What does tolerance means? Does it have a limit? [Archive]

panic_down_under

02-06-20, 00:11

Hello!
I want to know the real meaning/explanation of tolerance mentioned in Benzos
Does it mean that your body and brain will never & ever get enough of the usual drug dose by time, until you reach the toxic fatal dose?

Yes, the drug becomes progressively less effective as the number of binding sites diminish, or become less sensitive.

I take myself as an example, I started Lorazepam in 2016, 1,25mg was enough to get me relief, but now it doesn't kick-in until I pop 5 pills of 2,5mg which equals: 12,5mg

Which is an excessive dose. The recommended daily maximum is 9mg. Is your doctor prescribing that, or are you getting lorazepam elsewhere? If it's your doctor then he/she needs to be held to account.

I'm severly depressed and anxious, and tried many antidepressants with no success, my mental health is extremely poor.

Benzodiazepines (BZD) should only be used for short periods as they make anxiety, and especially depression worse. They trigger the brain changes that underpin these disorders.

What antidepressants have you tried, how long did you take each of them and at what dose.

I dont't even mind if a doctor gives me Tramadol which is addictive too.

Which would be a very stupid thing to do.

I'm Hopeless!

No one is ever hopeless, but it can take a while to find the right treatment.

SufferingSilent

02-06-20, 10:56

I want to thank you so much!
Believe me I'm anxious and deseprate to the point where I cannot even continue this topic.
I'm sick of myself...
I think I need to pop up some more Lorazepam to funcionate a bit...
No doctors had prescribed me more than 1,25mg. I'm just abusing it... on my own.
I'm currently trying to enter rehab center, but I'm still hopeless, not sure if they can fix me.
What do you think they will use as medications to get me off this deseperate situation? I think Gabapentin is good? or what about lithium, lamotrigine, ...?
I'm also thinking to stop abusing Lorazepam and head to Beer/Alcohol since they have same effects, they relief emotions, I want to get the blues I think, because my emotions are dead now, I can't cry to relief, and Im sure you know this means that I'm very close to a suicide.
I need to mention too, that few days ago I mixed expired Amitrptlyne with Escitalopram and it gave me the Serotonin Syndrome at a mild case, but mild in this situation means hell, thankfully I fixed it by 4 pills of 2,5 Lorazepam.
RESUME: I'M SUCH A MESS NOW!
I don't mind killing myself because in my thinking I know that I will die by the end, if not today, than it is tommorrow or after 20 years, but my mothers love me and I don't want to bring her more emotional pain.

panic_down_under

02-06-20, 12:39

I think I need to pop up some more Lorazepam to funcionate a bit...

Lorazepam isn't helping you to function, it is doing the opposite.

I'm currently trying to enter rehab center, but I'm still hopeless, not sure if they can fix me.

I know nothing about the Algerian health system and how it works, but I urge you to see a doctor today, or perhaps even better go to the nearest hospital emergency department and tell them what you've posted here.

I'm also thinking to stop abusing Lorazepam and head to Beer/Alcohol since they have same effects, they relief emotions

No, they don't. Both BZDs and alcohol make this worse. They only fool you into thinking they are helping while they slowly atrophy your brain, literally corrode parts of your brain. It is this loss of brain cells which produces anxiety and depression.

I need to mention too, that few days ago I mixed expired Amitrptlyne with Escitalopram and it gave me the Serotonin Syndrome at a mild case, but mild in this situation means hell, thankfully I fixed it by 4 pills of 2,5 Lorazepam.

There was probably nothing to fix as serotonin syndrome is unlikely with that combination. However, there are other potential dangers. What were you trying to achieve with this stupidity?

I don't mind killing myself because in my thinking I know that I will die by the end, if not today, than it is tommorrow or after 20 years, but my mothers love me and I don't want to bring her more emotional pain.

Then stop feeling sorry for yourself and seek help. There is no reason why you can't recover from this and have a happy, fulfilling life, but you need to make the first move.

SufferingSilent

03-06-20, 20:16

About the Amitryptline/Escitalopram mix, I was hopeless trying to get a relief from my miserable depression.
Because currently I cant describe the hell Im living...
Cant watch a movie
Cant concentrate reading
Cant relax in my bed
Cant listen to music...
Literally disabled...

Today a doctor started me on this mixture:
07h00: Clomipramine 25mg / Lamotrigine 100
(I've heard Lamotrigine is not for major depression, so what is this doctor doing to me?)
12h00: Clomipramine 25mg / Lamotrigine 100mg / 1.25mg Lorazepam
22h30: Quetiapine 50mg (for sleep)
I prefered to take Lorazepam at 12h00 while he told to me to take by night.
*I fill a very a bit of lift in my mood, I think it is Lamotrigine, even though I've googled about it and it seemed to be a nasty drug that causes serious side effect like rash and Steven Johnson.
I'm asking is there similar alternatives to Lamotrigine that do not cause rash and Steven Johnon Syndrome.
Thank you so much panc_under_down for being careful to my case, I was really need someone to give me just of a bit of emotional help like you did.

panic_down_under

04-06-20, 00:55

About the Amitryptline/Escitalopram mix, I was hopeless trying to get a relief from my miserable depression.

