Anyone understand why a doctor would stop letting you try different anti depressants?

[Ross MwcFan]

I'm in the UK and I've tried around 7 or 8 different anti depressants, none have really ever hit the mark.

 

Some have worked well for the first couple of weeks, but then they always end up hardly working at all.

 

I've seen 2 doctors so far and they're against me trying any more.

 

I can only remember what one of them said, and she said there's no point in trying any more since the one you're on now seems to be working a bit.

 

I can't see the sense in that. I'm still struggling a lot in life, and a medication which is only workng 'a bit' just isn't good enough. I can't understand the sense in giving up trying other anti depressants, when there could be one out there that would work really well for me.

 

Can anyone understand what is going on here? Is this normal?

[alphamale]

there are only 8 or 9 major classes of anti depressants. sounds like you've tried them all. you may get better results if you add an augmenter drug. but you should talk with your doctor. lithium with an anti depressant works well for some.

[thehead]

I'm in the UK and I've tried around 7 or 8 different anti depressants, none have really ever hit the mark.

 

Some have worked well for the first couple of weeks, but then they always end up hardly working at all.

 

I've seen 2 doctors so far and they're against me trying any more.

 

I can only remember what one of them said, and she said there's no point in trying any more since the one you're on now seems to be working a bit.

 

I can't see the sense in that. I'm still struggling a lot in life, and a medication which is only workng 'a bit' just isn't good enough. I can't understand the sense in giving up trying other anti depressants, when there could be one out there that would work really well for me.

 

Can anyone understand what is going on here? Is this normal?

 

You must be my brother from another mother because this is the 2nd thing you've posted I can relate to.

 

I changed doctors 3 times. Finally figured out not all doctors are equally skilled . I stuck with the first 2 too long. Lost valuable time.

 

First, make sure you're seeing a psychiatrist, not just a general practitioner.

 

Second, at your appointment, have a list of everything you've tried and for approximately how long. ADs take weeks to work so what do you mean they only worked the 1st couple weeks or so?

 

Third, explain exactly what effect the depression is having on your life. You say you're struggling. Tell them exactly how. Tell them if there's a history of it in your family. Tell them if you've attempted suicide or thought of it.

 

Fourth, what alphamale said. Combination of 2 drugs is sometimes needed. They added Lamotrigine to something I was taking and it did the trick. The rest of the depression I handled in psychotherapy.

 

Fifth, in the meantime, avoid weed or alcohol, anything that disrupts your natural chemisty. Both are depressants so they'll only make things worse.

Get plenty of sun and some exercise. Just to boost your own serotonin levels.

 

Edited to add: It's normal to get doctors who are less helpful than others. But no, it's not normal to have one leaving you without help or clear answers.

Edited June 4, 2011 by thehead

[Cee]

I'm on psych drugs (I'm bipolar) so I've read a lot on the subject. There is some research that suggests that non-responders to antidepressants shouldn't hop around too much. It actually worsens their chances of responding. It might be physical or maybe it's psychological, I don't remember.

 

Personally, I never responded to any SSRI or Wellbutrin. I could have gone to the older classes - MAOIs or tricyclics, but the side effects are pretty rough.

 

Like alphamale said, there are other options other than antidepressants including Lithium and Lamictal. Also the newer neuroleptics might bring relief if you have anxiety or hypomania.

 

I am extremely conservative about med switching and had to deal with docs who loved putting me on the newest thing. I've been on maybe 20 different psych meds and once I found the right combo, I stuck with it.

 

I have benefited a lot from non-medication treatments for my various mental health issues such as exercise, meditation, sunshine, cutting out sugar, and having a structured schedule so I have to do stuff.

 

I know it's hard to deal with psychiatrists. I've been dealing with them for 20 years. Often I thought they were wrong about something, but I discovered later, they were right.

[Ross MwcFan]

I'm on psych drugs (I'm bipolar) so I've read a lot on the subject. There is some research that suggests that non-responders to antidepressants shouldn't hop around too much. It actually worsens their chances of responding. It might be physical or maybe it's psychological, I don't remember.

