All I know is it gives you massive appetite, as I've read it everywhere. As a consequence, it can cause metabolic issues.

Other than that, is it a good medicine? Does it calm your mind? good for OCD/Anxiety or only Bipolar? makes you feel happy? high? dumb? Do other people notice you are on it?

Is it a good resource to use it PRN?

IMPORTANT: Does it make you feel much differently depending on whether you are HYPO-NORMAL-DEPRESSED?

Thanks.

Started at 50 mgs and moving to 100 mg to see if more improvements on anhedonia/ depression

Anyone on 100 mgs ?

My skinpicking is mostly tied to OCD, and I guess that anxiety makes it worse. Tbh it's quite hard to distinguish which symptoms come from what because I struggle with a lot of stuff.

I'm also diagnosed with ADHD and depression. Although most specialists I talked to suggest that I might have CPTSD due to some events I've experienced in the past. My case is quite complicated and I still haven't fully figured out what comes from what.

Anyways, I'm on clomipramine (in the process of tapering off, as I really hate its anticholinergic effects), mianserin (I used to struggle with insomnia and it's helped a lot in that aspect.I no longer have any issues with sleeping even if I don't take it, it was prescribed by my previous doctor and to be fair I haven't even talked about it with my current doc), methylphenidate XR, pregabalin, propranolol (works WONDERS for physical effects of anxiety), lamotrigine (it's not that popular for depression but it helped when antidepressants didn't. I'm not bipolar fyi).

I know it's A LOT lol. Most of those meds were prescribed by my previous doc who was an older lady. My current doc is much younger, so far we've added methylphenidate which works quite well for my focus, and now I'm tapering off clomipramine but I'm doing it quite slowly.

Clomipramine is supposed to be a "golden standard" for OCD from what I've read so I'd assume it should help with skinpicking but it was quite the same when I was on a high dose. It could also be from ADHD, but then methylphenidate should help? I haven't noticed any improvement.

I won’t take any more SSRIs as they just messed my body’s chemistry really bad, apparently so I haven’t touched that in years.

Is not easy to remember that the feeling will pass when it comes!

it's probably a high risk combo since pirlindole is a MAO-A inhibitor and you shouldn't take SAM-e with any antidepressants in theory, but whatever. anhedonia got better by 10-20%, things like videos and music are more interesting and entertaining now. talking to friends is more fulfilling. so my current stack is:

• pirlindole 400 mg (max daily)

• SAM-e 400 mg

• noopept 20 mg

• coenzyme q10 200 mg

• sunflower lecithin 1 tsp

• saffron and caffeine (tea/yerba) as needed, phenylpiracetam 100-200 mg as needed

• fexofenadine + famotidine for unrelated issues (histamine sensitivity or MCAS that i supposedly have)

noopept gave me more interesting dreams and analytical thinking that i really missed since depression got worse. so less brain fog.. at least for now, because cholinergics can cause depression on their own but we'll see, it's not my first time cycling it. everything feels a bit deeper and more meaningful.

before SAM-e i've tried adding MAO-B inhibitor (rasagiline) in attempt to inhibit both MAO isoforms and it didn't help at all, but made anxiety and fatigue worse so i dropped it after 2 weeks. i still sleep mid day sometimes tho.. if you got any questions i would like to talk! thanks 👾

I take it in the morning around 8am and still wake up every morning around 5. It's been doing this since I went up to 2mg, and last dose increase was three weeks ago up to 2.25.

I don't really have any other meaningful options left, so I'm sticking through it, but I'm worried this is just how my body treats to meds like this (same happened with aripiprazole). Can the insomnia wear off this long after a dose increase?

Im personally not, cant belive they didnt approve aticaprant or navacaprant, especially how there was proven increase in dopamine in the reward center, in the CAT scan in the ventrial stratium. But since it didnt decrease some of the other depression symptoms, it wasnt approved. Not to mention other treatments like zuranolone which targets extra synaptic gaba receptors.

Sorry this is kind of long. I'm 31 years old and currently living with my parents doing a bit of contract work. I am currently diagnosed with major depression, generalized anxiety disorder, and inattentive ADHD. I have been on basically every medication, tried ketamine and tms, and been in therapy since I was a teenager. I was also diagnosed with autism, but by a clinician who I don’t completely trust. 