Taking an antidepressant (AD) (or combinations of ADs) does not have an immediate effect on depression (or anxiety). They work by stimulating the growth of new brain cells (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels (alcohol (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4568748/) and BZDs (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374628/) also do this). The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly, and they take time to bud, grow and mature. For a more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF (https://www.americanscientist.org/sites/americanscientist.org/files/20057610584_306.pdf)) and How antidepressant drugs act (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/).

Because currently I cant describe the hell Im living...
Cant watch a movie
Cant concentrate reading
Cant relax in my bed
Cant listen to music...
Literally disabled...

This probably isn't all from depression. I suspect the benzodiazepine (BZD) abuse is also a factor.

Today a doctor started me on this mixture:
07h00: Clomipramine 25mg / Lamotrigine 100

I'm impressed that he chose clomipramine. Arguably, the most potent non MAOI class AD available. A much better choice, imho, than SSRIs and especial SNRIs.

(I've heard Lamotrigine is not for major depression, so what is this doctor doing to me?)

I assume it is to lower the risk of seizure from rapidly decreasing the lorazepam dose plus reduce agitation and to lift your mood.

I think it is Lamotrigine, even though I've googled about it and it seemed to be a nasty drug that causes serious side effect like rash and Steven Johnson.

The risk of these side-effects is tiny, between 0.08-0.3%, plus 100mg is a low dose and I assume you won't be on it for more than a few weeks.

I'm asking is there similar alternatives to Lamotrigine that do not cause rash and Steven Johnon Syndrome.

There are alternatives, but all medications potentially have some side-effects and given you probably won't be taking lamotrigine for long I see no pressing reason for switching to another med.

SufferingSilent

05-06-20, 09:50

I stopped Lamotrigine it gave me auditory Halliculations...
I was hopeful for it to work for me, now Im such a mess...
I going to use only Escitalopram (older prescription) in the morning and Lorazepam 1.25 by night.
I'm done with this!!!
Sometimes I think of a high dose of Lorazepam to make some courage and thow myself in front of a semi truck in the highway.
I miss old life
I miss enjoying massive collections of old music
I can't concentrate enjoy on anything... no music, no movies, no long walks, no car trips, nothing at all...

panic_down_under

05-06-20, 12:35

I stopped Lamotrigine it gave me auditory Halliculations...
I was hopeful for it to work for me, now Im such a mess...

Have you discussed this with your doctor? If not you should.

I going to use only Escitalopram (older prescription) in the morning and Lorazepam 1.25 by night.

Why the escitalopram and not the clomipramine?

Sometimes I think of a high dose of Lorazepam to make some courage and thow myself in front of a semi truck in the highway.

Applying a permanent 'solution' to a temporary problem doesn't sound sensible to me, and your problems are temporary. Plus, you might get it wrong and be in an even worse situation than you now are.

I miss old life
I miss enjoying massive collections of old music
I can't concentrate enjoy on anything... no music, no movies, no long walks, no car trips, nothing at all...

There is no reason why you can't have that all again, but there are no quick fixes. This is going to take some time, and it may not always be easy. On thing you need to change is going off on your own path with medication. If you have a problem then you need to discuss it with your doctor, not just change things on your own. Most of these meds need to be taken at the same time every day without fail and at the dose prescribed.

SufferingSilent

05-06-20, 16:26

SufferingSilent

05-06-20, 16:31

Do tou think I have some kind of dysthymia.
I remember doctor told me mý case is Pyschique (in French) and he scared me so much saying that, I felt hopeless when he said it...
Did he meant that my depression is kinda unfixable and very vicious.

panic_down_under

06-06-20, 01:21

I stopped Clomipramine because I took it in 2016 and it was reaaaaal awesome in the beginning but it lost all effect after only few months, when it worked, I experienced a real new version of me, I was very social, happy, fully satisfied with my mental statue but unfortunantely it stopped...

What was the dose?

I think I have good reaction to only Tetracyclic antidepressant and may be also (Tetracyclic antidepressant which I have never tried one of them)

Tetracyclic ADs are mirtazapine and maprotiline neither of which are good antidepressants, ime. Did you mean tricyclic antidepressants (TCAs)? If so clomipramine is a TCA.

Have you tried escitalopram, or another SSRI in the past? If so was it effective?

What do you think if I ask my doctor to try me on Trimipramine and leave Clomipramine, and in case Trimipramine crashes again I switch back to Clomipramine may be it will work again if it leave my system.

