[Miktis25]

My psychiatrist is starting me on anti-depressants, which I'm less than happy about as I really don't want medications messing with the neurotransmitter a in my brain when I haven't even got a proper diagnosis (my mother has clinical depression, so they decided they'll try treating that as I'm an 'unusual case' so there's no one to compare me to; I'm autistic so the symptoms I have are actually problems I was born with and will always have, and with severe hallucinations)

Anyway, they said that because I'll need to be 'happy' with the choice of medication in order for it to work properly I should do my own research (which I have been doing, but don't quite understand) so I'm at least 'comfortable' with some rather than completely against them all.
The neurotransmitter they want to boost are seratonin and noradrenaline/norepinephrine. I was wondering if there's any 'positive' experiences with medications specifically for this? I don't know which one they're putting me on yet but I'd like to know from people taking them how they've helped.

[-jimi-]

I don't know why you need to be happy with the med for it to work. That would just be a placebo effect and that does not last. Or do they mean you need to take it as prescribed?

Anyway, I hope they are informed to start you on a low dosage. Autistic people are often hypersensitive to medication, so a normal starting dosage might not be your ideal starting dosage.

[Moiraine]

I think what works for one person may not work for someone else. For me, Pristiq has worked when other meds have not. It would be what you are looking for....but if they are just guessing, I'm not really sure that I would agree to an antidepressant. Do you personally think you need one? If not, you can tell them no. Explain that it is part of your autism. Good luck with whatever you decide.

[Miktis25]

Originally Posted by -jimi-

I don't know why you need to be happy with the med for it to work. That would just be a placebo effect and that does not last. Or do they mean you need to take it as prescribed?

Anyway, I hope they are informed to start you on a low dosage. Autistic people are often hypersensitive to medication, so a normal starting dosage might not be your ideal starting dosage.

Actually I'm very resistant to medications. They usually have to double or triple doses before any effect even shows. Even with anaesthetic; it doesn't work completely and they have to give me another dose (for local) or they have problems keeping me under with general. It's a nightmare with pain meds.

I think they mean more that if you really hate them and believe fully that they won't work, then they won't work to their full capacity as a big part of any emotional feeling is belief. If I believe fully that in two hours time I'll get something nice to eat, I'll be more positive that if I believed that the something nice would give me stomach ache I suppose

[Miktis25]

Originally Posted by Moiraine

I think what works for one person may not work for someone else. For me, Pristiq has worked when other meds have not. It would be what you are looking for....but if they are just guessing, I'm not really sure that I would agree to an antidepressant. Do you personally think you need one? If not, you can tell them no. Explain that it is part of your autism. Good luck with whatever you decide.

Honestly, I have no idea. It may help with the anxiety which would be nice, but I really don't think it'll help the problems I'm having now. They won't do anything else until I try these, though I've asked for a different doctor to do a review as I didn't trust this one at all. It's a weird system though because there's a home treatment team that came out to get some information, then the doctor who was mean to do an hour long (and usually even longer) assessment, but even though she was also meant to ask all the questions and get all the information again for herself, I was barely allowed to speak. She made many assumptions on how I would've felt in different situations which have happened even though to me, the patient, these particular ones were much wanted and celebrated with happy dances when they came. She called me negative... I'm an incredibly positive person most of the time... Just not when they're trying to stick me with something that could affect whether or not to get the right help, and they don't really have proper reasons for it. Everything they decided was part of it is actually just me being autistic! Right down to forgetting to eat. I have timers for that because I've never remembered once in my life without being told to eat.

Sorry, that's a really long way of basically saying:
I don't think I need one for that, but I won't be able to get any help until I try them; and I hope that it at least helps my anxiety which would be nice

The SNRI medications do tend to help anxiety, but other drug classes do, too, so I'm not sure why your doctors are choosing that drug class.

I have taken two different SNRI medications both for depression/anxiety and fibromyalgia pain - Effexor/venlafaxine and Cymbalta/duloxetine.

One thing that I've experienced with them and that a lot of people experience is unpleasant withdrawal-type symptoms (anxiety, "brain zap", numbness and tingling in my lips and fingertips) if I miss one single dose.

I put up with having to be extra-vigilant about taking the doses at exactly the right time and making sure I never run out of the medication because it helps my fibromyalgia pain so much.

I'm curious, too, about your hallucinations - do your doctors not plan to do anything to help you with those? I would not expect an SNRI medication to affect those (although I could be wrong.)

The SNRI medications also have a severe discontinuation syndrome. If you have been taking one for a while (it usually takes a few months for your brain to become accustomed to the med to the point that you will experience severe side effects if you try to stop it too fast) and decide that you want to stop taking all psych meds, that will generally mean an extended "taper-down" regime and probably some type of medication for anxiety and insomnia while you're doing that.

