#bupropion — Public Fediverse posts

Per our post yesterday, we emailed the practice manager at our NHS GP surgery last night, enquiring about switching from paroxetine to another antidepressant medication.

We've reduced our paroxetine dose from 20 to 10 mg today in preparation for a change in medication. To counteract any ill effects, we're resuming taking half a tablet (75 mg) of bupropion extended release alongside. (We had to acquire this off prescription, as the NHS won't prescribe it for treating depression.)

If we can get a sooner appointment with the senior partner or another GP at our GP surgery to approve starting on something like vortioxetine (10 mg) or another suitable medication, we'll discontinue the bupropion. If not, we'll fully come off the paroxetine and continue with 75 mg of bupropion daily for a while.

#depression #MentalHealth #paroxetine #vortioxetine #bupropion #SSRI #SMS #NDRI

Hey folks :FediverseSymbol:

Apologies that it's taken us so long to write this update for y'all. Suffice to say, we've not had the executive function, time, or spoons to do so until now :PleadingFace:

For anyone who's not been following us for long, we've been on the StruggleBus™ for a long while now. In fact, our depression would almost certainly be described as chronic, even if it's somewhat under control.

Why are we depressed? SO many reasons, but some of the big ones are:

• Being an empathetic, neurodivergent (AuDHD) spoonie in a world designed by and for uncaring, ableist neurotypicals.
• Being a trans+ person in a world that is continuing to other us, villify us, criminalise us, legislate against us, deny us healthcare, and kill us (directly or indirectly).
• Living in England, UK, which has seen its formerly centre-left Labour Party become a right-wing copy/paste of the Tories.
• Living in a world in constant conflict, where genocides are not only ignored and denied by Western countries, but actively assisted with via arms supplies.
• Living in a world where people downplay conflicts outside Europe or North America and won't consider World War 3 to have started until a NATO country is attacked by the military forces of another :PleadingFace: 😞
• The institutional transphobia and gatekeeping intentionally baked into the NHS since it first began treating trans people in the 1960s.
• The struggles worldwide of people who are trans, queer, neurodivergent, disabled, and/or struggling with mental health.
  • Doubly so for POC living in countries ruled over by former colonial powers 😢
• Working for an employer who is not standing up for trans rights, despite claiming to do so, and is allied with arms companies :FaceExhaling:

... and many more things besides 😞

Whilst we have a formal diagnosis for autism (Autism Spectrum Disorder) from 2018, we're still on a waiting list for an ADHD assessment sadly :PleadingFace: We're actually on 2 waiting lists: the NHS one (which we went on first) and one for ADHD 360, which our NHS GP surgery referred us to under the Right To Choose.

Consequently, we cannot get any ADHD medication on NHS prescription to see whether it might help.

Our depression hadn't been helped on venlafaxine (an SNRI), even at the maximum dose of 375 mg with the extended / slow release tablets.

To try to combat this, we asked our NHS GP to switch us to sertraline (an SSRI) and bupropion (an atypical antidepressant and NDRI), so that we'd have our serotonin, noradrenaline, and dopamine levels raised. Sadly our local NHS ICB wouldn't allow my GP surgery to prescribe bupropion for us for any reasons, but sertraline was no issue.

So, we gradually lowered our venlafaxine dose (by 12.5 mg every other day) until we reached 150 mng daily, then cross-tapered with sertraline until we were solely on sertraline at 100 mg daily. We acquired bupropion from outside the NHS and began taking 1 tablet (150 mg, extended release) daily. This helped a lot with focus, energy, and executive function, but it wasn't enough to keep us functional enough, so we went up to 150 mg sertraline daily, and eventually the max dose of 200 mg daily.

Even with these doses, there was only so much that the meds could carry. So, we started reducing how much help and support we offered others in the community, as this was draining us. We even sadly paused streaming on Twitch, which we used to love doing 😞 We'd already broken the habit of doomscrolling or checking the news daily long beforehand, but due to the communities we're a part of and our current job role, there's only so much hate and suffering we could block out.

Eventually, it broke us. We have been signed off work since 28th October and have an extended fitness note last until 3rd December (inclusive).

