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-   -   So majorly depressed; I need help making a decision. (http://www.socialanxietysupport.com/forum/f30/so-majorly-depressed-i-need-help-making-a-decision-522730/)

gilmourr 08-28-2013 08:57 AM

Quote:

Originally Posted by depressed77 (Post 1066260497)
Keep it as it is, but add Lamictal.

/depressed77

reasoning?

depressed77 08-28-2013 09:00 AM

Quote:

Originally Posted by gilmourr (Post 1066260505)
reasoning?

I know people who have responded well to Abilify + Lamictal. AAP + Lamictal in general seems to be a combination with a fair chance of success. I have good experiences with it too.

/depressed77

kehcorpz 08-28-2013 09:07 AM

Quote:

Originally Posted by gilmourr (Post 1066260425)
Almost 3 weeks in I believe. Might even be 3 weeks. I don't have many side effects other than sleep troubles, but I feel more anxious and more depressed since starting abilify.

Somehow I have motivation though and more reward. Guessing this is the D2 mechanism.

I felt pretty god damn depressed though the other day, like death thoughts resurfacing...

Not sure what to do. I know more than 100 mg of Zoloft makes me feel more depressed. I think Zoloft is an inhibitor so my abilfy would probably be more than 2 mg in real life.

Advice? Should I try Zyprexa? My concentration is still a bit wack and so is my energy.

EDIT: I've got access to risperidone, zyprexa and nortriptyline as augmentors. Maybe I should use trimipramine at a therepeutic dose..

Well, out of all the AAPs zyprexa is my favourite. Only reason I stopped was because of blood sugar problems. You could give it a try, it will be different for you maybe, who knows, but drugs are trial and error unfortunately.

gilmourr 08-28-2013 09:20 PM

Yeah, was just wondering what you guys mainly thought personally.

ATM I sleep okay, have developed some mild-moderate depression and mild floating anxiety since being on abilify. It helps with motivation but I don't think that's a fair trade off atm. And when I say motivation I don't mean concentration. I just want to do work, but I'm still unable to concentrate exceptionally well. I don't expect it to all come back at once, but I know my basic concentration level.

I need something working on norepinephrine somehow without swinging me...

I want to try nortryptiline possibly. Maybe an NRI with alpha 1 antagonism will cause it to go to alpha 2 mainly which is more sedating/calming. It might give me a good balance, plus I heard MANY people have been helped with it. Along with amitryptiline.

depressed77 08-29-2013 12:45 AM

Quote:

Originally Posted by gilmourr (Post 1066273977)
Yeah, was just wondering what you guys mainly thought personally.

ATM I sleep okay, have developed some mild-moderate depression and mild floating anxiety since being on abilify. It helps with motivation but I don't think that's a fair trade off atm. And when I say motivation I don't mean concentration. I just want to do work, but I'm still unable to concentrate exceptionally well. I don't expect it to all come back at once, but I know my basic concentration level.

I need something working on norepinephrine somehow without swinging me...

I want to try nortryptiline possibly. Maybe an NRI with alpha 1 antagonism will cause it to go to alpha 2 mainly which is more sedating/calming. It might give me a good balance, plus I heard MANY people have been helped with it. Along with amitryptiline.

Good luck. Have you tried modafinil? Nothing gives me concentration like this one.

/depressed77

kehcorpz 08-29-2013 05:21 AM

Yah nortriptyline would be your best choice for that. Though watch out sometimes NRIs can cause erectile difficulties. But yah personally I loved zyprexa, but keep in mind that while on it with the effexor it got me out of my rut, so i'm very biased lol. I was able to concentrate really well on it, my guess is because it's such a powerful 5-ht2c antagonist. It also blocks serotonin receptors that help with memory like 5-ht6 receptors which increases cholinergic/glutamergic activity.

gilmourr 08-29-2013 10:50 AM

Quote:

Originally Posted by depressed77 (Post 1066277465)
Good luck. Have you tried modafinil? Nothing gives me concentration like this one.

/depressed77

I have not. I think this would be too stimulating though. How much anxiety does it give you? It might be hard to get.

gilmourr 08-29-2013 10:52 AM

Quote:

Originally Posted by kehcorpz (Post 1066280089)
Yah nortriptyline would be your best choice for that. Though watch out sometimes NRIs can cause erectile difficulties. But yah personally I loved zyprexa, but keep in mind that while on it with the effexor it got me out of my rut, so i'm very biased lol. I was able to concentrate really well on it, my guess is because it's such a powerful 5-ht2c antagonist. It also blocks serotonin receptors that help with memory like 5-ht6 receptors which increases cholinergic/glutamergic activity.

Never knew that antagonism at the 5HT2C receptor and 5HT6 cause an increase in concentration. Time to look whether abilify does this at a low affinity. And Zyprexa might be my next move. Just really worried about the man boobs, lactating issue.

EDIT1: It's actually a partial agonist at the 5HT2C receptor and doesn't touch 5HT6 really, so yeah, no help there for me taking abilify :( Feeling quite nauseous today and it's I think 21+ days now. I will be upping to 5 mg on Sunday after the weekend or moving to something else. I probably will try 5 mg of Abilify for 7-10 days and if that doesn't work well I'll probably think about another.

I'm getting heartburn and insomnia and heightened anxiety and depression with abilify with only motivation going up. It's not that great so far.

depressed77 08-29-2013 11:37 AM

Quote:

Originally Posted by gilmourr (Post 1066285009)
I have not. I think this would be too stimulating though. How much anxiety does it give you? It might be hard to get.

