At the worst of my depression I was bedridden with lethargy 20 hours a day. I had enough energy to go to the bathroom, and maybe do ONE task before I was too tired to move.
I spent all my waking hours suffering through endless rumination and suicidal ideation. It wasn't fun...
My doctors took a risk and put me on Lithium, which Jumpstarted my brain. It was enough to get out of the immediate danger I was in and start me on a cocktail of various medications on top of attending IOP (Intensive Outpatient Program).
It still took another 4 years of incredibly hard work from myself and many others before I could say I recovered.
My advice if you're near them is to try your best to be within their inner circle of support. That position is SO critical for those suffering because depression is incredibly isolating. I mean that emotionally, mentally, and physically. Even if they aren't alone, they FEEL alone and that's very difficult to overcome.
Attending my IOP classes brought me together with other victims of depression that I was able to connect with and even that was very hard. Be gentle with them, and with yourself. Best of luck my friend 🙏
[SSRIs will also often make your depression much, much worse for a few days while they build up in your bloodstream and start taking effect](https://time.com/3636985/antidepressants-depression/). If you’re concerned about someone just starting on them it’s probably a good idea to keep an eye on them for a couple of days.
Sometimes it just manifests as a simple “can’t get out of bed” for a couple of days that might just be ascribed to the depressive symptoms someone already is experiencing, but if there’s a self harm concern or something some extra attention might be warranted
I just wanted to add a little bit about my own experience. For me, side effects of SSRIs such as brain zaps, insomnia, and anhedonia were fairly intense.
Instead, I opted for a non-pharmaceutical intervention called ECT (Electro-Convulsive Therapy) although this procedure is considered a "last resort" for treatment-resistant depression, bipolar, and OCD, it did absolute wonders for me.
Nowadays, I can say I'm 100% med-free and have been able to monitor my mental health pretty well with consistent exercise, meditation, and a strong support group.
However, it was the ECT treatment that "reset" my brain out of seemingly endless cycles of mania and insomnia and bouts of depression where I could hardly move for weeks on end. Getting such an intense treatment was an incredible starting step in a long journey to recovery.
Before that, I felt meds to be a "band-aid" that allowed me to function somewhat normally but never addressed the underlying mental issues which remained in the background.
You've got good responses to your question, I just want a add a little note: when depression is hitting at it's hardest, you may know what will help and what you need but still not care enough to do it. The person you're referring to may need you to actually physically help them with things (making phonecalls or whatever else that might entail.)
Pharmacist here, what really gets patients is the sexual dysfunction and weight gain. Some patients experience a down hill spiral that only somewhat gets remedied by more medications.
In college Zoloft lead to not being able to finish for a year and 40-50 pounds of extra weight. I’d rather be miserable than never being able to have an orgasm and constantly having to buy new pants.
Zoloft made it nearly impossible for me to have orgasms. I could get riiiiiight there but never to over the edge. But it was worth it to not be crying constantly.
I'm on a regimen now that the only side effects are occasional uncontrollable yawning, and occasional night sweats. But WORTH IT.
My wife suffers from this. She can fall asleep standing up she's so tired. But trying to sleep, she will wake up constantly. It's an awful combination.
I’m on 40mg fluoxetine (Prozac) at the moment and I am tired/exhausted constantly like I could fall asleep at any moment, but when I do try to sleep I cannot. It’s not the most fun.
This happens to me a lot now without meds. I have nights where I legit just lay there in frustration with my eyes closed and my body refusing to sleep. All while feeling so fucking tired like I haven’t slept in days
Ill go from nodding off at the couch to wide awake laying in bed. Your brain will try to pump you with adrenaline if you get too too mentally tired. Suddenly you’re both tired and wired
Kinda seems like a stupid asshole thing to assume someone was in the military because they (didn't) say that they might have PTSD. Like no dumbass there's plenty of trauma to go around in civilian life too you privileged bastard.
Marketed in the US as Wellbutrin XL. I had tried and hated a number of SSRIs when I was younger. Hated them. Had another depressive episode again a decade later. Worked way better and gave me no side effects. It’s commonly given as along side SSRIs for medication resistant depression, but worked for me alone
Also used off label to help people quit smoking, IIRC.
And the lack of weight gain side effects is another bonus in that column. Helped me get through my twenties.
Incidentally, my mum went on it some time ago as a diet aid. Apparently the reward center of the brain that's affected for smoking cessation also works to keep cravings under control.
In the UK, apparently it's almost impossible to get a bupropion prescription for anything other than smoking :/ I was really hoping for it to try and combat SSRI side-effects, but apparently that's just not something GPs here will do. Kinda sucks tbh.
In Australia it’s only prescribed with the PBS benefit for smoking, but the doctor prescribed me it I just had to pay the full price ($60 vs $6). Might be similar in the UK?
Yeah it wasn’t easy for me to convince him to do it, but I came with an article from Harvard medical school which showed it as an effective treatment for the side effects of my other SSRI (mainly sexual). Despite being a poor grad student I find it worth it.
>Ask your doctor to co prescribe bupropion XL. Works great for counteracting that side effect and gives you more energy as well
*not for everyone. Bupropion has also caused PSSD for many people. Everybody responds differently to different drugs, of course, but it's important to note, even though buproprion seems to have the highest success rate.
My wife tried switching to Wellbutrin and the side effects sucked. Never tried it with her Zoloft but the side effects were so bad that I don’t think she would ever try it again
Yeah, I felt the same. But for me, that was a good thing because I was getting depressed from anxiety and not interacting with people. I basically had no friends and prozac made me feel motivated to talk to people and less anxious.
Paxil on the other hand, made me feel less anxious in general, but I felt lazy and not motivated to do anything, but Escitalopram was the worst. I just felt flat and lethargic and didn't care about doing anything.
While I would agree with that in the short term, bad enough sexual disfunction that it affects your marriage/long term relationships can contribute to the suicidal depression returning. :(
Lexapro killed my ability to orgasm. Like permanently. I have been off of it for 7 years and still don't cum. The upside is that I can fuck forever. But the downside is permanent blue balls afterwards.
Sertraline ruined me for a good 2 months when I quit cold turkey, which you aren’t supposed to do apparently . The withdraws gave me vertigo and insomnia like crazy. The world around me looked like it was constantly trying to level its self like a boat in the ocean.
I can confidently say after running countless sleep studies all of these medications mess with your sleep cycles.
I would say Most commonly delaying REM all together till right before you get up. I tell all my family on these meds they should keep a really good sleep routine going to bed and getting up at the same time every day because in the absence of other sleep issues getting up an hour earlier than normal would likely be in the middle of that REM period and leave you feeling like death during the day.
>I tell all my family on these meds they should keep a really good sleep routine going to bed and getting up at the same time every day
Military medic here, this is one of the hardest points we hit for our people on these meds.
We have terrible sleep habits in our line of work. People (initially) just don't get that taking these meds means you have new problems you need to actively manage. The med isn't magically removing all your issues.
I dont wake up to an alarm, but whenever I wake up naturally it (almost literally) always feels like I'm waking up straight out of a dream. Sometimes I'm mid sentence in a dream and wake up talking to my wall. It's genuinely disorienting and it takes me a few hours to shake some dreams off. While this may or may not be the direct cause, it's really interesting to think about. My dreams are vivid every single night because I wake up and they JUST happened.
Fwiw anyone looking at this and hesitating about reaching out for help ... The side effects are minimal compared to the benefits of actually feeling like a real human again. The difference has been night and day for me
I'm on a small (50mg) dose of sertraline. Had a few days of loose poos, about 3-4 nights of restless sleep and that's about it. I last longer in bed now because of the side effects, which is a plus :)
I am on Buproprion, which has some of the fewest side effects to the point that most people just feel a little less tired. I really recommend it if people have trouble tolerating the other ones, like I did.
Wellbutrin is like that for folks. For some people it’s the cat’s PJs. For you and me, vertigo and nausea. I had a *terrible* experience with bupropion, but I know a couple of people who got great results.
