depression and medication

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Just wondering if anyone has had positive experience/results with anti-depression medication. I am considering overcoming my stubborn attitude against taking anything for depression. I've basically been unable to function normally or sleep through the night for three years. I really do not like doctors. At all. And side effects are always magnified with me - I'm over sensitive to everything. But I may need to compromise on this. Anyways, thoughts and responses appreciated.
(If there's already a topic for this then maybe mods can help).

I have dysthymia.... and when I found out in 97 about it, I refused meds. I have the same attitude about it as you do. But then I got so down about 5 years ago, I went to the local county health clinic -- to a nurse practitioner, who put me on effexor. OMG! bad experience, it relieved my depression, but it made me manic. I was on that for a year, and they should have taken the checkbook away from me, and also, I was >for the first time in my life< able to REALLY enjoy alcohol..... so... an SSRI was a bad choice for her to make. But we had no idea about the aspergers at the time. So I took myself off it {two days curled up in bed and suicical} and I was therefore VERY reluctant to try again. But this year, I was so incredibly down, even in the summer, which is when I usually recharge my batteries {so to speak} and I decided to try again. I went to my family doctor, the general practitioner, and he listened to what I told him about the other experience. I told him that I need small doses, and that the effexor had been a relatively small dose, it was still overkill in the "joy" department. I am now on 75mg of bupropion. {aka Welbutrin} and I am better, but I could up the dosage. The first few days I had insomnia, but that has passed and I actually sleep on a better schedule than without medication. So. All I can tell you is to go to someone that kinda knows you already for a prescription, and not to someone who has never met you before, and who's business it is to just throw meds at the sad cases in the whole county.... the amount of time they spend listening to you is very important... the quality of their attitude toward you is very important. Someone who is kind of a "public defender" on the public payroll is used to doing kinda shoddy care for as many people as possible. And it shows. Going to someone you pay and who has seen you before for other things, someone who's reputation for care is imortant to them will benefit you, and they are more likely to LISTEN to you. You are depressed, but you are still in charge of what you want to put into your body, and don't let anyone treat you like a doormat, just because you *might* feel like you're begging for relief..... at least, that's the thought process that I had to address for myself. You can stop taking whatever they give you whenever you want... and you have a right to refuse it if you think that they are just pushing whatever pill they got a whole pile of samples of.... maybe take your prescription home, then get on the internet and research it before you fill it. I wish I'd done that with effexor.... would have saved a lot of grief. I also, personally, don't recomment SSRI's for our aspie types of problems. But do your own research. when I told my doc about it, he said that was one of the worst for side effects and stuff. As a person who WAS born with depression, that's what dysthymia is, I am loathe to take something for it, but every now and then, I really need a break from the weight on my shoulders. And I am liking this welbutrin... I don't know how it's going to work in the long term. I notice doc only gave me 4 refills, and I don't know if that's to evaluate it's effectiveness, or if doc doesn't understand that the depression will actually never ever go away, it's just part of who I am. We'll see, I guess. I usually go in cycles, feeling pretty good by end of summer, as I've stocked up on sunshine, then scraping the bottom about April. This year, spring was delayed by rain... that just went on and on and on, and it threw my annual cycle off quite a bit.

edited because I got interrupted mid-post and ended up repeating myself ...

That's exactly the kind of thing I was wondering about. I don't even know what ssri's are. I have to learn about these issues; and then go to a doctor with at least some knowledge on my side.
I usually feel better in summer too, but this year it's just gotten worse for whatever reason.
Thanks, fleurdelily. I am a hermit myself. I want to get back to being a creative, content hermit.

For the time being, I couldn't function without citalopram. I went on it and started to feel a little better, but recently my depression got worse and I've been feeling very bad lately. I've had my dosage increased from 20mg to 30mg, it's too early to tell yet, but I do feel a little better after taking larger doses.

Anti depressents never worked for me. They either made me worse or did nothing at all. Usualy they just ended up f*****g up my physical health.

It seems like no one wanted to help me with my actual problems and just wanted to throw pills at me. I could walk into a hospital with a bleeding, gaping hole in my head and they would just write me a perscription and send me off.

It takes a lot of trial and error to find the right medication. I think it's important to be aware of the possible side effects so you can recognize them right away. As a general rule, I have found that if I feel different in some way that is not positive, the first thing to suspect is the drug.

SSRIs do a number on me. They make me much more depressed, as well as agitated, out of sorts. It's hard to describe. But I've had doctors insist that I should stay on them because they work. I have found that the judgment I have to trust is my own.

I am currently on lamotrigine (Lamictal) and Abilify, and I have found them to be helpful.

I agee with bee33, you really have to take time and try a lot of meds before you find the one that will work for you.

