# What is the hottest new antidepressant out there?



## outsider77 (Sep 7, 2005)

What are all the doctors pushing these days? I've been on many different ones in the last decade and the side effects outweighed the benefits so I've been off them for a while. Which ones actually work for you without the sexual and gaining weight side effects?


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## No Surprises (Nov 1, 2009)

Given the experiences of most members here with mainstream antidepressant medication, I actually suspected the thread title was facetious at first glance, but since that doesn't appear to be the case...



outsider77 said:


> What are all the doctors pushing these days? I've been on many different ones in the last decade and the side effects outweighed the benefits so I've been off them for a while. Which ones actually work for you without the sexual and gaining weight side effects?


You're asking two separate questions here. In regards to what doctors are currently prescribing most often, I'm going to go out on a limb and say Lexapro and Pristiq are the popular kids on the block nowadays, but the older, off-patent SSRIs/SNRIs are still being prescribed very frequently.

In regards to your question about antidepressants without side effects, well, there really aren't any, as far as I know. But it's a fairly idiosyncratic matter; it's entirely possible that you may not experience significant side effects on certain medications regardless of what the stats indicate. What I'll assume you're actually asking is whether any miracle no-side-effect antidepressants have recently been released on the market, and the answer to that question, I'm afraid, is a resounding no.


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## drealm (Jul 7, 2009)

No Surprises said:


> What I'll assume you're actually asking is whether any miracle no-side-effect antidepressants have recently been released on the market, and the answer to that question, I'm afraid, is a resounding no.


:cry


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## Some Russian Guy (Mar 20, 2009)

outsider77 said:


> What are all the doctors pushing these days? I've been on many different ones in the last decade and the side effects outweighed the benefits so I've been off them for a while. Which ones actually work for you without the sexual and gaining weight side effects?


Lexapro.... it's what doctor prescribed to me after I asked for the newest and latest antidepressants... She also told me there's no side effects.


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## jim_morrison (Aug 17, 2008)

outsider77 said:


> What are all the doctors pushing these days? I've been on many different ones in the last decade and the side effects outweighed the benefits so I've been off them for a while. Which ones actually work for you without the sexual and gaining weight side effects?


I'd guess Lexapro, Pristiq and Cymbalta are being pushed the hardest since their still on patent.

As for whats unlikely to cause sexual side effects or weight gain, although not everyone will experience these side effects no matter what they try, anicdotally Wellbutrin and Parnate are said to have the least of these two specific side effects. Ofcourse parnate comes with it's own set of side effects though. Good luck whatever you end up trying.


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## mark555666 (May 1, 2008)

Cymbalta worked for me quite a bit. Nothing miraculous ofcourse because I think social anxiety more caused by dopamine dysfunction. Too bad the side effects were not worth it. Exsessive sleeping, sexuel dysfuntion and constipation to mention some. It's useful for general anxiety and OCD. Social anxiety is one of the hardest illness to cure.

I heard agomelatine has the same benefits as SSRI's and SNRI's without the the side effects. Anyone can comment on this?

I still have to try Wellbutrin with some good SSRI like zoloft, lexapro and paxil. Someone on this forum took 40 mg paxil and he was living on the clouds with no anxiety at all. Maybe selegiline can attack the side effects.


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## crayzyMed (Nov 2, 2006)

Freesix88 said:


> Cymbalta worked for me quite a bit. Nothing miraculous ofcourse because I think social anxiety more caused by dopamine dysfunction. Too bad the side effects were not worth it. Exsessive sleeping, sexuel dysfuntion and constipation to mention some. It's useful for general anxiety and OCD. Social anxiety is one of the hardest illness to cure.
> 
> I heard agomelatine has the same benefits as SSRI's and SNRI's without the the side effects. Anyone can comment on this?
> 
> I still have to try Wellbutrin with some good SSRI like zoloft, lexapro and paxil. Someone on this forum took 40 mg paxil and he was living on the clouds with no anxiety at all. Maybe selegiline can attack the side effects.


*Agomelatine* is better then the SSRI/SNRI's without all the side effects. Unfortionally its only prescribed in europe at the moment.