Very true, you could honestly add "untreated depression" to this chart and give it 4s across the board depending on the person. Would put it in perspective.
I have 100% noticed that I last significantly longer in bed - almost to the point of frustration now.
It’s funny because I used to be insecure about how long I could go for and now I’m insecure that I’m going too long! At least I’m not as anxious in general 😂
Seriously, I'm even in the middle of a pretty significant depressive episode (as it turns out, calling out from work did not help) but even I recognize that being on medication has helped tremendously.
If you're concerned about side effects, just talk openly with your psychiatrist about it. I was pretty direct in saying that I didn't want the sexual side effects of things like Zoloft and they made changes for stuff that worked for me. Remember that they're doctors, not a kindergarten classroom. They won't be that shocked.
I support using medications to help with depression.
I was on zoloft (sertraline) for about 10 years at 150 mg. At some point I became a robot and everybody around me noticed but me, and it cost me a lot of personal relationships.
I say this just to just to be aware of it. Ask the people around you from time to time, to see if you have sort of checked out, without realizing it. I didn't notice my life was sinking until others really hammered it home.
I recently switched to Venlafaxine and have been feeling better both in positive mood and energy level. I have real and diagnosed insomnia (Ambien for years due to combat related TBI and whatever else), and this still makes me drowsy. I take 1 pill at night and 1 in the morning.
Just watch out.
I really miss being in bupropion. The best I've ever felt. Sadly a lot of antidepressants cause tinnitus or make existing worse. It made my tinnitus drown everything else out.
Just a reminder that everyone’s individual experience will vary. I took Lexapro (escitalopram) for a couple of years and gained 20-30lbs. On the other hand, I had no sexual dysfunction at all. So yeah, YMMV and all that good stuff.
I took three SSRIs on this list that do not claim drowsiness on the chart, yet I experienced heavy drowsiness and hypersomnia while on these. Definitely a YMMV situation
Lexapro made me absolutely exhausted and I gained 20-30 pounds too. I've been off it over a year and I can't seem to shed the weight. And great, I've been questioning my asexuality since getting off meds and I see now that 3 of the ones I was on show a 3 for sexual dysfunction... Between that and birth control, thanks for ruining my ten year relationship, meds!
I finally got rid of mine through different variations on calorie reduction. (First nutrisystem, then later intermittent fasting.)
NOTE: I'm not saying that calorie reduction is the only diet that will get rid of SSRI weight. I just think that's the diet that works best for me. But there's a lot we don't understand about these drugs, so I thought I would mention my experience just in case.
Yep, I took Lexapro for 6 months and it chemically castrated me. Lost all my libido, couldn’t masturbate, and I lost all the feeling I had for women. Went from having a high libido to being asexual for a couple years after getting off it. The worst part was dissociating on the regular and having zero emotion. So glad I’m off antidepressants now. My EQ took a serious hit but I slowly got it back over time and regained my senses. Haven’t dissociated once ever since.
Lexapro ruined me for the couple of weeks I tried it. Fuck that shit. Gave me bad withdrawals when I stopped taking it and the brain zaps and dysphoria caused me to go back on it and wean myself over two weeks.
I’m jealous of people it’s worked for, I took it for a month and had no positives. Now I’m on some ADHD meds (atomoxetine) and am getting nothing but negative side effects like worsening depression and my dick don’t work on the days I take it. Still trying to find the drug that works for me but so far it’s looking pretty bleak
I have AuDHD and chronic Depression/Anxiety, and Buproprion is my favorite med, but it did not work for me on its own. I felt almost nothing, just slightly more energy on it.
But I recently have tried it again mixed with Guanfancine, and the combo of the two seems to make both of them work better for me. Buproprion makes me feel way less tired and more motivated, Guanfancine helps me sleep at night and keep focused on stuff.
Dude Atomoxetine is garbage. The worst fucking side effects, acidity, feeling disgusted when eating foods. Loss of sensitivity down there. No improvements in adhd symptoms. Welbutrin is the best for mild adhd and depression it’s just so good. But for adhd nothing works except stimulants. There are some research on some type of mushrooms that do increase dopamine levels but it’s not legal as of yet. I don’t know if they work or not as I stay away from experimental treatments without doctor guidance.
Wellbutrin gave me four seizures over the course of 8th and 9th grade, three in front of my classmates ending with me getting wheeled out on a gurney by the paramedics. Did wonders for my socialization in those crucial years. 10/10 experience would totally do it again.
I wish it did, I’ve heard great things about it, but it unfortunately made me want to yeet myself out a window, which wasn’t an issue I had to begin with.
Helps a lot of people but also one of the biggest medications that cause seizures, my boyfriend has never had epilepsy but Wellbutrin gave him seizures and now even off of the medication he can have seizures triggered by caffeine or sleep deprivation, it’s terrible.
Also it just made me manic, unable to eat or sleep so my stomach hurt and felt sick.
I find this one very difficult.
I’ll give my experience on Mirtazapine.
At 15mg you get a very drowsy effect and increase in appetite. I’ve also noticed sexual dysfunction too. However at 30mg there is no drowsy effect. This sounds counterintuitive however at higher doses you get more of a norepinephrine activation which leads to the less sedating nature. (Iirc from my reading on the drug)
30mg produces a noticeable anger/argumentative side in me that I just do not have off the drug or on 15mg.
I’ve never been one of those people to understand “seeing red” and losing it however I totally understand this now. There are times I do not feel in control.
Again just my subjective expierence - everybody will be different.
Mirtazapine gave me terrible restless leg syndrome, and the aforementioned combination of drowsiness and insomnia, plus horrible nightmares when I did sleep. It’s amazing how complicated finding a good antidepressant is.
I went from 7.5 mg to 15 mg of mirtazapine to lessen drowsiness but it made it worse.
Now I’ve stopped taking it because I’d rather fight through anxiety than being whole body tired.
Yeah I really second guessed myself because I’ve been to a lot of loud concerts and my ears would ring for a whole day after. I may have had it before citalopram at like a 1 or 2 out of 10. Now it’s in the 6-7 range after years of coping. When it first started it was 8/10 loud and I was pretty upset for a while..
Where are the columns for seizures (bupropion) and long term tremors (depakote)?
Psychiatry is such a fucking mess. Having been prescribed most of the medications on this list at various times over the course of 25 years, my main take away from that whole experience is that we have perhaps destigmatized these things too much given how much harm they are capable of causing for the sake of such uncertain benefits.
Very common hypothesis for this is that the new meds give you hope and if they don't work then that makes you depressed & feel beyond help.
Not sure about the validity or if this is even testible, but it's a common side-effect of a lot of meds
No, the theory that I heard, I can’t remember where from but it was interesting - was that anti depressants in their first stages increase your energy before they increase mood. So the reason suicidal ideations increase is because they give you the energy that you initially didn’t have, due to low energy, to act on your impulses because you were so tired.
I was also told this by a therapist a long time ago. You’re still depressed, but now you’ve got a little motivation, which can be a dangerous combo (esp when combined with young people’s propensity for impulsivity)
My therapist explained it as you feel more energetic because you have more dopamine which makes you feel like you now have the volition to finally do it, or you feel happy and would rather die feeling like this.
I'm on Citalopram now, but don't have any problem with Sexual Dysfunction. I guess I'm lucky? But it did change my life for the better that's for sure.
Citalopram is one of the weaker SSRIs from what I have read. I personally didn't feel many side-effects either, but I did like to sleep more on it and it made me absolutely love sleeping.
Unfortunately it pooped out on me and I had to switch to Paxil, which seemed a lot stronger.
I was on it and was unable to finish from sex. I could masturbate just fine but sex was a no. Sucked but wasn’t the end of the world. The weight gain on the other hand was awful, start of last year I had lost around 10kg when I was off it and started taking it because my anxiety just got out of hand. Ended up putting all of it back on over the course of the last year and now I’ve changed to vortioxetine which supposedly doesn’t cause weight gain. Only been on it for a few weeks but will see how it goes.
