View Full Version : A drug for only Depression?
Hi all, been on the Citalopram for quite a while and it kicks the butt of my anxiety but the old black dog of depression is ever present.
Anyone have any success stories of other drugs in relation to depression? Maybe I need a Dopamine boost or whats that other brain chemical Norepinepherin or something?
Has anyone gone from an SSRI to another drug and felt their low moods/apathy lift?
Will be seeing the Doc' soon but would like some alternative options apart from Citalopram to be able to discuss?
Thanks,
Steve.
william wallace
09-06-13, 22:57
Lots of folks that I know have changed from Citalopram to Sertraline with good results.
Technically, Citalopram and all other SSRI drugs are for depression and not anxiety. They stabilize our brains serotonin which is thought to be low for people with depression.
All SSRI medication work on this principle. The newer class of drugs, the SNRI's work on both our noradrenaline and our serotonin although there is no evidence to show that they are more effective than SSRI's.
Unfortunately these drugs tend to blunt out our moods.
AuntieMoosie
09-06-13, 23:52
Hi there,
Like you, I have depression and anxiety and I do understand how complicated it is to get the medication right.
It's like trying to do a balancing act!
I was on Citolopram, but was changed last year and put back on sertraline. I do have to say that I do find sertraline certainly more helpful than Citalopram.
In fact, I don't think I've got much good to say about citalopram, it made me emotionally dead in every way, and I found it extremely difficult to come off of too. But remember, this is only my experience and I expect others find it helpful, we're all different at the end of the day.
Unfortunately I really don't know what is the best medication for the depression too. There are the older type antidepressants but I think they had a lot more side effects and maybe not too good sorting out the anxiety either.
There are many antidepressants around now, from the older ones to the newer ones. So I'd just go for your appointment and discuss it with your doctor.
For further information you could always contact "Mind" as I know that they have lots of information on the different types of antidepressants, you many get some ideas there you can throw at your doctor maybe.
Steve I so agree with you that I have found that the SSRI's really do blunt your emotions a hell of a lot and that is one thing that I don't like about them. I found Citalopram to be the very worse for this, I hardly felt like I had any emotions or personality when I was on that!!
Thanks, I will mention Sertraline and have a look see in that sub forum.
Blunting our moods and emotionally dead inside are two very good analogies of exactly how I feel. I'm like just drifting through life at the moment in no particular direction.
I feel bad at times because I have a stable home with no real money or other worries like some others have to contend with and my anxiety has been stable for some time yet this blanket of depressed feeling will not lift.
Did a bit of research and saw something called an SNDRI class of drug that boosts three different brain chemicals, looks promising? It also seems that Venlafaxine becomes an SNDRI at higher doses so I will have to go look in that sub forum too?
My Serotonin must surely be OK having been on Cit' for ages? There must be something else going on as it can't be normal to be so down? I figure if Dopamine is the brains happy chemical then a bit more sloshing around up there must be a good thing but I have a feeling things ain't that simple?
I have my appointment tomorrow morning and usually like to go pre-armed with a little knowledge of the situation I'm in, thanks again for the suggestions.
steve
william wallace
11-06-13, 08:34
The main reason that GP's prescribe Citalopram is cost. In the UK a maintainance dose costs aprox £20 per month for the generic tablet and this is why most patients will be prescribed it initially. The only SSRI thats cheaper than Citalopram is generic Fluoxetene at aprox £15 per month.
Well my Doc suggested right away Sertraline and gave me a script for 50mg tablets.
Only thing to do is see how these work so will report back in a few weeks, hopefully with better news?
Steve.
Sertraline deals with almost the same neurotransmitters as Citalopram. Again, it's only stabilizing the re-uptake of serotonin. It does no more for depression than any other SSRI.
Venlafaxine is an SNRI, not an SNDRI. At a low does it barely touches the noradrenaline but at higher levels it starts to have an effect on our dopamine.