*Nardil* and *Parnate* still are the most effective antidepressants for social anxiety available. Unfortionally you will have to follow a special diet to avoid a hypertensive crisis, but when you compare the benefits to the downsides this shouldnt be much of an issue. Generelly ppl that dont like nardil do better on parnate and visa versa, its therefor recommend to try them both.
*Lyrica* can be prescribed offlabel and is anecdotally considered to be very effective and may be worth a try.

*Benzo's *are often prescribed for social anxiety and are very effective, unfortionally they have dependency issues but this can be avoided with taking enough breaks from your medication.

Besides those there is *amphetamine*, which is very effective for the social anxiety/ADD type, those usually arent prescribed for social anxiety but fortionally those who would only benefit from them have ADD symptons, and getting an ADD disagnosis is a possibly road to get those prescribed.

And we've also got *beta blockers* which prevent you from sweating/getting nerveus etc, for some ppl they help alot as they can give you extra confidence because you dont appear nerveus, if sweating, shaking etc is a big issue for you then beta blockers are definatly wort a try.
Beta blockers are easily prescribed and no problem to get.

For depression there are some good looking alternatives too, NMDA antagonists like *memantine* may be worth looking into, NMDA antagonists look promosing for OCD and depression.

And as last a small trial has found *acamprosate* to be effective for anxiety and may therefor also be wort looking into.


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## jim_morrison (Aug 17, 2008)

Freesix88 said:


> I still have to try Wellbutrin with some good SSRI like zoloft, lexapro and paxil.


Personally I'd go for zoloft or lexapro in combination with wellbutrin. Since their less likely to interact with eachothers metabolism.


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## mark555666 (May 1, 2008)

crayzyMed said:


> *Long text*


Well thanks for the clear explanation.

I'm going to think what I'm going to do in the next few weeks. See what options are still worth trying.


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## meyaj (Sep 5, 2009)

In response to the OP, there seems to largely be an inverse relationship between the novelty of a drug and how effective it actually is, so the title of this thread makes my head hurt.


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## Ehsan (Mar 21, 2009)

crayzyMed said:


> *Nardil* and *Parnate* still are the most effective antidepressants for social anxiety available. Unfortionally you will have to follow a special diet to avoid a hypertensive crisis, but when you compare the benefits to the downsides this shouldnt be much of an issue. Generelly ppl that dont like nardil do better on parnate and visa versa, its therefor recommend to try them both.


it seems to be the only paper about effectiveness of parnate in SAD in recent years:

Double-blind comparison of 30 and 60 mg tranylcypromine daily in patients with panic disorder comorbid with social anxiety disorder 

the results show 18 and 35 reduction in LSAS for 30 and 60 mg daily dose of tranylcypromine after 12 weeks.
i don't know baseline LSAS but does not seem to be much better than SSRIs.
_maybe I try it_ though.


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## crayzyMed (Nov 2, 2006)

Ehsan said:


> it seems to be the only paper about effectiveness of parnate in SAD in recent years:
> 
> Double-blind comparison of 30 and 60 mg tranylcypromine daily in patients with panic disorder comorbid with social anxiety disorder
> 
> ...


Nardil is considered to be more effective for social anxiety, i tought there was a paper with a much bigger response rate for it, i'l try to find it again.


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## meyaj (Sep 5, 2009)

A single, 36 person study is hardly conclusive evidence of its effectiveness. A proper meta-analysis is much better suited to this. Besides, there are numerous larger studies which conclude that SSRIs have no significant effect in anybody, even those with severe depression, except for those who rank the absolute worst even among the severely depressed patients.


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## Vini Vidi Vici (Jul 4, 2009)

crayzyMed said:


> *Agomelatine* is better then the SSRI/SNRI's without all the side effects. Unfortionally its only prescribed in europe at the moment.
> 
> \


i think its really funny, that agomelatine is just as effective as SSRIs/SNRIs, without the side effects. especially, since agomelatine dosing is 25mg at night......which means, its antidepressant effects are from re-regulating the sleep cycle. maybe there is a little bit of 5ht2c downregulation...but not very much, since ago is only in the brain for like 3 hours. and if these weak mechanisms are just as powerful in causing antidepressant effects as SSRI/SNRIs, it shows how weak SSRIs/SNRIs really are.


