#ssri — Public Fediverse posts

Further to our previous update, the switch from sertraline to paroxetine seems alas to be increasingly making us far too sleepy and unfocussed for it to be of any long-term use. We've just sent an email to the practice manager at our NHS GP surgery to advise.

We've tried the following classes and drugs on prescription:

• SSRI - citalopram, sertraline, paroxetine
• SNRI - venlafaxine

Discounting the older types with typically-worse side effects (tricyclics; tetracyclics; MAOI; SARI; sNRI), our last-ditch options appear to be either vortioxetine (SMS) or St John's wort (herbal remedy) 🤦‍♀️

Please note that NHS England only has limited prescription options for treating depression and/or anxiety relative to the larger number of total antidepressants.

Le sigh :FaceExhaling:

#depression #MentalHealth #NHS #NHSEngland #SSRI #SNRI #SARI #MAOI #TCA #TeCA #SMS

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

Everybody finds me much better to be around, says how much better I look and sound, and my brain is getting more broken by the day.

I just learned that when most people try hard to remember things, it can make their head hurt, and that they just stop trying to remember the thing they forgot.

My wife and dad had a whole conversation with which I struggled to interact, in which I ended up virtually non-verbal. They were more relaxed and comfortable because it no longer occurred to them to put in the effort to help me understand, and I hated myself for not understanding.

They both think I should go off the medication, with my wife less strenuously,because she doesn't want to decide for me (she's the absolute best), but I'm dedicated to giving this a real chance.

Anybody with experience here? Does this get better? Or at least tolerable?

#Lexapro #SSRI #MentalHealth #Autism #Anxiety #medicine #ActuallyAutistic #Autistic