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[Geddis]

So I think I've been on my current combination of meds for as long as they will help and I don't see any real benefit to staying on them anymore. This medication has never helped much with my mood or positively affected my anxiety, but it did greatly improve my motivation and had completely cleared my suicidal thoughts. When my medication first started to work it was a night and day change, a couple weeks in I realized I couldn't remember why I ever wanted to commit suicide and I was interested in doing things again. I've been noticing it wearing off since about November of last year when it was getting more difficult to keep up with my college courses and now the suicidal thoughts and impulses for self harm have been coming back and I can tell its reached the end of its life.

The medication:
300 mg Wellbutrin XL
80 mg Strattera
40 mg Geodon
.2 mg Clonidine
160 mg Propranolol

I landed on this combination after failing several other drug combinations and ECT. I've forgotten which drugs exactly I've tried, my psychiatrist has been keeping track of the list, but the tally adds up to a little over 20 medications that were all used in various combinations over three years time of experimenting. I think the list includes Prozac, Symbyax, Emsam, Lamictal, Lithium, Trazodone, Zoloft, Cymbalta, Effexor, Vyvanse, Xanax, Buspar, Abilify, Gabapentin, Clonazepam, and Lyrica.

The only one of those drugs I ever did for less than 4 weeks was Emsam and that was because it increased my suicidal thoughts after a week. I did these all in combinations of up to 8 medications at a time, So far the only thing to work for my depression at all is the combination Wellbutrin/Strattera, the Wellbutrin was not working very well but once I went on Strattera for ADHD in two weeks time I became just a really driven person. And the only thing to work for anxiety that I could tell was Lyrica, but I was getting a lot of headaches on it and after a few months I decided to drop it.

I don't usually get a lot of side effects but my current combination so far has probably been the worse for side effects. They include irritability, frequent/urgent urination, increased sex drive, insomnia, weight loss, possibly high blood pressure, possibly excessive sweating, possibly hair loss, vivid dreams, oversleeping, and possibly increased anxiety. For everything preceded by possibly* I'm not certain as to whether or not are being caused by the drugs because I haven't kept a really good record as to when they started.

What I'm looking at trying next:

You'll notice my list of medication does not include a single tricyclic. My psychiatrist does not like to prescribe tricyclics, she says it's like setting off a shotgun blast in your head. What I know about my depression is that it has no response to SSRI's and is the worst during winter on days with less sunlight. From looking into types of depression that kind of sounds like the subclass of melancholic depression which does seem to respond better to tricyclics. I'm going to press her to let me try a tricyclic and I need to know what might be the best one to start with.

Anyone have any idea what tricyclic I should try first? I was thinking of either amitryptiline, desipramine, or imipramine. I'm hoping to be able to treat my adhd, depression, and anxiety all with one medication this time around if it's possible.

[Velthir]

Desipramine probably isn't worth trying since it's basically just Strattera, it's very clean as tricyclics go and is just a pure NRI really. Either clomipramine/amitriptyline/imipramine, hard to know which one will work for you. Amitriptyline and clomipramine both hit tons of random serotonin receptors where imipramine is maybe less broad, so one of those might be best.