What combos of Wellbutrin (Bupropion) + SSRIs/SNRIs have people had success with for treating depression?
I plan on replacing Prozac once I adjust to Wellbutrin and would like to be prepared with some framework for my next session with my psychiatrist. Like a shortlist of 3-4 meds that may be good alternatives to Prozac to combine with Wellbutrin.
For context, Prozac makes me feel completely apathetic and dull.
*Edited to create a running list of responses:

• Lexapro (Escitalopram)
• Trintillex/Brintillex (Vortioxetine)
• Paxil XR (Paroxetine)
• Zoloft (Sertraline)
• Celexa (Citalopram)
• Luvox (Fluvoxamine)
• Cymbalta (Duloxetine)
• Pristiq (Desvenlafaxine)
• Viibrid (Vilazodone)
• Remeron, Remeronsoltab (Mirtazapine)
• Effexor (Venlafaxine)
• Lamictal (Lamotrigine)

hey guys :) im an 18 year old female who has struggled with depression since about 8 years old. my diagnoses are depression, anxiety, adhd (inattentive type), ocd, and bpd.
ive been on all the SSRIs, an NDRI (bupropion), and an SNRI (duloxetine) and none of them have improved my symptoms. i decided to take a genetic test (genomind) and the results came back saying that since i'm a caucasian, SSRIs have shown to be less effective. apparently this is due to the fact that white people more than any other race tend to be poor metabolizers of drugs when it comes to the CYP2D6 enzyme and that venlafaxine, clomipramine, and all antipsychotics except for pimavanserin have the highest likelyhood of being effective. i was going to start w/ venlafaxine but then i realized it was the inactive version of pristiq/desvenlafaxine and has to be metabolized in order for it to work. but pristiq wasnt recommended, and i was confused because i thought since im a poor metabolizer, venlafaxine would have an issue being fully metabolized whereas desvenlafaxine is active and doesnt have to be metabolized into an active form, since that is what it already is and thus would be more effective.
i talked to my psychiatrist about this and i asked to be put on desvenlafaxine, so she put me on 50mg of it. im about 2 weeks in and know that i have to give it more time but its not showing effectiveness (could be due to the depression regarding tapering off paroxetine at the same time and withdrawls from paroxetine are HELL). i did some more research and found that desvenlafaxine is the active version of the MAIN metabolite of venlafaxine but desvenlafaxine doesnt include the other minor metabolites. so im wondering if venlafaxine would be the better choice now and thats why it was recommended on the genetic test? idk. please let me know your thoughts and opinions. thank you!

I’ve tried:
Fluoxetine (too nauseous + insomnia, no emotions) Bupropion (felt good physically but had impulse control issues, too much motivation and took too many risks, attempts, increased heart rate) Venlafaxine (suicidal thinking increased), aripiprazole (for depression, felt extremely tired yet extremely awake constantly), desvenlafaxine (light sensitivity scared me and similar to venlafaxine)
Mirtazapine saved my life. The first day I took it was one of the best days I can ever remember, zero suicidal thoughts, so comfy and calm. But after 6mo I can no longer handle the weight gain, extreme fatigue, brain fog, inability to tell dreams from reality, difficulty getting out of bed, feeling drugged, its inconsistency and how it just randomly poops out every few months.
My first week on Trintellix, huge edge taken off my anxiety, sat at my desk and worked properly for first time in weeks, in a good mood after a couple weeks of bad depression, sleep a little disturbed but not as bad as prozac yet, nauseous but I don’t mind. I know you’re not supposed to feel it this fast, but idk I do. I usually wake up with almost a panic attack amount of anxiety, and now it’s so much better. I’m excited and hope it works out.

F24 166cm tall, 60kg. I have Autism, depression and anxiety. I take desvenlafaxine daily but will change to venlafaxine next month as per my doctors orders. She also gave me alprazolan to take in case of anxiety attacks.
I work out 3x a week because that's what my schedule allows me, but I'm still unhappy with my body. I've been wanting to take appetite supressants to help with the weight loss, but before I bring it up to my doctor, I'd like to know if the drugs interact with each other.

About a month ago I (19F) was prescribed Buspirone for anxiety and Desvenlafaxine for depression. These medications were chosen after I took a Genesight test and the results showed them to be among the best options. The person that prescribed them was not my usual consultant, but was the person I was told to go to while my normal person was out of town. Both are nurse practitioners as no doctors in my area are accepting patients. I have had a good experience for several years with my regular NP.
After taking the medication for several days, I developed deep anxiety. I had read that this sometimes occurs when you start on Busiprone, so I tried to push through to no avail. After several days I contacted my regular NP with concerns over the heightened anxiety, and she took me off Desvenlafaxine and replaced it with Vilazodone, which I have not begun to take. This was two days ago, and the anxiety has not decreased and I was noted to have a high heart-rate at my appointment. My blood pressure is good.
When Googling Vilazodone (which I clearly should have done with Desvenlafaxine), a serious interaction popped up between it and Busiprone: the two medications together knowing to be a risk factor for Serotonin Syndrome. Every website I check directly says not to take Busiprone with either Vilazodone or Desvenlafaxine because of the risk.
I am not sure where to go from here. I have stopped taking the Desvenlafaxine, as I said, and I am not going to start the Vilazodone until I’m off the Busiprone, or just never start it. I feel like a lot of trust is gone between myself and the care team, because this seems like an incredibly dangerous mistake. I fully own up that I should have looked up the medications, but they were prescribed virtually and I never had a conversation in person after taking the Genesight test.
I am going to write to my NP, but I don’t even know what to say. Any advice would be greatly appreciated.
Thank you.

I (F26) have been with my bf (26) for 8 years, today is our anniversary, and I keep thinking 8 years might be enough. I have been thinking about it for months now and already talked about it to my mom and my best friend. I have been living with him for almost 4 years and we have 2 cats. Everything was going well between us before maybe after a year of living together. We are both depressed, both on antidepressants (Venlafaxine for me and Desvenlafaxine for him), which I think makes things a lit worse for both of us. When I have a depression spell and can't stop crying, I can see him trying his best to take care of me but it seems like he doesn't know how, even after 8 years, its always the same. Trying to figure out whats wrong and blaming on the fact that I don't move (even though I kick my own ass to do some cleaning around the house). Mind you my depression gets sometimes so bad my body aches and I can't barely move to eat and wont brush my teeth for weeks on end, and yet if the kitchen counters were dirty one day he would sigh and make sure I know he is disappointed about it for the next half hour. I wasn't always depressed, it began after Covid and maybe a year of living with him. Whenever he is stressed, he can't stop pacing, pounding, sighing loudly and punching on stuff, closing doors hard etc. I have a lot of trauma from a teenage relationship and whenever I see him like this I freeze wherever I'm sitting until he cools off, which may sometimes take hours. And yes, I talked to him about it, MANY times... I also don't remember the last time he ever did something truly romantic. He works from home in IT and I'm unemployed, which is something he decided so I can work on my mental health. The thing is, even if he works from home, he is totally absent. I understand that it is a stressful job and all, but even after he's finished, he just stays on his computer all evening with his friends. Now now I'm a gamer too, but it is absolutely all he does. I do the cleaning around the house but I just want him to do one thing; the dishes, which he lets accumulate for days/weeks on ends to which points we had to throw some of our dishes due to mold. If I ask him for just one day of the week where we hang out together its just us on the couch or on the bed on our cellphone. I feel like I can't old a conversation without him turning everything into a debate. I can't even have an open opinion without him arguing, even if he has the same opinion. He just wants to debate, debate, debate. Even if I'm right about something he will continue to debate even if he knows he's wrong. He always manages to find the last word, always has an explanation for everything and is never at fault. He always answers me like I'm the dumbest person alive if I ask him a simple question. I no longer feel comfortable with him, I don't remember when was our last sexual intercourse. I still like his hugs and pecks from time to time but when he corners me or tries to put his tongue inside my mouth I just flinch and hope it doesn't last longer than 5 seconds. I feel like the more I stay with him, the more I find him annoying and clingy and I find myself hating him more and more everyday.
Like the title says, I'm staying with him only for the sake of my cat. I can't see myself leaving him behind. Like I said, we have 2 cats, but obviously one is mine, the other is his. I really have a connection with my cat, while my bf totally ignores him. I am actively looking for a job but haven't found anything for months. I even work with an employment service assistant. But even if I find a job, I can't seem to find anywhere where I can keep my cat. I tried looking for studios and small appartment, nothing accepts pets. I know I can leave my bf whenever, my parents always told me they'd be glad to take me back, but I can't bring my cat since my mom is allergic. Thinking about abandonning my cat really breaks my heart, he is my true therapist and I spoon with him every nights. My cat is only 4 years old... And I can't imagine losing him right now

Tldr Background: 33F, Officially (re)diagnosed last year. Is/was very much the typical inattentive, disorganized but intelligent/hyperfixative and daydreaming type, Started marathon napping/drowsing by age of 16. I've heard of the ADHD-insomnia link, but exhaustion/day and oversleeping seem rare. Thoughts? Resources? Advice? Thank you!!

