TL:DR - I'm on 75mg Nardil and added 1mg pramipexole. Motivation is up, but I still haven't between the anhedonia problem. I want to swing at other things than dopamine. What role does norepinephrine play in mood? Should I tackle opioid receptors or nmda, or something else? I'm open to all suggestions.
The long version... Ok. So you may remember me asking about whether I should try pramipexole or not. After a lot of advice saying no, I tried two different antipsychotics at low dose (good lord they spiked my anxiety). I also lack access to decent quality bromantane. Memantine is my only other option on this front, but in order to keep things cheap. I went with pramipexole.
So far it's mostly plain sailing. My mood has dropped pretty badly, which I expected. My sleep is wonky and my patience is a little short. On the other hand, my motivation is real good. Which is very welcome. However, there's still no shift in my anhedonia, which does undermine the motivational aspect.
I'm still unsure on the dopamine front, but the fact it helps my motivation suggests something positive.
Basically, what other neurotransmitters can I swing at? I've tried lamictal and gabapentin before. I've considered Straterra since it binds to kappa opioid receptors? What role does norepinephrine play in mood? I was considering it because I don't want to focus on dopamine anymore. I'm not certain it's my issue.
Thanks for the help and suggestions friends.

Just wondering if anyone has trialed it since it seems to have a lot of benefits including affecting the brain gut microbiota and anhedonia. It seems to also play a role in neurotransmitters as well.
https://pubmed.ncbi.nlm.nih.gov/32379622/
I am currently trialing lamictal and it is helping a bit with anhedonia and social situations but im still increasing dosage and it tends to bring some lows when i change the dose. I would probably trial Betaine next before Wellbutrin if I dont recover a lot of my sexuality with the lamictal.
Hopefully someone has tried it and benefitted from it.

Hey all, I know that a lot of you have questions and post mostly about issues and how to deal with more generally negative topics but I wanted to share an "it gets better" experience for those losing hope.
After years of about a month to a month and a half of upswing then 3-4 days of depression on a consistent cycle then a switch to the exact opposite of a month of depression for only 3-4 days of doing a month's worth of work in that time, I decided that I had a problem.
I was devastated with my bipolar 2 diagnosis and a series of 3-4 medications didn't help. Lamictal 100mg was harsh, seroquel (lowest dose split in half!) made me a zombie, and I don't recall the rest but each was worse than the last. I couldn't go unmedicated but the medicine only worked because you can't be depressed if you're asleep 😂😭.
When I moved back home state after college, I got a new doctor that saved my life. She listed to my concerns and side effects then recommended the GeneSight test. Best ~$330 that I've ever spent (they have grants for low-income, so it can be free to less on a sliding scale!). The test looks at various genetic factors to needing more/less of medications for them to be effective or not have side effects, how your system metabolizes medicine so it works at all, and it also tests a genetic mutation that a lot of people with European ancestry apparently have where we can't turn folate into its usable form. That makes us not able to make serotonin/some other neurotransmitter? no matter who much folate we eat.
I was prescribed Rexulti based on the test, and I was told to take L-Methylfolate 15mg. I started at 1mg then capped at 2mg. I can proudly say that I've been stable with no episodes either way nor side effects for over two years. I finished college, worked a few odd jobs, and am now in my dream grad school in France! Unfortunately the national healthcare here doesn't cover Rexulti, but Abilify is extremely similar and I don't have any side effects thus far on my 5mg starting regiment.
Don't give up. Rexulti/Abilify may not be for you, but GeneSight might be a worthy investment if you're having medication issues. I hope this helps someone.

From polls that I've seen in the past, it seems like chronic stress may be the most common cause of anhedonia, possibly second to SSRIs, antipsychotics, and general drug-induced forms. I think there is in general an excessive focus on dopaminergic dysfunction, which in my opinion is more of a consequence of underlying issues, though it is responsible for the most debilitating symptoms of anhedonia.
Excitatory/inhibitory imbalance, specifically, imbalance of glutamate and gaba seems to be the other key factor in anhedonia.