It's a quite tricky medication, sometimes it gives me confidence and makes me less anxious and sometimes it makes me anxious. I frequently used atenolol with it.

/depressed77

gilmourr 08-30-2013 02:16 PM

Due to the extreme tiredness and side effects of abilify, I'm going to stop it a bit soon. I might come back and try 5 mg another time, but 2 mg really should be doing more at 23-24 days in, plus I keep having really bad nausea spells and I just think another med might be better.

Zyprexa or nortryptiline seem less symptom causing

A Sense of Purpose 08-30-2013 04:40 PM

Zyprexa is delicious. Works like a charm with Zoloft.

depressed77 08-30-2013 09:09 PM

Quote:

Originally Posted by gilmourr (Post 1066312233)
Due to the extreme tiredness and side effects of abilify, I'm going to stop it a bit soon. I might come back and try 5 mg another time, but 2 mg really should be doing more at 23-24 days in, plus I keep having really bad nausea spells and I just think another med might be better.

Zyprexa or nortryptiline seem less symptom causing

At this point it should be doing more. +1 for nortriptyline.

/depressed77

gilmourr 09-01-2013 04:34 PM

Stopped abilify. Hard decision to make between Zyprexa, Nortryptiline, and Lamictal.

Zyprexa is interesting at low doses and works well with zoloft.
May cause sexual issues.

Nortryptiline might help with focus and energy + AD effect. Good with zoloft too.

Glutamate may be the BIG anxiety provoker for me and lamictal manages this well and is something new. So it's an interesting take.


I'll probably go nortrip just because I have it already.

kehcorpz 09-01-2013 05:27 PM

Just do both nortrip and olanzapine :P

gilmourr 09-02-2013 05:48 AM

What about desipramine?

Out of lamictal, nortryptline, desipramine and zyprexa what may be the order of sexual side effects? Worst to best.

kehcorpz 09-02-2013 05:52 AM

Quote:

Originally Posted by gilmourr (Post 1066375906)
What about desipramine?

Out of lamictal, nortryptline, desipramine and zyprexa what may be the order of sexual side effects? Worst to best.

Desipramine would be much better than nort as far as its side effects go.

Less histamine power, less muscarinic receptor binding and greater ratio between norepinephrine and serotonin.

http://en.wikipedia.org/wiki/Tricycl...nding_profiles

Though Alpha 1 is a bit stronger on the desp.

Don't know about lamictal but zyprexa didn't give me any sexual side effects. It's usually the serotonergic drugs that give you sexual side effects. Some people have issues with norepinephrine and erections, but that depends on the person.

depressed77 09-02-2013 07:20 AM

Quote:

Originally Posted by gilmourr (Post 1066375906)
What about desipramine?

Out of lamictal, nortryptline, desipramine and zyprexa what may be the order of sexual side effects? Worst to best.

Lamictal wouldn't impact on sexual functioning. Nortriptyline would be worst, but still not that bad.

/depressed77

gilmourr 09-02-2013 11:06 AM

Quote:

Originally Posted by depressed77 (Post 1066376986)
Lamictal wouldn't impact on sexual functioning. Nortriptyline would be worst, but still not that bad.

/depressed77


Yeah I was thinking nortrip would because of the alpha 1 antagonism that would affect getting an erection. Would also probably hurt my sex drive. And it's low atm without the abilify now.

Is the NRI function of TCA's the same as SNRI's? Because NRI's usually do a severe number on me making me more depressed. Wellbutrin, nardil, parnate, cymbalta..

But I think I can have just a BIT as long as serotonin is at a greater concentration. I need it for my motivation/concentration and sex drive again.

kehcorpz 09-02-2013 11:14 AM

Quote:

Originally Posted by gilmourr (Post 1066381130)
Yeah I was thinking nortrip would because of the alpha 1 antagonism that would affect getting an erection. Would also probably hurt my sex drive. And it's low atm without the abilify now.

Is the NRI function of TCA's the same as SNRI's? Because NRI's usually do a severe number on me making me more depressed. Wellbutrin, nardil, parnate, cymbalta..

But I think I can have just a BIT as long as serotonin is at a greater concentration. I need it for my motivation/concentration and sex drive again.

TCAs are all alpha 1 agonists not antagonists.

And the NRI function is way more powerful than any SNRI out there. Clomipramine was out of this world strong. It felt like I was on high dose ephedra sinica(not ephedrine hcl) back when it wasn't banned. Definitely had this crazy alertness to it. I've been on 375mg effexor and felt nothing like that from it.

gilmourr 09-02-2013 11:16 AM

Quote:

Originally Posted by kehcorpz (Post 1066375962)
Desipramine would be much better than nort as far as its side effects go.

Less histamine power, less muscarinic receptor binding and greater ratio between norepinephrine and serotonin.

http://en.wikipedia.org/wiki/Tricycl...nding_profiles

Though Alpha 1 is a bit stronger on the desp.

Don't know about lamictal but zyprexa didn't give me any sexual side effects. It's usually the serotonergic drugs that give you sexual side effects. Some people have issues with norepinephrine and erections, but that depends on the person.

I think that desipramine might agitate my depression since I'm very certain I have agitated depression/mixed states. I don't think I qualify as BP2. A strong NRI like that will probably make things worse... didn't realize it had such a strong affinity. I think Lamictal gets pushed back since I tried it once and it gave me an allergic reaction. Nortrip seems reasonable, though I like zyprexa because it shouldn't be too strong at a low dose, seems decent side effect wise and I like the 5HT2C and 5Ht6 antagonism + dopamine antagonism might not be that bad at 2.5-5 mg. I'll start at 2.5 though. Lets see if I can get it.


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