TW: Quote from Ableist Conversation in second paragraph
I'm from a family of artists and educators with generational trauma and chips on their shoulders regarding domestic abuse and how their own neurodivergences were treated. Originally got a diagnosis of ADHD when I was 10, Parents decided not to pursue treatment after a week of my sleeplessness during a ritalin test run, so I was told "you're just disorganized," and ADHD topic was benignly ignored, but with parents and school alternating between praising my intelligence and emphasizing my inabilities, I got a pretty dizzying emotional CPTSD whiplash. Now I marathon nap/drowse confronted with certain anxieties/stresses/emotional conflicts, and I hate it.
Anyone else suffer this? I always thought it was solely the result of a combination of depression/Learned helplessness and maybe a kind of influence from my mom, who for years would come home from work at 5:30 pm and go straight to bed from her own depressive symptoms-the waking hours she did spend with us were fixated on her need to overcompensate for my perceived academic flaws. She tried to do everything I wasn't immediately good at-even handwriting/typing- for me, something which has crippled my self confidence ever since. I'm just now starting to really confront the enmeshment there. It was common for me to hear from her "I'd never expect you to do (insert math related task here)-that would be like asking a paraplegic to run a marathon!" with complete, sincere compassion.
I've tried to fix the sleeping since the age of 21 with therapy and SSRIs. Both definitely helped with other issues surrounding my anxiety, but results were mixed re: depression and oversleeping. I've also tried nutritional, exercise, and vitamin deficiency treatments-helpful for lots of things, but not for the dysregulated day-sleep.
I've spent all my adult life falling prey to it, being shamed for it by my mother, missing out on life and feeling guilty and gross on my own behalf. I've been made to feel lazy and disdained for it as a personal flaw, even by relatives who are in the same boat and otherwise profess to understand and empathize with my condition. My family rarely talked about adhd or any other possible diagnoses for a long time after my parents tried me on ritalin and then discontinued it-I actually grew up assuming it had been another drug for a different issue (I presented with panic attacks and a depressive episode like two years afterward, and later conflated the two events and filled in the blanks with what I thought I remembered). My parents only corrected me on what the original drug trial was for when I was 28. While there might have been some ADHD snobbery from my mom, they were trying to balance family life, work, and the rest of my schooling, and I think the lack of discussion was mostly benign, as they were much more helpful when I was officially diagnosed with anxiety and depression at 20.
On top of that, my then and now best friend M (33M) was infamous in our childhood social circle for his severe ADHD. It had much stronger, more common presentations, and so both my parents, my other friends (and even M's family) were like "Nah, you definitely don't have that." So when 16 rolled around and I started napping during the day iin response to a very tense household that had inherited both depression, anger and generational trauma, I didn't associate it with M's own tendency to oversleep or nod off. Neither did our family GP.
M, Intelligent, competent and skilled in music and machinery, was also considered the good natured goof of our group, complete with a small litany of allergies and minor ailments, and a genially muppet like clumsiness rounding it all out. M would be the first to agree with you that it was simply how he was built, and our friends completely accepted and loved him for it, in the way that sparked little conversation, partly because at the time there wasn't really a vocabulary for it, anyway. I was definitely considered "quirky," but it was viewed in a different light. I could mask decently in public. That was more difficult for M.
M and I commiserate and lean on each other about it now, but when it comes to coping, a lot of the time he's been as in the dark as I am. I don't know any other ADHDers other than him who have this symptom, at least not in the "avoid difficult, painful feelings and learned helplessness" way. I've heard of Intrusive Sleeping, but I'm unsure if either of us technically qualify for it as concerns ADHD.
However, since my adult era ADHD diagnosis I've been put on 18 mgs of methylphenidate (game-changer, but am unfortunately out due to drug shortage-would absolutely welcome advice here, I've tried and hated adderall, but the other drugs I could try are mostly on backorder) paired with 150 mgs Venlafaxine, and I'm wondering for the first time if this isn't simply a "failing" of mine-The drug made it so easy to keep awake, and not want to curl up in a ball when overwhelmed.
My depression was lightening at the edges, I was dissociating less and less. I would go stretches where I could go the whole weekend with only a single nap. I felt hopeful for the first time about maybe having energy, the will to do things and the ability to be fully present. This isn't to say I don't think my depression, anxiety and physical health don't also play a part in this maladaptation, but wtf! I am so frustrated to think that if my parents hadn't been so quick to walk away from treatment after one stumbling block with ritalin, my life as it is might have been so different, for the better.
So, please, I'm collecting what scraps I can find on ADHD profiles like mine, especially info on neurodivergent circadian rhythms, what's "normal", resources for those who aren't hyperactive but drained, etc. But I especially want to hear your stories, strategies and any personal advice. Thanks, Folks!

This is my experience with Mirtazapine and why I stopped due to paralysis-like side effects. I’m sharing because the signs of paralysis slowly crept up and then one day I couldn’t move my arms or legs at all. So maybe this can help someone avoid it.. also I seriously want to know if someone else has experienced this as my Dr said he has never heard or seen someone affected in this way.
Background: Female, 24, 105 lbs. I started 30mg of Mirtazapine (Remeron) on April 13. First atypical antidepressant after having a TERRIBLE time with Desvenlafaxine (Pristiq) for 6 weeks. Took 150mg Wellbutrin a couple years ago (worked but didn’t feel sad or happy, too much personality change). Had a major fall into depression in early March this year that landed me in the hospital and I’ve since been very depressed at a low functioning level with the same diagnoses over the past two years: severe recurrent MDD, PTSD, PD w/o agoraphobia, GAD. I took mirtazapine and birth control (taking bc for the past 6+ years) every night. Here is the journal I have kept.
How my days went and side effects: 1. went to bed, woke up many times with nightmares or “busy” anxiety dreams 5am onward. difficulty waking up, extreme drowsiness, sluggish, clumsiness, coordination off, difficulty feeling things (general numbness), nap during day, meds at 9. 2. went to bed normally, woke up many times with “busy” anxiety dreams 5am onward, difficulty waking up, drowsiness, sluggish, clumsiness, coordination off, difficulty feeling things (general numbness), irritability and anger, frustration and sadness over anger, nap during day, meds at 10. 3. went to bed after overwhelming joint pain in ankles and wrists that stretching could not ease, woke up twice with nightmares, slept 11 hours, difficulty waking up, drowsiness, sluggish, heavy limbs, coordination off, tired, noticeable heart beat faster at random times, no nap. Much more movement and motivation! Meds at 8:45. (( this was the day I noticed heavy limbs or what I have deemed “ghost limbs” which is feeling like I don’t control my limbs, they aren’t mine, or my skin has trouble feeling things normally. Specifically laying down and having my legs touch each other felt weird af)) 4. woke up at 3:30 with nightmares and anxiety overthinking. Mind racing about dreams and reality/future. Really hungry?? Sleep eventually. Slow wake up, drowsiness, sluggish, heavy limbs, coordination off, tired, slow motion feeling. Coffee. Deep hopelessness and sadness. Feeling stuck. Crying, 2 panic attacks. No motivation. Chest pain for 4 hours and difficulty breathing. Thoughts of overding. sudal. binge eating badly. Hunger never satisfied. Meds at 9:30. 5. woke up at 8:30am with anxiety dreams. Slow start went to therapy. No coffee. Slow wake up, sluggish, heavy limbs, tired. Numbness gone? Ate so much food. Unhealthy food. Laid in bed all day. Mental numbness, sadness, overwhelmed. Cried. Small panic. Binged badly. Meds at 9:30 6. Went to bed after overwhelming joint pain in ankles and wrists that stretching could not help again, dreams seem less than usual, woke up 7:30, energy after waking up, heavy limbs, *ghost limbs, coordination off, noticeable heart beat faster at random times, no nap, difficulty feeling things (general numbness), slight irritability, heightened anxiety (situational), overstimulated, easily escalated anger, strong desire to cuss a lot?, overwhelmed, hopelessness. Meds at 9:30 7. Joint pain again. Woke up 5:30am couldn’t sleep for 2 hours. Anxiety racing. Slept again, woke up to phone call 8:30 very drowsy and can’t focus. drowsiness, sluggish, heavy limbs, ghost limbs, coordination off, clumsy, tired, slow motion feeling. More motivation! **Cleaned room and decided to clean at my slow sluggish pace. ((This was when I understood my meds were causing this ghosty, numb, detached feeling with my legs. However, if I moved slower I was fine. No muscle issues, no pain, no itching. I lifted my foot to stand on a 6-8 inch stool and I kicked it. It’s like I was unaware of my leg’s location, and it was slower than usual controlling it.)) Now I’m sad? Overwhelmed about the future but trying to stay happy on today’s accomplishments.. generally positive day. Nothing made me angry, nothing made me hopeless. Momentary sadness and living in the moment today. Meds at 9:30. 8. Sleep at 11, woke up at 1 very nauseous and threw up a few times. Overeating? ((This was not normal. This was not due to overeating. I had sour candy that I assumed was too acidic and maybe I ate more food than normal, but didn’t binge eat. I went to bed completely fine and just woke up feeling awful and had to throw up. Multiple times.)) Up until 2:30, sleep. Wake up at noon. Headache so bad. I can eat normally, no nausea. Made sure I didn’t overeat, was very hungry in evening. drowsiness, sluggish, heavy limbs, ghost limbs, coordination off, clumsy, tired, slow motion feeling. MUCH more motivation for thinking and not worrying or spiraling. Motivation to do things physically but body felt so weird it was annoying. Talked with others a lot, made plans for treatment, cooked dinner! Ghost all day long :/ (( at this point my legs felt worse like they were not easily controllable, but I can stand and walk fine. Not muscle weakness, but movement related. Moving in my bed was difficult because I could not tell where my legs were at all.)) headache. took ibuprofen, scared of waking up with anxiety or sick again. Meds at 9:30 9. Sunday 21st - woke up groggy, same side effects like coordination a little off, sluggish, but felt okay to drive 5 minutes to church in a small town. First day with no breakfast, had small coffee at church. Numbness started around the edge of my face, on hairline of neck/head. Increasingly became fatigued. felt like I just need something to eat. Left church, got to the car, and I was unable to lift my leg when getting into the car.. got food asap. I could not lift my legs while sitting down. My arms felt tired and like “ghost arms” at this point. Got home, couldn’t lift my leg to get out of the car. Like my brain said move and it just wouldn’t go. I could lift maybe an inch. Once I was helped to my feet, I could stand and walk forward wobbly. It’s Sunday so called pharmacist. Was told this is not a common side effect and was advised to take again tonight (for psych reasons bc I was recently hospitalized) but call psych Dr immediately in morning. If I was totally immobile I should go to the ER. I could feel the skin on my legs lightly, but had no awareness of them? had no tingling or itching but had no control of movement. I could move my feet always, and my calves sometimes. Moving my knees to chest or doing squatting movements for example was impossible. Despite feeling literally paralyzed, I felt mentally okay? Dealt with this with varying degrees all day. Panic attack caused by unrelated trigger. Leg movement changed, I could lift my legs more but not all the way. Very depressed, worried, kind of angry. Chose to not take meds again. Cried a lot, panic attack over med situation. Slept at 11 10. Monday 22 - woke up 8am extremely groggy. Difficult to wake up. Moved my legs as much as I could. They moved much better! maybe it’s fine. After 15-20 min can’t lift them normally again.. Sat a table to wake up. Coffee. Noticed my arms were affected more. Itching sensation all over body with numbness but not overwhelming, just annoying. Dr said to stop taking the meds immediately because that’s not a common side effect and to wait for the next appointment to get on something else. That’s all lol. Throughout the day, my movement changed a lot. Varied from being able to lift but verrrryyyy slowly to no movement at all in both my legs and arms. Sometimes I could move my legs decently but arms and fingers were frozen. Sometimes my arms were fine but I could not grip anything at all. One minute my left arm was dead and my right was fine, then they’d shift. Mentally I was okay, this day I felt STRANGELY positive. I enjoyed my day with my boyfriend and was happy even when I couldn’t feel my body. Mental happiness high? I felt very attracted to my bf and wanted to be silly. Increased sex drive (hasn’t existed for the past two months) but did not act on it, literally unable to lift my limbs lol. Deep conversations about random things. I had Panic moments with body function like “these arms aren’t mine what’s happening” or “I seriously can’t move right now that’s crazy” but it always went away after a few seconds and breathing, knowing it was the meds and I’ll be okay. Living like this made me realize what it would be like to be paralyzed in my legs and arms and this was very scary. Sorry if that’s insensitive somehow lol. Laying down and getting up is very difficult. Itching and feeling so uncomfortable where my clothes are on my body. Went to bed 10pm 11. Tuesday 23 hard to wake up. Groggy for 40 min. coffee. Movement better but I have to be slow. Can stand up from bed and chairs now. Can walk once I’m up. Did a seemingly small task but at a normal pace and became so fatigued. Symptoms worsen when moving how I normally would. Need to take it easy. Face and body itching, still can’t feel if there is something on my face when eating. Legs getting in and out of car hard still. Walking is better. Arms better but changes. Sleepy. Cleaned room up slowly, pet the dog. Gained motivation to enjoy something new and have hope? Enjoyed my day. Felt motivated but energy low. very itchy and ghost feelings everywhere. Gets worse with stillness after moving. Positive day? Night night 10:30 12. Wednesday 24 Woke up 8am. looked into what interested me the day prior, got bored and sad. Loss of motivation and interest in things. Negative outlook returning, no energy, YouTube in bed all day. Sad thoughts, tried to ignore. Therapy, great session. Stood up to leave, felt dissociation beginning.. am I sure? I think it’s just cause I can’t feel my body normally.. false. dissociative panic attack. numbness mentally, exhausted. Itchy and general numbness in body. I am able to stand and move almost normally but the numbness/itchiness comes and goes. The glimpse of motivation and positivity and happiness a few days ago are going away with the paralysis. Sleep at 11? TODAY: Wake up 5:30 anxiety dreams. Sleep at 9 until noon. drowsiness waking up, sluggish, heavy limbs, tingling and itching around body like previous two days, coordination off a bit still, tired, need to go slower. I think eating less makes it worse. I slept so long I hadn’t eaten and felt worse than the day before. Sad and hopeless, generally depressed. Therapy. Another dissociative panic attack, feeling the su***dal thoughts coming back due to how these panic attacks affect me and my spiraling thoughts into depression. Heightened anxiety the past 3 days very noticeable. Talked to Psych, starting me on Zoloft 100mg and a medication for sleep and nightmares, forgot what it was called.
That’s basically it. Sucks I could see potential benefits to my mental health on this med despite taking it just little over a week. It was definitely far better than being on pristiq. Hope to find a med that can help without crazy side effects. I hope this medication helps you if you are starting or currently on it! If you feel ghost limbs or cannot properly move your body, please stop taking it. It only gets worse and since I guess it builds up in the body, it takes days to go down. Still fighting numbness and itching and ghost feelings today but I am positive it will completely go away. Better every day. Don’t freak out if you’re starting it, I could find NOTHING on this side effect online or Reddit.

