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What is better option for treatment resistant depression, BPD, GAD and social anxiety?
Benzos don't work for me anymore so i need to find alternative solution. I am currently at 225 effexor, 200 mg seroquel (100 in the morning, 100 afternoon) and lyrica 450 mg (3 times a week). This combo works fine so far. I feel a little bit sedated after seroquel but my intrusive thoughts are less and my anxiety is less. I can function normally on this combo without feeling sleepy. Yes, i feel sedated but i love that feeling. It makes me calm and slows my brain so i dont worry so much. Coffee also helps me when i feel tired so i drink 3-4 cups of coffee every day.
My question is has anybody tried effexor/mirtazapine combo, also known as "california rocket fuel" wich is recommended for treatment resistant cases. Does mirtazapine works better with venlafaxine than seroquel. Which of these 2 is more sedating and work better for anxiety?
 

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I can't say I've just been on either seroquel + effexor, or seroquel + mirtazapine, but I am on the california rocket fuel combo because of treatment resistant depression, and was on all 3 for a bit. I was on 300mg effexor/45mg mirtazapine for over a year, and only just started to taper off the mirtazapine because I complained about slow brain and memory issues, so I went from 300/45 to 300/30 and now 300/15. I'd probably say the seroquel + mirtazapine would be much more sedating, because I never really had any sedating effect from the effexor, but got it from both mirtazapine and seroquel.
 

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I haven't tried either one of these combos just Effexor. I think those combos including the CA Rocket Fuel would be too heavily sedating for me, but if it works for you that's good. If you have a partial response to one or the other you can add Mirtazepine, it has anticholinergic effects and alpha 2 adrenergic antagonists. It could help further improve anxiety and depression, but may cause more sedation on top of seroquel and more weight gain because both supposedly have that side effect.

I honestly don't know if it works better than Seroquel or not, but it's worth the try. Lastly, there is Mirapex and Abilify for treatment resistant depression stimulants or MAOIs..
 

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Discussion Starter · #4 ·
sorry i meant Seroquel/Effexor VS Mirtazapine/Effexor
 

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Why not keep the seroquel and effexor together and also add on mirtazapine? So that if you don't like the mirtazapine by chance, you would still have the regimen that is benefiting you currently.
 

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My pharmacist, (who I believe is most likely an incompetent idiot) claims that there is an interaction between Remeron and Seroquel that causes elevated QT levels. A quick check on drugs.com drug interaction checker noted no such interaction but it did note that interaction between Amitriptyline and Seroquel both of which I was on at the time. How significant this is, I can't say as I've had the same interaction for years on various different meds and nothing that I was aware of ever happened, but it wasn't like my doctor monitored me with an EKG or anything. Doctors who had me on this combination were I assume completely obvious to these interactions or simply didn't give a ****, it wasn't like they were responsibly monitoring the situation as they would have you believe.

As for your question, I can't say that Seroquel nor Remeron did **** for my anxiety, I just took them together for issues regarding sleep.
 

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Seroquel/Effexor VS Seroquel/Mirtazapine
I didn't try Seroquel for very long because I absolutely hated it. It turned my insomnia into hypersomnia with a 15 hour nap.

I only tried mirtazapine as a sleep aid, so I never tried it long term, nor at a dose higher than 15 mg.

I'd prefer not to take either of the above as I'm plenty fat already and don't need drugs known for causing weight gain.
 

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Yeah quetiapine + mirtazipine = LOTS of antihistamine activity, sedation, potential for weight gain. I dunno. To each his own.

From your original post sounded like things are okay with your current combo. If that's the case then I wouldn't personally switch.
 

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Yeah quetiapine + mirtazipine = LOTS of antihistamine activity, sedation, potential for weight gain. I dunno. To each his own.
My GP eagerly hands out drugs that cause weight gain. I don't know what mental defect exists in his brain such that he thinks this makes sense when 1/3 of adults are obese. Do we really need to super-size them further? After all, he's treating obesity-related problems all day: high BP, diabetes, high cholesterol, osteoarthritis etc...

I was at Walmart recently and there were scooters galore, ridden by enormous folks who make me look slender by comparison. At least I have no problem walking around a huge store.
 

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just consider that NaSSas really lack the crucial reuptake inhibition...
 

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My GP eagerly hands out drugs that cause weight gain. I don't know what mental defect exists in his brain such that he thinks this makes sense when 1/3 of adults are obese. Do we really need to super-size them further? After all, he's treating obesity-related problems all day: high BP, diabetes, high cholesterol, osteoarthritis etc...

I was at Walmart recently and there were scooters galore, ridden by enormous folks who make me look slender by comparison. At least I have no problem walking around a huge store.
Just think, how many of those fat people were on Zyprexa or another atypical drug?
 

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I'm in Australia I'm on 300mg Effexor, 30mg Mirtazapine, 450mg Seroquel and prn lorazepam 2-4 mg a day I'm down to 2-4mg a week and I'm still hyper, my most recent locum psychologist said to handle that amount of sedatives and still be this wired at a baseline says alot... Oh I was on 30mg a day Oxycodone at that point aswell per day IR but finished weaning now ... This is 4 ish years now and I think it's just about right for me, I'm confident, social, pleasantly numb from years of trauma and fear, sex drive abolished and lost nearly all of the 60kg I gained on Olanzapine real quick, Seroquel doesn't make me hungry Effexor gives me energy and I can handle the Mirtazapine munchies by allocating a large chunk of my food calories to after evening dose 6pm ish I've lost almost all those 60kg finally!
 
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