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Anxiety/Dysthymia/Low libido. Need advice

ssri agomelatine depression anxiety

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5 replies to this topic

#1 VICREP

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Posted 03 January 2015 - 07:57 AM


Alright I have a host of problems that have been dragging me down for years now and I'm scared they may literally ruin my life. I'm 23. Just recently broke up with a short term GF (4 months) which may be confounding things, however I wasn't really that into her.

I'll just try simply my situation by listing my symptoms discreetly as possible.

Pessimism
General Anxiety
Social Anxiety
No libido
Fatigue
Obsessional jealousy
Perfectionism
Extremely low self-esteem
Poor memory
Poor concentration

Right now I'm taking Agomelatine 50mg and, Lexapro 5mg. Thinking of adding buspirone as well. Been on the Agomelatije for about a month, lex for a week. Most of my symptoms have not improved, I know medications are not the whole answer but I'm literally struggling to perform small daily tasks and can't imagine making the big moves I need to get out of this hole.

The closest I have come to full remission was on tianeptine. That stuff gave me incredible optimism and confidence, however given its mu agonist properties I question it's long term efficacy. In fact it gave me some rebound depression, which was not enjoyable.


Any ideas?

#2 Al Capacino

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Posted 03 January 2015 - 11:01 AM

I have all your symptoms except the jeallousy apart. Although that can come depending on certain medications. But usually I just don't give a crap which a problem when I don't see to my end of the bargain in a relationship.

Anyhow I'm 30 and been on and off medication for 10 years nearly. So I have good experience you might be able to take something from.

I've just recently tried agomelatine and it's effects were almost non-existent. Lexapro I've also tried and it provided slight stability but it didn't really take me out of my depression that much or alleviate many of my symptoms.

I've found for social anxiety and general anxiety that ssris are not enough. They help bring you out into the world from the box that is your home but the nervousness definately remains. It's the heart palpitations that kill me.

I had a favourable reaction to my first ssri which was seroxat but became quite suicidal on it and still had social anxiety, fear of authority etc and still took so many sick days at work just because of the apathy.

After umpteen ssris I was given venlafaxine an snri. This was the first time I really started to feel some sort of normality or what I thought was normality. Once up to 150mg I was very confident, almost arrogant, became a womanizer, drinker, gambler, shopaholic very competent at work and more driven. And I was very witty and funny.
I also had quietiapine added at one point to control the hypomanix symptoms that developed and it grounded my mood and I felt great. But I put on half a stone in 2 weeks lost my sex drive and as a sportsman decided to quit the quietiapine.

I have been on venlafaxine for a while but mood swings started to develop and jealousy with the missus. I became very possessive and manipulative so I got my own way. She started to dislike me on it and I couldn't blame her.

So I finished with that. I then went on mirtazapine which was a very unique pill. I became very self driven and despite the drowsiness had more energy mentally than I've ever experienced in my life. Nothing was too much and I was a machine at work and became quite popular.
For anxiety it was brilliant as I always knew what to say and was never blank. I've never felt this with any other medication.

Unfortunately I decided to quit it due to the sedation it causes. Also because I became very uncaring towards the missus and it really killed my emotions in that regard.
But I will say this. Despite sedation I was so active. I started running, weight lifting, taught myself to modify my car. I felt I could do anything I wanted. I didn't have any fear, I concentrated so well and believed in myself 100%. I was even considering starting my own business.

But yeah, then I quit and life fell apart. I quit my job the second day of lowering my dose. I just couldn't cope with work all of a sudden. Then I went to tricyclics. Trazodone which helped anxiety once you get to a high enough dose but did nothing much for mood or confidence. Lofepramine which was great for 2 days then I became incredibly anxious on it.

Then I bought nsi189 which is a research chemical. This has stabilized me for a little while with pregabilin to control the anxiety it causes. But I think I will be quitting it as the anxiety is too much, palpitations.

I've tried mochlobemide a reversible maoi but it's quite weak. It's not enough for remission of my symptoms.

I'm thinking of a full on maoi now or possibly one more tricyclic but they just seem a bit dirty to me from my experience so far.

I would consider mirtazapine if I was you. Start on something like 15mg for couple weeks then work your way upto max of 60. I reached 45mg and the further you go the better you feel. I'm just scared if I started it again I might want to quit it again then not cope with my work and quit that. So I'm pretty much at a loss but you still have many options out there.

I've found things like kratom good for a bit of a social boost every now and again. Yerba mate is a good drink which provides a nice wee boost for couple hours.

If you've any other questions ill be happy to answer.

Oh and tianeptine I found useful for anxiety and focus. But not so much for mood. Once you find the right pill it'sall about changing your lifestyle and trying to ground yourself I think. Although ill definately be on pills rest of my life no matter how much I feel grounded. Maybe one day in our lifetime they will find the real cause. I'm actually looking to try probiotics for the gut. There are some studies which are promising there.

Good luck

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#3 VICREP

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Posted 03 January 2015 - 11:34 AM

Thanks for your experiences Al Capacino.

From my understanding agomelatine works well with SSRIs to help prevent sexual side effects. That's the main reason I'm taking it. Although my libido is still somewhat lower since starting lexapro, which is why I'm going to add buspirone.

I really want to give NSI 189 a go. Especially because it seem to be pro-libido from what I have read, I would just need a anxiolytic along side it.

#4 3mp0w3r

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Posted 03 January 2015 - 02:23 PM

Even though you are 23 and this is not likely, did you have your testosterone levels checked?



#5 VICREP

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Posted 04 January 2015 - 02:04 AM

Yeah my test is high normal. Nothing to worry about there

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#6 VICREP

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Posted 08 January 2015 - 12:49 AM

Update:

 

So I have been on 5mg Lexapro (escitalopram) for a couple weeks, and 50mg Agomelatine for about 4-5 weeks.

 

So far I have noticed:

 

Positives:

Improved Mood

Reduced General Anxiety

Reduced Social Anxiety

Increased Extroversion

Increased Optimism

Increased Confidence

Reduced Jealousy

Reduced Obsessions

Increased Self Acceptance

Less Emotional Reactivity

Increased Motivation

Better Sleep

 

Negatives

Libido a little lower

 

Neutral

Increased Appetite

Delayed Ejaculation

 

I have Buspirone on it's way, which should help sexual functioning, plus further reduce anxiety.

 

I'm still low dose (5-10mg) of dexamphetamine 1-2 times per week to help get things done, I have ADD type symtoms as well. I will stop the dex all together soon though becuase I believe it makes my hair shed like crazy.

 

The combination of Escitalopram + Agomelatine + Buspirone should provide a solid stack for my depression and anxiety symtoms, without sexual problems. I have Bupropion on hand, and If fatigue and libido become an issue, I might add it in at a low dose.







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