Hello, hopefully you guys know some stuff about all this. I got on Amitriptyline a little over a year ago, and it helped me quite a bit with my depression and anxiety. That being said, I got a GeneSight test to see what meds would work best, at around the same time, and Amitriptyline was in the "middle," but wasn't considered the most effective med for me. It also says, "Difficult to predict dose adjustments due to conflicting variations in metabolism." in regards to Amitriptyline. The meds considered most effective are: "bupropion, clomipramine, desipramine, desvenlafaxine, doxepin, fluoxetine, imipramine, levomilnacipran, nortriptyline, selegiline, trazodone, venlafaxine, vilazodone, vortioxetine."
Also, I've been on Bupropion since a bit before I got on Amitriptyline. I was initially purely on Bupropion, which seemed to give me anxiety, and I was feeling really shitty around the time I was on it. But my psych never took me off the Bupropion, they just added the Amitriptyline. I was considering getting off the Bupropion for a long time, but I wanted to be more stable, and I also was afraid that because things seemed to be working, maybe I shouldn't mess with it.
So I've improved a lot on the Amitriptyline, but I've been feeling tired. I have bad sleep habits admittedly, but I feel near around the time I started this medication, I've stayed up way later, and I also need way more sleep. But even after 10+ hours of sleep, I still tend to be tired without coffee. But I did not feel like my sleep going to shit was related to the Amitriptyline, it just seems very possible. So I tested this by reducing my Amitriptyline from 100 to 75mg, and I noticed no improvement with tiredness, but a definite decrease in my mood. Would I have noticed a difference with such a small change in dose?
I also remember that around the time my sleep got really bad, I was very depressed, and had also gotten Covid. I considered maybe I have long Covid or something, but I don't really have any evidence of that. This led me to thinking that because I was sick and depressed, I was very inactive, and this caused me to gain weight, and perhaps this was the explanation for my tiredness. But I'm having difficulty losing weight, so I haven't really been able to test whether or not that would actually help anything. But I need to lose weight regardless.
Anyway, I'm just feeling somewhat overwhelmed with all this. I even got diagnosed with sleep apnea, got a CPAP, and I still tend to feel quite tired, though things have improved a bit with the CPAP. Doctors now are just recommending exercise and improved sleep hygiene. I am trying to do these, but I'm far more active than I once was, because I garden and do garden stuff every day. But this isn't exactly strenuous exercise I suppose. I just don't get why even with increased activity, I'm still feeling as tired as I am. I have definitely gained weight since starting antidepressants, I weigh 300 pounds. But I've been up and down in weight, and I feel like my sleep issues are uniquely bad right now, though perhaps my bad habits during my depressed period have just really been hard for me to get out of. Apologies for this huge post, do you guys have any ideas?
TL;DR: I feel tired. Could be due to Amitriptyline, but seems like it probably isn't. I'm also on Bupropion, which I'm not sure does much, but haven't gotten off of it, because I'm afraid it'll screw things up. I'm now considering stopping the Amitriptyline and trying a different med, and stopping or increasing my Bupropion. Though when I was on Bupropion by itself, increasing it just made my anxiety worse. How do I stop being so tired? Should I try a med that is adjacent to Amitriptyline maybe?

41m. Have felt like I’ve been “off” my whole life. Was started on Effexor XR (venlafaxine) in early 20’s for GAD/depression and was on it for quite a long time. I was newly married, stressed about finding a job and chalked it up to that. I was on it up until about 6 years ago when I took a Genesite test and was determined that Pristiq (desvenlafaxine) was a better fit for my DNA makeup, so I switched to that. At one point I was on Lamictal but not because of a BP2 diagnosis. I cannot recall what that really did and eventually discontinued. Last year I was also on Wellbutrin (150mg) along with my Pristiq (50mg) and felt much better late summer 2023 so decided to come off my Pristiq. I also used weed regularly and don’t have the best relationship with alcohol, but as I’ve read, for many, it really helps quiet down the noise and anxiety and makes me feel good so I kept using it. I just don’t have an off switch. In retrospect, I highly regret those decisions, but I can’t change the past, I can only do better moving forward.
Fast forward to October 2023 and I essentially stopped being able to sleep. Probably averaged 2 hours each night for an entire month. I was married to my second wife (we had been married for almost 2 years but together for 6), we each have two kids, she had just beat breast cancer and the stress of everything was at a peak in combo with the medicine switch and substance usage. Very early in November I voluntarily checked into the mental health hospital (psych ward, though I hate using that phrase) and was there for 4 days. They gave me some sleep meds and started me on some Mirtazipine. I was officially diagnosed with MDD without psychotic features. When I got out is when things started to get really bad. On top of everything else, I felt extreme shame and guilt for even letting it get to the point of admitting myself. I felt like I was letting my wife, kids, parents, siblings and work down. I do believe I went into full blown psychosis and a week later, readmitted myself to the hospital and I spent about 2 weeks in. When in I was given Trazodone to sleep, Mirtazipine, Gabapentin, and Olanzapine. I really struggled to communicate and advocate for myself with the doctors and was essentially “locked” in my brain. After meeting with the head psych doctor, he recommended me for ECT treatment. Unfortunately, I wasn’t of sound mind and just agreed to it without much discussion. I ended up with 4 treatments before I discontinued the treatments because I felt like it was frying my brain. Perhaps it did help some and snapped my psychosis, but I essentially lost the entire month of November memory-wise. On top of that, my wife told me she was getting an apartment right after one of my ECT sessions. 10 days after I got out of the hospital, she told me she wanted a divorce. In retrospect, I’m sure she was scared, confused, nervous and ultimately, she did what she felt she had to do. I still love her madly but do believe there will be no reconciliation. I’m still trying to figure out how to seek closure and apologize for everything to her, but I have not gotten there yet.
Follow all this with a recent formal diagnosis of ADHD (February 2024) and started Vyvanse 30mg and that seems to have really helped with focus, motivation and executive disfunction. I think I’ve lived with it my whole life after reading and learning more about it, and I’m glad to be able to get treatment for it.
I recently started back with a new therapist weekly to help me unravel all that has transpired and to REALLY get to the root of all my struggles. I very much relate to the concept of cycling and going from what I now believe to be Hypomanic stages and then also spending a lot of time in the depressive phases. Sometimes it seems daily, other times it’s week to week. If I look back on my life, I can see many other times where I was driven, focused, had a very elevated mood and felt like I could do anything, followed by unexplainable crashes, irritability, isolation and generally just living in my head, withdrawn and confused as to how I was one way for a while, and switched to another “version” of me. I wasn’t effective at communicating it often as I didn’t know how and felt shame and guilt that I couldn’t just be normal. My second wife was always even keeled, motivated, organized and loving and in my head, I always thought I would be dragging her down with my moods, so I masked the best way I knew how. She was supportive to an extent, but I think she kind of just wanted me to get fixed, not realizing that there is no easy fix for this, and you don’t fight mental illness like you fight breast cancer.
I’m not entirely sure why I’m writing this, and not sure if I’m in a mild form of Hypomanic phase now as I blurt all this out for this community to read. I just felt the need to get it all out there and maybe someone can relate or identify with things I mention. I feel strongly I need to get back with my psychiatrist and perhaps explore a formal diagnosis of BP2, but also, I’m scared of that and not sure how easy it would be at this point in my life while also having ADHD.
I’ve always been a high performer in my two careers and been with my second place for 11 years and even given a portion of ownership because of all my contributions. I feel like at times the possible Hypomania has been a blessing, but also realize it can be a curse and during the depressive phases, I struggle quite a bit. I’m a huge overthinker and ruminate about a lot of my past, wishing I could change things. When I’m the real me, I feel like I’m intelligent, loving, caring, kind and gentle. Other times, I don’t feel those things and it can be disconcerting to put it mildly, but I know that isn’t the real me. Maybe you can relate.
Anyways, thank you for reading and feel free to comment with perspectives, suggestions, etc. This is a throwaway account, as I’m still in the early stages of unraveling everything and because I do believe the stigma is real, unfortunately.
Take care.
EDIT: My new therapist is the one who suggested BP2 after him hearing all this. Prior to that, nobody has ever mentioned it being a possibility.