During this time, after a lot of research, we took a gamble to see if it might help us: switching from bupropion to [atomoxetine](Atomoxetine), which is most-commonly used to help with ADHD.

As we don't yet have a formal ADHD diagnosis, we couldn't get this through the NHS, so had to acquire it elsewhere. We were able to do this as it's not on the UK controlled substances list, presumably because it's not a stimulant. Instead, it's an sNRI, which boosts noradrenaline and dopamine levels.

In theory, it sounded really good. In reality, it was one of the most awful experiences of our life... and considering we've experienced some truly traumatic things in our life, that's really saying something 😖

We started off on a low dose of atomoxetine (20 mg) and gradually increased it up to 40 mg over the first week, rather than jumping in a 40 mg. We then gradually tapered up to 80 mg daily by the end of the next week, rather than just doubling the dose.

The effects were not overnight, but those 2 weeks were a nightmarish blur. The effects came on gradually, so we didn't spot them as being linked to the medication at first. Additionally, as one of the effects was increasing brain fog, it made it harder to think.

It didn't stop with brain fog though. We became irritable, restless, constantly tired, more depressed, more anxious, and more RSD-prone. We had increasing passive suicidal thoughts, which were beginning to tip us over the edge into the void.

Early into the 3rd week, we realised that we could no longer hear or communicate with our headmate, Hannah. It's hard to describe how we felt at that moment, but it's like having a piece of you torn out, taken away, or hidden from you. The best descriptions we can think of are extreme despair and feeling isolated and alone in our mind.

We stopped atomoxetine cold turkey, and resumed taking 150 mg bupropion daily the next morning.

There were side-effects (especially the first night) from doing this, but it was worth it to start to become functional again. It was only over the next few days that we realised just how negatively the atomoxetine had affected us, how intolerably painful it had made existing, and how close it had pushed us to the brink of the void.

The only good that came out of it was that it put many things into perspective for us, like how relatively lucky we've been with sertraline and bupropion, how resilient we've become in spite of all odds, and how we need to get out of our current job ASAP.

It also highlighted to us how fragile our existence is that a change in one medication could affect us so profoundly and dangerously. And, sadly, atomoxetine was our best hope for a prescription ADHD med, as we don't do well with stimulants typically. Methylphenidate (a stimulant and NDRI) is still a potential option, but it cannot replace bupropion as even the extended release version has too short an elimination half-life (2-3 hours) and duration of action (6-12 hours). For context and comparison, bupropion breaks down quickly (~1 hour) into 3 metabolites with long elimination half-lives (hydroxybupropion 20 hours; threohydrobupropion 37 hours; erythrohydrobupropion 33 hours).

After getting back stabily on bupropion at 150 mg daily, we've today increased our dose to 225 mg, as it's the only variable we can change right now to see whether it helps us.

Anyway, we've written a lot there, and it's past time for us to get some lunch.

Hope this provides more detail for everyone about why we've been so absent and down.

#depression #PassiveSuicidalIdeation #anxiety #MentalHealth #venlafaxine #sertraline #bupropion #SNRI #SSRI #NDRI #atomoxetine #sNRI #ADHD #AuDHD #ExecutiveDysfunction #neurodivergent #neurospicy #spoonie #NHSEngland #StruggleBus #disability

Hey folks 👋

For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.

Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.

During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.

We're still on 200 mg sertraline (an SSRI) daily, but we've made the switch from taking 150 mg bupropion (an NDRI) daily alongside to 40 mg atomoxetine (an sNRI, not an SNRI) daily alongside. We're slowly titrating up to the recommend 80 mg dose.

As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.

The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.

Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as methylphenidate. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.

Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.

Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg propranolol tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg diazepam tablets.

So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.

We are still very much in low power recovery mode, so don't expect anything much or consistent from us.

A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮‍💨 The waiting lists are rather long... even when using the Right To Choose a mental health service provider.

Apologies for any typos.

#MentalHealth #depression #anxiety #burnout #neurodivergent #ADHD #AuDHD #NHS #NHSEngland #sertraline #SSRI #bupropion #NDRI #atomoxetine #sNRI #serotonin #noradrenaline #dopamine #RightToChoose #propranolol #diazepam #stimulants #methylphenidate

Hey folks 👋

For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.

Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.

During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.

We're still on 200 mg sertraline (an SSRI) daily, but we've made the switch from taking 150 mg bupropion (an NDRI) daily alongside to 40 mg atomoxetine (an sNRI, not an SNRI) daily alongside. We're slowly titrating up to the recommend 80 mg dose.

As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.

The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.

Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as methylphenidate. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.

Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.

Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg propranolol tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg diazepam tablets.

So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.

We are still very much in low power recovery mode, so don't expect anything much or consistent from us.

A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮‍💨 The waiting lists are rather long... even when using the Right To Choose a mental health service provider.

Apologies for any typos.

#MentalHealth #depression #anxiety #burnout #neurodivergent #ADHD #AuDHD #NHS #NHSEngland #sertraline #SSRI #bupropion #NDRI #atomoxetine #sNRI #serotonin #noradrenaline #dopamine #RightToChoose #propranolol #diazepam #stimulants #methylphenidate

Hey folks 👋

For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.

Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.

During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.

We're still on 200 mg sertraline (an SSRI) daily, but we've made the switch from taking 150 mg bupropion (an NDRI) daily alongside to 40 mg atomoxetine (an sNRI, not an SNRI) daily alongside. We're slowly titrating up to the recommend 80 mg dose.

As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.

The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.

Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as methylphenidate. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.

Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.

Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg propranolol tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg diazepam tablets.

So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.

We are still very much in low power recovery mode, so don't expect anything much or consistent from us.

A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮‍💨 The waiting lists are rather long... even when using the Right To Choose a mental health service provider.

Apologies for any typos.

#MentalHealth #depression #anxiety #burnout #neurodivergent #ADHD #AuDHD #NHS #NHSEngland #sertraline #SSRI #bupropion #NDRI #atomoxetine #sNRI #serotonin #noradrenaline #dopamine #RightToChoose #propranolol #diazepam #stimulants #methylphenidate

Hey folks 👋

For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.

Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.

During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.

We're still on 200 mg sertraline (an SSRI) daily, but we've made the switch from taking 150 mg bupropion (an NDRI) daily alongside to 40 mg atomoxetine (an sNRI, not an SNRI) daily alongside. We're slowly titrating up to the recommend 80 mg dose.

As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.

The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.

Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as methylphenidate. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.

Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.

Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg propranolol tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg diazepam tablets.

So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.

We are still very much in low power recovery mode, so don't expect anything much or consistent from us.

A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮‍💨 The waiting lists are rather long... even when using the Right To Choose a mental health service provider.

Apologies for any typos.

#MentalHealth #depression #anxiety #burnout #neurodivergent #ADHD #AuDHD #NHS #NHSEngland #sertraline #SSRI #bupropion #NDRI #atomoxetine #sNRI #serotonin #noradrenaline #dopamine #RightToChoose #propranolol #diazepam #stimulants #methylphenidate

Hey folks 👋

For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.

Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.

During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.

We're still on 200 mg sertraline (an SSRI) daily, but we've made the switch from taking 150 mg bupropion (an NDRI) daily alongside to 40 mg atomoxetine (an sNRI, not an SNRI) daily alongside. We're slowly titrating up to the recommend 80 mg dose.

As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.

The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.

Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as methylphenidate. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.

Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.

Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg propranolol tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg diazepam tablets.

So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.

We are still very much in low power recovery mode, so don't expect anything much or consistent from us.

A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮‍💨 The waiting lists are rather long... even when using the Right To Choose a mental health service provider.

Apologies for any typos.

