How much good can an antidepressant really do?

I've been on a bunch of antidepressants, and they don't seem to work for long. Or maybe I get my hopes up at first and think it's working when long-term, it doesn't.

How much good can an antidepressant really do? It is possible to find one that works?

Do the things you learn in therapy actually help more than medicine? I know the combination of meds and therapy are more successful for many people.

The only AD that’s ever worked for me long term is an MAOI called emsam. The combination of emsam and invega kept me stable for nearly two years. Unfortunately I could not continue the invega due to physical side effects. I’ve yet to find a med combo that has worked as well.

As for therapy, my therapist tells me she has seen me work very hard to get out of episodes when they occur and that she believes I have prevented an episode from getting worse using the skills I learned. I am not sure this is true but I do trust her judgment better than my own, especially now that I am in a depressed state.

Last week when I saw my pdoc she said, "Antidepressants can't really do that much, anyway..." She was not referring to me, she was referring to AD's in general.

I was, to say the least, shocked.

For a lot of people with BP, taking AD's in the long-term can cause mania. My pdoc has put me on them short term if I'm very depressed (namely Effexor or Wellbutrin), but she points out if I'm on them longer than 3 or 4 months, I usually turn manic. So it really depends on the person. Anti-depressants can help some people with bipolar; for others, it is a flip of the switch and brings on mania.

Zoloft is amazing for me. Pulled me out of a deep depression. I also take lithium to prevent the mania Zoloft causes. Those drugs got me emotionally better and therapy is helping me even more. Therapy is helping me work on the way my brain thinks. It's pretty cool.

I think it really varies by person. For some people with bipolar (like me), antidepressants very often lead to mania and it gets bad. Sometimes they lead to rapid cycling and/or mixed episodes. And this also ON a moodstabilizer and/or antipsychotic. Other people do just swimmingly on an antidepressant along with a moodstabilizer and/or antipsychotic. I guess it can vary according to the antidepressant.

Since I can't take antidepressants with any good result, I have to depend on moodstabilizers and antipsychotics. There are some that work on getting rid of and helping to prevent depression. In my case my Seroquel XR is the major winner in that respect. I also take a small dose of Lamictal at 100 mg. Seroquel XR is also good for me (along with Tegretol XR) at curbing mania. In my mix, it is always my Seroquel XR that my psychiatrist manipulates.

I've heard of and tried other moodstabilizers that are helpful for depression (i.e. Lithium). I know other antipsychotics are helpful, too.

I don’t really know what your definition of a “bunch” is. But sometimes it takes a lot of trial and error to find one that works. It could be that they don’t work for you. Others have had succes with old school Meds like lithium. Bipolar depression is a different animal than clinical depression. It are you on any other Meds for bipolar? Wellbutrin is another option for people who don’t respond well to SSRIs.

I also have found success with Emsam. I was on so many ADs before it and they didn't work or they destabilized me. Emsam, as an MAOI, works differently and after just a few weeks on it I started having fewer deep depressions. In combination with the right AP (clozapine) my mood is much more manageable.

Wellbutrin has been really good for me. It has helped greatly with my depression plus I quit smoking as a side effect.

Pre bipolar a long time ago I suffered from severe post natal depression. I was put on Zoloft and attended fortnightly therapy. I think it was the combo of meds and therapy that helped me overcome the depression.

My son started suffering from ‘low moods’ at 18yrs of age. I was told with children and teens that exercise etc was equally as effective as meds. My son started exercising outdoors an hour a day, taking Vit D and meeting with his youth pastor weekly.
I would say he’s doing pretty well now.

Maybe for some teens. When I was in high school way back in the late '70's I was definitely symptomatic of bipolar. Never talked with anyone about it; it was almost unheard of for a kid to be open about mental health issues back then. I was very into modern dance, danced for at least 2 hours every day except Sunday. The exercise did not do anything to help my symptoms. I think that if a kid is depressed and nothing else is helping, it's cruel not to at least try an antidepressant.

If I’m honest I wish he'd consented to meds because they were offered. But because he was 18yrs old he was legally an adult and I had no say.

In my case, I owe my life back to Paxil.

Hmm. That is really too bad. A very difficult position for you, as a parent.

I’m not *allowed* to have antidepressants. I’ve tried on four psychiatrists. Even w/mood stabilizer it’s no. I give up.

On your therapy question, my anxiety rides together with depression. I find that working on the anxiety really helps both.

Oh, lord, so many questions!

I may be wrong but I think that SSRI’s are the most prescribed antidepressants these days. About two-years hospitalized, having been through all legally available antidepressants, my docs started me on Nardil and I think that I actually smiled within days.

