Ask MetaFilter questions tagged with SNRI

Please help make sense of my brain chemistry

tigrrrlily — Tue, 14 Jul 2009 18:15:59 -0800

Guess what! I know you're not my doctor. Get over it. I'm seeing one for depression, though, and need to know what to say next time I see her. I'm losing my marbles here. This is going to be long. If you were to take the time to read it and relate any comments, observations, suggestions, experiences you have I'd be ridiculously grateful.

For at least the past 7 years or so I've been dealing with something akin to depression, sometimes more pronounced, sometimes less. Took me a while to realize this was not just How People Felt All the Time. The past year or so I've been getting weekly therapy, but as things got worse and worse a doc put me on Wellbutrin. That was two plus months ago.

I'd been on antidepressants before, years ago: Tried zoloft for a while; didn't do much except make me yawn constantly and have weird withdrawal symptoms. Tried Wellbutrin right after that, but my memory of that time is hazy enough that I was willing to give the drug another go.

Somewhat unexpectedly, the subjective effects of the Wellbutrin this time around were different to start with, which gave me some initial hope. For the first two days on the 150 XL dose, I felt... well, I felt like I'd heard being on speed felt. Didn't sleep much, but those two days were wonderful, like someone had upped the color saturation of the world. Then it dissipated, and I settled back to a level similar, if maybe a bit more bearable than what i'd started out with. This was my first and last positive experience with the drug.
A month later I went onto a 300mg dose, but got heart palpitations, elevated blood pressure, blood rushing in my ears, etc. These never really went away. I was on the higher dose for a month. When that month ended, I dropped my dose back to 150, without consulting my doctor this time. Not because I didn't want to. I can probably get hold of her in a few weeks.

Mostly, I need to know what to tell my doctor about the following things I observed over the past months/years:

- A day or two after pleasurable sexual activity of any kind i hit rock bottom, find no joy in anything, and want to die;
- A day or two after enduring painful medical treatment for an hour i hit rock bottom, find no joy in anything, and want to die;
- A while back I had the option of taking Tramadol for pain, but couldn't because the day I took even a single pill I felt Wonnnderful, then next day I hit rock bottom, found no joy in anything, and wanted to die;
- I've taken Strattera long-term in the past, in the low dose (40mg/day) that my GP was willing to prescribe. I found it helped with day-to-day functioning a little bit. Nothing spectacular. I would describe the feeling as traction control... As opposed to everything being of equal importance and on my mind at the same time, I can prioritize somewhat. As well as an analgesic, Tramadol is also an SNRI. Strattera is an NRI.

So... Is there anything here that I'm not seeing? Should I be pursuing/suggesting some course of action?

How about hope? Hope would be nice.

how do I recover my medication mess...?

Anonymous — Fri, 19 Dec 2008 18:28:14 -0800

I'm supposed to be taking 300mg Effexor XR every day. Except I've been so grumblingly ill this last week and a half that I've not bothered. What's the best way to get myself back up to speed? Impact load or slow tapering? And how slow...?

SNRIs vs. libido

Anonymous — Sun, 09 Dec 2007 19:18:04 -0800

Is there any way to stay on SNRIs but restore libido? Possibly TMI about sex life inside, quite possibly NSFW. My doctor started me on an SNRI and it's working great except for one thing: my libido has decreased drastically.

I frequently can't maintain an erection or, when I can, there's no guarantee even under direct stimulation of ever reaching an orgasm. After an hour or so it's more likely the skin will eventually tear, even with a lot of lube.

It's not necessarily a problem when single, but I haven't been dating throughout most of this depression and I'd like to start again. Ability to have a reciprocal sexual relationship would be a big plus.

I tried a couple of cock rings; one couldn't guarantee an erection; the other kept the blood inside but after about 45 minutes I got bored and gave up, wanting to avoid hurting myself again.

Yes, I have a doctor and no, you are not him, but I'd like to try to solve this somehow without telling him the details of my mostly nonexistent sex life.

Are there any over the counter treatments reliably good at increasing libido? Naturally I'll look them up first in PubMed, PDR, etc. to make sure they play well with my particular SNRI.

Anti-depressants: alternatives to bupropion (Wellbutrin)?

Anonymous — Mon, 13 Nov 2006 10:43:03 -0800

I'm starting out on anti-depressants. My doctor has prescribed me venlafaxine (Effexor XR), an SNRI. I strongly suspect a dopamine reuptake inhibitor would be better suited for my condition and personality, but sadly, bupropion (Wellbutrin) isn't available as an anti-depressant in my country: only under the name Zyban (as a smoking cessation aid), which is not covered by insurance and hence very expensive. Are there any alternatives I should look into? I'm a few days into taking venlafaxine, and I think it might help me, but obviously it will take some time for the effects to be determined. However, I'm a little worried about the possible side effects (especially those related to libido and weight) and the eventual withdrawal, which reportedly can be quite bad with venlafaxine.

Any insight would be much appreciated - thanks in advance.