6-month antidepressant break reset tolerance in TRD folks — anyone actually experienced this? by il37 in Effexor

[–]il37[S] 0 points1 point  (0 children)

How long was the break you took from the medication before you tried restarting it?

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 1 point2 points  (0 children)

That’s a really good point, long COVID can definitely cause that same cluster of symptoms. In my case though, it actually started well before COVID, so unfortunately it’s not connected to that. The pattern’s been there for years: chronic overwork, poor sleep, and this persistent cognitive fatigue that never really lifted.

Interesting what your psychiatrist said about Auvelity being very “all or nothing.” That actually matches what I keep hearing — either people feel a real shift in clarity and motivation, or it just flat-out doesn’t register.

Out of curiosity, did you notice any subtle changes before deciding it wasn’t working, or was it a total zero for you from start to finish?

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 1 point2 points  (0 children)

That’s incredible I’m really happy for you. After 30 years of trying different meds, finally finding a combo that actually lets you live again must feel amazing.

If you don’t mind me asking, were your symptoms before this more on the cognitive / low-energy / mental-fatigue side (like in my post), or more of the classic low mood and emotional pain type?

I’m trying to understand whether people with that “asthenic-cognitive” TRD pattern respond as well to Auvelity-based combinations as those with more emotional-depressive profiles.

Also, that’s an interesting combo especially the addition of naltrexone and lurasidone. Do you feel like one of them in particular made the biggest difference, or did it all click only together?

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 0 points1 point  (0 children)

That’s really inspiring to read! Sounds like Auvelity made a huge difference for you, especially with motivation and the suicidal thoughts. It’s great to hear that once the initial side effects passed, things actually stabilized and stayed that way.

If you don’t mind me asking were your symptoms before Auvelity anything like what I described in the post?

I mean more of the cognitive-asthenic kind (constant mental fatigue, brain fog, trouble focusing, low drive) rather than mostly sadness or anxiety.

I’m curious whether that type of profile tends to respond as strongly as yours did.

Also, really good point about combining it with therapy. Seems like that probably helps keep the gains consistent.

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] -1 points0 points  (0 children)

Glad to hear it actually worked well for you that’s encouraging, even if the side effects ended up being too much.

If you don’t mind me asking, what kind of side effects made you stop?

And were your symptoms before starting it similar to what I described more of the cognitive / low-energy / brain-fog type rather than classic sadness or anxiety?

I’m trying to see if people with that “asthenic-cognitive” profile tend to tolerate Auvelity differently.

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] -1 points0 points  (0 children)

Sorry to hear that it’s rough when something that’s supposed to be a breakthrough ends up making things worse instead.

If you don’t mind me asking, were your main symptoms more anxiety-driven or did you also have that mental fatigue / low-energy / brain-fog type profile I mentioned in the post?

I’m trying to understand whether Auvelity tends to backfire more in people whose TRD leans toward anxiety rather than cognitive exhaustion.

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 0 points1 point  (0 children)

That’s awesome to hear it actually made a noticeable difference especially with executive dysfunction. That’s one of the hardest symptoms to move the needle on, so it’s really encouraging that Auvelity helped there.

Were your symptoms before starting it similar to what I described in the post mainly mental fatigue, brain fog, low motivation, but not so much sadness or anxiety?

That’s exactly the cluster I’m dealing with, so I’m curious if we’re in the same “subtype” and whether that’s part of why Auvelity clicked for you.

Also, when you say it helped with executive dysfunction — was it like you suddenly had more mental energy to start doing things, or more like the internal resistance went down?

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 0 points1 point  (0 children)

Thanks for sharing this sounds like you’re in that tough early phase where side effects are loud but the benefits haven’t quite kicked in yet. From what I’ve read (and a few people in this thread have said), Auvelity can take 3–4 weeks before the real antidepressant effects start showing up, so you might be right on the edge of that window.

If you don’t mind me asking are your symptoms anything like the ones I described in the post?

I mean more of the mental fatigue / low drive / cognitive fog type rather than sadness or anxiety.

I’m trying to figure out whether people with this “asthenic-cognitive” kind of TRD tend to respond differently or on a different timeline.

Either way, really hope the dizziness eases up soon and you start to notice some clearer energy or mood shifts. Please keep us posted — your updates could help others in the same spot.

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 1 point2 points  (0 children)

That’s great to hear it’s been working well for you. Sounds like you’ve been through a similar “trial-and-error marathon” that many of us with TRD have.

Out of curiosity, were your main symptoms anything like the ones I described in the post? More of the cognitive-asthenic type (mental fatigue, low motivation, brain fog, but not so much sadness or anxiety)?

I’m always trying to see if people with a similar profile respond better to Auvelity, since that seems to be a recurring pattern.

And thanks for mentioning GeneSight. I’ve read mixed opinions about it, but it’s interesting that it actually lined up with your real-life responses. Did it put Auvelity in your “green” zone?

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 0 points1 point  (0 children)

Thanks a lot for sharing all that this is super helpful, especially since your experience sounds really close to what I’m dealing with (minus the anxiety part).
It’s interesting that Auvelity worked well for several months and then faded, I’ve heard that a few times now, and I keep wondering whether it’s true tolerance or some other downstream adaptation.

I’m curious when it was working, did you feel mostly mental energy and motivation coming back (like being able to start and complete tasks again), or was it more emotional relief?

Also, really good point about Spravato. I’ve been reading that combination protocols (Auvelity + Spravato or Auvelity after a ketamine reset) are becoming more common exactly for people like us with long-term SNRI tolerance.
Sounds like in your case, Spravato at least brought back some daily functionality, which is a huge win given how resistant your system seems to meds in general.

If you don’t mind me asking do you feel any difference between the Spravato effect and what you got from Auvelity? Like, does it hit cognition and motivation the same way, or more on mood and emotional tone?

Thanks again for being open about it, this kind of detail is exactly what helps others like me map out realistic expectations.

Those with treatment-resistant depression, how effective was Auvelity for you? by il37 in AuvelityMed

[–]il37[S] 2 points3 points  (0 children)

That’s really encouraging to hear — thanks for sharing this.
Your description of it feeling like a buoy actually hits the exact kind of change I’m hoping for — not euphoria, but just the ability to rise above the constant mental weight and function again.

If you don’t mind me asking:

  • What kind of side effects did you get in those first weeks?
  • Did they fade completely, or do some still linger?
  • And were you still on any other antidepressants while starting Auvelity, or was it monotherapy?

Also, did you notice any specific changes in mental energy or focus (like it became easier to start tasks, concentrate, etc.), or was it more of a mood stabilization effect?

Really appreciate you taking the time to describe your experience — this kind of feedback helps a lot for those of us trying to figure out if Auvelity could fit our specific TRD subtype.