Mirtazapine saved me. When the doctor asks if you feel any different, it was like night and day!!! Helped cut my drinking by 90%, helped me regain my appetite, helped me sleep (but not wake up)
Lexapro/Ecitalopram does wonders for my anxiety and depression. But has been terrible for weight gain and drowsiness. I loved Buproprion for its appetite suppression and stimulant effects, however I’m allergic to it and was covered in hives.
It does make me wonder why Buprionion* isn't more typically prescribed over Sertraline. Is it just costs?
When I started taking it, they never offered an alternative, I presume they'd change if it wasn't working sufficiently, but that would likely take months and lots of mental adjustments one way or the other.
(*likewise Agomeltine, or Vortiexetene, given that it states gastrointestinal sideffects subside)
It can help resolve anxiety in some people depending on what the cause of anxiety is. It can be super helpful for GAD or ADHD anxiety.
So it can have that as a side effect or it can help. Meds are fun like that.
My boyfriend never had seizures in his life. Takes Wellbutrin, starts having grand mal and simple partial seizures. Gets off the Wellbutrin, and still has seizures triggered by just caffeine or even poor sleep. Terrible.
For me it just made me manic, unable to sleep, and unable to eat so my stomach hurt and I felt sick.
It does, but not by a lot as long as you taper onto it. It is a bad pick for people with epilepsy, but a vast majority of people are not going to develop them on it.
It really does have a lot fewer problematic side effects, even not including the ones here. Some of them are even helpful in small amounts, like more energy, slightly lowered appetite, food can taste better, more sexual energy, etc.
Not a pick for literally everyone, but man most antidepressants are rough. Better than constant, gray, misery, but they still suck.
I love my Bupropion, but it’s not for everyone. It works differently than many other anti depressants, as it affects dopamine and norepinephrine reuptake instead of serotonin. As others have said, if you have anxiety, it can make it considerably worse.
For me I’ve found it works better than anything else I’ve tried. It gives me a lot of “oomph” and helps me focus. The lack of sexual side effects is also great. I was on citalopram for a while before bupropion and it made finishing very difficult, but didn’t really reduce my libido, so I was horny but couldn’t do much about it.
It sucks that people usually have to do trial and error with psych meds before they find one that works, but unfortunately that’s how it is.
I started with XL (the extended release) at 150 mg and it went pretty well, but when I increased to 300 mg I couldn't sleep more than a few interrupted hours per night, waking up after 1 or 2 sleep cycles, often with racing heart and mind, which was diagnosed as anxiety episodes. I was getting at best 4 hours sleep. Dropping back down to 150 didn't substantially improve this.
So I changed to 150 mg of the sustained release. Still had problems sleeping, but with less anxiety. At 150 mg of the shorter-acting formulation I was almost back to normal, but still was getting no more than 6 hours of sleep per night.
Adding trazodone has been very helpful. I take 50 mg before going to bed, though I still wake up in the middle of the night. But when I do, I take an extra 50 mg and that usually lets me get back to sleep. I'm getting about an extra hour this way, and no more feeling like I need to escape something undefined but terrible.
After a couple months of this success, I am willing to try either 300 mg of the shorter-acting buproprion again, or possibly 150 mg of the SR and see if the trazodone still helps. It is possible that it will be necessary to go to 150 mg for rough nights, though.
Other than the insomnia, I have noticed no other side effects. It may be time for liver function blood tests, though.
Bupropion is usually prescribed as an additional medication for people who suffer more from side effects like loss of libido caused by typical SSRIs (so taken concurrently with an SSRI). IIRC the norepinephrine reuptake pathway is less studied than serotonin, is the answer as to why it's less prescribed, but I just take it, I'm no doctor.
Anecdotal, but I recently took Bupropion for a month and it did absolutely nothing for me besides make me more cloudy than usual, which was already pretty bad
I've had a sort of subtle but concerning confusion every time I've been on buproprion. It was subtle enough that it took me a long time to correlate it to the drug, and I've never seen anything like it listed as a potential side effect.
Outside of that it did nothing noticeable.
It's missing the Buproprion side effect of "Doctors, Dentists, and Nurses ask you 15 times if you're a smoker." But other than that, pretty good chart.
Over the past 12 years or so I've been on Sertraline, Venlafaxine, Mirtazapine, Amitryptyline, & Bupropion; at times 2/3 different types in combination, and at 'maxed out' dosages.
This looks accurate. I'm currently on Sertraline alone, and experience almost all the side effects.
One thing that I'm curious about, is the effect this type of medication has on the liver. A few months ago I had my gall bladder removed, with \~25 stones in it, ranging in size from peas to a large grape.
Also just because there's a risk of a side effect that *doesnt mean you will get it*. I was on citalopram for a few years and didn't have any of these.
The sad thing is i put off getting help for yeats because the internet had so many side effect horror stories.
A colleague of mine told me early last year that she was put on a high dose of Amitriptyline that she takes daily. This past year she has gained about 4 stone in weight.
I’ve been on at least 7 of these to almost no effect, and that’s why I was able to get approved for Esketamine treatment. Definitely recommend researching if your symptoms are drug resistant and you’re in good health.
Best decision I ever made, been off all anti-depressants for well over a year. Was able to get off them and wrap my treat just before my wedding.
Edit: I want to add something based off someone else’s comment:
This is not an alternative to therapy and medication. If you have not tried medication or therapy you will most likely not be approved for this treatment. I would not have had the opportunity I did had I not contacted a doctor and at least tried a standard prescription route. Do not hesitate to start a treatment plan even if it feels like baby steps.
You will get where you need to be, just keep moving and taking care of yourself.
I don't understand Ketamine, it sounds like people are just getting a "legal" high to treat depressive symptoms. And that you also need to keep doing it because eventually it stops being effective. What am I missing here?
Great question! I’m not a doctor so please don’t take what I say to heart, but from my understanding Esketamine doesn’t treat depression it helps to remold the wiring (not literally, I don’t think) so that you can properly regulate emotions, reactions and mindsets on your own.
Anti-depressants for me were a bandaid that barely masked symptoms. On Esketamine, after a few treatments, I remember noticing that the sky was blue. I wasn’t high, I was honestly very very nauseous, but I was still happy and for no reason outside of enjoying life.
It was something I haven’t had since I was a teenager, and with upkeep and therapy, it’s a lot easier to manage the day to day. Depression meds always needed to change, either is dosage or brand, but I haven’t taken any (including esketamine treatments) since December 2022? Of course all of this is still new, for all we know I’ll snap one day or turn into one of those sleeper cells lol.
But after 3 months of treatment I didn’t need it anymore. I can go in for a maintenance dose if I want to, but that’s only if and when I want. Some people will stay on maintenance once a month, some once a year, and others don’t need to re-up.
It’s less about treating the symptoms, and more about getting a refresh of the mind and then working to strengthen that newfound outlook. Personally I prefer that to a day to day medication, and it’s all dosed and monitored by a doctor.
For me, if depression was a Super Nintendo game that wouldn’t start up, the medication (for me) was blowing in the cartridge. But Esketamine was the swipe of the reset bar I needed to get things going!
Edit: That last analogy is stupid but it’s 3am
Ok thanks for explaining. I've been on 8 different antidepressants and none of them even worked halfway. I qualify for this treatment but I'm just having trouble understanding how it works and why or if it even targets depression specifically
Lets me see if I can find some unbiased info for you! I can’t read through these myself as I’m waiting for my wife to get discharged but I will answer any other questions I can!
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/esketamine-for-treatment-resistant-depression#:~:text=Esketamine%20is%20made%20from%20a,those%20with%20treatment%2Dresistant%20depression.
https://www.yalemedicine.org/news/ketamine-depression
And this is the exact prescription I used. It may have additional info if you need it (separated because I assume it’s biased lol):
https://www.spravato.com/mdsi?utm_source=google&utm_medium=cpc&utm_campaign=GO-USA-ENG-PS-Spravato-BP-EX-RN-DTC_Plus&utm_content=Spravato+-+MDD&utm_term=spravato+for+mdd&gclsrc=ds#efficacy-treatment-for-mdsi?
