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

[Nielk]

People have different reactions to anti-depressant. I take Wellbutrin. It works for me. But not for everyone. What my doctor did is just try one after another until we found one that worked for me.

Wow. we are so different! I took Wellbutrin about 6-7 years ago. The first few days, I felt great! After that, I became totaly suicidal.
It makes me think. Here we are giving each other advice as to what has helped us and what to stay away from. Yet, we really can't compare. Everyone is different. What helps one, is terrible for the next.
Is there anything out there that universally helps anyone who tries it? I haven't found one.

 

[valentinelynx]

I switched to Valdoxan (agomelatine) about 2 years ago. I used to take Effexor XR, but can no longer tolerate it due to blood pressure effects. Valdoxan is an antidepressant approved in Europe. It appears to be at least as, and perhaps more effective, than SSRIs, for depression, without any withdrawal syndromes (really). It is still in clinical trials in the U.S. I suspect if it makes it through (other drug companies may force the FDA to block it), it will push the other drugs off the map. It works on melatonin receptors with a very slight effect through serotonin receptors (I looked up all the gory details years ago and so can you if you wish). Bottom line, it helps me avoid severe depression without any noticeable side effects, and also promotes sleep. You need to order it from overseas, either through a Canadian pharmacy (prescription required) or one of the no-Rx needed European online pharmacies (such as International Anti-Aging Systems) which cost more. The stuff is expensive, however, about $3.50 a pill from CanadaDrugs.com. Dose is either one or two 50 mg tablets per night.

 

[justy]

Hi Pamb, i have had truly horrible and life changing side effects from antidepressants - i would never touch another one again as long as i live. My problem was just as miuch anxiety as depression.
what helped for me now and inj the past has been a medical herbalist - but like the 5HTP some herbs eg st johns wort can aggravate. also magnesium, injected Methyl B12 and lots and lots of rest and good pacing always helps my mood - when i overdo it for long stretches i can get very weepy and sad, generally my mood lifts if i am pacing correctly - sorry a biut tired now so may be coming out as nonsense - good luck
Justy.x

 

[GhostGum]

An interesting article here on creatine and uridine for depression,

http://www.wdam.com/Global/story.asp?S=13603594

Have also started using creatine myself in the past couple of weeks and think it is helpful. I also use to think it was just some body building supplement until I saw it mentioned as a supplement for multiple sclerosis (Terry Wahls Minding My Mitochondria) and there are studies showing it can raise IQ and improve cognition in the elderly.

Edit: I should have noted I do not have depression, never have over the 10 years I have had ME but believe many nootropics can have great benefit for us in at least helping with our cognitive difficulties and mood.

 

[Ocean]

It makes me think. Here we are giving each other advice as to what has helped us and what to stay away from. Yet, we really can't compare. Everyone is different. What helps one, is terrible for the next.
Is there anything out there that universally helps anyone who tries it? I haven't found one.

So true Nielk. I've found that to be really frustrating about this illness.

 

[November Girl]

It might help to sit down with a knowledgeable and discuss which antidepressants he's taken and just what effects they've each had. Most of the newer ones affect one or more neuro-transmitters. It's possible that the pattern of problems might lead to a better understanding of your husband's brain chemistry.

 

[Freddd]

Hi all,

We have a debate raging up here. My ME (CCC & ICC) hubby is clearly depressed, however since ME arrived about 10 yrs ago every time he tries an SSRI, after about three days his head feels like it is truly going to explode. We've recently moved back to Canada from France and his doc's here, (and son-in-law who is quite wise GP and has seen John at his worst lately and has known him for 30 years) are on a campaign to get him started on an antidepressant. I agree if one would work it would likely help him a bit with his negative and obsessed (with all the pains etc) outlook and perhaps help him find an easier way to come to peace with ME, but I sure don't support trying an SSRI again. Not unless he was hospitalized to try it, and we know hospitals are not good places for people who don't respond in the 'expected' way to medical interventions.

