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Discussion Starter #1
My husband has been depressed off and on for years, just recently it has become worse.

He has been telling me that I don't know what I'm talk about up until this past week. He finally went to the dr and now has a referral in for therapy and if in a month or 2 he is still not feeling better THEN they will give him meds.

Anyway, I am wanting to know what meds have worked for you or your spouse. I've seen that a few of you say Paxil is the devil. I would just like to have a list ready of meds that have had better results.

Thank you.
 

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There's really not a "list". It is very important to have a proper evaluation by a trained mental health professional. They actually do testing to determine what the mental problem areas are; and then make medication recommendations based on that. All depression can not be lump into "one size fits all" category. That's why so many medication failures are common place. All too often a general practitioner simply prescribes what the drug detailer is pushing for the week--not necessarily what the patient needs.

It's also good that your husband is being sent to therapy first. Sometimes that is enough. I was in therapy a couple of years and was holding my own until I became very ill. After that, I just couldn't handle everything on my own. I have been on Zoloft for over a year. It has definitely helped.
 

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Very true. And, I understand what you're saying. I just wanted to see what has worked for each person. There are certain meds that the majority say "oh hell no!", so I wanted an idea personal experience's. Make sense?

Thank you for sharing what what worked for you. I'm hoping therapy is enough.
 

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He has been telling me that I don't know what I'm talk about up until this past week. He finally went to the dr and now has a referral in for therapy and if in a month or 2 he is still not feeling better THEN they will give him meds.
It's nice to know that his doctor is a retard who don't know a damn thing about medicine. Pretty much every study about any mental problem has shown that drugs and therapy together are more effective than one or the other.

Anyway, I am wanting to know what meds have worked for you or your spouse. I've seen that a few of you say Paxil is the devil. I would just like to have a list ready of meds that have had better results.
Drug efficacy depends on the condition being treated. Different types of depression need different medication. For treating low energy and lack of motivation along with severe social anxiety, these are my ratings in order of efficacy:

Paroxetine (Paxil): 0/5
This drug causes extreme sedation, but it also causes insomnia. It's like having the flu or something. Extreme tiredness and desire to sleep, but can't sleep. Just lay in bed for hours and hours. The insomnia makes depression worse in every possible way. This drug had no addictive properties for me because I felt no desire to keep taking it.

Duloxetine (Cymbalta): 1/5
This drug feels like an anxiety attack. Stuff gets done, but it's not enjoyable. It improves motivation and energy, but it makes depression worse. I had no desire to keep taking this drug.

Trazodone: 2/5
This drug is given to help with sleep, but it sucks. It doesn't cause the kind of tiredness that makes me want to sleep. In terms of effects, it's basically the opposite of Sudafed because it blocks adrenergic receptors. That causes some sedation, but it also makes breathing more difficult, so the sedation does not lead to sleep. Trazodone gets a 2 instead of a 0 because it immediately stops panic or anxiety attacks. If I drink too much coffee and it leads to uncontrollable shaking or stomach pain, trazodone stops that shaking and pain. Others have said that trazodone is a great sleep aid, so it might be worth trying. This drug did not feel addictive.

Sertraline (Zoloft): 3/5
I didn't really feel better, but things got done. It made work a lot easier because it mostly reduced anxiety. Instead of procrastinating on things like phoning people or answering emails, they would get done immediately. I didn't really have any social life while taking this drug. This drug also caused night sweating, which was unpleasant. If you're stressed about work, this drug is worth trying. This drug felt strangely addictive because I had an unexplainable desire to take more of it all the time.

Venlafaxine (Effexor): 3/5
This drug was very effective stimulant drug, but it caused GI problems when swallowed whole. Chewing the pills fixed the GI problems, but that ruins the time release, so the drug wears off after 5 hours. Those 5 hours felt great, but the crash was not pleasant. I stopped taking this drug because I don't want to be forced to take drugs every 5 hours just to avoid crashing. Even though it's a great drug, it felt less addictive than sertraline. I didn't feel compelled to keep taking more of it, and my gf had to constantly remind me to take more of it to fix the 5 hour crash.

