Need an antidepressant again & Ideas on which one?

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I was on antidepressants & other psych meds for 5 years for a psychotic depression. Shortly after being off everything I felt better than I did the entire time I was on them. I've been off them for around 6 years now & I hadn't thought of myself as depressed. Various things have been going bad in me & my girlfriends lives for a while now & she's been thinking I might be depressed. I felt depressed at times because of things going wrong but I didn't feel like I had depression. It seems like everything just goes wrong & I feel the more I try, the more things screw up. I feel more & more like a giant loser who's gonna fail with everything. I feel stuck & getting strung out. I've gradually been getting more emotional & moody. I cant be supportive with my girlfriend like I used to be & feel like I'm getting more dependent & needy with her. I haven't been sleeping great for along time; I have minor sleep apnea & plan to get a sleep study done awhile after I get surgery in a month correct a deviated septum(my nose is alittle crooked) but my sleep has been gradually getting worse lately. I don't want to talk about it here but just when things were starting to look up abit something horrible happened two days ago & I don't feel I can handle things like I've been anymore. I've been feeling like total sh!t the last two days & crying some because of it & feel totally guilty about it even thou logically I know it's not my fault & I shouldn't blame myself. I feel like I'm developing depression & I don't want to reach the point I was at 11years ago before I got help: I went to the ER for slashing my arm 9x.

I do NOT want counseling because I have communication problems with counselors & psychs due to my Aspergers & dyslexia. They misunderstood me which caused them to them misdiagnose me so their recommendations & treatment plans didn't work for me. I'd much rather talk to my GP & get on something(or possibly a couple things) to help hold me together till I can work through some stuff & life stuff improves alittle. I don't want to try any of the meds I was on when I was depressed before. Remeron/Mirtazapine made me really sleepy & tired(I was eating when I wasn't sleeping), Anafranil/Clomipramine made me shaky & hard to focus. I tried Prozac/Fluoxetine, Paxil/Paroxetine & Pristiq/Desvenlafaxine but don't remember much about them except I kept going back to Lexapro/Escitalopram after trying every antidepressant because Lexapro seemed to work better but my psych had me take 1.5 times the maximum dose; I took the max dose(20mg) at night & took half the max(10mg) in the morning. Lithium made me tired & have less energy & didn't really help with depression. I tried Strattera/Atomoxetine & a stimulant(I cant remember which one) & I think I'm better off avoiding ADHD meds. I had problems tolerating anti-psychotics & they caused side-effects so I'm not interested in getting on those meds sense my depression isn't psychotic this time but I would be open to considering Latuda/Lurasidone. I tried the supplements St Johns Wart & 5HTP & they made me more emotionally sensitive. I'm not interested in trying Wellbutrin/Bupropion or Cymbalta/Duloxetine because my girlfriend had bad side-effects on them.

I currently take Buspar/Buspirone for anxiety & Neurontin/Gabapentin for OCD & take Klonopin/Clonazepam when I go out & may be out on a crowded bus because I feel claustrophobic like which averages 1ce a week. I'm somewhat straight-edge & never did any illegal drugs or abused prescription meds but I would love to be able to get medical marijuana, narcotics or heavy sedatives rite now; I want to feel high or feel so out of it that I don't care or feel. I'm almost completely certain I won't be able to get those so I'm not gonna try & I'll scratch those ideas. I'm thinking an antidepressant like Trazodone might be a good try but I'd like other ideas to research & to have in mind when I see my doc.

the one that the doctor recommends

I haven't had good luck going with what the doctors recommend. I've had much better luck researching things & asking them about specific things like Buspar & Neurontin which help my anxiety & OCD better than anything else ever has & I only got on them because I asked about em.

It's possible the ones that gave your girlfriend side effects won't do that to you.My sister in law takes cymbalta and swears by it.Lexapro works good for me,I take 20 mg a day.All the side effects went away after awhile.
Good luck,I hope you find one that works for you.
If the state you are in has medical marijuana it could help you to sleep,you can get the edibles if you don't like to smoke.

That's the thing... since there are so many different variables in physiology... finding the right medication is a process...

My suggestion is you don't ignore doctors and go on taking medication by yourself. Its true they could have suggested medication that failed. Some conditions, and i would say psychiatric ones especially, are very hard to diagnose precisely, and the medication/therapy varies from person to person.

If a phychiatrist doesn't know what you have, what he will probably try to do is try to go escalating on trying different medications, which is the same thing you are doing on your own.
The difference is that he knows all of the side effects, and he knows how to go from least-risky to most-risky in terms of side effects (not only mental, but physiological (ex. Better liver tolerance)). Trying randomized drugs might have a result as much as causing you a lot of trouble. Phychiatric drugs have MANY serious effects on the body and are not to play with.

Also, for many psychiatric problems, medication is not always effective on its own and needs to be paired with therapy. Maybe you haven't found the right therapist, because its hard to direct someone undiagnosed to a specialist. My suggestion is you don't close yourself to therapy. Maybe tell your concerns to your GP?

Goodluck.

@Misslizard~ Your rite that everyone can respond to meds differently. She didn't tolerate Lexapro as well as I did on it. Part of the reason I'm concerned about Cymbalta is because she had bad withdrawal effects till she got on another med. I looked up Cymbalta withdrawal & lots have bad side-effects & some need to get put on other antidepressants &/or benzos just to help with he withdrawal effects. I think I need to be on something short-term till environmental & other things improve some & certainly hope I won't need to be on one for 5 more years so I think it's better to avoid Cymbalta. She tried Wellbutrin because she was having problems with being tired & lacking energy & her psych said it can increase it because it's kind of a weak stimulant. I don't experience lack of energy or feel too tired except when I get little sleep which has been gradually getting worse. I think something that would help me sleep would be better than anything like a stimulant because that would make my sleep worse.