#MentalHealth #depression #anxiety #burnout #neurodivergent #ADHD #AuDHD #NHS #NHSEngland #sertraline #SSRI #bupropion #NDRI #atomoxetine #sNRI #serotonin #noradrenaline #dopamine #RightToChoose #propranolol #diazepam #stimulants #methylphenidate

Hey folks 👋

We'll try and keep this short, as we are running dangerous low on spoons, which is kinda the purpose of this announcement :MentalHealthFlagHeart:

As you likely already know, we are a non-binary, trans fem, disabled, neurodivergent (AuDHD) spoonie, who additionally struggles with major depression, requiring multiple meds daily in order to keep functioning at a full-time job :DisabilityPrideHeart:

Despite this, we have been pushing ourselves regularly beyond our limits, causing increasing tiredness and irritability, exacerbating many of our AuDHD traits, and leading to complete verbal shutdowns at times, as we so very much wanted to help as many people as we could :PleadingFaceWithRedHearts:

This has inevitably led to pretty-much complete burnout 🤦‍♀️

We'd already taken steps back in terms in terms of the amount and scale of support we were giving to people, as well as spending less time on fedi and other platforms, but it's not been enough 😞

As such, until further notice:

• We won't be streaming on our Twitch channel and have deleted our schedule.
• We won't offer private support about gender affirming hormone therapy, mental health, or anything else.
• We will largely be invisible on Discord and will not be on fedi as much as we used to be.

Of course we feel guilty about this, but right now we need to put ourselves first, so that we can fully recover from this burnout, then take steps to reduce the risk of further recurrence.

We want to stress that we are stepping back, not stepping away, from everywhere and everyone.

We'll still be in contact with folks when we have spare spoons, and we'll still interact and post on fedi occasionally.

And we'll still be doing some helpful activities at work and behind the scenes that we can't discuss :TransHeart: ✊

But yeah: you won't see us as much, but it's because we're allowing ourselves to prioritise our own health and needs.

#streaming #streamer #Twitch #TwitchStreamer #queer #trans #transgender #enby #femby #NonBinary #TransWoman #TransFem #CatGirl #LGBTQ+ #LGBTQIA+ #neurodivergent #neurospicy #ActuallyAutistic #ADHD #ActuallyADHD #AuDHD #ActuallyAuDHD #spoonie #NoSpoonsOnlyKnives #disabled #disability #burnout #VerbalShutdown #MentalHealth #depression #SSRI #NDRI #sertraline #bupropion

Hey folks

Apologies that we've been AWOL and still haven't replied to a lot of your notifications 😞

The short version is that we've overextending ourselves (again) in terms of the support we've been giving people. This has led to us becoming overly tired, easily irritated, and emotionally spent. Our RSD (rejection sensitive dysphoria) is through the roof right now :PleadingFace:

The last time we pushed ourselves too far, we had an empathy overload (sometimes known as compassion fatigue) and we can feel it starting again.

We're not going to ignore everyone or forbid ourselves from using fedi, Discord, or other such places we frequent, but we need to cut back and recharge a bit.

We've got a number of stressors IRL right now, and we're only even functional due to a combination of an SSRI (setraline, 150 mg daily) and an NDRI (bupropion, 150 mg daily).

The bupropion is probably the only reason we're able to deal with any of our AuDHD stuff right now 😅 However, it's also let us push ourselves beyond our safe limits until we basically... break.

We're a neurodivergent spoonie. If we push ourselves too far, sometimes we will literally lose the ability to speak out loud. There have even been occasions where Hannah (Evie's lovely headmate) has had to dictate to Evie what to write in WhatsApp messages to her wife!!!

So, just to clarify, we're not stepping away, but we are stepping back a little bit from the support we've been offering people.

Anyways, that's enough for now. Sorry for the long post.

Please look after yourselves, okay? :PleadingFaceWithRedHearts:

We will return. Promise.

#burnout #neurodivergent #neurodivergence #AuDHD #autistic #ADHD #spoonie #MentalHealth #SSRI #NDRI #sertraline #bupropion

SleepyCatten's log.

Earth date: 2024-07-21.

As of yesterday, we're down to 25 mg venlafaxine. Although we've only been prescribed 100 mg sertraline, we had sufficient spare 50 mg tablets to increase our sertraline dose to 125 mg daily, which has offset the reducing venlafaxine dose.

We've got a phone appointment with our NHS GP this coming Wednesday (the date we're completely stopping venlafaxine) to formally request an increase to 150 mg daily of sertraline.

The 150 mg bupropion extended release is continuing to work its magic, but it's been a bit limited by us physically and mentally pushing ourselves further than we should have for chores, looking after wife, etc.

