Yesterday I had my twice weekly appointment with my psychiatrist in the Mental Health Clinic that I am a inpatient at, at the moment. He had news for me that came as quite a shock. The antidepressant that I had been on for the last two years and was working really well was no longer being imported into Australia. I was devastated as it had taken about seven antidepressants before we found one that worked. I had suffered years of depression where I would get a short relief from an antidepressant and then it would stop working, would cause great weight gain, had other side effects that were intolerable or just plain didn’t work.
So to have finally found Zyban with no side effects, or weight gain and it controlled my depression so effectively I was obviously very disappointed to receive this news.
He went through the list of the ones I had tried before and why they hadn’t worked and that left us with Cymbalta. It apparently has minimal side effects and no weight gain so that’s a plus.
Cymbalta (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may be unbalanced in people with depression.
Antidepressant treatment is an inexact science, so make it has to be collaborative.
Your doctor needs to consider your current physical symptoms and condition when prescribing an antidepressant or mood stabilizer. If you have chronic insomnia, for example, she should obviously steer clear of the medications that list this side effect.
Medications you’re already taking can influence your doctor’s decision: SSRIs (selective serotonin-reuptake inhibitors) can interact with antihistamines, for example, triggering a racing heart and other potentially dangerous symptoms.
How doctors prescribe antidepressants
“If a person asks for a specific antidepressant,she often prescribe that one, unless there’s a clear reason not to that this is one way to put a patient at ease. If possible, go with something that they’re already familiar with, or that a friend is taking.
Depression may have a genetic basis, at least in some people. So if a patient tells a doctor that a certain SSRI or atypical antidepressant worked in a parent or sibling, he may prescribe that one first.
Next Page: Avoiding weight gain and other side effects
Some people ask not to be put on an antidepressant that could lead to weight gain, sexual dysfunction, or sleep problems. People react differently to antidepressants, and it’s not possible to predict who will experience which side effect.
Doctors can use a few rules of thumb, though. Antidepressants that are most likely to cause weight gain are Remeron and Paxil. It’s not clear why certain drugs add pounds, though some experts believe they stimulate appetite and/or slow metabolism. According to a large report issued in 2007 by the U.S. Department of Health and Human Services, the worst offender is Remeron, which adds an average of 7% of body weight.
How long to take an antidepressant
Once you find the drug or drug combination that works, your doctor will probably recommend that you take the drug for another four to six months, if you have not previously had a depressive episode (if you have, you may be on antidepressants for longer). At that point the doctor may wean you off the medication by progressively lowering the dose over the course of several weeks.
Never discontinue your medication abruptly, and don’t stop taking an antidepressant without guidance from your doctor. A gradual approach reduces the risk of side effects associated with stopping treatment and makes it easier for you to get back on a full dose if your symptoms return.
If your depression was severe, your doctor may recommend that you stay on the drug for months, years, or forever. Studies suggest that the relapse rate for severe depression may be as high as 70%.
For more information and advice on Depression visit Betterhelp.
I’m keeping my fingers crossed that Cymbalta works for me as well as Zyban did as I don’t want to go back into depression. Anything but that.
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