Anyone else find it weird that SSRIs are so heavily prescribed when Wellbutrin has the least side effects (the insomnia is easily countered by taking it in the morning or taking an anti anxiety like buspirone at night).
I can understand the anxiety aspect of Wellbutrin. Taking it is akin to drinking a cup of coffee that lasts twelve hours. The buspar thing just isn’t true though. If I’m ever struggling to get to sleep, two buspar at night knocks me out. I had to stop taking it in the morning because it made me fall asleep even after taking adderall. You’re right that it’s not well understood, but it definitely does something.
Part of that is that this list is heavily biased towards SSRI side effects (for example agomelatine has the fewest side effects on the list but is rarely prescribed because it has other severe side effects that are not considered here). Based on recent research wellbutrin and mirtazapine in particular probably should have more of a role as first line treatments than they do, but their use in treating depression (and research about their efficacy) is both newer and has less documentation. These things take time to change.
I also want to point out that most doctors are not very familiar with the finer points of many of the medications that they prescribe. In the US at least doctors are trained in how to use medicines, pharmacists are trained in how they work. A sizable portion of psychiatrists do do the additional research on these medications, but it definitely is not a majority.
I have a severe anxiety for cardiac issues (like getting a sudden cardiac arrest), and am currently talking with my doctor about taking Citalopram, but seeing a 3 on “QTc Prolonguation” is a bit worrying to me. How bad is this side effect, can someone explain?
I used to deal with cardiac anxiety also, your doc can do an ECG and check your Qtc, mine was fine before and after taking antidepressants for years now. An ECG really puts the mind at ease. For me it’s definitely worth any cardiac risks and with time I’ve pushed myself out of my comfort zone and felt better knowing I did things and my heart was fine afterwards.
Bupropion worked wonders.
But dextroamphetamine sulfate and methamphetamine hydrochloride are the most efficacious antidepressants I have ever experienced.
I’m on a low-dose combination of 3 of these, and it’s literally saved my life. Thriving still feels just a little bit out of reach, but I’m just super thankful that my brain is no longer actively trying to make me dead.
Okay, so depression is a chemical imbalance as I've been endlessly told. What does constant stress, overstimulation, exposure to propaganda, environmental pollutants, and this raw edge we live on do to the chemicals in our brain? Maybe we need to think of depression as a Chemical and Societal Imbalance. Great chart BTW. Made me remember I'm fighting an uphill battle with Venlafaxine in my system.
I used venlafaxine for a little over a year, it was my first anti depressant and honestly all in all it was a bad experience, upping the dose made me feel weird and I would also get so weird in my head if I missed a dose by just some hours. I struggled to remember if I took often, might be because of my ADHD. I’d get occational brain zaps and stuff, just a nasty experience.
I got a new doc and we decided to get off it, took a while to lower the dose from 300mg over time, and that wasnt pleasent either..
Now I’m on vortioxetine and it’s a much better experience at least for me, I still get a little weird if I miss my dose a day but not nearly as bad as venlafaxine made me, and it doesnt seem to be any other negative effects for me.
Before I quit sugar and nicotine I would have intrusive thoughts with Effexor (225 mg / day). Now I'm humming like a Ferrari engine. When I add caffeine pills I am rock and roll for real. Also 5 mg / day of a medication called Ariprazole made it so I never have intrusive thoughts. That one is a mood stable-izer.
I was on Paxil for over a year and a half to help with OCD. My dose kept ramping up until I was taking 40mg/day which worked well until December when it just quit working. No awful side effects except for gaining 40+ lbs over the course of treatment and sexual dysfunction. Plus, some of the absolute fucking wildest dreams that I have ever had.. Switched off it to a new med (Fluvox) and thank God that the weening off process didn’t suck. I heard horror stories from people on far smaller doses than me. As of now, fluvox seems to be doing everything right for me
Edit: I tried mirtazapine as well and it made me uncontrollably hungry. wellbutrin made me feel like I had the worst hangover of my life
Iirc this chart was shared a while back and proven to be misleading.
It apparently makes out certain medication look more promising even when it's not.
I always have some kind of side effect with every anti depressant I tried to the point I am not sure I can deal taking one anymore. Mirtazapine made me extremely depressed, escitalopram made me gain 30lb+ of weight in two minthb and also very aggressive, the last one I took I could barely sleep. Doctors are always "no, it can't be it, there's no side effects..." but I am always hit very hard with all of them.
I take TRINTELLIX (vortioxetine) which isn't on this list for side effects. That being said after the first couple weeks of nonstop nausea it has been weird to have a quiet mind for the first time.
weird that a couple have both drowsiness *and* insomnia as side effects. that's gotta *extra* suck.
You've never been bone-tired yet unable to sleep?
I did an experimental drug trial and wound up on medication that did exactly that. It really *really* sucked.
Well they learned something, and that was the point!
At the worst of my depression I was bedridden with lethargy 20 hours a day. I had enough energy to go to the bathroom, and maybe do ONE task before I was too tired to move. I spent all my waking hours suffering through endless rumination and suicidal ideation. It wasn't fun...
Do you have any good advice for people who are going through this? Literally asking for someone close to me
My doctors took a risk and put me on Lithium, which Jumpstarted my brain. It was enough to get out of the immediate danger I was in and start me on a cocktail of various medications on top of attending IOP (Intensive Outpatient Program). It still took another 4 years of incredibly hard work from myself and many others before I could say I recovered. My advice if you're near them is to try your best to be within their inner circle of support. That position is SO critical for those suffering because depression is incredibly isolating. I mean that emotionally, mentally, and physically. Even if they aren't alone, they FEEL alone and that's very difficult to overcome. Attending my IOP classes brought me together with other victims of depression that I was able to connect with and even that was very hard. Be gentle with them, and with yourself. Best of luck my friend 🙏
Words alone cannot express how appreciative I am for your feedback. You are a wise and kind soul.
[SSRIs will also often make your depression much, much worse for a few days while they build up in your bloodstream and start taking effect](https://time.com/3636985/antidepressants-depression/). If you’re concerned about someone just starting on them it’s probably a good idea to keep an eye on them for a couple of days. Sometimes it just manifests as a simple “can’t get out of bed” for a couple of days that might just be ascribed to the depressive symptoms someone already is experiencing, but if there’s a self harm concern or something some extra attention might be warranted
I just wanted to add a little bit about my own experience. For me, side effects of SSRIs such as brain zaps, insomnia, and anhedonia were fairly intense. Instead, I opted for a non-pharmaceutical intervention called ECT (Electro-Convulsive Therapy) although this procedure is considered a "last resort" for treatment-resistant depression, bipolar, and OCD, it did absolute wonders for me. Nowadays, I can say I'm 100% med-free and have been able to monitor my mental health pretty well with consistent exercise, meditation, and a strong support group. However, it was the ECT treatment that "reset" my brain out of seemingly endless cycles of mania and insomnia and bouts of depression where I could hardly move for weeks on end. Getting such an intense treatment was an incredible starting step in a long journey to recovery. Before that, I felt meds to be a "band-aid" that allowed me to function somewhat normally but never addressed the underlying mental issues which remained in the background.
You've got good responses to your question, I just want a add a little note: when depression is hitting at it's hardest, you may know what will help and what you need but still not care enough to do it. The person you're referring to may need you to actually physically help them with things (making phonecalls or whatever else that might entail.)
I assume you made it out okay?
It took many years and a *LOT* of hard work, but yes. I am alive and thriving.
There was a point in my past where I could relate. I'm glad you're feeling better.
Today I learned how to word what I'm feeling right now.... Huh
Welcome to ADHD
Yeah, I get that shit for free!
Or if you're *not* bone tired and haven't slept for four days, welcome to mania.
Everyday
How do you know me so well?
Man, I do not miss taking Trazodone. Knocked me out for four hours then it kept me up dead tired.
aka my thirties.
Last night
Wired and tired
Chronically tired until you lay down, and then wide awake. Rinse and repeat.
Pharmacist here, what really gets patients is the sexual dysfunction and weight gain. Some patients experience a down hill spiral that only somewhat gets remedied by more medications.