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## Ehsan (Mar 21, 2009)

meyaj said:


> A single, 36 person study is hardly conclusive evidence of its effectiveness. A proper meta-analysis is much better suited to this. Besides, there are numerous larger studies which conclude that SSRIs have no significant effect in anybody, even those with severe depression, except for those who rank the absolute worst even among the severely depressed patients.


i only found 2 papers for tranylcypromine in SAD. one published in 1988 and one in 2008. also last paper for phenelzine in SAD is published in 1998 which shows almost equivalent effectiveness with CBGT after 12 weeks.
i've bunch of papers about double-blinded analysis of SSRIs in SAD which show almost equivalent or even better results! maybe the main superiority of MAOIs is more responders(not more effectiveness). this is promising for who do not response to other drugs but a combination of meds seems to be more safe.
i noticed that you are on 10mg tranylcypromine. how it would be effective while 30 and 60mg of tranylcypromine are not such effective. have you perceived greater efficiency than many other meds you've tried.


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> i think its really funny, that agomelatine is just as effective as SSRIs/SNRIs, without the side effects. especially, since agomelatine dosing is 25mg at night......which means, its antidepressant effects are from re-regulating the sleep cycle. maybe there is a little bit of 5ht2c downregulation...but not very much, since ago is only in the brain for like 3 hours. and if these weak mechanisms are just as powerful in causing antidepressant effects as SSRI/SNRIs, it shows how weak SSRIs/SNRIs really are.


I'm pretty sure the 5HT2C antagonism plays a big role in the antidepressant effect as melatonin isnt exactly as powerfull as a antidepressant.

As far as SSRI, those are quackery, nothing can be whorse then them.


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## UltraShy (Nov 8, 2003)

Dextroamphetamine I've found can put even grumpy old me in a decent mood. But it's far from new and doctors haven't been pushing it since the the 1960s.


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## Your Crazy (Feb 17, 2009)

MTV. Just look at the people on one of their shows for five minutes, and you'll be so happy when you think "I'm not one of them."


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## ifp (Jan 4, 2009)

crayzyMed said:


> *Agomelatine* is better then the SSRI/SNRI's without all the side effects.


 Has anyone you know taken it? Was it really that good?


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## crayzyMed (Nov 2, 2006)

ifp said:


> Has anyone you know taken it? Was it really that good?


http://groups.google.ca/group/agomelatine-psychonauts?hl=en
You can become member at the agomelatine psychonauts group, there are loads experiences up there.


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## ifp (Jan 4, 2009)

Thanks crayzyMed!


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## crayzyMed (Nov 2, 2006)

Here's the hall of fame with the best meds ever:

Memantine
Amphetamine
Pramipexole
LDOPA + 5HTP + Cardidopa
GHB (Watch out for addiction, only praktical for occasional use)
Agomelatine
Benzo's (Dependency issues)
Buprenorphine (Altough opiates produce a rapid tolerance, bupe has been found to work long term for depression and anxiety without much tolerance developping).
Trivastal
Afobazol
Tandospirone
Lyrica
Nardil
Tofisopam

Stahl's heroic combo's are also worth looking into.


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## rustybob (Nov 19, 2009)

crayzyMed said:


> After the last few days id say that pramipexole is the hottest antidepressant.
> 
> Here's the hall of fame with the best meds ever:
> Memantine
> ...


I just learned how awesome GHB is last weekend. I was in Vancouver for the Olympics, and to say things didn't go as planned would be an understatement. My social anxiety really kicked my *** during that trip. But after going out with some friends on Friday night and having a great time, we went to a friend's place for the afterparty. A girl ended up coming over and brought some GHB. All I've gotta say is WOW! After fighting off the sedating part, I then found myself full of energy and completely anxiety free. That feeling of freedom from anxiety I only had one other time before when I had myself a month's supply of Valium (not prescribed). Needless to say, that night I made myself some new friends, and I'm much closer to a couple others. I just wish I could get my doctor to prescribe me Valium, because other than GHB it's the only thing that kills my social anxiety.


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## UltraShy (Nov 8, 2003)

Some Russian Guy said:


> Lexapro.... it's what doctor prescribed to me after I asked for the newest and latest antidepressants... She also told me there's no side effects.


I tried Lexapro 7 years ago. Not exactly new now. As for no side effects, I gather such doctors have never actually used any of the meds they prescribe.


