Drug info - Antidepressant advice please: Anything that can be taken "As Required"?

[humdroid]

Y has taken many different types of antidepressants.
He could not find one to suit him, and he found it all quite harrowing experimenting with them (under docs supervision)

Y would like to know if there is any drugs out there, with antidepressant/anti anxiety properties, which you can take on an as-and-when basis, and are not benzos or addictive in any way.

Y would feel that taking a pill which you have to take daily too triggering, as he is a newly recovered speed addict.

thank you

[SullyGuy]

In SWIM's opinion SSRIs are pretty terrible things, and should be avoided as much as possible.

I've heard of St. John's Wart and 5-HTP doing good things for depression, and Valerian root working well on anxiety. But as both of these would probably need to be taken on a day to day basis (if not more), they are out.

SWIM's recently found a mix of philosophy / spirituality literature and lectures in combination with mushrooms and DMT to be quite effective. This is in no way a "miracle cure" and should not be thought of as such, but SWIM finds a trip every few weeks really picks him up. DMT obliterated his social anxiety for a month and a half after he took it once, but thats just his experiance. Even if SWIY cant get the mushrooms or DMT, check out some philosophy like Alan Watts and something by Ram Dass (SWIM thinks DMT nexus hosts his first book in pdf format, "Be Here Now".)

SWIM has also heard a low dose of mescaline (50 - 80 mg or so) a day is a wonderful antidepressant.

Also SWIM spent 83 hours in a mental ward, and that was an... interesting and life changing expeiance. Not really reccomended, but there was lots of time to think.

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[rocknroll714]

Which antidepressants have you tried?

If you're looking for one that doesn't take weeks to kick in and works on an acute basis (ie., take a single dose and you'll feel the effects immediately), the following work in that such way:

- Bupropion (Wellbutrin)
- Mianserin (Tolvon)
- Mirtazapine (Remeron)
- Nefazodone (Serzone)
- Trazodone (Desyrel)

Bupropion is a Norepinephrine-Dopamine Reuptake Inhibitor (NDRI) with effects similar to methylphendiate (Ritalin) and amphetamine (Adderall), only much, much weaker, and without a significant abuse potential, if any at all. It produces a nice stimulant effect with a potent antidepressant effect at the same time. It will likely exacerbate anxiety however, especially in susceptible individuals, so it's not the best drug for everyone.

Mirtazapine is a Noradrenergic and Specific Serotonergic Antidepressant (NaSSA). It increases central norepinephrine transmission and central 5-HT1-mediated transmission, as well as blocks several other 5-HT receptors including 5-HT2A, 5-HT2C, and 5-HT3, which further enhances its antidepressant efficacy. Mirtazapine is very similar to mianserin, nefazodone, and trazodone, and is generally much superior to all of them. I've taken mirtazapine myself and I've found it to be excellent. I'd describe the feeling as "magical".

Both bupropion and mirtazapine are nice antidepressants and tend to be much more effective than SSRIs and SNRIs. They have fewer side effects and are more tolerable as well. Notably, there is no emotional blunting or apathy with these drugs.

If you're willing to put up with side effects, the monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and tranylcypromine (Parnate) are excellent antidepressants. They by far blow away everything else when it comes to treating depression and anxiety, even some street drugs. You will feel wonderful, have little to no stress or anxiety of any kind, and you'll feel super motivated on them. Life just becomes bliss on these drugs. Take my word for it, I take phenelzine myself. By the way the tyramine-related interactions and food restrictions are way over-hyped. There's nothing to worry about as long as you don't go and eat 3-4 full packs of cheese at once or something stupid like that.

By the way I agree with the above poster, SSRIs and SNRIs are vile, horrible, nasty nasty things. I'd never let another one of those in my body ever again. The same applies even more so to the TCAs. Also the drug buspirone which you may have taken or heard about is essentially a sugar pill. It's not bad it's just that doctors never prescribe it in high enough of doses. Most of the time it needs to be administered at like 5x the dose the doctors give you for real effects to become apparent. Lastly, antipsychotics for SSRI augmentation are utterly vile, even more so than SSRIs themselves. Antipsychotics should not be used for depression! They're literally dysphoric! Depression is not psychosis!

Hope that helps!

rocknroll714 added 2 Minutes and 26 Seconds later...

Oh also, St. John's Wort, Rhodiola Rosea, and SAMe are likely the most effective over-the-counter supplement antidepressants. They're somewhat useful with rhodiola rosea likely being the best of the lot. The problem is that rhodiola rosea likes to poop out. In fact when I tried it, I barely even felt anything after my first dose. The first dose was amazing though. Increasing the dose did nothing for me. St. John's Wort is mildly effective but not so much. I don't really recommend it. Haven't tried SAMe but I'd like to. I hear it's overhyped though unfortunately. Ridiculously overpriced as well.

