• Welcome to Phoenix Rising!

    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, long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

Anyone found an antidepressant that helped with fatigue?

Husband of

Senior Member
Messages
318
My wife has had significantly, like at least threefold, her energy since starting mirtazapine four months ago. It is likely that this is due to significantly better sleep.

@CSMLSM do your treatments help with anxiety? My wife has bad anxiety and panic attacks every day, especially in the evenings.

Similar effect was from 30 mg Mirtazapine, 10 mg Baclofen per day
Hi, wondering why you were prescribed baclofen and whether it helped with anxiety. I Understand that's not what it's usually prescribed for. My wife's doctor has suggested I look into what other drugs we could combine with mirtazapine to treat the anxiety.
 
Messages
72
Hi, wondering why you were prescribed baclofen and whether it helped with anxiety. I Understand that's not what it's usually prescribed for. My wife's doctor has suggested I look into what other drugs we could combine with mirtazapine to treat the anxiety.

At first, I was prescribed with Phenibut by my neurologist. It was extremely helpful but only for two weeks or so.

After that, I started to study the mechanism of Phenibut's action, this is how I learned about Baclofen that acts very similarly - activates GABA-B receptors which calm down your central nervous system by counterbalancing excitatory Glutamate level. It is also shown that Baclofen "increases dopanine" (I put that in quotes as it is not that straightforward and simple).

I consulted with my neurologist and he confirmed that it is a good idea to try Baclofen too.

So, overall the effect was extremely positive and long lasting. Basically, as long as I was on Baclofen (1-2 years with short breaks) I felt huge improvement in my condition. It performed best when I combined with Sertraline/Mirtazapine.

I had to stop for the only reason - urinary retention. Besides that, Sertraline/Mirtazapine plus Baclofen worked like a magic... I ate well, I slept well, I was 100% productive throughout the day. I noticed, sometimes I got overexcited which led to a strange feeling of internal "buzz" but it was a minor side effect considering the overall benefits.

For Sertraline, it was just 50mg in the morning and 10-15 mg of Baclofen 3 times a day - with every meal.
 

Violeta

Senior Member
Messages
2,945
This discussion reminds of someone with knowledge of Chinese medicine telling me that insomnia and depression are both a result of problems in the liver.

Mariovitali has been providing information about the liver's involvement in ME/CFS for years.

I am looking for how the liver is involved in catecholamines, if anyone has some leads.
 

CSMLSM

Senior Member
Messages
973
@CSMLSM do your treatments help with anxiety? My wife has bad anxiety and panic attacks every day, especially in the evenings.
Hi @Husband of, yes what I use for my treatment does work for anxiety, it directly targets the HPA axis which is responsible for the regulation of stress and thus anxiety.

In order for the treatment to work effectively you must have good levels of omega 3 and vitamin B12. These two things are very commonly low/deficient in many people who have ME/CFS and fibromyalgia.

Basically cannabidiol(CBD) and also caryophyllene act as enzyme inhibitors of an enzyme called fatty acid amide hydrolase(FAAH).

This enzyme is responsible for degrading and reducing the amount of a few things that will help your loved one.

One thing is oleamide which is related to sleep and in sleep deprived people it naturally increases to induce sleep, so more of this will help with better quality sleep.

Another is anandamide which is related to your question. Anandamide is responsible for many things and one of those things is regulating the HPA axis which is responsible for stress and anxiety. Anandamide also works like an antidepressant due to this regulation of stress and anxiety via the HPA axis.

CBD as well as being a FAAH inhibitor works to prevent tolerance to CB1 and CB2 receptors so any endogenous cannabinoids you have will go further. Anandamide is an endogenous cannabinoid and oleamide is classed in with this also.

Caryophyllene has a different action as it is a selective CB2 agonist. This just means it will only bind to the CB2 receptor which is mostly found in the immune cells of the immune system. Its activation helps direct the immune system away from an inflammatory adaptive immune state to a more naturally better state of innate immune system.

It will also cause B cells that are infected with epstein barr virus(EBV) to self destruct via a process called apoptosis. This means that enzymes are released within that cell that completely breakdown everything inside the cell even the EBV. B cells are part of the adaptive immune system.

Palmitoylethanolamide(PEA) is also increased when FAAH is inhibited and has many positive attributes too.
Here is a recovery thread that mentions using PEA just incase you would like to try that on its own.
https://forums.phoenixrising.me/threads/daughters-recovery-details.90429/

It is easily accessed and does not carry the stigma of coming from a cannabis plant like CBD.
I obviously benefit from it also as I use FAAH inhibitors but maybe it could work for your loved one on its own.