He is actually doing pretty good, all things considered, and Chinese herbs and acupuncture the last 3 months have been quite helpful with the brain fog and also with energy levels. For this we are both grateful. He is however, perpetually sleep deprived and in pain. Certainly lots of good reasons to feel depressed but the 'black cloud' just does not make any of it easier.

So my question, has anyone else who is SSRI intolerant tried and succeeded with anything else to help with depression?

Thanks so much in advance for any stories of success.

Merry Christmas from the frozen north :Retro smile:

Pam and John

Hi Pam and John,

I can't tolerate SSRIs either. Fortunately I found a solution and am no longer depressed for the former reason though this year has been tough with the death of my daughter.

These factors all reduced and removed my depression in the end.

Mb12, adb12, Metafolin, l-carnitine fumarate, SAM-e were rthe major factors on a background of all the other normal vitamins and minerals. See the active b12 prorocol basics at http://forums.phoenixrising.me/showthread.php?11522-Active-B12-Protocol-Basics

After all depression is a symptom of mb12, adb12 and methylfolate deficiencies which is the basis of FMS and CFS. I also am quite nicely CURED of FMS/CFS, 175 symptoms worth in all.

 

[Mimi]

Uridine with DHA fish oil and A-GPC.

 

[xks201]

I think elevated serotonin is probably more of an issue than decreased serotonin in CFS. Interesting, histamine decreases serotonin. Serotonin increases BM frequency.

 

[August59]

I'm sure this has more than likely already takin place, but I would make sure his hormones have been tested thoroughly and correctly. A TSH alone is no appropriate for testing the thyroid a minimum would Free T4, Free T3, Reverse T3 and Thyroid antibodies. I would have his LH, FSH, Total Testosterone and Free Testosterone, SBGH, Sensitive Estradiol, Prolactin and DHT. Also a 24 hour cortisol and a ACTH stim test, DHEA and aldosterone for adrenals and a Vitamin D test. An MRI of pituitary would be good, that probably would not happen unless they find abnormalities with the hormones.

I know this sounds like a lot, but abnormalities of these hormones could definitely be feeding his depression. I have probably forgot some that others may chime in and add. The neurotransmitter test (or some times called catecholomines) are a measurment of them in your blood, but generally does not represent the levels or proportions in the brain. However there may be another test that measures them, but I don't know who does that test.

I wish both of you much luck!

 

[xks201]

I think ACE hyperactivation is causing chronic fatigue in a lot of people. All the neurotransmitters suffer from high levels of angiotensin converting enzyme, and angiotensin 2 excessive stimulation blocks acetylcholine release and that also produces fatigue. This is one potential mechanism for CFS/depression that personally affects me.

 

[Rand56]

Uridine with DHA fish oil and A-GPC.

I tried Uridine and it did nothing for me. One has to be careful with the fish oil if someone is low cortisol.

 

[peggy-sue]

Did he try a lower than normal dose to start with?
I got (reactive) clinical depression after being ill for 4.5 years, and very reluctantly, knew I would have to start an SSRI.
I chose citalopram as rumour on ME forums seemed to suggest this was the least problematic, available one for ME.

I started on half the normal dose, 10 mg. I took valerian, hops and passion flower calmy stuff to help with the horrendous side effects, which lasted for 6 weeks before the drug finally kicked in. I never needed to increase the dose.

I wouldn't have given up after just 3 days - even though I was bouncing off the walls with anxiety and unable to sleep. My side-effects were truly horrendous. But so was the depression, I HAD to get through the initial side-effects - they're just part and parcel of taking SSRIs.

SSRIs DO take a long time to kick in. Serotonin has nothing to do with depression - hormones are what affect moods, serotonin levels being increased results in every hormone system you have being completely reorganised -
the evidence for that came from the discovery (after they were put out on the market) that when women are given the drugs, one of the first things that happens is the menstrual cycle gets so regular you can set your watch by it, it completely cures PMT. After that's happened the anti-depressant effects finally do kick in.
Then of course, there are the "neuterising" effects, very much played down by the Harmaceutical companies, rendering folk incapable of any love-life....