Our 15 year old has been on high doses of stimulants, which make him depressed. He begged his therapist for help when the depression got really bad, and started out with Lexapro. It helped, but not much. Then he changed to Celexa. Again, a little bit of help, but not much. Also, the combination of all the meds was really turning him into a zombie, and I just couldn't stand watching him feel so badly. I was really ready to yank him off of all of the meds. We talked with the therapist, and she changed him to Cymbalta and the difference in him is AMAZING -- he is as happy and cheerful and confident as he is when he's off all meds now. I really honestly didn't think this could happen -- I thought our choices would be a) use stimulants, have our son be focused and good at school, but a zombie and anti-social, or b) no stimulants, have a happy and social son who would be highly impulsive and say all the wrong things, therefore also causing social difficulties.

It would seem that things are pretty good right now, and our son is liking life again.

I hate to say it, but this took TWO full years to figure out. Hopefully it will take less time for you, but also, hopefully, you will be able to find the meds that work for you. A good, caring doctor and nurses are the important thing. Any kind of a doctor with a revolving door who throws meds at you won't be helpful.

well, this is looking like I'm back at the beginning - it's too freaky to think about endangering my already fragile state of mind with stupid side effects. I will have to figure out how to get comfortable with the depression indefinitely into the future.

[youtube]http://www.youtube.com/watch?v=AazObF_pHSU[/youtube]

I know people who take medicine are regarded by many to be lazy, even cowardly. That view truly annoys me, especially in light of the fact that my own medicine may have saved my life. And it isn't even an anti-depressant, but an anti-convulsant with what seems to be quite the happy side effect apart from its main job of controlling my seizures.

Sometimes I am sort of jealous of people who have found perfectly legal meds that work for them...lucky them. I still have to deal with the fact my drug of choice is technically illegal though even cops in my state don't seem to really give a crap about if people smoke cannabis...as long as they aren't out causing trouble they really don't seem to care. But still that is a little bit anxiety inducing that there are legal consequences.

[quote="Surfman"][/quote]

I agree with that u tube clip.

I don't take any anti-depressants, used to but I was too sensitive to them. Also don't find myself to be depressant, so I don't see why I should try them again. I just suffer big time from anxiety.

Thanks for all the responses and especially that youtube video. It reinforces my suspicions about the drug industry - the legal one I mean.
- mountain

I like what you have to say and wish to build on it. A whole lot of it is this trial and error in a respectful sense.

I. Change in Diet. Works great for some people, hardly does a thing for others. Trial and error in respectful sense.

II. Light Visor for Seasonal Affective Disorder (SAD). Again, great for some people . . . . . .

III. Medication. And yet again, great for some people, hardly does a thing for others, or has unacceptable side-effects. And that's just where the science is at this time. The biochem of the human brain is apparently very complex, and each person's is a little difference. And so, as I've read, the general game plan is try a medication with a light touch, and be ready to ease back and try another. (I sometimes struggle with depression, have read about antidepressants, have not yet tried them.) I have read that the side effects sometimes do abate. And, on the face of it, that's good news. However, it does set up an interesting dynamic in which the doctor can end up acting just like a wooden puppet with a string on the back. You pull a string and the doctor says, just try it a little bit longer. That is not helpful. It all depends on how bad the side effect is. So again, a person needs a light touch. If it's bad, stop taking it (phase out in stages if been taking it a while). And try something else. There are loads of stuff to try. We've had several positive recommendations here. They will work for some people, but probably not for others.

Like you, I also tend to be sensitive to medication. Can mention that to the doctor, and then look back on that conversation and continge it. If you feel like it was a good conversation, maybe follow the dosage laid out by the doctor, start with the smaller dose recommended and then ease in if needed. Or, if you feel like the doctor didn't really listen, then maybe start with a smaller dose on your own. And if necessary, just tell the doctor after the fact, still a little skittish, decided to start with a smaller dose. And same with stopping a medication (or phasing out), tell the doctor after the fact, or tell a new doctor. Just having these options available can give a person greater confidence. Doctors are used to patients not following orders, or should be. I've read that about a third of patients follow doctor's instructions, about a third kind of does, and a third doesn't. If the doctor fusses, kind of let it be like water off a duck's back. Or, doctor shop. Shouldn't be necessary, sometimes is.

And remember, a psychiatrist can prescribe antidepressents, but so can 'regular' doctors like internists or family practitioners. Who to see remains your personal choice.
Treating depression can be hit or miss (2009 article)
http://www.wrongplanet.net/postt163505.html


IV. Exercise. A slight bump for some people. More significant and cascades and flows in a positive way for others. Of course, when one is depressed without much hope of this working (perhaps realistically!) kind of hard to motivate oneself to try the experiment.

V. Sleep Hygiene. This is basically to find out about circadian clocks, and then light-touch experiments and find out about your particular circadian clock and continue to light-touch experiments.


