What is the best anidepressant?

SirMickTravisSirMickTravis Posts: 2,607
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The thing is I speak to lots of people and they are all on different kinds of antidepressants. However with me I get the impression they just stick to the obvious. I'm wondering if it has something to do with cost? I was on Citalopram for years which worked but had side effects like sleeping difficulty. Now I'm on Mirtazapine which I don't think is doing any good and I'm not at all sure what encouraged my GP to give it to me. Do people just end up on the other ones when these ones are shown not to have worked?
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  • Born lippyBorn lippy Posts: 2,839
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    St johns wort!
  • miss_astridmiss_astrid Posts: 1,808
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    There is no "best" anti-depressant, each one can interact differently with each person. I went through five anti-depressants before I found the right one for me. If you feel the one you are on isn't working (provided you've given it, say, at least two months as that's generally when you'll see the "good" side-effects) then go back to your GP and explain. It's not really about cost, it's about generics, generically citalopram works for a lot of people - but not everyone.

    It also depends upon what symptoms you are showing, for example, if you're depressed AND suffering from anxiety, the doctor would prescribe something different to someone that's simply just anxious or depressed, not both.

    My advice is give it time. The GP's generally know what they're doing, and if you don't think the anti-depressant is right for you/not working, go back to the GP and request a change. :)
  • [Deleted User][Deleted User] Posts: 1,954
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    I'm sure I read that they're very much similar other than the fact that you'll be more suited to some than other's because of the side effects.

    So Venlafaxine works for me but for someone else it may result in side effects that you find difficult to live with.

    The key with taking any of them is that you need to take them long enough to give them a chance to work, they can make you feel worse before you get better so you need to be prepared for this and continue taking them. You should notice a difference after 5 weeks, a dose can be increased and if they are definately not working your gp may suggest something else.

    I read somewhere that if you start feeling worse when you start taking one it's an indication that it will work for you.
  • Bex_123Bex_123 Posts: 10,783
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    The thing is I speak to lots of people and they are all on different kinds of antidepressants. However with me I get the impression they just stick to the obvious. I'm wondering if it has something to do with cost? I was on Citalopram for years which worked but had side effects like sleeping difficulty. Now I'm on Mirtazapine which I don't think is doing any good and I'm not at all sure what encouraged my GP to give it to me. Do people just end up on the other ones when these ones are shown not to have worked?

    Yes they will start with 'the obvious' as these are what are commonly most helpful.

    What 'other ones' do you mean?

    Everyone is different and like a lot of illnesses, is trial and error what medication or combination of medications (and other therapies) have the desired effect.
  • HypnodiscHypnodisc Posts: 22,728
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    I found Agomelatine to be very effective, it's one of the new generation anti-depressants that has a very low side effect profile and helps with sleep.

    The only problem is it's not so widely funded.
  • [Deleted User][Deleted User] Posts: 12,830
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    Imipramine, the first and the best, the Gold Standard of antidepressants.
  • HystericGlamourHystericGlamour Posts: 371
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    Do antidepressants just "numb the pain", or are they actually supposed to lift your mood?
  • Keren-HappuchKeren-Happuch Posts: 2,171
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    Do antidepressants just "numb the pain", or are they actually supposed to lift your mood?

    It's a bit of both really.

    GPs tend to prescribe SSRIs first because they have less side effects than the older drugs and are useful for people with mild to moderate depression. In my experience, people on the older drugs have either had no success with the new ones or have quite severe mental health problems so SSRIs aren't suitable. Cost definitely has an effect, citalopram is apparently the cheapest and it does seem to be the first choice for a lot of people. But it really depends what the problem is - fluoxetine is supposed to be good for people with eating disorders, sertraline for PTSD and social anxiety. Depends on your health in general as well, for example venlafaxine can raise your blood pressure so obviously not good for people with blood pressure problems.

    I seem to remember from your last thread that your weight is quite low, maybe that's why your GP prescribed mirtazapine as it's an appetite stimulant. Also, because you've had sleeping problems with citalopram and mirtazapine helps with sleep. I think it was quite an obvious choice for you actually but if you're not getting on with it then go back to your GP.
  • ChristmasCakeChristmasCake Posts: 26,078
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    I'm on mirtazapine, I had to through a few before I found one that works, even now, I'm due a review and I might look with the doctor at something else.

    I had some really bad reactions to fluoxetine and citalopram.

    Can't remember which one, but one of them sent me into anaphylaxis..
  • euphieeuphie Posts: 2,280
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    I have been on Mirtazepine for around two years now - it's worked for me most of the time but I do feel sometimes as though it has stopped working as my depression is creeping back in. I think I am also on too high a dose of it - I found that I had less issues with sleep when I was on a lower dose (I'm on 45mg a day)

    Unfortunately, there is no perfect medication for depression and sometimes it can take a while to find the right one for someone. Mirtazepine was fantastic for me when I started taking it but I'm not so sure now
  • gregrichardsgregrichards Posts: 4,913
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    The thing is I speak to lots of people and they are all on different kinds of antidepressants. However with me I get the impression they just stick to the obvious. I'm wondering if it has something to do with cost? I was on Citalopram for years which worked but had side effects like sleeping difficulty. Now I'm on Mirtazapine which I don't think is doing any good and I'm not at all sure what encouraged my GP to give it to me. Do people just end up on the other ones when these ones are shown not to have worked?