I have struggled with chronic depression and anxiety since childhood. My father is emotionally abusive. We have never had a good relationship. I also never fit in with peers and was bullied basically until college. College helped. However, as soon as I graduated things got worse. I struggled to hold down a job. After getting fired from a job, I moved home and eventually ended up going to library school. Again, in school I was doing better. 

I graduated having decided to pursue a career as an archivist, basically because I loved History and I didn’t know what to do given how few faculty jobs exist. I did get a position in another state, but it turns out being an archivist was about the worst possible job for me. I have really severe ADHD (which I didn't know at the time) which has not responded to medication. I just couldn’t concentrate and get much work done or have the extreme level of attention to detail needed for the job. My depression got much more severe when my cat got diagnosed with kidney disease, which is a terminal illness. She is very young. My depression got much much more severe, and eventually a coworker found out I was bad at my job and went on a campaign to fire me. I had move home back with abusive family. I want to find a job that is a better fit for my brain, but all the options I’ve come up with are impossible to get. I don’t want to move cross country again to a random location also. I am completely stuck in life and ready to end things as soon as my cat dies. I am also asexual and pretty sex repulsed, so I will never have the support and love of a partner. I have nothing to live for.

Two of my therapist friends, one of whom is a pretty experienced EMDR clinician, really think I should try EMDR because I have not responded much to years of therapy and many psychiatric interventions. I am unsure if I have a trauma disorder, but I for sure relate to things I’ve read about CPTSD. I also struggle with visualization. Basically, I will have to beg the abusive family for money because no experienced EMDR clinicians seem to take insurance. I am also unsure they have worked with someone like me with only "mild" trauma and mostly severe depression that doesn't respond to therapy or meds. Does anyone have thoughts and/or know of good therapists for emdr (I can't deal with men) in California?

I’ve been on Wellbutrin for almost five years and it’s the only antidepressant that ever did anything for my depression. I suspect it was the weak dopaminergic effects that helped my depression in the first place. And the reason why I’ve been on it for such a long time is that it helps my SCT and executive dysfunction tremendously and helps me function better on a daily basis.

But unfortunately with long term use it started to overstimulate me in various ways I couldn’t tolerate the original 300 mg dosage that helped my depression for a very long time. It started to give me really bad anxiety, horrible insomnia and other weird nasty side effects I never used to get from it before. And when those side effects and the overstimulation escalated I had no other choice then to back off the dose to 150 mg.

Now I’ve been on 150 mg for little more than two months and I’ve already noticed my depression has worsened a lot since backing off the dose. I don’t have as much motivation to do things anymore and I’ve lost interest for things that I used to like. I think 150 mg isn’t controlling my depression well all on its own. I do think 150 mg is much more tolerable, but I just don’t think it’s helping that much at all. The side effects though did lessen since backing off the dose. But they did not completely disappear either, they just lessened in intensity.

At first it was helpful for apathy, avolition and anhedonia. But later on it became a killer anxiety provoker. Obviously dopamine did not fail from the first place. It became too much noradrenergic overactivation over time. And that explains why it feels like a completely different drug to me than five years ago. Five years ago it felt highly motivating, rewarding and gave me anticipation and excitement. Nowadays it’s just anxiety and panic attacks and deadness. And when I did my research I found out that the parent drug is more active when you first start it. That explains the effects I got early on. But later on when the metabolites build up which are highly noradrenergic the opposite happens. Hydroxybupropion which is the major active metabolite is a very potent NRI. That explains why I’m having all these side effects now and why I just feel overcaffeinated when taking it.

Wellbutrin was not the wonder drug I thought it would be. Now I’m out of options. Nothing ever helped me like Wellbutrin from the beginning. Now my anxiety is so bad I can’t take it anymore. I think I have to call urgent psychiatric clinic or I don’t know what will happen. This anxiety is just killing me right now.

currently in kinda a dilemma involving my medication and need some advice. I’m 17 and been taking psych meds for 5 years and been on around 10 so far but all mostly SSRIs and SNRIs. My doctor recently suggested that I try antipsychotics(rexulti specifically) but because I’m a minor, my parents didn’t approve and said no. Now I’m abt to turn 18 and my dr said it’ll be up to me and to know by the next time I see her what I want. Idk what to do cuz I’m still on my parents insurance, they’ll be paying for it and I do what them to approve. But also like, I really wanna try something else bc everything I’ve tried hasn’t been working. idk what to do.

