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PoeticProse

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Everything posted by PoeticProse

  1. Hello, I would imagine that this side effect will diminish as your body gets used to the medication. Many SSRI's and SNRI's cause drowsiness, but one typically gets accustomed to its effects and notices it less and less. I would do your best to stick with it, possibly taking it in the AM and trying to stay active and busy. Physical activity always helps with this phase of activation as well; it is always a good idea as part of treatment for depression. It can also help with insomnia in the evenings. In preparation for your follow-up with your doctor, keep track, on paper, of all your symptoms; be an impartial observer, taking note of every symptom, even the ones you may consider irrelevant. Discuss these with your doctor, and then you can decide together what the next step should be. Until then, stick with your regimen and stay active. There are always medications to help exclusively with insomnia, but it's better to try behavior changes before resorting to them. Thanks for sharing. Good luck.
  2. Hello, I'm sorry to hear about your first impression of Cymbalta. I've been taking it for over two years now, 60mg for most of it, and I do believe in its efficacy. There are some activation side effects that should diminish as the drug reaches its therapeutic dose in your body. For me, the only difficulty Cymbalta gave me during this brief, beginning phase was overheating. Avoid being in the direct sun for a while, as it caused me to overheat and feel nauseous. As far as the muscle rigidity, that can sometimes be a serious adverse effect, more common during use of antipsychotics than with SSRI's and SNRI's (like Cymbalta). Exercise is always a good idea, especially with treatment for depression. Be sure to stay hydrated as well, as this is sometimes an issue with Cymbalta. On a personal note, I have had little problems with Cymbalta. The only consistent side effect I notice is dizziness upon standing, which is common with most antidepressants; it is gone within a matter of seconds. Stick with it, as it is a promising medication. At least give it 2-3 weeks to take its course, and if you still have unpleasant side effects that are systemic (rather than a placebo effect), tell your doctor. Do your best to be an impartial observer of all symptoms, even the ones that may seem irrelevant. Based on your history and the effect depression is having on your life, you and your doctor can weigh the benefits of the drug with its side effects, and determine whether an alternative treatment is needed. Good luck. I look forward to hearing more about your progress.
  3. Hey, I also started off over two years ago with Lexapro, moving from 10 to 20 mg daily. Though it seemed to work at the beginning of treatment, its effects seemed to disappear over time (possible placebo effect). I also know what it is like to be out of school, wishing you had something to do or some way to be productive. Online courses are great for this; I have been reading 10-15 books a month while out of school this year, teaching myself everything there is to know about my field. These behavioral changes can do wonders for anxiety, especially panic disorder with concomitant agoraphobia. I also had panic attacks, mostly for no reason at all, but sometimes triggered by stressors. The worst part about staying at home is that you will condition fear within the house over time as well, agoraphobia is tricky that way. Antidepressants are the best long-term treatment for these feelings; benzodiazepines work great for sudden panic attacks, but they are habit-forming and should only be taken as needed. I would speak to your doctor about all of your symptoms - do your best to be an impartial observer and take note of every symptom, even the ones you are tempted to deem irrelevant. There are many other SSRI's and SNRI's out there that may be more effective than Lexapro. Psychiatric medications are still in their years of trial and error, no two people being the same. Continue to strike a balance between psychotherapy and biomedicine, as this balance is the most effective method of treatment for your conditions. Don't lose hope. Surely you will find a medication that works for you. In the meantime, maybe asking about benzodiazepines (Xanax, Ativan, Valium) may help get you through the trial and error period of antidepressants. In my opinion, they all work well, but Xanax is fast-acting, allowing you to take one when you're on the verge of an attack, and it will prevent it. Again, i must stress to only take them as needed, as they are quite addictive and have the potential for abuse. These are not a long-term preventative; merely a lifeline to help you work your way to an effective antidepressant. Good luck, and I look forward to hearing more.
