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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Antidepressants

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
hi tania

Is there a specific test to detect low blood volume or would a basic CMP show this?

Rand

I dont know what a CMP test is. As far as Im aware, blood volume isnt generally tested and something which is more so tested in research labs (so there must be a way to actually test this).

Anyone who has ME should suspect they "may" have this issue but one thou can come to an fair idea if low blood volume may be partly involved in causing symptoms by various indications of it.
Some of these indications would be:
- thirst to which another cause cant be found or that someone drinks far more then usual to feel better some
- orthostatic intollerance eg headaches and dizziness when standing (not enough blood getting to brain), finding that one improves some on laying (blood gets to head better then).
- Finding standing is worst then walking. (less blood gets to the head when standing then when moving).
- POTS (in ME is usually caused by low blood volume). Other orthostastic autonomic issues may indicate too.
- finding that treatments which raise blood volume help
- those who have issues with low blood volume are usually affected by heat more then those who dont have this issue. So feeling worst on hot days is another indication.
 

Rand56

Senior Member
Messages
675
Location
Myrtle Beach, SC
hi tania

CMP is a blood test..stands for Comprehensive Metabolic Panel. From the list of symptoms you gave for low blood volume, I don't believe that would be the case with me.
 

Rand56

Senior Member
Messages
675
Location
Myrtle Beach, SC
Has anyone ever tried Reboxetine <Endronax/Vestra>? Better yet, has anyone tried both Reboxetine and Strattera <atomoxetine> and favored one over the other? Someone once recommended me take Reboxetine for my depression. I have not done so yet. I'm just looking for alternatives ahead of time just in case Wellbutrin doesn't do the trick for me.
 

IreneF

Senior Member
Messages
1,552
Location
San Francisco
Hmm, interesting. Have you considered gradually discontinuing the SSRI while keeping Wellbutrin?

If you don't mind sharing, what was the Wellbutrin dosage and for how long did you take it?

I'm not taking an SSRI. I'm taking an SNRI. And no, I'm not going to discontinue it for any reason. It's the only thing that works.

I don't remember the dosage or the length of time I took bupropion/Wellbutrin, although for a time I was taking the generic XL formulation mfd. by Teva that the FDA recently announced was no good.

Right now all I want is to recover from CFS. Everything else is secondary.
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
Right now all I want is to recover from CFS. Everything else is secondary.

Oh, of course! I am of the opinion, though, that a pure NRI (such as Strattera) or DNRI (such as Wellbutrin) is better for ME/CFS than an SSRI or even an SNRI such as Cymbalta (this one exhibits a reuptake inhibition of serotonin 10 times that of norepinephrine, for example).
 
Messages
15,786
I am never touching an antidepressant again. Any one else with any experience or understanding of why they would cause such fatigue??

I can't tolerate SSRI's either, or even supplements that should increase serotonin production - and this is somewhat odd because my blood platelet serotonin levels were quite low.

My norepinephrine also tested low, however, and I've had very good results for my OI with the NRI Strattera over the past 11 days since I started taking it. It was a little intense the first few days in a buzzed sort of way, but not beating the crap out of me like the SSRI did. And after that it settled down very nicely, and I'm far more functional than I was two weeks ago. I can take showers now, and load the dishwasher, and walk up and down stairs without needing to lay down for half an hour :D
 

Rand56

Senior Member
Messages
675
Location
Myrtle Beach, SC
I can't tolerate SSRI's either, or even supplements that should increase serotonin production - and this is somewhat odd because my blood platelet serotonin levels were quite low.