We're still waiting for our backup supply of sertaline to arrive from an IndiaMart seller, so if the official sertraline prescription difficulties continue, we won't be at risk of running out.

We've said this before, but honestly we're just SO looking forward to being off venlafaxine entirely.

#MentalHealth #depression #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog #AuDHD #ActuallyAuDHD #ADHD #ActuallyADHD

SleepyCatten's log.

Earth date: 2024-07-13.

As of yesterday, we're down to 75 mg venlafaxine and up to 100 mg sertraline, alongside our 150 mg bupropion. Can't wait to be entirely off venlafaxine now.

Definitely getting the feeling already that 100 mg sertraline won't be enough by itself, so getting ready to ask for an increase in the prescription to 150 mg sertraline daily.

The bupropion is continuing to work its magic. Having to get reaccustomed to hyperfocusses though... and not getting snappy if someone interrupts them 😅

Also, looks like we picked a fun time to move to sertraline: many pharmacies are having trouble getting hold of it 🙃

Guess what we've just ordered on IndiaMart to give us a backup supply?

#MentalHealth #depression #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog #AuDHD #ActuallyAuDHD #ADHD #ActuallyADHD

A major advantage of bupropion (NDRI) is that it's helping massively with my depression along sertraline (SSRI), and has also helped with the worst struggles we were experiencing with our ADHD, which we would have described as inattentive type before bupropion.

Our worst struggles previously were:

• Lack of executive function.
• Not being able to easily start tasks or even start playing a new game!
• Prioritising tasks appropriately.
• Struggling to do any dull task.

Now, everyday we feel like how some combined or hyperactive people on a stimulant like lisdexamfetamine describe themselves as feeling.

On bupropion, we are:

• Full of energy.
• Able to focus on a task, or even juggle a few tasks at once.
• No longer having to nap every night after work.
• Actually enjoying our work tasks, even the duller ones.
• Able to speak and think quicker.

The only downsides are ones that we're happy to adapt to, such as:

• Being able to keep going until we literally crash, which can cause use to go mute 😅
• Getting fixated and hyperfocussed on tasks much more easily.
• Focussing so much on tasks that need doing that we forget to take breaks for gaming etc.
• Being able to be a bit more spontaneous (which fights with our autistic side).
• Talking even more than we did before 😅

#bupropion #ADHD #autistic #AuDHD #ActuallyADHD #ActuallyAutistic #ActuallyAuDHD #neurodivergent #neurodivergence #MentalHealth #depression #sertraline #SSRI #NDRI

SleepyCatten's log.

Earth date: 2024-07-04.

We're down to 125 mg venlafaxine daily, along 50 mg setraline and 150 mg bupropion.

We've made a minor adjustment to our original scheduled regimen. On 6th July, when our venlafaxine dose decreases to 112.5 mg, we'll up our setraline dose to 75 mg then, rather than increasing it straight up to 100 mg on 12th July without an intermediate step. (It helps to have a precise pill cutter.)

What's kinda funny is that the longer we're on bupropion, the more we're acting a bit more like a stereotypical combined / hyperactive ADHD person on ADHD meds allowing them to focus. But unlike how other ADHD meds work (i.e., they may be short-lived, or last for maybe part of a day), the effect on bupropion is constant.

We're still having to be careful, as despite having the mental energy to do more stuff, we keep pushing ourselves too hard and overloading ourselves, particularly our speech centre. (Yep: we can go completely non-verbal if we overload.)

NGL though: bupropion is awesome and it's a disgrace that the NHS won't prescribe this in the UK. It could help SO many people with ADHD and depression!

#MentalHealth #depression #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog #AuDHD #ActuallyAuDHD #ADHD #ActuallyADHD

SleepyCatten's log.

Earth date: 2024-07-01.

Yesterday we finally got down to 150 mg of venlafaxine, meaning we could start cross-tapering with setraline :MentalHealthFlagButterfly:

Today's mental health regimen was:

• 150 mg venlafaxine prolonged release
• 150 mg bupropion extended release
• 50 mg setraline

Our venlafaxine dose will continue to decrease by 12.5 mg every 2 days. When we reach 75 mg daily on 12th July, we will be increasing our daily sertraline dose to 100 mg.