  4. The role depression plays in our faith is multifaceted. I believe that my faith has affected my depression more than the other way around. Battling with my beliefs, and witnessing/experiencing events that contradict the beliefs I once had, was part of the overall precipitating event. I do think that retrieving the faith I lost would be a huge step in my recovery, but I have yet to reach the point where I am willing to do so. I respect everyone's beliefs, as I think each and every one is important. It is not the content of the belief, but the belief system itself, that gives people hope for a better tomorrow. It is what instills morals and values into lives, and forces us to realize that we are merely a small part of a much larger picture.
  5. Hello, I'm sure my advice will be somewhat redundant, but hiding is not the answer to any of the problems you may be facing. I completely understand the need to hold onto your job, to play the necessary role day to day despite what you feel inside. I presume that is why you are venting on this forum - you don't find pleasure in daily activities, to the point where it is affecting your life negatively. I strongly recommend speaking with your doctor about your feelings, leaving nothing out. Psychotherapy can be extremely beneficial for those with incipient depression. Medications are always an option, their efficacy is irrefutable, but if you have not tried therapy, I would do so. You could schedule around your work hours, and make it part of your daily routine. As easy as it is to expect your negative feelings to just disappear over time, that is not always the case. It is important to seek the necessary professional help before it causes damage. If keeping your job and performing well are your top priorities, seeking psychotherapy should be as well. We are not meant to merely go through the motions, but to enjoy life. As cliche as this may be, it is true, and there is help available. Thanks for sharing. Good luck, I wish you the best.
  6. Fluvoxamine is an SSRI like many other antidepressants. Being of a serotonergic nature, it was obviously prescribed to rid you of worrisome thoughts/feelings. Though some SSRI's can present emotional blunting as a late-onset side effect, it is quite rare. After reading your brief statement, I doubt this is the case. Is it possible that your obsessive-compulsive tendencies cause you to seek closeness? Did you ever find yourself falling in and out of 'love' in rapid cycles, or counterintuitively? Love can be, and often is, an obsession; it is more like an addiction. It is a desire not only for companionship, but closeness. This desire can often be confused with real love. If any of this sounds familiar, or possible, I would continue with your treatment. Discuss this topic with your doctor, and see how he/she feels about your relationships and the role you believe you play in them. I don't think the SSRI you are taking, presumably at a somewhat low dose, would cause emotional blunting. You're just viewing your emotions differently. Thanks for sharing. I look forward to hearing more.
  7. Hello, I would be willing to bet those symptoms have little or nothing to do with Lexapro. Though there is a chance of mild activation side effects, it is highly unlikely that the symptoms you described are of this nature. Those symptoms seem to correlate more with those of an anxiety/panic attack than side effects from an SSRI. I would expect, in time at at the right dosage, for the Lexapro to provide long-term assistance in the prevention of these episodes of anxiety. As always, psychotherapy works wonders with anxiety. There are medications to help one cope with attacks, but many are habit-forming (benzodiazepines). I would let the Lexapro work its way into your system, and see how you feel from there. Tell your doctor about all your symptoms, even the ones you may see as irrelevant, as this will help him/her in choosing the best route of treatment. Thanks for sharing.
  8. Hey, As a matter of fact, switching between two SSRI's should help with adverse effects. I have been on Cymbalta for roughly two years, with very little side effects. There were a few mild activation side effects, but with you tapering off Wellbutrin simultaneously, you should not notice these. Cymbalta has worked wonders for me, this is irrefutable; it was not, however, one of the 'success stories' you can find online. I do not feel like a completely new person because of this medication. It does help with my symptoms of depression (I am taking 60mg doses). I also take Seroquel XR, as an adjunct treatment for major depressive disorder, and it has been a tremendous help. The only side effect I notice from Cymbalta on a regular basis is dizziness upon standing. This goes away in a matter of seconds, and is common with most antidepressants. Other than that, Cymbalta is quite promising in that aspect. I have not, however, taken Buspar. I have considered it, since I do not like taking benzodiazepines for anxiety, but I want to let my new dose of Seroquel to take effect before adding on yet another medication. Since you mentioned little difference while taking it, I may not consider it any longer. Thanks for sharing your story. Hopefully Cymbalta works as well for you as it does for me. Keep us posted.
