[Americano]

The first few days can be full of side effects. Do any of make your choices based on the most tolerable starting out? It's a long term commitment sticking with an AD until it works. Few have years to spend trying each one for a few for a few months. Surely there are indicators of which may be an appropriate fit early on.

[Guiness187055]

You don't choose. You keep trying different ones until you find one that works. It's called the med merry-go-round and we all go through it. Sorry

[emgreen]

Originally Posted by Guiness187055

You keep trying different ones until you find one that works.

You're...BRILLIANT, Guiness!!! Why didn't someone think of that! You'll surely win the Nobel Prize now! Then...You'll run for the seat as president of Zimbabwe!

[still_crazy]

hi. ideally, a knowledgable doctor thinks about your problems, other drugs you're taking, your history, any health conditions, response or lack of response to past treatments, and what adverse effects are OK and which aren't, and then comes to an informed decision and writes a prescription.

it seems that more often...your symptoms play a role, but so do other factors, such as your social status, your gender, the kind of doctor you're seeing (community mental health, private practice, cash only private practice, etc.), the sort of insurance coverage you have (hopefully...), and the diagnoses on your records....plus, honestly, what a given doctor (especially psychiatrists...) think you're "good enough" for.

For instance: I am on disability, and I go to a community mental health clinic. My now well-to-do parents are taking care of me. I am diagnosed w/ Bipolar I and obsessive traits. When my mood dipped very low, I asked my doctor about Wellbutrin, and he said it'd be worth a shot. It did help for a while there, and I dropped it w/o incident.

I mention this because....if I was, say, a poor minority woman going to the same clinic, I'd be diagnosed w/ Schizophrenia or something, and I don't know that they'd even take the time to ask about mood problems. If they did, the answer would probably be an SSRI.

And if I was going to a private practice doctor, I'd be getting much more leeway, but not as much leeway as people w/ less severe diagnoses. A cash only, no insurance private practice doctor would probably give me (and their other patients, too, of course...) the most leeway, especially the high(er) status ones.

[Americano]

Yes I've seen quite a number of doctors and been prescribed all the ssri/snris (not sticking them all out for months because it's difficult to quit and go through sides at work). Well maybe there isn't a good answer to this question yet. I also feel a lot of guilt about taking so many pills every day. I fear it's going to destroy me from the inside out.

[Guiness187055]

Originally Posted by emgreen

You're...BRILLIANT, Guiness!!! Why didn't someone think of that! You'll surely win the Nobel Prize now! Then...You'll run for the seat as president of Zimbabwe!

I'm a MOTO (master of the obvious) Do you wanna be my VP in Zimbabwe?

[NeedHaldol]

I have just accepted that taking meds are a part of my life now.

Morning and at night.

People have to take meds for all kinds of medical conditions - high blood pressure, diabetes, etc.

It takes a couple of months to see if you are the right track to a good cocktail of meds. See them through and adjust accordingly.

[Americano]

I know but I'm curious as to if the way it felt in the beginning is an indication of how well it will work for you months later. I'm in the process of switching from celexa to either Prozac or cymbalta because they have the least side effects when I take them.

Just a general comment here not directed at the Original Poster in particular. I have observed that a certain nation's population seems somewhat fixated with 'shopping' their medication. I have also noted that pharmaceutical companies in this same country do a great deal of advertising direct to the consumer. You don't see that here. The notion of walking into my doctor's office and saying, "I want to take XYZ" is absolutely foreign to me. Hence, I find such questions implying choice to be rather alarming.

[NeedHaldol]

i agree justafriend.

I don't mention my diagnosis or my meds on here.

Talking about certain medications is not productive and can lead people down the wrong path. Keep the meds in the hands of professionals.

[vishva8kumara]

Antidepressants are prescribed for a variety of illnesses, not just depression. Usually, nowadays a doctor will first try with an SSRI.

Different SSRI are good for different illnesses, and comes with varying side effects. For an example, Lexapro which is an SSRI would not be given to someone already having cardiovascular problems. Those little papers with fine print they put into boxes of medicine have everything they know about the medicine. Most of the time there are sections such as Contraindications and Side-effects.

Actually it takes at least a week to start feeling a relief from an antidepressant. My doctor started me on Escitalopram from 5mg to 20 gradually, and therefor having enough time for me to adjust to side effects. Also some add-on medications such as Xanax and Ambien was added for the first two weeks that gives immediate results until the antidepressant kick in. Previous time it was an antipsychotic,

As soon as I could, I got back into working out to maximize the effects. This most recent episode was the hardest hitting one as well as the fastest recovery it seems.

