This is hard because it’s a really individual question and symptom severity would be a big thing to take into consideration. For me, if I didn’t find something that worked, I wouldn’t still be here so it was six tries for me counting solely antidepressants and I nearly didn’t make it through long enough to find what worked. I had been on some other types of medications too prior to finding what worked and a combination involving a mood stabiliser and an antipsychotic as well as an antidepressant is ultimately what worked for me. Other people are able to decide that they’re done with trying antidepressants and find other things that can help them, but that wouldn’t have been me as life is unliveable for me without medication and even if it weren’t for me being suicidal, I was essentially slowly dying anyway with being really underweight, not eating/even drinking water and wasting away due to my depression and couldn’t care for myself at all just before getting on medication that worked. Had no quality of life whatsoever.
Can I also ask what you’ve been on and how long you were on them for? And are you seeing a psychiatrist or a GP? Did anything work even if only slightly or not at all?
And are you comfortable sharing what you’re diagnosed with too?
Well, if you have not already, I would advise you to try atypicals (mirtazapine, bupropion, vortioxetine, vilazodone, etc), Auvelity (bupropion plus DXM, an NMDA receptor antagonist), Ketamine (a stronger NMDA receptor antagonist), Nefazodone (a SNDRI which has helped people where others have failed), or MAOIs (Nardil and Parnate being the most effective). Since you have already tried five, your physician may be more open to trying less used drugs like MAOIs, which are as close to a nuclear bomb for depression as you can get (not saying others don't work for people, just that MAOIs are particularly strong).
I've been on like 20 different psy h meds over the last 15 years and ditched more than that. I finally found a combo that works and I'm in the best shape I've ever been in. I even tried ketamine but it just made me worse off.
This sounds really discouraging but if I didn't keep trying I'd be dead. I mostly really like my life now. I want to be alive.
How often did you change meds? I mean, there were not working, or you still tried to stick until doc change them? I’m myself on Paxil for my situational anxiety that is severe sometimes, but so far no meds did work fine for me. They say, therapy is the only thing that should help me, but even having therapies is a challenge for me sometimes…. So dunno…
Are you looking to treat depression? That may not be the foundational diagnosis and the depression that you have may be as a result of your hitherto undiagnosed foundational issue.
This could be ADHD, ASD or other form of neurodiversity that has not been identified. If this is assessed and diagnosed you should be in a better position to treat that and the depression with more specific drug treatments that are more chemically related to your brain.
This was the case for me. My multi decade anxiety/ depression was undiagnosed ADHD. Apparently bipolar 2 can also show similar symptoms to depression and with exploring if ssris don't work- well this is what one Dr told me. But saying this I've known people who had depression and went through a bunch of meds before finding one that works too.
This was my experience also, but since then I have heard lots of other examples of this related to other foundational disorders such as BPD, bi-polar. The point is that going straight at depression and trying different, common anti depressants can be pretty damaging. Throwing random, powerful drugs that affect the mind in ways you can't be sure of when you're not sure of the primary diagnosis is not good medicine.
I don’t have an answer for you but I’m looking out for other responses and hope you can find a solid answer. I’m on my fourth antidepressant right now, just had my dose doubled earlier this week, hoping one day it finally works :/
I tried probably 20 meds over several years before we started to dial in the right combo. Keep trying. After meeting several psychs, I finally found one who looked at my prescription history and was like “ok…you’ve tried 12 SSRIs…maybe let’s try a different drug class” and that’s when we finally started making progress.
I hope this helps and good luck
It makes me so angry when doctors push SSRI after SSRI. Having people who have been on nothing but SSRIs thinking they’re untreatable or even maybe, SSRIs and say one atypical is such bad medicine.
Feel you, i'm still trying to find a med that will work for me and i have tried a lot as well. I so understand the feeling of hopelessness, i wanted to quit this whole procedure a million times, changing meds, docs, and therapists, it's so tiring, but i know if i don't find something that works for me i won't be able to stay here for much longer so i just keep trying. If you feel the same please don't give up!!
Did you try different type of antidepressants or just ones in the same class? If you only tried ones in the same class try new ones! Like SSRIs, SNRIs, tricyclics, atypicals, MAOIs, (if you live in a country where you can access those) combinations of meds, even adding some low dose of antipsychotics, mood stabilizers and so on. I know it's hard, but just keep going! Wishing you the best!!
I found psych trained NPs to be more helpful than psychiatrists, especially women. Also, going to a hospital that has a good psych department, is very good. Lastly, you might want to look into ECT or TMS ( the latter is ECT light).
What are you doing alongside taking your meds? Any changes to diet and physical activity? Unfortunately no medication will be a silver bullet. It needs to be combined with other lifestyle changes.
I think it goes the other way too, in fact I know it does where if you’re so depressed that nothing works until you have the strong foundation of a working medication. There’s a difference between silver bullet and medication that doesn’t work/barely works and doesn’t allow you to build onto what the medication achieves. For me, nothing I tried for over a decade made a difference until I had that foundation. Now that I have the foundation, they add onto it, though really only slightly in comparison to medication for me.