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## millenniumman75 (Feb 4, 2005)

****Thread Lock Watch****
Okay, folks. This thread is about antidepressants, not illegal drugs (like GHB the date rape drug or any of those that make you use a pacifier anc make googly eyes at lightsticks.


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## meyaj (Sep 5, 2009)

millenniumman75 said:


> ****Thread Lock Watch****
> Okay, folks. This thread is about antidepressants, not illegal drugs (like GHB the date rape drug or any of those that make you use a pacifier anc make googly eyes at lightsticks.


GHB is available as a prescription under the brand name Xyrem. Very difficult to get, and extremely expensive, but everything about your comment screams ignorance.


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## 10PercentExtra (Nov 8, 2009)

rocknroll714 said:


> Agomelatine (Valdoxan).


I have been following threads about this drug on dr bob and some other sites.

The results sound amazing. Pity it is not approved in the US.


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## crayzyMed (Nov 2, 2006)

So agomelatine beats sertraline in anxiety and depression, and that without any of the sexual side effects!

J Clin Psychiatry. 2010 Feb;71(2):109-120.
Efficacy of the novel antidepressant agomelatine on the circadian rest-activity cycle and depressive and anxiety symptoms in patients with major depressive disorder: a randomized, double-blind comparison with sertraline.

Kasper S, Hajak G, Wulff K, Hoogendijk WJ, Montejo AL, Smeraldi E, Rybakowski JK, Quera-Salva MA, Wirz-Justice AM, Picarel-Blanchot F, Baylé FJ.

Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Währinger Gürtel 18-20, A-1090 Wien, Austria. [email protected].

OBJECTIVE: This study evaluates the efficacy of agomelatine, the first antidepressant to be an agonist at MT(1)/MT(2) receptors and an antagonist at 5-HT(2C) receptors, versus sertraline with regard to the amplitude of the circadian rest-activity cycle and depressive and anxiety symptoms in patients with major depressive disorder (MDD). METHOD: Outpatients with DSM-IV-TR-defined MDD received either agomelatine 25 to 50 mg (n = 154) or sertraline 50 to 100 mg (n = 159) during a 6-week, randomized, double-blind treatment period. The study was conducted from 2005 to 2006. The main outcome measure was the relative amplitude of the individual rest-activity cycles, expressed as change from baseline to week 6 and collected from continuous records using wrist actigraphy and sleep logs. Secondary outcome measures were sleep efficiency and sleep latency, both derived from actigraphy, and efficacy on depression symptoms (17-Item Hamilton Depression Rating Scale total score and Clinical Global Impressions scale scores) and anxiety symptoms (Hamilton Anxiety Rating Scale total score and subscores). RESULTS: A significant difference in favor of agomelatine compared to sertraline on the relative amplitude of the circadian rest-activity cycle was observed at the end of the first week (P = .01). In parallel, a significant improvement of sleep latency (P <.001) and sleep efficiency (P <.001) from week 1 to week 6 was observed with agomelatine as compared to sertraline. Over the 6-week treatment period, depressive symptoms improved significantly more with agomelatine than with sertraline (P <.05), as did anxiety symptoms (P <.05). CONCLUSIONS: The favorable effect of agomelatine on the relative amplitude of the circadian rest-activity/sleep-wake cycle in depressed patients at week 1 reflects early improvement in sleep and daytime functioning. *Higher efficacy results were observed with agomelatine as compared to sertraline on both depressive and anxiety symptoms over the 6-week treatment period, together with a good tolerability profile.* These findings indicate that agomelatine offers promising benefits for MDD patients. TRIAL REGISTRATION: www.isrctn.org: ISRCTN49376288. © Copyright 2010 Physicians Postgraduate Press, Inc.

PMID: 20193645 [PubMed - as supplied by publisher]

I live in belguim and it still isnt aproved in my country.


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## fredericmoreau (Dec 1, 2009)

meyaj said:


> GHB is available as a prescription under the brand name Xyrem. Very difficult to get, and extremely expensive, but everything about your comment screams ignorance.


I'd like to second this comment. I enjoy reading this forum because of its open-minded discussion of effective pharmacotherapy, irrespective of puritanical social mores and unscientific legalities. To label GHB as the 'date rape drug' shows a profound misunderstanding of its efficacy for treating real illness and is frankly quite dismissive of those individuals who have found relief through its use, whether prescribed or not.


