Quote:
Originally Posted by jo_thorne
Maybe mirtazapine and buproprion? There are also the SNRIs (Effexor, Cymbalta, Pristiq.) They often work well, but they have a severe withdrawal syndrome similar to that of a benzodiazepine.
I take Cymbalta and low-dose mirtazapine (Remeron, 7.5-15 mg). The mirtazapine is at a lower than typical dose because it helps more with sleep at that dosage.
How's your sleep?
Effexor is probably the antidepressant that's had the biggest effect in the area of helping me to feel happiness again. It usually causes sexual dysfunction and sometimes insomnia, too, though.
Wellbutrin (buproprion) is supposed to fix the sexual dysfunction. Low-dose mirtazapine or Ambien will usually fix the insomnia. Mirtazapine has good antidepressant effects, too, but it tends to increase appetite. I gained around 8 pounds the first month I took it, but no more since then. Some people gain more.
Speaking of food, I find that the types of food that I eat have a surprisingly powerful effect on my moods, but I'm not going to suggest that you adopt a "mood diet", because I am never able to do it unless my mood improves first from meds.
My depression had been so much better for about six months, but during the last month I am starting to have more and more days where my mood is "slipping", so I'm getting worried. There have been specific events that have caused this, but I am not handling them as well I did 3-4 months ago.
I hope that some other people will post and give you some more ideas. You've expressed where you are, mood-wise, very well. That kind of boredom and lack of interest in life is painful.
If you try Effexor, I'd definitely go for the extended release type unless your doctor has a really good reason to do otherwise. I don't even understand why they still make the 3-times-a-day type.
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Thanks for your detailed response. I don't want to ask too much and I know I can't have it all, but the sexual side effects that SSRI had on me was annoying to say the least. Lexapro was the worst. It was basically like that:
"I stopped feeling desire to have sex. And when I can tease myself to have a good desire the orgasms are just tasteless. A little bit better than taking a pi. Not any erectile dysfunctions problems, but the orgasm itself is like eating pure rice with no sauce and no salt, just cooked rice."
So I am inclined to try Wellbutrin for a second time. Yeah, I did try that, but I went from sleeping 8 hours per night to 4 hours at most, in the first week, so I gave up. Need to try again, maybe a lower dose (75mg).
Must say that prozac and paxil were BETTER. I think Lexapro is the worst one when it comes to sexual side effects.
So do you know anything about Effexor in terms of sexual side effects? Is it better than lexapro/prozac/paxil for mood/happiness/motivation/energy?