Antidepressants (most effective?)

[David Ducati]

I had MS symptoms 32 years ago - but it has come back - specifically scary vision problems (world seems distant, I'm in a daze, as if detached from reality, like I'm drunk).... It is not derealization, but is strictly connected to sleep deprivation and fatigue... My brain does not have the physical strength it seems to process the word around me. I get very scared. I use valium to calm me down - but only occasionally (and no, the valium does not create these symptoms. My doctors do not listen, do not understand, not interested ... I think I need an antidepressant to keep my mood up and preventing the psyeudo-suicidal thoughts I had 32 years ago. Back then I was 20 - now I'm a 54 year old teacher - but I can't handle this reoccurance. Can anyone help me?

 

[Andryr]

I am sorry you have these symptoms David.
From what I know, antidepressants are sort of a hit or miss. What works for me may not work for you (and neither has worked for me). In my country only psychiatrists can prescribe antidepressants. What you describe looks more like anxiety for me. I wish you finding a good doctor.

 

[Hufsamor]

I’m a 52 years old woman.
I’ve recently started with testosterone replacement.
Fo me, it have helped a bit with most of the symptoms you’ve mentioned.
Being your age, it might be worth to look into?
Your doc might be willing to let you test your level?

 

[David Ducati]

I am sorry you have these symptoms David.
From what I know, antidepressants are sort of a hit or miss. What works for me may not work for you (and neither has worked for me). In my country only psychiatrists can prescribe antidepressants. What you describe looks more like anxiety for me. I wish you finding a good doctor.

Thank you for replying... Just the fact that someone is listening means a lot. Yes, anxiety plays a big part and surely adds to the vicious circle - which I want to break before it breaks me... I will persevere with a doctor who is on my side. Best wishes to you.... David

 

[David Ducati]

I’m a 52 years old woman.
I’ve recently started with testosterone replacement.
Fo me, it have helped a bit with most of the symptoms you’ve mentioned.
Being your age, it might be worth to look into?
Your doc might be willing to let you test your level?

Hello... And thank you for writing... This is an interesting insight... I had never thought of this. I am a 54 old male... I've had lots of blood exams, but never had testosterone tested. Could be worth a shot. Best wishes to you..... David

 

[Ingold12]

Sorry to hear about these symptoms, when I started getting ME/CFS symptoms I had quite severe anxiety (because of not knowing the cause of the symptoms plus cause of the physical and mental distress they caused me) and terrible sleep disturbances such as early waking insomnia, hypnic jerks and restless legs.

My doctor prescribed a very low dose of Amiltriptyline (used as a sleep regulator) which seemed to relieve some symptoms, maybe it's worth asking your doctor about sleep regulators such as this one or melatonin?

 

[Alvin2]

They are all highly addictive so my advice is to avoid them.
If you are having a psychotic break then thats a different story but the treatment for that is antipsychotics, not antidepressants.
If you have MS or some other treatable condition then you need the right tests to figure out what you have and get the correct medication.

All that said the currently popular antidepressant is Trintellix.

 

[lenora]

Hi David.....Two things strike me when I read your symptoms. The first was an electrolyte imbalance. If your vision is affected and extreme weakness in any limbs, then I would look into this. Blood work should give answers. Too many liquids will cause this problem...just the opposite of what we think. A good diet is an absolute must.

I've been on lexapro for years now and have had no problems. I also take small doses of lyrica and again, I'm able to withstand both.

Insofar as really bad anxiety (panic disorder), I've had anxiety for probably my entire life. I controlled it myself in the beginning, then went to Recovery, Inc. (a strange group, but it helped), bought the AA Blue Book which helped me in the very beginning, was put on buspar over the years & finally developed shingles and was bedridden for over a year. The nervous system had a strange reaction and I was hospitalized b/c of the anxiety which by then was straight panic disorder.

I've now been on low doses of xanax twice/day for the past 10 years....and it helps immensely. I had a hard time finding a doctor who would prescribe xanax. My neurologist retired and then died in November....very sad. Anyway, my internist is going to prescribe a lot of my drugs and I'll see a new neurologist that I've already met, in January. I have a few neurological illnesses in addition to ME.

Amitriptyline is a really old anti-depressant often used for depression and the pain of fibromyalgia (FM), which I also have. Lexapro has replaced A in my case.

It's true, that not all drugs work for all people. Breathing properly helps and is something you need to practice. Still, I have severe problems and all of my doctors agree on that, thus it's easier to be treated (but not easy, if you understand me). I expect to be on xanax for the remainder of my life...but I'm 75, prior to that I tried less addictive drugs but they finally stopped when I developed shingles. Buspar was used for probably 20 years. No herbs, vitamins or supplements worked in my case....and I really tried.

You'll do a lot of visiting doctors, taking tests, etc., but do it because you need help to overcome this problem. Try to let the doctor decide what to try you on....at one time there were so, so few and now there are a great many. Good luck. Yours, Lenora

 

[David Ducati]

Hi Lenora...

Thank you for writing and explaining so much. I'm so sorry you have had to go through so much... In a way I feel guilty for only having a part of the symptoms you have had... Although maybe mine are to come...