But as I mentioned earlier, there is very little evidence to suggest that SNRI's are any more effective than SSRIs at treating depression.
Unfortunately there is no chemical cure for depression either. The theory that it's down to our brain chemicals is almost disproven now. Evidence clearly shows that placebos have a much more positive effect on depression and anxiety than anti depressants medications.
You say that 'a bit more dopamine sloshing around'. I just need to point out that none of these medications increases our levels or serotonin nor dopamine.
To increase these levels you need to look into amino acids such as L-Tryptophan and L-Tyrosine. These are precursors to the neurotransmitters, serotonin and dopamine (but can't be taken whilst taken SSRI''s or SNRI's due to risk of Serotonin Syndrone). These naturally increase the levels of these neurotransmitters.
Depression is an awful lot harder to try and fix through medication than anxiety.
bethanyjay
11-06-13, 15:16
Each to there own ..... citalopram has helped me no end tbh it has been my life saver.
It was my first AD though, but unlike you it did nothing for my anxiety but did heeps for my depression.
At first I was diagnosed with anxiety but then after some delving this was because I was depressed.
Speak to your gp about your feelings and Im sure they can help you decide and maybe swap.
Bethany
Depression is an awful lot harder to try and fix through medication than anxiety.
The thing is is that I know there is still good/pleasurable/content/inspiring etc... feelings possible from my brain as I get flashes of these feelings say when eating nice food, seeing or hearing something outstanding, riding my motorbike or being noticed by the opposite sex.
Inevitably those good feelings fade away or indeed drop dramatically and should be replaced by a normal state of being somewhere between the high and the low but entirely acceptable to most? But what is lacking that causes the way we feel to crash from a high straight to low?
Whatever gives the high is surely needed in lower amounts to maintain a steady state of wellbeing? Is it Serotonin that is responsible for this action? Can a brain be damaged and not produce enough Serotonin even when in the presence of it's reuptake inhibitor?
Steve.
You're experiencing dopamine. It's a rewarding neurotransmitter. When something good happens, we eat something lovely, we see something pleasurable, riding a motorbike or being noticed by the opposite sex, thats dopamine.
But then it's not black and white. The neurotransmitters often work with each other.
Half of the problem with anxiety and depression is that it's a cognitive disorder. That can't be helped by a magic tablet. Those issues need to be addressed via some sort of therapy, to retrain how you think.
A brain wouldn't be physically damaged not to produce enough serotonin no. None of us have physically damaged brains. It's just not as simple as being able to identify what neurotransmitter is causing your moods to crash.
Psychiatric medication is 100% subjective. If you saw 100 different psychiatrists today and told them how you feel, I bet you would get 30 or 40 different plans for treatment.
I'm saying this as a qualified nurse, and someone that has personal experience. I've seen 3 different psychiatrists this year alone, and several GP's.
Each one had their own drug of choice of what they believe will help me. Some of the GP's and psychiatrists even disagreed with what the other had recommended.
On this website, we can only say what works for us and what doesn't. What works for me, might not work for anyone else. Some people try Citalopram and have the worst time of their lives, for some people, it completely changes their lives. I've tried medication that I've read to be absolutely fantastic, but it made me feel horrible!
There is no drug for depression alone, unless we start getting into the extreme ends of the depression spectrum, bordering on manic depression, in which case drugs like Lithium are used to steady moods.
It's trial and error I'm afraid. That's going to be the case for everyone. GP's will prescribe the cheapest medication. GP's are fantastic, but they are fantastic at EVERYTHING, so much so, that their knowledge of psychiatry is limited to normally just a firstline treatment. When that doesn't work, it's guesswork once again.
My suggestion is to make sure you're sticking to the drugs for at least 4 months at the same dose to make sure they've had a good chance to work in your system. I also highly recommend getting therapy, perhaps in the form of CBT to address the cognitive side of your depression.