Ever since I was prescribed Duloxetine, my life has followed an unfortunate set of circumstances. The awful reaction I had to this medication is still causing me insomnia today, and it's been 2 months of living in this nightmare. This is the story of how Duloxetine ruined my life.
Before I start, I need to emphasize that this story is not intended to encourage anyone to avoid Duloxetine; my goal is to forewarn individuals who are considering trying this antidepressant drug to consult their Doctor first and discuss their biological risk of developing the horrific side effects this medication has evoked in me.
Something I've noticed is that I am someone who cannot tolerate any reuptake inhibitor drug, so I should have known better than to start a new one. Previously, I was taking Wellbutrin and Venlafaxine simultaneously. I then tapered off with Prozac, which resulted in serotonin syndrome. I quit Methylphenidate because it makes me excited and angsty, and I am a recovering crack cocaine addict, which, for those of you who don't know this, cocaine works as a serotonin-norepinephrine-dopamine-reuptake inhibitor, or for short form SNDRI.
https://en.wikipedia.org/wiki/Serotonin–norepinephrine–dopamine_reuptake_inhibitor#Addiction
Sound familiar? It should be because all of the drugs mentioned work via reuptake inhibition, similar to cocaine. The reason I bring up this is because everyone I've smoked crack with can tolerate it better, and the duration of their high would last exponentially longer than me. Meanwhile, I crash really hard, sometimes really quickly. So thus, my theory is that regardless of whether it's pharmaceuticals or street drugs, I cannot personally tolerate any reuptake inhibitors. So, if you can relate to this yourself, use precaution when considering a new antidepressant, ask your Doctor about the mechanisms of action and educate yourself on the drugs that you are going to put in your body.
And now….. On to the Story.
To preface this story, I am a 21-year-old Male; I live in a country where hospital visits are free, and medications are insured by the government for those under 25 years of age. I have been battling crack addiction for 5 years now. I quit 10 months ago, and since then, I've had about 5 slip-ups. I've been an addict since I was 14, and I have literally been to rehab 6 times. I'm currently on a waiting list to get into rehab, and it has almost been a year since my relapse, and I'm still figuring this shit out.
This story began in February of 2024. At this time, I had been on 30mg of Duloxetine for a month, with no effects nor side effects, so my dose was increased to 60mg just 5 days before my admission date into rehab.
I've been adjusting and changing meds since I was 17 for my mental health, and on this particular day, when my dad dropped me off at the rehab, he noticed I was more stable than he's seen me for as long as he can remember. "Boy, was he wrong"!
After settling in my room, I was ready to participate in the program. I found some friends, and we all sat at a table together in the cafeteria. When lunch was served, I noticed that my appetite had vanished entirely, and I was repulsed by the thought of eating at all, but I didn't give it much thought.
When I was in line for nighttime meds, I was very confident that my good old reliable Zolpidem 10mg would warmly nussle me to sleep like a lullaby, as it always did. I practiced good sleep hygiene before bed, including showering, avoiding screens for 2 hours, making the bed, and taking my meds immediately before bed. After 15 minutes, I felt the Zolpidem's comforting effects; however, I was still awake an hour after taking it, which was unusual. At first, I thought, "Maybe I'm just getting acclimated to the program," but soon enough, the Zolpidem wore off, and I was wide awake. So I hunkered down and had no option but to lay in bed the whole night.
I wasn't that bent out of shape or pissed off the next day because 24 hours without sleep isn't a lot of time to be awake for me, and I've probably done it 100 times already. Furthermore, at this time, I was prescribed a brand of 50mg Methylphenidate called Foquest, which has triple layer beads, designed to release 3 times throughout the day for a longer lasting extended release effect than double layer beaded XR medications like Adderall or Dexedrine.
I was thrilled when the sun came up, reasonably so because I had been basically confined to that room all night. Once the wake-up call went off, I was free to go elsewhere, like the TV room, to lay down on the couches or sit in the cafeteria to socialize with the early birds, and nobody appeared to notice I hadn't slept at all.
My concern was amplified when I was still repulsed by my breakfast, but I went on about my day, attended all of the daily programming, and soon enough, it was nighttime again. "Surely, I'll be able to sleep this time," I said. Anyone would pass out from exhaustion if they were sober the whole time like me."
Nighttime meds came again, and now I was less confident in the Zolpidem to do its duty. However, I was prescribed 10mg diazepam and 300mg pregabalin at bedtime on top of the Zolpidem. So, at this point, I was relying on the back-burner meds. Sure enough, the meds wore off after an hour, and eventually, I called it quits again, but I knew I had to preserve my energy, so I stayed in bed tossing and turning, just trying to sleep, but to no avail. On this night, I thought to myself, "Maybe I'm just going through weed withdrawal," although I hadn't noticed any cravings or anything up to this point, so it never occurred to me prior.
As the clock struck 6 am, 48 hours had gone by without any sleep. When I woke up, I was at home. Now I'm two hours away in the middle of nowhere. Being this far from home, and even how far I was from the nearest hospital, I grew weary. I knew that I wouldn't be able to access the psychiatric care I clearly needed.
Things weren't looking good this morning. I started becoming unwell, with anxiety, and my freeze would keep kicking in. I had no idea what was going on and why the fuck I couldn't eat or sleep at all.
This all pissed me off because I had fought a long battle of suffering and trying to pull my shit together for 8 months so that I could get into rehab again, and of course, it backfired on me.
To fill you in on those eight months between June and February, I was put on long-term disability with the condition that I go to rehab to maintain my job, which I already had plans on doing anyway. I found a rehab with lots of praise across my country, but the waiting list was 3 months long. So I was stuck at home on the rural back roads and spent all my time living a very sedentary lifestyle until I got offered a bed. When I got there, however, I quickly felt like I was in a labour camp rather than a drug rehab.
I hated every day of the 8 weeks I spent there because of the sheer overexertion and exhaustion due to the intensity of the rehab. We worked from 6am until 9 or 10:30pm every single day, with very little free time. Half of the clients at the place were on parole conditions, and the other half were what we called "health beds." I wasn't on parole, nor have I ever served jail time, and when I asked the parolees, every single one of them told me the exact same thing. They all said, "This program is far harder than jail," and "I wanna go back to prison." Keep in mind some of these guys came from medium security and witnessed horrible things, which I won't elaborate on.
After those 8 weeks, I had enough. I was withdrawing off Diazepam because the psychiatrist at that rehab tapered me down way too fast. I was also suffering from akathisia when I had to start an antipsychotic because I had an episode of paranoid psychosis due to the exhaustion combined with the entire dynamic of the program. They were making me wait forever to get the meds I needed for the akathesia, and they let me continue to withdraw even though I visited the hospital and they faxed them a prescription for benztropine and re-prescribed Diazepam. I had enough of their bullshit, and so I left.
My parents were furious that I quit, but I was determined to find a better rehab, one that didn't practice slavery and intentional sleep deprivation as their entire philosophy, and 3 months later, I ended up in the rehab where this story began.
I was incredibly frustrated after being awake for 48 hours straight. It felt like the last 8 months had flashed before my eyes. I saw all the misery, hopelessness, grief and loss that my addiction had caused over the years. Despite all the effort I had put into overcoming it, everything seemed to be coming together, and my dad had commented on how stable I seemed; suddenly, I found myself in crisis.
On morning two, I wasn't fucking around. No Foquest, no relaxing with my eyes closed, and I powered through the day. It wasn't enough, though, because all night, I still hadn't gotten even a little half sleep in; I was fully conscious the whole time.
At this point, I proposed I go to the emergency room so I could speak to a psychiatrist fast, which is something I've had to do several times, but I was met with discouragement by my counsellor. He kept saying, "This is just a part of recovery." Then I refuted him by saying, "I haven't been smoking crack for 8 months. This isn't detox! This is my medication causing a crisis". I had enough of how oblivious he was, so I walked away from that conversation because he made me feel guilty for even asking such a thing, even though it was the best option, and I should've followed my gut instinct.
My mind was so slow because of the time disorientation, and I became very compulsive. I was extremely uncomfortable living in my own skin, and my body would go into its freeze instinct. For example, I got into my room and had snowy boots, and I didn't want to track snow into my room, so I just froze and stood there staring into space, lost in my thoughts. It took me 30 minutes to remove my boots and rigidly tip-toe into bed.
One of the rules of the rehab I was at was that you cannot refuse meds, but suddenly, In the blink of an eye, I remembered my Doctor's words when he increased the Duloxetine from 30 to 60. He said, "I'm gonna give you two 30mg capsules, but if anything bad happens, return to one capsule."
At that moment, I was in line to get my meds, and I realized that I had factored out everything. It was very unusual for me to have appetite suppression to this extreme, and if the weed withdrawal was the sole problem, I would've gotten poor sleep or not enough. It'd be very unlikely to have resulted in complete insomnia for three days straight, maybe one, but I'd end up crashing the next night. I did factor in the new environment, but only for the first night. Another indication that I had was I had an uncontrollable urge to crack my neck constantly, which Is a side effect I've had from other antidepressants and indicates the dose is too high or something adverse is happening.
I told the nurse I was choosing to lower my dose without their permission, and she vaguely warned me, saying, "Well, part of being in this program is taking your meds." I just shrugged it off, not understanding what she was eluding, but I wasn't gonna go through this torture any longer. This was on a Friday, so all the weekday staff in charge of the rehab left, and the weekend staff were there until Tuesday because it was a long weekend.
On the fourth night, I anticipated a repeat of the same routine, and despite my efforts, I couldn't fall asleep; instead, I felt as if I were hypomanic because I felt mental energy that kept my mind alert, but the fatigue was getting to me, and I ended up falling asleep at like 5 am only to be loudly awoken by the P-A speaker in my room gave us a wake-up call at 6 am. And when I woke from this, I was sure as hell pissed off because I felt so much worse than before, but the good thing was it was the weekend which meant free time all day. After the fucking megaphone in my room awoke me into shock, I stumbled out of bed, staggering, not so far as tripping over my feet yet, but needless to say, things were getting terrible given that in 4 days, I had slept 1 out of the other 95 hours. This morning at breakfast, I confirmed my theory that Duloxetine was causing these side effects because I began eating more and slowly regained my appetite.
So, on day 4, I was losing myself after that 1-hour nap that destroyed me. But the straw that broke the camel's back was a song I heard coming from the next room over, and I had the worst panic attack of my life because it was a song that my evil ex-girlfriend involved in my last relapse, would play while we smoked crack together so, of course, it caused flashbacks.
