Saliency

Hi David. I posted quite an in-depth account of my own experience with Valium withdrawal in a thread/topic that I made on this forum only a couple of weeks ago. I will copy and paste the information I posted in that thread for you to read here. I have noticed that you are posting quite a lot on this forum recently, usually about the same topic and problems, more or less. I'm not criticising you for this but I want you to know that this neuroticism and health anxiety that you are experiencing is a normal symptom of Valium and benzodiazepine withdrawal in general. You may feel that you're right to be this anxious about everything, but it's just how your brain thinks when you're coming off benzos. You will feel far less neurotic, have far less health anxiety and feel much less of a need to seek reassurance from others (e.g. via posting here about the same topic) once you've been off the Valium for a few weeks. My experience and advice based on that experience is below: I essentially followed the Ashton Manual for tapering off the Valium. You should be able to easily access this by doing a Google search for "Ashton Manual". It should be one of the first results. It's essentially a free, online instruction manual from a university professor who has studied the topic and helped patients through withdrawal. After I quit alcohol completely, I started on 10mg of Valium per day, 5mg in the morning and 5mg at night. I then dropped my dose by 1mg every ten days until I got down to 4mg of Valium per day (2mg morning and 2mg at night). Once I got down to the 4mg per day, I went a bit slower and reduced my dose by 1mg every 14 days. I stopped taking the Valium completely after I had taken the final 1mg per day for 14 days.The Ashton Manual recommends dropping the dose of Valium by no more than 1mg every 7 days, at the fastest. But you have to adjust your schedule to your own symptoms, so the Ashton Manual shouldn't be taken as Gospel. It is a very effective and helpful guide, however. A lot of people end up finding out about it when they want to taper off their benzos and it's relied on by people all over the world. The general consensus is that if you're tapering off benzodiazepines, you need to give up alcohol as this acts on the same receptors. You could probably start drinking alcohol again after you're off the benzos, but you should wait at least a few months after the end of your taper. I plan to avoid it in the long-term for a plethora of reasons. You should also check what other medications you're on and make sure none of these medications act on GABA. Most antidepressants are safe as they do not act on GABA, but a lot of the anticonvulsants do act on GABA in some way, even if it's not via the same mechanism as the benzodiazepines. These anticonvulsants are commonly used to treat bipolar disorder and some other mental illnesses, and they include: topiramate, gabapentin, pregabalin, lamotrigine and sodium valproate. Obviously if you're prescribed these for long-term use, don't stop taking them when you begin the benzo taper. You should speak to your doctor and you should only be tapering off one drug at a time. The reason I mention these drugs though is that a lot of people want to just jump straight from their benzo to one of these drugs instead of doing a proper taper and having a washout period before they start new meds. In addition to medications, you should avoid taking any herbal supplements for anxiety, as a lot of these affect GABA and act on the same receptors as the benzos. These supplements include Valerian, Kava, Gotu Kola, Ashwagandha and maybe Bacopa. I say maybe because the actual pharmacology of a lot of herbal supplements isn't totally understood. However, vitamin and mineral supplements are generally safe. I used magnesium to help during my taper and continue to take it. A lot of people swear by magnesium supplements, but the worst they can do is not work for you. It won't disrupt the tapering process. In terms of withdrawal symptoms, I had constant suicidal thoughts, anxiety so severe I couldn't read, constant crying spells, insomnia, rapid heart beat, weight loss and I couldn't control my emotions. It was really awful. But once I gave up the alcohol completely and started tapering the Valium properly, all these symptoms started to dissipate. I had a couple of random crying spells near the end of my taper, but overall it was a pretty smooth process. I took 10mg Lexapro in the morning and 15mg of mirtazapine and 2mg-3mg melatonin at night. Mirtazapine and melatonin really helped with sleep and got rid of the insomnia. Lexapro helped reduce my anxiety and depression. I also took propranolol and prazosin as needed for the physical symptoms of anxiety, like the rapid heart beat, sweating and shaking. Apart from these meds, magnesium and a multivitamin were the only other things I relied on. If you educate yourself about the process and what to expect, set up a decent tapering schedule, tell your loved ones about what you're going through and find a supportive doctor (if you don't have one already) to help you through the process and monitor your symptoms, it doesn't have to be a horrible process. Make sure you get all of these things sorted to the best of your ability before you actually start the tapering process to avoid giving yourself more anxiety. A lot of people still manage to work and/or go to school while they're tapering, as long as they're doing a proper taper. The final thing I will say is that other than finding the Ashton Manual online and reading/understanding that, you should stay away from all the online Benzo Withdrawal communities. I know some people do find these online forums/communities to be very helpful, but they just gave me more anxiety because they were full of horror stories and worst case scenarios. You need to avoid all this negativity while withdrawing because your heightened anxiety will trick you into thinking that your withdrawal will be a worst case scenario. People are highly sensitive to suggestion when withdrawing due to their high anxiety levels. The mind is powerful and can trick your body into having worse withdrawal symptoms. Sorry for the super long post, but I hope this helps you - if you are planning to taper yourself, I think you might have just meant this question as a general query - or anyone else who is having a problem with the benzos and wants to come off them. Obviously keep in mind that I didn't study Medicine or any Health Science degrees so I'm not a professional. So talk to your doctor (or at least a doctor) about your withdrawal plan. I had a great doctor that I saw regularly during withdrawal and I highly recommend finding a doctor like this. You will need a doctor to provide the prescriptions for Valium in any case. The other information I've provided is based on my own experience and the experience of others that I gathered during my research.

