Why are SSRI’s too stimulating !!!!!!

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I have lost hope in ever being in remission again from anxiety and depression and feel lost in the blur of which is which....I have always found remission in medication- But this episode has lasted over 4 years and I’m poly drugged, so so unsure and scared to try to change anything. As it may result in total disaster any advice or help please !!!!

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I have lost hope in ever being in remission again from anxiety and depression and feel lost in the blur of which is which....I have always found remission in medication- But this episode has lasted over 4 years and I’m poly drugged, so so unsure and scared to try to change anything. As it may result in total disaster any advice or help please !!!!

What are you taking, at what dose and what were you on the last time you achieved remission?

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What are you taking, at what dose and what were you on the last time you achieved remission?

I’m screwed PDU we have spoken before if you recall ??? I haven’t been able to tolerate any SRI meds, be it SSRI/SNRI they just cause untold skin burning and hot flashes

I therefore take Lyrica to help dampen this side effect and I also take Diazipam, Mirtazipine and Brintellix (The latter causing the burning)

I have tolorated this for 3 years trying to force my body to accept this painful and distressing Side Effect. But it’s still there, albeit not as fierce.

Lyrica is an awful drug - weight gain, black outs, diarrhoea, nose drip and water sensation in ears and head.

Brintellix- anxiety, skin burning, bruxism - although a good antidepressant effect. But not good enough!!!!!

Mirtazipine- relaxed feeling, after 10 years tolorance has built to its sedative effects

Diazipam - think this attenuates the Lyrica and not much else...But skip it and holy crap

Can’t see a way out I want the weight gone the anxiety gone the bruxism gone the skin burning gone the black outs gone the diarrhoea gone the running nose gone and of course the residual depression gone....All just get up and fly away !!!!! Dreams for now, but will loose everything in time I’m sure of that

Thanks if anyone had stuck with this post Ta J

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I’m screwed PDU we have spoken before if you recall ??? I haven’t been able to tolerate any SRI meds, be it SSRI/SNRI they just cause untold skin burning and hot flashes

...Brintellix- anxiety, skin burning, bruxism - although a good antidepressant effect. But not good enough!!!!!

No point in taking a med that doesn't work as well as you need especially if it is causing side-effects so unpleasant that you need to take other meds to make life barely bearable.

Lyrica is an awful drug - weight gain, black outs, diarrhoea, nose drip and water sensation in ears and head.

And you're taking this just to tolerate the vortioxetine induced burning sensation?

Btw - I suspect much of the weight gain is caused by the mirtazapine, not pregabalin.

Mirtazipine- relaxed feeling, after 10 years tolorance has built to its sedative effects

Sedation is about all mirtazapine does...and stack on weight.

Diazipam - think this attenuates the Lyrica and not much else...But skip it and holy crap

Yes, and it is counteracting the positive brain effects of the vortioxetine, although pregabalin might be lessening this to some extent.

Can’t see a way out I want the weight gone the anxiety gone the bruxism gone the skin burning gone the black outs gone the diarrhoea gone the running nose gone and of course the residual depression gone...

SSRIs and SNRIs are not the only ADs, or the most effective. The only advantage they have is being safer in overdose and this isn't actually true of all of them. You would likely to do much better with one of the TCAs and without all the other crap although you'll need to keep taking them for a while till you can slowly wean off them.

Who is your GP, the Marquis de Sade?

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No point in taking a med that doesn't work as well as you need especially if it is causing side-effects so unpleasant that you need to take other meds to make life barely bearable.



And you're taking this just to tolerate the vortioxetine induced burning sensation?

Btw - I suspect much of the weight gain is caused by the mirtazapine, not pregabalin.



Sedation is about all mirtazapine does...and stack on weight.



Yes, and it is counteracting the positive brain effects of the vortioxetine, although pregabalin might be lessening this to some extent.



SSRIs and SNRIs are not the only ADs, or the most effective. The only advantage they have is being safer in overdose and this isn't actually true of all of them. You would likely to do much better with one of the TCAs and without all the other crap although you'll need to keep taking them for a while till you can slowly wean off them.

Who is your GP, the Marquis de Sade?

Thanks PDU I have a good understanding of TCA’s and even MOAI’s, but the thought of going through all the trial and error with AD’s again will be the end of me.

However I can’t live a full quality of life as is and in the past I found Peroxatine to be my saviour. It was beautiful and I was a poster child for it....But I came off and went back on it to many times, then it bit my arse big time. I thought nothing would ever help again....Then I researched and asked for Effexor, which didn’t cause any SideFX and eventually worked up to 375mg and still no relief.

