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#3
Dec 22, 2014, 12:19 PM
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 avlady
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#4
Dec 23, 2014, 12:18 AM
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Fetzima is the best one ever for me.
We are all different and may have to try a few or more. There can be side effects and possible withdrawal symptoms if you stop taking them all together. Always do a very slow taper going off or switching.
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The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
| avlady
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#5
Dec 23, 2014, 06:53 AM
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When I was depressed Zoloft helped me
__________________
“All the darkness in the world cannot extinguish the light of a single candle.” -St. Francis of Assisi Diagnosis: Schizoaffective disorder Bipolar type PTSD Social Anxiety Disorder Anorexia Binge/Purge type |
| avlady
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#6
Dec 23, 2014, 07:48 AM
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Fetzima has been working very well for me. It's the first one in years that has worked.
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Bipolar I, Depression, GAD Meds: Zoloft, Zyprexa, Ritalin "Each morning we are born again. What we do today is what matters most." -Buddha  |
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#8
Dec 23, 2014, 01:11 PM
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The most effective treatment for my treatment resistant depression has been ample sleep, a healthy whole foods diet, regular exercise, and phototherapy. These are not things which will cause a short-term 'feel good' shift in mood, but is a lifestyle change which becomes more effective over time and, in my experience, goes a long way to mitigating recurrent episodes.
In the short-term psychotherapy can be quite helpful on an emotional level. If the depression is stress induced (chronic pain, sleep deprivation, psychological stressors) then supplements such as Sensoril (a standardized Ashwagandha root extract) and Suntheanine (98% free-form L-Theanine, an amino acid found in green tea) can help mitigate the effects of depression without drastically altering mood or causing serious side effects. I believe the more worrisome part of anti-depressants, even the majority of psychiatric drugs, is more than potential side effects. These substances alter the brain, gut, and physiology in ways which interfere with the benefits which can be derived from natural sleep, exercise, and healthy diet. These three cornerstones of health are impaired by ADs. This can lead to a dependence on drugs to do what lifestyle changes would otherwise be are able to address. Worse yet, AD'S offer no promise of relief, hence diagnoses of 'treatment resistant depression' and the constant changing of medication to find something which 'works' until it stops working, at which point it's time to once again engage in chemical roulette. The depressing reality regarding your question is that there are no good medications for depression. There are but substances touted to be medicines which are anti-depressant, yet, when one responds positively the cause of that positive response is, as evidenced in the research of these substances, nearly as likely to be placebo as it is any action of the 'medicine'.
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BP II - Sleep, Diet, Exercise, Phototherapy. |
| vital
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 vital
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#9
Dec 23, 2014, 04:42 PM
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#10
Dec 23, 2014, 06:38 PM
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I know of no studies that say AD's interfere with exercise or diet. They can interrupt sleep which is well known. And I notice you are taking a mood stabilizer and an amphetamine. The clinical trials comparing AD's to placebo are very old and only lasted 6 to 8 weeks and it is well known that they can take that long to work. In the real world they are much more effective and I think the best evidence says in 50% of people. My experience when an antidepressant is working as Fetzima currently is that I just feel like my normal self. I can't tell I am taking it and don't feel dependent. I just function like my normal self and am in touch with my inner self. Exercise, healthy whole foods, and good sleep hygiene has never prevented me from having a depressive episode.
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The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
| krisakira, lonely-and-sad
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#11
Dec 23, 2014, 07:09 PM
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Effectiveness of Antidepressants.
NIMH · Antidepressants: A complicated picture Antidepressants: Effectiveness, Trials, Realistic Expectations NIMH · Questions and Answers about the NIMH Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study ? All Medication Levels Are antidepressants really no better than sugar pills? | The Johns Hopkins News-Letter Robert DeRubeis on anti-depressants | News Center | Stanford Medicine http://www.nytimes.com/2011/07/10/op...anted=all&_r=0 Study confirms antidepressant efficacy | Yale Daily News
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The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
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#13
Dec 23, 2014, 07:16 PM
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Dangers of antidepressants.
What are the real risks of antidepressants? - Harvard Health Publications SSRI Discontinuation or Withdrawal Syndrome | Psych Central Quote:
Withdrawal From Antidepressants: Symptoms, Causes, Treatments Quote:
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The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
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#15
Dec 27, 2014, 03:41 PM
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My research materials are organized so that they are effective resources which directly aid in learning to devise solutions for my own treatment. While I could go through them and find the information in support of my claims and then provide citations I honestly do not currently have the energy or focus to scan through the several hundred pages contained in the research articles in order to do so. I could list the titles for the articles I have but it's a long list and the abstracts do not provide the information necessary to verify what I have stated. I can, however, try to explain matters more clearly.