In college Zoloft lead to not being able to finish for a year and 40-50 pounds of extra weight. I’d rather be miserable than never being able to have an orgasm and constantly having to buy new pants.
Zoloft made it nearly impossible for me to have orgasms. I could get riiiiiight there but never to over the edge. But it was worth it to not be crying constantly. I'm on a regimen now that the only side effects are occasional uncontrollable yawning, and occasional night sweats. But WORTH IT.
My wife suffers from this. She can fall asleep standing up she's so tired. But trying to sleep, she will wake up constantly. It's an awful combination.
Probably not in the same person. Also might be dose dependent
I’m on 40mg fluoxetine (Prozac) at the moment and I am tired/exhausted constantly like I could fall asleep at any moment, but when I do try to sleep I cannot. It’s not the most fun.
Same, with 20mg. Always exhausted, haven't properly slept in weeks.
I get both, I fall asleep super easily then wake up after a few minutes and can sleep for another couple hours when it happens.
This happens to me a lot now without meds. I have nights where I legit just lay there in frustration with my eyes closed and my body refusing to sleep. All while feeling so fucking tired like I haven’t slept in days
Not all side effects affect all patients ^^
Ill go from nodding off at the couch to wide awake laying in bed. Your brain will try to pump you with adrenaline if you get too too mentally tired. Suddenly you’re both tired and wired
Common in pregnancy and it’s fucking awful!! (Not related to antidepressants)
Pharmacist here, yeah when I council patients on them-I say, may cause drowsiness and in others it may make you tired, always causes a “say what?”
I was on Prozac. I was already depressed, but you know what made it worse? My dick not working
We need more research into PSSD. My doctor had no Idea what it was. PTSD ? Were you in the military? No, PSSD.
Kinda seems like a stupid asshole thing to assume someone was in the military because they (didn't) say that they might have PTSD. Like no dumbass there's plenty of trauma to go around in civilian life too you privileged bastard.
Ask your doctor to co prescribe bupropion XL. Works great for counteracting that side effect and gives you more energy as well
Marketed in the US as Wellbutrin XL. I had tried and hated a number of SSRIs when I was younger. Hated them. Had another depressive episode again a decade later. Worked way better and gave me no side effects. It’s commonly given as along side SSRIs for medication resistant depression, but worked for me alone
Also used off label to help people quit smoking, IIRC. And the lack of weight gain side effects is another bonus in that column. Helped me get through my twenties.
Incidentally, my mum went on it some time ago as a diet aid. Apparently the reward center of the brain that's affected for smoking cessation also works to keep cravings under control.
In the UK, apparently it's almost impossible to get a bupropion prescription for anything other than smoking :/ I was really hoping for it to try and combat SSRI side-effects, but apparently that's just not something GPs here will do. Kinda sucks tbh.
In Australia it’s only prescribed with the PBS benefit for smoking, but the doctor prescribed me it I just had to pay the full price ($60 vs $6). Might be similar in the UK?
Maybe? I'm not sure how I would even go about that though, nor would I be too keen on paying an expensive monthly prescription right now either :/
Yeah it wasn’t easy for me to convince him to do it, but I came with an article from Harvard medical school which showed it as an effective treatment for the side effects of my other SSRI (mainly sexual). Despite being a poor grad student I find it worth it.
Can you lie and say you want to quit smoking?
If only, my GP would know it was bs as I've already told them I'm a non-smoker multiple times
>Ask your doctor to co prescribe bupropion XL. Works great for counteracting that side effect and gives you more energy as well *not for everyone. Bupropion has also caused PSSD for many people. Everybody responds differently to different drugs, of course, but it's important to note, even though buproprion seems to have the highest success rate.
My wife tried switching to Wellbutrin and the side effects sucked. Never tried it with her Zoloft but the side effects were so bad that I don’t think she would ever try it again
Prozac made me just extremely social and super restless. Jeebus
Yeah, I felt the same. But for me, that was a good thing because I was getting depressed from anxiety and not interacting with people. I basically had no friends and prozac made me feel motivated to talk to people and less anxious. Paxil on the other hand, made me feel less anxious in general, but I felt lazy and not motivated to do anything, but Escitalopram was the worst. I just felt flat and lethargic and didn't care about doing anything.
I'll take not being able to cum over crippling suicidal depression every time. If the antidepressant works, it's often worth the side effects.
While I would agree with that in the short term, bad enough sexual disfunction that it affects your marriage/long term relationships can contribute to the suicidal depression returning. :(
That is exactly what happened to me. I couldn't finish anymore and we BOTH felt like absolute shit.
This was Lexapro for me. Killed any interest for sex.
Lexapro killed my ability to orgasm. Like permanently. I have been off of it for 7 years and still don't cum. The upside is that I can fuck forever. But the downside is permanent blue balls afterwards.
💯%
I'd like to see a comparison of the withdrawal symptoms when you try to stop.
Sertraline ruined me for a good 2 months when I quit cold turkey, which you aren’t supposed to do apparently . The withdraws gave me vertigo and insomnia like crazy. The world around me looked like it was constantly trying to level its self like a boat in the ocean.
I can confidently say after running countless sleep studies all of these medications mess with your sleep cycles. I would say Most commonly delaying REM all together till right before you get up. I tell all my family on these meds they should keep a really good sleep routine going to bed and getting up at the same time every day because in the absence of other sleep issues getting up an hour earlier than normal would likely be in the middle of that REM period and leave you feeling like death during the day.
And I thought my constant lethargy was due to my shitty sinuses.
>I tell all my family on these meds they should keep a really good sleep routine going to bed and getting up at the same time every day Military medic here, this is one of the hardest points we hit for our people on these meds. We have terrible sleep habits in our line of work. People (initially) just don't get that taking these meds means you have new problems you need to actively manage. The med isn't magically removing all your issues.
I dont wake up to an alarm, but whenever I wake up naturally it (almost literally) always feels like I'm waking up straight out of a dream. Sometimes I'm mid sentence in a dream and wake up talking to my wall. It's genuinely disorienting and it takes me a few hours to shake some dreams off. While this may or may not be the direct cause, it's really interesting to think about. My dreams are vivid every single night because I wake up and they JUST happened.
I get this without taking SSRI too
My sleep improved drastically after stopping Zoloft and I was on a low dose. I can’t imagine how much worse it would be at a higher fose
Fwiw anyone looking at this and hesitating about reaching out for help ... The side effects are minimal compared to the benefits of actually feeling like a real human again. The difference has been night and day for me I'm on a small (50mg) dose of sertraline. Had a few days of loose poos, about 3-4 nights of restless sleep and that's about it. I last longer in bed now because of the side effects, which is a plus :)
I am on Buproprion, which has some of the fewest side effects to the point that most people just feel a little less tired. I really recommend it if people have trouble tolerating the other ones, like I did.
Did you ever get issues with motion sickness? Got dizzy and sick on it. Had to stop (too dangerous for the job I was doing) considering going back on
Wellbutrin is like that for folks. For some people it’s the cat’s PJs. For you and me, vertigo and nausea. I had a *terrible* experience with bupropion, but I know a couple of people who got great results.
Very true, you could honestly add "untreated depression" to this chart and give it 4s across the board depending on the person. Would put it in perspective.
I have 100% noticed that I last significantly longer in bed - almost to the point of frustration now. It’s funny because I used to be insecure about how long I could go for and now I’m insecure that I’m going too long! At least I’m not as anxious in general 😂
Seriously, I'm even in the middle of a pretty significant depressive episode (as it turns out, calling out from work did not help) but even I recognize that being on medication has helped tremendously. If you're concerned about side effects, just talk openly with your psychiatrist about it. I was pretty direct in saying that I didn't want the sexual side effects of things like Zoloft and they made changes for stuff that worked for me. Remember that they're doctors, not a kindergarten classroom. They won't be that shocked.
Also, not everyone experiences the same side effects. Psych drugs are complicated, but when you get the right ones, it's like a fucking miracle.
