Posted by Survector on March 27, 2004, at 20:50:57
Three nights ago, I began a regimen of 2 mg of Klonopin before bedtime for insomnia, anxiety and social phobia. Now I'm feeling agitated and depressed during the day. I'm also taking the French antidepressant Stablon (tianeptine) which is an SSRE (Selective Serotonin Reuptake *Enhancer*). I'm taking it because it doesn't have the normal sexual side effects that the standard SSRIs and Effexor has. I can't tell if I'm feeling agitated because my Klonopin dosage is too high or because I'm taking it with a potentially 'suboptimal' atypical antidepressant (as opposed to the standard SSRIs and Effexor).
The last time I was on Klonopin I felt great - I was on .5 mg before bed and took it with Celexa. My current Klonopin pills are 2 mg and scored, so I can only halve them into 1 mg tablets if I wish to reduce the dosage. Even with my pill cutter, I can't split them into fours (.5 mg each) without crumbling the entire pill. Will this agitation/depression continue unless I lower the dosage? Is .5 mg the only dosage that can provide a calming effect without making one foggy and agitated?
On another note, I'd like to ask any self-proclaimed psychopharmacology type gurus out there if you have yet to find for yourselves an antidepressant as effective as the standard SSRIs and Effexor without the sexual side effects (I realize this is the $1,000,000 question). Stablon is 'ok' but nothing like the SSRIs and Effexor - same goes for Serzone, Trazodone, Remeron and Wellbutrin. I'm open to any suggestions, particularly pertaining to novel antidepressant approaches (U.S. or international).
The standard SSRIs and Effexor are wonderful for depression but they have destroyed any possibility for a sex life, and hence, have caused great distress (especially when potential partners reject me once they see that I can't 'get it up' in bed - this has been demoralizing as it can make one appear less 'endowed' than he really is). Ginko Biloba, etc doesn't help enough and Viagra/Cialis/Levitra appear to be too expensive.
The medications I am now on are Stablon (standard dosage of 12.5 mg 3 times daily) and Klonopin (2 mg once at bedtime).
The medications I have been on as of the past many years: Zoloft, Paxil, Luvox, Celexa, Prozac, Lexapro, Remeron, Wellbutrin, Serzone, Neurontin and Risperdal (Wellbutrin made my anxiety worse and Remeron and Serzone were slightly calming/sedating but had no antidepressant effects). Of these meds, Effexor has been the best, followed closely by Luvox and Celexa - the rest did nothing for me. In addition, I have tried the mild, non-amphetamine based French psychostimulant Olmifon (adrafinil) which is the chemical analogue to Provigil (modafinil). The adrafinil made me alert, hypervigilant, anxious and somewhat paranoid but did not provide any type of 'mood boost' worthy of being considered useful for treating depression.
I did do some research on a supposed Effexor-like dual-reuptake European antidepressant called Ixel (milnacipran) which is touted as having less sexual side effects than Effexor (while working on both serotonin and norepinepherine), but user reports from this board don't appear encouraging. While the French-based dopamine reuptake inhibitor Survector (amineptine) appears to be an ideal antidepressant due to pro-sexual effects, it also has high abuse potential based on reports of friends who ordered a standard supply, abused it and consequently had no choice but to flush the remainder of their supply down the toilet (hence why it was taken off the market in every country in the late 90s). In addition, amineptine is extremely pricey due to only being available on the 'grey' market. I've also read about a relatively new MAO-based antidepressant called Manerix (moclamine) but I'm quite wary of even seemingly safe/new MAO drugs - but if one can convince me of its safety and effectiveness then I'm all ears. Edronax (raboxetine) appears interesting, but unfortunately it doesn't work on serotonin (only norepinepherine) which makes me skeptical since all of the seemingly effective antidepressants thus far appear to work mainly on serotonin (I tried Strattera, which is similar in action to Raboxetine, and it did nothing for my depression). As far as stimulants/amphetamines go, they are too short acting and addictive to be a viable option as standalone therapy or as adjunctive therapy to antidepressant medication.
Any constructive comments or advice from anyone who is familiar with novel or unique treatment approaches (for powerful antidepressant therapy options without the associated libido loss) are most welcome and appreciated.
poster:Survector
thread:329242
URL: http://www.dr-bob.org/babble/20040325/msgs/329242.html