At this point, I had no composure left; I ran down the hall, went outside and started hitting my head off a brick wall until it bled. I was stopped in the act, and the staff had to call the ambulance.
I knew I was the most isolated hospital I'd ever been to when I arrived, and they told me they literally had no psychiatrists. Eventually, after waiting for a doctor, I had to explain everything all over again because the ambulance driver didn't hand off any of the info I had given them in the ambulance, and I almost didn't get any help. The nurse walked in and said, "How can I help you?" I was in shock and didn't realize yet that she didn't know anything about me, but even after I explained that I'd been awake for 4 days straight because of a medication, she just looked at me and said, "Well, you seem fine to me" This made me really angry at the world. She just thought I was high since she knew I had addiction issues, but after talking with her and the Doctor, I said, "It seems as if you guys think I'm just high." They both just looked at each other, and from then on, I could tell they believed me. We talked, and I suggested we add 25mg of Seroquel, so the Doctor sent me back to the rehab with a week's worth in a bottle.
After I got back to the rehab, it was time for bed again, and thankfully, I got some sleep that night. However, the sleep wasn't restful enough, so I was still loopy and anxious. However, I continuously regained my appetite, which made me feel better.
The following 2 nights, I managed to sleep through, and my eating habits were much more natural than before. I was starting to think my sleep was returning to normal. I began feeling like everything would be okay, but when I got up Tuesday morning after 7 days of torture, I thought I had suffered enough. I was wrong because the staff in charge returned, and they concluded that I needed to be medically discharged from the rehab, and I had 15 minutes to gather my shit and leave.
I was under the impression I could reapply when I got home. When I called, the intake coordinator said I had to wait three months before reapplying.
After hearing this, I felt hopeless, so I started digging. I discovered that I could call the clinical director of the rehab and make a formal complaint. So I called her up, and after I explained how much I wanted to return, she decided that all I would need to reapply would be a note from my Doctor explaining that I am medically stable on my meds. I was thrilled to hear this, and furthermore, I didn't have any problems sleeping anymore, so I was confident that I'd get the letter I needed to return.
When I called my Doctor, I didn't need Seroquel anymore because my sleep had returned to normal. I was having a lot of agitation and discomfort, so my Doctor switched me from Diazepam to clonazepam to give me the best opportunity for success upon returning to rehab.
I don't remember the following 9 days after, But on March 2nd, it hit me again and I could no longer sleep without medication, nor could I eat anything without forcing myself. In a sleep-deprived state the next day, I made the poor decision to go into my parent's closet, where they hid my medication and stole fifteen 10mg Diazepams, so that night, I took 90mg just so I could sleep.
The next night rolled around, and I took 60mg and couldn't sleep at all. My grandfather lives next door and has always been helpful to me when I have insomnia. He sometimes would give me 15mg of oxazepam. So I went home and took it, and just sat there and still couldn't sleep. In a drunken state from all the benzos, I lost my inhibitions, had enough of the insomnia, and was ready to die for the first time in my life.
I decided I was ready and attempted to gulp back all my pills, knowing I would end up in a coma or dead. I found over 2 months' worth of pregabalin; I take 600 per day, so there were approximately 35 grams. There were also about 150mg of Diazepam that hadn't been returned to the pharmacy, a month's worth of clonazepam, so about 45mg, I had probably 500mg of Methylphenidate and maybe 100mg of Zolpidem and some other stuff I can't remember.
I had to get past my mom first because she was in the way of the closet, so I walked by casually, grabbed the bag and tried to get past her. She gripped the bag, and I didn't want to be aggressive with my mom, so I let go. She was traumatized by my behaviour and quickly dialled 911. I was so remorseful for what I did to my mom, so I jumped over the railing down a flight of stairs but landed on my 1 foot and just fell up the stairs, and was barely injured.
When I got to the hospital, they ended up giving me 50mg of Seroquel, and somehow, I managed to fall asleep. When I woke up, they contacted my parents, and they didn't want me to come home and needed a break, so I went directly to a crisis centre from the hospital.
The centre I was in was for people at risk of homelessness or just for crisis support. It's a nice house with a beautiful kitchen. I could even bring my nicotine vape with me. They also had lock boxes for people to store their drugs in; the only rule was you had to leave the property to get high, and you could come back tweaking balls if you wanted to. When I arrived, I was so drugged up from all the benzos that I stumbled around everywhere and had to use the elevator.
The first night was pretty easy, even though I didn't sleep because I could vape outside whenever I wanted, and other people were awake all night that I could talk to. This made it much easier to remain calm since I wasn't confined to my room this time. My Doctor was away for the week, so out of the kindness and love in my dad's heart, he took me to a walk-in clinic to get some trazodone. The clinic doctor only gave me 25mg, which was not nearly enough because, by this point, my sleep threshold was substantially higher. That night, I combined it with 2.5mg of Clonazepam and Zolpidem, but it was useless, and I stayed awake.
On Night three at the centre, I managed to get 3 hours of broken-up sleep from 6am to 9am. I was sleeping so lightly that I had a hypnagogic hallucination, which is a type of hallucination where you're on the cusp of waking up. It felt like I was on DMT for a couple seconds, and then I woke up.
I had enough; I was skeptical but decided to stop taking the Cymbalta because I was living on protein shakes and could barely eat a small yogurt; I was sitting at the table crying because I just wanted to eat.
The environment I was in was very triggering for me, especially since I was a 20 minute walk away from my dealer, and I could return back to the centre when I was done. So this is where the stupidity began, and I gave in even after three days of barely sleeping. And went to grab a 70-piece of crack.
Even though the cops don't care about drug users in my city, and people can be spotted smoking drugs all over the place, I still felt paranoid about where I was smoking up. Whenever I don't have a place to use safely, I walk around downtown looking for alleyways or trying to find tents in the park where the homeless live. This time, I wanted to be more stealthy, so I climbed up this mountain in my city with a stairway about 100 or so steps tall. As I walked up the stairs, my legs were trembling, and I could barely descend the steps without collapsing.
When I got back to the centre safely, I was tweaking and could barely compose myself enough to communicate, and my fine motor function was fucked that I needed help opening the pills I took to calm down.
Needless to say, because of my stupidity, I didn't deserve to sleep that night, but it's just unfortunate the hospital would refer me to such a triggering environment right after I left rehab early.
This facility is not allowed to stop people from taking extra meds; you could overdose if you wanted to, and there's nothing they can do other than call an ambulance. Luckily for me, my dad only left me with the amount of medication I needed. That night, 75mg of Trazodone must have provided me with some sleep, I honestly can't remember, but after 2 days off the Duloxetine, I regained my ability to eat again, and I was eating like a champ. I had lost about 10lbs, and I gained it back quickly.
The last night I was there, I didn't get any sleep again, but luckily, someone was awake to keep me company. He had some good weed, and the staff let us roll up in the front room. Then we could walk across the road and smoke up on the sidewalk, and we did that all night until I was ready to go and my parents allowed me to come back home. I ended up crashing at 4pm off 50mg of Trazodone for 5 hours, and when I woke up, I took 100mg of Seroquel and crashed again and woke up 13 hours later.
The sleepless nights were getting to be too much, and I was having suicidal Ideation, so I bit the bullet and decided to drive an hour away to the best mental health hospital in all of my country. My dad and I were worried that I wouldn't get admitted, but they did because of my suicidality.
The Doctor gave me 200mg of Trazodone for my first night, and I just became a complete zombie and laid there in bed for 3 hours, but then I got up, and I could barely even muster up a word and looked like I was slumped, told a staff member I was trying to look for ways to kill myself so they gave me Ativan to fall asleep. I didn't want to take it because my benzo tolerance had already skyrocketed, but I succumbed, and it actually worked.
Every weekday, the clients all got to speak to a psychiatrist, and when we were talking, even the psychiatrist agreed that what was going on was perplexing, so we just kept throwing sleeping meds at me to see what worked.
One night, I was feeling so suicidal that I left my room and started hitting my head on the concrete, and the hospital had to announce a code white, which is the code used for patients deemed "dangerous." The only person I was a danger to was myself. I kept punching myself in the head, and they called the intensive care unit to bring a restraint bed and told me If I didn't take Ativan and Loxapine, they were gonna strap me down and give it to me intravenously.
I took the pills, so the restraint bed was brought back over to the intensive care unit, but a staff member had to be in my room that night until I woke up. On Friday, the psychiatrist and I finalized my medication regimen, and he suggested that Monday would be a good day to leave. I was so eager to go on Monday that I didn't tell him I barely slept that night.
I'm thankful I went, though; I wouldn't dare go to the psych ward in my own city because I've been locked in a foam room with a mattress on the ground, no pillow, a camera facing the toilet, and nobody came to talk to me for 5 days people screaming all night in the hallway. I hated those pigs, so every time I had to piss, I did it on the floor beside the toilet so the camera couldn't watch me, and I threw all my food waste on the floor. I stuffed my blanket in the toilet bowl when I was about to leave. They deserved it, and I'm very proud I did so.
I travelled to the mental health hospital I went to because it's much more humane. Everyone gets their own room and bathroom with a shower. They have programs to go to throughout the week and a big common room with a TV and tables and chairs where I spent most of my time colouring with the friends I acquired.
It's been about 3 weeks since I was discharged from the hospital, and I have had problems sleeping every night since. I've constantly bothered my Doctor with emails and calls to the office to change meds, but I'm finally at the point now where I'm on the waiting list to get back into the rehab I was discharged from, and I slept the whole night last night which I haven't done since the very beginning of this story.
I thought this story would end on a sad note, but things are looking up for me. If I continue to sleep every night, I'll be all set to go as soon as they call me.
In the end, to sleep, I'm taking 200mg of Seroquel, which is insane to me because, before the start of the story, I was taking 8x less than what helped me before this story began. I'm also now taking mirtazapine and Davigo for sleep, and I didn't need any of these meds before this all started. This is further proof to me that Duloxetine caused all this stuff to happen in my life, and here I am 2 months later, still recovering.
EDIT**** I included a citation to prove the mechanism of action of cocaine in relation to antidepressants

