antidepressants - s&d, CoD, evil bitches, cash cows and saviours of sanity

the thing that's weird to me with a lot of the newer drugs is that some of them sound like they are "downers" but are being used as "uppers" ... or idk ... realizing how much of my assumptions about psych meds come from the mandatory Reagan era "Just Say No to Drugs" class everyone had to take in the 1980s

I recently upped my paroxetine to 40mg, and my doc said that we could still go up to 60.

never liked the upper/downer terminology
i get that "stablization" or "regulation" doesn't quite have the same ring to it, though

i've been having terrible issues with dry mouth for a while now. i don't know if it's medications, anxiety, some combination of the two, but it's really driving my spouse up the wall, particularly the sound of it. i don't particularly want to change any of my meds, because they're working for me (aside from not really having any pharmaceutical options that work on my anxiety that is!)

it took me a while to understand how amphetamines were effective against adhd, precisely because of that "upper"/"downer" schema. well i say "understand" but i'm not a pharmacologist, "accept" really. i blame binary thinking and sapir-whorf but then i blame binary thinking for everything.

having a bit of a suboptimal time with venlafaxine. only on 70mg. it really worked to lift me out of a period of pretty bad anhedonia were i was spending all weekend lying around my house, isolating myself, being morose around my gf, and taking sick days from work for invented illnesses etc. so, that's great, that's honestly amazing, and i almost can't complain.

but otoh ive just been partying too much. like any opportunity for a late night rager I've been taking. I've had to decide not to drink at all for a while because it got pretty out of hand. now this might be because i am a heavy drinker and a lot of my socializing is around alcohol, but to be honest i do feel sort of wired and hyperactive, and am having some trouble sleeping also. then for more iltmi type content: I'm finding it super hard to orgasm, which is unfortunate. also I'm v sweaty.

that's one of the ones i've never done. are you seeing a therapist? when i get on ups i start to worry about crashing...

sweaty anorgasmic cru UNITE

jim, my experience with venlafaxine, which lasted about two-and-a-half years, was pretty similar to yours, it sounds like - i had to stop drinking entirely because being drunk on venlafaxine just felt terrible, like it took all the fun buzziness out of it and left a weird tinny hollow reproduction of drunkenness which was just... blecch

i found it a pretty decent mood stabiliser while i was on it (135mg for most of the time) and it definitely helped me get back on my feet but now that i'm a month or so off it i've realised just how much it sawed off the edges of every emotion and put me at a distinct distance from my own life - that was what i needed for a while for sure but now i feel much more connected to my emotions, for good and for ill

anyway, good luck with it - hope it helps get you where you need to be

sweaty anorgasmic cru UNITE

― michael keaton IS jim thirlwell IN ‘foetaljuice’ (bizarro gazzara)

not to get into iltmi territory but 20 years of PSSD on top of... other things... has changed my outlook

i used to worry about having my emotions blunted. either that's not happening with the sertraline or my emotions are so intense i appreciate having them blunted.

xp. thanks bizarro. venlafaxine hasn't made my drunkenness feel worse, but it gets me more drunk and gives me stamina to drink more than i should and stay up too late. which is also bad obv.

rusho, im not seeing a therapist. i keep meaning to get on that but while I'm not typically "cis man won't seek help or go to doctor because dumb male issues" - I'm very happy to go to my gp and am open with her about how I'm doing etc. - I'm sort of reluctant to talk to a therapist but i probably should.

i think my main issue with the idea of talking to a therapist is that generally there is nothing wrong with me and no specific issues I'm working through other than not enjoying everything and being anxious. I'm not really sure what id say to a therapist.

the therapist will know what to do
this does not sound like "nothing" other than not enjoying everything and being anxious
i can't tell you how many times i have heard a cry of distress followed by a walking back ("nothing wrong with me") and refusal to try therapy.

in fact, i used to be this person and i used to think this way and have since drastically reconsidered. i am better off for having changed my mind. can't speak for anyone else's experience but mine has been very helpful.