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[humdroid]

Y says thanks for the replies.

Y agrees SSRI's are best avoided.
He has had them in the past, and felt they were more trouble than they were worth, for Y.

5htp gives Y sleep paralysis, but he does get some mileage out of having valerian during the day. He dosent do it daily, to keep tolerance low.
Y has also got a little straightening from kanna (aka sceletium tortuosum) so is unable to use SJW on top, as they both have SSRI type behaviours and can imply a risk of serotonin syndrome, if taken ontop of kanna.

Y agrees with the philosophy / spirituality literature side of things. He sometimes listens to deepak chopra on his phone mp3 at night, among others.
Y has also gained some permanent help from shrooms in the past.
Y knows shrooms/psychedelics are there but does not yet feel at a right time to take these.
He will, though, when the time is right.
Y takes them theraputically rather than recreationally.

As for DMT, this is one thing Y is not ready for, but he does not rule it out, as never gonna try, unlike heroin.
Y has never tried mescaline, and didnt know it worked at such low doses, is this the cactus? Sorry for ignorance.

Y also had the privelidge of spending time on a mental ward. He was not glad to be ill, but he was glad to meet interesting people, and to learn.


Y wonders, can mirtazapine be taken on an as and when basis, rather than daily, like SSRI. Y knows mirtazapine is not SSRI, and he would be interested in this, but his friend says that he took it and it made him short tempered, after a year on it.
Y had another friend who took Bupropion and went into a paranoid episode. As Y has a propensity to psychosis, he feels he should avoid this one, given its amphtetamine like similarities.
Too much caffeine even makes Y jittery.
As it also exacerbates anxiety, another propensity of Y's he will decide against Bupropion.

If Y were to go for a pharm, it would probably be the mirtazapine, but Y would have to look into the short temper side effect, as Y has been prone to self harm from temper. He takes his temper out on his self and gets a bit afraid of his self sometimes.

Its enouraging to know there are no emotional blunts with mirtazapine though.

What are the side effects, of the monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and tranylcypromine (Parnate), please?
Y is saying he is liking the sound of these bad boys.
You will feel wonderful, have little to no stress or anxiety of any kind, and I like cheese, but no great amounts, so thats no problem.

These replies have all been very helpful.

Y has taken Rhodiola Rosea, 500mg a day, and they made me jittery. He got a bit scared of them, so came off them. He's sure they work, maybe heshould lower or upp the dose?
It is claimed big doses of Rhodiola Rosea is very sedating, but Y never dared try it in case it makes me super jittery, and he needs a handful of benzos to sort it.
Y hasen't tried SAMe but Y'd like to hear others' views.

Thanks again, for the very informative posts.

[Abider]

SWIm just ever took one antidepressant : Amitryptiline.

It kicked in within 2 weeks.. and it was great ...
He woke up and thought : SO wonderful is the sun , and the nature , so great..
in the evening he got out .. and the stars were blinking "blink-blink-blink" ...
He has to admit that he took 150-300 mg in the evening..

But amitryptiline works.. and you can kick it off ..
SWIM took it for 3-4 months.. and kicked it off one day ..
to zero... no withdrawal !

[rocknroll714]

Originally Posted by humdroid

Y says thanks for the replies.

Y agrees SSRI's are best avoided.
He has had them in the past, and felt they were more trouble than they were worth, for Y.

5htp gives Y sleep paralysis, but he does get some mileage out of having valerian during the day. He dosent do it daily, to keep tolerance low.
Y has also got a little straightening from kanna (aka sceletium tortuosum) so is unable to use SJW on top, as they both have SSRI type behaviours and can imply a risk of serotonin syndrome, if taken ontop of kanna.

Y agrees with the philosophy / spirituality literature side of things. He sometimes listens to deepak chopra on his phone mp3 at night, among others.
Y has also gained some permanent help from shrooms in the past.
Y knows shrooms/psychedelics are there but does not yet feel at a right time to take these.
He will, though, when the time is right.
Y takes them theraputically rather than recreationally.

As for DMT, this is one thing Y is not ready for, but he does not rule it out, as never gonna try, unlike heroin.
Y has never tried mescaline, and didnt know it worked at such low doses, is this the cactus? Sorry for ignorance.

Y also had the privelidge of spending time on a mental ward. He was not glad to be ill, but he was glad to meet interesting people, and to learn.


Y wonders, can mirtazapine be taken on an as and when basis, rather than daily, like SSRI. Y knows mirtazapine is not SSRI, and he would be interested in this, but his friend says that he took it and it made him short tempered, after a year on it.
Y had another friend who took Bupropion and went into a paranoid episode. As Y has a propensity to psychosis, he feels he should avoid this one, given its amphtetamine like similarities.
Too much caffeine even makes Y jittery.
As it also exacerbates anxiety, another propensity of Y's he will decide against Bupropion.