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## euphoria (Jan 21, 2009)

crayzyMed said:


> Lyrica


My personal experience with Lyrica would put it in the opposite to the hall of fame. 1 day of useful effects followed by severe confusion and depression. Nowhere near as good as benzos, and I highly doubt the claims that it's not as dependency-forming as them - I've heard reports of Lyrica dependency too.


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## crayzyMed (Nov 2, 2006)

Everyone responds differendly to meds, i found quite a few succes stories using lyrica.


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## flapjacker (Nov 30, 2008)

Love

ooh yeaa im cheesin today


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## crayzyMed (Nov 2, 2006)

I added tofisopam to my hall of fame.



> Tofisopam (marketed under brand names Emandaxin and Grandaxin) is a drug which is a benzodiazepine derivative. Like other benzodiazepines, it possesses anxiolytic properties but unlike other benzodiazepines it does not have anticonvulsant, sedative,[1] skeletal muscle relaxant, motor skill-impairing or amnestic[2] properties. While it may not be an anticonvulsant in and of itself, it has been shown to enhance the anticonvulsant action of classical 1,4-benzodiazepines such as diazepam (but not sodium valproate, carbamazepine, phenobarbital, or phenytoin).[3] Tofisopam is indicated for the treatment of anxiety and alcohol withdrawal, and is prescribed in a dosage of 50 - 300 mg per day divided into three doses. Peak plasma levels are attained two hours after an oral dose. Tofisopam is not reported as causing dependence to the same extent as other benzodiazepines, but is still recommended to be prescribed for a maximum of 12 weeks.[4]


http://en.wikipedia.org/wiki/Tofisopam

And also:


> Indirect dopaminergic effects of tofisopam, a 2,3-benzodiazepine, and their inhibition by lithium.
> Chopin P, Stenger A, Couzinier JP, Briley M.
> 
> Tofisopam, a 2,3-benzodiazepine, has been shown to have anxiolytic activity. However, in contrast to the widely used 1,4-benzodiazepines, it has no anticonvulsant, sedative or muscle relaxant effects. Tofisopam enhanced the behavioural actions of various dopaminergic drugs, both direct agonists, such as apomorphine (climbing behaviour in mice), and indirect agonists, such as (+)-amphetamine and amineptine (jumping behaviour in mice). Chronic treatment with lithium abolished the tofisopam-induced increase in the activity of these dopaminergic drugs. Thus tofisopam appears to induce acutely an increase in the sensitivity of central dopaminergic receptors which can be prevented by pretreatment with lithium.


It appears to upregulate dopamine receptors, wich is excellent for us.

So a anxiolytic without tolerance and dependency wich upregulates dopamine receptors. Looks very interesting!

Unfortionally it isnt available in many countries.


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## euphoria (Jan 21, 2009)

I doubt it doesn't cause dependency.


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## crayzyMed (Nov 2, 2006)

euphoria said:


> I doubt it doesn't cause dependency.


Doubt as much you want, it doesnt.

It does seem to increase density of dopamine and GABA receptors and enhance the effects of dopamine agonists, amphetamine and muscimol.

Looks like the next best thing in tolerance prevention. (maybe, cant wait to try this stuff out)


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## meyaj (Sep 5, 2009)

Your own quote seems to disagree with you...



crayzyMed said:


> Tofisopam is not reported as causing dependence to the same extent as other benzodiazepines, but is still recommended to be prescribed for a maximum of 12 weeks.


Living in Belgium, I don't know if English is your first language, but that sentence there STRONGLY implies that it is capable of causing dependence. Very few things do so "to the same extent as other benzodiazepines", which wouldn't be expected here anyways, as it lacks anticonvulsant properties.

If you've got anything reliable that indicates otherwise though, I'd love to see it.

Also, according to this, "Tofisopam also has mixed dopamine agonist and antagonist-like properties in several in vivo and in vitro tests in animals." Even partial dopamine antagonism sounds like bad news to me...


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## crayzyMed (Nov 2, 2006)

1. I'l post that study regarding dependency when i'm back from work
2. It potentiates dopamine agonists and amphetamine so the dopamine antagonism doesnt seem to be a big problem.