I just wanted to add that ACUTE dystonic reactions to antipsychotics are usually treated with anticholinergic drugs like Benadryl (diphenhydramine) or Cogentin (Benzatropine). However, if you've developed a Tardive Syndrome (Tardive Dyskinesia or Tardive Dystonia), anticholinergics won't help. As you've been on a high dose of Seroquel for 8 years, it seems highly unlikely that this is an "acute" reaction (these occur within about the first two weeks of starting the drug). It doesn't fit the criteria for acute dystonic reaction at all. However, the eye problems you're describing sound like an Oculogyric Crisis, which is a common acute dystonic reaction. There are lots of videos of this reaction on Youtube just FYI. My doctor (well, the one who finally diagnosed me) knew I had Tardive Dystonia when I didn't respond to Cogentin. He then prescribed Tetrabenazine. There's a newer version of Tetrabenazine out now called Valbenazine, which is supposed to cause less side effects. I couldn't tolerate the Tetrabenazine at all, but it did seem to help the dystonia. It's prescribed for these Tardive Syndromes as well as Huntington's Disease. It's essentially the opposite of an MAOI: it causes your neurotrasmitters to break down faster (especially dopamine), which stops the uncontrollable movements. The movements you're experiencing are likely being caused by the upregulation of D2 receptors in the basal ganglia. This is the brain's natural response to antipsychotic drugs that block dopamine receptors. It's something along the lines of your brain overcompensates and creates too many D2 receptors in this particular region of the brain, the region which is responsible for involuntary movement. Until someone discovers a drug that can cause these D2 receptors to downregulate, the best medications we have are monoamine depleting agents like Tetrabenazine, which reduce your brain's amount of dopamine receptors, rather than reducing the number of D2 receptors. Last time I checked, medical science hadn't figured out how to downregulate these receptors. So Tetrabenazine and Valbenazine are other meds you could try if you don't get put on Clozapine. There was a user here whose son developed this same problem after taking Risperidone for a while. She told me that his movement problems were improved by taking Guanfacine. This is an alpha-2-adrenergic agonist similar to clonidine, used for high blood pressure and ADHD. So Guanfacine and Clonidine are two other meds that you could bring up with your doctor, as these could help you as well! They're very good for anxiety in any case and have muscle relaxant properties, so it probably wouldn't hurt to try them and they would likely help with your pain.

David, I'm not a doctor or a health professional, but I've had this horrible problem too and it took ages before I found a doctor who could correctly diagnose the problem and what caused it. I saw three general physicians before that and they were all totally clueless and wanted me to stay on the meds I was taking, even though they were making the problem worse every day! I guarantee you that it's the Seroquel that is the primary culprit here. Probably the only culprit based on the meds you've listed, but the Zoloft could be making it worse. SSRIs and SNRIs made my dystonia worse, but the actual dystonia was caused by the dopamine antagonist I was taking. Seroquel is far less likely to cause Tardive Dyskinesia than most of the other antipsychotics (except Clozapine), but it still definitely happens. It's the only medication that you've mentioned that really fits the bill based on the symptoms you're describing. I hope you can see a neurologist about this soon, because stopping the Seroquel won't necessarily make everything get better right away. You'd need to slowly taper off the Seroquel with your doctor's guidance and approval. However, as this is likely a semi-permanent change in your neurochemistry that's been caused by years of using the drug, the problems won't necessarily all go away as soon as you're off the Seroquel. Although a lot of people do find that their symptoms improve after a few months of abstinence. I understand that going without meds is just not an option for a lot of people. The good news is that Clozapine has actually been able to REVERSE the movement problems you're describing in people who got this movement disorder from taking other antipsychotics, including Seroquel. A lot of people with this movement disorder seem to improve once they are switched to Clozapine and eventually it seems to go away completely after they've been on the Clozapine for a few weeks. Benzodiazepines like Klonopin are often used to treat this movement disorder, but you're on a lot of other meds that may interact with it. Could you ask your doctor about increasing the Depakote if they won't switch you to Clozapine? Anticonvulsants do sometimes help put a stop to this disorder. But the one anticonvulsant that seems to have the highest success rate and is often used for this is Tegretol (carbamazepine). If you do get switched to Clozapine, you could perhaps ask about taking another anticonvulsant called Topamax (Topiramate). Topamax has been quite successful in treating this disorder in a few studies I've read recently, and the good news is that Topamax causes weight loss as one of it's main side effects and is often prescribed to people who take antipsychotics that make them gain weight. Clozapine causes the most weight gain of any of the antipsychotics in existence, but Topamax can prevent this and might also treat your movement problems at the same time. It might be a good combination to try and ask about when you get to see a specialist. Please get in to see that neurologist ASAP! I imagine he/she is going to diagnose you with either Tardive Dyskinesia or Tardive Dystonia. I have Tardive Dystonia. They sound very similar but the difference is that Tardive Dyskinesia causes a lot a lot of uncontrollable, rhythmic movements. Tardive Dystonia on the other hand causes sustained muscle contractions and postures, which can become extremely painful. Best of luck to you and please let us know how your appointment goes. I developed Tardive Dystonia 6 years ago and it was pretty much gone a year later, after I got off the meds I was on and changed to different medication. I still get "flare ups" every now and then, but they're usually caused by me taking some medication that stirs it up. Mine seems to go through periods of returning if I ever take a med I probably shouldn't have (like when I have severe nausea or migraines that I'm desperate to get rid of) but it always seems to improve as long as I'm off all the meds that can aggravate it. I believe you will get better too. I know the idea of waiting months or years for this to improve sounds awful when it's so painful! I broke down crying when the doctors told me this could be permanent. But it eventually got much better and I live a pretty normal life now! Make sure you tell your doctor about how much PAIN you're in, because it really does sound like you need some pain medication in the short term as well!