1. "Inflammation-induced alterations in dopamine and glutamate converge to affect corticostriatal reward and motor circuitry and drive symptoms of anhedonia and psychomotor retardation." https://pharmrev.aspetjournals.org/content/73/3/1084/tab-figures-data
2. "Blockade of Astrocytic Glutamate Uptake in the Prefrontal Cortex Induces Anhedonia" "These results suggest that depressive-like outcomes correlate with increases in glutamate and astrocyte dysregulation that may lead to increases in glutamate- changes that, therefore, probably contribute to an anhedonic phenotype. We have shown that decreasing astrocytic glutamate uptake in the PFC can induce some of the symptoms observed in depressed patients, including anhedonia and irregular EEG patterns."
3. "More specifically, we show that anhedonia in MDD is associated with disrupted communication between the pVMPFC and reward- and emotion-related regions during the processing of positively valenced stimuli. Our results also indicate that in adults with MDD, anhedonia reflects a lack of engagement between the pVMPFC and reward-related functional circuits when contextually appropriate, rather than a constant deficit in connectivity." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070048/
4. "These results suggest that NMDA activation is crucial for stress-induced dendritic atrophy in mPFC. Furthermore, NMDA receptor blockade uncovers a new pattern of stress-induced dendritic changes, suggesting that other neurohormonal changes in concert with NMDA receptor activation underlie the net dendritic retraction seen after chronic stress."https://academic.oup.com/cercoarticle/21/10/2366/329996?login=false
5. "Moreover, a very recent report has shown reduced GABA level in ventromedial PFC (107) of depressed subjects. Additionally, reduced level of GABA has been reported in PFC of chronic stress model of depression in rodents (112, 118). Hence, lower GABA level is often considered as one of the most promising endophenotypes of MDD (156)." https://www.frontiersin.org/articles/10.3389/fpsyt.2021.637863/full
6. "Mounting evidence suggests that acute and chronic stress, especially the stress-induced release of glucocorticoids, induces changes in glutamate neurotransmission in the prefrontal cortex and the hippocampus, thereby influencing some aspects of cognitive processing." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645314/
7. "In addition, an emerging literature shows that chronic stress also causes extensive alteration of GABAergic inhibitory circuits in the PFC, leading to the hypothesis that inhibitory neurotransmitter deficits contribute to changes in PFC neuronal excitability and cognitive impairments. Here we review evidence in rodents and human, which point to the mechanisms underlying stress-induced alterations of GABA transmission in the PFC, and its relevance to circuit dysfunction in mood and stress related disorders. These findings suggest that alterations of GABA interneurons and inhibitory neurotransmission play a causal role in the development of stress-related neurobiological illness, and could identify a new line of GABA related therapeutic targets." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086803/

...
As a disclaimer, this is not medical advice. However, evidence suggests that targeting and rectifying the excitatory/inhibitory balance is crucial for treating anhedonia. There are many different drugs that have been suggested to potentially achieve this. The problem is that the reduction of glutamate will increase anhedonia. I don't know the exact mechanisms behind this. Whether it is due to the downregulation of receptors or due to the concomitant dopaminergic deficits is unclear. But I am at least trying to come up with a comprehensive list of things that have the potential to correct these deficits. As a warning, these drugs have the potential to worsen anhedonia.
​