Trimipramine is a weak serotonin reuptake inhibiting TCA. Clomipramine is a potent serotonin and noradrenaline/norepinephrine reuptake inhibiting TCA. Imo, clomipramine would be the better choice.

I bought Melatonin now and I set up my own prescription like this:
07h00: Escitalopram 10mg
21h00: 1.25mg Lorazepam / Melatonin
I've checked on drugs.com interaction and there is no serious interactions in this.
The problem is that I can't stay awake and I always force my self to sleep due to depressive mood.

I'm confused. You can't stay awake, or you can't sleep?

Do tou think I have some kind of dysthymia.

Probably. Dysthymia is a less severe form of depression than 'major depression' but it is longer lasting unless treated. Major depression has stronger symptoms, some can become almost catatonic, but it tends to have more and longer periods of remission between episodes whereas dysthymia can continue for years without a break.

I remember doctor told me mý case is Pyschique (in French) and he scared me so much saying that, I felt hopeless when he said it...
Did he meant that my depression is kinda unfixable and very vicious.

Anxiety disorders and depression are physical disorders as I wrote in an earlier post. They are caused by a loss of brain cells due to high stress hormone levels in the brain (or the prolonged use of alcohol, or BZDs). Both therapy and ADs work by stimulating the growth of new brain cells. Your condition is not hopeless.

SufferingSilent

06-06-20, 19:14

Clomipramine dose was 50, after we tried to 150, but no positive. It stopped working for my depression.

Yes I tried some of Escitalopram, Venlafaxine... but I think I didn't give them a lot of time...

I meant I can't stay awake and have pleasure to live my day like normal people, I have no pleasure to do my hobbies... All I want to do is stay sleep, and I abuse a bit of Quetiapine because of this to force myself to sleep all-day. It effective at first at 50mg but now I raised it to 100mg on my own, and If I try it on 200mg I feel my heart going slow and feel like a zombie (such a disguisting feeling) and gives me nightmares, I can't tolerate more than 100mg of this drug.
One doctor gave me chlorpromzine 100mg and he told me to do 200mg If I can't sleep, and it was such a nasty drug, I felt like a zombie on it, I HATE all that family of drugs "Phenothiazines" ( and I tried one time another one of the same family called NOVAZIN, generic: Lévomépromazine.
I suspect my negative reation is because I might be having a cardiac issue. (NOT SURE JUST GUESSING)
As always Im feeling hopeless even though Im trying to get myself hospitalized in psychatric hospital for my major depression and lorazepam abuse, and my brain is still saying to me that even the hospital is not going to fix you, all I have is a dark negative cloud on my brain.
I'm asking my mother to buy me a treadmill to start exercsing on it, may be it will help me a bit. At least I start exercising before bed and take my 50mg Quetiapine to sleep.
I have hope on drugs like Gabapentin as I saw on drugs.com, most people loved it and it solves their depression, but unfortunately I'm sure that is impossible a doctor will give to me here in Algeria, since they're abused on street with Pregabalin.

panic_down_under

07-06-20, 02:00

Clomipramine dose was 50, after we tried to 150, but no positive. It stopped working for my depression.

How long did you take 150mg?

I meant I can't stay awake and have pleasure to live my day like normal people, I have no pleasure to do my hobbies... All I want to do is stay sleep, and I abuse a bit of Quetiapine because of this to force myself to sleep all-day. It effective at first at 50mg but now I raised it to 100mg on my own, and If I try it on 200mg I feel my heart going slow and feel like a zombie (such a disguisting feeling) and gives me nightmares, I can't tolerate more than 100mg of this drug.

One doctor gave me chlorpromzine 100mg and he told me to do 200mg If I can't sleep, and it was such a nasty drug, I felt like a zombie on it, I HATE all that family of drugs "Phenothiazines" ( and I tried one time another one of the same family called NOVAZIN, generic: Lévomépromazine.

You need to stop self-prescribing medications because you clearly don't know what you are doing. Forcing yourself to sleep all the time with sedating drugs such as quetiapine and chlorpromazine is making your depression worse. Stop doing this nonsense please!!!! :mad:

As always Im feeling hopeless even though Im trying to get myself hospitalized in psychatric hospital for my major depression and lorazepam abuse, and my brain is still saying to me that even the hospital is not going to fix you, all I have is a dark negative cloud on my brain.

That is the depression talking. Stop listening to it.

I'm asking my mother to buy me a treadmill to start exercsing on it, may be it will help me a bit. At least I start exercising before bed and take my 50mg Quetiapine to sleep.

Exercise has been proven to significantly ease depression. Does anxiety make it difficult/impossible for you to leave the house/apartment to go for a walk?

I have hope on drugs like Gabapentin as I saw on drugs.com, most people loved it and it solves their depression, but unfortunately I'm sure that is impossible a doctor will give to me here in Algeria, since they're abused on street with Pregabalin.