  9. Hello, I am sorry to hear about your unfortunate situation. You are correct in realizing there is no need in dwelling on your decision, as you cannot go back in time and do things differently. As far as future situations are concerned, I would take the time to weigh both sides. If panic attacks are an issue, and you do not take medication to help, it is quite overwhelming to make these decisions. Going through with your plans would recondition your fears, but depending on their severity, you may want to do some psychotherapy before going about that on your own. Those with anxiety and panic attacks have a different neurocircuitry than others, and it takes time to re-wire connections relating to fear. You definitely want to make sure you're not forcing anything upon yourself, as it would probably increase your anxiety if you were to find yourself in a different country when an attack occurs. My panic attacks used to be so terrible and debilitating, I would never have survived being away from a familiar place. This, however, may not be the case for you. Cancelling plans may even cause anxiety; not knowing what to say to your friends who know very little about your problems. I would say that your decision was wise - if you're questioning whether or not you should go, maybe you shouldn't. Behavioral-cognitive therapy, as well as biofeedback, work wonders for anxiety-ridden individuals. Medication is always an option, and they are extremely effective, but most fast-acting anxiolytics (like Xanax, Ativan, Klonopin) are habit-forming and should only be taken on an as-needed basis. Therefore, I would first try to find a therapist you like, and work through your anxiety the best you can. Hopefully this psychotherapy will help make your decision easier next time. Good luck, and I look forward to hearing more.
  10. Hello, It is not a guarantee that your sex drive will be affected by psychotropic medication, though it is possible. There is just as much risk of impotence if you are to let depression run its course. Antidepressants have not had this effect on me, and I've been taking various forms and doses for over two years. I would talk to your doctor, as you plan to do, and weigh the pros and cons. It seems to me that if you have been in counseling, and you are now seeing a psychiatrist, the depression has started to affect your daily life. I do not know the specifics of your situation, but there are many benefits to biomedicine, even if a low dose were enough to rid you of the depressive symptoms. Good luck.
  11. 60mg Cymbalta is the highest dose that showed therapeutic improvement in its research. Also, I did consider, at one time, switching to an SSRI like Prozac. However, Cymbalta is a SNRI, so switching would require tapering off Cymbalta before starting a new SSRI. This can become difficult, as well as dangerous, as I would be on a low dose of serotonin-affective medication before starting a new one. Looking into adjunct treatments was the best route to take, all things considered. Standard disclaimer, none of the following is professional medical advice, nor should it replace it. Purely based on my own experience/research :P How many meds have you tried? It's a bit early to call yourself treatment resistant just because Cymbalta for a year hasn't helped much. If 60mg Cymbalta was still not anywhere near satisfactory after a couple of months, you could've probably asked your pdoc for an increase or to try a new med. Might be worth trying some of the SSRIs like Fluoxetine(Prozac) or Sertraline(Zoloft) if you haven't yet. I've you've already tried SSRIs, you could try Effexor(different SNRI). Mirtazapine RLS can go away after a couple of weeks anyway I believe, so depending on how long you tried it for, it could be an option still. Aside from that, there's still tricyclics like Amitriptyline (Elavil), Imipramine, Clomipramine, etc. Also MAOIs, some of which don't have dietary constraints like the Emsam patch in the US, Moclobemide (Manerix, Aurorix). If you really want to stick with the Cymbalta and add more stuff, maybe low dose Amisulpride (supposed to be good for Dysthymia, low grade very persistent depression with loss of enjoyment being one of the common problems), although I'm not sure that's available in the US. I'd probably try more standalone ADs before trying to add stuff to them if you've only tried a couple, as side-effects for a lot of the addon meds can suck. But there's some ideas for things you could try anyway. I'm also still trying to find something that works, having tried Citalopram, Cymbalta, Lofepramine and currently being on a mixture of Mirtazapine and Reboxetine.