You have to talk with your doctor about how you are doing and side effects from meds so the doctor can decide if you should continue or switch meds.

One does not need to try every antidepressant out there to see what works best for them. Doctors know if A fails should B or C tried next. And they rule out whole classes of meds based on your history, other co-morbidities and so many other factors.

[reb569]

It took nearly 6 months to get my daughter to a place where a deep depression was lifted, well technically much longer than that, but that's when she started on her current cocktail. If you don't give the meds time enough to work, you may never find anything that will work.

[Americano]

I don't have a lot of trust in doctors. I know more than all I've come across. I'm sure its more common here in the south. I've got it down to cymbalta or Prozac. Probably prozac as it has more hypomanic vibe and I'm not usually a fan of noradrenaline.

[Americano]

It's so frustrating because to go to celexa to Prozac will take a long time to wean down while adding Prozac then when I'm on Prozac having to give it a couple months solo, then if it doesn't go well having to devot more months. I guess on the bright side I'm down to two so if neither work I'll move on to another class. I think the idea is not to think about it. And just try to get on with life. But being depressed at work literally makes me fear losing my job because I don't interact well with people at all.

[reb569]

Originally Posted by Americano

I don't have a lot of trust in doctors. I know more than all I've come across. I'm sure its more common here in the south. I've got it down to cymbalta or Prozac. Probably prozac as it has more hypomanic vibe and I'm not usually a fan of noradrenaline.

I trust my daughter's PDoc. He has always explained why he's trying a certain med compared to another one, what the side effects could be, what might be the next steps if that doesn't work. I've done a lot of research and what he has said is backed there. He also treats her like a person, it's not all about the meds, he really wants to know how she's doing overall. Encourages her to go out and live life despite being MI. It's not blind trust. He's earned it. My daughter has been a challenging case.

[Americano]

Originally Posted by reb569

I trust my daughter's PDoc. He has always explained why he's trying a certain med compared to another one, what the side effects could be, what might be the next steps if that doesn't work. I've done a lot of research and what he has said is backed there. He also treats her like a person, it's not all about the meds, he really wants to know how she's doing overall. Encourages her to go out and live life despite being MI. It's not blind trust. He's earned it. My daughter has been a challenging case.

I apologize reb that wasn't directed at you at all I was referring to the poster above you. Also I had gone to the Psych doc yesterday and he wasn't very friendly. I'm quite bitter because I stayed on Zoloft for many years increasing the dose even though when I finally got off and tried all the others it was the worst of all of them (anxiety, sedation, agitated). Not that anyone forced me but after seeing lots of doctors none said let's quit the Zoloft and try another one until I asked to do so after having been through some terrible experiences over the years.

[reb569]

Originally Posted by Americano

I apologize reb that wasn't directed at you at all I was referring to the poster above you. Also I had gone to the Psych doc yesterday and he wasn't very friendly. I'm quite bitter because I stayed on Zoloft for many years increasing the dose even though when I finally got off and tried all the others it was the worst of all of them (anxiety, sedation, agitated). Not that anyone forced me but after seeing lots of doctors none said let's quit the Zoloft and try another one until I asked to do so after having been through some terrible experiences over the years.

No need to apologize. I understand that not everyone's experience is the same, and I really do feel lucky that we have found a psychiatrist that is very good and see's my daughter as a living person, not a chart. I wish everyone could have a pdoc like him.

[kkrrhh]

I'm with Americano when it comes to not entirely trusting psychiatrists. Unfortunately not everyone has access to a pdoc they can put their full faith into. I've tried a lot of meds and out of the half a dozen or so that have been of any help to me, I can only think of 1 that was suggested by a doctor... the rest that've actually helped have been meds that I researched and then asked about trying. I've corrected doctors on things, known things they didn't, and even stopped a pdoc from prescribing things that could've interacted badly.
reb569, I'm sincerely really happy (and maybe a little jealous :P) that your daughter's found a psych like that. He sounds wonderful, and I agree that things would definitely be much better if more pdocs were that way.

Americano - Prozac's actually a med that gave me a little boost at the beginning and I was told this was a good sign...although I've thought other meds were doing same and then it ended up just being anxiety and side effects?? But either way, the Prozac did end up helping.

MAOIs are supposed to be really rough starting out, and they kind of are for me, but not any worse than some SSRIs/SNRIs have been. Nardil was really rough at the beginning though, then ended up being worth sticking it out because it's been the best antidepressant for me. But it seems a lot of meds makes me feel like crap at the beginning and just stay that way.
Unfortunately it is pretty much true about just having to stick it out to see, but sometimes that's just not an option for me because of how unlucky I am with side effects, so I do end up having to decide based on how I feel pretty early.