 

Personally, I never responded to any SSRI or Wellbutrin. I could have gone to the older classes - MAOIs or tricyclics, but the side effects are pretty rough.

 

Like alphamale said, there are other options other than antidepressants including Lithium and Lamictal. Also the newer neuroleptics might bring relief if you have anxiety or hypomania.

 

I am extremely conservative about med switching and had to deal with docs who loved putting me on the newest thing. I've been on maybe 20 different psych meds and once I found the right combo, I stuck with it.

 

I have benefited a lot from non-medication treatments for my various mental health issues such as exercise, meditation, sunshine, cutting out sugar, and having a structured schedule so I have to do stuff.

 

I know it's hard to deal with psychiatrists. I've been dealing with them for 20 years. Often I thought they were wrong about something, but I discovered later, they were right.

 

 

The thing is, I'm sure if the two docs that I've seen, thought it would be a good idea for me to have a combination of 2 different drugs, they would've suggested it already. Since they haven't, there doesn't seem like much point in asking them.

 

I will arrange to see a new doc, and ask him about it.

 

You must be my brother from another mother because this is the 2nd thing you've posted I can relate to.

 

I changed doctors 3 times. Finally figured out not all doctors are equally skilled . I stuck with the first 2 too long. Lost valuable time.

 

First, make sure you're seeing a psychiatrist, not just a general practitioner.

 

Second, at your appointment, have a list of everything you've tried and for approximately how long. ADs take weeks to work so what do you mean they only worked the 1st couple weeks or so?

 

Third, explain exactly what effect the depression is having on your life. You say you're struggling. Tell them exactly how. Tell them if there's a history of it in your family. Tell them if you've attempted suicide or thought of it.

 

Fourth, what alphamale said. Combination of 2 drugs is sometimes needed. They added Lamotrigine to something I was taking and it did the trick. The rest of the depression I handled in psychotherapy.

 

Fifth, in the meantime, avoid weed or alcohol, anything that disrupts your natural chemisty. Both are depressants so they'll only make things worse.

Get plenty of sun and some exercise. Just to boost your own serotonin levels.

 

Edited to add: It's normal to get doctors who are less helpful than others. But no, it's not normal to have one leaving you without help or clear answers.

 

 

I might be seeing a psychiartrist eventually.

 

I don't know, it's just that a quite a few of the medications that I've tried would seem to start working really well after a few days of taking them, and then about 2 weeks down the line, they will just hardly be working anymore.

 

I don't have a list of every medication I've tried. Maybe the psychiartrist will have access to that infomation.

 

I have told both docs about how much I'm strugggling, and how I have felt suicidal several times. I have written down pretty much what I want to say to the psychiatrist which does include how I'm struggling and have felt suicidal.

 

I really hope he doesn't turn out to be an ass who doesn't show any understanding.

 

I really hope he can help me, and put me on the right kind of medication. I believe depression and anxiety is only part of the issue. I really think something else is wrong.

Edited June 4, 2011 by Ross MwcFan

[thehead]

The thing is, I'm sure if the two docs that I've seen, thought it would be a good idea for me to have a combination of 2 different drugs, they would've suggested it already. Since they haven't, there doesn't seem like much point in asking them. I might be seeing a psychiartrist eventually.

 

I don't know, it's just that a quite a few of the medications that I've tried would seem to start working really well after a few days of taking them, and then about 2 weeks down the line, they will just hardly be working anymore.

 

I don't have a list of every medication I've tried. Maybe the psychiartrist will have access to that infomation.

 

I have told both docs about how much I'm strugggling, and how I have felt suicidal several times. I have written down pretty much what I want to say to the psychiatrist which does include how I'm struggling and have felt suicidal.

 

I really hope he doesn't turn out to be an ass who doesn't show any understanding.

 

I really hope he can help me, and put me on the right kind of medication. I believe depression and anxiety is only part of the issue. I really think something else is wrong.