    Mirtazapine takes about 6 weeks to get into your system. My GP wouldn't let me switch from ecitalopram to it until two months had passed and I know the same has applied to people I know. I hope it works eventually Mick.
  • Hank1234Hank1234 Posts: 3,756
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    A hug
  • annette kurtenannette kurten Posts: 39,543
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    Hank1234 wrote: »
    A hug

    : shudder:

    because depression is just that simple.

    there isn`t really a best, just a best for you at the time.
  • yorkiegalyorkiegal Posts: 18,929
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    I've probably been on most of them over the decades. I remember prozac made me feel manic and citalopram didn't make much difference to my low mood. Have been on venlafaxine for years now and I don't know if it works or not in general. I still have episodes every couple of years which last a few months but they are mixed moods, not just depression. The main issue with venlafaxine for me is that it is a nightmare to reduce and I get very bad withdrawals if I miss a dose. My moods are all over the place at present. Yesterday I was planning suicide in the afternoon and sat laughing and watching a film with a friend in the evening.
  • big macbig mac Posts: 4,583
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    It also depends upon what symptoms you are showing, for example, if you're depressed AND suffering from anxiety, the doctor would prescribe something different to someone that's simply just anxious or depressed, not both.

    This is why I was prescribed Sertaline because I have both depression and anxiety. It does have a side effect of lack of sleep.
  • whitecliffewhitecliffe Posts: 12,006
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    big mac wrote: »
    This is why I was prescribed Sertaline because I have both depression and anxiety. It does have a side effect of lack of sleep.

    Yes sertaline also has worked to some extent for me but have had real problems with sleep. It such a struggle to get up in the morning and go to work especially as I have a really long commute.
  • SirMickTravisSirMickTravis Posts: 2,607
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    I used to have depression AND anxiety but after years of citalopram it's now just depression. I do feel motivation and goals are like a chicken and egg thing.
  • wendy09wendy09 Posts: 3,934
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    best anti dep is one that you dont take in a pill form.

    it takes less than a week to become addicted to them even on low doses .

    issues need to be resolved , rather than reliance on these medications which do have side effects
  • benjammin316benjammin316 Posts: 264
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    Exercise
  • TelevisionUserTelevisionUser Posts: 41,404
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    What is the best antidepressant?

    It's the one that works best for the particular person concerned and it might mean trying out a couple to find out which one works well. These days, even chronic and severe depression can be treated e.g. by the use of an antidepressant and an adjuvant such as lithium.
  • marc822marc822 Posts: 3,118
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    A councellor! Chemical drugs put into your body is only half the issue. Im of citalopram and have been for a year. Id rather a sex life
  • annette kurtenannette kurten Posts: 39,543
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    wendy09 wrote: »
    best anti dep is one that you dont take in a pill form.

    it takes less than a week to become addicted to them even on low doses .

    issues need to be resolved , rather than reliance on these medications which do have side effects
    marc822 wrote: »
    A councellor! Chemical drugs put into your body is only half the issue. Im of citalopram and have been for a year. Id rather a sex life

    not all depression is caused by an outside event or "issue", very often it hits for no identifiable reason, or by other [physical] illnesses..
  • TelevisionUserTelevisionUser Posts: 41,404
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    marc822 wrote: »
    A councellor! Chemical drugs put into your body is only half the issue. Im of citalopram and have been for a year. Id rather a sex life

    Yes, marc822, talking therapies such as cognitive behaviour therapy [CBT] can often help with depression but in many cases it can require the use of both antidepressants and CBT to overcome a period of depression.
  • CosinCosin Posts: 765
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    I was on Seroxat years ago and I wouldn't recommend it. It was a bit like being on amphetamines which was fun at the time, but the withdrawal symptoms are quite severe and there was a lot in the papers about people topping themselves because of it. Antidepressants don't really numb and the pain, they just get you back on the right path if you have strayed for some reason or another. I have taken mirtazapine before and they were fairly helpful, but they made my legs feel weird soon after taking them, similar to that feeling of having an itch deep under the surface that you can't get to, except it was an aching in my leg bones. It all depends how bad your depression is I suppose on which ones are the best. Mine wasn't that bad, but I had strayed from the path that I was accustomed to, and they sorted that out.
  • SirMickTravisSirMickTravis Posts: 2,607
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    Thought I'd rejig this as I've been on Mirtazapine for nearly 8 weeks and I don't think it is helping. Admittedly only 3 weeks at the higher dose of 30mg. Perhaps I should give the higher dose a bit longer? Not sure where I'd go next.
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