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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Hordak on August 27, 2018, at 11:47:58
Somehow I can't get my a$$ up while being on SSRIs. It's just so... "meh"... I feel indifferent and apathetic. I don't get things done anymore: I was more productive without SSRIs... :afr
DID you experience something similar?
Posted by Christ_empowered on August 27, 2018, at 17:57:44
In reply to Were you apathetic and indifferent on SSRIs...?, posted by Hordak on August 27, 2018, at 11:47:58
yes. its kind of...how ssri drugs work. next to the tranquilizers, they're probably the worst when it comes to apathy and laziness.
maybe wellbutrin? some doctors add wellbutrin or a stimulant to an ssri.
Posted by beckett2 on August 27, 2018, at 22:29:12
In reply to Were you apathetic and indifferent on SSRIs...?, posted by Hordak on August 27, 2018, at 11:47:58
> Somehow I can't get my a$$ up while being on SSRIs. It's just so... "meh"... I feel indifferent and apathetic. I don't get things done anymore: I was more productive without SSRIs... :afr
>
> DID you experience something similar?Absolutely. My depression has improved, but there's an underlying loss of interest. But I seem to 'need' the meds. Idk :(
Posted by linkadge on August 28, 2018, at 13:17:11
In reply to Were you apathetic and indifferent on SSRIs...?, posted by Hordak on August 27, 2018, at 11:47:58
Yes.
I experienced this on 20mg of citalopram (and 10mg of citalopram to a lesser extent).
I did ok on 10mg, by taking it in the evening and using certain supplements during the day to offset the effect.
Linkadge
Posted by Hordak on August 28, 2018, at 14:55:25
In reply to Re: Were you apathetic and indifferent on SSRIs...? » Hordak, posted by linkadge on August 28, 2018, at 13:17:11
> Yes.
>
> I experienced this on 20mg of citalopram (and 10mg of citalopram to a lesser extent).
>
> I did ok on 10mg, by taking it in the evening and using certain supplements during the day to offset the effect.
>
> LinkadgeRegarding Sertraline: 100mg was unbearable, 75mg was borderline, 50mg is okay but not perfect. Right now I am on 50mg. But I miss the "kick", something that stimulates me and gives me drive to accomplish things. Maybe Clomipramine with its strong SNRI properties would be worth a try ;-)
Posted by Hordak on August 28, 2018, at 14:56:12
In reply to Re: Were you apathetic and indifferent on SSRIs...? » Hordak, posted by beckett2 on August 27, 2018, at 22:29:12
> > Somehow I can't get my a$$ up while being on SSRIs. It's just so... "meh"... I feel indifferent and apathetic. I don't get things done anymore: I was more productive without SSRIs... :afr
> >
> > DID you experience something similar?
>
> Absolutely. My depression has improved, but there's an underlying loss of interest. But I seem to 'need' the meds. Idk :(
>
>Which antidepressants did you try?
Posted by Hordak on August 28, 2018, at 14:57:02
In reply to Re: Were you apathetic and indifferent on SSRIs...?, posted by Christ_empowered on August 27, 2018, at 17:57:44
> yes. its kind of...how ssri drugs work. next to the tranquilizers, they're probably the worst when it comes to apathy and laziness.
>
> maybe wellbutrin? some doctors add wellbutrin or a stimulant to an ssri.Welloft is a popular combination :-)
problem ist: I am quite skinny, and Sertraline suppresses my appetite and so would Bupropion....
Posted by Christ_empowered on August 28, 2018, at 15:47:25
In reply to Re: Were you apathetic and indifferent on SSRIs...? » Christ_empowered, posted by Hordak on August 28, 2018, at 14:57:02
oh man. that's rough. i've read of people being given low dose abilify to help with anhedonia and the ssri blahs, but...
i dunno. i take abilify, and its good as tranquilizers go, but...its not what i would consider an anti-anhedobia pill. then again...low doses are a lot different, or can be. but then you'd have to worry about NMS, TD, EPS, dysphoria, over hearing in high temperatures...
maybe mirapex? I keep reading that it helps depression in ways standard antidepressant just don't...with concentration, anhedonia, etc.
If the ssri helps but you've got the amotivational stuff going on, maybe...a switch to effexor? some people swear by it, and its got a huge dosage range. tapering and discontinuing is very hard on a lot of people, though.
do they have medical marijuana where you live? some places have special blends for the moody among us.
hope this helps.
Posted by beckett2 on August 28, 2018, at 19:45:54
In reply to Re: Were you apathetic and indifferent on SSRIs...? » Christ_empowered, posted by Hordak on August 28, 2018, at 14:57:02
You've likely tried adding remeron?
> > yes. its kind of...how ssri drugs work. next to the tranquilizers, they're probably the worst when it comes to apathy and laziness.
> >
> > maybe wellbutrin? some doctors add wellbutrin or a stimulant to an ssri.