1. Ketamine - Ketamine rapidly reverses stress-induced impairments in GABAergic transmission in the prefrontal cortex in male rodents - I have some doubts about this, but it in theory it is supposed to rectify this imbalance.
2. Agmatine - "Inhibition of NMDA receptors by agmatine is followed by GABA/glutamate balance in benzodiazepine withdrawal syndrome"
3. Lamictal - "This study demonstrates a clear pro-motivational effect of repeated lamotrigine administration, accompanied by a restored dopaminergic response in the NAcS, possibly consequent to the modulation of VTA dopaminergic neurons firing rate." "Repeated lamotrigine administration prevented and relieved the stress-induced hyporeactivity to negative aversive stimuli (that is, escape deficit) and reinstated the physiological response to natural rewarding stimuli (sucrose) in a stress-induced depressive-like phenotype in rats. The pro-motivational effect of repeated lamotrigine administration that we observed in stress-exposed “anhedonic” rats is a novel finding since only the consummatory component of reduced responses to pleasurable stimuli has been previously investigated in animal models [18]."https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6190531/
4. Lithium Orotate - "Chronic stress exposure impaired the NAcS dopaminergic response to VS, acquisition of VAB and sucrose SA, in terms of FR1 and FR5 schedules of reinforcement and breaking point score. Repeated lithium treatment restored these parameters to control group values, even when treatment began in rats already showing an anhedonia-like condition. Since the breaking point defines the reinforcement efficacy of a hedonic stimulus, the present data suggest that lithium treatment is endowed with anti-anhedonic activity in rats." https://pubmed.ncbi.nlm.nih.gov/23363811/
5. Zuranolone - "Owing to the probable hypothesized pathophysiology of MDD being an outcome of abnormalities in the amino acid neurotransmitter system, including glutamate (the primary excitatory neurotransmitter) and γ-aminobutyric acid (GABA), SAGE-217 (Zuranolone) is being evaluated as a possible therapeutic treatment for MDD. Zuranolone is a synthetic, neuroactive steroid (NAS) and positive allosteric modulator (PMA) of GABAA receptors, regulating both synaptic and extra-synaptic release of GABA. It is administered as a once-daily oral dose for 2 weeks due to its low-moderate clearance." https://pubmed.ncbi.nlm.nih.gov/36848317/
6. L-Theanine - "The brain volume of SAMP10—a stress-sensitive mouse—decreased by stress loading. However, theanine—the main amino acid in tea leaves—suppressed brain atrophy. Theanine was suggested to prevent stress-induced brain atrophy by modifying early stress responses such as Npas4 and Lcn2."
7. Probiotics? - "Both pure and mixed Lactobacillus and Bifidobacterium were effective in ameliorating glutamate excitotoxicity as an autistic feature developed in the PPA-induced rodent model. Their therapeutic effects mostly involved the correction of oxidative stress, restoration of depleted GABA, and up-regulation of GABA receptor gene expression. Pure Bifidobacterium was the most effective, followed by the mixture of probiotics and finally lactobacillus. In conclusion, Bifidobacteria and lactobacilli can be used independently or in combination as psychobiotics to ameliorate oxidative stress and glutamate excitotoxicity as two confirmed etiological mechanisms through the gut–brain axis." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9416367/
8. Memantine - "Memantine treatment reversed anhedonia and the increase of adrenal gland weight, normalized corticosterone levels and increased BDNF protein levels in the prefrontal cortex in stressed rats. Finally, these findings further support the hypothesis that NMDA receptor antagonists such as memantine could be helpful in the pharmacological treatment of depression. " https://pubmed.ncbi.nlm.nih.gov/22327556/

...
Maybe? - Riluzole (glutamate release inhibitor) - "The cellular, metabolic and behavioral alterations induced by CUS [chronic unpredictable stress] were reversed and/or blocked by chronic treatment with the glutamate-modulating drug riluzole. The beneficial effects of riluzole on CUS-induced anhedonia and helplessness demonstrate the antidepressant action of riluzole in rodents. Riluzole treatment also reversed CUS-induced reductions in glial metabolism and GFAP mRNA expression. " https://pubmed.ncbi.nlm.nih.gov/18825147/
...
Other factors and approaches:

1. Treating underlying inflammation or infections
2. Meditation
3. Taurine
4. Zinc and B6

Hey.
So I have two big problems. When incidents happen that cause my heightened PTSD stress response I immediately run home for safety and avoidsnce. The other - terrible morning depression.
I have become obsessed with neurotransmitters .. any progress I've made medication wise has been of my own making. Lamictal for glutamate .. gabapentin etc etc.
I've postulated that my cptsd caused damage to my gaba system and thus my fight flight and stress response is abnormal. Anyone used propranolol for this.. oddly enough I posted before that it helped but it was a long time ago and I cant figure out why i forgot abour it.
If so anyone found out it helps in the morning. I believe in the morning that when cortisol is heightened I simply don't have the gabapentin response for counter it. I am wondering if taking it early am or late at night might help

Forgive me if my wording is incorrect.
I am wondering if overdoses on medication used to treat depression and treatment resistant depression can cause brain synapses and neurotransmitters to have long term problems. I have overdosed twice, the first time on a lot of zoloft, lexapro, lamictal, and gabapentin, and the second time on a lot of latuda, lamictal, and propranoprol. Both lead to hospitalization and multiple days in the ICU with seratonin syndrome and heavy monitoring, and then a psych hold. No one has ever explained to me if there are any long term effects of medication overdoses. After an overdose, does the brain act as it did before overdose, creating the same amount of neurotransmitters, or is there a permanent change in how the brain operates chemically after a medication overdose?