Our last dose of venlafaxine will be on 23rd July. From 24th July onwards, we will officially be off venlafaxine, and we indeed to stay that way.

We won't know for a while whether 100 mg sertraline will be sufficient for us, but we have the option to ask our GP surgery to increase it further if we tolerate it well and it's helping.

We don't want to up our bupropion dose, as 150 mg already seems to be massively helping. Also, SSRIs and NDRIs kinda make each other more potent, so we want to be very careful there.

Also, bupropion is both helping with some aspects of our ADHD, whilst bringing others more to the surface 😅

Before bupropion, we would have said we meet the criteria for either inattentive or combined ADHD. On bupropion, we're much more hyperactive, but we're also able to mostly channel the energy into productive tasks, albeit via task hopping sometimes if we're tired.

It's also giving us way more energy and alertness, but with the downside that we can now limit break, causing us to keep going until we crash hard. (We've crashed our language centre twice. Hannah had to step in to tell Evie what to write via WhatsApp messages to Evie's wife to explain.)

Our thinking is also a lot clearer, but we're making a lot more silly errors when typing. Plus we can hold more than 3 things in our head at a time now (!!!), but we might forget the thing you just told us a moment ago 😅

It's swings and roundabouts. Overall very positive though.

#MentalHealth #depression #anxiety
#TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog #AuDHD #ActuallyAuDHD #ADHD #ActuallyADHD

SleepyCatten's log.

Earth date: 2024-06-18.

First day of being down to 225 mg of venlafaxine. Emotions definitely getting more prominent. Countermeasures have been deployed to maintain equilibrium.

No symptoms of serotonin syndrome yet from taking 150 mg bupropion extended release alongside the venlafaxine prolonged release.

Despite the bold warnings about the risk of serotonin syndrome, the reported cases are almost exclusively where folks have overdosed on their medications. Conversely, our venlafaxine dose is lowering and we will keep our bupropion dose steady until we have successfully switched from venlafaxine to an SSRI at a stable dose.

#MentalHealth #depression #anxiety #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog

SleepyCatten's log.

Earth date: 2024-06-17.

Last day of 237.5 mg venlafaxine daily now before we go down to 225 mg.

Now that our venlafaxine dose has been significantly reduced, today marks our first official day of taking a bupropion 150 mg extended release tablet alongside.

We were originally going to wait until we had fully switched over from venlafaxine to setraline, but we need the boost in noradrenaline and dopamine levels sooner.

We are still on course to reach 150 mg venlafaxine on 30th June, at which point we will begin taking 50 mg sertraline alongside.

Once we have reached 75 mg venlafaxine daily on 12th July, we will increase our setraline dose to 100 mg, assuming that we've had no bad reaction to the setraline by then.

Our last dose of venlafaxine is scheduled for 23rd July, at which point we will be on 100 mg sertraline and 150 mg bupropion daily.

#MentalHealth #depression #anxiety #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog

SleepyCatten's log.

Earth date: 2024-06-16.

We're down to 237.5 mg venlafaxine daily now.

How much is it affecting us?

We're starting to think that the Americans were right to change S to Z in words where there's a -ze or -zing sound at the end.

e.g., realise / realising --> realize / realizing

Coming off venlafaxine is no joke, folks.

#MentalHealth #depression #anxiety #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog

SleepyCatten's log.

Earth date: 2024-06-08.

We're down to 287.5 mg venlafaxine daily now. Really beginning to feel how much it might have been helping to control some of our ADHD side 😅

• Our short-term memory is definitely being negatively affected.
• We've simultaneously got more energy and no focus to it.
• Our short-term memory is struggling.

Nonetheless, we're continuing onwards, and hoping that we can use techniques to keep us focussed and on task, until we can start making the cross-tapering switch to sertraline.

We won't be able to get bupropion (an NDRI - noradrenaline-dopamine re-uptake inhibitor) prescribed to go alongside this, but let's just say we know affordable ways around this.

