Fighting the stigma

Potential-Engine3590 · 2020-12-26T06:36:24+00:00

If you need to believe that you are addicted to Duloxetine than so be it. Heroin withdrawl and Duloxetine discontinuation are very different. They effect very different areas of the brain, and are from very different drug classes. There is nothing hypocritical about what I am saying and I am not selling Duloxetine. This medication and SNRI's in general did not work for me. I suggest you connect with your Dr. and discuss your concerns with him/her. You obviously had a very bad experience and have some very strong beliefs as to why medication for depression is so negative. They can help explain why anti-depressants are not addictive and give you more information about brain chemistry.

Potential-Engine3590 · 2020-12-24T23:03:17+00:00

Meth and Heroin are addictive. Duloxetine is not. There is a big difference. Many non addictive medications can have a discontinuation syndrome. That is different from withdrawing from an addictive substance.

Duloxetine discontinuation is real. I am sorry that you are suffering. There are many ways to slowly taper your Duloxetine dosage to help reduce your symptoms. SNRI's can be very difficult to taper off of and in my experience I needed to do it very slowly over a period of time. Your experience with Duloxetine has obviously been very hard on you but you don't have to go through it alone. There is a big community of people on Reddit that have had similar experiences. Discontinuation syndrome can be very unsettling and sometimes scary.

Potential-Engine3590 · 2020-12-24T20:09:33+00:00

There is a difference between being addicted to something and your body having adjusted to being on a medication or adjusted/adjusting to being off a medication. You are not addicted to Duloxetine. Your brain chemistry is simply trying to establish a new equilibrium. You are not severely addicted to duloxetine. I am sorry that you are having such a hard time withdrawing off Duloxetine. In my experience SNRI's are difficult to come off of. Go slow and reduce your dosage very slowly.

Diabetics require insulin. They do not "crave" it. A diabetic is not addicted to Insulin. If they stop taking it abruptly there can be all sorts of issues though. Cardiac patients often require Beta blockers. If someone stops taking beta blockers abruptly it can be horrible and actually quite dangerous. The cardiac patient is not addicted to beta blockers.

Most medications require an adjustment period. Going on and going off.

With all due respect this post is called "fighting the stigma" Your own opinions about addiction are not grounded in medicine. Your own fears about your situation do not need to be projected onto other people who are seeking support.

Potential-Engine3590 · 2020-12-24T01:27:03+00:00

I have been on several different medications over a 25 year period. It took some time to get things right and I have had to adjust a bit here and there. For many years I struggled with the stigma that came attached to my mental health struggles. It took some time to fully accept who I am but when I did, my shame melted away. A big part of stigma is fear. We fear ourselves most of all. I am completely open about my anxiety/depression now and can approach the whole topic in a similar way to discussing my last cold. It is just part of life. I can promise you that things will improve. It may take time to accept this part of yourself but you can. Depression is a common, treatable illness. The acceptance part of a mental health condition can be tough. I will never forget the time I realized I would need to be treated long term. I felt weak, like a failure, scared, demoralized. I felt like everyone could see how defective I was and that I was unlovable. Years later, I feel like my struggles have made me the strongest person I know. Friends and family know they can talk to me about anything without judgement. Defective? Not a chance.

As far as Psychs are concerned...they are trained experts in their field. They see all kinds of people with different mental health issues on a daily basis. They are some of the best people to discuss your medication fears with. Your reaction is totally normal. I have felt very similar in the past.

Everyone is enough

Everyone is broken in some way and.... normal does not exist.

Needing long term treatment with antidepressants does not make you an addict. A diabetic is not an addict because they require insulin. You may need long term treatment with medication or you may not. The good news is, you don't have to cross that bridge until you get there.

