#fluoxetine — Public Fediverse posts

• 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

Evidence suggests that I forgot to take my #fluoxetine (Prozac) last night.

(I thought I had, but the bottle was still upside-down -- I turn it right-side up after taking it at night, and then upside-down again in the morning, just so every time I'm in there I do something with it -- and I'm feeling more anxious than usual today, so... that's two pieces of evidence going against my never-super-reliable memory.)

While I do feel more anxious, I also feel more clear-headed and better able to focus. We'll see how this plays out for the rest of the day... it's the afternoons when I'm more likely to have to nap in order to recover my concentration.

...and more motivated, too... that was always a thing that I noticed about being on it: motivation was much more tenuous, and needed more #methylphenidate (Ritalin) to power up.

(Does this mean I have to feel anxious in order to feel motivated?)