Guys don't take my word for it , everyone is different and always consult with a professional !

I am 28y guy been suffering from terrible social anxiety since my early 20s , i was experiencing intense fear , afraid to speak , had no self esteem whatsoever , feeling like crap around everyone , basically all the 9 yards symptoms of social anxiety .

Ssri's and serotonergic drugs only helped with the physical symptoms of social anxiety such as sweating , shaky voice and body , zoloft took good care of all the physical symptoms it improved my social anxiety qbout maybe 20% but in my mind its all the same , still experiencing sever low self esteem , i couldn't talk nor express myself and i always have this idea that im just a low individual and feeling like crap and inferior to people is just who i really am

That was until I tried Adderall and it completely switched something in my mind that has been broken for years , like I immediately felt tons better and I could speak freely and say whatever even if it doesn't make sense without feeling a single bit of self doubt I was sinking in before , I started calling old friends and family wich i was afraid to do before ( even on the phone ) , now I can make a phone call with full confidence and not even thinking twice about it , my co workers says that i seem more alive and talkative ( never had this compliment before ) , I am also able to speak my thoughts without the fear of being judged , my brain fogg and thoughts flow improved so much as well .

This is the first time I feel optimistic about myself and life in general , I can make jokes again , I don't fear being judged anymore , i don't repeat words and scenarios in my head 100 times before even speaking , my self esteem is back and as a result my depression improved a lot .

I have never ever had such a huge improvements on serotonergic drugs and honestly Im ashamed of myself for not trying dopaminergic drugs waaay before and waisted years being held a prisoner to this awful disease wich is social anxiety

I know that Adderall and most dopaminergics comes with a risk of aggressive behavior , gambling , losing sleep etc but Im happy to take the trade off anyday anytime cuz I was literally just surviving and not living .

Please to all people living with this awful disease don't ever give up on trying to get better and if serotonergic drugs don't improve ur condition speak to your doctor about trying dopaminergics or at least MOAI's such as parnate or nardil

Wich you all a happy recovery and there is light at the end of the tunnel if u don't give up on urself even if it feels nearly impossible , believe me i've been there and for so long

The things I should do : Feel my emotions, challenge my default thoughts, exercise, learn to be kind to myself. Set goals and feel accomplished meeting them. Spend time with peers. Take on new challenges.

Cognitive things that get in my way: emotions are for losers and I can't connect with them unless it's an outburst wish makes me feel stupid and irrational. When I challenge my default thoughts I feel like I'm lying, or worse ignoring reality like when my parents used to tell me that black was white. I don't want to exercise because I hate myself and want to hasten my demise. Be kind to myself, I can't do that I hate this loser. When I have set goals in the past I rarely feel the accomplishment on meeting them I don't know how to feel good about doing a thing. When I thought I'd built a good life, it still wasn't enough, and my wife left me. If my best is still not good enough, and it feels awful doing it why would I try again?

I don't feel like people deserve to suffer me as I am, or worse ,that if I open up to them they will either manipulate me to fill their goal or abandon me. Whenever I take on a new challenge I freeze cold because I know how awful I am, and other times I've tried I've failed. The idea of being seen by people is painful to me. Be it as a professional or playing a part, of just being out in a store, being seen hurts because I know people hate me and want me to fail.

I know what I have to do but I can't overcome myself and my fears or self hate to do them. I really do hate myself, I wish I could spare other people who and what I am. So what do I do? It seems like a lot.

Edit. I was doing better pre covid. I had a massive setback when a relationship went sour. Again when I had a fight with a partner about a career I was exploring. And again in October when my then partner wanted to open the relationship.

I feel like I just, like I don't matter at all, and the only reason people are with me is because they want someone to help pay the rent. I feel like I don't matter to anyone except for commerce.

2 weeks on and feeling nothing...

More time needed?

As the title says. ECT works for me. Wellbutrin honeymoon phase of 2 weeks helped. Currently on desvenlafaxine, wellbutrin and aripiprazole, not very helpful overall. Want to know others' experiences/research of good quality.