I have heard of people doing stuff like this, but that whole process just sounds too cumbersome to me. I can't imagine the stress of having to prepare my meds every day like that during benzo withdrawal. Some people swear by the whole liquid titration thing, but that was just going too far for me and it seemed unnecessary. All I did was use a combination of 5mg and 2mg Valium pills that my doctor prescribed. I cut them them in half with a pill cutter, doing my best to make sure I went straight down the line in the middle. I bought one of those plastic pill organisers that I could store all my medicine in for a week (two separate compartments for each day, AM and PM). So I would just sit down once a week and cut up all my pills to the best of my ability. After doing it for a few weeks I became quite proficient and could organise my whole weeks worth of pills in about 10 minutes. I actually travelled to the USA and Canada for the first time in my life with my family while I was withdrawing and doing this. I was worried about something going wrong with my meds, like my luggage getting lost or someone at customs questioning why I had all this Valium and antidepressants. But luckily that never happened in the four weeks I was overseas. I had letters from my doctor and everything, but I was still a bit worried about losing my pills! So it is possible to do the taper even when you're travelling as long as you get yourself organised. I'm so glad I went on the trip too, because it took my mind off the fact I was tapering and almost made me forget about what I was going through.

David, what other medications are you taking apart from the Valium? Your symptoms sound like a dystonic reaction or dyskinesia caused by antipsychotics. Are you taking any antipsychotics like Seroquel, Zyprexa, Risperdal etc? Or any drugs for nausea or vomiting, like Reglan/Maxolon, Compazine/Stemetil? All of these drugs can cause dystonic reactions because they block dopamine receptors. I recently tapered off Valium successfully. I actually made a rather long post about my Valium taper only a couple of hours ago. If you look at my profile, it should be the last post I made before this one. Otherwise, you can send me a private message and I can just copy and paste the advice I gave, as it's pretty comprehensive and covers a lot of my experience with tapering off the Valium.

It sounds like you have another disorder such as ADHD in addition to the anxiety and depression. However, as you have sleep apnoea, it is possible that your ADHD symptoms were being caused by the untreated sleep apnoea. But you had those symptoms since you were a child and my understanding is that you don't usually develop sleep apnoea until adulthood. Anyway, the treatment for sleep apnoea and ADHD is actually the same: stimulants such as amphetamine (Adderall). I find it odd that your doctor prescribed you bupropion instead, but I suppose it does have stimulant properties. ADHD and sleep apnoea are not approved uses for bupropion though. Usually, you'd be prescribed Adderall, Dexedrine or Vyvanse. Or even Provigil or Nuvigil if you want something with an improved safety profile and a much lower potential for addiction/dependence. You can take any of these stimulants in combination with certain SSRIs. I take Lexapro with Nuvigil. Lexapro and Zoloft both have the least drug interactions of all the SSRIs, so taking Zoloft with one of these stimulants I mentioned does some feasible. Can you ask your doctor about a proper stimulant medication to take instead of the bupropion? I found that bupropion greatly exacerbated my anxiety without providing any noticeable pro-cognitive effects. Nuvigil is my favourite of all of the stimulants and provides those desired effects for me without the anxiety that bupropion caused. I have previously taken Dexedrine as well, and even that gave me less anxiety than bupropion.

