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Can't tolerate SSRI's - other suggestions for depression?

August59

Daughters High School Graduation
Messages
1,617
Location
Upstate SC, USA
It's having ME that got me depressed. Cure me, and my depression will go!
My depression is always reactive - put me in an untenable position, with no way out and I will get depression.
I'm going to have to investigate trazodone...

I do already take high dose fish oils - pharmaceutical grade - but I avoid DHA like the plague. EPA is the right one.
I did, for a couple of months take one with DHA, because I couldn't get hold of my EPA one - and I went right downhill brain-wise. Just a fortnight back on my EPA and I was back to "normal".
Quite enough proof for me that DHA is bad!

Trazodone is very good for helping you get into the deep sleep cycles. It is best to take it a least 2 hours before bedtime because of the half-life. Taking it this way sort of syncs up the peak potency time of the trazadone with general times you should be cycling through your deep sleep cycles plus it will give the body a chance to clear most of the trazodone before you wakeup which helps avoid the hangover effect.
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,098
Location
australia (brisbane)
i am sensitive to ssri's but have no problems with trazadone and also use tramadol for other reasons and have had no issues, tramadol use with antidepressants usually comes with a warning of serotonin syndrome, no problems here. Traz helps improve my sleep quality but need a benzo to initiate sleep. I do use traz intermittently in a rotation of things i use for sleep.
 

jeffrez

Senior Member
Messages
1,112
Location
NY
I have the same experience as you, August59 & heapsreal. Traz doesn't seem to help initiate sleep, and it takes a couple hours to really kick in. It's kind of strange b/c I get *really* drowsy about 20-30 mins after taking it, but still no sleep unless I take something else or wait it out.

Another really weird thing is I get almost completely stuffed up from it, even though it supposedly blocks H1. I usually take some benadryl, and that helps solve both problems at once. By morning, all effects seem to be cleared. I'm on 75mg, btw.

Anyway, to the OP, use whatever works, by all means. Not trying to push traz, but it does seem to be a reasonable alternative to the SSRIs for some people. And the antidepressant effect seems better than the SSRIs, which to me anyway (when they work) give a feeling of throwing a wet blanket over everything. Just kind of numbs you to things. But there are lots of options out there to try, I'm sure your huz/hub will hit on the right one eventually. It sometimes just takes some trial and error.
 

peggy-sue

Senior Member
Messages
2,623
Location
Scotland
My SSRI is working - but I do feel that it makes me more callous. I can understand how they can cause suicide - because of not actually being too bothered by the notion. I feel it blunts good stuff as well as bad.
 

SOC

Senior Member
Messages
7,849
My SSRI is working - but I do feel that it makes me more callous. I can understand how they can cause suicide - because of not actually being too bothered by the notion. I feel it blunts good stuff as well as bad.

Sounds like you're over-medicated. Have you considered backing down the dose a bit?
 

peggy-sue

Senior Member
Messages
2,623
Location
Scotland
I'm only on 10 mg - half the normal "low" dose. I do need it, because I'm quite aware that I'm only just away from the depression.
 

SOC

Senior Member
Messages
7,849
I have the same experience as you, August59 & heapsreal. Traz doesn't seem to help initiate sleep, and it takes a couple hours to really kick in. It's kind of strange b/c I get *really* drowsy about 20-30 mins after taking it, but still no sleep unless I take something else or wait it out.

Another really weird thing is I get almost completely stuffed up from it, even though it supposedly blocks H1. I usually take some benadryl, and that helps solve both problems at once. By morning, all effects seem to be cleared. I'm on 75mg, btw.

I take Tylenol PM (acetaminophen and fast-acting Benadryl) to initiate sleep and Trazodone to maintain sleep. This was recommended to me by an ME/CFS specialist doc 4-5 years ago and has worked like a charm for me ever since.

Maybe I never noticed getting stuffed up with Traz because I've always taken it with Benadryl.
 

jeffrez

Senior Member
Messages
1,112
Location
NY
I take Tylenol PM (acetaminophen and fast-acting Benadryl) to initiate sleep and Trazodone to maintain sleep. This was recommended to me by an ME/CFS specialist doc 4-5 years ago and has worked like a charm for me ever since.