>
> Welloft is a popular combination :-)
> problem ist: I am quite skinny, and Sertraline suppresses my appetite and so would Bupropion....
Posted by Hordak on August 29, 2018, at 17:05:47
In reply to Re: Were you apathetic and indifferent on SSRIs...? » Hordak, posted by beckett2 on August 28, 2018, at 19:45:54
Yes, I tried augmenting Sertraline with Mirtazapine, and in some respects it was nice, but gave me terrible agitation in my feet & toes. I presume that is the notorious RLS?
> You've likely tried adding remeron?
>
>
> > > yes. its kind of...how ssri drugs work. next to the tranquilizers, they're probably the worst when it comes to apathy and laziness.
> > >
> > > maybe wellbutrin? some doctors add wellbutrin or a stimulant to an ssri.
> >
> > Welloft is a popular combination :-)
> > problem ist: I am quite skinny, and Sertraline suppresses my appetite and so would Bupropion....
>
>
Posted by Hordak on August 29, 2018, at 17:27:34
In reply to Re: Were you apathetic and indifferent on SSRIs...?, posted by Christ_empowered on August 28, 2018, at 15:47:25
Posted by Hordak on August 29, 2018, at 17:28:56
In reply to Re: Were you apathetic and indifferent on SSRIs...?, posted by Christ_empowered on August 28, 2018, at 15:47:25
I've read that for minimizing anhedonia the following properties are important: 5HT2/5HT3 antagonism, NRI, moderate H1-antagonism and some noticeable anticholinergic action...
Regarding Pramipexole: Not sure if I want to get into this stuff... (my dad had Parkinsons, died last month at 57 due to pneumonia, and he was taking lots of parkinson medications which often had many side effects...)
Effexor might be worth a try, although I have read terrible discontinuation stories. Secondly it is rather weak as an NRI. I would rather try Clomipramine before trying Effexor...
They have medical marijuana in Germany, BUT getting it prescribed is more bureaucratic than applying for a leading position @ german public service. And let me say you that: Germans are the most bureaucratic people around... ;-) it's easier to get it through unofficial channels...
--------------------> oh man. that's rough. i've read of people being given low dose abilify to help with anhedonia and the ssri blahs, but...
>
> i dunno. i take abilify, and its good as tranquilizers go, but...its not what i would consider an anti-anhedobia pill. then again...low doses are a lot different, or can be. but then you'd have to worry about NMS, TD, EPS, dysphoria, over hearing in high temperatures...
>
> maybe mirapex? I keep reading that it helps depression in ways standard antidepressant just don't...with concentration, anhedonia, etc.
>
> If the ssri helps but you've got the amotivational stuff going on, maybe...a switch to effexor? some people swear by it, and its got a huge dosage range. tapering and discontinuing is very hard on a lot of people, though.
>
> do they have medical marijuana where you live? some places have special blends for the moody among us.
>
> hope this helps.
Posted by bleauberry on August 31, 2018, at 7:13:54
In reply to Were you apathetic and indifferent on SSRIs...?, posted by Hordak on August 27, 2018, at 11:47:58
Apathy is maybe the biggest complaint of SSRIs, or maybe equal to the sexual side effects. It happens a real lot. People get emotionally numb with too much serotonin.
The excess serotonin is mopped up by norepinephrine and dopamine receptors. That isn't supposed to happen. That's my hypothesis of how the apathy is caused. There are clinical studies that show that is exactly what happens.
That's why I don't call them antidepressants. They aren't antidepressants. They are 'emotional anesthetizers'. They numb the emotions to depression - which is good, right? But the problem is they also numb the good emotions. They make your hobbies boring. You recover from depression in some ways, but not in your interests in hobbies or social activities. You can take a test that says you no longer qualify as depressed, and yet you have no interest in life. And a psychiatric will call that successful treatment. NOT! A clinical study would call that an effective antidepressant. NOT!
The problem is that our medical system is designed to manage disease but not to restore wellness. SSRIs only manage a slice of the depression spectrum but worsen other parts of it.
That said, you can find small numbers of people who have been on prozac or Zoloft for 10 years with great effect and no apathy. So the negative effects are not totally universal. But they are extremely common.
If you like a particular SSRI and the only remaining complaint is apathy, then a quick fix is to add Ritalin or Adderall to it. Most people will respond very well to one or the other and very bad to one or the other. So you have to try both to see. Some people might suggest norepinephrine meds such as TCAs but I disagree with that simply because I have experienced and witnessed those meds making apathy worse also, not to mention the considerable side effects which make tolerating difficult for many people.
> Somehow I can't get my a$$ up while being on SSRIs. It's just so... "meh"... I feel indifferent and apathetic. I don't get things done anymore: I was more productive without SSRIs... :afr
>
> DID you experience something similar?