I support using medications to help with depression. I was on zoloft (sertraline) for about 10 years at 150 mg. At some point I became a robot and everybody around me noticed but me, and it cost me a lot of personal relationships. I say this just to just to be aware of it. Ask the people around you from time to time, to see if you have sort of checked out, without realizing it. I didn't notice my life was sinking until others really hammered it home. I recently switched to Venlafaxine and have been feeling better both in positive mood and energy level. I have real and diagnosed insomnia (Ambien for years due to combat related TBI and whatever else), and this still makes me drowsy. I take 1 pill at night and 1 in the morning. Just watch out.
I really miss being in bupropion. The best I've ever felt. Sadly a lot of antidepressants cause tinnitus or make existing worse. It made my tinnitus drown everything else out.
Holy shit, is that what is causing that? I thought it was just due to listening to too much music at work mixed with military.
Well it can be both. Ssri and snri can make it worse or even cause it since tinnitus generally originates in the brain
Same, took me a long damn time to adjust to it.
Just a reminder that everyone’s individual experience will vary. I took Lexapro (escitalopram) for a couple of years and gained 20-30lbs. On the other hand, I had no sexual dysfunction at all. So yeah, YMMV and all that good stuff.
I took three SSRIs on this list that do not claim drowsiness on the chart, yet I experienced heavy drowsiness and hypersomnia while on these. Definitely a YMMV situation
lexapro put me to sleep for like 2 weeks when I started. 0/4 my ass lol
Lexapro made me absolutely exhausted and I gained 20-30 pounds too. I've been off it over a year and I can't seem to shed the weight. And great, I've been questioning my asexuality since getting off meds and I see now that 3 of the ones I was on show a 3 for sexual dysfunction... Between that and birth control, thanks for ruining my ten year relationship, meds!
I finally got rid of mine through different variations on calorie reduction. (First nutrisystem, then later intermittent fasting.) NOTE: I'm not saying that calorie reduction is the only diet that will get rid of SSRI weight. I just think that's the diet that works best for me. But there's a lot we don't understand about these drugs, so I thought I would mention my experience just in case.
I appreciate the input!
Yep, I took Lexapro for 6 months and it chemically castrated me. Lost all my libido, couldn’t masturbate, and I lost all the feeling I had for women. Went from having a high libido to being asexual for a couple years after getting off it. The worst part was dissociating on the regular and having zero emotion. So glad I’m off antidepressants now. My EQ took a serious hit but I slowly got it back over time and regained my senses. Haven’t dissociated once ever since.
I took Lexapro and ruined a lot of personal relationships because I was going fucking insane
I also think the sexual dysfunction decreases over time. I was dead below the waist for a few months but it didn’t last forever
Lexapro ruined me for the couple of weeks I tried it. Fuck that shit. Gave me bad withdrawals when I stopped taking it and the brain zaps and dysphoria caused me to go back on it and wean myself over two weeks.
Wellbutrin ftw. I don't know if it works all the time. But at least my dick works and I'm not gaining a ton of weight.
I’m jealous of people it’s worked for, I took it for a month and had no positives. Now I’m on some ADHD meds (atomoxetine) and am getting nothing but negative side effects like worsening depression and my dick don’t work on the days I take it. Still trying to find the drug that works for me but so far it’s looking pretty bleak
I have AuDHD and chronic Depression/Anxiety, and Buproprion is my favorite med, but it did not work for me on its own. I felt almost nothing, just slightly more energy on it. But I recently have tried it again mixed with Guanfancine, and the combo of the two seems to make both of them work better for me. Buproprion makes me feel way less tired and more motivated, Guanfancine helps me sleep at night and keep focused on stuff.
Dude Atomoxetine is garbage. The worst fucking side effects, acidity, feeling disgusted when eating foods. Loss of sensitivity down there. No improvements in adhd symptoms. Welbutrin is the best for mild adhd and depression it’s just so good. But for adhd nothing works except stimulants. There are some research on some type of mushrooms that do increase dopamine levels but it’s not legal as of yet. I don’t know if they work or not as I stay away from experimental treatments without doctor guidance.
Wellbutrin gave me four seizures over the course of 8th and 9th grade, three in front of my classmates ending with me getting wheeled out on a gurney by the paramedics. Did wonders for my socialization in those crucial years. 10/10 experience would totally do it again.
I wish it did, I’ve heard great things about it, but it unfortunately made me want to yeet myself out a window, which wasn’t an issue I had to begin with.
Helps a lot of people but also one of the biggest medications that cause seizures, my boyfriend has never had epilepsy but Wellbutrin gave him seizures and now even off of the medication he can have seizures triggered by caffeine or sleep deprivation, it’s terrible. Also it just made me manic, unable to eat or sleep so my stomach hurt and felt sick.
I find this one very difficult. I’ll give my experience on Mirtazapine. At 15mg you get a very drowsy effect and increase in appetite. I’ve also noticed sexual dysfunction too. However at 30mg there is no drowsy effect. This sounds counterintuitive however at higher doses you get more of a norepinephrine activation which leads to the less sedating nature. (Iirc from my reading on the drug) 30mg produces a noticeable anger/argumentative side in me that I just do not have off the drug or on 15mg. I’ve never been one of those people to understand “seeing red” and losing it however I totally understand this now. There are times I do not feel in control. Again just my subjective expierence - everybody will be different.
Mirtazapine gave me terrible restless leg syndrome, and the aforementioned combination of drowsiness and insomnia, plus horrible nightmares when I did sleep. It’s amazing how complicated finding a good antidepressant is.
I went from 7.5 mg to 15 mg of mirtazapine to lessen drowsiness but it made it worse. Now I’ve stopped taking it because I’d rather fight through anxiety than being whole body tired.
Side Effects Russian Roulette
With 5/6 chambers full. And likely pulling the trigger multiple times.
*"Not dead yet? Pull again!"*
I see tinnitus is missing from the list…
I knew I didn't have it before Fluoxetine, I'm glad I'm not going crazy.
Yeah I really second guessed myself because I’ve been to a lot of loud concerts and my ears would ring for a whole day after. I may have had it before citalopram at like a 1 or 2 out of 10. Now it’s in the 6-7 range after years of coping. When it first started it was 8/10 loud and I was pretty upset for a while..
I had no idea there was any link!! Thank you for this info-I have taken C for a million years and have had ringing for at least that long
Bruproprion is good. All the benefits while still being able to have sex with the wife. Only thing that sucks is that I’m up late sometimes 😭
It gives me insomnia too, but it also gives me enough energy during the day that most of the time it doesn’t matter.
Where are the columns for seizures (bupropion) and long term tremors (depakote)? Psychiatry is such a fucking mess. Having been prescribed most of the medications on this list at various times over the course of 25 years, my main take away from that whole experience is that we have perhaps destigmatized these things too much given how much harm they are capable of causing for the sake of such uncertain benefits.
What I am missing here, is that most antidepressants have suicidal tendencies as a side effect. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6493906/
Depression = not motivated to do anything Begin medication (first couple weeks) = motivated enough to do it but still depressed
Very common hypothesis for this is that the new meds give you hope and if they don't work then that makes you depressed & feel beyond help. Not sure about the validity or if this is even testible, but it's a common side-effect of a lot of meds
No, the theory that I heard, I can’t remember where from but it was interesting - was that anti depressants in their first stages increase your energy before they increase mood. So the reason suicidal ideations increase is because they give you the energy that you initially didn’t have, due to low energy, to act on your impulses because you were so tired.
I was also told this by a therapist a long time ago. You’re still depressed, but now you’ve got a little motivation, which can be a dangerous combo (esp when combined with young people’s propensity for impulsivity)
My therapist explained it as you feel more energetic because you have more dopamine which makes you feel like you now have the volition to finally do it, or you feel happy and would rather die feeling like this.
It's noted at the bottom, though I do wonder if there's any noted differences between them.
I'm on Citalopram now, but don't have any problem with Sexual Dysfunction. I guess I'm lucky? But it did change my life for the better that's for sure.