If I were in your shoes, I would want to know why my doctors wanted me to take a drug in the SNRI class rather than, say, an SSRI like Zoloft/sertraline. When I took sertraline, it also helped my anxiety.

I think of the SNRI drugs as being good for severe depression and also for certain types of chronic pain. If you don't have either of those, an SSRI medication seems more appropriate.

Actually, if you were in the US, I imagine you'd be prescribed an antipsychotic medication either instead of or in addition to an antidepressant because you have the hallucinations.

[Miktis25]

Originally Posted by jo_thorne

The SNRI medications do tend to help anxiety, but other drug classes do, too, so I'm not sure why your doctors are choosing that drug class.

I have taken two different SNRI medications both for depression/anxiety and fibromyalgia pain - Effexor/venlafaxine and Cymbalta/duloxetine.

One thing that I've experienced with them and that a lot of people experience is unpleasant withdrawal-type symptoms (anxiety, "brain zap", numbness and tingling in my lips and fingertips) if I miss one single dose.

I put up with having to be extra-vigilant about taking the doses at exactly the right time and making sure I never run out of the medication because it helps my fibromyalgia pain so much.

I'm curious, too, about your hallucinations - do your doctors not plan to do anything to help you with those? I would not expect an SNRI medication to affect those (although I could be wrong.)

The SNRI medications also have a severe discontinuation syndrome. If you have been taking one for a while (it usually takes a few months for your brain to become accustomed to the med to the point that you will experience severe side effects if you try to stop it too fast) and decide that you want to stop taking all psych meds, that will generally mean an extended "taper-down" regime and probably some type of medication for anxiety and insomnia while you're doing that.

If I were in your shoes, I would want to know why my doctors wanted me to take a drug in the SNRI class rather than, say, an SSRI like Zoloft/sertraline. When I took sertraline, it also helped my anxiety.

I think of the SNRI drugs as being good for severe depression and also for certain types of chronic pain. If you don't have either of those, an SSRI medication seems more appropriate.

Actually, if you were in the US, I imagine you'd be prescribed an antipsychotic medication either instead of or in addition to an antidepressant because you have the hallucinations.

I've given up on trying to understand their decisions to be honest; the transmitters dopamine and glutamate can cause psychosis symptoms but they seem set on those two. Psychotic depression has hallucinations, but they've said I'm definitely not psychotic. Hallucinations and confusion are my biggest problem though, the former is constant. They refuse to budge on the idea that antidepressants are the only way, and they're the only help I can go to do I can't even get another angle on it.
I've completely refused Prozac and Nefazadone, I just don't feel comfortable at all taking either of those two, so I know they're not giving me those; I don't really want to go on any of them though because I think it's a waste of time when none of what they help with is a lroblem for me anyway. And the things that are such as forgetting to eat and not sleeping more than two hours most nights... I'm Autistic, they are and always will be my problems...

[Moiraine]

It really sounds like the so called helpers are well, not helpers. So much of the time "professionals" don't bother to listen to the patient because they think they know more, even if they've never met the patient before and know squat about them. I am sorry that this is happening.

[Moiraine]

Welcome. Been there and done that, so I know what it feels like.

[ManOfConstantSorrow]

Well it is not a life sentence, you can quit when you please and the health risks are very low so you might as well see if they help and if not, try something else. I found citalopram good for anxiety and depression, but others say the opposite.

[Miktis25]

I think the one they've now decided on is fluvoxamine just to start with, which is an SSRI, and the starting dose will be 10

[Miktis25]

Nevermind, picked up the prescription and they've changed to Citalopram; we'll see how it goes I suppose

[Miktis25]

Originally Posted by ManOfConstantSorrow

Well it is not a life sentence, you can quit when you please and the health risks are very low so you might as well see if they help and if not, try something else. I found citalopram good for anxiety and depression, but others say the opposite.

Citalopram is what they've given me to try, I start it in the morning. That's the thing though, if I could quit when I please I wouldn't even be starting them, but I've been told that until I take it for however long they decide then they won't do anything else. I've never heard of such a weird system before but that's how they're doing it. Maybe it'll help with my anxiety, that would be good

[ManOfConstantSorrow]

I am sure it will be OK but be sure the read the leaflet that comes in the packet and see your doc if you feel odd or unwell.

This drug needs two weeks or more to have an effect so be patient. I expect 'they' are just waiting to see if this will cap your anxiety. It did for me and I was then able to undertake therapy.

Good luck.