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Lexapro Augmentating Suggestions ?

depression lexapro anti-depressants

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#1 ovecta

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Posted 31 October 2014 - 01:18 AM


So having finally conceded to myself that for the past few months I've been battling with major depressive disorder I booked an appointment with my doctor, we chatted for about an hour about how I had been feeling and how I had basically completely withdrawn myself from almost all my family and friends and was finding it next to impossible to experience any pleasure in social activities I once enjoyed, on top of that studying for my master seemed like a monumental challenge given that motivation was no longer there and I was on the verge of dropping out.

 

He prescribed me lexapro (escitalopram) 10mg daily and asked me to report back a month later to assess my progress, the first week was a nightmare in terms of the increased anxiety, insomnia and sexual dysfunction. But! over the next two weeks I gradually noticed an increase in motivation to be more much social and I found it much easier to just live in the moment and stop overly worrying about negatives all the time, with each day that I'm noticing small but significant improvements in mood and overall outlook, I also feel much calmer around strangers which is something completely new for me.

 

My list of previous failed antidepressants are; 

-Mirtazapine = worked for a month then stopped, daytime fatigue remained for the month I was on it.

-Tianeptine = worked for some aspects but didn't completely rid me of depression.

-Wellbutrin = Made me more nervous and didn't seem to do much else, negative effect on memory also.

-St.johns Wort = Tried a few brands but to no avail.

 

I don't Intent on staying on Lexapro for months on end, I made that clear to my doctor so he advised me stay on it for 3 months to reduce the chances of future relapses.

 

To boost the effectiveness of lexapro I'm thinking of augmenting it will 1g of pure EPA oil, Creatine, B-Vitamins, aerobic exercise and I'm thinking of adding NSI-189 phosphate to see if any synergistic effects occur, I also have memantine on the way but I need to do more research on that.

I have selegiline and came across a report on erowid of someone who had been combining 10mg of lexapro with 5mg of selegiline with great success in treating not only depression but also ADHD, so I may also consider that at some stage. [https://www.erowid.o...p.php?ID=67864]

 

Heres some studies on EPA and Creatine

 

A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs.

BACKGROUND:In depressed patients, low blood levels of eicosapentaenoic acid are seen. We tested the antidepressive effect of ethyl-eicosapentaenoate in these patients.
METHODS: We included 70 patients with persistant depression despite ongoing treatment with an adequate dose of a standard antidepressant. Patients were randomized on a double-blind basis to placebo or ethyl-eicosapentaenoate at dosages of 1, 2, or 4 g/d for 12 weeks in addition to unchanged background medication. Patients underwent assessment using the 17-item Hamilton Depression Rating Scale, the Montgomery-Asberg Depression Rating Scale, and the Beck Depression Inventory.
RESULTS: Forty-six (88%) of 52 patients receiving ethyl-eicosapentaenoate and 14 (78%) of 18 patients receiving placebo completed the 12-week study with no serious adverse events. The 1-g/d group showed a significantly better outcome than the placebo group on all 3 rating scales. In the intention-to-treat group, 5 (29%) of 17 patients receiving placebo and 9 (53%) of 17 patients receiving 1 g/d of ethyl-eicosapentaenoate achieved a 50% reduction on the Hamilton Depression Rating Scale score. In the per-protocol group, the corresponding figures were 3 (25%) of 12 patients for placebo and 9 (69%) of 13 patients for the 1-g/d group. The 2-g/d group showed little evidence of efficacy, whereas the 4-g/d group showed nonsignificant trends toward improvement. All of the individual items on all 3 rating scales improved with the 1-g/d dosage of ethyl-eicosapentaenoate vs placebo, with strong beneficial effects on items rating depression, anxiety, sleep, lassitude, libido, and suicidality.
CONCLUSION:Treatment with ethyl-eicosapentaenoate at a dosage of 1 g/d was effective in treating depression in patients who remained depressed despite adequate standard therapy.

→ source (external link)

 

A randomized, double-blind placebo-controlled trial of oral creatine monohydrate augmentation for enhanced response to a selective serotonin reuptake inhibitor in women with major depressive disorder.

Abstract
OBJECTIVE: Antidepressants targeting monoaminergic neurotransmitter systems, despite their immediate effects at the synaptic level, usually require several weeks of administration to achieve clinical efficacy. The authors propose a strategy of adding creatine monohydrate (creatine) to a selective serotonin reuptake inhibitor (SSRI) in the treatment of patients with major depressive disorder. Such augmentation may lead to a more rapid onset of antidepressant effects and a greater treatment response, potentially by restoring brain bioenergetics at the cellular level.
METHOD: Fifty-two women with major depressive disorder were enrolled in an 8-week double-blind placebo-controlled clinical trial and randomly assigned to receive escitalopram in addition to either creatine (5 g/day, N=25) or placebo (N=27). Efficacy was primarily assessed by changes in the Hamilton Depression Rating Scale (HAM-D) score.
RESULTS: In comparison to the placebo augmentation group, patients receiving creatine augmentation showed significantly greater improvements in HAM-D score, as early as week 2 of treatment. This differential improvement favoring creatine was maintained at weeks 4 and 8. There were no differences between treatment groups in the proportion of patients who discontinued treatment prematurely (creatine: N=8, 32.0%; placebo: N=5, 18.5%) or in the overall frequency of all reported adverse events (creatine: 36 events; placebo: 45 events).
CONCLUSIONS: The current study suggests that creatine augmentation of SSRI treatment may be a promising therapeutic approach that exhibits more rapid and efficacious responses in women with major depressive disorde

→ source (external link)

 

Hoping the above applies to men also, I don't eat meat very often so perhaps supplementing creatine might not be a bad idea.