So I have to meet with a new psychiatrist soon, and while I’d really rather not, I need prescriptions to taper off of Pristiq (desvenlafaxine). But the last thing I want is some new diagnosis, or to sit there while he tries to push some other meds on me.
How do I navigate my interactions with him in such a way that I can get my prescriptions filled, but without giving him any information about me or how I’m doing?
I know that even my silence will be pathologized. If I tell him I don’t trust psychiatrists anymore—poof! That’s “splitting.” I must be a Bordeline. If I tell him about my withdrawal symptoms, he’ll invariably say that it’s my underlying disorder returning, so I need more meds. Honestly, it feels like a trap. If I lie, then that’s surely a personality disorder, for I must be manipulating him.
So what the hell am I supposed to do? I’m damn sure going to record the conversation.

Going to Dr tommorow
Hello all, I am a 39 yo male down in New Zealand. I began getting panic attacks at 20 yo and have had anxiety for what seems my whole life. I did not have symptoms indicative of ADHD as a child. I am a registered nurse. My nurse colleague who has ADHD is 100% positive I have ADHD as well and she has talked me into seeing my dr about this. My symptoms that my colleague says line up with ADHD are

• hyper fixating, going head first into hobbies buying all the stuff and then dropping it and repeating with another hobby.

-my mind is so fast it's always analysing every single thing at every moment, especially people, what they are wearing, features, kinda like know what they are gonna say before they have even said it.
-forgetful, forget what ppl are talking about mid sentence, lose keys all the time, miss little stuff at work, always feel kinda brain fogged even tho it's going 100mph
-people say I am smart especially at pathophysiology, I can remember things about that like a doctor, because I enjoy it, to a molecular level I can recall things, yet if something is boring to me I don't even hear the conversation.
-She gave me a few ritalin to try and it does not make me speedy etc, I feel calm focused and my anxiety dissapeers almost
-i am not hyperactive at all and never have been, but am on propranalol and venlafaxine for anxiety disorder
I am going to talk to my dr tommorow about this but I think she's gonna just say its me overthinking because of my anxiety which also makes me think I am actually overthinking because of my anxiety
What do y'all think of this information? Thanks so much

Hello all, I am a 39 yo male down in New Zealand. I began getting panic attacks at 20 yo and have had anxiety for what seems my whole life. I did not have symptoms indicative of ADHD as a child. I am a registered nurse. My nurse colleague who has ADHD is 100% positive I have ADHD as well and she has talked me into seeing my dr about this. My symptoms that my colleague says line up with ADHD are

• hyper fixating, going head first into hobbies buying all the stuff and then dropping it and repeating with another hobby.

-my mind is so fast it's always analysing every single thing at every moment, especially people, what they are wearing, features, kinda like know what they are gonna say before they have even said it.
-forgetful, forget what ppl are talking about mid sentence, lose keys all the time, miss little stuff at work, always feel kinda brain fogged even tho it's going 100mph
-people say I am smart especially at pathophysiology, I can remember things about that like a doctor, because I enjoy it, to a molecular level I can recall things, yet if something is boring to me I don't even hear the conversation.
-She gave me a few ritalin to try and it does not make me speedy etc, I feel calm focused and my anxiety dissapeers almost
-i am not hyperactive at all and never have been, but am on propranalol and venlafaxine for anxiety disorder
I am going to talk to my dr tommorow about this but I think she's gonna just say its me overthinking because of my anxiety which also makes me think I am actually overthinking because of my anxiety
What do y'all think of this information? Thanks so much

Ever since I was prescribed Duloxetine, my life has followed an unfortunate set of circumstances. The awful reaction I had to this medication is still causing me problems today, and it's been 2 months of living in this nightmare. This is the story of how Duloxetine ruined my life.
Before I start, I need to emphasize that this story is not intended to discourage anyone from avoiding Duloxetine; my goal is to forewarn individuals who are considering trying this antidepressant drug to consult their doctor first and discuss their biological risk of developing the horrific side effects this medication has evoked in me.
However, I can say that I am someone who cannot tolerate any reuptake inhibitor drug, so I should have known better than to start a new one. Previously, I've been on Wellbutrin+Venlafaxine at the same time, I took Prozac and got serotonin syndrome, I quit Methylphenidate because it makes me excited and angsty, and I am a recovering crack cocaine addict, which, for those of you who don't know this, cocaine works as a serotonin-norepinephrine-dopamine-reuptake inhibitor; or for short form SNDRI.
Sound familiar? It should be because all of the drugs mentioned work via reuptake inhibition, similar to cocaine. The reason I mention this is because everyone I've smoked crack with can tolerate it better, and the duration of their high would last exponentially longer than me. Meanwhile, I crash really hard, sometimes really quickly. So thus, my theory is that whether it's pharmaceuticals or street drugs, I cannot personally tolerate any reuptake inhibitors. So, if you can relate to this yourself, use precaution when considering a new antidepressant, ask your doctor about the mechanisms of action and educate yourself on the drugs that you are going to put in your body.
And now….. On to the Story.
To preface this story, I am a 21 year old Male, and I have been battling crack addiction for 5 years now. I quit 10 months ago, and since then, I've had about 5 slip-ups. I've been an addict since I was 14, and I have literally been to rehab 6 times. I'm currently on a waiting list to get into rehab, and it has almost been a year since my relapse, and I'm still figuring this shit out.
This story began in February of 2024. At this time, I had been on 30mg of Duloxetine for a month, with no effects nor side effects, so my dose was increased to 60mg just 5 days before my admission date into rehab.
I've been adjusting and changing meds since I was 17 for my mental health, and on this particular day, when my dad dropped me off at the rehab, he noticed I was more stable than he's seen me for as long as he can remember. "Boy, was he wrong"!
After settling in my room, I was ready to participate in the program. I found some friends, and we all sat at a table together in the cafeteria. I noticed when lunch was served that my appetite had vanished entirely, and I was repulsed by the thought of eating at all, but I didn't give it much thought
When I was in line for nighttime meds, I was very confident that my good old reliable zolpidem 10mg would warmly nussle me to sleep like a lullaby, as it always did. I then practiced my sleep hygiene before bed, such as showering, avoiding screens for 2 hours before bed, making my bed, and going to bed immediately after taking my meds. Only 15 minutes later, it kicked in, and I felt the comfort it usually provided me. Then, an hour rolled by, and I was still awake, which concerned me because I usually fall asleep an hour after taking zolpidem. At first, I thought, "Maybe I'm just getting acclimated to the program," but soon enough, the zolpidem wore off, and I was wide awake. So I hunkered down and had to lay down in bed the whole night.
I wasn't that bent out of shape or pissed off the next day because 24 hours without sleep isn't a lot of time to be awake for me, and I've probably done it 100 times already. Furthermore, at this time, I was prescribed a brand of 50mg methylphenidate called Foquest, which has triple layer beads, designed to release 3 times throughout the day for a longer lasting extended release effect than double layer beaded XR medications like Adderall or Dexedrine.
I was thrilled when the sun came up, reasonably so because I had been basically confined to that room all night. Once the wake-up call went off, I was free to go elsewhere, like the TV room, to lay down on the couches or sit in the cafeteria to socialize with the early birds, and nobody appeared to notice I hadn't slept at all.
My concern was amplified when I was still repulsed by my breakfast, but I went on about my day, attended all of the daily programming, and soon enough, it was nighttime again. "Surely, I'll be able to sleep this time," I said. Anyone would pass out from exhaustion if they were sober the whole time like me."
Nighttime meds came again, and now I was less confident in the zolpidem to do its duty. However, I was prescribed 10mg diazepam and 300mg pregabalin at bedtime on top of the zolpidem. So, at this point, I was relying on the back-burner meds. Sure enough, the meds wore off after an hour, and eventually, I called it quits again, but I knew I had to preserve my energy, so I stayed in bed tossing and turning, just trying to sleep, but to no avail. On this night, I thought to myself, "Maybe I'm just going through weed withdrawal," although I hadn't noticed any cravings or anything up to this point, so it never occurred to me prior.
As the clock struck 6 am, 48 hours had gone by without any sleep since I woke up in my bed at home before driving 2 hours away in the middle of nowhere, where the rehab is located. Being this far from home, and even how far I was from the nearest hospital, I grew weary. I knew that I wouldn't be able to access the psychiatric care I clearly needed.
Things weren't looking good this morning when I started becoming unwell, with anxiety, and my freeze instinct kept kicking in. I had no idea what was going on and why the fuck I couldn't eat or sleep at all.
This all pissed me off because I had fought a long battle of suffering and trying to pull my shit together for 8 months so that I could get into rehab again, and of course, it backfired on me.
To fill you in on those eight months between June and February, I was put on long-term disability, so I was stuck at home on the rural back roads, and I spent all my time living a very sedentary lifestyle. The condition of the long-term disability was that I go to rehab to maintain my job. In those 8 months, I did end up finding a rehab with lots of praise across my country, only to get there and realize I was in a labour camp rather than a drug rehab.
I hated every day of the 8 weeks I spent there because of the sheer overexertion and exhaustion due to the intensity of the rehab. Half of the clients at the place were there on parole conditions, and the other half were what we called "health beds." I wasn't on parole, nor have I ever served jail time, and when I asked the parolees, every single one of them told me the exact same thing. They all said, "This program is far harder than jail," and "I wanna go back to prison." Keep in mind some of these guys came from medium security and witnessed horrible things, which I won't elaborate on.
After those 8 weeks, I had enough. I was withdrawing off diazepam because the psychiatrist at that rehab tapered me down way too fast. I was also suffering akathisia from the antipsychotic I had to start taking 2 weeks into my stay because I had an episode of paranoid psychosis due to the exhaustion combined with the entire dynamic of the program. They were making me wait forever to get the meds I needed for the akathesia, even though the hospital faxed them a prescription for benztropine. I had enough of their bullshit, and so I left.
My parents were furious that I quit, but I was determined to find a better rehab, one that didn't practice slavery and intentional sleep deprivation as their entire philosophy, and 3 months later, I found the rehab where this story began.
So you can imagine how frustrated I was on hour 48 without sleep because the last 8 months flashed before my eyes. I saw all the misery and hopelessness, the grief and loss of all the years that were torn into shambles from my addiction, and after all the hard work and dedication, suffering and despair, just as everything seemed to be coming together and just after my dad said he had not seen me this stable for as long as he can remember, all the sudden I'm in a crisis.
On morning two, I wasn't fucking around. No Foquest, no relaxing with my eyes closed, and I powered through the day. Soon enough, it was hour 72, and I still hadn't gotten even a little half sleep in; I was fully conscious the whole time.
At this point, I proposed I go to the emergency room so I could speak to a psychiatrist fast, which is something I've had to do several times, but I was met with discouragement by my counsellor. He kept saying, "This is just a part of recovery." Then I refuted him by saying, "I haven't been smoking crack for 8 months. This isn't detox! This is my medication causing a crisis". I had enough of how oblivious he was, so I walked away from that conversation because he made me feel guilty for even asking such a thing, even though it was the best option that I should’ve done
My mind was so slow because of the time disorientation, and I became very compulsive. Sometimes, I would go into my room, and I was so uncomfortable living in my own skin. At times such as this, my body would go into its freeze instinct, and I was so uncomfortable. One time, I got into my room, and my shoes were all snowy, and I just froze and stood there staring into space, lost in my thoughts. It took me 30 minutes to take off my boots and tip-toe into bed.
One of the rules of the rehab I was at was that you cannot refuse meds, but suddenly, In the blink of an eye, I remembered my doctor's words when he increased the Duloxetine from 30 to 60. He said, "I'm gonna give you two 30mg capsules, but if anything bad happens, go back down to one capsule."
At that moment, I was in line to get my meds, and I realized that I had factored out everything. It had to be Duloxetine that caused these problems. I told the nurse I was choosing to lower my dose without their permission, and she vaguely warned me, saying, "Well, part of being in this program is taking your meds." I just shrugged it off, not understanding what she was eluding, but I wasn't gonna go through this torture any longer. This was on a Friday, so all the weekday staff in charge of the rehab left, and the weekend staff were there until Tuesday because it was a long weekend.
It was night four, and I could only expect the same shit over again, and sure enough, no matter how hard I tried, I didn't feel tired instead, I felt as if I were hypomanic because I felt mental energy that kept my mind awake but the fatigue was getting to me and I ended up falling asleep at like 5 am only to be loudly awoken by the P-A speaker in my room gave us a wake-up call at 6 am. And when I woke from this, I was sure as hell pissed off because I felt so much worse than before, but the good thing was it was the weekend which meant free time all day.
After the fucking megaphone in my room awoke me into shock, I stumbled out of bed, staggering, not so far as tripping over my feet yet, but needless to say, things were getting terrible given that in 4 days, I had slept 1 out of the other 95 hours. This morning at breakfast, I confirmed my theory that Duloxetine was causing these side effects because I began eating more and slowly regained my appetite.
So, on day 4, I was losing myself after that 1-hour nap that destroyed me. But the straw that broke the camel's back was a song I heard coming from the next room over, from my room, and I had the worst panic attack of my life because it was a song that my evil ex-girlfriend involved in my last relapse, would play while we smoked crack together so, of course, it caused flashbacks.
At this point, I had no composure left; I ran down the hall, went outside and started hitting my head off a brick wall until it bled. I was stopped in the act, and the staff had to call the ambulance.
I knew I was the most isolated hospital I'd ever been to when I arrived, and they told me they literally had no psychiatrists. Eventually, after waiting for a doctor, I had to explain everything all over again because the ambulance driver didn't hand off any of the info I had given them in the ambulance, and I almost didn't get any help. The nurse walked in and said, "How can I help you?" I was in shock and didn't realize yet that they didn't know anything about me, but even after I explained that I'd been awake for 4 days straight because of a medication, she just looked at me and said, "Well, you seem fine to me" This made me really angry at the world. They just thought I was on drugs, and eventually, after talking with her and the doctor, I said, "It seems as if you guys think I'm just high." They both just looked at each other, and from then on, I could tell they believed me. We talked, and I suggested we add 25mg of quetiapine, so the doctor sent me back to the rehab with a week’s worth in a bottle.
After I got back to the rehab, it was time for bed again, and thankfully, I got some sleep that night. However, the sleep wasn't restful enough, so I was still pretty loopy and anxious, but I continuously began eating more and more.
The following 2 nights, I managed to sleep through, and my eating habits were much more natural than before. I was starting to think my sleep was returning to normal and that everything would be okay, but when I got up Tuesday morning after 7 days of torture, I thought I had suffered enough. Unfortunately, since the staff who were in charge returned, they concluded that I needed to be medically discharged from the rehab, and I had 15 minutes to gather my shit and leave.