@Feralucce~ The process is majorly complicated.

@Notimportant1~ I'm not taking or planning to take any psych related meds on my own. My GP prescribes Buspar & Neurontin but I was on them from another doc before I started seeing her a year ago. She prescribes Klonopin & my other meds too. I'm defiantly going to mention my concerns to her.

I think I just need something to help hold me together till some various things going on in life & things improve. I feel like I'm breaking down & I'd be better equipped to ride the changes out & continue to work on things if I had medication help. I'm going to listen & consider my GP's ideas but I'd like to have ideas of my own too going in & have researched different 1s that might seem more appropriate for this so we can discuss & pick together.

It has to be. certain meds won't work with certain body chemistries, others won't work unless they reach a certain concentration in the blood, some of them can be toxic at too high of levels, some are good for type one, others for type two... Add to that the fact that all of them take time to work... It is a process that is necessary in its implementation.

I suppose if you want something out of the left field you could give an MAOI a shot. It is a different class of drugs that some people swear by.

I took Nardil, an MAOI, and found it to be marginally more effective than SSRI's. However, I quit because of the food interactions. Importantly, this is one med you certainly don't want to take without a doctor recommendation. It interferes with other psych meds as well as food. You also want to have Nifedipine on you if you take it in case of an allergic reaction.

Myself, I'm on Celexa, Depakote, and Seroquel and it's like blah...whatever...i don't want to kill myself...great. I can't say I give it a glowing recommendation.

Most psych meds are pretty crappy. With the sole exception of antipsychotics for acute psychosis, they basically suck. But then again, I suppose my depression is biasing this post.

I don't mind your depression biasing your post because I'm interested in hearing others experiences here. I know not everyone responds the same way but hearing about experiences gives me more angles to factor in & analyze when making a suggestion or decision.

I'm a very picky eater so food interactions with MAOIs like Nardil would be a major concern but I doubt I'd have a chance of getting one prescribed without seeing a psych & trying other meds 1st anyways. If I was going to try an MAOI, I'd be interested in trying Moclobemide which seems safer than the others but it's not approved in the US so I'd have to order it online which I'm not planning to do rite now. It's aLOT safer & cheaper going to my GP. I'd also be open to trying the MAOI patch Emsam but I doubt she'd prescribe that either.

My girlfriend didn't have good luck with Celexa but I'd be willing to consider it & also willing to consider most meds I haven't mentioned or ruled out including all the Tricyclic antidepressants except for Anafranil which I had problems tolerating.

I'm experiencing agitation without anxiety at night maybe because I'm not doing much to distract myself & am worn out & upset from the day & everything else. I'm feeling pretty tired rite now from not sleeping well lately. What can help with depression, sleep & agitation?

I went to the health center today & my appointment is in a week.

I have difficulty understanding the difference between agitation and anxiety. Anyway, Risperidone at 0.5 mg helps me for anxiety, sleep and depression. A lot of people don't like Risperidone but antidepressants don't help me. This is an atypical antipsychotic that has serious side effects at relatively high doses. It can be used for autistic irritability. Good luck with what you choose.

The difference can be confusing. Agitation is kind of like restlessness, anger, irritability, & wanting to lash out at those around you. I tried afew anti-psychotics out including Risperidone which I couldn't tolerate the lowest dose of. I would be open to trying Latuda/Lurasidone sense it's newer & seems abit safer & different than the others I tried but other anti-psychotics scare me.

I'm sorry guys if I give the impression that I'm arguing or dismissing ideas. I sometimes analyze by kind of debating & I'm also frustrated & discouraged amongst other things. I'm kind of basing things off my previous experience of what didn't work for me before even thou that was at least 6 years ago & this depression is different & I'm different in some ways too. I really do appreciate the ideas guys & will keep them in mind.

so... you are self medicating?

I've been having scrips for all the psych meds I currently take & won't try anything else till I see my GP next week & hopefully get a script for one. I have been drinking one or two beers at night some nights to help feel alittle better, take the edge off & sleep alittle better but I didn't drink any last night. I don't plan to buy anymore 1ce the 12pack is gone because I would hopefully be on something else then & drinking alcohol with psych meds is more risky.

I considered EMSAM as well but it was very expensive so I dismissed it (I can't remember but it was well over $100 a month i think) Depending on your insurance, you might be able to get a better deal than I got. I think some doctors are willing to prescribe MAOI's and others simply aren't open to it. They are probably paranoid of a lawsuit or something in case something goes wrong (?) However, it might not be the right choice for you anyway.

I feel relatively stable on what I am on now but from my experience, they only work so much. They also tend to "poop out" I've been trying to avoid alcohol and getting some exercise which has been slightly helpful.

By the way, I have psychotic depression as well. When my depression gets out of hand, that is, I sometimes start thinking irrationally/hearing voices/etc. So you're not alone. It was really brutal for me. It started when I was a teenager, but I have noticed as I have grown older the psychotic symptoms seem to have faded out of the picture. The depression is under control, it's just I have a lot of issues related to not having a normal childhood. The severe depression I experienced in highschool and college hindered my social development. I lost a good chunk of my life.

I'm rambling but yeah, psychotic depression is about as bad as it gets.

Benzos are helpful. Just don't get addicted to them like I did. That was a hellish 4 months.