  12. Hey there, First, I would like to compliment you on your persistence and determination to complete school. Many of us can relate to the stress and desire to just call it quits when things get tough. Anxiety makes it even more difficult to comprehend one's reactions in the face of difficulty. Your drive is admirable. I am not surprised to hear that you had unpleasant side effects while taking antidepressants; many people have this problem. Biomedicine is not a panacea, and some people just do not benefit from their effects. I am sorry to hear that therapy fees are burdensome. I would continue to search for a psychologist/psychiatrist who you can afford, or even seek someone doing pro bono work, as these professionals do exist. If your anxiety is causing problems in your everyday life, it is very important to seek help. We all suffer from terminal uniqueness, believing that we are different from everyone else and can work through our problems on our own. This may be true in some cases, but not when your life suffers because of anxiety. Behavioral-cognitive therapy is a possible route for you to take. It is extremely effective in relieving anxiety and worrisome thoughts. There are also medications to help with incipient anxiety, as needed, such as benzodiazepines. Be aware that these are habit-forming, so I would not recommend this as a cure-all, daily medication. Medications like Xanax, Ativan, and Klonopin should only be taken when needed, but they do work. I would speak with your doctor about these options. As I said, behavioral or cognitive therapy, as well as biofeedback, could help with your anxiety. It is not as simple as working through it on your own. Anxiety-ridden individuals have a different neurocircuitry, and it takes work to re-wire the connections. Again, I applaud your ability to strive toward success. Do everything you can to seek professional help. While doing so, keep in mind that anxiety can overwhelm and cause many problems down the road if not managed. Psychotherapy is your best bet, in my non-professional opinion. Good luck, and I look forward to hearing more.
  13. Hello, Are other symptoms present at the moment? Try to be an impartial observer of your symptoms, taking note of everything, even if you're tempted to neglect them. Typically, anhedonia presents itself with concomitant symptoms. Such things as energy level, overall mood, and any precipitating events would be very helpful to know. Based on these answers, the method of action will be more visible. I wouldn't immediately search for biomedicine to solve symptoms of anhedonia. Behavioral therapy can be exceedingly beneficial with a lack of interest in daily activities. Biomedicine does wonders, but it is pertinent to find a balance between it and psychotherapy. Speak with your doctor about all of the symptoms you suffer from, including every single one despite your opinion of importance/relevance. Good luck.
  14. Hey there Unfortunately, depression does diminish energy. Often times, the symptoms of depression get worse before getting better; this would explain your lack of energy amidst recovery. Always remember, it does get better. Are there any other symptoms present? Are you in psychotherapy, or taking medication? These answers would help me better understand your current situation. Many antidepressants cause drowsiness, especially during activation in one's body. This often diminishes as one gets used to the medication, but sometimes it requires other medication or behavioral changes. It is great that you are working full-time, I applaud you. For many suffering from depression, this is extremely difficult. Behavior plays a pertinent role in recovery, getting out of the house and doing things whether you want to or not. Continue doing these little things, and maybe start exercising regularly, as these will also help with your tiredness. Physical activity is important for everyone, but even moreso in your case. It will give you more energy as you create a routine, and help you sleep at night. Despite you saying that you're constantly drowsy, I am guessing that you still find it difficult to fall asleep and stay asleep. If this is a true assumption, it is merely a cause of your depression. I appreciate you sharing your story, and I look forward to hearing more.