Thank you everyone for your kind words. You support and encouragement really means a lot to me. Hi Atra, I essentially followed the Ashton Manual for tapering off the Valium. You should be able to easily access this by doing a Google search for "Ashton Manual". It should be one of the first results. It's essentially a free, online instruction manual from a university professor who has studied the topic and helped patients through withdrawal. After I quit alcohol completely, I started on 10mg of Valium per day, 5mg in the morning and 5mg at night. I then dropped my dose by 1mg every ten days until I got down to 4mg of Valium per day (2mg morning and 2mg at night). Once I got down to the 4mg per day, I went a bit slower and reduced my dose by 1mg every 14 days. I stopped taking the Valium completely after I had taken the final 1mg per day for 14 days.The Ashton Manual recommends dropping the dose of Valium by no more than 1mg every 7 days, at the fastest. But you have to adjust your schedule to your own symptoms, so the Ashton Manual shouldn't be taken as Gospel. It is a very effective and helpful guide, however. A lot of people end up finding out about it when they want to taper off their benzos and it's relied on by people all over the world. The general consensus is that if you're tapering off benzodiazepines, you need to give up alcohol as this acts on the same receptors. You could probably start drinking alcohol again after you're off the benzos, but you should wait at least a few months after the end of your taper. I plan to avoid it in the long-term for a plethora of reasons. You should also check what other medications you're on and make sure none of these medications act on GABA. Most antidepressants are safe as they do not act on GABA, but a lot of the anticonvulsants do act on GABA in some way, even if it's not via the same mechanism as the benzodiazepines. These anticonvulsants are commonly used to treat bipolar disorder and some other mental illnesses, and they include: topiramate, gabapentin, pregabalin, lamotrigine and sodium valproate. Obviously if you're prescribed these for long-term use, don't stop taking them when you begin the benzo taper. You should speak to your doctor and you should only be tapering off one drug at a time. The reason I mention these drugs though is that a lot of people want to just jump straight from their benzo to one of these drugs instead of doing a proper taper and having a washout period before they start new meds. In addition to medications, you should avoid taking any herbal supplements for anxiety, as a lot of these affect GABA and act on the same receptors as the benzos. These supplements include Valerian, Kava, Gotu Kola, Ashwagandha and maybe Bacopa. I say maybe because the actual pharmacology of a lot of herbal supplements isn't totally understood. However, vitamin and mineral supplements are generally safe. I used magnesium to help during my taper and continue to take it. A lot of people swear by magnesium supplements, but the worst they can do is not work for you. It won't disrupt the tapering process. In terms of withdrawal symptoms, I had constant suicidal thoughts, anxiety so severe I couldn't read, constant crying spells, insomnia, rapid heart beat, weight loss and I couldn't control my emotions. It was really awful. But once I gave up the alcohol completely and started tapering the Valium properly, all these symptoms started to dissipate. I had a couple of random crying spells near the end of my taper, but overall it was a pretty smooth process. I took 10mg Lexapro in the morning and 15mg of mirtazapine and 2mg-3mg melatonin at night. Mirtazapine and melatonin really helped with sleep and got rid of the insomnia. Lexapro helped reduce my anxiety and depression. I also took propranolol and prazosin as needed for the physical symptoms of anxiety, like the rapid heart beat, sweating and shaking. Apart from these meds, magnesium and a multivitamin were the only other things I relied on. If you educate yourself about the process and what to expect, set up a decent tapering schedule, tell your loved ones about what you're going through and find a supportive doctor (if you don't have one already) to help you through the process and monitor your symptoms, it doesn't have to be a horrible process. Make sure you get all of these things sorted to the best of your ability before you actually start the tapering process to avoid giving yourself more anxiety. A lot of people still manage to work and/or go to school while they're tapering, as long as they're doing a proper taper. The final thing I will say is that other than finding the Ashton Manual online and reading/understanding that, you should stay away from all the online Benzo Withdrawal communities. I know some people do find these online forums/communities to be very helpful, but they just gave me more anxiety because they were full of horror stories and worst case scenarios. You need to avoid all this negativity while withdrawing because your heightened anxiety will trick you into thinking that your withdrawal will be a worst case scenario. People are highly sensitive to suggestion when withdrawing due to their high anxiety levels. The mind is powerful and can trick your body into having worse withdrawal symptoms. Sorry for the super long post, but I hope this helps you - if you are planning to taper yourself, I think you might have just meant this question as a general query - or anyone else who is having a problem with the benzos and wants to come off them. Obviously keep in mind that I didn't study Medicine or any Health Science degrees so I'm not a professional. So talk to your doctor (or at least a doctor) about your withdrawal plan. I had a great doctor that I saw regularly during withdrawal and I highly recommend finding a doctor like this. You will need a doctor to provide the prescriptions for Valium in any case. The other information I've provided is based on my own experience and the experience of others that I gathered during my research.