And remember, anti depressant medication has been proven to be less effective than a placebo and can cause terrible mood blunting which only adds to the depression. Many side effects to anti depressants are often paradoxical to why people take them.
I wish you all the best with your search for a drug that works for you. I found mine 11 years ago, and it worked so well, I figured I was well enough to come off it!
Bad idea. Things got worse and that drug no longer works for me. 3 more different medications and I'm now bedbound with anxiety, agoraphobia and depression of the likes I've never had before in my life.
I have many many months, maybe years, of trial and error of these nasty drugs.
Great post Steveo thanks for clarifying a few things:)
Finding that magic bullet by trial and error is what it's all about and maintaining it is the game? What works for one may produce the opposite effect in others? A combination of treatments may be needed or maybe nothing will have any affect?
Well after reading up on the Sertraline I'm quite optimistic and maybe that's what is needed, a little hope?
Steve
Absolutely. Hope is probably the key to defeating this horrible illness.
If you feel positive about a treatment or illness then go for it!! Sertraline does work wonders on some people so hopefully that's the one for you.
Hope works the same way as the placebo effect. As I've already mentioned, placebos have a better outcome than anti depressant medication. That means when they were testing the anti depressants on patients with anxiety and/or depression, a larger number of people on the PLACEBO tablet, reported to have less anxiety and/or depression than before taking the medication. They weren't even taking anything!
A tablet will only for as far as to meet you half way though. Don't expect to be able to pop a tablet each day and for depression and anxiety to be lifted. It's only going to shave the edge off your condition, hopefully enough for you to be able to then try and deal with it through therapy or other means etc.
Lots of people come on here to post about how bad the medication is and how it's not working etc. I can't stress enough that there is no medicinal cure for anxiety or depression.
The less you read into things, read about tablets, side effects, peoples experiences, symptoms etc, the better off you'll be. I've shot myself in the foot by doing my nursing dissertation on anti depressants. I studied them for almost 6 months. I've read every bad thing there is to know about every single anti depressant tablet and now that's proven to be very unhelpful for me. I've already declined 6 tablets from GP's and psychiatrists because of what I know about them. One of them could really work for me but I would go into it with a negative mindset and then it won't work.
I stay away from reading peoples experiences on different drugs now. I'm currently trying to wean myself off Diazepam which is sheer hell. Once I'm off that, I then have to try and find another antidepressant medication and go through the cycle for the 4th time this year!
Well my Doc suggested right away Sertraline and gave me a script for 50mg tablets.
Only thing to do is see how these work so will report back in a few weeks, hopefully with better news?
Steve.
Sertraline predominantly inhibits the reuptake of serotonin, but it also does the same with dopamine - around a tenth of that of the serotonin reuptake. I think that this is the least selective of all the SSRIs with regards to the other 2 neurotransmitters. Which isn't a bad thing tbh. Incidentally, when I was on 25mg of sertraline for 4 and a half weeks, I noticed an increase in libido and sexual function, even though I read that this increase in dopamine reuptake should not be large enough to have any effect.
---------- Post added at 01:35 ---------- Previous post was at 01:22 ----------
Did a bit of research and saw something called an SNDRI class of drug that boosts three different brain chemicals, looks promising? It also seems that Venlafaxine becomes an SNDRI at higher doses so I will have to go look in that sub forum too?
steve
I would be wary of venlafaxine and similar drugs - they are apparently the worst meds to come off because they have a ridiculously short half-life. One medication that increases all 3 neurotransmitters are MAOIs - natural ones include Rhodiola Rosea and St John's Wort. There are also synthetic ones such as Phenelzine which come with food restrictions, and ones such as Moclobemine which do not.
Having said that, the whole idea of depression being caused by low levels of a neurotransmitter does sound a bit suspicious, and appears to be embraced by the pharmaceutical companies. I've found that citalopram has increased my mood, but I think my whole body/brain was a bit screwed up from years of SSRIs as it were - I really want to be off everything given that I'm experiencing some visual side effects with citalopram despite the benefits to my mood and anxiety levels.