Moclobemide: 3/5
This drug is incredible. It makes everything feel awesome. The down side is that it wears off extremely fast. I can go from feeling great to shaking uncontrollably in less than 4 hours. Moclobemide is a newer MAOI that is reversible, which makes it safer than older MAOIs, but that also makes it have a short effect. I plan to switch this over to phenelzine, which is an old MAOI that permanently disables the MAO enzyme and therefore has a much longer effect.

Bupropion (Wellbutrin): 4/5
This is a stimulating drug. It helps with energy, motivation, and depression, but it does not help with anxiety. It makes life a lot easier. It has a very long effective half-life, so it's a nice and stable drug. I could forget to take it for a week and still not feel any withdrawal. The down side is that the lack of any addictive properties makes it easy to forget about taking it.

Citalopram (Celexa): 5/5
This drug is excellent. It has some effect on motivation, but it greatly helps with depression and anxiety. I started keeping a journal while taking this drug, and I became interested in writing about everything. Journal entries written while taking citalopram were extremely long, detailed, well-written, and positive. The journal entries mostly focused on people and social activity. I was on an 80mg dose when this was going on. I changed doctors and the new doctor said the limit for this drug is only 40mg, so he switched me to 40mg. I felt this wasn't strong enough, so I had to take something else.

Fluoxetine (Prozac): 5/5
This drug helps a lot with anxiety, and drinking alcohol with it causes intense euphoria. I don't feel as social as I was on citalopram, but I'm a lot more focused on science and learning. Instead of writing about my own thoughts, I like to read things. Everything feels a lot softer on this drug, and I like snuggling a lot more. This drug has a very long half-life, so it's stable like bupropion. People who are trying to break SSRI addiction are often put on fluoxetine because fluoxetine is much easier to stop taking due to its slow metabolism.

Mirtazapine (Remeron): 5/5
Like trazodone, mirtazapine is a sleep aid. The difference is that mirtazapine is an excellent sleep aid. I very quickly gained 30 pounds on this drug because it makes food taste incredible, and most people think I look much healthier with that extra weight. Mirtazapine causes restful sleep, and that really helped with anxiety. This drug was incredibly addictive because it made everything so much better. The first thought after getting home was that I should take mirtazapine and chill out. I had to stop taking mirtazapine because I couldn't control my desire to take mirtazapine then eat food all evening.
 

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Discussion Starter #5 (Edited)
Thank you for your take on each drug. It helps to see it broken down like that.

I feel that he needs drugs NOW and then that combo'd with therapy, take his dosage down as he starts to feel and handle things better. But, it's the military and real drugs come last.

He has told me that he has no energy, no motivation and nothing makes him happy anymore. He spent this whole past weekend in his room on base doing school work and sleeping. He never initiated contact with me or the kids, but would respond if I texted him. I asked when his referral should go through and he said another week or 2 and the therapist's first appointment isn't till half way through Dec. WTF? I asked him to please call tomorrow (today) to try to get everything pushed through faster and he responded with "stop telling me what to do." So I left it at "I care and worry about you and we want YOU back. I'm just trying to help the best I know how with what options I have from 2.5 hours away." Well I see from our phone bill that he called first thing this morning. So, I'm hoping it sunk in. Oh yeah, and he did go buy St. John's Wort.

So frustrating and heart breaking.
 

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Everyone is different. He'll have to begin his journey and find out which drug works best with him. I hope he continues on the path to seek which drug works...some get frustrated when they don't feel anything different and go off them all together. It can take months to find one that works. They don't work immediately either. It took me years to go through them to find that prozac works best for me. I went off them for a couple years and this summer I'm back on them due to some stress... but its taken since the summer for me to feel like they are "working" I had to work my dose up to where I'm at now... just be prepared to take things slowly and don't give up, that's for him and for you. Best of luck!
 