They're now being tested (successfully, apparently) as treatment for paedophiles.

 

[jeffrez]

Sometimes the older drugs work better than the newer ones. The TCAs have a lot of the same side effects as SSRIs, only worse, and some the SSRIs don't usually have, but they can sometimes be effective.

An older tetracyclic called trazodone can sometimes work when you can't tolerate TCAs or SSRIs. Not only does trazodone not have the sexual and other side effects that the others have, but it can have a positive effect on sexual function and can also promote stage 4 sleep, very important in ME/CFS.

The MAO inhibitors aren't really in favor as much anymore, but in desperate cases psych docs will often agree to try one when nothing else works.

EEG neurofeedback can work wonders on depression, and often relatively quickly.

A lot of the adaptogens like ginseng, eleuthero, withania, maca, etc. can have a positive effect on depression, perhaps through some of the hormonal mechanisms peggy-sue mentioned, balancing cortisol, etc.

Best approach is probably to find the reason for the depression and try to treat it naturally, with herbs, diet, nutrient replacement where deficient, etc. That can take time though, but can be worth it in the long run to avoid some of the negative effects of ADs.

 

[Sparrow]

An older tetracyclic called trazodone can sometimes work when you can't tolerate TCAs or SSRIs. Not only does trazodone not have the sexual and other side effects that the others have, but it can have a positive effect on sexual function and can also promote stage 4 sleep, very important in ME/CFS.

Just wanted to mention that while trazodone may not be known for the same side effects as SSRI's, it can still have intense side effects, like all of these medications. My husband turned into a crazy rage machine taking a tiny dose for sleep. Like, frighteningly, off-the-charts aggressive. And he is a super sweet guy normally. Thankfully, in his case it went away quickly after stopping the medication, and we clued in before he did anything truly damaging.

 

[adreno]

Not only does trazodone not have the sexual and other side effects that the others have, but it can have a positive effect on sexual function

Penile Amputation After Trazodone-Induced Priapism: A Case Report

 

[urbantravels]

Wellbutrin is not an SSRI.

I've never had trouble with Trazodone. I take it for sleep, though, not as an anti-depressant per se. I never knew what it was like to actually NOT wake up at 3 AM with heart pounding and racing thoughts (I had this problem long, long before I had ME/CFS) but Trazodone actually stopped that, for me.

No priapism, but then I lack the necessary equipment. Technically, the sleep-inducing property of Trazodone *is* a side effect - it just happens to be a desirable one in cases of insomnia.

 

[SOC]

Wellbutrin is not an SSRI.

I've never had trouble with Trazodone. I take it for sleep, though, not as an anti-depressant per se. I never knew what it was like to actually NOT wake up at 3 AM with heart pounding and racing thoughts (I had this problem long, long before I had ME/CFS) but Trazodone actually stopped that, for me.

No priapism, but then I lack the necessary equipment. Technically, the sleep-inducing property of Trazodone *is* a side effect - it just happens to be a desirable one in cases of insomnia.

Same here on all counts. I've taken Trazodone for years for sleep with no problems and great effect.

HOWEVER, last winter I was given a different brand than I usually get and it was horrible -- big crash, suicidal ideation (me, of all people!!), totally messed up mood. It was unbelievable how messed up I was. I strongly suspect that one of the commonly used brands ain't what it's supposed to be.

 

[urbantravels]

Hum. I just get the Kaiser generic (as with all my meds) and it's always been the same for me. Perhaps you fell victim to a bad batch.

 

[jeffrez]

Penile Amputation After Trazodone-Induced Priapism: A Case Report

Haha, right. Yes, god forbid anyone gets that. From what I understand, however, that particular side effect is very rare, usually on really high doses. Nothing like the very common sides from the SSRIs and TCAs. But of course everyone has to weight the costs/benefits/risk ratios for themselves.