Gabapentin and pregabalin are not antidepressants, although they may ease anxiety triggered depression. They do the same thing as BZDs, but by a different mechanism. BZDs slow down neuron 'firing' by making it easier for negatively charged chlorine ions (Cl -) to enter neurons making it harder for them to raise their internal voltage to the depolarising (firing) point. Gabapentin/pregabalin achieve the same result by inhibiting positively charged calcium ions (Ca ++) from entering the neurons.

SufferingSilent

07-06-20, 19:19

panic_down_under

08-06-20, 00:59

I now started thinking that may be Lorazepam or other drugs has damaged a certain part of my brain that regulates mood.
The damage look permanent and unfixable, not sure If I can survive more with this mood...

Lorazepam and whatever other drugs you took may have reinforced the hippocampal atrophy initially caused by high brain stress hormone levels, but this is reversible with antidepressants and/or therapy. It is not a permanent condition unless you decide to make it so by continuing down the destructive path you seem to have been on with self medicating. OTOH, if you follow the treatment prescribed by your doctor you will likely recover to lead a normal life. It is really up to you.

SufferingSilent

15-06-20, 22:06

I posted this on a facebook group but they deleted it, anyone can give me ideas, im hopeless, please do not ingore:
https://i.ibb.co/cwnvrtj/Screenshot-20200615-220214-Facebook.jpg (https://ibb.co/JqJds29)

panic_down_under

16-06-20, 00:49

The rehab centre may use meds like carbamazepine (Tegretol) to help ease withdrawal, but I don't think getting off lorazepam is the most important issue at the moment. Getting your anxiety and depression under control is. Are you taking the antidepressant prescribed by your doctor? If not, you should.

SufferingSilent

16-06-20, 05:35

Yes Im trying my best, but the doctor is not giving me much time to, it gives me only one week to see her again, and as you know antidepressants recommends at least 3 or 4 weeks to see their benefits.
Im currently retrying Paroxetine which it didn't work in 2016, but we decided to give it another shot.
Thank you panic_under_down, Im really happy to find people like you, I wish you the best in your life.

panic_down_under

16-06-20, 10:11

Yes Im trying my best, but the doctor is not giving me much time to, it gives me only one week to see her again, and as you know antidepressants recommends at least 3 or 4 weeks to see their benefits.

More likely 5-12 weeks. As this is not your first time of antidepressants it will probably be closer to 12 weeks than 5 weeks.

Im currently retrying Paroxetine which it didn't work in 2016, but we decided to give it another shot.

I thought you were trying escitalopram

SufferingSilent

16-06-20, 12:57

No I stopped it, Im seeing a new doctor now...
Is it possible that it can work now for me, (Paroxetine) while it didn't in 2016 which I had bad reaction to it in that time... have you seen similar cases like this? people who tries the same antidepressant that it didnt work for them after trying them a long time ago, sorry for asking such miserable and stupid questions like this... I hope you feel how miserable I'm trying to fix this low depressive mood.

I have set this list of meds that I still have faith in them, especially Abilify.

● Antidepressant I didn't try:
TRIMIPRAMINE
MIANSERINE
SERTRALINE
FLUVOXAMINE
ESCITALOPRAM (I did not give it much time to see if it works or not)
DULOXETINE / CYMBALTA
CLOZAPINE
CITALOPRAM

MAPROTILINE
MIRTAZAPINE

●Neuroleptics: (I hate zombie feeling drugs, I want something to give me mental energy and emotions like Clomipramine did to me before it pooped out)
ABILIFY
SULPIRIDE
OLANZAPINE
...
(What do you think?)

Sorry that I didn't tell you that I had some psychotic ideas in past, once I gave my money on the street to people thinking that god was telling me things to do...
Also lost a job because one time I had paranoia and thinking god was telling me that my father did an accident on road after taking me to my job location and I had to quit the job to check the road where my brain was telling and lying to me.
But for now I learned to manage this problem, I don't respond to these psychotic obsessions anymore, the only struggle I have now is the extreme low mood and the zero motivation to do things I once enjoyed, like walking 6kms everyday and spotting old and interesting cars around me, collecting music, use my pc... I lost all interest because of the low mood...

panic_down_under

17-06-20, 05:27

Is it possible that it can work now for me, (Paroxetine) while it didn't in 2016 which I had bad reaction to it in that time... have you seen similar cases like this? people who tries the same antidepressant that it didnt work for them after trying them a long time ago,

Depends on why it didn't work. How long did you take paroxetine and at what dose?

I have set this list of meds that I still have faith in them, especially Abilify.