I was reading a study about how a patient was administered ketamine as a sedative after a lamictal overdose with little to no effects. Something about the blocking of the glutamate neurotransmitter.
I am wondering, if this could have any correlation to why my IV infusions are never very psychedelic. I am 125 lbs and usually have IV infusions of 120mg, which to my understanding is a high dose. However, I never have very profound infusions. I feel myself dissociate, and it feels like my body and the room around me is changing in dimension (shape/size), but I never have these intense, psychedelic, spiritual, or relieving experiences. I am currently going through a mini-series of 3 in a week to soften my symptoms, but other than a slight relief in my depressive symptoms, I have never had any profound relief from depression or CPTSD. I overdosed on multiple bottles of lamictal 4 and a half years ago, resulting in seratonin syndrome and a hospitalization. I am wondering if my glutamate transmitters have been somehow screwed with?
I also don’t usually use the eye mask, because when I try to use it I only see darkness and that makes me uncomfortable. I am thinking of trying it again for my next infusion, but along with this, any suggestions for how I can maximize healing and processing on a deeper level than just symptomatically for my next infusion?

My functional doctor is trying to figure out why I need so much cytomel to stop low thyroid symptoms (including weight gain, constipation, etc). The amount I need supresses my TSH which of course is not a great thing long term
My saliva test for cortisol came back fine, so now he has me getting my neurotransmitters testes (ZRT lab)
I take anti-depressants (and Lamictal). Has anyone else had some kind of impact by neurotransmitters? (with our without anti-depressants)
Thanks!
​

I made a similar post a while back that was quite lengthy but didn't delve into antidepressants/medications.
Basic premise: prolonged AP/emotional/physical abuse doesn't just make you feel bad, it actually changes the composition of your brain, as well as creating deficiencies/instability in your neurotransmitter levels.
The big 4 neurotransmitters are Serotonin, Norepinephrine, Dopamine, and Gaba.

• There are countless others but these 4 dictate the majority of our emotions (along with the amygdala but that's another story.)
• If I was a betting woman, I'd say that many people on this subreddit are on an antidepressant or prescribed medication of some kind.

This may be basic bitch info to some or news to others:

• Psychiatrists (in the US) tend to prescribe antidepressants in more or less the same manner, and tend not to foray outside that "realm."
• Millions of prescriptions are written in the US for the following:
• SSRIs such as Prozac, focusing on Serotonin
• SNRIs such as Cymbalta, focusing on Serotonin and Norepinephrine
• Atypical antidepressants such as Wellbutrin, focusing (to a weak extent) on dopamine
• Stimulants such as Adderall focusing on dopamine and to an extent Norepinephrine.
  • In the case of Adderall, it's an unsustainable means of treating depression on its own. Adderall boosts dopamine levels very high while lowering your overall dopamine levels over time. Simplified explanation: extreme jump descends to a lower baseline than before. Ritalin, on the other hand doesn't work in that manner, but like Adderall, is not a sustainable solution overall.
• Benzos such as Valium, focusing on GABA.
  • Doctors will squabble back and forth about the prescribing of benzos for anxiety, the duration, the problems, and the benefits. Either way, attending to GABA yields very little options. They are options out there though, and I'm not discounting benzos all together. I'm just saying that benzos are not "the way out."

The above is just about the extent of general prescribing practices. Some psychiatrists will try Tricyclic and or MAOI antidepressants but not often.
The problem?
You don't know what the hell is wrong with your brain and where your deficiencies are or where they are the most deficient.

• And...this may sound contentious but IMO, it's one LUCKY MFer who emerges from prolonged AP abuse without having any need to reconcile deficiencies/damage within the brain.
• You might not have any idea that highly suicidal people often have a significant deficiency in Serotonin.
• You might think you have ADHD when you might actually have anxiety from hell and your Norepinephrine levels are fucked.
• You may think you're doomed to be a lazy fuck with no motivation when in actuality, your dopamine levels are depleted.