Hi everyone, I made a post last year when I was extremely depressed and suicidal. Original post for background/context is here: I successfully tapered off the benzodiazepines and have maintained total abstinence from alcohol. I finished my benzodiazepine taper on September 11, 2018. I am currently taking 10mg of Lexapro in the morning and 25mg Valdoxan at night. I was previously taking 10mg Lexapro and 15/30mg of Mirtazapine during my benzo taper, but have switched from Mirtazapine to Valdoxan because of the weight gain. Valdoxan helps with sleep (not as much as Mirtazapine), so I have found it to be an appropriate substitute. I also found a great psychiatrist who has taken a real interest in my life, my wellbeing and success. He also prescribed 150mg Nuvigil (armodafinil) for me to take occasionally. The Nuvigil in combination with Lexapro and Mirtazapine pretty much eliminated my depression and anxiety. I would actually be happy with never drinking alcohol again. The only difficult part of it for me is navigating peer pressure and societal pressure to drink. I think I am probably better off without people who encourage me to drink though. It's funny, because I have some friends who drink and cannot deal with my decision to abstain from alcohol. Then I have other groups of friends who occasionally indulge in alcohol (as well as other substances) and they have absolutely no problem with me not drinking. It's the people whose only vices are alcohol and cigarettes that have had the most issues with me not drinking. I never really enjoyed "partying" in the sense of going out to clubs and whatnot, no I have no real desire to drink anyway. I think abstaining from alcohol, benzodiazepines and other drugs that affect GABA has led to great improvements in my mental health. During my benzodiazepine taper, I was unemployed and I still am. However, I was able to complete both my university degrees (Law and Commerce) and I was able to finish my thesis. My official graduation ceremony isn't until March, but I will be graduating with First Class Honours in Law (as well as graduating with a Commerce degree, majoring in Accounting). I am very happy with my progress so far and I'm currently applying for full-time graduate positions in law firms. I am looking forward to full-time work and starting my career. Still waiting on two employers to get back to me, but I'm hoping I will have a job by February. I don't know what else I can say. My goals for this year are to get back into exercise and lose the weight I have gained from Mirtazapine. I also need to continue eating better, and I hope these changes to my diet and lifestyle will improve my mental health as well as my physical health. Feel free to ask if you have any questions. It does get better with the right medication and lifestyle changes. I thought my suicide was inevitable last year and could see no other way out of my situation. But I was wrong. So, so totally wrong. I have other physical health problems that I've told other people about online and in real life. A lot of people seem to feel sorry for me because of those issues, but I feel quite positive about everything. With the right mindset and support, I feel like I can overcome anything. I already survived the worst year and drug withdrawal of my life and I know that you can do it too if you're currently in a bad place and are suffering from these type of problems.

Being Australian and an avid fan of horror movies that are well-made, I just had to go see the movie "Hereditary" the other day with some friends before it finished its run in Australian cinemas. I'll do my best to try not to give away any spoilers when I explain why I don't recommend anyone who is currently severely depressed or going through a rough patch see this movie. It's probably especially applicable to those members here who are parents and struggle with depression or another mental illness while struggling to meet the demands of parenthood while dealing with their mental illness. So if you've heard of this movie and don't want anything at all to be spoiled because you're definitely going to see it no matter what I say, maybe stop reading here. I'd also like other members to chime in if they have seen this movie, or if there are other movies you have seen that have affected you in a profoundly negative way (even if you weren't expecting it) and therefore don't recommend people with depression or another mental illness go and see that particular movie. To me, Hereditary was actually a brilliant movie, but I don't think I could see it again. I think it hit a little too close to home. It's about a family that suffers through unspeakable tragedy and things just keep getting worse and worse until it totally flies of the handle and turns into a bizarre nightmare. The thing that really struck me about it is how normal everything is on the surface, and how apathetic the universe and everyone else is towards what the family is going through. The world carries on as normal, while each member of the family endures unspeakable internal torment (reminds me of my own struggles with mental illness). And things never get better - they get worse, and there's many inferences to be made throughout the film that this was the inescapable destiny of the family. Things were always going to end badly, and each effort they make towards improving things just backfires and makes things worse (reminds me of when I am proud of myself for getting out of bed in the morning and something very bad happens to me during the day, which makes me think that I should just stay in bed forever). Mental illness is also frequently referred to throughout the film. But it's hard to know whether what the family is experiencing is a result of mental illness in response to trauma (there's one interpretation of the title, "Hereditary": hereditary mental illness) or if something supernatural is actually going on. And that's one of the things that really got to me, because one of my first breakdowns when I was a teenager was due to severe OCD which involved obsessions of a religious/spiritual nature. There's also a lot of drug use throughout the film - the teenage son smokes illegal drugs and the parents pop large amounts of sleeping pills (presumably some kind of benzos) in order to numb the grief that they are experiencing. I felt the way the characters were feeling to be so relatable it was horrifying: the feeling of internal torment, unspeakable suffering, feeling like you're losing control of everything and getting no sympathy or help from the rest of the world, who just go about their lives as normal while treating you like a nutcase. Has anyone seen this movie or any other movies they'd advise people with mental illness don't go and see? Or have you read any books or TV shows that have had the same effect? I know one obvious example is '13 Reasons Why', but I only made it through the first episode of that, not because I found it triggering, but because I found it so inane and already knew from word-of-mouth that the rest of the series would just be a glorification of suicide and treat it as a rational response to teenage angst. Hereditary, on the other hand, was so well-made and relatable that it shook me to my core.