My norepinephrine also tested low, however, and I've had very good results for my OI with the NRI Strattera over the past 11 days since I started taking it. It was a little intense the first few days in a buzzed sort of way, but not beating the crap out of me like the SSRI did. And after that it settled down very nicely, and I'm far more functional than I was two weeks ago. I can take showers now, and load the dishwasher, and walk up and down stairs without needing to lay down for half an hour :D

hi Valentijn

Glad to know the Strattera is helping you. If I may ask, do you suffer any insomnia from it? I'm on Wellbutrin which I started about a little over 2 weeks ago and my sleep sucks real bad. About the last 5 nights I've only averaged about 3 hours of sleep at night. Hoping as time goes by it will alleviate that problem but who knows. That's why I'm asking you because I need to find out more about some alternatives if for some reason I need to ditch this Wellbutrin at some point.

Rand
 

nanonug

Senior Member
Messages
1,709
Location
Virginia, USA
I'm on Wellbutrin which I started about a little over 2 weeks ago and my sleep sucks real bad.

I am also on Wellbutrin XL. Sleep doesn't suck for me. However, I also take 10mg of lithium orotate with dinner. I have been taking lithium orotate at this dosage for years now for anxiety and works very well for me: anxiety is gone and sleep is great.
 
Messages
15,786
Glad to know the Strattera is helping you. If I may ask, do you suffer any insomnia from it? I'm on Wellbutrin which I started about a little over 2 weeks ago and my sleep sucks real bad. About the last 5 nights I've only averaged about 3 hours of sleep at night. Hoping as time goes by it will alleviate that problem but who knows. That's why I'm asking you because I need to find out more about some alternatives if for some reason I need to ditch this Wellbutrin at some point.
Rand

I had trouble a few nights ago when I first started taking a 2nd dose in the afternoon. I took it an hour earlier yesterday (1:45pm), and had no problem falling asleep at 10pm. I also take N-acetylcysteine before going to bed, since I have high glutamate levels and the NAC seems to help bring them down so my brain can shut down.

I'm keeping a daily log with effects/side-effects/etc I'm experiencing while starting Strattera, most of which I'm posting on the thread at http://forums.phoenixrising.me/index.php?threads/strattera-atomoxetine.19755/
 

Rand56

Senior Member
Messages
675
Location
Myrtle Beach, SC
nanonug

I still have some Lithium Orotate laying around so I'll start out low with it and and go from there.

Valentijn

Thanks for the link on the thread. I'll keep an eye on it.
 

beaverfury

beaverfury
Messages
503
Location
West Australia
Has anyone ever tried Reboxetine <Endronax/Vestra>? Better yet, has anyone tried both Reboxetine and Strattera <atomoxetine> and favored one over the other? Someone once recommended me take Reboxetine for my depression. I have not done so yet. I'm just looking for alternatives ahead of time just in case Wellbutrin doesn't do the trick for me.

Hi Rand, I took Edronax for four weeks long before i got cfs. I hardly got any sleep the whole time.
It was a nightmare! They just made me keyed up, with no good effects to offset the lack of sleep factor.

Everyones different though. I had a friend taking them, they worked fine for her and she could sleep.

I keep pumping David pearces Good Drug Guide on PR. People will get sick of me. But i just love it!
I cant paste the link for some reason. Just google Biopsychiatry The Good Drug Guide.
Still gives me a laugh and rightfully puts some shite ADepressants in their place.
 

Rand56

Senior Member
Messages
675
Location
Myrtle Beach, SC
Hi Rand, I took Edronax for four weeks long before i got cfs. I hardly got any sleep the whole time.
It was a nightmare! They just made me keyed up, with no good effects to offset the lack of sleep factor.

Everyones different though. I had a friend taking them, they worked fine for her and she could sleep.

I keep pumping David pearces Good Drug Guide on PR. People will get sick of me. But i just love it!
I cant paste the link for some reason. Just google Biopsychiatry The Good Drug Guide.
Still gives me a laugh and rightfully puts some shite ADepressants in their place.


hi beaverfury

Sorry you had insomnia taking it. Yeah you're right, we can all have different reactions to the same stuff. Thanks for the source on the drug guide. Will definitely be a good reference for me to check out.