#MentalHealth #depression #anxiety #TreatmentResistantDepression #SNRI #SSRI #NDRI #venlafaxine #sertraline #bupropion #SleepyCattenLog

• SNRI - serotonin-noradrenaline reuptake inhibitor
• SSRI - selective serotonin reuptake inhibitor
• NDRI - noradrenaline-dopamine reuptake inhibitor

Hey folks

As many of you will know, we've been struggling a lot rather too frequently recently.

After a lot of research and reading up, we asked our GP to switch us over from venlafaxine (SNRI) to setraline (SSRI).

In order to do this, we first need to slowly titrate down from 375 to 150 mg daily of venlafaxine. It needs to be done slowly, as coming off venlafaxine too quickly (or even missing a dose) can cause super nasty withdrawal symptoms.

Fortunately for us, the venlafaxine capsules we get (Vencarm XL) each contain an appropriate number of 12.5 mg tablets. This makes it very easy to titrate down slowly, by removing a set number of tablets from each capsule.

We'll be gradually reducing our dose by 12.5 mg every other day. This should hopefully allow our brain to gradually adapt to the lessened serotonin and noradrenaline levels, rather than going down in single big steps of 37.5 or 75 mg weekly.

Our GP will then prescribe us 50 mg sertraline daily to take alongside as we continue to titrate down our daily venlafaxine dose.

Assuming no negative side effects (or at least no more than on venlafaxine), our GP can then increase the setraline dose as required, likely to 100 mg.

If there are negative side effects with sertraline, we have backup plans of fluoxetine and, if necessary, citalopram (which we've had before).

Once we're off venlafaxine and on a stable dose of an SSRI, we will then start taking bupropion (NDRI) extended release at the starting dose of 150 mg daily. This should help boost our noradrenaline and dopamine levels somewhat, which should, alongside the setraline, should help more than venlafaxine ever did.

We sadly can't get bupropion through the NHS, so we'll have to acquire it via means outside of the NHS prescription system. Yes: NHS England and NICE are quite a bit behind the times on many things.

In case anyone is wondering why we would even consider an initial switch from an SNRI to an SSRI in the first place, it's because we discovered that it really doesn't boost noradrenaline levels by much: as little as 1/30th to 1/10th as much as it boosts serotonin, depending on dose.

Additionally, venlafaxine just isn't working for us, and our only realistic remaining option medically is to switch to an SSRI first, then bring in a well-reviewed NDRI to give us a decent boost in noradrenaline and dopamine.

#SNRI #SSRI #NDRI #venlafaxine #sertraline #fluoxetine #citalopram #bupropion #depression #TreatmentResistantDepression #MentalHealth

Hey folks

Previous relevant posts can be found here and here.

tl;dr - NHS can't and won't prescribe an NDRI like bupropion for depression/anxiety 😞

This pretty much leaves us stuck with venlafaxine (SNRI) only, as there's literally no point in switching to solely an SSRI, as we'd just lose the noradrenaline boost, which is likely the only thing that keeps us awake and alert most of the time.

We're at the max daily dose of venlafaxine prolonged release (375 mg), so there's no available further medication route for us sadly :FaceExhaling:​

#MentalHealth #depression #antidepressants #SSRI #SNRI #NDRI #venlafaxine #bupropion

Hi folks

We believe we experienced an empathy overload yesterday. It seems to have completely overwhelmed the emotional centre in our brain, so right now we feel rather robotic and zombie-like. It's making our speech and typing feel rather disconnected, like we're typing through a fog or at a distance.

In order to help us recover, we're continuing to largely reduce our time spent on the fediverse, Discord, and any other social media (especially Reddit) that might be triggering to us right now.

We've also let multiple folks on Discord know that we cannot offer them any support of any kind presently.

Per our earlier post here, we're still presently waiting to hear back from our NHS GP over our request to switch from our current SNRI (venlafaxine) to an SSRI (any decent one) plus an NDRI (bupropion).

If anyone has any experiences of combining a specific SSRI with bupropion, we would very much welcome the details, especially if they are positive.

We will be doubly-appreciative if you are also neurodivergent. We are/have AuDHD (inattentive).

Thank you.

#MentalHealth #depression #antidepressants #SSRI #SNRI #NDRI #venlafaxine #bupropion