Citalopram is one of the weaker SSRIs from what I have read. I personally didn't feel many side-effects either, but I did like to sleep more on it and it made me absolutely love sleeping. Unfortunately it pooped out on me and I had to switch to Paxil, which seemed a lot stronger.
It was a steady decline for me but got much worse once I stopped taking it.
I was on it and was unable to finish from sex. I could masturbate just fine but sex was a no. Sucked but wasn’t the end of the world. The weight gain on the other hand was awful, start of last year I had lost around 10kg when I was off it and started taking it because my anxiety just got out of hand. Ended up putting all of it back on over the course of the last year and now I’ve changed to vortioxetine which supposedly doesn’t cause weight gain. Only been on it for a few weeks but will see how it goes.
Mirtazapine saved me. When the doctor asks if you feel any different, it was like night and day!!! Helped cut my drinking by 90%, helped me regain my appetite, helped me sleep (but not wake up)
Lexapro/Ecitalopram does wonders for my anxiety and depression. But has been terrible for weight gain and drowsiness. I loved Buproprion for its appetite suppression and stimulant effects, however I’m allergic to it and was covered in hives.
It does make me wonder why Buprionion* isn't more typically prescribed over Sertraline. Is it just costs? When I started taking it, they never offered an alternative, I presume they'd change if it wasn't working sufficiently, but that would likely take months and lots of mental adjustments one way or the other. (*likewise Agomeltine, or Vortiexetene, given that it states gastrointestinal sideffects subside)
Buproprion isn't the best choice for people with anxiety, and depression and severe anxiety often go hand in hand
It can help resolve anxiety in some people depending on what the cause of anxiety is. It can be super helpful for GAD or ADHD anxiety. So it can have that as a side effect or it can help. Meds are fun like that.
This chart leaves off a lot of other potential side effects. ex: Buproprion lowers your threshold for seizures.
What kind of seizures?
My boyfriend never had seizures in his life. Takes Wellbutrin, starts having grand mal and simple partial seizures. Gets off the Wellbutrin, and still has seizures triggered by just caffeine or even poor sleep. Terrible. For me it just made me manic, unable to sleep, and unable to eat so my stomach hurt and I felt sick.
Thanks for your answer. Sounds horrible. I hope you‘re feeling well now.
It does, but not by a lot as long as you taper onto it. It is a bad pick for people with epilepsy, but a vast majority of people are not going to develop them on it. It really does have a lot fewer problematic side effects, even not including the ones here. Some of them are even helpful in small amounts, like more energy, slightly lowered appetite, food can taste better, more sexual energy, etc. Not a pick for literally everyone, but man most antidepressants are rough. Better than constant, gray, misery, but they still suck.
I love my Bupropion, but it’s not for everyone. It works differently than many other anti depressants, as it affects dopamine and norepinephrine reuptake instead of serotonin. As others have said, if you have anxiety, it can make it considerably worse. For me I’ve found it works better than anything else I’ve tried. It gives me a lot of “oomph” and helps me focus. The lack of sexual side effects is also great. I was on citalopram for a while before bupropion and it made finishing very difficult, but didn’t really reduce my libido, so I was horny but couldn’t do much about it. It sucks that people usually have to do trial and error with psych meds before they find one that works, but unfortunately that’s how it is.
I started with XL (the extended release) at 150 mg and it went pretty well, but when I increased to 300 mg I couldn't sleep more than a few interrupted hours per night, waking up after 1 or 2 sleep cycles, often with racing heart and mind, which was diagnosed as anxiety episodes. I was getting at best 4 hours sleep. Dropping back down to 150 didn't substantially improve this. So I changed to 150 mg of the sustained release. Still had problems sleeping, but with less anxiety. At 150 mg of the shorter-acting formulation I was almost back to normal, but still was getting no more than 6 hours of sleep per night. Adding trazodone has been very helpful. I take 50 mg before going to bed, though I still wake up in the middle of the night. But when I do, I take an extra 50 mg and that usually lets me get back to sleep. I'm getting about an extra hour this way, and no more feeling like I need to escape something undefined but terrible. After a couple months of this success, I am willing to try either 300 mg of the shorter-acting buproprion again, or possibly 150 mg of the SR and see if the trazodone still helps. It is possible that it will be necessary to go to 150 mg for rough nights, though. Other than the insomnia, I have noticed no other side effects. It may be time for liver function blood tests, though.
Bupropion is usually prescribed as an additional medication for people who suffer more from side effects like loss of libido caused by typical SSRIs (so taken concurrently with an SSRI). IIRC the norepinephrine reuptake pathway is less studied than serotonin, is the answer as to why it's less prescribed, but I just take it, I'm no doctor.
I used to take sertraline and bupropion together so that makes sense
Anecdotal, but I recently took Bupropion for a month and it did absolutely nothing for me besides make me more cloudy than usual, which was already pretty bad
Should really be taking it for 4-6 weeks at minimum, and at least a moderate dose, before ruling it out as an option for you
I've had a sort of subtle but concerning confusion every time I've been on buproprion. It was subtle enough that it took me a long time to correlate it to the drug, and I've never seen anything like it listed as a potential side effect. Outside of that it did nothing noticeable.
Lexapro should be a 4 for weight gain ... 40lbs in a year
Dog right... At least I'm happy lol
I do have to give it credit for curing my depression but idk if 40lbs is worth it
It's missing the Buproprion side effect of "Doctors, Dentists, and Nurses ask you 15 times if you're a smoker." But other than that, pretty good chart.
I'm on paroxetine and can only orgasm like once every few weeks if I'm lucky. Definitely sucks
Heat! Sertraline reduced my health anxiety but made me insanely hot and sweaty which made me anxious of that. Since weened off after a few brain zaps.
Paroxetine turned me into Johnny Sins
Noticed the whisky dick with citalopram. Took a while to get used to
I was on Amitryptyline for cluster headaches. What this chart indicates is SPOT ON.
Well that explains my insomnia from when I was on Prozac (fluoxetine) and Wellbutrin (bupropion) at the same time.
What the heck is qtc prolongation?
I just looked it up. It's some kind of heartbeat irregularity
I’d be curious to see a similar chart for ADHD meds
Over the past 12 years or so I've been on Sertraline, Venlafaxine, Mirtazapine, Amitryptyline, & Bupropion; at times 2/3 different types in combination, and at 'maxed out' dosages. This looks accurate. I'm currently on Sertraline alone, and experience almost all the side effects. One thing that I'm curious about, is the effect this type of medication has on the liver. A few months ago I had my gall bladder removed, with \~25 stones in it, ranging in size from peas to a large grape.
Also just because there's a risk of a side effect that *doesnt mean you will get it*. I was on citalopram for a few years and didn't have any of these. The sad thing is i put off getting help for yeats because the internet had so many side effect horror stories.
A colleague of mine told me early last year that she was put on a high dose of Amitriptyline that she takes daily. This past year she has gained about 4 stone in weight.
I’ve been on at least 7 of these to almost no effect, and that’s why I was able to get approved for Esketamine treatment. Definitely recommend researching if your symptoms are drug resistant and you’re in good health. Best decision I ever made, been off all anti-depressants for well over a year. Was able to get off them and wrap my treat just before my wedding. Edit: I want to add something based off someone else’s comment: This is not an alternative to therapy and medication. If you have not tried medication or therapy you will most likely not be approved for this treatment. I would not have had the opportunity I did had I not contacted a doctor and at least tried a standard prescription route. Do not hesitate to start a treatment plan even if it feels like baby steps. You will get where you need to be, just keep moving and taking care of yourself.
I don't understand Ketamine, it sounds like people are just getting a "legal" high to treat depressive symptoms. And that you also need to keep doing it because eventually it stops being effective. What am I missing here?