Anti-depressants are known to potentially have adverse effects on metabolism. The long list of side effects that commonly occur clearly illustrate that alterations affecting the gut are present. The gut has roles to play in a natural sleep cycle. The natural sleep cycle is perturbed by ADs. In short, anti-depressants screw with important physiological cues the body uses to maintain balance. The disclaimer of 'everyone is different' invokes an easy dismissal of a particular persons response to a substance. Even so, it pointedly illustrates how limited an understanding there is regarding how anti-depressants work. For example, the theory that anti-depressants work by causing neurogenesis is interesting, even compelling, useful, but far from evidence of efficacy in treating a mood disorder. Other substances, such as L-Theanine and Ashwagandha root, are not known to provide any 'feel good' relief from depression but have also been observed to induce neurogenesis. In my view inducing neurogenesis is more likely to be involved in reducing the damage caused during a depressive state through neuroprotective actions thereby impeding any further deterioration. It will not stop one from feeling depressed; a lack of neurogenesis is not a cause of depression but is caused by what triggers the depressive state (i.e. chronic stress continually triggering the HPA-axis) and then contributes to it due to the cognitive deficits which are caused by reduced neurogenesis in the hippocampus and other select regions of the brain. At least, in theory and theory is all there is when it comes to causes of depression and potential therapies. As little as is understood some matters are quite clear, such as AD's can cause changes in body weight. Becoming overweight makes it harder to exercise, increasing stress, impeding the quality of the workout, and can lead to developing or drastically worsening sleep apnea as well as a variety of other conditions affecting physical and mental health. Such difficulties influence one to be less inclined to regularly exercise. Regular exercise is key to its anti-depressant qualities as it is toned lean muscle which provides the greatest benefit. Anything interfering with building and maintaining toned lean muscle mass interferes with the anti-depressant efficacy of exercise. Metabolic dysfunction, cardio vascular issues resulting from sleep apnea caused by weight gain caused by the drug, difficulty absorbing and utilizing nutrients for recovery - must I list all the ways in which chronic administration of an AD can lead to a chronic condition worse than the initial episode? The next time you're in line at the grocery store look at what people nearby have in their carts. How many of those carts are full of vegetables, lean meats, fruits, nuts, grains, legumes? When I bother to look I see a lot of cookies, sugary cereal, chips, frozen premade meals, crackers, etc. That's what is part of a normal diet for a great deal of individuals and changing eating habits like that is hard. If it becomes necessay then one is more able to find the motivation, but if a pill can make it no longer a necessity but merely an option that 'you know you should do it but do not because <excuse>' then it becomes unlikely that someone will go to the trouble of breaking ingrained habits. Afterall, life is fine because pills make it so, but then it stops working and it's time to try other pills... Meanwhile, the efficacy of regular exercise supported by good diet and ample sleep continues forward unabated. It is always helpful in maintaining health, it will never stop being so. Yet, this subforum is about psychiatric medications so it is forgivable that other methods of coping with depression are not emphasized as having greater importance. Whatever import one may choose to give to anti-depressants as efficacious thereapeutics it is paramount that the inverse of the dismissal presented by 'everyone is different' be equally applied to the medications as well - how it is that differences in physiology affect mood is unknown, how it is that anti-depressants affect the physiology relevant to mood is unknown. These unknowns stipulate that whether or not a chemical agent is therapeutic will be unknowable so long as the mechanism by which the therapy is efficacious remains unknown. Why some substances have measurably improved - though such improvement has at times been subject to reviews criticizing the results as clinically insignificant - efficacy to placebo is unknown; attributing the difference in response as indication of effective treatment for a biological disease is speculation. One line of speculation which places further doubt on the efficacy of anti-depressant medications is that it could very well be that due to the design of many placebo-controlled studies the participants being given the real drug may form a stronger belief that they are on the real drug due to experiencing very real side effects and as a result have a statistically higher chance of experiencing a positive response due to a placebo response to the medication being tested. I believe emphatically that the current pharmacological treatments for depression are far from being good, that at best they are but substances which may or may not lead to a positive outcome and if such an outcome is reached the likelihood of a placebo response is higher than in any clinical trial because a clinicians office is not double-blinded and does not treat disease with placebo (at least, not knowingly).
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BP II - Sleep, Diet, Exercise, Phototherapy. Last edited by LastQuestion; Dec 27, 2014 at 04:05 PM. |
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#16
Dec 28, 2014, 12:10 AM
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I was just trying to point out relevant information that someone might want to be aware of when making a choice about taking an antidepressant. The question was "Does anyone know a good med for depression?"