Maybe I never noticed getting stuffed up with Traz because I've always taken it with Benadryl.

Excellent! Thanks for the validation that it's a good strategy. How much traz do you take, if you don't mind me asking? Have you ever noticed loss of effectiveness causing you to have to increase the dosage?
 

SOC

Senior Member
Messages
7,849
I'm only on 10 mg - half the normal "low" dose. I do need it, because I'm quite aware that I'm only just away from the depression.

Another thought -- SSRIs alter brain chemistry, as I'm sure you know. What if there's nothing wrong with your brain chemistry? Then any amount of messing with it could be too much. Since your depression is unquestionably situational, then maybe some form of talk therapy for dealing with chronic illness would be better for you than altering your brain chemistry...?

Or maybe a different med? Have you tried an SNRI? The right AD for you should not be blunting your emotions. I think a consult with your prescriber is in order.
 

SOC

Senior Member
Messages
7,849
Excellent! Thanks for the validation that it's a good strategy. How much traz do you take, if you don't mind me asking? Have you ever noticed loss of effectiveness causing you to have to increase the dosage?

I've taken 100mg all along. I've never noticed a loss of effectiveness or had to increase the dose. I did have a horrible experience when I got a different brand than I'm used to -- it didn't work for me, I didn't sleep for days at a time, and had a crazy bad mood crash. Very ugly. Other than that, it's been great. :D
 

urbantravels

disjecta membra
Messages
1,333
Location
Los Angeles, CA
My current sleep drug strategy is much the same - I take trazodone, but also need a benzo (Clonazepam) to help get to sleep. I've been on the same dosage of each for a few years now, no tolerance or need for increased dosages of either.

My brief experiment with Ambien didn't do me much good. It did make me fall asleep, but I had pretty "jumpy" disturbed sleep until about 2-3 AM when I would wake up in an irreversible state of awakeness. That short half-life is apparently really short in some people (it's supposed to let you wake up after about 7-8 hours of sleep, not three!) Never tried the extended release version as my HMO wouldn't cover it, and I wasn't so crazy about the sleep I was getting so it didn't seem that more hours of it would be that great. Trazodone sleep is way better in my experience.
 

xks201

Senior Member
Messages
740
I took trazadone and priapism was the last thing on my mind. It knocked me the hell out even at a small dose. You'd have better luck getting priapism from apple pie.
 

peggy-sue

Senior Member
Messages
2,623
Location
Scotland
I'm on citalopram. I'm also of the opinion counselling would not help. I think I'd be about 6 steps ahead of any counsellor in anything they might say, or any way they might try to get me to see things. I'm pretty damn good at "counselling" myself.:rolleyes:
At the end of the day, I'm still a prisoner of this damned disease and I'm furious about it and the psychobabblers robbing me of my life.
I'd only just found it.:cry:
 

jimells

Senior Member
Messages
2,009
Location
northern Maine
I started Trazodone this week, about 12 mg two hours before sleep. Like the SSRIs, SNRIs, TCAs, and many other drugs, more than I can shake a stick at, this drug looks to be another one that I can't tolerate. I had hoped it would decrease REM sleep (I feel like I'm dreaming all night) and improve sleep quality. So far it seems to be making the nightmares worse (lots of violence) and this morning I woke with vertigo, even while lying down. Being too dizzy to get out of bed is a new and alarming symptom. Is this common for trazodone?
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,098
Location
australia (brisbane)
I started Trazodone this week, about 12 mg two hours before sleep. Like the SSRIs, SNRIs, TCAs, and many other drugs, more than I can shake a stick at, this drug looks to be another one that I can't tolerate. I had hoped it would decrease REM sleep (I feel like I'm dreaming all night) and improve sleep quality. So far it seems to be making the nightmares worse (lots of violence) and this morning I woke with vertigo, even while lying down. Being too dizzy to get out of bed is a new and alarming symptom. Is this common for trazodone?

look into baclofen to help improve sleep quality.

cheers!!!
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
I started Trazodone this week, about 12 mg two hours before sleep. Like the SSRIs, SNRIs, TCAs, and many other drugs, more than I can shake a stick at, this drug looks to be another one that I can't tolerate

Have you tried Diphenhydramine (Benadryl) or Doxylamine (Unisom)?