Inositol has been found to have positive effects on mood and anxiety - its safe to take alongside antidepressants as well.
That's interesting about the reuptake inhibition of Dopamine with the Sertraline even though it is by such a small amount!
There is no question in my mind that the Citalopram has improved my anxiety, the difference is like night and day and this must be due to the Serotonin level having been balanced out by the SSRI? I will have to assume that the Sertraline will continue this effect?
As for the triple reuptake inhibitors being the worst to come off, maybe this is because in some part due to them causing the feel good chemicals to increase in the synapses? Remove the drug that is causing this increase in a depressed person and you get a depressed person back hence the withdrawals?
Do the same to a normal, not depressed person by introducing Cocaine, Amphetamine etc... and they too will get extra good feelings and on taking the drug away will return to baseline but go through terrible withdrawals until they either get another hit or their brain eventually balances out the chemicals to a normal level?
The depressed person unfortunately balances out to a pre-existing low state so stays depressed?
Obviously a person cannot stay high off of illicit drugs their whole life without problems? They literally cause the brain to dump large quantities of the feel good neurotransmitters into the synapses and over time will damage them beyond repair. But get these feel good chemicals in a depressed persons brain to normal levels and they should be good to go, no?
Sorry rambling,
Steve.:blush:
I like this discussion and your way to ask question.
Is quite similar to what I am asking myself...
There is an idea that the "depressed people" needs the antidepressant only for a period of time (like 9/12 months) and then they will be "cured" and can stop.
But I see many people come back taking them, or maybe stay on longer term (I am 10 years on cit now).
I am asking myself if there is a way for the brain to recreate after a while the good conditions, maybe before the depression?
If the brain heals itself, while is not under stress?
Meditations for example shows to modify some phisical patterns in our brain.
Like exercise and so on.
I don't care anymore (or I worry less) if I will need the drug long term, if I really need it.
But I am interested in how it works, I would like to know if I can exists withouth medication.
Obviously I am not ready to try :P
I am in the process to switch and add, not for sure to stop now.
But the brain and these problems are something that misterious and interesting...
Hi Arfasc.
I'm not sure where you heard your information from but I don't think it's a reliable source. There is absolutely no body of evidence to show that some people can take an anti depressant for a certain period and be 'cured'. It's just not how they work. Unfortunately Anti depressants are far too overly prescribed. Most of my friends have been on them at some point and they have never had clinical depression or anxiety. They have had bad periods of their lives like everyone does and without a diagnoses, their GP's handed them out the tablets. Those cases are short term and normally after their stressful period is over, they stop taking the medication and that's the end of it.
Exercise and meditation don't exactly 'physically' change our brains. Exercise is good for for depression as it depletes our adrenaline and pump us with endorphins. They are more chemical changes.
There are more and more concerns over the uses of anti depressants and other psychiatric medication as we learn more about how drug companies are refusing to publish all of their data regarding the trials. In other words, we are only being shown the positive trials. It's much like me filming myself flip and coin 10 times. Chances are I won't get heads 10 times in a row, but I can just not show you the film clips of me getting tails and just show you me flipping heads 10 times.
More and more negative information are being discovered about these drugs. We, as the patients, believe that this is the only choice. We are also led to believe this drugs are safe for us to use. It's simply not true.
Psychiatry is not like medicine. To be diagnosed with a medical condition, we are put through rigorous tests to eliminate other options until we are finally told what's wrong with us. Psychiatry relies on what the patient says and then the diagnoses is subjective to the psychiatrist. It's quite easy for anyone to present themselves to a psychiatrists and to come out with a diagnoses of depression, but not so easy for someone to tell a GP that they have cancer as we can do tests for that.
