Below is a list of pills from different classes of antidepressants of which I have taken for
Depression/Anxiety body dysmorphic disorder and Obsessive compulsive disorder
Paroxetine (Paxill)
Fluoxetine (Prozac)
Setraline (Zoloft)
Celexa (Citalopram)
Effexor XR (Venlafaxine)
Amitryptyline hcl (First generation antidepressant)
Nortriptyline (Second generation Antidepressant)
Each pill works differently but may have fallen into the same category
The classes of drugs I took are from three different classes of antidepressant medication including
Selective serotonin re uptake inhibitors (SSRI)
Serotonin and noradrenaline re uptake inhibitors (SNRI)
Tricyclic Antidepressants (TCA)
Other classes of antidepressants include
SSRE selective serotonin re uptake enhancer (different to the well known SSRI's)
SNDRI Serotonin noradrenaline dopamine re uptake inhibitors
NRI 's Noradrenaline re uptake inhibitors
MAOI's Monoamine oxidase inhibitors
A bit about each class of Antidepressants
SSRI's are the most well known and supposed "Safest drugs on the market" for mental illness
They work on selectively increasing serotonin levels in the brain, serotonin is a neurotransmitter.
Unlike the other classes I have tried, SSRI's are selective, meaning they only work on serotonin levels nothing else. Because of there selectivity they have less harmful side effects than older antidepressants like Tricyclics and less stimulating effects like SNRI's and no restrictions on food like MAOI's may have.
The most popular selective serotonin re uptake inhibitor was for many years known as Prozac, the generic version of this is Fluoxetine and it is said to be the best antidepressant for OCD, Bullimia and Anorexia, depression and insomnia related to anxiety.
My experiences with SSRI's was not pleasant.
Despite having some major positive side effects, SSRI medication was unable to help any of my mental illnesses long term and caused extreme anxiety, sweatiness, dizziness, mania, euphoria, insomnia with increased periods of sleeping, PMT, hunger, weight gain, lethargy, tiredness, sexual dysfunction, impotence in males, anorgasmia, vaginitis in females, decreased libido and fatigue.
The worst for this was Fluoxetine by far.
The most effective Antidepressant for Social Anxiety and Anxiety disorder a few years back was Paroxetine, known as Paxill in the united states and Aropax in australia and new zealand. Due to its severe withdrawal symptoms and suicide related deaths, Aropax is no longer distributed and is sold under the generic name Paroxetine hydrochloride.
Side effects on Paxil were noticeable at first and my social levels were higher than they had ever been before. The downside to paxil is the extreme mood lifts and lows I experienced. The weight gain, lethargy, bulimia, suicidal depression and anxiety was a lot higher too on this drug, I also had a bout of serotonin syndrome for being on a high dose of this drug, and its not recommended to exceed 60 mg of ANY SSRI.
The least effective SSRI given to me for Social phobia and OCD was citalopram , it was a waste of time and money. The withdrawals were a breeze though, making it easier to switch back to paxil for one last go before changing very slowly onto a newer drug which works on both serotonin and noradrenaline known as Effexor XR (extended release)
SNRI's have many positive side effects and just as many negative. Working on the levels of noradrenaline as well as serotonin, some peopel find the benefits of Effexor and other drugs in this class such as Cymbalta very effective for treating depression, anxiety, eating disorder and OCD.
Effexor was not very good for my severe depression or seasonal affective disorder as its efficacy in anti depressive studies has been low. Effexor have been the best medication I had ever taken for my eating disorder and my anxiety lowered and sociability soared. The honeymoon period with SNRI medication is much more longer lasting than that of an SSRI. The downside with Seretonin noradrenaline re uptake inhibitors is their withdrawal side effects and difficulty being able to remain off them.
SSRI's can be bad and your body definitely feels disgusting withdrawals however, with the milder SSRI's the withdrawals can sometimes be non existent compared to the withdrawals from Effexor.
Side effects of Effexor include: Nausea, dizziness, heart palpitations, restlessness, insomnia, increased appetite, decreased appetite, sexual dysfunction, decreased libido, erection problems, mania, weight loss or gain, slight euphoria dry mouth.
Think thats bad? Well the withdrawals are even worse
So far I have experienced. Migraine headaches, insomnia, constant sleepiness, increased hunger and bingeing, crying uncontrollably, inability to sit still, Akathisia (restless leg syndrome and an inner restlessness that does not go away) irritability, upset stomach, diarrhea, frequent urination and night terrors.
I am currently trialing a Tricyclic antidepressant known as Nortriptyline (Pamelor) which unlike its older brother Amitriptyline has less side effects and a a more effective efficacy in treating severe, major depression. Nortriptyline is a chemical compound that contains three different types of use, this chemical is known as a Tricyclic compound and works as an antidepressant, sedative, antihistamine, and has tetracyclic properties meaning it has the same ingredient that is used in antipsychotics.
Because of their wide variety of uses, Tricylcics are commonly given to people with migraine headaches, nocturnal bed wetter, smokers and insomniacs in very small doses (10-50mg per night) they also give therapeutic relief to people with chronic back and neck pain and irritable bowel syndrome.
