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Author Topic: No Anti-depressant has ever worked for me?  (Read 431 times)

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Offline sgreens1

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No Anti-depressant has ever worked for me?
« on: February 09, 2014, 01:28:12 AM »
I've had depression since I was 13, and have tried many different medications. SSRIs I've taken: Lexapro, Zoloft, Celexa/SNRIs I've taken: Pristiq, Cymbalta/Atypical antidepressants Ive taken: Wellbutrin.

Has anybody had more success with tricyclics? I know they can be more dangerous and hard to ween off of, but I've also heard that some people just don't respond to SSRI/SNRIs.

I know that MAOIs are also available, but are very dangerous and interact poorly with several other drugs and foods.

Any feedback would be appreciated!
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Offline johnathonm

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Re: No Anti-depressant has ever worked for me?
« Reply #1 on: February 09, 2014, 01:58:23 AM »
Have you tried an adjuvant like abilify with you antidepressant? Also did you stay on them for like 4 to 6 weeks? As for tricyclics they didn't agree with me but they can really help or work well.
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Offline insights

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Re: No Anti-depressant has ever worked for me?
« Reply #2 on: February 09, 2014, 02:20:18 AM »
Has anybody had more success with tricyclics?

I've been taking tricyclics (TCAs) almost continuously for 26 years.

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I know they can be more dangerous

TCAs can be more dangerous in overdose than the SSRIs except Celexa (citalopram) and Lexapro (escitalopram), but not usually at the doses typically prescribed. I've been taking dosulepin, aka dothiepin, which is the most cardio-toxic antidepressant, for about 20 years at above the maximum recommended dose and it has had no harmful effects on me so far, though it may in old age.

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and hard to ween off of,

The TCAs are usually much easier to wean off than the SSRIs, and also generally produce far fewer and less severe starting side-effects too. The down-side is that they typically produce more ongoing side-effects such as constipation, dry-mouth, etc.

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but I've also heard that some people just don't respond to SSRI/SNRIs.

About a third don't respond well enough to any antidepressant to make it worth taking them. TCAs may work when other classes of antidepressants fail, but this doesn't necessarily mean they will for you. The only way to know is to try them. Given your lack of success with SSRIs, the more norepinephrinergic TCAs such as desipramine and nortriptyline might be the better initial choice.

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I know that MAOIs are also available, but are very dangerous and interact poorly with several other drugs and foods.


All of which is true, but they can also be very effective. The best antidepressant I've ever taken was Nardil (phenelzine). Unfortunately, the food restrictions became a real pain in the butt because I was eating out a lot at the time. If you have control over what you eat then the MAOIs may be worth a try. The reversible MAOI moclobemide (Manerix), which have far fewer restrictions, rarely does much, IME.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline sgreens1

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Re: No Anti-depressant has ever worked for me?
« Reply #3 on: February 09, 2014, 02:37:55 AM »
Yes I've taken Abilify, and I've stayed on the meds for at least 4 weeks
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Offline Andrew90

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Re: No Anti-depressant has ever worked for me?
« Reply #4 on: February 09, 2014, 11:23:54 AM »
Just curious, have you tried Remeron (Mirtazapine)?
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Offline sgreens1

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Re: No Anti-depressant has ever worked for me?
« Reply #5 on: February 09, 2014, 02:12:02 PM »
No, I haven't
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Offline Andrew90

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Re: No Anti-depressant has ever worked for me?
« Reply #6 on: February 09, 2014, 04:24:52 PM »
Might be worth a try. It's neither an SSRI nor an SNRI, and it is a pretty well tolerated medication. Something to consider before going to the Tricyclics or MAOI's.
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Offline stevo1111

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Re: No Anti-depressant has ever worked for me?
« Reply #7 on: February 14, 2014, 08:53:58 AM »
For severe cases of anxiety and depression, most often high doses of a TCA (Clomipramine and Imipramine being generally regarded as very effective for anxiety) or an MAOI (most effective is probably Nardil) might be necessary.

Like you, I tried a bunch of the more modern anti-depressants which almost no success. It was not until I began on Clomipramine that I found any relief and it was like night and day.

Personally, I think that Remeron may not be a great way to go because of the high short term "poop out" rate and the tendency for people to get uber fat on it. 100mg of Clomipramine a day for going on 9+ months now and I have gained 2-3lbs and have no other lasting side effects.

The long short of it seems to be, although the side effect and overdose profile of the "old" antidepressants, TCA and MAOI, is a little bit worse (for some) than the new SSRI and SNRI classes, the power of the medicine is like comparing a pea shooter to a Howitzer. Plus, the start up anxiety from a TCA is probably 10% of that from an SSRI, at least for me. Those things drove me into a dark corner for the first month.
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