One we have our subjective diagnoses, we then have the subjective medication given to us. Chances are, it will be the cheapest and most common drug available for us. It will one that a drug rep has 'wowed' a psychiatrist or GP into prescribing.
When I was a student nurse, I did placements in GP surgeries and I saw first hand how drug reps work. Up to as much as once a week, a rep from a drug company would come down to the surgery at lunchtime, bringing lavish lunches for the nurses and GP's along with lots of drug company freebies. They would then casually tell us how great their drugs are compared to the others on the market. Thankfully there has now been a law passed to limit gifts from drug company reps to GPs to a maximum of £100. Is that not still bribing and bias?
The other issues are that there are probably very good natural cures for depression and anxiety, such as the amino acid therapy that I briefly touched upon in a previous post.
Unfortunately, no one 'owns' the patent to these natural remedies so no one can really make much money off them. Therefore, drug companies aren't going to waste money on drug trials on these products, or if anything, they will run a small scale trial to show that they don't work.
It's still not known how or why antidepressants do sometimes show signs of improvement in patients. It's a very quick and easy way to 'get rid' of a patient though. We know that. It takes a GP less than 5 minutes to hear about how down and gloomy someone is feeling and then type in PROZAC or CITALOPRAM (depending on what he prefers and whats cheap) into his computer, and press PRINT. " Here you go, take one of these a day and everything will be ok" NEXT PATIENT PLEASE.
We are not offered therapy as a front line treatment anymore, we are not offered exercise therapy. We are not assessed on how we are getting on with our medication. Most importantly, we are not warned about how hard it is to eventually come off these drugs, should you wish to do so in the future or the terrible side effects they can cause.
Depression is still just as much a mystery as cancer. We know certain things can increase the risk of having it such as genetics, but we don't really exactly know what causes it and what cures it. We are still living in a guesswork age.
Steveo,
I don't have specific resources.
In general they are used in this way.
Maybe as you said because the person has not clinical depression.
I know that depression and anxiety are still something they don't know that much.
But I am also quite sure that in some way these drugs can work.
Yes, it's not easy to come off.
I am sure.
And I didn't know that.
But I started taking them in a period of my life I couldn't cope maybe without.
Sometimes I wish I've never started, because it looks like a spiral where I will add more and more.
But I don't think that all the doctors are as bad as you described.
I don't love medicine and doctors.
But I know that there are people that are trying to do their job in a good way.
I am not relying only on the pills, as I think there should be a way to find other resources. Difficult. Maybe impossible. But we need to try always.
I am not a crazy person for meditation.
But it helps so many people, so why not trying?
I know the money about the medications will be always a problem.
But it seems to help many people no?
No idea.
I am sure it's important to not try ONLY medication because they will not solve your problem for all your life.
Like we are not trying to get indigestion only to use then a stomach pill.
Same thing we should take care of our mental health and try to live without pills or as less as we can...
AuntieMoosie
12-06-13, 21:04
Steve I so agree with most of what you're saying:)
I honestly think that there is sooo much that we don't really know about antidepressants, and what they do or don't do.
I agree also that too much today they are being used as "quick fixes" and a quick way to say cheerio to the patient.
To be honest, in my opinion, I really don't think GP's should be prescribing any of the mental health medications. In America, you are immediately sent to see a psychiatrist if you present with any mental health issue. I have friends in the States and they never go and see their GP for that sort of issue.
I know that the government will say that we haven't got enough psychiatrists or other mental health professionals, but my opinion is "well get some more"!!!!
Mental health is a very specialist subject which should be dealt with by specialist people.
It is also becoming a massive problem in this country now, so why is this not being addressed I ask????
I am on SSRI's and have been for many years and before that I was on the old sorts of antidepressants.
But I really don't feel comfortable taking this medication at all, I have many doubts in my mind, but unfortunately, I have no choice, I cannot come off of antidepressants as every time I've tried I've ended up with a depressive episode and have usually ended up in hospital, so now they tell me I have to have them for life.