Aside from scientific studies and theories what is most important to me in making decisions about my treatment is my own personal life experience. Beside medication I have applied many many non med methods of treatment. My grocery cart is full of milk, eggs, cheese, lean meats, and lots of fresh fruit and vegetables and greens. It may not be an optimal diet but it is whole foods and covers all the nutrients. For twenty years I have been meditating, practicing mindfulness, going to therapy and group therapy, AA's twelve steps, lots of good exercise, clean and sober for twenty years, CBT, many spiritual related things. Yet I will still go into long severe depressions. Two and a half years ago I was working full time installing plumbing at a big prison hospital job which required a lot of physical labor outdoors in the sun. I was eating good and sleeping great. Getting awards at work. Perfectly content and happy at that time. No stress. What ended up being the worst depression I have ever had started coming on after nine months on that job for no apparent reason. I know the evidence that keeps piling up on stress and stress hormones but I have never seen my depressions as being triggered by stress. They hit totally out of the blue for no apparent reason. I normally and very resilient and have a very high tolerance for stress. I don't even see it as stress but a challenge and fun when I am doing well. The only thing that makes sense about the nature of my depression is the cycles it follows. I can set the calendar by it. It follows a seasonal circadian rhythm it would seem. Three or four times a year, the two worst ones being spring and fall with a short one in mid summer. It is a pattern over twenty years. 37 years of having depression but twenty years of treatment and looking closely at it. Sometimes very severe depressions that have lasted up to nine months where I was very suicidal the whole time with horrible anxiety and paranoia. When I was in high school I was in optimal shape. Ran two miles a day, 100 sit ups, 100 push ups, 10 sets of 10 pull ups, sprints, lots of stretching, played hockey everyday all winter and played neighborhood pick up sports all summer. Ate a good whole foods diet. Slept great. And yet would get hit with bouts of severe depression. In spite of all the non medication things I have thrown at this depression thing anti depressants have been by far the best treatment when they work. They have not all worked. Some have worked great and some not at all. Currently Fetzima is working far better than anyone I have tried. I felt it lift me straight up out of a very severe depression that had been going on for six months. This is not placebo. I have been around the block to many times for placebo to play any part. Placebo effects normally wear off rather quickly anyway. Eventually I would have snapped out of it as I always do at some point but this was totally the med doing it. It has kept me from going into what would be the normal cyclical depressions. Especially the one that hits mid november and is really bad. Nine months of normal functioning real me. A great christmas and I have had many that were not good at all because of depression. I have never gained weight on an AD. I get very few side effects and they go away quickly. I have never had withdrawal even when switching between totally different classes. No lasting adverse effects that I have noticed at all. No cognitive decline. The sexual side effects I have had with all of them but to my surprise with fetzima those have totally went away. It took a few months but gone now. that shows me they are reversible at least for me. Worst effect ever was on a high dose of Effexor and has cognitive blunting which did effect my driving. We lowered the dose and it went away quickly. Also reversible. That is my experience. I think that core causes and what treatments may or may not be effective is highly individualized and varied when it comes to depression as the term is broadly used and we have to make the best choices we can based on our experience and best available information. I take fish oil, b vitamins, vitamin D, melotonin, L theanine, and a multi. I have taken many supplements over the years and I cannot say any of them have helped including the ones I take now. Even L Methylfolate for quite some time. If I were to have a genetic test done that showed I had a L Methyfolate genetic polymorphism that caused me not to be able to synthesis folate into L Methylfolate than it might be worth the 120 bucks a month for Deplin. Deplin didn't seem to help me though when I did take it for a long time. I take B vitamins just in case I have a genetic polymorphism that makes it difficult to produce folate. I've covered the freaking bases yet I get slammed with depression. Maybe I will get lucky and Fetzima will work for a very long time. Your information was collected and devised to aid in your own treatment which is wise. Mine has been as well but it may be different and the success may be different. Some of us have had to learn to live with and manage in the face of it.