Nortriptyline is used for Depression, anxiety, smoking cessation, nocturnal bed wetting, chronic fatigue syndrome, irritable bowel syndrome, insomnia and tension headaches
the most common side effects with Nortriptyline are dry mouth, headache and increased appetite although I have found them to be weight neutral, have little to no effect on my appetite, create no loss of libido or urine retention.
The common side effects for Tricyclic antidepressants in general are
Tiredness, sleepiness, blurred vision, dry mouth, headache, weight gain or loss, increased appetite, anorexia, mania, cardiac arrhythmia in high doses and terrible urinary retention in males.
The only side effects i find on nortriptyline are: dry mouth, better sleeping patterns and headaches.
From my experience with these three classes of
Antidepressants I would personally recommend TCA's (Tricyclics) for people with severe depression and insomnia. The anxiety is still a small issue for me, but its subsiding while the effexor leave my system.
The other classes
If you or anyone you know are fortunate enough to be prescribed newer more effective antidepressant medication without weight gain and sexual dysfunction as a side effect you would most likely be taking something from the SSRE class known as Vilazodone OR a potent NRI medication called Bupropion
Vilazodone works similar to SSRI's but with enhancing effects and little to no sexual side effects or weight changes.
Bupropion is used for smoking cessation in Australia and New Zealand under the name Zyban. Around the world this drug has been approved by the FDA as a potent antidepressant and anxiety medication with a very low risk of sexual dysfunction as a side effect, in fact wellbutrin (Bupropion) can increase libido and reduce appetite which sounds like a dream, however this drug is not without its side effects.
Yes this drug works on three receptors, Serotonin, noradrenaline and dopamine but side effects are just as common and sometimes more potent with this drug.
The most dangerous side effect on this medication is seizure. Alot of people experienced anger and irritability while taking bupropion and the dry mouth, insomnia and bad breath were also a concern for people who I have spoken to on this medication.
The high success rate of smokers who managed to quit while on this antidepressant keeps Zyban still active, but because there is not yet any conclusive evidence on the effects of burpopion as a long term drug, it is hard to know exactly how long or what damage this pill may cause in terms of side effects.
SNDRI and SSRE medication is rare here where I live and some drugs are not even on our shelves let alone the medical labs so I cannot comment firsthand on their efficacy.
revolution health has great reviews on medication if you are interested in how other people reacted to these newer drugs.
MAOI's are monoamine oxidase inhibitors that are now used as a last line of treatment (when all else fails) as opposed to a first line treatment for Depression and Atypical depression (the depression that induces weight gain and sleep as opposed to melancholic which decreases appetite and sleep tendencies) The highest risk associated with MAOI's is the potential for interactions with other antidepressants, antipsychotics,anthistimines, over the counter medications and benzodiazepines. Natural supplements such as St. John's Wort) If you are taking any other form of antidepressant and switch to an MAOI based antidepressant you will need a wash out period of at least fourteen days for the old drug to leave your system as interactions with other antidepressants and stimulants such as Adderall and Ritalin can be fatal. Pain medication like Tramadol should be avoided when taking an MAOI as the combination of pain or sedative medicine with this drug causes potentiation and prolonged effect.
Too much of any of the drugs/medications that increase the levels and activity of serotonin, norepinephrine, and/or dopamine activity, can result in very harmful and negative effects, such as serotonin syndrome,hypertensive crisis, and psychosis.
Foods can play a role in how the MAOI drugs work. Food containing tyramine should be avoided because it can easily cause hypersensitive crisis in people taking these drugs for depression. Cheese and tyramine based yeast extracts such as Marmite, vegimite and bovril are dangerous when taken with MAOI's.
The most commonly prescribed Monamine oxidase inhibitors are called Phenelzine (Nardil) and Tranylcypromine (Parnate, Jatrosom) Nardil can increase appetite and cause weight gain whereas the Non-Hydrazine medication such as Parnate can have the opposite effect and include weight loss and decreased appetite as two common side effects.
Nardil is regarded as one of the most effective drugs for depression but its efficacy in social anxiety and generalized anxiety is possibly not as effective as serotonin inhibitors or SNRI medication. Despite their great success with depression, these pills are like any other in terms of side effects and not working for everyone. They can take up to ten weeks to show any positive effect and have side effects related to mental and physical well being, including dizziness, insomnia, sleepiness, lack of energy, increased or decreased libido, weight gain and loss, anorexia, sexual impotence and anorgasmia, hypotension and irritability.
Drugs containing hydrazine's such as Nardil are commonly known for their side effects, whereas MAOI's non hydrazine's like Parnate have fewer side effects where weight gain and sexual dysfunction are concerned.
The doctor told me it was unlikely an MAOI would work for me, given my treatment resistant past, I also decided that I did not want to go through a two week "cold turkey" period, dropping all my therapeutic sedative medication for something that may or may not take ten weeks to work and could possibly cause more severe side effects than I had anticipated.
Exercise with extreme caution, they are not a miracle pill.
No pills are magic, well no legal drugs are anyway and often the pills that are contain addictive potential and great euphoria.
Which leads me to the next set of medications
Benzodiazepines
the structure of benzo's.
(Will post about these another day)
bye for now
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