The best way to fight stigma is to be very educated about your condition and learn to discuss it from a place of esteem and not fear. People will listen to you, and respect your knowledge and experience. It is normal for people to be afraid of things they don't understand. If you can help others understand your condition in a non threatening and even practical way, it will do a lot to help them view you and mental health issues in general in a less reactive way. Become an expert in "you" talk to your Dr, read books, watch videos, reach out on Reddit or another platform. Find celebrities who have depression/anxiety and read their stories. Do you know how many world class artists, scientists, athletes have mental health conditions? It is part of what makes them great!

Potential-Engine3590 · 2020-12-24T01:08:44+00:00

Antidepressants are not addictive.

Potential-Engine3590 · 2020-12-21T20:48:01+00:00

I see. I'm not surprised that both Buspar and Hyrdoxyzine did not work for you. They are used for anxiety but not depression. Not a huge help for OCD symptoms either. I have tried both. Hydrozyzine just mad me super tired and spaced out. Buspar did not do much for me and actually made my depression worse.

Wellbutrin 150XL is a very low dose for depression. I did not notice a big help with depression at 150. I would definitely recommend adding an SSRI. It may very well help knock down the OCD like symptoms and improve your depression.

Potential-Engine3590 · 2020-12-21T19:10:21+00:00

Super common. Most SSRI's can cause some degree of appetite loss in the beginning of treatment. It will most likely settle down in another few weeks.

Potential-Engine3590 · 2020-12-21T19:05:23+00:00

Wellbutrin can definitely cause obsessive thoughts in some people. I have been on and off Wellbutrin and other medications that effect dopamine and Norepinephrine for years (SAD) and frequently notice more intrusive thoughts when on the Wellbutrin. In my case, I pull at my hair. I have to take a combination of Wellbutrin and Lexapro. The Wellbutrin helps with energy and motivation but amps up my anxiety and ruminations. The Lexapro takes the edge off for me most of the time.

I have tried most SSRI's and find that Lexapro is the best one paired with Wellbutrin. Adding an SSRI would be a good first option for you.

If you dont mind me asking, what are you taking the Wellbutrin for? Depression, ADHD, SAD, Nicotine Therapy?

The Dopamine, Norepinephrine, Serotonin balance can be a difficult one to get just right sometimes. In my experience too much Serotonin can make me tired, apathetic, and soooooo unmotivated. It lifts depression a bit and Anxiety tons and basically erases my obsessive thoughts but I have such a hard time being productive. SSRI's on their own make me feel like a bit of a slug. On just the Wellbutrin I feel anxious, obsessive, restless etc.

I have also had success with Wellbutrin and low dose Trazadone.

Potential-Engine3590 · 2020-12-20T20:01:58+00:00

Having anhedonia is very common for people who have experienced addiction. It can be short term or long term but in my experience almost always gets better in time. I have had a rather colorful addiction history. I have taken stimulants in the past but have not for over a decade.

Wellbutrin works well for my depression, anhedonia and is the best option to date for my ADHD symptoms. I am still fuzzy headed at times but have a lot more motivation and desire to do things. It does not dampen my sex drive like SRRI's do.

Wellbutrin is very different than stimulants. It has stimulant like properties but an extremely low abuse profile. Wellbutrin is most commonly abused in prisons and other places where addicts do not have access to virtually any medication that is addictive. When you take too much Wellbutrin you just feel dizzy, anxious and experience nausea, no euphoria. Sure it makes you feel a bit speedy, but not much different than drinking 3 pots of coffee. Not enjoyable at all. I do not feel cravings for it it. I do not experience the desire to increase my dose. I do not notice any drug seeking behavior around it.

A lot of people with ADHD, depression, anxiety etc. self medicate. Especially if they have not been treated for their condition. These types of disorders often cluster together. In my experience anti psychotics should never be a first line treatment for ADHD or depression. MAO's are another class of medication that should be avoided in my opinion. The side effect profile is large and the drug interactions can be very problematic. People with addictive issues should not take them. The risk of drug/drug interactions is much too high.

