Posted by bleauberry on July 18, 2009, at 21:52:55
In reply to Re: Sick of searching}}Bleauberry, posted by Dima on July 18, 2009, at 15:15:41
> I did try a few antidepressants. I tried Paxil for 3 days but the fatigue was unbearable. I tried Wellbutrin for about 4 weeks but I felt no antidepressant activity, only increased general anxiety. I tried Zoloft for 2 months, with no effect at all.
>
> I would love to eat an extremely healthy diet, but I feel I don't have the energy or the money to keep up with exactly the right foods to eat.
>
> The only thing I've put into my body that has helped my depression/social anxiety significantly is Adderall. The tolerance builds up far too fast for it to be practical, though.Excellent. Ok now we're getting somewhere.
First the food. It is actually cheaper to eat that way. And it is easier because there isn't as much cooking involved. Unless you eat a lot of packaged, frozen, or processed foods. Those really gotta go. Take it in steps. Just choose one thing you know should be changed, and do that for a month. Next month, choose another and add that to your successes. And then another the following month. One step at a time so as not be overwhelming or unsustainable.
The meds tell me you probably do not have a serotonin problem. You probably have something wrong in the dopamine/norepinephrine system, as evidenced by the help of Adderall but the nonhelp of ssris. Wellbutrin's action on dopamine and NE is so negligible that I do not see your nonrepsonse to that as being a useful clue in this thing. Its mechanisms are still a mystery, but they are not what it is usually assumed to be.
So that makes it pretty easy actually. If you do meds again, first choice is Nortriptyline 10mg to start with. If it feels too much in the way of side effects or whatever, empty the capsule and take just half for a 5mg dose. It should be quite tolerable within 2 to 3 weeks and then you can increase. Honestly though, compared to the tiredness you felt on Paxil, Nortriptyline should feel a lot better than that, especially with a bit of Adderall if you are still doing it. If it is not completely helpful, then the next steps are easy. The horizon is too far away to have the next steps on the radar screen today, but they are easy and straight forward. Nothing exotic.
St Johns Wort still might be an option. It hits a variety of receptors including dopamine and norepinephrine in addition to serotonin, gaba, and glutamate. It supposedly has equal affinity for all of them, but I don't know, it felt more serotonergic to me than anything else. However, before my meds journey began, St Johns Wort was actually quite good. I never had an antidepressant work as good as that herb did.
poster:bleauberry
thread:907300
URL: http://www.dr-bob.org/babble/20090709/msgs/907416.html