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## facade (Oct 1, 2009)

UltraShy said:


> I tried Lexapro 7 years ago. Not exactly new now. As for no side effects, I gather such doctors have never actually used any of the meds they prescribe.


I couldn't agree with you more! Next time I am prescribed anything I am going to say you take it first. "So shall we make an appointment in 4 weeks so you can let me know how your feeling and the side effects!:yes


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## jobee (Mar 9, 2010)

*cymbalta*

Hi, I have just joined
I have sufferd fibromyalgia overlapping with CS & depression since 15yrs of age. I am now coming upto my 39th birthday & will be lucky to even make it out the house to enjoy it.
Will try & keep this as simple as possible but over the years have been used as a ginuea pig, tried most tricylcates, ssri's, lithium salts & even a course of electro convulvise therapy - which I started treatment as an out patient & ended up as an impatient on about my 3rd session - all very frightening - needless to say it didn't work - just made me worse!
For 12 years I had been on a totally different drug Nardil/Phenelzine part of the group of Maoi's this turned my life around, dont get me wrong I still had rough days with the fibro pain etc but gave me the get up and go I had lost along the way while being swapped & changed around with meds.
About 2 months ago It was advised by my phsciatrist to come off the Nardil as I was getting hypotensive side effects as it had been in my sytem for so long amongts a few other minor side effects.
I agreed but wasn't convinced after past experience but was told this drug was one I hadn't tried before SRNI - stated was good for fibro pain & had turned peoples lives around - Reluctantly I tried it.
Spent 2 weeks coming off Nardil - Mentally was doing fine - Pain wise I was in complete agony with the fibro & fatigue so the Phenelzine had kept my pain at bay to a ceretain extent also.
6th day on Cymbalta - God I wish I cud be comatosed until it's all over - I feel so ill, So Anxious, hot sweats, wrestless legs (my partner had to get up & sleep on the sofa at 3am) as I was apparantly violenty thrashing about so much. I have a constant headache, no energy & spend most days in bed as I just cant face anyone or anything - been told to stick it out for 2 weeks for the full effects to work - I just know this drug is not right for me but cant quite get my head around how the maoi's work differently on the brain to tricylicates, ssri's & srni's - I understand how they work on the brain but not the maoi's - anyone else know? & also there must be an alternative to phenelzine within the Maoi Group with less dia effects/interactions as nardil - Can anyone advise.
Many Thanx. A Very Desperate Jo :blank xx


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## meyaj (Sep 5, 2009)

jobee said:


> Hi, I have just joined
> I have sufferd fibromyalgia overlapping with CS & depression since 15yrs of age. I am now coming upto my 39th birthday & will be lucky to even make it out the house to enjoy it.
> Will try & keep this as simple as possible but over the years have been used as a ginuea pig, tried most tricylcates, ssri's, lithium salts & even a course of electro convulvise therapy - which I started treatment as an out patient & ended up as an impatient on about my 3rd session - all very frightening - needless to say it didn't work - just made me worse!
> For 12 years I had been on a totally different drug Nardil/Phenelzine part of the group of Maoi's this turned my life around, dont get me wrong I still had rough days with the fibro pain etc but gave me the get up and go I had lost along the way while being swapped & changed around with meds.
> ...


Parnate (generic name: tranylcypromine) is a great MAOI, should have less hypotensive effects, DEFINITELY has less side effects (on average), and isn't toxic to the liver like the few other available MAOIs, including Nardil. All MAOIs are going to have a lot of interactions though, it's unavoidable because these interactions are a direct consequence of how the drugs work.

Also, MAOIs work by increasing neurotransmitters (very broadly... it does it for serotonin, norepinephrine, and dopamine, as well as a bunch of others). Think of SSRIs as a tactical missile that can hit their target within a few feet, whereas MAOIs are more like a nuclear bomb where the effects are big and broad. It does this by disabling the enzymes in your body that would normally break down these neurotransmitters (monoamine oxidase A and B), and with most MAOIs, the effects on the enzyme are permanent, though they have a life cycle of about 2 weeks at which point your body almost completely replenishes them.