__________________
The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
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#17
Dec 28, 2014, 12:06 PM
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#18
Dec 28, 2014, 12:39 PM
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Most of the metabolic effects that you describe are a serious issue with antipsychotics. FAR less of an issue with the most commonly prescribed antidepressants, SSRIs and SNRIs. I have in my 7 years of treating depression have had zero patients gain enough weight that it adversely impacted their ability to exercise. I HAVE however seen people begin to exercise or improve their exercise regimen once they were treated. I also found it a bit condescending that you thought it was "forgivable" that the medication forum focused on medication. As if there was some failure or flaw that needed forgiving. In most forums you are expected to actually stay on topic. Posts on exercise therefore in the other treatment strategies sub forum.or a discussion of "big picture" depression management in the depression sub forum. I think where people like zinco and myself get frustrated is when it's assumed that those who take medication don't follow basic healthy lifestyles or consider other forms of treatment. Zincos shared his story. Me: I've always been physically fit. I've a degree in exercise physiology, trust me I'm the first person to rave about the benefits of exercise. What I'm hearing out if all this is that taking meds is a lazy way out which trust me is not the case dr a lot of us...it is certainly not a quick fix. And even if it. "Is" lazy on other peoples part well it's certainly still their choice to make |
| Mindful55
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#19
Dec 28, 2014, 04:21 PM
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It is not a quick fix or a cure all. When one works as my current one is I can and do get lots of exercise and eat and sleep better. Depression itself has a profound effect on my ability to exercise, messes with my appetite, and totally reverses my daily circadian rhythms to mention just a few of the effects of depression for me.
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The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
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#20
Dec 29, 2014, 03:47 PM
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My personal experience with Mirtazapine is that after four years of dieting and exercise I lost ~forty pounds while gaining some lean muscle mass. When I discontinued Mirtazapine I dropped thirty pounds in less than ninety days while consuming more calories per day with less intense exercise per day than in the previous four years! My weight stabilized of its own accord at 198 lbs, and during the time I was rapidly losing weight and since I steadily gained substantial lean muscle while staying at 198lbs. Exercising is much easier without all that weight. Everyday life is in general easier. When I go to a public space I notice that a lot of people are overweight. They get extra butter on popcorn, the largest size of soda, some candy or other sugary delight, then go out later to eat some pizza, and don't exercise. Such habits of self-care seems somewhat normal in the region I live in. There is much evidence indicating it is likewise the case in other regions of the U.S. as well. I am suggesting not that people take anti-depressants as any easy out, but that most people have developed habits of self-care in which it is normal to take pills and not normal to permanently radically alter their diet and daily routine. People grow into their habits. I assume that creatures of habit tend to remain largely complacent to the negative long-term outcomes resulting from their habits until it becomes plaintively clear that change is now necessary in order to exist in a favorable state of being. Or, in other words, humans have a tendency to do what is neccesary to be happy on a short-term basis while leaving long-term well-being a task to be approached with less fervor. I no doubt could have used better words in my earlier post which would not have seemed to imply some inherent fault in being strictly on topic. I do, however, still feel it necessary to include the larger picture of coping effectively with depression on a long-term basis as I find that providing a value judgement as to whether or not a treatment is good or bad requires evaluating the potential outcomes of such treatment and those outcomes are brought about by more than merely an Rx.
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BP II - Sleep, Diet, Exercise, Phototherapy. |
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#21
Dec 29, 2014, 04:11 PM
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I enjoyed reading your response zinco. I'm still in the process of finding what works best for me, and it's been extremely difficult, so I can respect the effort involved and appreciate the wisdom the experience can impart.
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BP II - Sleep, Diet, Exercise, Phototherapy. |
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#22
Dec 29, 2014, 04:43 PM
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__________________
The "paradox" is only a conflict between reality and your feeling of what reality "ought to be." -- Richard Feynman Major Depressive Disorder Anxiety Disorder with some paranoid delusions thrown in for fun. Recovering Alcoholic and Addict Possibly on low end of bi polar spectrum...trying to decide. Male, 50 Fetzima 80mg Lamictal 100mg Remeron 30mg for sleep Klonopin .5mg twice a day, cutting this back |
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#23
Dec 29, 2014, 04:54 PM
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2) I don't disagree with your general outlook on depression managment; that's what I follow myself. I see cymbalta as being a sort of stabilizing force on my emotions so I can more calmly and rationally see how other facets of self-care fall into place for me. Then Ideally I'd like to taper off once I have a firm foundation in place. |
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#24
Dec 31, 2014, 12:36 PM
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I happened upon a study that does claim that antidepressants do lessen the long-term benefits of exercise Exercise treatment for major depression: maintenance of therapeutic... - PubMed - NCBI It's discussed in this video by Robert Whitaker about 48:00 into the video. - vital |
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#25
Dec 31, 2014, 01:13 PM
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NOWHERE does it say that taking AD's reduces the efficacy of exercise. What is DID say is that patients in the AD only group, with no exercise (as opposed to those who exercised with or without AD's) had significantly higher relapse rates. This study was saying that exercise improves depression symptoms with or without AD's. It was NOT saying AD's lessen long-term benefits of exercise as you are claiming. |
| Closed Thread |
This is an old thread. You probably should not post your reply to it, as the original poster is unlikely to see it.|
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