Posted by GoddamnElectric on May 15, 2012, at 0:06:54
Long time lurker here! I'll try and introduce myself and my predicament...
I'm a 28 year old male from Australia.
I was prescribed high dose SSRI's from the age of about 11 onwards for anxiety and panic attacks. (It was moreso very high amounts of anxiety that lingered for months at a time.) *Note, I have never been off medication until now*
I have been on practically every SSRI medication available, and unfortunately during all these years I never really received help to understand what I was feeling and/or why, until I was old enough to fend for myself... this has been a slow process through attained wisdom (from therapists and collective understanding from online information - wikipedia FTW) and self-insight.
I have been on:
Mirtazapine - 45mg
Tricyc drug - Clomipramine- ?? can't remember dose
Effexor - 75mg starting dose.... now here's where things went crazy for me, I will get to this towards the bottom of this wall of text... (not in a bad way)
I felt for many years, no matter how much I tried to get well rested... I never felt like I'd slept, as to say even more tired than when I went to bed on a daily basis. I am in a normal BMI range, being 86kg's or so at 6'ft tall, ectomorph body type.
Only in the last 6 months, after seeing several different sleep doctors, normal GP's, psychiatrists, sleeping pills you name it for the last 4 years, I went to my doctor and said "I demand a sleep study, I've asked you and many other doctors for the same thing, they all tell me it's in my head, but I know how I feel... I don't care if I have to pay for a sleep study, I'm unhappy with how I'm feeling". He thankfully agreed and put it through... I asked for this for YEARS from a range of doctors, including sleep specialists. I was told my sleep concerns were all in my head and I just had anxiety/depression. I find it hard to get a doctor to listen to you if they see you've had a history of anxiety and what not, like they jump straight onto mental problems and stop listening.
I had the sleep study done, and BAM... SEVERE SLEEP APNEA. Over 45 combined apneas/hypopneas per hour, lots of breath holding. Now this is unusual for someone like myself, I've had myself checked out by an ENT and all seems fine... perhaps a thick tounge, narrow pathways in my neck but that's just run of the mill imperfect human design, really.
When I review all the medications I've been on in my time, I realised all of them gave me apathy/lack of motivation/carelessness and tiredness... except for when I tried an SNRI. Whether or not I've had sleep apnea for many years is anyones' guess, but it's taken care of now with a CPAP machine and my life has improved for the better.
My concern is I still don't feel like I have energy in my brain, no drive or desire or motivation... even though I have many great things I want to do with my life, I just can't seem to get a fire lit under my butt.So this leads to something amazing which happened for me when I tried Effexor... my mind felt like it had energy, drive, motivation, desire... literally a fire lit under my buttocks! And this was when I was still suffering with terrible yet to be diagnosed severe sleep apnea.
I responded so well to the starting dose of 75mg, and it made me feel amazing within days, perhaps great improvement within the first day. The problem I had with it over months was increased muscle tension, and so pain... it became quite intense over several months and so I simply had to quit. I tried again a few more times, being told that was an unusual side effect, but the same thing happened.
Now with several months of cpap therapy... trying to make something of myself (I tried studying and my brain just felt so slow and foggy, so I'm just working an average job) and doing a lot of reading... I really believe some sort of stimulant medication would work wonders for me. Whether I start with an NRI or a workable amphetamine based drug with less of a tendency to cause increased anxiety, is hard to say. I have got over 95% of all my anxiety related issues, the the general low mood I had with being so incredibly unrested all the time just by getting a good nights sleep, who woulda' thought?! No medication for the last few months and I feel like I've finally found a path to fixing my poor brain/body which has been holding me back from all I wish to achieve.
After much thought and investigation, I believe I either have Inattentive ADD (no hyperactivity aspect) and/or my brain chemistry has truly been rooted from being on SSRI's for so long through my young life/terrible sleep apnea/who the funk knows what EXACTLY... but I can say the NRI aspect of Effexor clearly worked for me, even at the dose which 'supposedly' doesn't work much on NE at that dose. I know it's very possible just with the way my brain is wired, and my body chemistry... that it works very well, perhaps it worked by repumping some dopamine as NE is very closely related.
So, for those who managed to read through my long winded post (which I think was necessary), what would be my best starting point in terms of NE/DA Reuptake/Release effect?
My guess is to start out with an NRI, before I even think about a dual NE/DA medication and see how I go.
For those out there much more intelligent than I, what would you speculate is the reason the NRI portion of a medication worked so well for me at such a preliminary dose? What would you recommend to me on this basis?
Sorry for the wall of text, but I am always a student to learning more about how this crazy world works, medications, life in general and I'd like to think those of you here could help salvage the life of someone who really wants to be as well as he can possibly be.
Thanks for reading!