 

Frankly, if you're not seeing a psychiatrist for medication, you're wasting your time.

 

In the United States, only psychiatrists can prescribe psych drugs.

 

They don't let general practice docs mess with that.

Doctors in general practice don't have the same level of education or knowledge required.

 

No wonder you're frustrated. And yeah tell the psychiatrist just what you said in the last part of the post. That depression anxiety are only part of it. Make sure they give you an evaluation of your symptoms.

 

Have you ever been tested for anything else? Like bipolar depression?

[wuggle]

I've been here for a couple of years now and have watched you grow over that time and gain confidence. I was only commenting to my wife the other day that you seem to be be much more aggressive, less apologetic and more assertive over the last few months. It has been nice to see. If that has been even a little due to whatever meds you have been on then so be it.

 

IMO, from what I have seen of you recently you are definitely on the right road lately, I like the new confident you, It looks to me like you are growing all the time. I say listen to your doc on this one, stick with what your currently doing , it seems to be working.

[melodymatters]

Frankly, if you're not seeing a psychiatrist for medication, you're wasting your time.

 

In the United States, only psychiatrists can prescribe psych drugs.

 

They don't let general practice docs mess with that.

Doctors in general practice don't have the same level of education or knowledge required.

 

No wonder you're frustrated. And yeah tell the psychiatrist just what you said in the last part of the post. That depression anxiety are only part of it. Make sure they give you an evaluation of your symptoms.

 

Have you ever been tested for anything else? Like bipolar depression?

 

Just thought I'd point out that the bolded statment is completely untrue. I've struggled with anxiety disorder my whole life, and have had not only general practice docs, but nurse practioners prescribe anti-d's.

 

They don't work for me either, and have such horrific side effects I feel like I'm having a stroke ( SSRI's) or put me in to a 16 hr coma ( tricyclics). So, I just deal, and thankfully have a doc who will prescribe diazapam ( valium) once yearly for me to use as needed.

 

Good luck Ross, if meds help TERRIFIC, but for those of us who they don't work for, accept it and try everything else out there ( lifestyle changes, diet, excercise, religion, sex, weed, beer, volunteer work etc, etc)

[johan]

I've seen 2 doctors so far and they're against me trying any more.

 

I can only remember what one of them said, and she said there's no point in trying any more since the one you're on now seems to be working a bit.

 

I can't see the sense in that. I'm still struggling a lot in life, and a medication which is only workng 'a bit' just isn't good enough. I can't understand the sense in giving up trying other anti depressants, when there could be one out there that would work really well for me.

 

I imagine the doctors you're seeing know a bit more about your particular circumstances than the average LS poster will. But maybe your expectations of what the medications can do for you is unrealistic.

[cerridwen]

I agree with alphamale and Cee. There might be an augmenting drug that's helpful. Or, something new.

 

Getting a third opinion isn't unreasonable, especially if it's from a specialist. Kicking it up to the next level and getting advised by a psychiatrist makes sense.

 

I've noticed more confidence in you too, Ross. More willingness to forge ahead. It's pretty awesome.

Edited June 5, 2011 by cerridwen

[britchick]

Hi Ross, sorry to hear how you're feeling. I just wanted agree with other posters that anti-depressants will take a few weeks to kick in and also your GP will probably put you on a low dose and leave it there. You have to ask for what you want, so after the initial couple of weeks when you make sure you can deal with any side effects and then a few more weeks to see if they are working you could try increasing the dosage (with your doctor's agreement). GPs never seem to do this unless you ask them to.

 

Has your GP not offered you any talking therapies? Anti-depressant with something like CBT has much better results. A mental health professional will have a much better idea of how to treat 'treatment resistant' depression, you could ask your GP for a referral to your local access/intake mental health team where you will at least get a decent assessment and qualified advice from mental health nurses and a psychiatrist.