Antidepressant I didn't try:
TRIMIPRAMINE
MIANSERINE
SERTRALINE
FLUVOXAMINE
ESCITALOPRAM (I did not give it much time to see if it works or not)
DULOXETINE / CYMBALTA
CITALOPRAM
MAPROTILINE
MIRTAZAPINE

Imo, the pick of these are citalopram/escitalopram and sertraline. Trimipramine, mianserin and mirtazapine are not really antidepressants, but antihistamines which mostly ease anxiety by sedation and aren't really effective for depression. Mianserin and mirtazapine are nearly the same med. Mianserin was the makers first attempt and it soon proved useless so they came out with mirtazapine which is actually a weaker AD than mianserin. The fact it is still popular demonstrates the power of marketing and the placebo effect. That isn't only my opinion, see: Mirtazapine: dubious and misleading evidence supporting its dual action status (https://psychotropical.com/mirtazapine-dubious-evidence/) and Mirtazapine: dubious and misleading evidence supporting its dual action status (https://psychotropical.com/mirtazapine-a-paradigm-of-mediocre-science/) by Ken Gillman (http://scholar.google.com.au/citations?user=ea6KeD0AAAAJ&hl=en) who knows more about antidepressants and neurotransmitters than most.

Fluvoxamine is generally the pick of the SSRIs for OCD spectrum disorders, but the TCA clomipramine is the better med, imo. the SNRI duloxetine is often very effective, but can produce severe side-effects at the beginning so I'd try the TCAs amitriptyline, imipramine, or clomipramine first.

Neuroleptics: (I hate zombie feeling drugs, I want something to give me mental energy and emotions like Clomipramine did to me before it pooped out)
ABILIFY
CLOZAPINE
SULPIRIDE
OLANZAPINE

...
(What do you think?)

All the neuroleptics and anti psychotics are sedating to some degree.

Sorry that I didn't tell you that I had some psychotic ideas in past, once I gave my money on the street to people thinking that god was telling me things to do...
Also lost a job because one time I had paranoia and thinking god was telling me that my father did an accident on road after taking me to my job location and I had to quit the job to check the road where my brain was telling and lying to me.
But for now I learned to manage this problem, I don't respond to these psychotic obsessions anymore,

Where you taking anything at those times which may have triggered, or worsened the psychotic episodes?

the only struggle I have now is the extreme low mood and the zero motivation to do things I once enjoyed, like walking 6kms everyday and spotting old and interesting cars around me, collecting music, use my pc... I lost all interest because of the low mood...

Your best chance of recovering is by taking an antidepressant daily exactly as prescribed for at least 12 weeks and none of the other crap you've experimented with. There is no quick fix. It will take months before you begin seeing positive results.

SufferingSilent

02-07-20, 05:57

Hello again!
No I wasn't taking anything illegal when I was delusional.

I'm now on week 3 Paroxetine after switching from Clomipramine, every next week feels worse than the previous one, should I switch to another antidepressant or just keep giving it time and feel more worse and worse?
I feel unstable and my ocd is back now with the intrusive thoughts and the distress. (it was 20% controllable on Clomipramine now it's less than 5%)

panic_down_under

02-07-20, 13:12

No I wasn't taking anything illegal when I was delusional.

What about legal medications and substances, alcohol, for example?

I'm now on week 3 Paroxetine after switching from Clomipramine, every next week feels worse than the previous one, should I switch to another antidepressant or just keep giving it time and feel more worse and worse?
I feel unstable and my ocd is back now with the intrusive thoughts and the distress. (it was 20% controllable on Clomipramine now it's less than 5%)

Unfortunately, antidepressants will often make things worse at the beginning and typically take 5-12 weeks to begin working well. Given you've been on paroxetine before it will probably take closer to 12 weeks than 5. Frequently changing ADs will just prolong the agony. Take a small, repeat small dose of diazepam, say 2mg to 5mg maximum, if you have it, but only if you need it, or maybe ask your doctor to prescribe a small dose, 7.5mg, of mirtazapine as a sedative.

SufferingSilent

02-07-20, 18:21

12 Weeks which is 3 months.
When I started Clomipramine I didn't feel worse at first, but I was given Lorazepam with it, it was my first time Benzo, it was giving me much relief. Now I have built such a high tolerance on Benzo so that none of them will work on me in little doses.
Even most doctors in my country won't give you the medicine you suggest.
I've never tried Mirtazapine before, but I think I asked my doctor and she said it is not available in Algeria, I think she lied to me... because I found it avaliable on the online Encyclopedia of meds in Algeria:
http://www.pharmnet-dz.com/m-2552-remeron-30mg-comp-enro-b30

SufferingSilent

02-07-20, 21:18

panic_down_under

03-07-20, 09:37

Does everything that affects GABA builds tolerance and lose efficacity by time?
I wanted to ask my doctor about Zolpidem for sleep but I already have Lorazepam tolerance (doesn't work until I reach 10mg+).
I think it will be useless, right?

I'm afraid so. Tolerance to BZD sedation typically develops quickly, often within a few weeks and this is true of both benzodiazepines and meds such as zolpidem which target the same BZD binding sites. The anti anxiety effect is produced by different binding sites and tolerance is much slower to develop, especially with the long half-life BZDs such as diazepam and chlordiazepoxide.