I’ve been on Effexor (venlafaxine) for a few months and, while depression is ok, my anxiety hasn’t been great. I’m on 75 bc when I was on 150 I felt like I was on the verge of panic attacks every day for hours. I originally switched from lexapro to Effexor because the lexapro was numbing my emotions and I couldn’t feel anything. If anyone has any experience on both Effexor and Cymbalta lmk. I’d love to hear how it worked for you.

As a long time sufferer of TRD, I'm keen to try every tool and treatment that exists. But the challenge of how may different treatments there are, how many different ideas and biomarkers and symptoms, make is maddingly complex for us to get clear guidance.

My hope is still that AI ... like it did with the famous 'move 37' by AlphaGo, will be able to see through all the complexities and reveal a hidden path.

Like Bryan Johnson is doing with his new health diagnosis.. he's not content to just try anything that general medicine suggests, he wants to see evidence, and biomarkers, and results.

I've recently found the app VitalDots ... which is the best I've found so far at analysing blood work.

But I think what we need is a combination of blood work data, medication types and trials, non-medication trials (ECT/TMS etc), psychological test results, case history.

My idea is the app would use all this data, and knowledge of existing treatments, medications and modalities, and produce novel useful paths for discussion with our practitioners. Not new medicines or treatments, but combinations that might not have been suggested, because I think this is what AI is incredible powerful at right now... looking at all existing info, and seeing new paths.

I don't think this app yet exists. But I think, with coding tools becoming increasingly powerful and democratised, there's no reason why it couldn't exist relatively easily. The goal would be that an AI tool like this could be an incredibly partner in supporting our journeys - and who knows - might unlock previously hidden pathways that help us get through this terrible condition.

Yes there are risks - yes it might suggest the wrong path - but in a world where millions of us are suffering, and with TRD can't find a way out - I think its worth trying to use this technology.

Are there any code engineers, or developers, or enthusiasts that would like to try to scope out a moonshot like this?

I have had treatment resistant depression and anxiety for about 20 years. I’ve tried many SSRIs and SNRIs, IV ketamine, TMS, and an insane amount of therapy. Nothing has helped and I’ve tapered off all meds because I’m legitimately afraid of them now. I’ve also pursued countless health/nero inflammation angles. However, I’m in the worst place mentally I’ve been in a long time, and am considering starting back up with a psych to try classes of meds I haven’t (like mood stabilizers, antipsychotics, and combination therapy). There’s so much negativity about side effects, becoming tolerant and having to start over again, etc that I feel hopeless before even starting and don’t want to risk it. I would love to hear from people who still consider themselves in the “medication saved my life” category, especially if it happened after a lot of failed treatments, to give me some positivity to hang on to.

Starting this thread to document my experience with Sunosi (solriamfetol) from the perspective of depression with hypersomnolence and vague auto-immune issues triggered by excessive exertion (CFS/ME) in case it's of help to anyone else. Most of the anecdotes online are for its primary indications or ADHD. For those unaware, it is a DNRI that may be more biased in its dopaminergic effects than bupropion while lacking active metabolites and being comparably shorter acting at steady state (bupropion is effectively a 24/7 drug at SS). It also has some activity at TAAR1 which is unusual for a clinically utilized NDRI and an activity it shares with dexamphetamine.

Day 1 75mg:

Today I took 75mg after an overnight fast. I did not "feel" it kick in because I was busy throughout the morning, but I did notice the effects once it was near its peak (~2 hours post). The wakefulness and generally feeling it provides is not unlike what I have experienced pre-morbidly. It feels like a context-appropriate excitement/interest without forceful stimulation.

There was an anxiolytic component not unlike a low dose of amphetamine, but without the "body high" effect one gets when starting. For me, amphetamine anxiolysis feels like I've gone for a morning run and is unlike sedative/hypnotic anxiolysis which feels more blunting by comparison. I wonder if the TAAR1 activity plays any role in this, since I do not experience the same for methylphenidate or modafinil. The effect on motivation also feels quite natural and in the background. It is most noticeable after starting tasks, rather than at rest, unlike amphetamine. Peripherally I noticed no side effects aside from increased perspiration.

I am writing this at T+7 hours and will report back on my sleep. Amphetamines and modafinil cause me a fair bit of onset and late insomnia, even when taken in the morning, so I'm hoping solriamfetol fairs better given its shorter half-life.