Hi GoldenOne, Are you currently on medication, and what is the most extreme/last resort therapy you have tried for your depression? Sometimes people find that adding something like Lithium or Lamotrigine to their current regime really helps, especially with suicidal feelings/ideation. If you have been through all the other medications (including combinations like Remeron and Effexor or adding Lithium), it might be time to consider something like an irreversible MAOI (i.e. Nardil or Parnate). I briefly looked through your old topics and saw that you suffer from Social Anxiety? Nardil is one drug that seems to help a lot of people with severe social anxiety and co-morbid depression. These drugs (Nardil and Parnate) have saved people even where ECT has failed, but I understand it's very difficult to get them prescribed and they have a lot of drug interactions and food restrictions that makes it difficult for people to stick with them. I would seriously recommend speaking to your doctor/psychiatrist about trying one of the less frequently used medications if you've tried everything else and are still feeling this way after 6 years after relentless depression. Or at least speak about changing your current medication/regime or adding something else on with the potential to have benefit. You should not have to keep going through this, especially after 6 unrelenting years of depression. But I'm sure there are medications out there which could help that you have not yet tried!

Are you on any other medication apart from the Cymbalta? Other drugs for completely unrelated conditions (high blood pressure for example) can interact with antidepressants, sometimes by inhibiting the liver enzymes and preventing them from metabolising the antidepressant at the normal rate or alternatively, inducing the liver enzymes, and causing the antidepressant to metabolise faster, so that it doesn't reach normal therapeutic concentrations in your body. Do you think your son coming out as gay and the prospect of not having grandchildren has been a factor in causing your depression? I'm gay myself, and I still want to have kids someday. Has your son explicitly said he doesn't want children? There are lots of gay people out there who still want to have kids and find ways to do so. I do find it a bit odd that your doctor would start you on an SNRI like Cymbalta rather than trying an SSRI first. If you're having trouble sleeping and no sex drive, in my personal opinion, the best medication (although not an SSRI or SNRI) would actually be Remeron (Mirtazapine). It knocks people right out like nothing else (about 40 mins after taking it you will be asleep), but it's not addictive, and it's one of the only antidepressants that has no impact on sex drive - in fact, many people find it increases/improves their sex drive. Remeron is probably the best medication for someone who is having trouble sleeping and doesn't want their sex drive to be destroyed. It also has a tendency to work a lot faster than other antidepressants - only two weeks for a lot of people compared to the usual six to eight weeks for other antidepressants. The only major concern with Remeron is that it can really increase your appetite and cause weight gain (but so can Cymbalta and lots of others), so if you're overweight, it might be one you want to avoid - but if you're currently still fit and active, I would recommend trying it. The weight gain can be mitigated by realising it will increase carb cravings, sticking to a good diet, and keeping up the exercise. The best antidepressant therapy I have come across in my experience was the combination of Remeron and Pristiq. Some people also add Remeron to Cymbalta or to Effexor (Effexor plus Remeron is the most often used combination for severe depression where one or more drugs have already failed). Switching antidepressants or combination therapy might be something to look into. I personally tried Cymbalta (by itself) for about three days but it severely aggravated another condition I have and I had to stop taking it. But if you're going to take more than one antidepressant, you have to be aware of increased risks of side effects, particularly serotonin syndrome, which can be a potentially life threatening condition. So switching from Cymbalta to something more appropriate for your symptoms (like Remeron) may be the best option. If you're feeling flat or unmotivated, Prozac or Zoloft are SSRIs that might be better options - they are the most stimulating SSRIs. If you have high anxiety and are looking for a more rapid antidepressant effect, you might want to consider Lexapro. I currently take Lexapro and Remeron. There is also Wellbutrin (bupropion), which is an NRDI antidepressant and smoking cessation aid. It tends not to affect weight or sex drive, but a lot of people find it makes them too anxious and can actually cause/exacerbate insomnia. But everyone is different. You could look into gene testing - it was recommended by a former psychiatrist and it cost me about $150. It told me that I am a normal metaboliser with regard to most major liver enzymes, except CYP2C19, for which I am a rapid metaboliser, meaning that certain drugs (like diazepam) are excreted by my body a lot faster than your average person. I'm also an intermediate/poor metaboliser regarding CYP3A5, but that enzyme is apparently only important for one particular drug (which is not an antidepressant). I don't necessarily promote this though - the drugs that the test told me would not be useful to me are actually some of the drugs that I've found most beneficial for me (e.g. Lexapro). So considering your current and previous medication history, as well as any external factors that might be causing your depression (e.g. your relationship with your son or other family members) might be a good place to start, and if I was in your situation with those symptoms, I would ask my doctor about switching from Cymbalta to Remeron. This typically requires titrating down your dose of Cymbalta until you're off it, then allowing a 'wash-out' period in which you take no medication, and then starting the Remeron and gradually increasing the dose. However, as I said, some people do take those two antidepressants together, but if I was new to antidepressants, I would be concerned about the risk of increased side-effects and serotonin syndrome. So it might be better just to taper Cymbalta and switch medications - but make sure you do all this under the guidance of a doctor/psychiatrist so that you do everything at the appropriate rate/time. Don't just stop taking the Cymbalta under any circumstances: make sure you have your doctor's support and a plan in place first. Cymbalta and other SNRIs like Effexor have a reputation for causing "discontinuation symptoms" in people who come off them, especially if you just stop cold turkey. I had a friend who was on Cymbalta for about six months and decided to just stop taking it. She was off work for at least a week and couldn't function because she stopped taking it cold turkey: she experienced brain zaps, perceptual distortions, diarrhea and general flu-like symptoms. You could look into that DNA/gene testing if you're willing to pay for it. As I said, apart from being interesting information, it hasn't been a great help in my situation. But some people who are poor metabolisers regarding certain major liver enzymes (of which I am not), get major benefit from having these kinds of tests, as poor metabolisers generally experience more severe side effects from antidepressant drugs. I would be inclined to speak to a psychologist about those personal issues if you feel you cannot discuss them with your wife or anyone else.