I dislike how therapy tends to put the onus on the patient when oftentimes depressive situations are unacceptable for reasons utterly beyond our control. Which isn't to say that nothing is to be done, but there's an undercurrent of victim-blaming that systematically comes to the fore when you're faced with a subpar therapist.

xp. by nothing wrong with me i more mean I'm not working through some specific issue(s). i feel those ways but i don't have a specific reason to. of people i have been close with who have gone to therapy they've been dealing with issues such as bereavement of parent at young age, dysfunctional family, childhood abuse and bullying, trauma, body dysmorphia, persistent suicidal ideation etc. ive had the great fortune of having a blessedly uneventful life.

i had a bit of a hallelujah moment the first time i heard about intergenerational trauma because my father had a very traumatic set of experiences in his youth as a political prisoner in chile, but i don't really know a) what the mechanism of the transferral of this trauma is supposed to be - my father seems to have struggled with undiagnosed ptsd for a decade or so but was a great dad - b0 what are you supposed to do about trauma you didn't actually suffer?

otm.

I am several years without a therapist now after my relationship with my last one ended extremely badly and while I miss it, it took a while for me to build that sort of trust again and it will be doubly hard next time. The absolute best who I moved away from was assigned to me by the NHS and she was genuinely life saving for me and I think of her guidance often.

in some sense i honestly appreciate therapy putting the onus on the patient because for me bemoaning the shitty state of the world in general was a pretty decent distraction from dealing with my actual problems (also so many people had it worse than me, etc etc). it's been good for helping me deal with stuff i'm responsible for without guilt and shame getting in the way and fucking up my ability to cope.

i have also found that therapy has been a very good complement to mood-stabilizing drugs and has helped them be maximally effective for me.

At its best it helps you snap out of defeatism. At its worst, however, it impels more guilt: 'So you think you've done everything you can to cope with the eradication of your soul? Well, you need to do more'.

So I kind of hate the psychopharmacologist I am seeing who is attached to my therapist's office. I have been taking the 2 mg of Abilify as she suggested, despite being really wary, and now the positive effects are kind of wearing off and I am left with only the side effects. So I asked if there was a withdrawal from Abilify and she said no. I then looked online and it seems there is a lot of withdrawal associated with it. She suggested I go down to 1 mg per day because I am still having trouble sleeping since I started (I wake up about 4-5 times throughout the night). I originally had more energy but jitteriness and now I feel like I have less energy again and am just am left with the jitteriness I think. She said if I have less energy from it I should go up to 5 mg but she thinks that I don't really want to do that, which I don't.

So all I want is for her to increase my paroxetine dose to 40 mg but she doesn't want to because she doesn't think it is helping me. However, she wants to add 10 mg the week before my period and for me to take birth control so I don't get my period bc now she is sure I have PMDD. She says that paroxetine doesn't help with energy, only depression. But I think if I am less depressed I would have more energy.

She's very combative with me and doesn't listen to what I want and she is super expensive. So frustrating! Has anyone tried going off of Abilify and did you have any side effects?

Also, this woman says she doesn't like paroxetine because it leads to weight gain, whereas in my research it seems Abilify if much more tied to weight gain. I asked her if she could suggest anything else for me and she was like no, because then we would have to taper you off the paxil (?!). So she's basically doesn't like Paxil but has no suggestions for me other than adjuncting with Abilify.

How do you find a good prescribing doc? This woman charges $250 per half hour! Previously I was getting meds from my GP and honestly it was a much better experience, and a whole lot cheaper.

The fact she thinks weight gain is the worst possible side effect is pretty telling

ditch her, she sucks and no one is worth 500 an hour, what the hell?? I'm so sorry

She sounds like someone who is not interested in learning anything new for the rest of her life, because thinking is hard, but being a credentialed 'expert' lets you off the hook for doing any new thinking ever again.

haha, thanks guys! my friend knows someone who takes my insurance so I will try and get an appointment with someone else. she's young too! like in her 30s...

The book Rabbits for Food has some pretty funny commentary on psych meds...the character says no to the exact same thing my psych prescribed to me.

I am a fan of psych nurse practitioners (and NPs in general). For most stuff I would take an NP over an MD every day of the week. Nurses rule.

She is an NP :( Just a very stubborn one. Hi Q!

Paxil seems like bad news, in a new way.