SufferingSilent

06-07-20, 09:01

I've stopped taking Paroxetine 40mg after few days, almost a week (I was 20mg for the 2 previous weeks). The extreme bad mood started being unbearable, and my suicidal ideas went so bad, this medication is clearly not for me.
I wanted to ask about the best combinations of antidepressants? Do you know some about this? And can you mix an SSRI with TCA? I've checked on drugs.com that it causes the serious hell of Serotonin Syndrome (I remember one time a doctor add me Venlafaxine to Clomipramine, was it trying to kill me with this evil way of Serotonin Syndrome, I'm not afraid of death but I'd rather git hit by a semi truck than diying by a SS)
Althought I think they can be mixed but in low doses right? (TCA with SSRI)
Please if you can list me the best effective AD's combinations.
Thank you so much.

panic_down_under

06-07-20, 10:18

I've stopped taking Paroxetine 40mg after few days, almost a week (I was 20mg for the 2 previous weeks). The extreme bad mood started being unbearable, and my suicidal ideas went so bad, this medication is clearly not for me.

Have you considered only taking 20mg to see whether it works?

I wanted to ask about the best combinations of antidepressants?

I'm not a fan of taking multiple ADs unless other options have failed and you are a long way from that.

Should it ever become necessary the best initial option would be taking the SSRI sertraline and if it didn't work adding the TCA nortriptyline to make a tailored SNRI. This was the preferred combination of old time psychopharmacologists before SNRIs became available and many still rate it as better than any of the SNRIs.

And can you mix an SSRI with TCA?

Some yes. The only two that are a definite no are clomipramine and imipramine. Amitriptyline is generally okay as long as not taken in excess. The others don't have enough serotonin action to trigger serotonin syndrome.

I remember one time a doctor add me Venlafaxine to Clomipramine, was it trying to kill me with this evil way of Serotonin Syndrome

Sigh! Do doctors in your country use computers to print prescriptions? If so, they usually flag such errors. If not the pharmacist should pick it up. This is the reason people should only see one doctor and get all medications from the same pharmacy.

SufferingSilent

06-07-20, 18:51

Yes, I've seen my psychiatrist today she decreased the Paroxetine to 20mg.
About the computer use of prescriptions, it varies but most doesn't I think.
My doc now is putting me on:
20mg Paroxetine
10mg Clorazepate (Tranxene) x2 times per day, I'm sure it will be useless since Lorazepam is more powerful than Clorazepate and I have already a high Lorazepam tolerance.
25mg Hydroxyzine
200mg Amisulpiride (Solian)
Thank you panic_under_down

panic_down_under

07-07-20, 00:58

My doc now is putting me on:
20mg Paroxetine
10mg Clorazepate (Tranxene) x2 times per day, I'm sure it will be useless since Lorazepam is more powerful than Clorazepate and I have already a high Lorazepam tolerance.
25mg Hydroxyzine
200mg Amisulpiride (Solian)
Thank you panic_under_down

Yes, the clorazepate is unlikely to do much on its own, however, hydroxyzine may help as it has strong anti anxiety properties. Not quite as potent as the BZDs, but often potent enough to make a difference. Unfortunately, the dose is low, but that might be because of a potential interaction with the amisulpride and clorazepate. Amisulpride should also ease anxiety levels.

SufferingSilent

17-07-20, 07:08

I respect so much my psychiatrist because of her humanity but last time I got angry of her and blurted out of it office cursing on myself, she wants to force me on this hell of Paroxetine, and I'm done with it... 6 weeks is enough for me to take all that torture, it was unbearable along with the useless Amisulpride / Atarax. (at least for me, everyone reacts differently)
And she refused to give me 100mg Quetiapine for sleep, I'm completely dependent on it.
I've seen another doctor after having a breakdown in front of my family I was crying and miserable...
He gave me Escitalopram/Abilify, I don't know what I'm heading now...
At first he wanted to give me Zyprexa but after telling him that I'm already not having a normal rhythm of sleeping because I spent most day sleeping and agitated in my bed he switched to Abilify after I purposed on him.
NOW! what do you think about this new mess... I know Abilify is not very loved and welcomed but at least there are some good reviews about it... and comparing it to Zyprexa which one do you think from your experience is the best for a bad mood major depression.

panic_down_under

17-07-20, 08:54

she wants to force me on this hell of Paroxetine, and I'm done with it... 6 weeks is enough for me to take all that torture, it was unbearable

What are the problems with paroxetine? Side-effects, or not working?

He gave me Escitalopram/Abilify, I don't know what I'm heading now...

You have been on escitalopram a couple of times recently, but each time stopped taking it after only a day, or two. What was the reason for doing this?

which one do you think from your experience is the best for a bad mood major depression.

