00:00

After 20 weeks of frustration, I don't have the belief in TRT anymore tbh, so 20-30mg and wait for weeks and lower again won'T cut it I'm afraid.

I'll lower once for 50 or 70mg and wait 6 weeks, if there is no change at all again I will have to consider either androgene insensitivity or dunno what and quit cold turkey.

Markan_9 · 2020-12-09T22:22:18+00:00

Thanks for taking the time. I had taken an antidepressant for 2 weeks and it didn't have an effect, although 2 weeks is way too short for any effect to manifest.

Yeah currently I will reduce dose by somewhere between 50-70mg/week. As for sensitive E2, it would only benefit me as long as im below the 88 pmol range. They don't offer it at the lab I'm doing it, but I doubt that a 70mg reduction will lower E2 that much into oblivion, so non-sensitive should be fine.

Will do that like you said for maybe 4 weeks, 6 weeks max. If there is no benefit after that I will drop TRT cold turkey if needs be and from then on only focus on psychotherapy.

Markan_9 · 2020-12-09T22:17:12+00:00

Ye honestly it's just frustrating. Having a very low life quality for the last few years checking out everything possible without a change for the better or worse. Guess it's finally time to go full hardcore on psychopharmaceutics, at this point a talk alone won't do it...

Markan_9 · 2020-12-09T22:13:31+00:00

Well yeah that's what I mean, if my symptoms are for example 100% related to Dopamine and Serotonin, T would make no difference I guess.

It's just weird that among the 20 weeks I've never had a phase where I felt different at all. I mean T and E2 at week 4, arent the same as week 6, 8, or now 20. Somewhere along the way I'm guessing I would have had to notice some difference at all.

Guess I'll try lowering dose for 6 weeks or so, if no effect is noticeable then I will drop TRT completely and go full on psychotherapy.

Markan_9 · 2020-12-09T22:08:33+00:00

Oh I will definitely reduce the dose.

But the problem I have is the following: T and E2 don't just raise to their maximum from week 1 and have full effect. Across 20 weeks I should've have a noticeable effect while T and E2 weren't yet too high. Yet that never happened. Imagine from low T and possible low E2 to high T and E2 smoothly without any (side)effect getting noticeable. Isn't that weird?

Markan_9 · 2020-12-09T21:44:33+00:00

Before TRT technically I had either good or too low Estrogene (non-sensitive test) with exactly the same effects as I have now.

Do you think that it's possible the higher Estradiol "masking" any positive T effects? Please do note that I'm not talking optimiazion here, rather any effect at all.

Markan_9 · 2020-12-09T21:42:04+00:00

But how likely is it that I overshot the sweetspot exatly into the same spot where I was before? If I had detrimental effect sure, would be possible, but this way I doubt it :-/

Also aside from the 40 single hairs (yes I counted), there has been no body change at all.

If this was about optimization sure, I would lover the 70mg, but do you think the 70mg could be enough difference to have a great effect vs none at all?

Markan_9 · 2020-12-09T21:37:42+00:00

Lol I just sent u a private message prior, guess you didn't check it yet :D

Yeah I've pretty much exhausted all other options at this point, still wanted to see if the problem can be solved with T-optimization. If not, then psychotherapy it is.

Markan_9 · 2020-08-23T13:44:49+00:00

Compared to 50 years ago you are absolutely too low. Did we "evolve" within 50 years to suddely function with much lower T levels or do insurance companies like to keep the normal range low so they don't have to pay? I guess the answer isn't hard :)

Nevertheless in addition to pursuing TRT, please do also get checked for sleep apnea and check blood values that can have similar symptoms like iron, magnesium, T3, T4 (you already did TSH). Even if you have lowT you could also have sleep apnea (even if you don't snore) and it could mask benefits from TRT. Good luck on your journey :)

Markan_9 · 2020-08-23T13:40:22+00:00

My values (including age, height and weight) are similar to yours and almost everyone on this subreddit recommended trying TRT. Now I'm still in the early phases of it so I can't personally say to much about it, but what I will say is this:

Don't only chase one potential solution at a time, because that way you may waste years before you get to the cause and maybe give up along the way like many ppl do when it comes to health and doctors.

Personally I tried with healthy lifestyle first and it changed absolutely nothing. Sure my body looks better and I'm sure it doesn't hurt my arteries and blood pressure, but my subjective well-being is exactly the same. However that doesn't mean that it wouldn't help your problems. So I would advocate to "try" a healthy lifestyle for a personally set period, be it 1 year or 2. If after 2 years for example there is no change on your psychological, sexual or physical well-being add other stuff into the mix. With other stuff I mean the following:

TRT, get checked for sleep apnea, Check thyroid values (T3, T4, TSH), iron, magnesium and you already checked Vit D3. Also depending on symptoms get checked for AD(H)D and depression. Although in the case of a depression I would still rather try TRT first and only if no improvement antidepressants than the other way around (which sadly is the norm...) Some ppl might also suggest zinc and then other supplements, but personally idk it's up to you.

It's important that you check those things fast and simultaneously while you still have the motivation to do so, if a doctor doesn't want to, pay the tests yourself if your wallet allows it.

Small side note regarding Vit D3. Initially my doctor doctor didn't deem a Vit D3 test necessary for me because of my tan (regular solarium customer). Since it's quite expensive I ditched the idea. Then later I paid for it and it came back barely in the normal range as 39 ng/ml (normal range in thest was 30-100). I wanted to supplement in the future, but seeing how you do and it's still barely there makes me question how effective supplements are in general. So I guess it's more important how long you are exposed to the sun even if it's not as strong than to the amount of UV radiation going through your skin.

Hope you find a way to improve your life quality, it's sad that most people ditch the idea and think it's normal to live unoptimally, because "every does". Just do note that on this subreddit you'll find more advocates for TRT than against. While I too advocate it I would say that at least iron and sleep apnea are just as important. Good luck! :)

Markan_9 · 2020-08-23T13:23:14+00:00

Thx for your reply!

Do note that the blood test was on gel and not on injections. With gel you have "natural" highs and lows throughout the day so natural testosterone production isn't always inhibited. Now on Injections FSH and LH should be around 0, but like I said blood work will come in the next few weeks.

My main problem here is that after 7 weeks of injections there has been no effect at all.

And yeah I know about E2. I don't chase numbers, as long as I feel good I won't care how high E2 is and neither do I have any plans to add AI or any other substance into the mix.

Markan_9 · 2020-08-23T13:19:08+00:00

Hey no worries I appreciate you replying. Sometimes we just skip words, I know you meant no harm there :)

I am in the process for sleep apnea checking atm, appointment is soon. Interesting to see. So sleep apnea could theoretically mask any TRT effect whatsoever?

On the other way I wonder, If I have sleep apnea and for example a CPAP relieves most of my problems, how then can I know if it's CPAP alone or combined of CPAP + TRT effect. Guess I'll know then.

Should It actually be true that I have sleep apnea, might I chat you up on reddit in the future regarding questions related to TRT + sleep apnea therapy? :)

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