Antidepressants

Eventually I went back to him went back to the psychiatrist and he said, you know, I don’t feel that fluoxetine is working for you anymore maybe it’s time to put you on something else and he put me on Vensir and that was just like waving a magic wand I mean it just almost immediately I was right back on, I felt better than I had in years I was taking, you know, not an unsubstantial dose about 40 milligrams a day but I just felt brilliant, I felt fantastic and the Fluanxol is for, I’m taking that as well, which is for anxiety rather than depression although obviously the two are linked. And I started taking it and I just feel fine now and I take then every day and occasionally miss a day but that usually accident rather than design or I’ve gone to my parents’ house which is 30 miles away and I’ve forgotten to you know, bring them with me or something like that but it’s never more than a day anyway. And I just feel fine now I mean I have off days and, you know, like everybody I have good days and bad days but my experience of antidepressants and particularly Vensir is that it doesn’t make you feel happy or sad it just makes you able to cope better and that’s good.
 
You said that it kicked in almost immediately?
 
Yes.
 
Can you describe how different you suddenly felt then?
 
 
I just felt a lot better you know I just felt less tired a lot brighter a lot clearer thinking I started to appreciate life a lot more I started to appreciate people around me more, I started to appreciate how fortunate I am, became much more optimistic just a much happier person.

My new GP, my new GP, had looked at my records and said ‘well you’ve been on’ I was actually back on fluoxetine by then, ‘you’ve been on fluoxetine for years, you’re still suffering from depression so, you know, let’s try and do something about it’. and she like many GP’s, well actually she was very good because she’d, she didn’t try to pretend that she knew the answer I’ve found some GP’s have favourite drugs that they tend to prescribe but she was, ‘this is your case, you’ve been suffering, you know, all your, most of your life, you know, this isn’t just, you know, someone having a bad patch’, so she referred me to a psychiatrist at the local hospital. And he said well obviously, you know, you’ve tried all the normal drugs why don’t we put you on venlafaxine which is it does the same as Prozac but inhibits or enhances one of the other neurotransmitters as well.
 
And that worked, I did see again quite a significant lift in mood after that but that one completely suppressed my libido, my sex drive, I had no interest - which was fine because I was single at the time. but and that, whether it was the drug whether it wasn’t… but I had quite a period then of being, you know, pretty stable in terms of mood but then a few years later I met my current wife and having no sex drive isn’t a very good approach to a new marriage. So I had to go back to back to citalopram which is what I’m on now, another SSRI.
 
And did you notice any, any effects from that different from the citalopram?
 
Yes venlafaxine was, that’s the one drug over the years that I have, I have, I can say I can sort of feel something different. It seemed to, you know, within the six week period it did seem to produce a lifting in, I did feel better. And I did seem to sustain that feeling better while I was on it so that’s, you know, it was, it was sort of I’d like to still be on venlafaxine from the point of view of its therapeutic effects.

Yeah, so, so Autumn of 2009 it had been sort of building up all Summer and I was feeling terrible again so I went to see the same GP and this time he prescribed mirtazapine and I’d been having terrible trouble sleeping and so I took it in the evenings and it was just incredible, it was, had quite a strong sedative effect and that was just very, very useful a time where I couldn’t sleep and that kind of, you know, knocked me out for a few weeks and allowed me to kind of sleep off the worst of it and you know, sort of, sort of slowly getting back there but I felt after maybe taking it for three or four months just like a completely new person. It had cleared up a lot of stuff that I hadn’t even, that I thought, you know, was my personality that I hadn’t even realised was related to the depression, stuff that I just thought was an intrinsic part of how I was and when I found that stuff kind of lifting and just feeling much more optimistic than I’d ever felt before I was like wow this is, this is pretty good stuff. So I continued taking that more or less straight for three years which have been the three happiest and most productive years of my life.
 
When you started taking that one did you get any different effects?
 
I felt like a zombie for the first few weeks, I felt like almost stoned, it was the sort of cognitive effects were really powerful, I remember thinking it’s great that I can sleep for twelve hours but, you know, if this stuff doesn’t clear up then I’m not going to be able to function long term on this.
 
So when you were waking up after your long sleep you were still feeling groggy?
 
Yeah, for about three or four hours, yeah which, which again was useful it was a kind of cushion from all the horrible feelings which, you know, it sort of gave me a couple of weeks to sort of sleep off the worst of it and. But yeah luckily after, I kind of acclimatised to the levels or whatever it, the cognitive stuff got a lot better. I had a bit of, sort of strange short term memory stuff going on as well, the first maybe month that I took it but all that cleared up really quickly.
 
And so you said that you felt really good on that one.
 
Yes, yeah.
 
And how different was the feeling from fluoxetine then?
 
Yeah it felt like, it felt like I was finally, you know, my true self and living my own life and able to do the things that I wanted to do, you know, for, for the first time in years since I, since childhood almost I felt like this was how normal was supposed to feel and this was, you know, how to be happy, it was yeah, which I never quite got on fluoxetine, I kind of felt, you know.
 