None of the anti psychotics. However, I think the doctor prescribed it mostly to keep you calm until the escitalopram begins to work, not to treat the depression directly.

SufferingSilent

17-07-20, 12:50

1. The paroxetine seemed to make me worse, It made me worse than Anafranil, I started crashing on it in front on my family, I cry and beg them for help... I'm going mad, 5/6 weeks should be enough to see a bit of improvement not making me worse like it did.

2. I stopped the Escitalopram after 2 days of 3 because of switching doctors a lot, I'm hopeless...

I'm on my first day now on Abilify 10mg / Escitalopram 10mg and I already experiencing extreme yawning, I'm not sure if I will take more of it in the next days, it seems like just another poison to avoid...
I think I will keep taking Escitalopram only for 1 month and see what will results.
My psychiatrist offered me Hospitalization but I don't know what to do, I feel courageless, I keep asking myself what are they doing to me since I have tried a lot of meds without success (but most meds I didn't give them time)
Imagine I don't even have energy to wash my feet and take a shower.

SufferingSilent

17-07-20, 12:52

Do you mean antipsychotics are useless at treating depression?

panic_down_under

18-07-20, 00:27

Do you mean antipsychotics are useless at treating depression?

Clozapine (Clozaril) has shown promise in treating depression, the others less so and at least one, haloperidol (Haldol), may reverse the positive effects of antidepressants.

However, all antipsychotics with the exception of haloperidol can have other benefits when prescribed with an antidepressant for depression. They are less useful for anxiety and so should not be prescribed (https://www.nice.org.uk/donotdo/do-not-offer-an-antipsychotic-for-the-treatment-of-generalised-anxiety-disorder-gad-in-primary-care).

SufferingSilent

18-07-20, 12:31

Clozapine looks good it effects GABA's too no? Olanzapine too?
You meant Haldol is bad when used with antidepressants, makes them ineffective?
Dear panic under down you cant imagine the stage of depression I'm struggling with now, even washing my feet is nearly impossible now can't even hold of glass of water, since I have a belly fat and weight gain because of meds, I was very skinny before meds, I was about 70kg and I'm now 111kg which is causing me extreme distess...
Not sure if my depression is fixable now snice I started being bothered with real life problems especially weight gain... not irrational intrusive thoughts.
Forgot to tell tou that I have Bromazepam now and I just started abusing like Lorazepam before...
I will try to give my point of view here which is related to my problem and psychiatrist.
Now we simulate:
When a new depressed patient (never took meds) goes to a psychiatrist he will be given an antidepressant and a benzo as always, so the benzo works fastly to fool the patient that his medication is working but in the other hand an unwell informed patient would think that both antidepressant and the benzo are working... but when tolerance builds and the antidepressant is not effective he will be thrown in the deep hole of medication trials and the inefficacity of benzos.
END.

I asked my docs about Gabapentin since it would do the same job as benzos but with strong GABA action but they told me it is unvailable in Algeria, Lyrica I think exists, what do you think about the Lyrica? even though I'm surely no doctor would prescribe to me because they are abused on street.
And I really really need something to ease my extreme emotional depressed mood until my antidepressant start working.

By the end I started thinking tha psychotherapy is a big deal because when you have a good therapist who is intellegent and well informative he will diffenitly helps you.

If I enter Hospitalization what do you think they will do them?
i heared my doc that she will put me on Anafranil Injection cure?! is it different than pills?
Ans what do you expect about things that happens in Hospitalizations?

panic_down_under

19-07-20, 03:15

Clozapine looks good it effects GABA's too no? Olanzapine too?

Clozapine binds with GABA(B) receptors which increases dopamine neurotransmission. OTOH, benzodiazepine target binding sites on GABA(A) receptors. Olanzapine binds only weakly to GABA(A) receptors.

You meant Haldol is bad when used with antidepressants, makes them ineffective?

Yes, because it inhibits hippocampal neurogenesis.

Dear panic under down you cant imagine the stage of depression I'm struggling with now, even washing my feet is nearly impossible now can't even hold of glass of water, since I have a belly fat and weight gain because of meds, I was very skinny before meds, I was about 70kg and I'm now 111kg which is causing me extreme distess...

You need to exercise more. Not only will it help reduce your weight, but it has been shown to increase hippocampal neurogenesis just as ADs do, although not as strongly.

Forgot to tell tou that I have Bromazepam now and I just started abusing like Lorazepam before...

You need to stop abusing BZDs. This is making your condition worse. Take one if anxiety becomes unbearable, but only then.

I will try to give my point of view here which is related to my problem and psychiatrist.
Now we simulate:
When a new depressed patient (never took meds) goes to a psychiatrist he will be given an antidepressant and a benzo as always, so the benzo works fastly to fool the patient that his medication is working but in the other hand an unwell informed patient would think that both antidepressant and the benzo are working... but when tolerance builds and the antidepressant is not effective he will be thrown in the deep hole of medication trials and the inefficacity of benzos.
END.