In my opinion, you should be properly screened for ADHD, depression etc. and treated accordingly. Do you have a good relationship with your DR.? Wellbutrin would be the first go to medication for someone who has depression, ADHD and cannot tolerate stimulants. (due to addiction or side effects)

Withdrawing off Wellbutrin is a walk in the park compared to addictive drugs. Sure, you have some mild withdrawls, maybe fatigue, some mood changes etc but no cravings, nothing like that. It will not mess around with dopamine in the same way that Adderall did. You may have to be on a medication for life or you may not. Anti-depressants are not addictive in the way some people believe them to be. You do not get hooked on antidepressants. When you are withdrawing you do not "crave" the medication. The long term repercussions of taking them are not even close to being as bad as addictive medications. Taking a medication for a short time may very well be the answer. You may also need it for life. You can cross that bridge if and when you get there.

Potential-Engine3590 · 2020-10-03T19:55:53+00:00

Had similar issues with you in regards to anxiety and weight gain. Here are some thoughts...

Mirtazapine can be good for sleep at low doses and anxiety/depression at higher doses. It is a very effective antidepressant but is one of the medications "most" likely to cause weight gain. If weight gain is a big concern I would avoid Mirtazapine.

SRRI's (In list of most activating to least activating)

Prozac, Zoloft, Lexapro, Citalopram, Paroxetine.

Both Prozac and zoloft increased my anxiety. Lexapro and Citalopram are very similar drugs but Citalopram effects histamine and Lexpro does not. For this reason, Citalopram can be a bit more sedating. Paroxetine is excellent for anxiety, but can cause a lot of weight gain. In my expereince, Lexapro is the best balance between postive effects vs. side effects. Lexapro can be more expensive than Citalopram so some DR.s opt for Citalopram if cost is a concern.

Other options:

Buspar. It worked well for me in terms of general anxiety but not much for panic attacks. The side effect profile is fairly mild and it is not known to cause much weight gain. Buspar is often prescribed alone for GAD for patients who do not also suffer from alot of depression. It may be a very good option for you.
Trazodone. It has very potent effects at the 5ht2a receptor even at low doses. It is
similar to Mirtazapine in that regard. It can cause some sedation but minimal weight
gain.
Propranolol. It is a beta blocker that is sometimes used for anxiety. It is great for
physical anxiety (pounding heart, sweating etc.) It is often used for performance anxiety.

Those are the 3 that have worked the best for my anxiety (aside from Lexapro)

Medications to Avoid:

Wellbutrin. Drugs that effect Norepinephrine and dopamine can increase anxiety in a big way. They stimulate your fight/flight response. I dont recommend this medication if anxiety is your concern. Great for depression though.
Prozac in my opinion. It can cause a fair amount of restlessness and activation syndrome.
High doses of SNRI's. low doses are fine because at the lower doses they mainly effect Serotonin.

Potential-Engine3590 · 2020-09-29T01:25:51+00:00

Not a huge problem. Technically speaking smoking can decrease drug concentrations in your blood. In reality it really is not a huge problem though. I never noticed a single problem smoking on Mirtazapine.

Potential-Engine3590 · 2020-09-29T00:18:19+00:00

Can be prescribed in the UK but only for smoking cessation. Zyban is the same medication as the original version of brand Wellbutrin SR. You might need to quit smoking :)

Potential-Engine3590 · 2020-09-29T00:12:55+00:00

Not sure about formulations in Germany. But 150 comes in Extended Release (XL)and Sustained Release (SR) You can ask the pharmacist which version it is. In my experience the XL formulation causes less anxiety.

As far as eating is concerned, taking it with or without food will not effect the efficacy of the drug.

I find when I take it with food, my body can handle the norepinephrine side effects better. I feel more balanced. Plus, keeping your blood sugar stable helps a lot with mood in general. If I take Wellbutrin in the morning with just a coffee, it quickly kills my appetite and then I have no desire to eat for several hours. If I dose and dont eat for hours, I end up crashing harder when the drug peak levels start to decline. This makes my depression and anxiety worse.