Back to antidepressants:

• An SSRI such as Prozac that focuses exclusively on Serotonin isn't going to do jack shit if you have Norepinephrine issues (the fight or flight neurotransmitter)
• Similarly, a benzo will calm you down for a while due to its effect on GABA but won't attend to any of the other problems within your neurotransmitters.
• Ergo, most antidepressants/antidepressant polypharmacy are a waste of time, money, and energy. It's like throwing a dart at a dart board and hoping it sticks.
• More often than not, it doesn't stick, and doctors start stacking the medications (eg. Cymbalta + Wellbutrin + Valium) and perhaps throwing in things like beta blockers, Lyrica, Lithium, or even Lamictal.
• Beyond that, they may go in a different direction and add an antipsychotic to the mix because they are "beneficial for depression as well." I disagree with that but whatever.
• Note: antipsychotics are used for good reason but IMO have no place in treating depression/anxiety/PTSD.

Anyhow.
The point: if you're in therapy and it works, by all means keep doing it. If you're on medication and it's not working, there's a reason for that.
Do your research and don't let your shrink throw darts in the hope they'll stick. The only one who suffers is you. I'm talking about the people who've been on Zoloft for 7 years and are more or less in the same emotionally fucked place, the people who were prescribed Cymbalta and ended up in a polypharmacy nightmare and are now on a daily regime of Cymbalta, Adderall, Klonopin, and Abilify, and the people who bought the hype surrounding California Rocket Fuel, found it to be of little benefit and are living hellish days withdrawing from the three medications that comprise the aforementioned.
Hope this helps someone, anyone.
Notes: There is a suggestion I made in the comments. In no way am I saying its a cure-all nor that over the counter options are more efficacious than prescription medications.
What I am saying is that it worked well for me once upon a time, albeit not perfectly, I'm considering it again, and it's helped a lot of people change their lives.
Biological elements can vary quite a bit, and some people will find that the addition of B6, "the right form" of B12, Methylfolate and sublingual D3 can be gamechangers.
Regarding this statement: "IMO, it's one LUCKY MFer who emerges from prolonged AP abuse without having any need to reconcile deficiencies/damage within the brain."
Anecdotal addendum: I once told a sibling there was no way anyone was coming out of our childhood completely intact (emotionally, biologically) and this sibling (who disagrees with me on everything under the sun) paused, contemplated, nodded and wholeheartedly agreed...that we and those with similar experiences have to fix the damage or our lives would remain in a fractured state...basically half-living and half-suffering.
​

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I suffer from depression and social anxiety since I was 15 years old (symptoms occured even before but with 15 I started noticing it very clearly, with 17 I first started going to a psychiatrist and therapist). Now I'm 23 and tried 3 different forms of therapies as well as over 14 different types of meds. Nothing helped so far, nothing reduced my symptoms. It's now called treatment resistant depression and even my doc says normal therapy is not effective for my type of depression, it definitely is caused biochemically/neurologically/biologically.
Except for my very last one: Lyrica. Lyrica helps at least a bit and makes my anxiety and depression a bit better. But I know Lyrica can cause dependance and horrible withdrawal as well as tolerance, so best would be to not use it daily but only as rarely as possible. I don't want to use any substance daily at all anyways, cause I've been through many horrible withdrawals. Hence my plan of cycling substances, meds, supplements, whatver to finally have a painless life.
My doc wanted to try every possible med left with me, so she's very open for new meds, which I'm too. She mentioned Tianeptine to try on me soon as - as said - Im trying my 15th med now without success or symptom reduction, for years, 2 depth psychological (analytical) and 1 cognitive behavioral therapy failed to help. I also do sports weekly (tennis and/or gym, skiing sometimes).
I might just take it if needed then, even if she prescribes it for daily. I mean, if it‘s an opioid and one says even harder to get off than oxy… Maybe if needed same as my Lyrica so one can switch them to reduce risk of tolerance/dependance/withdrawal of each. A 3rd med of different class would still be better to have a good cycle and get maybe at least 3, maybe even 5, worthful to live days and free of suffering days a week. 2 days completely off then.
Any idea? Lyrica is gabapentinoid = calcium channels, a teeny bit of GABA receptors itself too. Tianeptine is opioid = opioid receptors. What else could be added but not using the same receptor or system? What about Buspirone, Hydroxyzine, Clonazepam? So far I only have found Lyrica & Kratom to be helpful (even if it's not "curing" me, just making my day and symptoms by maybe 20-50% better, but only if not taken daily - hence the need for a cycle and not taking any similar chemical daily)
As I don't want to use any similar chemical daily or many days in a row or a week at all and in the best case only one neurotransmitteCNS system once a week max, I thought about cycling following, each one only once a week to reduce any risk of possible dependance, withdrawal or tolerance:
Voltage gated calcium channels (Gabapentionoid):