Functioning?
 
Yes functioning but not really good whereas on the mirtazapine I felt incredibly high achieving.

So she put me on fluoxetine which I still take now.
 
So I was prescribed 20 milligrams when I started them last year and I stayed on that for about two months and then she upped it to 40 milligrams and that seemed to work for quite a while until about May time this year when again I started to get very depressed again, so she’s now increased that to 60 milligrams and also added on mirtazapine. One of the side effects of fluoxetine, which I was never told that I read about on the patient leaflet is, insomnia. And as she increased the dose of the fluoxetine the insomnia got worse which is why she had to add the mirtazapine because the mirtazapine is a sedative. So that helps me sleep, so I’m taking an antidepressant to deal with the effects of an antidepressant which I don’t really like doing but you kind of get to the point where you have to trust them and trust that they know what they’re doing. So that’s what I currently take alongside something else, quetiapine, which again is an antipsychotic which she uses to minimise my impulsive behaviour in terms of self-harm and to keep me calm, and that’s kind of where we are now.

On the mirtazapine it kind of had an adverse effect and I became very aggressive and even at one point raised my fist to my partner at the time, my ex-partner now. I didn’t actually strike her thankfully but went back to the GP’s going there is something very wrong, I know I have a few anger issues but I’ve never done that before, that is so out of character, you know, I was shocked I did it, my partner at the time was shocked I thought oh this isn’t right. So we did a quick change over from mirtazapine to duloxetine. All the while I then started doing CBT with the mental health service but it didn’t go so well so we ended up doing art therapy as well, finished the CBT then started art therapy which went even worse, and then we started psychoanalytical therapy which didn’t go too bad. I was on the duloxetine for two years, actually stuck to this one stayed on it for two years got to the point where I was feeling a lot happier with everything and was ready to try to come off it with this with the support of the GP and we discussed it and discussed weaning off of it which wasn’t too bad, it took me a long time to wean off it, the physical side effects from withdrawal weren’t very nice.
 
Can you describe them?
 
Well my head would spin one way my stomach was spinning another it was a bit of vertigo you end up with a bit of an odd twitch because my head would spin kind of jerk out a bit just even though we were still weaning down very slowly at first even then it was still too fast and I just basically ended up curled in a heap on the sofa because I couldn’t move, to try and move would make my head spin.
 
Quite alarming actually
 
It was, it wasn’t nice it took me, as I say, it took me months to come off of it, absolutely months to come off of it because actually it was so, so slowly in the end the last little bit was the worse.

So I was quite happy because I was sleeping what they didn’t tell me, and I found out by reading the kind of, you know, patient note information leaflets that you get, was that it makes you sugar crave in a really, really big way . So I didn’t, I didn’t get on very well with that drug because I had a history, well have a history of eating problems so giving a drug that makes you sugar crave to someone who has eating issues was probably not the best idea in the world.
 
And can you, do you counteract that or do you, you know, just sort of fight against it or?
 
I try to kind of when I was first put on it I was very aware that that was, I knew having been on it in the past I knew that was going to happen. So I was kind of like right I’ll have, you know, if I want sugar I’m going to have fruit and I’ll have yoghurt and I’ll have healthy sugars and I lasted for about three weeks and then I was just like I need chocolate. I don’t, it’s a constant battle with me not just necessarily just with this drug but I used to think that I would rather be rather be dead than fat. And somehow somewhere along the way that changed and I my sanity took over as being more important and so I think you have to kind of balance.
 
Yes it’s that balancing the side effects against the benefits I suppose.
 
Yeah it is, yeah.

Think they had a complete overhaul on the medication at that point and that’s where the mirtazapine came about. I think that was the first time I’d experienced severe anxiety, which is why I think mirtazapine was particularly thought to be quite useful because I’d had a period of insomnia again the first time I’d ever experienced insomnia and severe anxiety. And mirtazapine for the first year was actually really, really good although the very, the huge negative on mirtazapine was weight gain, which was horrendous because if you’re already, if your self-esteem’s low even though your moods increasing you're getting bigger, you know, it’s just, it’s just horrible and I went up, I must have gone up to a size 18 and I put on about four stone it was really quite, quite horrible.
 
Did you notice increased appetite, where you eating a lot more?
 
Yes a huge increase in appetite and it’s funny because they say well it’s not always just the medication, just try and eat a healthy diet and everything but it was completely different for me, I’d never been that way ever on anything and I know you can comfort eat with depression but, you know, that’s going a bit too far, you know, I have been, I have, have tended to be little bit up and down but usually it’s within a stone certainly not within sort of four, about three or four stone.
 
And yet the positives to that were that I was sleeping and anxiety was hugely reduced, so it was a huge dilemma and I’d really struggled with, with what I was going to do about that but actually the answer came from itself in that for whatever reason it stopped working anyway, and as the lethargy, as the sleep had pretty much sorted itself out and had, so had the anxiety, it was felt that well why not go back to Prozac.