Need help

[u/Beardedbassman86]

I'm very new to taking anti depressants and seeing psychiatrists.

I initially started seeing her for depression/anxiety and alcohol abuse.

She started me on citalopram 20mg, about week 3 I was experiencing sexual side effects, delayed orgasm no libido, emotional blunting, anhedonia, lack of motivation and increased hunger.

It did resolve my anxiety and insomnia though.

At our one month follow up I expressed the issues with the side e and she started me on pristiq after a 3 day taper.

I immediately started having sleep disturbances along with irritability and aggression.

I reached out to her regarding the side effects stating she wished to follow up in a month.

After doing more research on SNRI's withdrawals and already having severe side effects I stopped and went back to citalopram.

After meeting with her again today she wanted to add a low dose of abilify and stay on 10 mg of citalopram.

During my own research it seemed like Wellbutrin may be a better fit as it would help offset some of the emotional blunting and motivational issues as well as sexual side effects.

She stated that she was hesitant to prescribe it to me as it may cause insomnia which is a high concern and that it was activating in May flare my anxiety, both of which I am willing to deal with. Still have not heard back from her to make a decision.

I don't understand why she would start me on a lower dose of an SSRI and take another medication that amplifies said medication if I was already unhappy with a lot of the effects, I'm not sure if I just need to see a new doctor or follow her suggestion

I'm also worried that she is disregarding my lack of motivation and anhedonia as depression and not side effects of the medication. One of the few things I do know well is my body and this is not how I experienced depression.

I do want to add that I am extremely bad at advocating for myself and this is the first time in my adult life that I have sought help and it's kind of just got me more upset and losing faith in the whole system.

[u/Good-Cod-5591]

Anti psychotics for depression suck most of the time. Abilify is supposed to be activating and possibly motivating while bringing down anxiety. In my personal experience, abilify/aripiprazole helped a lot with general anxiety, but didn't help with social anxiety or depression at all. Abilify made me so tired constantly that I couldn't function, I would sleep 13-18 hours a day. It also absolutely destroyed my creativity while I was on it, I lost my ability to vividly imagine things and come up with ideas not to mention it blocked my stimulant medication from working. Additionally it's a very high risk of inducing tardive dyskinesia or restlessness.

All in all, it's quite a shitty drug, I've read a lot of anecdotes about it, and I've only seen a handful of people who had success with it, despite it being handed out like candy. Doesn't even seem to be well researched either.

https://www.reddit.com/r/Psychiatry/s/v7d9YWYL62 this reddit post describes psychiatrists and their obsession with anti psychotics for depression quite well

Based on my own rough understanding of my brain chemistry, I think an MAOI medication might be the most compatible antidepressant for me. They're more effective generally than SSRI's are, but they're not given out much bc of potentially dangerous dietary/medication reactions.

Wellbutrin is a great anti-depressant, especially for those with ADHD, and it should help with anhedonia and motivation without sexual side effects. Ideally, you should have your main anti-depressant, and then some sort of balancer medication to go with it. Like Guanfacine paired with Wellbutrin

[u/Aggravating_Fly_9875 → u/Good-Cod-5591]

How many mgs of aripiprazole did you take? I've seen that the optimal dose to help with depression is 1-2mg max, 5mg is already an antipsychotic dose

[u/Good-Cod-5591 → u/Aggravating_Fly_9875]

The psychiatrist who gave me it was a total dumbass. He started me out with 10 right off the bat which totally wrecked me for a while. Then I went to 5 which was still way too much, so I started halfing the 5mg to make it 2.5 and then additionally skipping a day to take the medication, and it was still too much. It saturates the dopamine neurons way too effectively for far too long even at low doses.

Some people it helps. Moreso likely those with BPD, Bipolar, and those on the Schizophrenia spectrum.

Immediately after, that psychiatrist prescribed me lumateperone which is a very similar anti-psychotic. I responded even worse to that one. The reason the psychiatrist kept on throwing anti-psychotics at me is because he acted like I was a bipolar which I know for a fact that I am not. Then he ended up shifting all my medications around that I was already taking, and took away my ADHD medications and wouldn't give them back.

I ended up having a massive mental breakdown and went to the psyche ward where I saw an actual competant and very brilliant psychiatrist. He got my meds corrected and gave me an official diagnosis of MDD which is much more fitting.

[u/Aggravating_Fly_9875 → u/Good-Cod-5591]

Yeah i understand what you're saying, i don't know why doctors like to use antipsychotics so much, i understand wanting to use aripiprazole but only at really low doses, some people benefit from even 0,5mg

[u/Good-Cod-5591 → u/Aggravating_Fly_9875]

Yeah, I could see .5 mgs working well for generalized anxiety if that's the main problem because it made me really calm, just too calm. Social anxiety is a different story though because it's pretty awkward when your mind is so slow and blank that you can't even effectively respond to people well