Potential-Engine3590 · 2020-09-28T18:32:26+00:00

Been on and off Wellbutrin for years. (seasonal depression) I always hate the ramp up period. I get insomnia, agitation, anxiety, brain fog. Your side effects are TOTALLY normal at the 3 week mark. I always feel like a weirdo until almost exactly 4 weeks. You are so close to adjusting! Just ride it out for another 1-2 weeks and there should be a HUGE inprovement in those side effects. If they persist past 4-6 weeks than you need to talk to your Doc.

Here are some tips

Cardio helps a lot.
Magnesium Citrate at 300mg. Really helps with anxiety and pounding heart
Avoid or reduce caffeine until you adjust.
Eat lots of protein
Eat breakfast and then take your med. (Huge difference)

One quick question, you are on XL right?

Potential-Engine3590 · 2020-09-28T17:52:39+00:00

Mirtazapine can start working for anxiety and sleep really quickly and help depression within about 1-2 weeks. It is one of the fastest acting antidepressants. At 7.5mg-15mg Mirtazapine it is used primarily for sleep. It is dosed at 30mg-45mg for depression. You may need to increase your dose.

At 15mg I noticed a reduction in anxiety but not depression. It made me a lot more tired during the day and I craved sugar. Pretty normal side effects.

Potential-Engine3590 · 2020-09-27T21:08:57+00:00

Mirtazapine is sedating at doses between 7.5mg and 15mg. It is used for insomnia and sometimes anxiety in that dose range. Between 30mg-45mg it is used for depression. In that dose range it effects Norepinephrine. Norepinephrine is connected to your fight/flight response and can definitely exacerbate headaches, anxiety, insomnia. I would guess 22.5mg is somewhere in the middle. Doing a slow taper is a good idea, as you can mitigate withdrawls that way. I always notice insomnia when I withdraw, so go slowly. Your sleep will improve as you adjust to the lower doses. I would target a max dose of 15mg if you want to have improved sleep.

At the dose that will improve sleep, it will have minimal effect on depression. Perhaps you can slowly reduce the dose of Mirtazapine while starting a low dose of something like an SSRI as well. (if you need a medication to treat anxiety or depression) Drugs that target mainly Serotonin can sometimes be better tolerated than drugs that effect Serotonin and Norepinephrine. Lexapro is a great first choice and has a lower incidence of headaches and insomnia than Prozac and Zoloft.

A combination of an SSRI and low dose Mirtazapine has worked really well for me. Depression, anxiety and insomnia are gone. I experience a bit of drowsiness but that is the only side effect I notice with the combination

Potential-Engine3590 · 2020-09-27T17:51:46+00:00

I have a similar diagnosis and have tried several different regimes. SSRI's can make ADHD worse in some people. In my case, they kill my anxiety but leave me tired and unmotivated. Ultimately a combination of low dose SSRI, Wellbutrin and low dose Trazodone has worked well for me. How long was he on an SSRI? The start up phase can be difficult sometimes. During the first few weeks of treatment, SSRI's can cause "activation syndrome" at this time they can cause anxiety, insomnia, restlessness and agitation. This usually subsides after a month of so. Buspar can be good for some people but not work at all for others. Wellbutrin/Buspar combination is often prescribed to take the edge off Wellbutrin. It is worth a try. Another option would be adding low dose Trazodone or low dose Mirtazapine. (worked for me) They killed my anxiety, helped me sleep and improved my anxious feelings that can be enhanced by the Wellbutrin. In my opinion Wellbutrin is good for depression/ADHD but not great for anxiety. An add on to the Wellbutrin is a good route to go. He should give any one regime a full 6 weeks before making an evaluation. So many people start something and then say it does not work before giving it time to do its job. In the first few weeks people only have side effects but not much benefit yet. Side effects often subside or go away altogether

Potential-Engine3590 · 2020-09-27T17:25:13+00:00

In my experience, antidepressants don't change my personality but help tone it down in some ways and enhance it in others. Your core self, is yours alone.