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All too often a general practitioner simply prescribes what the drug detailer is pushing for the week--not necessarily what the patient needs.
From what I've seen, a lot of general doctors don't know anything about the brain or nervous system, nor do they care. The most useful source of information for drugs and dosage is the internet. If you can find a forum for people who have the same problem as you (social anxiety, ADD, major depression), those people will help push you in the right direction. I'm genuinely impressed by how informed depressed or anxious people are. On the social anxiety forum, people have discussions about specific receptors and how drugs affect them. People argue about the role of 5-HT1a and 5-HT2c receptors when comparing drugs like fluoxetine and citalopram. I didn't know MAOI drugs were given for depression or anxiety until I saw that on the social anxiety forum, and the people on that forum seem to agree that the old MAOI phenelzine is the gold standard for treating anxiety.

There are also websites like drugs.com where people review drugs. If 9 out of 10 people post that drug X makes them feel tired, then you know this drug will likely make you tired as well. A person should have a pretty good idea of what they want to fix before they start taking drugs. Find drugs that do the things you want. If you want more energy and motivation, look for antidepressants that increase energy and motivation.
 

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From what I've seen, a lot of general doctors don't know anything about the brain or nervous system, nor do they care. The most useful source of information for drugs and dosage is the internet. If you can find a forum for people who have the same problem as you (social anxiety, ADD, major depression), those people will help push you in the right direction. I'm genuinely impressed by how informed depressed or anxious people are. On the social anxiety forum, people have discussions about specific receptors and how drugs affect them. People argue about the role of 5-HT1a and 5-HT2c receptors when comparing drugs like fluoxetine and citalopram. I didn't know MAOI drugs were given for depression or anxiety until I saw that on the social anxiety forum, and the people on that forum seem to agree that the old MAOI phenelzine is the gold standard for treating anxiety.

There are also websites like drugs.com where people review drugs. If 9 out of 10 people post that drug X makes them feel tired, then you know this drug will likely make you tired as well. A person should have a pretty good idea of what they want to fix before they start taking drugs. Find drugs that do the things you want. If you want more energy and motivation, look for antidepressants that increase energy and motivation.

As a former pharmacy owner, I have seen some real disaster stories. General practitioners and OB/GYNs are among the least qualified to be diagnosing and treating mental disorders. But, then, I have seen some doozies when it comes to internet advice also. When it came time for me to get treatment, I relied on a neuro-psychologist to do complete testing. Fortunately, the psychologist and my physician were willing to work together and got the medication right the first time.:)

Also, to the OP... Do rule out other problems either. Could he also be suffering from insulin resistance or low testosterone? Both of those problems can sometimes mimic depression.
 

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Remeron is a tetracyclic and very hard to titrate correctly. Chemically they operate far differently in a different way than SSRI/SNRI's etc. Instead of inhibiting the reuptake of serotonin they create channels to more efficiency move the serotonin around in the brain. It creates massive cravings for sweets. It also conks out VERY fast.

Celexa has some ferocious withdrawal symptoms but still not as bad as Paxil. Conks out for no known reason. Didn't do a great job for me.

When Paxil works it works great. Then it conks out and you want to pistol whip people in the street. And if you stop taking it you'd swear there are electric eels in your skull so you want to bang your face on a wall to dull the pain.

Lexapro is known to create teeth grinding (bruxism) and related anxiety tics. Has a 'speedy' effect.

Effexor has the shortest half life in the body and many people split their dose in half and take it twice a day.
 

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Also, to the OP... Do rule out other problems either. Could he also be suffering from insulin resistance or low testosterone? Both of those problems can sometimes mimic depression.
Low thyroid too

What drug works for one person, may be a disaster for another.

I can not tolerate Wellbutrin or Celexa but Zoloft works great for me.
 

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Fluoxetine (Prozac): 5/5
This drug helps a lot with anxiety, and drinking alcohol with it causes intense euphoria.
That's what I have been taking for at least a year. Have not tried anything else but it sure has helped with the depression.

Have not noticed any difference re the alcohol intake.

It may affect sexual performance, but then I take 4 other meds that definetly do so if it contributes to the problem I think it is minor.
 
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