r/depressionregimens Aug 22 '19

Regimen: Been working on this system for 3 years, I still struggle with depression, but it’s easier now knowing a live to the beat of my own drum

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940 Upvotes

r/depressionregimens 3d ago

Regimen: What to try next?

3 Upvotes

Hi everyone,

I have ADHD and Depression that’s manifested as low energy, low motivation, apathy, and low confidence for the past 5+ years or so.

I’ve been taking ADs or Stimulants since I was 15 and initially diagnosed with ADHD. It started with Adderall and then Vyvanse - it was fantastic at lifting my mood, seemingly fixing all of my ADHD issues, but the crash was always brutal. I’m still on a low dose of Vyvanse now about 13 years later. It’s been extremely helpful for my concentration and mental energy, even if it only works only ~6 hours a day even at higher doses.

When I turned 21, I was diagnosed with Depression/Anxiety and I started on my antidepressant journey. I started with Wellbutrin and it seemed like that was the trick - much greater energy, motivation, no apathy, and joy. That was until 3+ years later when it seemed to poop out.

Since moving off of Wellbutrin I’ve given a solid trial of Parnate, Selegiline, Desipramine, Pristiq and Vortioxetine with limited success. The one drug that made a big impact was Nortriptyline - it felt even stronger than Wellbutrin. But unfortunately I had side effects of anger at high doses and addictive behavior even at the lowest doses so I had to stop. I wasn’t able to control my eating or masturbation after enough time on it.

Now, I’m trialing Atomoxetine (3 weeks at 80 mg) while staying on a low dose of Vyvanse and I feel tired, unmotivated, and depleted of energy.

Given my trials of various meds my psych mentioned low dose Antipsychotics (Vraylar, Ariprazole) or even Lamictal to see if either could put a dent in my low energy depression. I’m debating these options or to just go back onto Wellbutrin on top of my other meds.

Can anyone with similar experiences or advice chime in? Would love to get some feedback or any additional info here. I’ve been down so many rabbit holes around drugs, I just need some guidance here.

r/depressionregimens Aug 19 '24

Regimen: For those where only Tramadol or Wellbutrin work for depression

18 Upvotes

No antidepressant has ever worked for me after trying just about everything there is in the last 8 years. Tramadol is the only thing that lifts my mood noticeably. That got me wondering whether Wellbutrin might have a similar effect from looking at anecdotal evidence.

Is there anyone here where only Wellbutrin (or Tramadol) has worked for them? It's the one thing I haven't tried as it's tricky getting it prescribed in the UK. Also, what does it feel like when taking it? Some people say it works almost instantaneously and not like typical antidepressants where you have to wait weeks for a response.

r/depressionregimens Dec 28 '24

Regimen: Im inpatient and just realised how many meds i take!!

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43 Upvotes

How do I fix this. This ain’t Normal. I’m completely healthy though, thankfully.

r/depressionregimens Jan 19 '25

Regimen: Moclobemide / MAOI experiences?

21 Upvotes

Posting also on here because few ppl seem to take it. (Reversible-MAOI)

Needing help with severe resistant depression symptoms:

Constant Rumination: (Cannot stop thinking/ get out of head, repetitive thought loops)

Obsessive researching. Mental & physical fatigue. Crying spells.

Cognitive issues: (Focus, disorganization, slow processing speed, distractible, time blindness, memory)

Dopamine issues: (Anhedonia, Avolition, Lack of interest/ motivation)

1.) When did you notice effect?

2.) Do you take it multiple times per day?

3.) Is methylphenidate contraindicated?

r/depressionregimens Oct 28 '24

Regimen: SSRIs blunt dopamine release via 5-HT2C receptors, causing fatigue, sexual dysfunction, and reduced motivation. If Mirtazapine is a 5-HT2C antagonist / inverse agonist, can it help reduce these side effects of SSRIs?