  15. Hello, I wouldn't exactly label your doctor's advice as 'typical', it seems to be more of a professional protocol. Since you have only been taking 75mg for a week, I would wait at least another week, if not two, before drawing any conclusions. Though a common side effect of SSRI's is drowsiness, for many people, it causes the opposite. I would do your best to be an impartial observer of your symptoms, taking note of even the most minute symptoms that you may want to neglect. Excluding your insomnia, is the Zoloft helping with your symptoms of depression? What is your energy level like? Is your interest in daily activities improving, or staying the same? It is possible, and rather easy, to go from a SSRI to an SNRI (like Cymbalta), if the Zoloft is not working and your doctor believes that you should switch. However, there are many medications that serve as an adjunct treatment to major depressive disorder, like Seroquel, which do help with sleep (once-daily tablet taken 1-2hrs before bedtime). This could be an option for you. Also, are you seeing a psychiatrist or a general practitioner? Believe it or not, GP's are the ones who prescribe majority of the psychotropic medications, but their knowledge of psychopharmacology is limited. So if you're not seeing a psychiatrist, I would try to find one. If you are, I would just continue to see what the Zoloft has to offer. Furthermore, keep track of all your symptoms, both the positive and negative, mild and severe, and speak to your doctor about them. If your depression is diminishing, changing medications may not be the best idea. Any unpleasant side effects can be managed exclusively rather than altering your entire pharmacotherapy. Good luck, and I look forward to hearing more.
  16. Hey there, That is quite an interesting story. It's a shame that there are professionals out there who don't belong in the field. I've had my share of therapists who have done the exact same things you mentioned: forgetting details (even important ones), repeating questions (not for clarification, but for lack of memory), and reading off handouts rather than speaking from knowledge. Unfortunately, they exist; it is just a trial and error situation until you find a psychologist/psychiatrist who works for you individually. Secondly, your concern with a diagnosis and possible BPD. You're correct in thinking that your health is more important than any stigma that may affect your employment and future. I believe that if your symptoms were serious enough, there would be no question of this. Here is my impression based on what you said, as the psychologist may be reluctant for multiple reasons: BPD is a personality disorder, meaning it lies on a continuum, ranging from very mild to an intense severity of symptoms. Everyone will fit into at least one personality disorder, as the criteria are both vague and specific. So this could be the reason you are so adamant about BPD. But more importantly, in my opinion, is the desire to have a clear diagnosis. Thanks to insurance companies and HMO's, many professionals are forced to make a diagnosis, treat, and send the patients on their way. But there is a legitimate reason why many psychiatrists hesitate to do so. A simple diagnosis can affect psychotherapy and the way in which you are viewed. It is a perceptual set - you see what you want to see or what you believe you will see. Once a diagnosis is made, every little symptom that verifies it will be seen, and all other possibilities will be neglected, diminishing the possibility of finding the true problem you may be having. Since you did not list your symptoms, I do not have an opinion regarding a diagnosis. If i were you, I would try to keep an open mind and keep track, on paper, of every symptom that arises. And when I say 'every', i mean it; do your best to be an impartial observer, avoiding your own opinions and keeping track of even the minute symptoms. As far as the Seroquel goes, I have been taking it for quite a while. If you do get better, it still will not lead to a clear diagnosis. It is prescribed for manic episodes of manic-depression and schizophrenia-like symptoms, but also as an adjunct treatment for major depressive disorder. Since you did not mention any other medication, I am assuming the goal is to target your positive symptoms, rather than the negative. I hope it works out for you. So taking not of everything, I would continue to search for a psychologist you like, and keep track of all the symptoms you may suffer from. Do not get caught up with the diagnosis, as this is not an exact science. The DSM does a lovely job (sarcastic) setting strict criteria on ilnesses, but they typically venture away from reality. Diagnosing too early in the therapy process could eliminate all possibility of finding the correct one, which would benefit no one. Thanks for sharing your story, and I look forward to hearing more.