They tried adding meds but I couldn’t tolerate them, until Mirtazipine came along and I slept like a baby and felt my crushing depression beginning to lift, albeit a very slow process. Which only ended up in full remission after nearly a year and then titrated off the diazipam.

But now I can’t tolerate any SRI meds, they all cause the same side effects hot burning stinging sensation...I have kicked around switching to imipramine, but I don’t have the bottle to risk it !!!!!

I know you were once on imipramine and it worked very well for my mum too. I’ve got a job and house that would be at risk if it goes pear shaped.

So feel trapped in this situation of my own making !!!

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But now I can’t tolerate any SRI meds, they all cause the same side effects hot burning stinging sensation...I have kicked around switching to imipramine, but I don’t have the bottle to risk it !!!!!

You don't necessarily need to jump from the frying pan into the fire. Talk to your GP about doing a slow cross taper. I suggest switching to amitriptyline rather than imipramine as it is less serotonergic so eliminating the risk of simulating the burning sensation by synergy.

The norepinephrine reuptake inhibitor nortriptyline is another possibility. In the past it was often prescribed with sertraline, both at highish doses, to make a bespoke SNRI. Vortioxetine+nortriptyline is likely to be more effective combo than vortioxetine+mirtazapine and you could slowly reduce the vortioxetine to a dose you can tolerate, or wean off it completely.

[AntsyVee]

Hang in there buddy, you’ll get it figured out eventually

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You don't necessarily need to jump from the frying pan into the fire. Talk to your GP about doing a slow cross taper. I suggest switching to amitriptyline rather than imipramine as it is less serotonergic so eliminating the risk of simulating the burning sensation by synergy.

The norepinephrine reuptake inhibitor nortriptyline is another possibility. In the past it was often prescribed with sertraline, both at highish doses, to make a bespoke SNRI. Vortioxetine+nortriptyline is likely to be more effective combo than vortioxetine+mirtazapine and you could slowly reduce the vortioxetine to a dose you can tolerate, or wean off it completely.

Hi PDU I appreciate your input and suggestions...I feel the only way forward reality is to start by swapping out the Vortioxatine, as I feel this is causing the most distressing side effects. Ie. Skin burning, bruxism and it’s useless for anxiety.

And as I consider myself to suffer from highly anxious and agitated depression, so anything that may stimulate will make matters worse not better, or even remain the same.

I have a full awareness of Dr Ken Gillman and his YouTube channel, plus website and it all sounds accurate good information to me.

However why did I completely recover after only 6 weeks on Peroxatine??? It was an amazing AD and is the strongest SSRI. I have never had a drug turn me round so fast and make me feel so good...Why is that ???? I don’t know !!!!

If I could only find another Peroxatine I would be a happy man again, for now I live a life, albeit not to the quality I used to have.

Truth is I’m on 4 meds and they don’t play nice together, so I have been trying to work out what’s causing what and think I’ve got a handle on that.

I understand the difference between TCA’s some being bias toward serotonin and some bias to noradrenaline and some more balanced ie. Amitriptyline and some bias to noradrenaline ie. Nortriptyline....But to be honest I don’t think it’s the serotonin that’s the problem, I think it’s the mechanism of action that’s causing it.

I took Amatriptyline a couple of times at the beginning of this protracted episode and first time just wanted to fall asleep, no other side effect, but the second time I took it I also took duloxetine and Mirtazipine and had a huge panic attack - I had to take a lot of Diazipam to stop it and that spooked me with it...Don’t know why this didn’t happen the first time.

As for weight gain PDU I agree Mirtazipine will make you sleep and eat - Well pregabalin will do the same so double the weight gain and your screwed !!!!

Also pregabalin isn’t a walk away from med and will blow up in doctors faces as Benzos did !!!! Their being dished out for everything!!!!

Sorry for rambling on so long - But I do feel TCA is the way to go, but not with vortioxatine, so swapping that out, without falling into the pit of debilitating depression and anxiety. I like the idea of Amatrip but that PA spooked me, I also like the idea of imip or even Clomipramine the strongest serotonin biased TCA.

I don’t have the burning reaction to TCA’s but it’s getting through the drop in one med and the start up of another and as you know people with high anxiety disorders don’t do well on switching meds !!!!

Thank you PDU your input is validating and adding value to my current knowledge, which is pretty good. But not as extensive as yours pal Ta John

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Hang in there buddy, you’ll get it figured out eventually

Thanks I’ve been battling for nearly 4 years now, which is too long and I never thought I’d still be trying to sort meds out for this long Ta John

[pulisa]

Surely your GP can't be in charge of prescribing all these drugs?