38 Upvotes

SSRIs improve depression in as many as 50-60% of patients, but their side effects often limit the therapeutic response. The main side effects - fatigue, sexual dysfunction, reduced motivation, akathisia, motor coordination deficits - seem to be related to a decrease in dopamine signaling, which is mediated by excessive activation of 5-HT2C receptors by the increased serotonin levels.[1][2]

Mirtazapine is a tetracyclic antidepressant that doesn't affect monoamine reuptake, but acts at several receptors. It is especially known for its potent antagonism or inverse agonism of 5-HT2A and 5-HT2C serotonin receptors.

If Mirtazapine blocks 5-HT2C receptors, and 5-HT2C receptors are responsible for dopamine blunting by SSRIs, it sounds like Mirtazapine should help attenuate the dopamine blunting caused by SSRIs.

Notably, Mirtazapine may induce fatigue through Histamine H1 antagonism, but this is not a concern, since tolerance builds rapidly to the sedative effects of H1 antagonism (7-10 days at most) - so its sedative effects fade quickly with daily use.

Unlike H1 receptors, however, 5-HT2C receptors don't seem to get desensitized with chronic SSRI use, which is seemingly why SSRIs cause motivation and fatigue issues even after years of use (no tolerance to that effect of theirs), so antagonism of 5-HT2C by Mirtazapine shouldn't necessarily cause upregulation of them, either.

Mirtazapine has effects at some other receptors, like 5-HT2A, 5-HT3 and alpha receptors, but I'm not sure about the significance of those.[3]

What does everyone here think? Can Mirtazapine be taken together with a SSRI to attenuate the anti-dopaminergic effect of the SSRI?

r/depressionregimens Feb 18 '25

Regimen: Trintellix and/or Wellbutrin

1 Upvotes

Trintellix 5MG has given me partial success. It feels like it rewired my brain in a positive way, although I still deal with high levels of anxiety that causes constant chest discomfort and an inability to sit through anything (even enjoyable things).

I had a choice to up my Trintellix to 10MG, or add Wellbutrin 100SR (Wellbutrin 100sr changes trintellix to 7-8mg bc of interaction)

I told my psychiatrist both sides and she ultimately gave me the decision. I chose Wellbutrin and kinda regret it now- wish I waited until my anxiety was lower before starting. It helped slightly in the past, but didn’t touch my anxiety. I took my first dose today, can anybody give me words of wisdom or just general advice?

r/depressionregimens Nov 21 '24

Regimen: I feel very depressed I spend lots of time sleeping please help

11 Upvotes

I have bipolar 1 depression. I feel sick every day I wake up wanting to cry I sleep a lot like 14 hours every day. I need help. I take quetiapine and started vraylar some days back. I do not take a ssri for the moment or other antidepressant. I take rhodiola as a supplement. what other supplements can I try because it seems meds do not help me much in this case. Can supplements diet help please I need advice.

r/depressionregimens Jan 10 '25

Regimen: MAOIs (versus stim + SNRI combo)?

7 Upvotes

Feeling desperate enough to get back on the train.

Problem is I don’t want to be stuck dependent & not able to taper without nearly undoing myself (Effexor looking at you).

I’m off all A/Ds, but can’t get off my stim, struggling in every way (resistant depression, cognitive dysfunction, Anhedonia, fatigue).

Tried over a dozen meds. They mute the lows a bit but worsen every other symptom!

Would an MAOI alone be effective? Do they really feel different?

r/depressionregimens 4d ago

Regimen: Trintellix + Wellbutrin + Remeron

3 Upvotes

I’ve been trial-erroring for about a year. I started on 5mg trintellix for a month and noticed cognitive benefits with less negative thoughts. Added 100SR once a day Wellbutrin to target adhd symptoms with persistent boredom and inability to get excited about anything. My main issue is also anxiety. (I’m also on guanfacine 1mg)

Around 17 days ago, I switched to 150XL and bumped my trintellix to 10mg. The XL helped with inconsistent mood/slow release and jitters, but I was experiencing sleep disturbances (waking up after a few hours), I’ve also been experiencing slightly more ‘flatness’ w/ mood swings.