  17. Despite not being alone in your feelings, as far as you're concerned, you might as well be. Depression rids us of the hope needed to believe in tomorrow and the fact that it truly will get better. Just by your brief post, I can tell that you are in no shortage of insight, which is a very good thing. It's possible that you do not find comfort in others - I am much the same. Realize that when depression arises, it may not be in waves. It is out of your control, yet it does not define you. Help is available, in psychotherapy and biomedicine. Hold on to the hope that it will get better, and in the meantime find a psychologist/psychiatrist who can help you work through the tough days. Self-destruction often seems like the only sure-fire solution, but it is never the correct answer. I wish you the best of luck, and hope you find a therapist who works for you.
  18. Hey there, I understand where you are coming from. To touch on your comment about manic-depression, I think it can be left as merely that. What many people do not know is that depression often includes hypomanic states, along with the typical depressive state; it is below the intense manic states of manic-depression. As far as your current situation and feelings, I have a few pieces of advice. First, I would recommend psychotherapy, specifically a behavioral/cognitive direction. Going out and being active is one way of managing depression, and it truly does help. But I understand not having the energy or desire to do so. For this, you should speak with your doctor, probably a psychiatrist, and see if you can be prescribed an adjunct treatment, such as Remeron (generic: mirtazapine). I tried this for a while, and it did help somewhat, but I suffered from akathesia when I reached 30mg. This may not happen with you, so it is always worth a try. At the moment, however, I have been taking Seroquel XR, which is typically prescribed to treat manic-depression and schizophrenia-like symptoms, but it is also being used as an adjunct treatment for major depressive disorder (I take Cymbalta, as it works for me). It is a once-daily tablet like most other medications of its kind, and it helps with sleep. Additionally, it does not make you feel groggy the following morning, and it does seem to give you energy. Furthermore, I have Xanax as well, for panic attacks, but I also do not like taking it. Beyond the drowsiness, I do not like the idea of taking a benzodiazepine daily, as it can be habit-forming. Seroquel XR has prevented me from needing to use it - my panic attacks have nearly diminished. Lastly, I know any addiction can make the situation quite messy. You have been sober for long enough, it would seem, but do not confuse triggers or cravings with symptoms. It takes most addicts 6 months, at absolute minimum, to start feeling like he or she can function without their drug of choice. For many, it takes much longer before they will even benefit from psychotherapy and psychopharmacological methods. As I said, I would not expect this to be a problem for you, but just be cognizant of your feelings. Talk to your doctor and discuss your options. I would recommend Seroquel XR, and I am speaking from experience. Good luck, and I look forward to hearing about your progress.
  19. ***Regarding the idea of a pen name: be cognizant of the statement that may make. In fiction, it is one thing; in nonfiction and memoir work, it is quite another. The authors you will find among this genre have made the competent decision to share their stories, to reach those who may not have another medium through which to vent, and to single-handedly prove that we are not our diseases. A pen name may indirectly show your unwillingness to be seen as someone with depression. And further, what does that say about your view of the illness itself? Should people with depression keep it inside and avoid others finding out about it, or should they be open and seek the medical attention they need? I believe a pen name will send a message that counters the one you wish to present.
  20. In all honesty, I would be more concerned with other issues pertaining to a memoir/creative nonfiction work. I am a writer as well, freelance; there are more things to keep in mind than non-writers could possibly imagine. There is a stigma attached to mental illness, this fact is irrefutable. However, it has been getting better, and there are many writers, as well as professionals, who have written about themselves. Psychiatry is exceedingly concerned with the mental health of its professionals, and yet people like Kay Redfield Jamison have written in great depth about their struggles with mental illness. As I'm sure you know, memoirs are not complete without a look at how the author affected others - this is where an issue arises. Though we may be willing to share our lives with others, that does not give us the right to air the dirty laundry of others. This seems to be the greatest difficulty is writing an effective memoir. Even if information such as names, places, et al are changed, those who are a part of your life will be able to connect the dots. Again, as a writer, I am sure you are well aware of this. Therefore, in my opinion, allowing yourself to be seen as a person struggling with depression is not a terrible idea. Further, it is not even , in general, a bold or unique idea. Depression is a disease one has no control over, and many writers have used this topic in their own writing. I'm sure your life story is unique, and would benefit many people. Your writing will reach others who struggle with similar issues, and reaching that demographic should be your priority. Hope this helps. Good luck in your future endeavors.