Posted by porkpiehat on December 18, 2018, at 21:57:57
In reply to Re: Were you apathetic and indifferent on SSRIs...?, posted by bleauberry on August 31, 2018, at 7:13:54
Oh boy, yes! Helped with the suicidal thinking and general anxiety but I could just lay in bed and miss appointments staring at the ceiling and not caring. Zoloft was the worse it helped more with my concentration but eventually I felt strangely detached in a terrible way.
I've been chasing an AD that would help with more, not less, emotional affect, and landed on MAOIs thinking they were a panacea. I'm realizing that the NE that gives some people energy makes me hyperfocused, zoned out, and very detached from loved ones. DA feels great for a while but adds to an almost psychotic feeling of detachment eventually, like I could watch the world burn and not care.
Of course I think it's more complicated than that because straight up wellbutrin makes me activated and nervous, but with a serotonergic gives me an awful tired and dissociated feeling. Same with nortriptyline, desipramine, and of course the MOAIs. Does anyone else have this phenomenon?
Things that DO make me feel more connected are the gabapentin/oxcarbamazepine kind or drugs, but the make me so friggin cloudy and stupid I can't take them. Oddly nothing makes me feel more "human" than the day after a night of drinking...brain fog, avoidance, ruminations, flattening, all gone until about dinnertime.
Posted by SLS on December 19, 2018, at 9:26:28
In reply to Re: Were you apathetic and indifferent on SSRIs...?, posted by porkpiehat on December 18, 2018, at 21:57:57
Hi.
Which MAOIs have you taken? What dosages? What were your reactions to them?
Have you ever tried an antipsychotic that demonstrates antidepressant properties?
Abilify
Saphris
Latuda
SeroquelWhat about Remeron?
How do SNRIs affect you?
I'm wondering if there might be some indication that Lyrica would be beneficial given your experiences with alcohol.
- Scott
Posted by porkpiehat on December 19, 2018, at 11:43:15
In reply to Re: Were you apathetic and indifferent on SSRIs...? » porkpiehat, posted by SLS on December 19, 2018, at 9:26:28
> Hi.
>
> Which MAOIs have you taken? What dosages? What were your reactions to them?
>
> Have you ever tried an antipsychotic that demonstrates antidepressant properties?
>
> Abilify
> Saphris
> Latuda
> Seroquel
>
> What about Remeron?
>
> How do SNRIs affect you?
>
> I'm wondering if there might be some indication that Lyrica would be beneficial given your experiences with alcohol.
>
>
> - ScottI have tried all the MOAIs...Parnate, Marplan, and now Nardil. My responses has been good in terms of interpersonal anxiety, less frantic/hysterical/neurotic (bordlerline ish traits). Terrible in terms of numbing and compulsive behavior, not caring about my wellbeing, detachment from loved ones. Sedation/exhaustion and motivation suck too. Many have contributed to this "I don't belong here; something is wrong; I am in trouble; police lights in the mirror" kind of amorphous fear. Sleep, of course, is a constant problem. I have become a chain smoking alcoholic, much like I'm on coke or speed.
I have been at or just below therapeutic levels, mainly because the bad symptoms tend to get worse with increases, and I can't imagine when I would take the extra doses because I usually feel like garbage after I take them.
I thought I had hit a good stride with Nardil, 45mgs...dosing 15mgs in the am with 50mgs modafinil and 100mgs lamictal; another 15mgs nardil in the early afternoon; and 25mgs lamictal and maybe 2.5 mgs ritalin in the late afternoon. Last 15mg nardil at the end of the day....Sleep meds vascilate between ativan .5 mgs, trazodone 25-50mgs, and gabapentin 100 mgs.
Then I stopped drinking and I felt like I was on nothing at all...apathetic, throat so tight I felt like I was choking, and bad interpersonal anxiety/cognitive skills. I am thinking that the alcohol is boosting the effect of the Nardil. Had a few drinks last night and today all of those symptoms are gone...
I'm very interested in your thoughts about lyrica providing relief somehome similar to alcohol!
The antipsychotics have all made the serious blunting and detachment worse for me.
I hated effexor I couldn't get about 75 mgs I felt so numb and hateful, detached. I tried desipramine for a few days and I felt hyperfocused and very sad. Wellbutrin with celexa or lamictal made me feel good for a few days before becoming very tired and dissociated. I tried nortriptyline for sleep on MAOIs and I lost interest in a lot of things, couldn't sleep either.
I'd like to cut the cord on MAOIs because the detachment and compulsiveness have been constant and I'm not doing anything to make my life better, just hedonistic stuff. However I don't have any hope for a better treatment.
I'm wondering if clomipramine would be the way to go so Im not constantly taking pills throughout the day and walking this crazy tightrope, being thoroughly numbed out like SSRIs, or dying drunk and fat in a gutter somewhere.
This is the end of the thread.
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