Hi everyone, I am ambivalent when it comes to psychiatric medication. Medication has definitely saved my life in the past and I have found some to be extremely effective, while others, not so much. But sometimes I can't help but wonder how things might be different if I had learned proper coping mechanisms that could have allowed me to avoid using medication in the first place. The doctor's visits and costs of medication itself really add up, and I've experienced some horrible side effects from certain drugs that were pushed onto me in the past (some of which I feel might be permanent). I often wonder about the influence that pharmaceutical companies have over doctors and psychiatrists. For example, when I last saw my psychiatrist about tapering off of diazepam (which I am in the process of doing, thanks to a supportive GP), he tried to convince me to take olanzapine, despite knowing that I have had adverse reactions to dopamine blocking drugs in the past and weight gain is one of the main side effects that has caused me to discontinue medication. I was then charged about $350 for this appointment. Being prescribed a drug that is not suitable for me and then having to pay someone who couldn't even remember who I was, couldn't find my file, didn't seem to care about me at all, etc, really made me even more depressed. I wonder if others feel traumatised by the experiences they've had with certain doctors, psychologists or medication in the past. I recognise that I do need to be on medication, but I have issues with the types of medication some experts seem to believe are suitable for me (despite a number of studies showing that they are not suitable for people with my condition). Due to the side effects that I've had from certain medication in the past, I've become very wary and distrusting of psychiatrists in general. Sometimes I feel like I have finally found a decent psychiatrist, then at the next appointment, they'll be persuading me to take a medication that is totally unsuitable for me (based on my history) and just don't seem to care about how much I'm struggling, and the fact that they have all the resources to help me if only they cared enough to take me seriously. I have some friends who have been on a cocktail of different drugs for years, and I can't help but wonder if some of their new symptoms or new diagnoses are actually a result of the side effects of the drug they are taking, or a result of withdrawing from one drug while switching to another (a friend who has been on diazepam for a long time and then stopped and switched to another anticonvulsant comes to mind). I know everyone is different and a lot of us definitely need to be on medication (myself included), but I feel a deep sense of helplessness about the careless prescribing that goes on, the lack of concern for the patient as an individual, and the fact that some professionals seem very keen to prescribe the latest and most expensive drug - which often hasn't been extensively studied or used long enough to know that it is truly effective. My sister takes one antidepressant and it has definitely helped her with her OCD, so I recognise that she should stay on that one medication and may need to have her dose increased in future. I worry about my younger brother developing a mental illness in his teens (given that my sister and I both developed ours around 15/16), and I worry about how he will be treated when he seeks help and how the financial and psychological burden of seeing doctors and taking medication will impact his life. I don't want him to have to go down the same path I have, running into uncaring doctors and swapping and switching drugs all the time and spending so much money on medication to find one that is effective, while experiencing horrendous side effects. My parents aren't equipped with the knowledge and experience to deal with this process, so I feel like it will be up to me to help guide him if he has to go down the medication path. As I said, I'm ambivalent about medication and I take it myself - I recognise that a lot of us are on medication and do need to be on medication. Obviously, it's never a good idea to suddenly stop any medication that you're on, and all medication that one decides to stop taking needs to be slowly tapered off under the guidance of a qualified professional (like a doctor, or psychiatrist). What I'm referring to is more the decision to start taking a medication in the first place, or switching from one medication to another, or adding yet another medication to the cocktail. Has anyone else had similar experiences with medication, doctors and psychiatrists? How do you feel about taking medication generally? Does anyone feel traumatised by some of their experiences or wishes they had tackled their mental illness in a different way? How do you feel about psychological interventions and their effectiveness?

I'm gay and have only had one relationship, which lasted less than six months (I am in my mid twenties). I tend not to get along well with a lot of other gay people and don't find the stereotypical gay culture to be particularly appealing. But I am not interested in the types of things that heterosexual men are typically interested in either (e.g. sports, cars etc). The only other gay people that I've had genuine feelings for ended up rejecting me. I have often developed intense feelings for guys whose sexuality was uncertain at the time, who have then turned out to be straight and ended up dating girls who I have felt are worse people than me (in terms of their personality, empathy, ambition etc). Instead of accepting the fact that these guys are just straight and they are dating these girls because that's who they're physically and romantically attracted to, I analyse the behaviour and personality of these girls and then compare it to my own. While I know that these guys don't want to date me because they don't want to date anyone of the same sex, I internalise this pseudo-rejection and conclude that I'm not good enough: I'm not attractive enough, I'm not smart enough and I have a terrible personality. So I already have a much more limited pool of potential partners due to my sexuality, and every "rejection" makes me more inclined to give up and avoid any attempt at fostering romantic relationships. Even if I met someone who I was attracted to and the feeling was initially mutual, I feel that upon finding out about my mental illnesses and other health issues, any prospective partner would promptly abandon me, making the whole thing a waste of time and just another trauma to add to the list. Feeling like I'm not wealthy, attractive, stable or smart enough makes me want to avoid the process in the first place, as my subconscious tells me that these fears about my inadequacies will be eventually be confirmed if I begin another relationship, making me feel even more inadequate by fueling my insecurities and self-loathing.