I have tried amitriptyline briefly, mostly since the neurologist says it's good for tension headaches.... But even two drops a night (which is tiny) is enough to clash with the mogadon I take to sleep. The result is worse... I know we should give each drug a chance to work, but for this reason I feel I need something such as prozac, or as you suggest lexapro to protect from general depression.

The blood exams you suggest are interesting... I've had three sets in the last year. I'm sure they covered those bases. Problem is, I'm British, and although having lived in Italy for 14 years, the language barrier adds to my confusion..... Even explaining symptoms in your own mother tongue (and likewise being understood) can be a challenge as I'm sure you can testify too.

I try to keep a healthy diet and realise it's essential. If I'm honest though, it's keeping a positive attitude which is hardest. When I began feeling ill some weeks after covid (3 x vaccine) I had this plan to be well within a certain time frame.... It's my character to expect my body to be better "by this time tomorrow" for example. It's dumb I know, and maybe something I need to eliminate from my thinking processes.

Anyway, wishing you all the best... Thank you again. David

 

[Hip]

This is how I treat my depression:

Effects kick in within a couple of hours:

• Amitriptyline 10 mg — TCA antidepressant, a reuptake inhibitor of serotonin and norepinephrine
• Manganese 3 mg — needed for dopamine synthesis. I find this one increases enthusiasm for doing things
• Spanish saffron 100 mg twice daily — increases dopamine (shown to be as effective as antidepressant drugs).
• Moclobemide 75 mg — MAO-A inhibitor, increases dopamine

Effects kick in within 12 hours:

• High-dose inositol 12 to 18 grams day — increases serotonin

Effects kick in after a few days:

• High-dose cod liver oil (at least 300 mg of EPA per day)
• Folinic acid 200 mcg

Moclobemide is a good antidepressant, as it has low side effects (SSRI or TCA antidepressants can cause sexual dysfunction and emotional flattening after long term use). You should not take moclobemide and amitriptyline together though.

Spanish saffron works well for me (make sure you don't buy fake saffron though - YouTube has good videos showing how to detect fake saffron).

 

[Alvin2]

• Amitriptyline 10 mg — TCA antidepressant, a reuptake inhibitor of serotonin and norepinephrine
• Manganese 3 mg — needed for dopamine synthesis. I find this one increases enthusiasm for doing things
• Spanish saffron 100 mg twice daily — increases dopamine (shown to be as effective as antidepressant drugs).
• Moclobemide 75 mg — MAO-A inhibitor, increases dopamine

I am curious, have you tried BH4 or Tyrosine?

 

[lenora]

Just check (Google's fine) and make certain that you aren't eating the foods you shouldn't with MAO's. Perhaps they're safer today.....this lasts for up to 14 days after stopping the drug.

@Hip is Spanish saffron expensive? I know that saffron come from the stamens of the crocus bulb and used to be prohibitively expensive. Perhaps use in a drug is less. Just wondering. Lenora

 

[Hip]

I am curious, have you tried BH4 or Tyrosine?

I tried the Ecological Formulas Pteridin-4 product, which contains 2.5 mg of BH4 per capsule, but even this low dose of BH4 seemed to trigger the unpleasant very mild psychosis symptoms I get from time to time, so I had to discontinue.

I tried L-tyrosine briefly, but did not notice much.

 

[Alvin2]

but even this low dose of BH4 seemed to trigger the unpleasant very mild psychosis symptoms I get from time to time, so I had to discontinue.

Egads

I tried the Ecological Formulas Pteridin-4 product, which contains 2.5 mg of BH4 per capsule

I found this online as well but it would cost almost $300 CAD to get a bottle, which is more than my entire yearly discretionary supplement budget.

I tried L-tyrosine briefly, but did not notice much.

I'm trying it now, its doing something but not a hell of a lot (started 3 days ago).

 

[minimus]

@David Ducati - Sorry to hear you are going through a relapse. If you or others suspect you have MS, you probably should see a neurologist and have them order an MRI to rule in/out MS.

It is possible that your chronic insomnia is causing cumulative sleep deprivation that is exacerbating your cognitive symptoms, fatigue, and depression. As alluded to by Hip in his earlier post, tricyclic antidepressants such as amitriptyline and doxepin might be worth considering, especially because they are sedating, though potentially quite sedating at the high doses indicated for depression. They might help with insomnia, although at the risk of causing excessive daytime drowsiness.

An alternative to tricyclics is the atypical antidepressant mirtazapine. It is also sedating, but the recommended dose for depression is not as sedating as the tricyclics are at their recommended doses.

There are also plenty of SSRIs and SNRIs, the "go-to" medications most doctors use as first-line therapy for depression, but these medications for the most part will not help with insomnia. Actually, some of them -- especially the SNRIs -- tend to be "energizing" and might potentially worsen your insomnia.

Obviously, this is not medical advice. You should try to find a doctor who takes your symptoms seriously and is willing to treat you. Good luck.

 

[xploit316]

Manganese 3 mg — needed for dopamine synthesis. I find this one increases enthusiasm for doing things

@Hip Im really interested in Manganese since I'm getting some good cognitive benefits from eating Manganese rich foods like Pineapple, Macadamia nuts, cloves lately. I always seem to easily gravitate to manganese rich foods and It seems to mask the effect of certain foods that cause cognitive issues for me like choline, dairy etc. Small amount of Fructose in form of raisins, agave syrup does the same as Manganese but not sure what the mechanism is.