 

Anyone with any bit of advice would be great appreciated!

 

 


Edited by ovecta, 31 October 2014 - 01:23 AM.


#2 drg

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Posted 31 October 2014 - 02:22 AM

Yea NSI 189 may be all you need on its own, no augmentation required. I think you find EPA, and creatine not making enough of a difference but they certainly won't hurt to try. Exercise always is good. 

Other augmenters :

 

abilify

lithium

seroquel

strattera?

segeline would work too

 

idk

 

There are other antidepressants you can try without being too redundant 

Desvenlafaxine

Agomelatine

Reboxetine?

 

Good luck

 

--

 

An augmenter i am looking at for myself is: l-methylfolate, a bioavailable version of folic acid (B12) that is apparently helpful for depression. I would expect hardly any side effects from it. 

 


Edited by drg, 31 October 2014 - 02:24 AM.

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#3 ovecta

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Posted 31 October 2014 - 02:54 AM

Yea NSI 189 may be all you need on its own, no augmentation required. I think you find EPA, and creatine not making enough of a difference but they certainly won't hurt to try. Exercise always is good. 

Other augmenters :

 

abilify

lithium

seroquel

strattera?

segeline would work too

 

idk

 

There are other antidepressants you can try without being too redundant 

Desvenlafaxine

Agomelatine

Reboxetine?

 

Good luck

 

--

 

An augmenter i am looking at for myself is: l-methylfolate, a bioavailable version of folic acid (B12) that is apparently helpful for depression. I would expect hardly any side effects 

Thanks for advice, I'm not looking to switch anti-depressant just to optimize how I response to it, I actually tried Agomelatine but it didn't help, not saying it won't help others though.

Funny you mentioned L-Methylfolate as I literally just ordered it there after reading numerous studies showing its very effective in partial and non-responders to SSRI treatment when used in combination with the ssri, be careful with the dosing though as very high dosages have been linked to higher incidences of stomach cancer. 


Edited by ovecta, 31 October 2014 - 02:55 AM.


#4 drg

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Posted 31 October 2014 - 06:49 PM

I can't find l-methylfolate cheaper than 80$ a month. I am just going to try folic acid because it is much cheaper, idk if it will help but I may aswell try it at the price.

 

Let me know if you think of anything else because I want a better option then some that I mentioned.


Edited by drg, 31 October 2014 - 06:51 PM.

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#5 ovecta

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Posted 31 October 2014 - 07:50 PM

I can't find l-methylfolate cheaper than 80$ a month. I am just going to try folic acid because it is much cheaper, idk if it will help but I may aswell try it at the price.

 

Let me know if you think of anything else because I want a better option then some that I mentioned.

 

Try looking on Iherb, they have loads of brands of l-methylfolate at very reasonable prices, I got Doctor's Best (90x400 mcg) for less than $10.

As far as i'm aware in some countries its classed as a "medical food" wherein a doctor may prescribe it in certain cases http://www.deplin.com/ but that does not mean however you need a prescription to purchase it online or in shops.


Edited by ovecta, 31 October 2014 - 07:51 PM.


#6 drg

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Posted 31 October 2014 - 09:44 PM

The study for depression used 15mg a day is the issue.

#7 ovecta

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Posted 01 November 2014 - 11:18 AM

Well it could be worth getting and dosing to those levels, wouldn't last long but would give you some indication of how you react to it..http://youtu.be/7eRJTand8jE this gives some good info on it

#8 Son of Perdition

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Posted 01 November 2014 - 06:04 PM

i believe trazodone is a good one for this



#9 ovecta

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Posted 07 November 2014 - 10:47 PM

Just reporting back after receiving pure EPA oil a few days ago that it compliments the anti-depressant effects of Lexapro substantially, so much so that I'm thinking of lowering my dosage down to 5mg, it also seems to prevent emotional numbing as I'm actually experiencing feelings of elation I haven't felt in months, not a mania I should mention.

Interestly another study has come out linking both response and non-response with fatty acid intake http://www.ecnp-cong...lease FINAL.pdf


Edited by ovecta, 07 November 2014 - 10:51 PM.


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#10 ovecta

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Posted 13 November 2014 - 11:00 AM

Coming into my second month of taking lexapro ( 10mg ) along with Methylfolate (3mg) EPA Oil (1 gram) Memantine (10mg) and NSI189 (40mg).

The addition of Methylfolate and EPA have definitely potentiated the anti-depressant effect of lexapro and the memantine has definately boosted the anxiolytic aspect of it.

Hard to say to what degree the NSI189 is helping, I haven't noticed any blunting of emotion whatsoever but instead I have noticed a definite increase in extroverted behavior which is something I'm enjoying and haven't felt before.







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