I have included the detail so you may easily find information online when you look this stuff up.

Good luck and did you try the epsom salt baths before or get a supplement that worked? Magnesium is involved in regulating stress also so would be best to target that too.
 
Messages
72
I also confirm that CBD does work for anxiety but only temporarily in my case. Also, it required way too much of CBD oil to get a noticeable effect for me - around $100 worth of 30% oil just for a couple of days. Anyway, in 3-5 days my body adapted to it and no longer responded positively, so I had to stop.
 

CSMLSM

Senior Member
Messages
973
I also confirm that CBD does work for anxiety but only temporarily in my case. Also, it required way too much of CBD oil to get a noticeable effect for me - around $100 worth of 30% oil just for a couple of days. Anyway, in 3-5 days my body adapted to it and no longer responded positively, so I had to stop.
That is unfortunate maybe you have low omega3 and/or vitamin B12.
 
Messages
72
I also confirm that CBD does work for anxiety but only temporarily in my case. Also, it required way too much of CBD oil to get a noticeable effect for me - around $100 worth of 30% oil just for a couple of days. Anyway, in 3-5 days my body adapted to it and no longer responded positively, so I had to stop.
So, after writing that I decided to give CBD oil one more chance)

The effect is definitely there - my whole body's calms down, or numbs would describe it better - I do not sense a lot of small pains, my appetite growths a bit and by stomach is not that sensitive to the usually forbidden stuff like dairy and pastry. However, there is a big but - by the evening the very bright symptoms of depression come - those you often get when you start a classical antidepressant... Plus, my lower back and leg witness does not go anywhere at all. And there was no change in my overall level of energy...

So, after another 3-day trial I decided to stop it completely.
 

pattismith

Senior Member
Messages
3,941
Antidepressants Tianeptine/Vortioxetine helped me a little for fatigue/sleepiness but the effect was limited.

I started low dose anti-inflammatory poly therapy and it seems much more powerful for me since I started three weeks ago.

My regimen is currently low doses Piroxicam + Colchicine + Spironolactone + Naltrexone and I am tapering antidepressant and stimulant drugs.
 

CSMLSM

Senior Member
Messages
973
My regimen is currently low doses Piroxicam + Colchicine + Spironolactone + Naltrexone and I am tapering antidepressant and stimulant drugs.
Interesting approach.

I am sure you have looked into safety of these drugs before starting but after a quick look at what they are it seems you might want to look out for ulcers and gastrointestinal issues, but given you are doing a low dose approach it will be a lot less likely one would think.

Have you looked for drug interactions between the 4 drugs you are combining?
Is this a regime you came up with or a treatment approach you have come across elsewhere?
 

pattismith

Senior Member
Messages
3,941
Interesting approach.

I am sure you have looked into safety of these drugs before starting but after a quick look at what they are it seems you might want to look out for ulcers and gastrointestinal issues, but given you are doing a low dose approach it will be a lot less likely one would think.

Have you looked for drug interactions between the 4 drugs you are combining?
Is this a regime you came up with or a treatment approach you have come across elsewhere?
It's a regimen that came from empirical approach and an urgent need to adress my issues with myalgia/iron deficiency/cervical herniated discs/extreme fatigue and PEM/sleepiness etc...
 

CSMLSM

Senior Member
Messages
973
It's a regimen that came from empirical approach and an urgent need to adress my issues with myalgia/iron deficiency/cervical herniated discs/extreme fatigue and PEM/sleepiness etc...
Cool, so you have covered everything then. Very much the same approach I take to these these things.

Empirical approach is a way of studying and interpreting information based on evidence. Empirical evidence is information that can be gathered from experience or by the five senses. Empirical approach relies on real-world data, metrics and results rather than theories and concepts. Empiricism is the philosophy that knowledge is primarily received through experience.
 

pattismith

Senior Member
Messages
3,941
Cool, so you have covered everything then. Very much the same approach I take to these these things.
That said, NAISD COX inhibitor + colchicine combo has a long story of treating pericarditis/myocarditis and colchicine + Spironolactone combo was used in an Australian Study for long covid. So when something seems useful for me, I look into the reason why it works and why the combo works.
Be careful that Rapammune/sirolimus musn't be added to that regimen and must be use alone.

https://forums.phoenixrising.me/thr...ssy-study-2022-long-covid.90434/#post-2438780

https://forums.phoenixrising.me/thr...ssy-study-2022-long-covid.90434/#post-2439093