Rand
 

PhoenixDown

Senior Member
Messages
455
Location
UK
If the drug itself doesnt start building in the system enough for the positive affects for 4-6 weeks, what is happening that would make me so tired right from dose one?
Because the "it takes weeks to work" line is BS. I've taken about 4 different anti-depressants and all of them had an effect within 24 hours, none of them "built up".

I think it's a line they just tell so that if your depression naturally resolves for one reason or the other, they can claim the outcome was due to the treatment. They know statistically some people's depression will just resolve anyway, treatment or not.

In any case there is no objective follow up test carried out to demonstrate this long term "build up", just like they don't measure your serotonin.
 

PhoenixDown

Senior Member
Messages
455
Location
UK
My main hypothesis of CFS is excessive norepinephrine signaling, which can be reduced with clonidine and wellbutrin. It is a hyper - sympathetic nervous system state. Alternatively it could be gut bacteria exuding toxins which block efficient norepinephrine signaling.
Is this a too much adrenaline/cortisol, "adrenal fatigue", or adrenaline-stress-feedbackloop type of hypothesis? A lot of them have been put forward over the years, none of them have helped explain much. Wouldn't too low/too high adrenaline or cortisol show up on a test? Granted doctors rarely do proper (periodic through out the day testing).
I don't know of many people that do well on SSRIs as monotherapy. Serotonin is a chemical of hibernation. It elevates to put us to sleep. Sure some is needed for everything but I am not entirely convinced that people with chronic fatigue need more serotonin.
Serotonin metabolises to melatonin...
 

Rand56

Senior Member
Messages
675
Location
Myrtle Beach, SC
Because the "it takes weeks to work" line is BS. I've taken about 4 different anti-depressants and all of them had an effect within 24 hours, none of them "built up".

I think it's a line they just tell so that if your depression naturally resolves for one reason or the other, they can claim the outcome was due to the treatment. They know statistically some people's depression will just resolve anyway, treatment or not.

In any case there is no objective follow up test carried out to demonstrate this long term "build up", just like they don't measure your serotonin.

hi Phoenix

With all due respect, I don't buy your line of "it takes weeks to work" is BS. When you say you had an effect within 24 hours are you referring to your depression was totally relieved within 24 hours? When you took these AD's, were you really diagnosed as having clinical depression? If your depression lifted within 24 hours, that's awesome, but if that is the case, you are definitely not the norm. If that was the norm, wouldn't you think a prescribing doc would say "listen, we are going to trial this for no more than 2 days. If it doesn't work, we will try something else". Yes, from the get go you can feel something from the AD, but "lifting" depression in 24 hours, I don't think so, not the majority of people anyway.

Rand
 

PhoenixDown

Senior Member
Messages
455
Location
UK
hi Phoenix

With all due respect, I don't buy your line of "it takes weeks to work" is BS.
No Worries
When you say you had an effect within 24 hours are you referring to your depression was totally relieved within 24 hours? When you took these AD's, were you really diagnosed as having clinical depression?
I had an effect, the symptoms of what ever illness I have were never long term treated by the medication. I was diagnosed by my primary care practitioner, then again at a different date by both a mental health nurse & a psychiatric doctor as having "Depression".

Of course I don't believe depression is anything other than a dust-bin / wastebasket term with irresponsibly wide and unobjective diagnostic criteria (the practitioner has no idea what's actually wrong with the unfortunate patient) . The interesting thing is that my "Depression" wouldn't resolve when I was happy or had better "psychosocial" factors. However they ignored me saying that and diagnosed it anyway. The term is basically being abused just like the terms CFS/ME & Fibromyalgia are given out when the doctors can't be bothered to investigate, or believe on faith that the patient's implied existential unhappiness is causing symptoms. I think this will change with in a 100 years time.

For those who advocate for "there are such n such objective tests for depression", I suggest they advocate for using a term other than depression, when that particular test is positive. I think a lot of harm has come to patients by the label.