Hey malkat, I can understand where you're coming from given the nature of your triggers for your anxiety. I know it probably doesn't help, but try to take some comfort in knowing that having an anxious reaction to these recent world events is the "normal" reaction to have; i.e. you're responding like a healthy person would, only to the extreme due to pre-existing issues with anxiety and depression. Being the pessimistic misanthrope I am, I on the other hand would welcome a nuclear war. It's something I've fantasised about since my childhood, to be honest. Last year, I saw what must have been a shooting star, but was actually hoping it was a incoming nuclear missile set to obliterate my city and myself along with it. I have actually expressed to my friends that I hope the nuclear war begins soon, or said things like "I can't believe they're predicting the end of the world is still so many months away!" Everything I say seems to be taken as a joke, but the sad reality is that I'm completely serious. To be honest though, I think a lot of this fear with the Doomsday Clock (which is symbolic, by the way and doesn't really mean anything) moving forward, the current President of the United States, etc is all just politically motivated drivel that's be drummed up by the media because they profit off making people afraid and turning people against each other. But that's just my opinion. I don't think the world is really any closer to ending than it was two years ago. The media just like to play on people's fears because that's where the money is at. Unfortunately for me, and fortunately for you, I think the threat of nuclear war was the highest during the Cuban Missile Crisis and it really hasn't gotten any worse in the past couple of years.

Hi everyone, About two weeks ago, I was suicidal. Since then, I have been on Moclobemide 300mg twice a day, Pregabalin 75mg twice a day and Diazepam 5 mg once per day. My depression and anxiety have improved to the point where I am no longer suicidal at all. I also haven't had a drop of alcohol in 7 days. Last time I managed to do that, I was severely depressed and even more suicidal than when I was drinking everyday. The Pregabalin and Diazepam have no doubt had a major role in stopping my withdrawals and making me feel less anxious, but I would still be severely depressed and have the urge to drink if it weren't for the Moclobemide. My improvement over the last week is nothing short of remarkable and I am very thankful for it. However, I do have a few concerns. Mainly to do with the fact that I don't have an endless supply of these medications and I'm not sure I can convince my doctor to prescribe them again. I asked about switching from Pregabalin to Topiramate, so now I have a script for Topiramate and only three repeats left on my Lyrica script (3 months worth) before that runs out, and only 6 months worth of the Moclobemide (which is decent), but most worringly of all, only 26 doses of Valium left, so that will last me less than a month. Maybe by that time I will be able to taper off. I live in Australia, which I think is a far less liberal country in terms of prescribing meds than the US. You could not get a prescription here for something like Ritalin or Adderral to help with depression/fatigue. No physician would prescribe it and you'd have to prove to a psychiatrist that you have ADHD in order to acquire it. I don't want those meds, but that's just an example. Endless prescriptions for benzodiazepines like diazepam are also extremely rare in my experience, which is unfortunate for me. However, I start a new job on Monday so I will definitely need to be on all my meds at the same dose for at least the next few weeks. I wouldn't mind switching from Pregabalin to Topiramate in the future, but the dose of Topiramate I have been prescribed is simply too low to match the dose of Pregabalin I am taking, as my doctor wanted me to taper upwards to the recommended/effective dose, as could be expected. However, I don't really have time to do that due to the new job, as my situation has been pretty desperate these last few months, so I'm sticking with my old meds until I can transfer over to a dose of Topiramate that actually does something. I tried the lowest dose for a day and felt anxious for most of the day, as I believe it simply didn't do anything for me. I know antidepressants can take a while to work, but my understanding is that with drugs like Topiramate and Lyrica (which are anti-convulsants/anti-anxiety), you should feel something almost immediately - similarly to benzodiazepines - even if it is just side effects like making you feel too relaxed or stupid. I'm not sure where I'm going with this, other than venting my concerns. But I'm wondering if anyone else has found themselves in this position, where they have gone back to their old meds, found them to be effective, but have been prescribed new meds that are far less effective and then have to somehow convince their doctor to let them stick with the old ones. I also suffer from pain issues, hence the reason for having the Pregabalin and Topiramate in the first place. I don't want to find myself going back to drinking in a few months time due to not being on the right medication, after having made such a drastic improvement over the last few weeks. My medications have also given me the energy and motivation to exercise, which is something I love but have not done for ages. I don't want these current improvements to go backwards and end up suicidal again - it's such an awful mindset to be trapped in, as I'm sure many of you know.