BZDs should not be routinely prescribed with an AD and especially not for depression, only if AD induced anxiety become an issue and then only for a few weeks until the heightened anxiety from taking the AD diminishes.

I asked my docs about Gabapentin since it would do the same job as benzos but with strong GABA action but they told me it is unvailable in Algeria,

Gabapentin does not act via GABA. It is not a BZD. BZDs work by increasing the infux of negatively charged chlorine ions into cells which inhibits their ability to reach their depolarisation (firing) potential. Gabapentin (and pregabalin (Lyrica)) work by inhibiting the infux of positively charged Calcium ions into the same cells. The result is the same, they just do it from opposite directions.

Lyrica I think exists, what do you think about the Lyrica? even though I'm surely no doctor would prescribe to me because they are abused on street.

Pregabalin does exactly the same thing as gabapentin. They are developed by the same company. Pregabalin is the better medication because gabapentin has low bio-availability and it become less bio-available as the dose rises. You need to take much more than twice the dose to get twice the effect. Pregabalin generally has fewer side-effects than gabapentin too. I do not recommend either. You'd just be replacing one addiction with another.

And I really really need something to ease my extreme emotional depressed mood until my antidepressant start working.

Then you shouldn't be taking either gabapentin, or pregabalin, or a BZD. These are all nervous system depressants. They are making your depression worse.

By the end I started thinking tha psychotherapy is a big deal because when you have a good therapist who is intellegent and well informative he will diffenitly helps you.

If therapy is available then it can be as effective as medication.

If I enter Hospitalization what do you think they will do them?
i heared my doc that she will put me on Anafranil Injection cure?! is it different than pills?
Ans what do you expect about things that happens in Hospitalizations?

Hopefully, they will wean you off BZDs and treat you with an AD only until you begin to recover. You might also be offered therapy. I don't know why your doctor has suggested intravenous clomipramine (Anafranil). It has no advantage over the pills as far as I know.

SufferingSilent

23-07-20, 19:14

Thank you so much!
I was in Hospital from last Sunday, I got out today, things were awful, they were mixing toxicomans with psychotics and I was bothered by people there for cigarettes, and they made only worse.
Now I'm out taking Venlafaxine 75mg (they will up my dosage by time) / Clorazepate x3 times / Quitiapine for sleep as I've become depedant on it for sleep but I noticed it have became a bit useless recently and my original dosage was 100mg for a good sleep, now I have only 50mg, I suspect it will not knock me for good sleep. So I will probably go back to Hospital and ask them for Nozinan oral solution (drops) I heard they are good for sleep.

SufferingSilent

23-07-20, 19:16

Doctor also will put me on RTMS for soon.
And I will not switch doctors from now, this only make things worse.

panic_down_under

24-07-20, 01:21

Now I'm out taking Venlafaxine 75mg (they will up my dosage by time) / Clorazepate x3 times /

So the antidepressant has been changed again? This is :curse: ridiculous!!!! :mad: It is vital you stay on one AD and only one AD for at least 3 months. Do not change it again no matter what stupid :curse: doctors tell you. If whatever you take is not working effectively at the maximum dose after 3-4 months then a change may be necessary, but not before.

Quitiapine for sleep as I've become depedant on it for sleep but I noticed it have became a bit useless recently and my original dosage was 100mg for a good sleep, now I have only 50mg, I suspect it will not knock me for good sleep.

Quetiapine and other similar medications which sedate by inhibiting histamine H1 receptors are usually most sedating at low doses and become less sedating as the dose increases.

So I will probably go back to Hospital and ask them for Nozinan oral solution (drops) I heard they are good for sleep.

NO! Not while you are also on both venlafaxine and quetiapine. All three may trigger heart irregularities, taking 3 at the same time is not recommended. A good doctor would be able to adjust doses to compensate, but from what you've posted the doctors treating you are of questionable competence.

WiredIncorrectly

25-07-20, 19:04

If you've been given Quitipline (spelling?) surprised they've not tried promazine. That's an anti-psycotic and it works wonders for me. My doc has me take 2 doses at night and that helps get me to sleep. It took a while to get the right timings for my meds; everything was wonky for a bit.

I'm on promazine, paraxatine and valium. All 3 have me stable right now.

Not sure about tolerance. My tolerance has remained the same, except when I've purposely abused the Valium. Which is a benzo. There was a stage my anxiety was so messed up I was taking double the dose prescribed. That can build up a tolerance to the point where you need more to feel the effects but it soon decreased again. You'll feel a mess for a bit. Tbh though not sure I could live without them.

The body will build up some sort of dependency to any drug that helps you. And it can be hard to get back on track when they start messing with your medications. Been there so many times.

Personally, I trust my team now. I trust their judgement and follow what they advise. So far so good, but if they shook my tree I'm pretty sure I'd be all over the place.