Any help with medications!

Hi I am 38 years old and have suffered from depression for about 20 years. I have tried many medications, without a lot of luck. I am currently on Cymbalta 60 mg and was recently on adderall xr 20 mg.

I have not been tested for bipolar, but at one point I was put on a bipolar med. It made me feel terrible and almost knocked me out. I was not able to function. I do have really bad depression, but not periods of mania. To combat those lows of depression, the adderrall helps and the opiates help. I am sure that the cymbalta helps at some level, but it is not nearly enough. originally the doc gave me the adderall IR and i would break them into quarters and take some throughout the day, but I would get a high and then a quick low from it. so then the doc gave me adderrall XR at 30 mg, but that was too strong, so he dropped it to 20 mg and that seemed to work.

The only problem is that the meds would work good for a week or so, and then i would need to take a few days off to withdraw and start back up again to keep from having to increase the dose. This cycle applies to any opiates or adderall or when I tried concerta (which gave me chest pain). The bad thing is that these are the only meds that have made me feel normal, but I have to go through this starting and stopping cycle of withdrawal over and over and over. I would like to find some kind of medication that would help me out that I could take continually without having this problem. I got tired of the up and down so I quit taking the adderall a few weeks ago and now I am just down.

Also wondering if anyone has tried upping their cymbalta with good results, or maybe adding another med?

Ok, I have gotten some medication suggestions from others which include: Viibryd, Lamictal, Latuda, Abilify, Remeron, Wellbutrin, and Buspar. Does anyone have any experience with and of these for severe depression? I am looking for anything that will help.

Me! I took 60 mg then I took 120 mg. I'm pretty sure that the literature says that 120 mg is not usually more effective than 60 mg. My depression got better on the 120 mg for a couple of years then it got worse again. (I have fibromyalgia and need the Cymbalta for pain, so I kept taking it.)

Now I'm back on 60 mg Cymbalta and 7.5 to 15 mg Remeron at bedtime. The Remeron seemed to give the whole meds cocktail a good kick and fixed my insomnia. I've been on it for about 5 months now & I'm keeping my fingers crossed that it keeps working.

Are you self medicating w alcohol or street drugs?

Wellbutrin can be added to the Cymbalta. My p-doc recently put me on that combo for depression. I was taking 60 mg of Cymbalta for a couple months, depression seemed to be returning, so she upped it to 90 mg. I think it helped the depression more, but I started having leg jerks when I was laying down (or occasionally my arm), which seriously interfered with sleep. So I went back down to 60 mg, but depression came back. So last week, she added on 150 mg of Wellbutrin. So far I think it may be helping, but it hasn't even been a week. She said another option would have been to add Abilify instead of Wellbutrin. So maybe ask your doc about adding one of those?

I have done plenty of both in the past, but not at the moment.

Good Morning Jess,

Thanks for your candid replies. I still would like to understand what symptoms of depression you seek relief from most. Oversleeping, frequent crying, lack of pleasure in life, suicidal thoughts, self harm, insomnia (early, middle, late) as a few examples. Do you have psychotic symptoms like hallucinations or extreme delusions?

My concern reading your story is that you find a great deal of relief from a mixture of or separate doses of amphetamines (Adderal) and opiates. I see that you also recognize the danger in this and this is why you are seeking alternate solutions. I do not think any of the meds or med combos you are seeking will give you the same amount of pleasure and relief as the controlled substances do.

That being said, I will go with what I know. Cymbalta, an SNRI, is pretty strong and a real heavy hitter in the SSRI/SNRI world. If you have had some success with it and want to stay in the SNRI world, Effexor and Pristiq are Cymbalta's SNRI brother and sister.

I've never taken an SNRI, but I have and currently enjoy an SSRI and Norepinephrine booster (Prozac and Welbutrin). That's almost the same as an SNRI. Beyond that here is what I know about the meds you listed in the other thread:

Viibryd - a very new serotonin style (like SSRI) anti-depressant. I have never tried it, but it would probably be similar to an SSRI or SNRI.

Lamictal - a anti-epileptic mood stabilizer - very popular with Bipolar folks, esp bipolar depression. I enjoy 150 mg (a small to med dose). There is a 5 week build up. It's mild for me.

Latuda - an Atypical AntiPsychotic for Bipolar (mainly depression) and Schizophrenia/SZA. This would be powerful for you, but AAPs carry risks. I enjoy it at 40 mg (a small to med dose) but it took about 5 weeks to settle in.

Abilify -An AAP like Latuda also a popular adjunct to SSRIs, meaning they give it to plain depressed people too and not just bipolar. I enjoyed this at 2 mg, 5 mg, and 10 mg. It's not bad at all. Made me a little restless. Worth Trying.

Remeron - I am least familiar with this med. I have heard some complaints about weight gain.

Wellbutrin - This lil guy is probably your best bet. I have enjoyed it at 90 IR, 100 SR, 150 SR, 150 XL and 300 XL. It's energizing and about the closest thing you are going to get to lift you out of bed and keep you motivated. While it helps many with this, unfortunately it will not come close to the energy and focus you got from Adderal.

Buspar - This is an anti-anxiety med. I enjoyed it at 15 mg. It's mild, decent. I do not think it would be great for depression. It's a little numbing and like I mentioned, really for anxiety.

In summary, If you are seeking a workaround to Adderal, you might continue to work around the stimulant wheel, concerta, straterra, provigil, nuvigil, etc and get that uppity and speedy focus. Welbutrin seems to be the likely winner, but I have always combined it with an SSRI.

The most important thing to realize is that you are coming off Adderal, which is basically like quitting using speed. Marked depression and lack of energy are the most common side effect of doing this. Some of this will just have to be waited out.

Please keep posting and let us know your thought process and updates with results.

Thanks,

moogs

AbIlify knocked me out at 5 mg. I forgot to mention that in the other thread. They wanted to up it to 10mg, but I refused since I was already a zombie on 5.

Thank you so much for your response!!! The main symptoms of depression that are bothering me are just the lack of energy and motivation and the loss I
of interest in things. I feel like it is hard to get out of bed and get the day going and I have no desire to do anything. It sounds like wellbutrin might help me some with that. I am seeing my doctor tomorrow morning, so I will talk to him about it. Also, do you know of any other meds that would be helpful in that area? Right now I am down to just taking my 60 mg of Cymbalta, but from what I see here, a lot of people take several medications combined. I am a large man of about 6'4" and over 250 pounds, so that may affect my tolerance for things too.