​
(This story is not done. Its still happening today)
Ever since I was prescribed Duloxetine, my life has followed an unfortunate set of circumstances. The awful reaction I had to this medication is still causing me problems today, and it's been 2 months of living in this nightmare. This is the story of how Duloxetine ruined my life.
Before I start, I need to emphasize that this story is not intended to discourage anyone from avoiding Duloxetine; my goal is to forewarn individuals who are considering trying this antidepressant drug to consult their doctor first and discuss their biological risk of developing the horrific side effects this medication has evoked in me.
However, I can say that I am someone who cannot tolerate any reuptake inhibitor drug, so I should have known better than to start a new one. Previously, I've been on Wellbutrin+Venlafaxine at the same time, I took Prozac and got serotonin syndrome, I quit Methylphenidate because it makes me excited and angsty, and I am a recovering crack cocaine addict, which, for those of you who don't know this, cocaine works as a serotonin-norepinephrine-dopamine-reuptake inhibitor; or for short form SNDRI.
Sound familiar? It should be because all of the drugs mentioned work via reuptake inhibition, similar to cocaine. The reason I mention this is because everyone I've smoked crack with can tolerate it better, and the duration of their high would last exponentially longer than me. Meanwhile, I crash really hard, sometimes really quickly. So thus, my theory is that whether it's pharmaceuticals or street drugs, I cannot personally tolerate any reuptake inhibitors. So, if you can relate to this yourself, use precaution when considering a new antidepressant, ask your doctor about the mechanisms of action and educate yourself on the drugs that you are going to put in your body.
And now….. On to the Story.
To preface this story, I am a 21 year old Male, and I have been battling crack addiction for 5 years now. I quit 10 months ago, and since then, I've had about 5 slip-ups. I've been an addict since I was 14, and I have literally been to rehab 6 times. I'm currently on a waiting list to get into rehab, and it has almost been a year since my relapse, and I'm still figuring this shit out.
This story began in February of 2024. At this time, I had been on 30mg of Duloxetine for a month, with no effects nor side effects, so my dose was increased to 60mg just 5 days before my admission date into rehab.
I've been adjusting and changing meds since I was 17 for my mental health, and on this particular day, when my dad dropped me off at the rehab, he noticed I was more stable than he's seen me for as long as he can remember. "Boy, was he wrong"!
After settling in my room, I was ready to participate in the program. I found some friends, and we all sat at a table together in the cafeteria. I noticed when lunch was served that my appetite had vanished entirely, and I was repulsed by the thought of eating at all, but I didn't give it much thought
When I was in line for nighttime meds, I was very confident that my good old reliable zolpidem 10mg would warmly nussle me to sleep like a lullaby, as it always did. I then practiced my sleep hygiene before bed, such as showering, avoiding screens for 2 hours before bed, making my bed, and going to bed immediately after taking my meds. Only 15 minutes later, it kicked in, and I felt the comfort it usually provided me. Then, an hour rolled by, and I was still awake, which concerned me because I usually fall asleep an hour after taking zolpidem. At first, I thought, "Maybe I'm just getting acclimated to the program," but soon enough, the zolpidem wore off, and I was wide awake. So I hunkered down and had to lay down in bed the whole night.
I wasn't that bent out of shape or pissed off the next day because 24 hours without sleep isn't a lot of time to be awake for me, and I've probably done it 100 times already. Furthermore, at this time, I was prescribed a brand of 50mg methylphenidate called Foquest, which has triple layer beads, designed to release 3 times throughout the day for a longer lasting extended release effect than double layer beaded XR medications like Adderall or Dexedrine.
I was thrilled when the sun came up, reasonably so because I had been basically confined to that room all night. Once the wake-up call went off, I was free to go elsewhere, like the TV room, to lay down on the couches or sit in the cafeteria to socialize with the early birds, and nobody appeared to notice I hadn't slept at all.
My concern was amplified when I was still repulsed by my breakfast, but I went on about my day, attended all of the daily programming, and soon enough, it was nighttime again. "Surely, I'll be able to sleep this time," I said. Anyone would pass out from exhaustion if they were sober the whole time like me."
Nighttime meds came again, and now I was less confident in the zolpidem to do its duty. However, I was prescribed 10mg diazepam and 300mg pregabalin at bedtime on top of the zolpidem. So, at this point, I was relying on the back-burner meds. Sure enough, the meds wore off after an hour, and eventually, I called it quits again, but I knew I had to preserve my energy, so I stayed in bed tossing and turning, just trying to sleep, but to no avail. On this night, I thought to myself, "Maybe I'm just going through weed withdrawal," although I hadn't noticed any cravings or anything up to this point, so it never occurred to me prior.
As the clock struck 6 am, 48 hours had gone by without any sleep since I woke up in my bed at home before driving 2 hours away in the middle of nowhere, where the rehab is located. Being this far from home, and even how far I was from the nearest hospital, I grew weary. I knew that I wouldn't be able to access the psychiatric care I clearly needed.
Things weren't looking good this morning when I started becoming unwell, with anxiety, and my freeze instinct kept kicking in. I had no idea what was going on and why the fuck I couldn't eat or sleep at all.
This all pissed me off because I had fought a long battle of suffering and trying to pull my shit together for 8 months so that I could get into rehab again, and of course, it backfired on me.
To fill you in on those eight months between June and February, I was put on long-term disability, so I was stuck at home on the rural back roads, and I spent all my time living a very sedentary lifestyle. The condition of the long-term disability was that I go to rehab to maintain my job. In those 8 months, I did end up finding a rehab with lots of praise across my country, only to get there and realize I was in a labour camp rather than a drug rehab.
I hated every day of the 8 weeks I spent there because of the sheer overexertion and exhaustion due to the intensity of the rehab. Half of the clients at the place were there on parole conditions, and the other half were what we called "health beds." I wasn't on parole, nor have I ever served jail time, and when I asked the parolees, every single one of them told me the exact same thing. They all said, "This program is far harder than jail," and "I wanna go back to prison." Keep in mind some of these guys came from medium security and witnessed horrible things, which I won't elaborate on.
After those 8 weeks, I had enough. I was withdrawing off diazepam because the psychiatrist at that rehab tapered me down way too fast. I was also suffering akathisia from the antipsychotic I had to start taking 2 weeks into my stay because I had an episode of paranoid psychosis due to the exhaustion combined with the entire dynamic of the program. They were making me wait forever to get the meds I needed for the akathesia, even though the hospital faxed them a prescription for benztropine. I had enough of their bullshit, and so I left.
My parents were furious that I quit, but I was determined to find a better rehab, one that didn't practice slavery and intentional sleep deprivation as their entire philosophy, and 3 months later, I found the rehab where this story began.
So you can imagine how frustrated I was on hour 48 without sleep because the last 8 months flashed before my eyes. I saw all the misery and hopelessness, the grief and loss of all the years that were torn into shambles from my addiction, and after all the hard work and dedication, suffering and despair, just as everything seemed to be coming together and just after my dad said he had not seen me this stable for as long as he can remember, all the sudden I'm in a crisis.
On morning two, I wasn't fucking around. No Foquest, no relaxing with my eyes closed, and I powered through the day. Soon enough, it was hour 72, and I still hadn't gotten even a little half sleep in; I was fully conscious the whole time.
At this point, I proposed I go to the emergency room so I could speak to a psychiatrist fast, which is something I've had to do several times, but I was met with discouragement by my counsellor. He kept saying, "This is just a part of recovery." Then I refuted him by saying, "I haven't been smoking crack for 8 months. This isn't detox! This is my medication causing a crisis". I had enough of how oblivious he was, so I walked away from that conversation because he made me feel guilty for even asking such a thing, even though it was the best option that I should’ve done
My mind was so slow because of the time disorientation, and I became very compulsive. Sometimes, I would go into my room, and I was so uncomfortable living in my own skin. At times such as this, my body would go into its freeze instinct, and I was so uncomfortable. One time, I got into my room, and my shoes were all snowy, and I just froze and stood there staring into space, lost in my thoughts. It took me 30 minutes to take off my boots and tip-toe into bed.
One of the rules of the rehab I was at was that you cannot refuse meds, but suddenly, In the blink of an eye, I remembered my doctor's words when he increased the Duloxetine from 30 to 60. He said, "I'm gonna give you two 30mg capsules, but if anything bad happens, go back down to one capsule."
At that moment, I was in line to get my meds, and I realized that I had factored out everything. It had to be Duloxetine that caused these problems. I told the nurse I was choosing to lower my dose without their permission, and she vaguely warned me, saying, "Well, part of being in this program is taking your meds." I just shrugged it off, not understanding what she was eluding, but I wasn't gonna go through this torture any longer. This was on a Friday, so all the weekday staff in charge of the rehab left, and the weekend staff were there until Tuesday because it was a long weekend.
It was night four, and I could only expect the same shit over again, and sure enough, no matter how hard I tried, I didn't feel tired instead, I felt as if I were hypomanic because I felt mental energy that kept my mind awake but the fatigue was getting to me and I ended up falling asleep at like 5 am only to be loudly awoken by the P-A speaker in my room gave us a wake-up call at 6 am. And when I woke from this, I was sure as hell pissed off because I felt so much worse than before, but the good thing was it was the weekend which meant free time all day.
After the fucking megaphone in my room awoke me into shock, I stumbled out of bed, staggering, not so far as tripping over my feet yet, but needless to say, things were getting terrible given that in 4 days, I had slept 1 out of the other 95 hours. This morning at breakfast, I confirmed my theory that Duloxetine was causing these side effects because I began eating more and slowly regained my appetite.
So, on day 4, I was losing myself after that 1-hour nap that destroyed me. But the straw that broke the camel's back was a song I heard coming from the next room over, from my room, and I had the worst panic attack of my life because it was a song that my evil ex-girlfriend involved in my last relapse, would play while we smoked crack together so, of course, it caused flashbacks.
At this point, I had no composure left; I ran down the hall, went outside and started hitting my head off a brick wall until it bled. I was stopped in the act, and the staff had to call the ambulance.
I knew I was the most isolated hospital I'd ever been to when I arrived, and they told me they literally had no psychiatrists. Eventually, after waiting for a doctor, I had to explain everything all over again because the ambulance driver didn't hand off any of the info I had given them in the ambulance, and I almost didn't get any help. The nurse walked in and said, "How can I help you?" I was in shock and didn't realize yet that they didn't know anything about me, but even after I explained that I'd been awake for 4 days straight because of a medication, she just looked at me and said, "Well, you seem fine to me" This made me really angry at the world. They just thought I was on drugs, and eventually, after talking with her and the doctor, I said, "It seems as if you guys think I'm just high." They both just looked at each other, and from then on, I could tell they believed me. We talked, and I suggested we add 25mg of quetiapine, so the doctor sent me back to the rehab with a week’s worth in a bottle.
After I got back to the rehab, it was time for bed again, and thankfully, I got some sleep that night. However, the sleep wasn't restful enough, so I was still pretty loopy and anxious, but I continuously began eating more and more.
The following 2 nights, I managed to sleep through, and my eating habits were much more natural than before. I was starting to think my sleep was returning to normal and that everything would be okay, but when I got up Tuesday morning after 7 days of torture, I thought I had suffered enough. Unfortunately, since the staff who were in charge returned, they concluded that I needed to be medically discharged from the rehab, and I had 15 minutes to gather my shit and leave.