 

I'd agree that you should also eat well, try to sleep well and get in the fresh air everyday for a bit of a walk at least. Hope things get better for you soon. xx

[Datura]

I don't know, it's just that a quite a few of the medications that I've tried would seem to start working really well after a few days of taking them, and then about 2 weeks down the line, they will just hardly be working anymore.

 

You must be experiencing the placebo effect. Antidepressants don't cause an immediate mood change ("a few days").

 

You seem to be completely clueless as to what to expect from these drugs. You don't even know which ones you've been on. It's odd that these physicians have not referred you elsewhere, but continue giving you pills without supplying much information. Are they?

 

On average, ADs must be taken for six weeks before concluding whether or not they're helping. Even then, an increase of the dosage may be necessary. Once it's deemed a failure, tapering off the drug is important. Giving up after the 2 week mark isn't giving it a fair trial. And if you aren't giving up, and are properly being tapered down, then this ongoing treatment would be lasting over a year (presuming no troubling side effects have taken place).

See a psychiatrist.

[Ross MwcFan]

Have you ever been tested for anything else? Like bipolar depression?

 

No, I haven't.

[Ross MwcFan]

I've been here for a couple of years now and have watched you grow over that time and gain confidence. I was only commenting to my wife the other day that you seem to be be much more aggressive, less apologetic and more assertive over the last few months. It has been nice to see. If that has been even a little due to whatever meds you have been on then so be it.

 

IMO, from what I have seen of you recently you are definitely on the right road lately, I like the new confident you, It looks to me like you are growing all the time. I say listen to your doc on this one, stick with what your currently doing , it seems to be working.

 

Thanks mate, I think I have grown too. I also have a lot of fight in me, and want to do whatever I can to make myself better and my life better. I don't know where it's come from, because I used to kind of be the complete opposite of this, but obviously still wishing I could get better and make my life better.

Edited June 5, 2011 by Ross MwcFan

[Ross MwcFan]

Hi Ross, sorry to hear how you're feeling. I just wanted agree with other posters that anti-depressants will take a few weeks to kick in and also your GP will probably put you on a low dose and leave it there. You have to ask for what you want, so after the initial couple of weeks when you make sure you can deal with any side effects and then a few more weeks to see if they are working you could try increasing the dosage (with your doctor's agreement). GPs never seem to do this unless you ask them to.

 

Has your GP not offered you any talking therapies? Anti-depressant with something like CBT has much better results. A mental health professional will have a much better idea of how to treat 'treatment resistant' depression, you could ask your GP for a referral to your local access/intake mental health team where you will at least get a decent assessment and qualified advice from mental health nurses and a psychiatrist.

 

I'd agree that you should also eat well, try to sleep well and get in the fresh air everyday for a bit of a walk at least. Hope things get better for you soon. xx

 

I had done CBT, it seemed that the support of seeing someone to talk to each week helped more than anything. I had spoken to a doctor and someone else in the mental health field about seeing another one, but they said you can't keep having CBT therapy forever or seeing someone for support forever, you have had a lot of sessions whereas most people only need a few, and you have all the papers with the CBT techniques on them that you had disccused with the therapist. You just now need to start using them.

 

I will be seeing a team of people this week probably.

[Ross MwcFan]

You must be experiencing the placebo effect. Antidepressants don't cause an immediate mood change ("a few days").

 

You seem to be completely clueless as to what to expect from these drugs. You don't even know which ones you've been on. It's odd that these physicians have not referred you elsewhere, but continue giving you pills without supplying much information. Are they?

 

On average, ADs must be taken for six weeks before concluding whether or not they're helping. Even then, an increase of the dosage may be necessary. Once it's deemed a failure, tapering off the drug is important. Giving up after the 2 week mark isn't giving it a fair trial. And if you aren't giving up, and are properly being tapered down, then this ongoing treatment would be lasting over a year (presuming no troubling side effects have taken place).

See a psychiatrist.

 

I don't give up after 2 weeks, I'll continue taking them for about 8 weeks minimum, and sometimes for around 9 months maximum.