Coupland et al, 2019. Anticholinergic drug exposure and the risk of dementia: a nested case-control study. JAMA Int Med.

Hi VP! Sorry ‘bout your bad NP :(

^^ haha, I mentioned that study to my NP (I had read it in the NYT). She hadn't heard of it, but got very annoyed and said that she didn't know why Paxil should be linked to dementia, unless you ate so much that you got lethargic and didn't move around very much--hence leading to dementia.

oof

boy that is an unfathomably stupid response from a medical professional

So the NP just called me bc my therapist tried to intervene on my behalf and she said, “So, I don’t want your therapy sessions to be taken over by discussing medication.”’ And then she said she would up the Paxil if that’s what I wanted and I said yes and then she said she was on the train and basically implied she was not available to discuss further so I said thank you. She has the worst bedside manner! Hopefully insurance will cover this latest dosage. I feel like she is threatened and angry that I am questioning her judgment. She said nothing about if
or when or how I should taper off the abilify.

I have been taking sipralexa for years. Afraid to go off it. The issues which caused my anxiety have been solved (more or less) but I’m afraid to go off it. :-(((

So I saw the psych nurse for the last time. I have an appointment with a doc who takes my insurance in a month. I stopped taking the Abilify due to side effects and now she recommends Lamictal and Ativan. Thoughts?

Careful with the ativan is my only thought. Benzo addiction is no joke.

Good news for once: Met with a psych my coworker recommended who takes my insurance and he questioned everything the NP prescribed and told me stop taking the Lamictal and to start taking Wellbutrin on top of the Paxil and see how it goes. If it goes well he said we can lower the Paxil and up the Wellbutrin. He's still ok with me taking benzos to sleep, even though I asked him about the danger of it. Glad to be back in the land of on-label usage. The best part about it: my copay was $15. Hopefully my summer of experimentation with legal drugs is coming to a close. Good luck to everyone dealing with this bs! And thanks to those who listened to me whine and offered advice.

Lexapro/Cipralex turning out to be utterly insufficient so far; I felt better for a few weeks and experienced some of the common side effects at the initial dose, but before long both side effects and intended ones fell away entirely. Got my dosage upped and felt no change. Took the step of upping it again and once again feel no different. (We're talking 10mg->15mg->20mg here.) I have a (virtual) consultation with a new doc next week, we'll see how it goes I guess. Did other folks experience a similar arc?

(At that first uppage I asked my clinic doctor if my brain was simply "too powerful", which he did not seem to find amusing.)

friendship ended w lexapro, now zoloft is my best friend*

*remains to be seen actually

zoloft and i are currently friends with benefits, i also went to it as a rebound from my most recent breakup with lexapro

we're doing ok for now but navigating ltrs with antidepressants is really challenging, i just feel like a lot of them aren't able to make a long-term commitment

as mentioned previously lexapro was nice for a bit but became both emotionally and physically absent very quickly, oh well

time to find out if I get insomnia OR sleep like a log, I love brains

Anybody ever get a feeling like you've missed a pill but you haven't? A few times in the last couple of weeks I've had a low level spacey, zappy feeling, just like I'd missed a day really. Just wondering if this is a thing?

yes get that quite often, slightly wobbly in head. I got one of those pill dispensers with a different compartment for each day so that I can keep it straight (although other health problems contribute more to my day/time confusion)

I definitely took it this morning tho. I hear even a few hours can make a difference and tbh I may have a bug, can't tell what's physical and what's not at the moment

oh I meant that I got the dispenser so I can tell that I did take it that morning even though I'm feeling the wobble. it tends to go away by the next day though. do you get it lasting more than a day?

Nah, just happening on odd days, maybe for a few hours

I could use a dispenser like that

Yes, but as far as I can tell it’s totally random, no idea why it happens

That's why I asked really, not alarmed but good to know other people have experienced similar

Yeah, I get that all the time. I can never remember if I actually did miss a day or not

Same over here. My memory's so bad that I should probably start using my dispenser again but, er, I forget to fill it. (I always thought pill dispensers would make good band merch, I think at least a couple of people have done that but more people should do it.)

I used to get pills with the days printed on the packet but thattlonh gone