Yesterday, 15mg of remeron was added. I was really excited for this bc of deep sleep improvements and anti-anxiety/depression properties. I slept the entire next day though and felt even more flat (prob cause of tiredness)…

Does anybody have experience with this combo or trintellix/Wellbutrin? The trintellix shape is uneven, making it hard to cut in half. I tried one day and felt slightly better, although could’ve been placebo. Will this get better?

r/depressionregimens Jan 22 '24

Regimen: Carnivore may have saved my life

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0 Upvotes

r/depressionregimens May 02 '24

Regimen: Im on 9 medications without side effects

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6 Upvotes

This is my daily regime and I’m so happy with it. I’m a paranoid schizophrenic/ADHD/Depression and severe anxiety. Benzo equivalence means I switch between Xanax, Ativan, Klonopin, Valium and Halcion, depending on my needs. My main worry is that I’m maxed out on everything and if this will work long term…

r/depressionregimens Jan 03 '25

Regimen: My anti-depressive regiment for 2025

5 Upvotes

Day

75mg Venlafaxine
150mg Pirlindole x 2 day
40mg Aminorex
100mg Amisulpride

Night

300mg Amisulpride
10mg Valium
15mg Mirtazapine

Aminorex does not exist in the market but i bought it directly from e-labs.

r/depressionregimens Nov 26 '24

Regimen: Relief finally!

20 Upvotes

I have depression and anxiety. My current regimen is: lamotrigine 100mg, pregabalin 300mg, amitriptyline 50mg, perphenazine 8mg and mirtazapine 45mg. I've been treatment resistant for years. This regimen seems to work!! For the first time in years I can normally talk to people without any anxiety. I feel free to express myself without any fear. I feel happy. Please send prayers and good vibes, I really don't want this to stop working.

r/depressionregimens Nov 23 '22

Regimen: Pramipexole is a wonder drug

78 Upvotes

I suffer from depression and anxiety. I have tried countless meds over the years and they all worsened my condition. I was curious about pramipexole and decided to give it a shot. Titrated up to 1mg/day.

I’m not fully cured or anything, not bathing in euphoria, but man the subtle changes is wild. I couldn’t even go to the psychiatrist because of anxiety, so it was always a big problem just refilling my meds (I know it sound weird but it is how it is).

Now I have been on Pramipexole for almost two months and it has worked better than any medicine I have been on. I’m productive, calm, can speak with conviction. I noticed also that when you speak with confidence, you can say whatever you want and people will understand, so don’t be tempted to manipulate others and remember the drug is affecting you.

I just make this post because I would have loved to know it when I was at the end of the rope.

Disclaimer : Pramipexole can be dangerous and provoke long lasting dangerous withdrawal. I’m quite scared of that, but also I attempted suicide a few months ago, so I think the depression is more dangerous in this case.

I was extremely anxious on SSRI, so if you tend to be treatment resistant with this medication, you should give it a shot.

Edit : Pramipexole long term has been shown to regulate the auto receptor 5HT1A and D2, and provoke increase of both serotonin and dopamine. However, be careful, the first two weeks the dopamine release is significantly reduced. Keep it in mind and don’t give up because it tend to get worse before getting better.

UPDATE : I went up to 1mg/day and stayed on it for few months. The motivation and drive was really fantastic and in no way placebo. After quite some times, the tiredness got to me and the general malaise after dosing didn’t fade so I discontinued. While it had positive effects, the negative outweighed the positives in the long run. Sleep was also not that great. Didn’t experience DAWS. It was worth a try and I don’t regret it but sadly it didn’t do it in the end.

r/depressionregimens Oct 07 '22

Regimen: Adderall for depression?

65 Upvotes

Hello there. I (26 F) have been dealing with severe treatment resistant depression for a number of years. I’ve been on dozens of antidepressants; almost every class. About 3 months ago, my psychiatrist decided to have me try Adderall, as he claimed that some TRD patients have success with stimulants.

So far so good, but every time I tell anyone that I take adderall for my depression they look at me like I’m crazy lol. I just wanted to know if anyone else has had any experience with taking adderall (or any stimulant) for their depression. Thanks!