If Y were to go for a pharm, it would probably be the mirtazapine, but Y would have to look into the short temper side effect, as Y has been prone to self harm from temper. He takes his temper out on his self and gets a bit afraid of his self sometimes.

Its enouraging to know there are no emotional blunts with mirtazapine though.

What are the side effects, of the monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and tranylcypromine (Parnate), please?
Y is saying he is liking the sound of these bad boys.
You will feel wonderful, have little to no stress or anxiety of any kind, and I like cheese, but no great amounts, so thats no problem.

These replies have all been very helpful.

Y has taken Rhodiola Rosea, 500mg a day, and they made me jittery. He got a bit scared of them, so came off them. He's sure they work, maybe heshould lower or upp the dose?
It is claimed big doses of Rhodiola Rosea is very sedating, but Y never dared try it in case it makes me super jittery, and he needs a handful of benzos to sort it.
Y hasen't tried SAMe but Y'd like to hear others' views.

Thanks again, for the very informative posts.

It certainly can. You can take mirtazapine in the same way as a benzo. Kicks in instantly, wears off within a day or two. Also I haven't noticed a short temper with mirtazapine at all. That's just me though.

Side effects of the MAOIs tend to be more harsh than the SSRIs/SNRIs but less harsh than the TCAs. Unlike the TCAs, the MAOIs have no antihistamine or anticholinergic effects. They merely inhibit the enzyme monoamine oxidase (MAO) and therefore the breakdown of serotonin, norepinephrine, and dopamine. In essence they're not all that much different in concept from a so-called "triple reuptake inhibitor". The main side effects include sedation, changes in sleep, changes in appetite, weight loss or gain, sexual dysfunction, fogginess, and mild emotional blunting (though nowhere near as bad as the SSRIs). Pretty similar to an SNRI like venlafaxine really. I'm hoping to combine mirtazapine and phenelzine in the future to help remedy some of these side effects.

Phenelzine and tranylcypromine also have some unique properties of their own. Phenelzine is a GABA-transaminase inhibitor and stops the breakdown of GABA. This is only at about 30% inhibition compared to 80-90% for MAO however. This is excellent if you have anxiety or insomnia problems (for example the benzos work on GABA). I've gotten great sleep on phenelzine and I've felt practically immune to anxiety of any kind. Tranylcypromine is a monoamine release agent just like amphetamine, though with only about 1/10th the potency, but still enough to be noticeable. It tends to be quite activating while phenelzine is more sedating. Tranylcypromine seems to be a little better for depression, while phenelzine is typically much better for anxiety, but both are quite good against each ailment.

The biggest problem is finding a doc who'll prescribe one to you. Most docs are timid of the MAOIs because of the drug interactions and food restrictions. A few people died when the MAOIs first came on the market because nobody knew about the interactions. Ever since they've had a dark cloud hanging over them. They're really not dangerous at all as long as you've got a slight bit of common sense however. Check the drug interactions before you take them and don't eat too much cheese and you should be fine!

[Man5onite]

Originally Posted by rocknroll714

It certainly can. You can take mirtazapine in the same way as a benzo. Kicks in instantly, wears off within a day or two.

Do you have a ref. to that?
Other than that it causes immediate sedation, I have never heard that the antidepressant effect kicks in instantly.

[rocknroll714]

Originally Posted by Man5onite

Do you have a ref. to that?
Other than that it causes immediate sedation, I have never heard that the antidepressant effect kicks in instantly.

Too lazy to dig up a ref but I can assure from both a pharmacological standpoint and from my own experience, mirtazapine kicks in instantly. Though tolerance to the antihistamine effects builds up over about a week or two at first which eventually makes it more tolerable. That has nothing to do with its antidepressant properties however. It should also be noted that mirtazapine is very subtle, but the benefits definitely are there.

[humdroid]

Y had a read up on mirtazapine (no links, due to Y jumping from one page to another) just a general mooch about.
This is the pill he want to his my doctor about.
The only things that are worrying Y are: a) a possible increase in anxiety and depression. Y stopped taking valium about five weeks ago, and is suffering terrible anxiety and depression. He would be very concerned if this increased, as he dosen't have much support.
The other concern b)Y has read that mirtazapine has nasty withdrawals. Y is looking to use these pills as a temporary solution to his depression, so does not want the worry ahead of having horrible withdrawals.
Y had slight withdrawals of valium, and knows they could have been a lot worse, but Y only had a slight habit. The symproms are very distressing, as the anxiety is crippling. Is mirtazapine withdrawals as bad? Will Y have loads of insomnia, sadness, and paranoid ideation to look forward to?