Not meant for severe depression but it worked somewhat for me — better than anything else they had tried.

Unfortunately, even though the dietary folks controlled the odd diet that Nardil requires, my blood pressure was headed toward Strokeville so I had to come off it after less than two months. I think that it’s an MAOI?

There are so many types of antidepressants but some docs won’t stray into older areas. I guess that you need to discuss a desire to experiment with your doc and see if he/she is agreeable.

Yes. There are antidepressants that work.

Yes. I have been/am being treated with medications and therapy. I’m still as mad as I was twenty-years-ago but I’m much more functional, now. I feel better, although I still have slips and other concerns.

Speaking only of my experiences: the meds usually serve to calm me down and the therapy allows me/the therapist listens and coaxes me as I release the voluminous crap that is in my head.

When I first sought the services of a shrink I thought ‘this’ll fix me,’ but my disorders didn’t go away. Just like the physical diseases for which I receive treatment, so I continue to be treated for my psychiatric disorders.

I think that most people who seek help for, e.g., mild depression, can be ‘cured’ with a dose of CBT and a placebo and get back to living. I didn’t know that my head was ****ed for life.

I was never able to ‘handle money.’ Stole from myself without thinking of consequences. Bounced checks at 13.

Here’s a not-so-secret secret: I got married whilst in high school. Almost immediately annulled so I don’t refer to her as ‘my first wife,’ although, well, she was. This was early 1970’s and I didn’t have a handle on my impulsive nature, my risky ventures.

Definitely symptomatic of bipolar, too.

Because I was ‘exceptional’ no one thought of mental problems. I was able to exhibit the behavior of a bipolar teen without consequences and no one considered the ‘bipolar teen’ behavior anything other than the work of a genius, a mind beyond comprehension.

The expectations were incomprehensible. Scary. Stomach-aching.

But I knew nothing about mental disorders — they were not on the radar, then.

Then off to college and my symptoms roared but my grades were good, always making Dean’s list, so symptomatic behavior was ignored.

But I began to suspect that I was exhibiting behaviors that were like those of a manic-depressive.

My answer was to flee the country.

I was so very ****ed up for so very many years.

Well, I remain ****ed up.

I played four sports in high school, became a long distance rambler in college. Exercise never exorcized my demons.

I should have been medicated in high school. And, while I understand the concern about over-medicating kids, depression can be so debilitating to a teenager.

Peter D. Kramer (of "Listening to Prozac" fame) has a relatively new book out called "Ordinarily Well: the Case for Antidepressants". I felt like if you do the math yourself for the studies he cites antidepressants didn't come out that well, but he obviously feels different about them. It's worth reading anyway.

For me the only antidepressant that worked was Wellbutrin.

Sad girl, Zoloft pulled me right out of depression too, it worked well, unfortunately that was before I knew I was bipolar and eventually it made me manic. Would love to be on some Zoloft and a mood stabilizer such as lithium. My doc just isn’t prescribing it it, I don’t understand. It’s like no one cares how mentally bad off I am.

I was on a lot of ADs. Had genetic testing done and found out I couldn't metabolize most of them. I think there were three ADs I could take, and all of them did not have a generic equivalent and they were very expensive.

I eventually was put on Viibryd during my last IP. I'm taking it with Latuda. I'm just thankful I live near a military pharmacy, or I wouldn't be stable at all because I can't afford the meds.

I've been stable over 1 ½ years now.

So I guess it depends on the individual.

Fetzima works very well for me. It’s a newer SNRI, emphasis on the norepinephrine. I need to take mood stabilizers with it, but it got me out of a deep depression.

ADs have thrown my 17 year old and 19 year old into psychotic mania and hospitalisations (one of them was eating right and exercising right) The 15 year old tried several (lexapro, zoloft, prozac, wellbutrin, cymbalta) for 6-8 weeks at a time, they activated her and increased her anxiety and panic attacks. They are no good for my family but I am sure they work for some

If the ADs threw your kids into a spin it’s a good chance they could be bipolar. I can’t take ADs unless I’m also taking a mood stabilizer. I take serewuel and it helps me from getting hypomanic and unable to sleep.

Please talk to the doctor about this issue.

If you have amazon prime, I highly recommend watching The Brain by David Eagleman. It’s an amazing series and hopefully it will help with you coping and understanding the process of ‘why’

I just got out of the hospital and a nurse there gave a class on meds. He said meds won't cure you, you have to do most of the work. I think he might be slightly uninformed as to their efficacy.