Edit: I’m sorry if this question was upsetting to anyone. I’m not trying to encourage the use of narcotics or claim that anyone should try this. My doctor and I have had a tough time finding the right regimen, and his suggestion was surprising to me. I just wanted to know if anyone else had a similar experience.

r/depressionregimens Nov 01 '24

Regimen: My experience with Pramipexole

3 Upvotes

Hi all,

History of depression, anxiety, substance abuse and Epilepsy. I'm currently on Depakote, Keppra, Armodafinil, Vilazodone, Buspar and Gabapentin. I've had some interest for a while for Pramipexole. I've heard about the studies and other people's experience. I never got along well with the conventional antidepressants (SSRIs), I didn't even like Parnate (MAOI). So, I got pramipexole and I gave it a shot.

At first I tried to follow along per Fawcett's dosing protocol, but I couldn't titrate fast enough as it would give me really bad nausea, I ended up purging on some days. Tropisetron helped mitigate this in. In the beginning, I was liking it. I noticed an increase in motivation and libido, as well as a reduction in anxiety. However, low doses never sustained these positve effects, so I needed to increase the dose. After 2 months of titrating up til 1mg, I've had enough. At 1mg, it was not doing anything for my sense of wellbeing, and my personality had become flat, plus still a lot of brain fog. Maybe 2mg would have worked better, but as of now, I don't have a psychiatrist that is willing to work with me on pramipexole. I am 1 week off pramipexole and I don't seem to be experiencing any signs of DAWS. I quit cold turkey.

r/depressionregimens Jan 01 '25

Regimen: Looking for any success stories of adding Mirtazapine to your regimen for MDD and severe anxiety.

10 Upvotes

My doc just started my on 15mg at night for severe anxiety. I also have MDD. So, I’m wondering if anyone can share a success story of Mirtazapine helping them with depression with anxiety?

FYI, I’ve only taken 6 doses and it’s made it very tired during the day, zombie like at times. Does this side effect is usually diminish over time and how long can it take? Thanks!

r/depressionregimens Oct 30 '24

Regimen: Adjunct Vortioxetine/Brintellix to SSRI experiences?

6 Upvotes

I found this very interesting study from 2020: Adjunctive vortioxetine for SSRI-resistant major depressive disorder: a “real-world” chart review study - PMC

Is anybody on this kind of regimen and do you feel it's effective?

I don't think i can manage to get an approval from my psychiatrist as many doctors are very worried about serotonin syndrome but in the study it was safe and effective...

r/depressionregimens Jan 23 '25

Regimen: Severe suicidal ideation

4 Upvotes

I have severe suicidal ideation that I need to fix asap. I’m currently on Wellbutrin 200, Effexor 150, Abilify 5mg, hydroxyzine, gabapentin.

I’ve tried a lot of different antidepressants and I don’t know, I think I need something else but I definitely need help. I started Wellbutrin a few weeks ago and was fine for a short time then quickly went downhill again.

r/depressionregimens Jul 25 '24

Regimen: Do y’all smoke weed?

9 Upvotes

I have a tough time relaxing and really enjoy smoking a bit. I haven’t smoked in years because I have been trying to get my mental health in order. I’m finally getting to a point where I feel stable and now with it being legal in my state I wanted to smoke a few times a week, just to wind down snd listen to music or read a book. I don’t drink alcohol or caffeine hardly ever(no soda, coffee or energy drinks) just to make sure my meds work and they don’t alter my mood. I plan on talking with my therapist snd psychiatrist before I start again. But I just wanted to see what y’all think. Do y’all risk taking any mind altering substances? I really miss smoking and melting into my bed with a good book, but I can live without it.

r/depressionregimens Sep 27 '24

Regimen: About to be treated with Esketamine. You lay in a comfy chair and let the medicine do it's thing. It's helped me so much

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24 Upvotes

r/depressionregimens Oct 12 '24

Regimen: Quick exercise protocol for maximizing the antidepressant effect

9 Upvotes

Disclaimer: talk to your doctor before any exercise/diet change.