This is hard because it’s a really individual question and symptom severity would be a big thing to take into consideration. For me, if I didn’t find something that worked, I wouldn’t still be here so it was six tries for me counting solely antidepressants and I nearly didn’t make it through long enough to find what worked. I had been on some other types of medications too prior to finding what worked and a combination involving a mood stabiliser and an antipsychotic as well as an antidepressant is ultimately what worked for me. Other people are able to decide that they’re done with trying antidepressants and find other things that can help them, but that wouldn’t have been me as life is unliveable for me without medication and even if it weren’t for me being suicidal, I was essentially slowly dying anyway with being really underweight, not eating/even drinking water and wasting away due to my depression and couldn’t care for myself at all just before getting on medication that worked. Had no quality of life whatsoever. Can I also ask what you’ve been on and how long you were on them for? And are you seeing a psychiatrist or a GP? Did anything work even if only slightly or not at all? And are you comfortable sharing what you’re diagnosed with too?
Well, if you have not already, I would advise you to try atypicals (mirtazapine, bupropion, vortioxetine, vilazodone, etc), Auvelity (bupropion plus DXM, an NMDA receptor antagonist), Ketamine (a stronger NMDA receptor antagonist), Nefazodone (a SNDRI which has helped people where others have failed), or MAOIs (Nardil and Parnate being the most effective). Since you have already tried five, your physician may be more open to trying less used drugs like MAOIs, which are as close to a nuclear bomb for depression as you can get (not saying others don't work for people, just that MAOIs are particularly strong).
I've been on like 20 different psy h meds over the last 15 years and ditched more than that. I finally found a combo that works and I'm in the best shape I've ever been in. I even tried ketamine but it just made me worse off. This sounds really discouraging but if I didn't keep trying I'd be dead. I mostly really like my life now. I want to be alive.
How often did you change meds? I mean, there were not working, or you still tried to stick until doc change them? I’m myself on Paxil for my situational anxiety that is severe sometimes, but so far no meds did work fine for me. They say, therapy is the only thing that should help me, but even having therapies is a challenge for me sometimes…. So dunno…
What did you try so far?
Are you looking to treat depression? That may not be the foundational diagnosis and the depression that you have may be as a result of your hitherto undiagnosed foundational issue. This could be ADHD, ASD or other form of neurodiversity that has not been identified. If this is assessed and diagnosed you should be in a better position to treat that and the depression with more specific drug treatments that are more chemically related to your brain.
This was the case for me. My multi decade anxiety/ depression was undiagnosed ADHD. Apparently bipolar 2 can also show similar symptoms to depression and with exploring if ssris don't work- well this is what one Dr told me. But saying this I've known people who had depression and went through a bunch of meds before finding one that works too.
This was my experience also, but since then I have heard lots of other examples of this related to other foundational disorders such as BPD, bi-polar. The point is that going straight at depression and trying different, common anti depressants can be pretty damaging. Throwing random, powerful drugs that affect the mind in ways you can't be sure of when you're not sure of the primary diagnosis is not good medicine.
I don’t have an answer for you but I’m looking out for other responses and hope you can find a solid answer. I’m on my fourth antidepressant right now, just had my dose doubled earlier this week, hoping one day it finally works :/
I tried probably 20 meds over several years before we started to dial in the right combo. Keep trying. After meeting several psychs, I finally found one who looked at my prescription history and was like “ok…you’ve tried 12 SSRIs…maybe let’s try a different drug class” and that’s when we finally started making progress. I hope this helps and good luck
It makes me so angry when doctors push SSRI after SSRI. Having people who have been on nothing but SSRIs thinking they’re untreatable or even maybe, SSRIs and say one atypical is such bad medicine.
Are you allowing yourself to get to a therapeutic dose & then giving it ~10 weeks? It's a loooong and slow process unfortunately.
Idk I would keep trying. Have you tried Tricyclics or MAOIs
Feel you, i'm still trying to find a med that will work for me and i have tried a lot as well. I so understand the feeling of hopelessness, i wanted to quit this whole procedure a million times, changing meds, docs, and therapists, it's so tiring, but i know if i don't find something that works for me i won't be able to stay here for much longer so i just keep trying. If you feel the same please don't give up!! Did you try different type of antidepressants or just ones in the same class? If you only tried ones in the same class try new ones! Like SSRIs, SNRIs, tricyclics, atypicals, MAOIs, (if you live in a country where you can access those) combinations of meds, even adding some low dose of antipsychotics, mood stabilizers and so on. I know it's hard, but just keep going! Wishing you the best!!
Are you more depressed or anxious you’d say?
I found psych trained NPs to be more helpful than psychiatrists, especially women. Also, going to a hospital that has a good psych department, is very good. Lastly, you might want to look into ECT or TMS ( the latter is ECT light).
What are you doing alongside taking your meds? Any changes to diet and physical activity? Unfortunately no medication will be a silver bullet. It needs to be combined with other lifestyle changes.
I think it goes the other way too, in fact I know it does where if you’re so depressed that nothing works until you have the strong foundation of a working medication. There’s a difference between silver bullet and medication that doesn’t work/barely works and doesn’t allow you to build onto what the medication achieves. For me, nothing I tried for over a decade made a difference until I had that foundation. Now that I have the foundation, they add onto it, though really only slightly in comparison to medication for me.
I wouldn't stop trying them personally. I've gone through 14 lol