But how true is that???? I have no idea, I just keep taking them to prevent me becoming ill.
This is a very interesting thread thank you :)
That's what worries me, every time I come off the SSRI's my anxiety comes back. Sometimes I'm OK for months and other times it has been days or weeks. I sometimes wonder if this is due to the drugs?
I guess in a way we are still kind of guinea pigs with these drugs with them not having been around for very long? Hopefully our experiences will help 'em make better treatments eventually?
Steve
theharvestmouse
12-06-13, 22:30
This post could have been written by myself, I'm taking Citalopram, while my anxiety seems to have improved I am experiencing highs and lows on a daily basis. Like Steve I am capable of having really good feelings but they then seem to plume to a worrying state where I was actually having suicidal thoughts just last week. I've been thinking about going to the doctor again but then I have a good day and then think I''m ok.
Well,
I am always wondering if it's due to the medication.
And I know that one day maybe I will be able to try to discover it.
Weaning off the medication.
I've never been forced to take them.
And I haven't find doctors that were pushing me towards the medications.
I am sure they should take care not giving so many around, maybe it depends from the country.
There are countries where they are used too much.
But it's us that we are going to say that we feel bad.
And keep going and going until they prescribe medications.
I suppose.
Yes, I think we are guinea pigs.
Not only with this problem but for a lot of illnesses we are all guinea pigs and they are just trying to discover something.
We need to believe a bit in what we do and the most important I think it's to try combined strategies.
I have been doing some more research about the various anti-depressants and came across one called Wellbutrin or Bupropion. From what I have read it seems to be as effective an anti depressant as the SSRI class of drugs?
It seems to act on norepinephrine and Dopamine and can be used along side an SSRI to treat depression? Also it in 2006 it became the first drug to be specifically approved for the treatment of SAD by the FDA!
This tells me that while an SSRI may well work to some extent, the inhibition of reuptake of the other two brain chemicals must also play a role in depression because Bupropion also works as an anti depressant while not affecting serotonin?
As this drug can be used with an SSRI I think it may be worth a shot to ask to try it if nothing improves?
I don't really see this drug mentioned on this site and the search comes back as an error each time?
Steve
Rennie1989
13-06-13, 18:30
I have a feeling its not documented for a reason. By all means ask your GP about it though.
I have a feeling Bupropion is indicated for cessation of smoking and marketed as Zyban? For depression it may have to be prescribed off label? Seems to get rave reviews in the USA?
Steve.
Wellbutrin is only prescribed in this country for cessation of smoking I'm afraid.
Of all the medications I can think off the top of my head, I believe Prozac is the only one that is mainly aimed at depression rather than anxiety.
Someone on these forums from the UK managed to get a prescription for Zyban for depression. One of the side effects is a considerable worsening of anxiety/agitation though. Its not just the fact its unlicensed for depression in the UK that would make a GP reluctant to prescribe it though - it costs something like £40 a box.
Prozac worked wonders for my depression but did nothing for the anxiety - in some ways, it worsened it.
---------- Post added at 00:57 ---------- Previous post was at 00:52 ----------
When I was a student nurse, I did placements in GP surgeries and I saw first hand how drug reps work. Up to as much as once a week, a rep from a drug company would come down to the surgery at lunchtime, bringing lavish lunches for the nurses and GP's along with lots of drug company freebies. They would then casually tell us how great their drugs are compared to the others on the market. Thankfully there has now been a law passed to limit gifts from drug company reps to GPs to a maximum of £100. Is that not still bribing and bias?
That's actually quite scary. I know that this happens in the US, but didn't think it did in the UK where the GPs are trying to save money and prescribe the cheapest meds. I heard that one of the reasons why citalopram is so widely prescribed is because it costs something like £1 per box (generic). Escitalopram on the other hand costs £15 I think, hence GPs don't tend to prescribe this as frequently.
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