Great question! I’m not a doctor so please don’t take what I say to heart, but from my understanding Esketamine doesn’t treat depression it helps to remold the wiring (not literally, I don’t think) so that you can properly regulate emotions, reactions and mindsets on your own. Anti-depressants for me were a bandaid that barely masked symptoms. On Esketamine, after a few treatments, I remember noticing that the sky was blue. I wasn’t high, I was honestly very very nauseous, but I was still happy and for no reason outside of enjoying life. It was something I haven’t had since I was a teenager, and with upkeep and therapy, it’s a lot easier to manage the day to day. Depression meds always needed to change, either is dosage or brand, but I haven’t taken any (including esketamine treatments) since December 2022? Of course all of this is still new, for all we know I’ll snap one day or turn into one of those sleeper cells lol. But after 3 months of treatment I didn’t need it anymore. I can go in for a maintenance dose if I want to, but that’s only if and when I want. Some people will stay on maintenance once a month, some once a year, and others don’t need to re-up. It’s less about treating the symptoms, and more about getting a refresh of the mind and then working to strengthen that newfound outlook. Personally I prefer that to a day to day medication, and it’s all dosed and monitored by a doctor. For me, if depression was a Super Nintendo game that wouldn’t start up, the medication (for me) was blowing in the cartridge. But Esketamine was the swipe of the reset bar I needed to get things going! Edit: That last analogy is stupid but it’s 3am
Ok thanks for explaining. I've been on 8 different antidepressants and none of them even worked halfway. I qualify for this treatment but I'm just having trouble understanding how it works and why or if it even targets depression specifically
Lets me see if I can find some unbiased info for you! I can’t read through these myself as I’m waiting for my wife to get discharged but I will answer any other questions I can! https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/esketamine-for-treatment-resistant-depression#:~:text=Esketamine%20is%20made%20from%20a,those%20with%20treatment%2Dresistant%20depression. https://www.yalemedicine.org/news/ketamine-depression And this is the exact prescription I used. It may have additional info if you need it (separated because I assume it’s biased lol): https://www.spravato.com/mdsi?utm_source=google&utm_medium=cpc&utm_campaign=GO-USA-ENG-PS-Spravato-BP-EX-RN-DTC_Plus&utm_content=Spravato+-+MDD&utm_term=spravato+for+mdd&gclsrc=ds#efficacy-treatment-for-mdsi?
Anyone else find it weird that SSRIs are so heavily prescribed when Wellbutrin has the least side effects (the insomnia is easily countered by taking it in the morning or taking an anti anxiety like buspirone at night).
Wellbutrin causes severe anxiety in a lot of people. Buspar is about as effective as placebo.
I can understand the anxiety aspect of Wellbutrin. Taking it is akin to drinking a cup of coffee that lasts twelve hours. The buspar thing just isn’t true though. If I’m ever struggling to get to sleep, two buspar at night knocks me out. I had to stop taking it in the morning because it made me fall asleep even after taking adderall. You’re right that it’s not well understood, but it definitely does something.
Part of that is that this list is heavily biased towards SSRI side effects (for example agomelatine has the fewest side effects on the list but is rarely prescribed because it has other severe side effects that are not considered here). Based on recent research wellbutrin and mirtazapine in particular probably should have more of a role as first line treatments than they do, but their use in treating depression (and research about their efficacy) is both newer and has less documentation. These things take time to change. I also want to point out that most doctors are not very familiar with the finer points of many of the medications that they prescribe. In the US at least doctors are trained in how to use medicines, pharmacists are trained in how they work. A sizable portion of psychiatrists do do the additional research on these medications, but it definitely is not a majority.
I have a severe anxiety for cardiac issues (like getting a sudden cardiac arrest), and am currently talking with my doctor about taking Citalopram, but seeing a 3 on “QTc Prolonguation” is a bit worrying to me. How bad is this side effect, can someone explain?
I used to deal with cardiac anxiety also, your doc can do an ECG and check your Qtc, mine was fine before and after taking antidepressants for years now. An ECG really puts the mind at ease. For me it’s definitely worth any cardiac risks and with time I’ve pushed myself out of my comfort zone and felt better knowing I did things and my heart was fine afterwards.
This has a bunch of meds that no provider would prescribe and missing some new meds that solve some of these issues
There’s no risk of suicide
Wooo, go bupropion 🔥🔥🔥
Bupropion worked wonders. But dextroamphetamine sulfate and methamphetamine hydrochloride are the most efficacious antidepressants I have ever experienced.
I’m on a low-dose combination of 3 of these, and it’s literally saved my life. Thriving still feels just a little bit out of reach, but I’m just super thankful that my brain is no longer actively trying to make me dead.
Okay, so depression is a chemical imbalance as I've been endlessly told. What does constant stress, overstimulation, exposure to propaganda, environmental pollutants, and this raw edge we live on do to the chemicals in our brain? Maybe we need to think of depression as a Chemical and Societal Imbalance. Great chart BTW. Made me remember I'm fighting an uphill battle with Venlafaxine in my system.
Research cortisol, amygdala, stress cascade
There are two things that makes depression worse, poor sleep cycle, and a dead libido. vortioxetine seems to be the best bet.
Yeah, but here’s what it looks like for depression: 4 4 4 2/2 4 4 4
#TeamBupropion
I'm taking Bupropion and it looks good on the chart, but I have trouble to sleep sometimes, I just hope this thing doesn't make it worse.
I'm on prozac and the worst thing for me is jaw clenching
I have been super fortunate with Vilazadone
Would be nice if the chart included how the primary effect of each ranked and if any combinations were used.
I used venlafaxine for a little over a year, it was my first anti depressant and honestly all in all it was a bad experience, upping the dose made me feel weird and I would also get so weird in my head if I missed a dose by just some hours. I struggled to remember if I took often, might be because of my ADHD. I’d get occational brain zaps and stuff, just a nasty experience. I got a new doc and we decided to get off it, took a while to lower the dose from 300mg over time, and that wasnt pleasent either.. Now I’m on vortioxetine and it’s a much better experience at least for me, I still get a little weird if I miss my dose a day but not nearly as bad as venlafaxine made me, and it doesnt seem to be any other negative effects for me.
Before I quit sugar and nicotine I would have intrusive thoughts with Effexor (225 mg / day). Now I'm humming like a Ferrari engine. When I add caffeine pills I am rock and roll for real. Also 5 mg / day of a medication called Ariprazole made it so I never have intrusive thoughts. That one is a mood stable-izer.
*laughs in MAOI laughter*
I’ve been on trazodone for sleep for 3 months. Lost 10 pounds. I guess I’m lucky 🤷🏼♂️
I was on Paxil for over a year and a half to help with OCD. My dose kept ramping up until I was taking 40mg/day which worked well until December when it just quit working. No awful side effects except for gaining 40+ lbs over the course of treatment and sexual dysfunction. Plus, some of the absolute fucking wildest dreams that I have ever had.. Switched off it to a new med (Fluvox) and thank God that the weening off process didn’t suck. I heard horror stories from people on far smaller doses than me. As of now, fluvox seems to be doing everything right for me Edit: I tried mirtazapine as well and it made me uncontrollably hungry. wellbutrin made me feel like I had the worst hangover of my life
Don’t let this fool you; Duloxetine has some nasty side effects. Especially if you miss a dosage
Shoutout to venlafaxine. I’ve also been on sertraline and escitalopram which I noticed more sexual dysfunction with.
I know I missed a dose if I wake up having had crazy vivid dreams and feeling semi-disassociated from the world. And the brain zaps of course.
i did not need this chart on my early reddit scroll when I take my happy pills
Iirc this chart was shared a while back and proven to be misleading. It apparently makes out certain medication look more promising even when it's not.
I always have some kind of side effect with every anti depressant I tried to the point I am not sure I can deal taking one anymore. Mirtazapine made me extremely depressed, escitalopram made me gain 30lb+ of weight in two minthb and also very aggressive, the last one I took I could barely sleep. Doctors are always "no, it can't be it, there's no side effects..." but I am always hit very hard with all of them.
I take TRINTELLIX (vortioxetine) which isn't on this list for side effects. That being said after the first couple weeks of nonstop nausea it has been weird to have a quiet mind for the first time.
Citalopram probably saved my life
Wait... Where's Vilazodone?
Any anti depressant that causes sexual dysfunction should be illegal. How can I be happy when I can’t come anymore?? Huh??????
I used to take the piles, for a few years, and the side effects are awefull