I can’t figure this out. I can sometimes tolerate talking to people now that I’ve added some meds in (venlafaxine, butterbur-note butterbur is risky though it desensitized sensory nerves and venlafaxine is the antidepressant I’m best able to tolerate due to genetics). Went from 2 minutes of conversation being overwhelming to an hour. And even the sharp high pitched noises like metal or glass or clapping are not quite as terrible. But music still is worse for me. I started out able to tolerate 5 seconds. Then 10 seconds 3x a day. Now I can do 15 seconds 3x a day before I get overwhelmed. Why is it so much slower for recovery than the rest? Is music worse than other sounds for anyone else? I think it’s something about being a complex sound that sustains some sounds for several seconds at a time.
Part of how I think I got worse initially was “getting sick of” having to limit myself and listening to music all day while ignoring my increasing discomfort. Also flying the day before. I’m honestly hoping it’s partially some kind of neurological conditioning.

I'm getting frustrated with my GP as every time I ask him about my hormones he tells me to talk to 'my specialist', referring to the Auckland SHC. They have long signed me off to the care of my GP regarding my HRT and when I do reach out they say that if my GP has any questions he can contact them.
Ive been looking to up my progynova to 6mg from 4 (SHC were happy to lean into my initial apprehension meaning its been nearly 2 years just to get this far). But after an initial back and forward I finally got my GP to agree to an increase depending on blood tests except now it turns out my blood pressure is high so his response is to talk to 'my specialist'.
While yes hrt can cause an increase in blood pressure so too can my anxiety medication (venlafaxine) which he happily doubled late last year with nothing more than a conversation. So now he wants me to talk to 'my specialist' about an increase in blood pressure that might have nothing to do with them and he should be more than capable of treating himself.
I'm tempted to find a new GP to deal with this with but need one who's not just going to tell me do this back and forward. Any suggestions?

Today was not a bad day. But the smallest things are sending me over the edge. When a pack of wild animals exists and one becomes fatally injured, they stay behind to die so to no longer hold back the rest.
I am not old. I interact minimally with my family. I study full time. I work full time without pay, guess it's classified as a volunteer role, but work is work. I have few friends, and can't speak with any of them about this.
I have spent the last 10 years in and out of hospitals for repeat attempts. About 14 months of my life was formed by mental institutions. An additional 4 years with weekly therapy, schema, dbt, cbt, conversational models. Mirtazapine, venlafaxine, sertraline, citalopram, fluvoxamine, seroquel, olanzapine. Far out, the list of treatments never fucking ends. Declined a diagnosis of ADHD and ASD from the public system, private is beyond my budget and would cripple what savings I have reserved for university. I ceased everything 3 years ago and found I have never truly felt free until I stopped medication and routine therapy.
I can say I've given treatment a fair go. It's done more damage than its successfully treated.
I feel trapped in a relationship where I am the secondary partner, and the first partner has no idea. This relationship was formed over work. Shared interests, hobbies and humor but they still love their first partner and will not leave them. Or tell them about us. This has taken away what morales I had left, I no longer care about anyone's feelings. Over the last two years I feel like I have never been the true priority, and I've always known this, it was a matter of being okay with it. I am not okay. I am exhausted. I have repeatedly become an irritable, unpleasant, narcissistic person to be around. Because I have not been able to justify myself, I cannot trust the people I call friends or colleagues, I cannot see this improving over time.
People continue to say not to give up, its about the journey not the destination, it'll pass, it'll get better over time. I've given it a fair go. I've improved parts of myself in sacrifice of others. I am not happy with who I am, and what I can see myself becoming. I am a person I feared to become when I was younger. While I can acknowledge these feelings of wanting to end it, and how they come and go. Regardless, it present itself as a solution to every single problem. I am struggling immensely to care what anyone else thinks is right. I've been struggling with every type of relationship for years, and i will not be able to improve myself in time before everything I care about crumbles away again. I cant do this anymore.
I plan on going on an offroading trip with no supplies but a tent and enough fuel to take me a couple hundred kilometres away from any help, and to stop there. There is no reception, no water, no food. I will likely freeze to death if dehydration doesn't take me while I sleep. It will be uncomfortable but not painfully unbearable like common methods. It would be the most peaceful way to go with the resources I have.
I'm sure my friends will be devastated to discover me as a missing person. I'm sure my partner would be even more devastated, but has his primary partner as his support network. People will either move on, or follow my direction. I won't be there to care anymore, I won't be there at all.

Hi all,
Thought I would ask local - a lot of the threads on reddit for AD and mental health support are US based and it would be good to get a local perspective - sorry if this isn’t allowed.
I came off sertraline 25mg 6 weeks ago. I thought I was well equipped to do without it now.
6 weeks on - I am finding myself stressed out and irritated easily again. Small things are an inconvenience to me, and I’m just getting really annoyed about stuff and I feel like snapping back at people - which is really out of character for me. I am not sleeping as well as I was but find myself needing less sleep - maybe 5 hrs per night
I really don’t want to go back on an anti depressant to be honest - I thought my exercise at this stage would be enough to stave off the over thinking and ruminating. I have been on meds in the past - effexor (venlafaxine), fluoxetine, wellbutrin and mirtazapine as a compliment to one of those, 10mg.
I have done LOADS of therapy before, so much in the past alongside ADs. I just don’t feel it works anymore as I am good at writing down my thoughts and speaking to my family and fiancee. (I get married in a few months)
I would be open to trying some herbal or natural medicines however I live in mid ulster if that’s an issue location wise. Is it possible that 6 weeks on the drugs have just finally left me and I’m having a tough week or two?
I don’t do drugs, smoke and I have alcohol maybe twice per month at the weekends.
I was on 50mg sertraline since July 2022 for depression and overthinking / anxiety. I tapered down to 25mg in September 2023, I came off it early February 2024, so about 18 months.
Since I first went on it July 2022 I’ve lost 2.5-3 stone in weight (about 30-35 pounds) and I work out now 4-6 times a week. I eat well too and I’m engaged to my fiancee.
It was really good for me - I started a new job at the time and had a few important life events going on. However - I found for the final few months of 2023 I had :

• Decreased concentration, productivity, can’t settle at desk
• Very sleepy wanting to nap during the day,
• putting off tasks
• Night sweats
• Disconnected / numb with emotion eg funerals
• Zone out occasionally when mid conversation with people - wanting to finish the conversation

I came off it as I felt I was in a lot better place physically mentally and emotionally to deal with it - plus I walk a lot now with my dog, work out regularly, eat better and have a solid career and partner I’m getting married to.
Many thanks, any helps is appreciated.

Hi all,
I came off sertraline 25mg 6 weeks ago. I thought I was well equipped to do without it now.
6 weeks on - I am finding myself stressed out and irritated easily again. Small things are an inconvenience to me, and I’m just getting really annoyed about stuff and I feel like snapping back at people - which is really out of character for me. I am not sleeping as well as I was but find myself needing less sleep - maybe 5 hrs per night
I really don’t want to go back on an anti depressant to be honest - I thought my exercise at this stage would be enough to stave off the over thinking and ruminating. I have been on meds in the past - effexor (venlafaxine), fluoxetine, wellbutrin and mirtazapine as a compliment to one of those, 10mg.
I have done LOADS of therapy before, so much in the past alongside ADs. I just don’t feel it works anymore as I am good at writing down my thoughts and speaking to my family and fiancee. (I get married in a few months)
I would be open to trying some herbal or natural medicines however I live in Northern Ireland if that’s an issue location wise. Is it possible that 6 weeks on the drugs have just finally left me and I’m having a tough week or two?
I don’t do drugs, smoke and I have alcohol maybe twice per month at the weekends.
I was on 50mg sertraline since July 2022 for depression and overthinking / anxiety. I tapered down to 25mg in September 2023, I came off it early February 2024, so about 18 months.
Since I first went on it July 2022 I’ve lost 2.5-3 stone in weight (about 30-35 pounds) and I work out now 4-6 times a week. I eat well too and I’m engaged to my fiancee.
It was really good for me - I started a new job at the time and had a few important life events going on. However - I found for the final few months of 2023 I had :

• Decreased concentration, productivity, can’t settle at desk
• Very sleepy wanting to nap during the day,
• putting off tasks
• Night sweats
• Disconnected / numb with emotion eg funerals
• Zone out occasionally when mid conversation with people - wanting to finish the conversation

I came off it as I felt I was in a lot better place physically mentally and emotionally to deal with it - plus I walk a lot now with my dog, work out regularly, eat better and have a solid career and partner I’m getting married to.
Many thanks, any helps is appreciated.