I need some advice please. This is day 22 on my low dose 2.5mg Escitalopram/Lexapro/Cipralex for my combined atypical/melancholic depression and OCD intrusive looping thoughts that come with it. First of all, I do have some social anxiety (I'm an introvert with some extrovert tendencies, so that's no surprise - but then how can you not have some extroversion in our cherished extroverted world), but I manage and my overall anxiety is manageable prior SSRI treatment.
I'm getting waves of that intense jitteriness from SSRIs in the start up phase and they are not letting up. My intention was to increase to 5mg for a treatment period of about 3-6 months. Now I don't know because I really am afraid of SSRI w/d (bitten by the benzo withdrawal bug) if I remain on it longer. So many people on forums rave about how wonderful Escitalopram is for anxiety and I don't get it. Yes, we are all different
I can't handle the awful waves of jitteriness/internal restlessness (without the need for movement - what is that called?)/anxiety/stimulating factor of SSRIs. I don't want to take a benzo because I was on them for 15 years when I started up on Prozac way back then and got the same side effect and the rest is history. Ignorance isn't bliss I went through an awful isolated 18 month taper plus I'm now 2 years post benzos and recovered, except for depression creeping up AGAIN.
I'm not sure which neuros are out of wack?? Maybe I don't need serotonin from SSRIs for my depression? Plus, now research shows that serotonin isn't exactly the only neuro related to depression and SSRIs are questionable. Is it Dopamine, Norepinephrine, GABAa or the other subsets or other neurotransmitters? Over a hundred neurotransmitters at play here and still no one knows jack shit with what works for depression. No blood tests or other tests available yet. Nothing in 2014, maybe 2015. Done rant.
So I've been waiting out the jitteriness and it doesn't seem to be subsiding. I'm feeling a little better mentally and am slightly motivated. I'm very sensitive to SSRIs and SNRIs in general. Another popular one, Wellbutrin (XL or SR ) did nothing except for emotional blunting me to the point of being a robot, and I could only handle 150mg.
I fare much better with TCAs, namely, 50mg Desipramine because it doesn't cause jitteriness or anxiety and helps with my depression. I go into remission longer if you classify 2 years as long. The only problem with Desipramine is that I get dry mouth which I tolerate but the brutal constipation that doesn't let up even when I increase fibre a hundred fold is too much. It's so frustrating and VERY upsetting because I am usually very regular!
Two of my questions is: I was wondering if 25mg Desipramine can be therapeutic? A while back, I tried some Imipramine 10mg for 2 weeks, but that only sedated me more, hence more depression. I understand that at that low dose it is more a histamine and I don't need SLEEP, yet the sympathetic side effects were over a bit over the top. I could only do 2 weeks. Maybe I should try a different dose?
Here's a little background. I eat healthy and sleep well. Exercise, but need to caution myself because I weigh 100 pounds right now due to my SSRI venture. I veer towards hypersomnia because it's my way to escape my brain and life as needed. When very depressed, I start researching suicide methods and have lots of suicide ideation, but don't act on it. I think it's because I've tried to suicide six times in my lifetime. That changes your psyche.
I tend to overanalyze problem(s) or read/dwell/obsess on philosophical existentialism/societal issues that overwhelms me beyond belief (yes I know -- don't go there) and that gets me into trouble, but CBT/ACT/etc has helped me with that. I do mediation and yoga when I'm able and keep on top of it. The problem with OCD repetitive looping thoughts is that in major depression, it's useless for me to stop this and CBT doesn't work whatsoever.
Distracting is a fruitless at that point and dysphoria has taken over. Trying to perform CBT = blank mind and being frustrated and more depressed. I have had lots of CBT and talk therapy, but my depression keeps coming back.
I have tried over 20 ADs (SSRIs, SNRIs, MOA,) plus some anti-psychotic meds (because what else is left) and, of course, combo meds which were of no help. Too much time and distress trying out combos. Typically, I have the following things going on when it comes to side effects, namely, jitteriness, loss of appetite hence loss of weight (have to force feed), increased sleep, fatigue, zombieness, and apathy.
I can only handle low doses of ADs because I'm so sensitive to meds and in the past my pdoc kept trying to increase my AD because he said I have to get to the therapeutic level. Then I am get intolerable side effects. Last pdoc said I had treatment resistant depression and he was going to send me to a med specialist. We talked about ECT - I didn't go there. That was 2 years ago. I don't have a pdoc now nor do I want one. I use my GP to get the meds I want after I do extensive research. I was going to find a psychologist since it's such a happening trend right now.
I'm taking Vit D3, B6/12 and L'Theanine. I can't take magnesium sups on an ongoing basis unless it's in food. I ultimately end up having a paradoxical effect to it. My bloodwork is all normal eight months ago, except Vit D 25Hydroxy which was at 42 and in the mid end of insufficient range. I do make it a point to get out in the sun at noon for about 10-15 minutes plus Vit D3 sups. I was considering doing my thyroid T3 and T4 again.
One final question for anyone daring to venture. I have a rare blood type. It's AB Rh-. I was wondering if the Rhesus negative protein in my blood causes my intolerance to ADs. Eight-five percentage of the world is Rh+. Thought that might be my problem with ADs.
Any help on any points would be very appreciated.