SSRIs/SNRIs/tricyclics largely work by keeping one or two select neurotransmitters in the synapse longer than they normally would, but if your brain doesn't have much of these chemicals to work in the first place, it's not really possible for them to be effective. MAOIs increase the levels and this is probably at least partially why they are undoubtedly the most effective class of antidepressants available. Another contributing factor is probably the fact that having such insanely broad effects on so many different transmitters means, much like the nuke example, that it can probably hit its target even if you don't know exactly where the problem lies.


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## Lacking Serotonin (Nov 18, 2012)

Fetzima is an SNRI that got approved in 2013.


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## GiftofGABA (Oct 2, 2013)

Great. Everyone needs a new SNRI. When will they start doing something new? FFS, even a pure DA RI or 5-HT+DA RI would be appreciated.


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## Caedmon (Dec 14, 2003)

Lacking Serotonin said:


> Fetzima is an SNRI that got approved in 2013.


The name sounds like "eczema" to me. Or some kind of entree.


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## Lacking Serotonin (Nov 18, 2012)

Caedmon said:


> The name sounds like "eczema" to me. Or some kind of entree.


There is also Oleptro which is Tarzodone ER marketed as an anti-depressant now too. Fetzima is Levomilnacipran ER. The immediate release form has been approved in Europe for years now.


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## Caedmon (Dec 14, 2003)

Have extended release trazodone really does make sense - the only way to adjust to the sedation is to keep a constant level in your system. But i would rather just take small doses 3x/ day. Generic trazodone is dirt cheap. I once titrated to 150 mg of trazodone per day and you do adjust. But i felt dumber on it - it wasnt fantastic.


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## Caedmon (Dec 14, 2003)

The hot new thing is going to be *Brintellix (vortioxetine)*. It is an SSRI combined with antagonism on 5ht7 and 5ht3, 5ht1d, and agonism on 5ht1a and 5ht1b. Possibly some norepinephrine reuptake inhibition.

Time will tell if it is any improvement over regular SSRIs. I think it will mostly be marketed for treatment-resistant depression, and may get some attention for off-label ADHD. Personally I think it sounds promising. I am following it closely.


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## Ben12 (Jul 8, 2009)

Bitopertin. It's a new medication that is in clinical trials. Unlike these serotonergic acting antidepressants, this one works on other neurotransmitter systems.


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## MrKappa (Mar 18, 2013)

nootropics


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## MrKappa (Mar 18, 2013)

Brain fog? Like when you close your eyes, and see fog? I find cigarettes do that with me. Or fog, like a cloudy feeling?

Never got the brain fog off noopept. Not that I remember.


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## Lacking Serotonin (Nov 18, 2012)

Ben12 said:


> Bitopertin. It's a new medication that is in clinical trials. Unlike these serotonergic acting antidepressants, this one works on other neurotransmitter systems.


I was just reading about Bitopertin thanks to you and trials have shown significant improvement in patients. Looks like it may take a couple more years though.


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## MrKappa (Mar 18, 2013)

failoutboy said:


> Cloudy feeling.


I've read people mention they get a "brain cloud" off of lecithin supplements, and have heard others reference too much choline somehow being a part of it, unfortunately no, I have no experience with that sort of thing. I've gotten the "brain sizzle" though. Fairly sure the depression which followed was a clear indication the attack dose route was a bad move, not enough choline, and too high a dosage. Leads to a tiny bit of depression. Not off noopept but other racetams. I'm going to give SSREs a go next, eagerly waiting my mail order.

Fairly sure I've done plenty of damage to my serotonin system overall in my youth, and am working towards better understanding the serotonin / lucid dreaming connection, if any. Hey... if I can dream like a normal person, then I figure I'm on the right track to a healthy mind.

Have you ever had lucid dreams? It's like the brain is evolved to handle the most wonderful clarity yet as a whole, we are void from the experience, most of us, anyways.

Here I found something on the "brain fog" thing.






In a sense, I've always considered the racetams, "accelerants" in laymans terms, so maybe your brain fog is a lack of oxygen to keep up the pace? Could mean any number of things though really. Personally, I've found the racetams by themselves to increase overall oxygen supply to the brain, so yeah, brain fog is a bit of a mystery to me. I don't truly understand the terminology when racetams are the issue.

The jist of it though, yeah, blood oxygen supply make huge differences. So much in fact, yeah, they had that whole oxygen bar trend happening for a bit, right?


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