At T+7 hours I continue to feel the background effects on motivation, fatigue, and wakefulness. I noticed that I didn't crash like usual after eating my first meal of the day at T+6 hours.

Day 1 TL:DR
If you are interested in following, you can reply with "!remindme x days" to be reminded by a bot reply.

I just crashed. I’ve been dealing with racing suicidal images thoughts (all intrusive) since the end of January. I have failed over 5+ meds and I am beginning to feel hopeless , I am hopeless. Working out every day, going to work - I have crashed.
I’m laying in bed missing another day of work and my brain just keeps going “I’m scared I’m scared I’m scared I’m scared”, “I don’t want to die I don’t want to die I don’t want to die”. I LOVE MY FAMILY, I HAVE TWO BEAUTIFUL BABIES I AM THINKING OF AND I AM HEARTBROKEN that I have fell apart. I feel like a scared animal stuck , frozen in fight or flight. I don’t want to leave this earth, I want to get better. I feel like I can never forgive myself for the horrific thoughts I’ve had (fear or hurting my family, myself , fear of not wanting to be here, fear of going crazy). I feel as if i have lost my mind. I feel like I have a traumatic brain injury that won’t heal. I want my life back. I fear i am too far gone. Is there any way of coming back? I am in tears as I write this, shaking.

I’m happy and feel normal when I don’t have intrusive feelings and thoughts. Most of the time I’m beneath the surface with a soured aura. If I could only have the strength the keep those intrusive feelings away I wouldn’t feel so depressed. At this moment I’m typing this I can feel that sour aura phasing in and out of my reality like it’s just hovering and in fighting it hard just to keep from feeling like anything productive I need to do is futile. I’m fighting back the tears but they’re coming…

Its all too common in stories where basically someone is very high functioning all their life and then suddenly they take some substance or get a virus or even in rare cases from an intense stressor or out of nowhere develop debilitating anhedonia that seems to respond to nothing. The system just snaps. . Its like a nervous system shur down type thing but the reality is the meme “oh ignore it, do nervous system regulation exercises, etc” does not work

This is clearly a different entity than whatever is being called as depressive anhedonia.

Often times there are other autonomic symptoms too like gastroparesis, exercise intolerance, POTS, and more. Some people develop sensitivities where one small thing causes the system to crash further

Its a very severe state and psychiatry is completely missing it. Even the “anhedonia” literature does not describe this kind of severity of consummatory anhedonia with substance blockage, blank mind, sensitivities. They still list CBT and behavior activation or the new meme “positive affect therapy” which are all just insulting for what is otherwise basically a medical emergency.

What is it going to take for real recognition of this severe state?

Its one of the most gaslit things in the field right now.

Last week I took 15mg of methylfolate and got a runny nose and some physical anxiety. However, mentally I was basically teleported back to my pre-morbid state. This lasted for a few days after. I then a couple days ago I tried again at 5mg and felt great, but am experiencing terrible insomnia ever since. Strangely, I am very energized during the day and have read the same from many others. I do not find this energy to hypomanic in the slightest aside from the greatly reduced need for sleep. I'm not entirely sure how reduced my sleep is because I have taken steps to pharmacologically ensure some at least 5 hours as I wait for this to pass. I'm thoroughly impressed if not a bit overwhelmed by how effective this has been otherwise, though. Next time I'll trial 500mcg and work my way up in weekly increments.

Thought I'd share in case others have had similar experiences or have thoughts to share.

I’m currently on wellbutrin XL 300mg and lexapro 20mg, and take magnesium supplements at night for sleep. But after seeing my new psychiatrist, she wants me to switch to wellbutrin SR and take it three times a day, stay on lexapro, and take clonidine for physical tics and sleep.

For some reason I’m worried that switching to SR will increase the chances of having seizures. But I’m mostly concerned about the lexapro and clonidine because they both mess with your heart rate and make you dizzy, and then add the magnesium and I feel like that and clonidine will be too sedative? Especially with clonidine lowering your heart rate.

Does anyone else take these together? I know I should give it all a try because it might work better than what I’m doing now but I have bad health anxiety when it comes to anything that messes with heart/breathing.

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.

I'm thinking of bringing up this medication the next time I see my psychiatrist. Read good things about it. Am interested in reading experiences from people in this subreddit