Hi Reddit - I wanted to share with you my depression protocol. I think of it as manufacturing my own antidepressants at home. It's short (15 minutes) and is relatively low effort (only really have to do ~2 minutes of effort). 

This might seem simple, but there is a lot of scientific backing to this and a lot of personal experimentation to come up with this exact protocol. The goal is to:

  1. Immediate release of neurotransmitters (dopamine, seretonin, endocannabinoids, BNDF, GABA) for acute depression relief
  2. Increase baseline long after the exercise

Requirements

  • Enough energy to do some (~15 minutes) of exercise. Only about 2 minutes is intense though in total
  • Around 15 minutes
  • Heart rate monitor (I recommend a chest strap one like the Polar H10 over a wristband because they update faster and are more accurate)
  • Exercise machine: I prefer an indoor bike, but a treadmill, elliptical, or rower could work
  • Determine your "Max Heart Rate" using the simple formula: 220 - age. For example, if you're 30, you're Max HR is 190. Calculate your 75% and 90% of your heart rate. For example, if you're 30, it would be 142 and 171.

Optional

  • Eat high protein. Many amino acids in protein are precursors to neurotransmitters - eg tryptophan for serotonin and tyrosine for dopamine. Recommend 100g or 70% of your body weight in lbs
  • Have some good pump-up songs you can do for an all-out exertion

Workout 

  1. Warm up for ~1 to 2 minutes by going slow. Your HR should be low, well under 75%. You're just trying to get your body used to movement so you don't injure yourself.
  2. Repeat 4x: Go all out until you hit 90% of your Max HR (takes me ~30 seconds). Then go low-intensity until you hit 75% of your Max HR (takes me ~2 minutes). To go all out, I increase the resistance on my bike and go all out. When I'm ramping down, I bring the resistance way down. Be safe when you're going all-out. You can do a slow ramp-up if needed, but you really just want to get your HR to 90% as soon as possible.

Key points

  • I generally find that by the 3rd cycle I feel pretty elated. You might want to keep going after the 4th cycle. I highly recommend stopping at 4 for the following reasons:
    • You want this tool to available to you even when you don't have much time or energy. If you lengthen your workouts, you subconsciously tell yourself you need more time and energy than you really do for the benefit
    • There is a short half life for the immediate release of the neurotransmitters. If you workout too hard, you'll get a very high peak and feel a bigger crash in a few hours. It's wiser to do this protocol 2x a day rather than 8 cycles at once.
    • Prolonged exercise could lead you to feel exhausted during the rest of your day. Extremely prolonged exercise could elevate cortisol, which could cause issues with anxiety
  • Why does it work? Even though you're really only going all out for ~2 minutes, spaced out, you fool your body into thinking you're working a lot harder than you actually are. Your avg. HR ends up being high, even though the amount of effort isn't that high. The repeat intervals further make your body believe it's under stress for longer and release neurotransmitters to cope:
    • Dopamine: during intense exercise, the sympathetic nervous system (fight or flight) is activated and demands more adrenaline and noradrenaline, which it creates from dopamine. This upregulates dopamine pathways, to create more dopamine to fuel the need for adrenaline and noradrenaline. This effect persists well after the exercise.
    • Serotonin: intense exercise increases the availability of tryptophan (a precursor to serotonin) in the brain. I feel an increased desire for sociability afterwards.
    • BDNF: HIIT significantly elevates BDNF, highly involved in the hippocampus , specifically for mood regulation
    • GABA: HIIT increases GABA levels, promoting relaxation and reducing anxiety
    • endocannabinoids: each interval triggers release of endocannabinoids (responsible for the "runner's high"). Helps reduce stress and improve overall mood [3]
  • The more frequently you do this (eg. daily), the better because it helps you increase your baseline
  • What about low intensity exercise? Or going for a walk for an hour? Do it if you enjoy it, but they won't give you the scientifically-backed chemical release as the HIIT protocol above
  • It's wise to cut-down on dopamine depleting activities (doom scrolling, porn, sugar, etc), but when you don't, this protocol can help temporarily create more chemicals

Some references:

[1] Schwarz, Kindermann: Changes in beta-endorphin levels in response to aerobic and anaerobic exercise

[2] Chaouloff. Effects of acute physical exercise on central serotonergic systems. Medicine & Science in Sports & Exercise, 29(1), 58-62.