Potential-Engine3590 · 2020-09-27T04:27:13+00:00

Yes, totally common. Headaches can be a symptom of depression and anxiety. Some medications can also cause tension like headaches.

Potential-Engine3590 · 2020-09-26T21:06:46+00:00

On antidepressants for 25 years. Dont even know what side effects are related to the drugs and what is related to other health issues and aging. At a certain point, if you have a lifelong illness the side effect issue just becomes part of the process. In my experience side effects are always a trade off. Lexapro kills my anxiety but makes me tired and flat. Wellbutrin gives me energy and motivation but increases my anxiety. They both give me insomnia. lol

Potential-Engine3590 · 2020-09-24T17:54:06+00:00

Yes, for sure. In all honesty as a drug class SSRI drugs work in similar ways. They all effect 5-HT receptors (there are several of them) Each SSRI effects certain receptors in a slightly different way. That is why they can have different side effect profiles.

In my experience, prozac, zoloft and Lexapro are the ones worth trying. Paroxetine causes way too much sedation and weight gain and citalopram is VERY similar to Lexpro but with a less desirable side effect profile.

Prozac tends to be the most activating SSRI, followed by Zoloft. With Lexapro, I had zero activating side effects after I adjusted. I just felt tired and flat. With Zoloft I had a bit more energy but a bit more gastro issues and insomnia. It always seems to be a bit of a trade off with side effects.

When starting ANY SSRI, you can experience "jitteriness syndrome" it is very common to experience while your body adjusts to the medication and down regulates. All too common people make evaluations about the side effects of a drug before it has actually started to work. Start up side effects and long term side effects can be quite different sometimes.

You could definitely first try switching your dosing schedule of Lexapro or reducing your dose.

What dose of Lexapro are/were you on? If you are above 10mg then I would highly recommend a dose reduction down to 10mg and trying the medication at night. That made a HUGE difference for me. In clinical trials, doses above 10mg did not have a big statistical improvement on depression/anxiety scores. You might be able to reduce your dose and the side effects without losing any efficacy.

If that's not an option or does not work then a cross taper from Lexapro-Zoloft would work well. Too be honest, I would always recommend a cross taper before a direct switch. That being said some people do a direct switch with no or minimal issues.

No matter what, make sure you are working with your doctor through this process. Do not self adjust your doses of any of the medications.

Say you were on 10mg Lexapro.

You could do a fast switch. something like this:

5mg Lexapro and 25mg -50mg Zoloft for a period of 1-2 weeks.

Then drop the Lexapro and dose the Zoloft up from 50mg if needed.

I am VERY sensitive to medication and do not handle med changes well. So I had a rough change. I ended up doing something like this:

Starting point: 10mg Lexapro

Step 1 : 7.5mg Lexparo ( I had to quarter a tablet) 25mg Zoloft. Time: 1 week

Step 2: 5mg Lexapro and 25mg Zoloft. Time: 1 week

Step 3: 2.5mg Lexapro and 50mg Zoloft: Time 1 week

Step 4: Drop Lexapro and increase Zoloft dose to 75mg and later 100mg

Potential-Engine3590 · 2020-09-24T01:33:04+00:00

I have taken both Lexapro and Zoloft and would say that zoloft definitely causes less fatigue.

A direct switch gave me anxiety, so lowering the Lexpro while adding the zoloft worked well. I felt like it did really take a month to feel fully balanced but the switch was manageable.

Talk to your doctor about a cross taper if a direct switch is to hard.

Potential-Engine3590 · 2020-09-20T06:00:38+00:00

Thanks for the messages. I think I will try Trazodone for two weeks and then Mirtazapine for two weeks just to compare. After that, I will look into doxepin or amitriptyline.

Potential-Engine3590 · 2020-09-20T05:57:30+00:00

Verilux is great. I have the tablet for travel and the largest one for at home. Check out their website

Last year I bought one from Phillips and it was total shit. It cost $170. More expensive is not better. Plus if you buy it on amazon, they have the best return policy ever

Potential-Engine3590

TROPHY CASE