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I will try and watch the video. I have read bad things about some clinical drug trials and am kind of scared of them. Or, at the very least, please remember that you have an absolute right as a human being to quit a clinical trial if in your judgment it is not promoting your health.

http://www.youtube.com/watch?v=AazObF_pHSU

Okay, some of my response to the video. . .

I kind of disagree with Ms. Olsen about the idea of "maintenance." Someone with diabetes is using medication for purposes of "maintenance," quite intelligently and healthfully. And if someone with depression has more of a biochem imbalance and needs the drug long term, so be it, thank goodness the drug is there. I am in favor of better living through chemistry.

Other people, might face a situation of less interaction (or less positive interaction) and thus the downward spiral of less feel-good healthy neurotransmitters running around in the brain, and thus even less activity and interaction, and then even less neurotransmitters. And medication can help turn this around and get a upward spiral going.

Provided the person gets the right medication for them. And then we're back to the point that something like Prozac (or Cymbalta or Wellbutrin) might work great for one person and not do a thing for another and it's impossible to predict in advance. It might be the 7th drug that works for a particular person, and aren't you glad you didn't get bogged down with the first six? Typically takes four weeks to tell if the thing's going to work or not (of course shorter if it has unacceptable side effects). The key is you having the patience to do this and finding a doctor with the patience to do this. And frankly, I think a person will have better luck with a family practitioner than an egotistic psychiatrist, but then, one pays one's money and takes one's chances. Or, doctor shop as necessary.

About 2:38 into the video, Gwen Olsen says there was a UK meta study that showed antidepressents no better than placebos. I'd be interested in seeing the study and stumbling and skimming through it the best I can (and these things are often more readable than a person might think), but one study is not going to be the end-all and be-all.

Please note: I AM NOT A DOCTOR. I'm just a guy who looks up stuff on the Internet. And yeah, sometimes you can run across some pretty good sources that are actually readable.

About 5:06 into it, Gwen talked about pharmaceutical companies using contrived data, cherry-picking patient populations, minimizing side effects (and I know they do that with buff, formalized language). This part I generally agree with her. Yes, compared to academic institutions and independent research, I think Big Pharma has too damn much power and obvious conflicts of interests. Something we as citizens should be concerned about and step-by-step start correcting.

NB I am a suspected - but undiagnosed - Aspie

I do have some experience with psychiatric drugs, however, as I have struggled with depression off and on pretty much my whole life and have been in the mental health system in the UK since a major breakdown a couple of years ago.

I found citalopram (an SSRI) to be a complete waste of time. It made me feel worse initially and for the first couple of weeks each time the dose was put up. After that, despite ending up on 40mg which is a high dose, it had no effect on me at all. In the end I refused to take it.

I found duloxetine (brand name Cymbalta, an SNRI I believe) to have a similar effect to citalopram, except that I did not realise this initially as I was not taking it in isolation in the first instance. It also made me rather manic at the 60mg dose and interfered with my sleep.

I found zopiclone (a hypnotic i.e. sleeping pill) very ineffective after the first few nights use. It also left a bad taste in my mouth the next day. It might be good for occasional use though and did not cause any drowsiness the following morning. I did find I needed to take the full 7.5mg as 3.25mg did not work.

I found zolpidem (also a hypnotic) to be very helpful for a prolonged period of time, although I did need to take 15mg, which my GP said was more than the normal dose. It also did not cause any drowsiness the next day. However, when I stopped taking it, even though I weaned myself off gradually, I had terrible trouble sleeping, so it may be a double-edged sword.

Aripiprazole (brand name Abilify, a neuroleptic/antipsychotic/major tranquiliser) made me so antsy I literally could not sit still. This seems to be quite a common side effect, from talking to people, although some people do take it just fine. I didn't stay on it long enough to find out how it affected my mood.

Olanzapine (brand name Zyprexa, also a neuroleptic...) was a great help for me. It just seemed to calm everything down and bring my mood and emotions under control until I could cope with life again. 15mg seemed to be the optimum dose for me. The two major drawbacks were that I put on a LOT of weight the first few months I was on it which I couldn't shift until I stopped taking it, and that it was hard weaning myself off it as my emotions were quite raw for a few weeks. I wouldn't recommend it though unless you are suffering major distress as these are a powerful class of drugs and can have serious side effects, especially if used long-term.

Buspirone (an anti-anxiety med) had no effect on me whatsoever. I can't remember what dose I took as I wasn't on it for very long.

I also take topiramate (brand name Topamax, an anti-epileptic) for a neurological condition. There is some research to suggest this could be used to help with emotion regulation but at either of the doses I have been on I haven't noticed it having any effect in this area.

These are just my experiences, they are probably very little help as you will more than likely react completely differently to anything you take anyway. I guess the main point is that you should always tell your doctor if something isn't working for you, or you can't cope with the side-effects, as there is usually something else they can try, and if you decide you've had enough you can stop taking meds at any time.