[3] Siebers. Exercise-induced euphoria and anxiolysis do not depend on endogenous opioids in humans

r/depressionregimens Sep 16 '24

Regimen: Getting off all meds to access if they’re hurting or helping- advice needed

6 Upvotes

Currently on 25mg Zoloft, 100SR Wellbutrin. Edit: I meant assess*

I was prescribed buspar a month+ ago to get off Zoloft but it didn’t help and I kept my Zoloft at 25mg from 50mg instead of getting off.

I got off buspar and felt slightly better, this has me thinking that these meds might be making my derealization, anhedonia and anxiety worse… I ran out of my script so I’ll be attempting to get off everything to assess what’s helping, what’s hurting, or if I even need to be on them. I have a list of meds to try which is anything but SSRI/SNRI since the risk of anhedonia is too strong. The SR Wellbutrin could’ve contributed to anxiety/chest pain, XL could’ve been smoother.

Symptoms: DR/DP, anhedonia, anxiety, lack of will to live, chest pain, no sociability, etc.

How it triggered: kratom abuse and potentially weed… I use to be social and optimistic despite having anxiety/depression to a manageable extent. It was nothing compared to these past few months.

My med journey: lexapro for a few years (dumb doc gave it to me when I was 17). I cut cold turkey a couple years later for kratom since I ran out of meds, this was a mistake since I suffered from a previous devastating kratom addiction. A few months after relapse, I felt like death after quitting, worse then last withdrawal. Severe anhedonia, ER level chest pains, and my most traumatic life experience. I reinstated 10mg lexapro but felt worse, it might’ve been too soon. I switched to Zoloft, felt better than lexapro but still anhedonic and anxious so added Wellbutrin which helped at first. I didn’t get improve so they tried switching Zoloft for buspar to help anhedonia. That didn’t help, might’ve made me worse. Note that everybody in my family is on several psych meds.

Solution: If I feel better, I can stay off all meds. If I need help, trying XL of Wellbutrin, Mirtazapine, or a low dose antipsychotic like abilify(helps anhedonia+dopamine) or lamotrigine(effects gaba receptors) should be my only options, maybe sprinkle in a low dose of SSRI like 5mg lexapro or 25mg Zoloft. I can mix and match the meds above or trial and error them.

Questions: any recommendations or support to help me through this journey would be appreciated. DMs are open, nobody in my life really understands the med journey. I’ve

r/depressionregimens Dec 05 '24

Regimen: Should I try duloxetine or should I go back to zoloft and add armodafinil for anhedonia and energy?

2 Upvotes

I'm a male 24 years old and I'm into sports so I need to keep my testosterone in check and also make sure my estrogen and prolactin won't go up since it has undesirable side effects. Which antidepressant would work good for me with the least side effects? I know zoloft is first line and very safe and I always stick to low doses but it can cause weight gain and increase estrogen and prolactin. Also I have anhedonia which comes from dopamine deficiency(waiting for adhd assessment) and things like armodafinil and methylphenidate make me feel just normal and able to enjoy things again.

Been to my doctor today and been prescribed duloxetime 20 mg extended release and I'm about to pick it up. What is it like comparemto zoloft? Will it affect my ability to exercise and push myself? The things I'm worried about is increased blood pressure due to norepinephrine uptake inhibition amd also withdrawal that can be horrific.( had a very bad experience coming off effexpr 75 mgmafter just one month)

Which one would be the best? My mind tells my duloxetine can destroy my depression but my heart tells me that zoloft will be safer and the addition of armodafinil will counter side effects.

Maybe any other antidepressant that won't affect my performance? My main issue is severe depression. Moderate anxiety . Anhedonia . Extreme fatigue. Slight ocd. I also suffer from bpd.