  21. At first, I was put on a low dose of Lexapro and worked my way up to the maximum therapeutic dose. It seemed to work for a few weeks, but I'm quite prone to the placebo effect. Not that I'm arguing with it - if it works, it works - but after a while, it doesn't. I switched directly over to Cymbalta from there. After being on it for this long, I feel like my biomedicine options are limited. If I were to switch to an SSRI, I would have to taper off the Cymbalta, which even done safely, I've heard/read it is quite unpleasant. MAOI is not really a territory in which I wish to venture, too many risks. I have been doing psychotherapy ever since I started the medications, and behavior changes have definitely helped the situation. I'm a believer in finding a balance between psychodynamic therapy and biomedicine. I do find myself questioning my motives, or rather my expectations; the success stories one hears about rarely happen, and it is possible that I'm expecting too much from medication. To touch on the Mirtazapine issue, I took 15mg for about 3 weeks, then moved up to 30mg for another 3-4 weeks. The akathesia gradually worsened, so my doctor and I decided to taper off it completely. It was at this point I started seeing a psychiatrist rather than my GP, and he was the one who started me on Seroquel XR, believing that it would prove to be beneficial. Standard disclaimer, none of the following is professional medical advice, nor should it replace it. Purely based on my own experience/research :P How many meds have you tried? It's a bit early to call yourself treatment resistant just because Cymbalta for a year hasn't helped much. If 60mg Cymbalta was still not anywhere near satisfactory after a couple of months, you could've probably asked your pdoc for an increase or to try a new med. Might be worth trying some of the SSRIs like Fluoxetine(Prozac) or Sertraline(Zoloft) if you haven't yet. I've you've already tried SSRIs, you could try Effexor(different SNRI). Mirtazapine RLS can go away after a couple of weeks anyway I believe, so depending on how long you tried it for, it could be an option still. Aside from that, there's still tricyclics like Amitriptyline (Elavil), Imipramine, Clomipramine, etc. Also MAOIs, some of which don't have dietary constraints like the Emsam patch in the US, Moclobemide (Manerix, Aurorix). If you really want to stick with the Cymbalta and add more stuff, maybe low dose Amisulpride (supposed to be good for Dysthymia, low grade very persistent depression with loss of enjoyment being one of the common problems), although I'm not sure that's available in the US. I'd probably try more standalone ADs before trying to add stuff to them if you've only tried a couple, as side-effects for a lot of the addon meds can suck. But there's some ideas for things you could try anyway. I'm also still trying to find something that works, having tried Citalopram, Cymbalta, Lofepramine and currently being on a mixture of Mirtazapine and Reboxetine.
  22. I was diagnosed with major depressive disorder1.5 years ago, precipitating event irrelevant. I have been taking 1cap 60mg Cymbalta PO QD for roughly a year. No significant changes occurred, so I experimented with Mirtazapine to augment the Cymbalta; it caused RLS-like symptoms at bedtime, so I tapered off of it. I have been taking 1tab 300mg Seroquel XR PO QD, expecting to see improvement, but have not noticed any noteworthy. Though my appetite and overall energy have improved, and my panic attacks have weakened in intensity (not frequency), my mood still seems to be suboptimal. As I mentioned panic attacks, I have been prescribed everything in the book; Xanax does work well if I do not catch the attack in time to use other methods, but I do my best to avoid using benzodiazepines. With that being said, I have taken no more than 1mg Xanax in the past 5 months or so. I have been looking into Buspar, and I have heard great things, but I just do not know what the best 'next' thing should be. Will an anxiolytic medication be the best route, or is there something else I should consider to improve my overall mood? I just want to be able to enjoy the things that used to be a integral part of my life; I'm tired of going through the motions.
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