• Lyrica (Pregabalin) => said to don't have much GABAergic affinity on its own, rather acts indirectly and weakly on GABA, hence hess less risk of cross tolerance with GABAergics (if I should add any GABAergic as a benzo to my cycle, too)

Opioidergic:

• Tianeptine (opiodergic antidepressant)
• Kratom (legal opioidergic plant) => question is, how strong would the cross-tolerance with Tianeptine be if used with a break of many days in between as both are opiodergic afaik?

GABA:

• Benzodiazepine => Valium/Diazepam didn't work so I told my doc to quit my script for it as I don't find any use for it => a friend of mine with very similar symptoms had great experience with Clonazepam instead

Dopamine and/or Norepinephrine:

• Ritalin
• Adderall
• Modafinil
• or similar AD(H)D stimulant medication
• => big issue: I guess I only have a 10% chance of getting any of these stimulant AD(H)D meds cause even if I strongly suffer from symptoms very similar to ADD (without the H for hyperactivity) no doc ever wanted to test me for ADD as long as my depression and anxiety weren't cured, that's why I never got a diagnosis until now and now docs tell me, you can mainly only get a diagnosis for ADD if it has been diagnosed in the childhood or when one has been very young, also one had to have very bad grades in school for one of the diagnosis checks => so my school grades have only been medium bad, not very bad + I'm now 23 and maybe a bit too late for school medicine to hop on the ADD train even if I always had the thought of suffering from ADD cause of my very bad cognitive symptoms (focus, memory etc.) + ADD goes hand in hand with depression and anxiety and might be a cause of these symptoms afaik (so why the hell no doc ever tested me for it before trying to always continue treating me with typical depression therapy and meds instead of giving the ADD train a go???)

Other psychiatric medication (with need of a prescription by my doc) I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Hydroxyzine
• Buspirone
• Lamictal
• Abilify
• Amisulpride
• Selegiline
• any other ideas? as said my doc is really open to try new meds with me cause she knows how desperate and treatment-resistant I am and have been for years now

OTC meds/supplements/herbs I thought of to add to cycle for the other left days in my week full of suffering that may be helpful for finally making my life painless and livable:

• Kava: legal anxiolytic plant, had some good experiences with it reducing my symptoms strenghts, being anxiolytic and antidepressant BUT it's a big hit and miss, causing skin issues for me (when taken some days daily in a row) and very expensive, hence surely also nothing to take daily => ALSO: there's not much science about rather it's GABAergic or also rather a voltage gated calcium channel blocker (VGCC blocker) as Lyrica, or how it really works, but it's said to not have any physical dependance or withdrawal issues or risk => question again, is there any cross tolerance with Lyrica or Benzodiazepines?
• DXM (Dextromethorphane): dissociative antitussive => originally a cough medicine, now officially used for depression and I already read years ago many times about people using it to self medicate their depression and anxiety in non-trip-doses (cause some people abuse it in mega-doses to get a psychedelic trip from it, which I never planned or wanted to)
• Kanna (Sceletium tortuosum): natural SSRI => sadly never noticed any effects from it when I tried the plain herb as well as extract orally or sublingually in low to medium dosage (some swear on having to take it intranasally to get antidepressant/anxiolytic effects but I already hate the thought of having to take something through my nose)
• Gotu Kola => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Lemon Balm => seems to help a bit, might be good for my "off-days" off "real stronger medication"
• Beta Alanine => some studies promise anxiolytic effects because of it's GABAergic properties

Some probably very weak herbs having no sense to try for my severe treatment-resistant depression and social anxiety:

• Tongkat Ali => testosterone increasing, read some reviews about people having success with it for depression and/or (social) anxiety
• SAM-e => read some reviews about people having success with it for depression and/or (social) anxiety
• Bacopa => read some reviews about people having success with it for depression and/or (social) anxiety
• Lions Mane Mushroom => read some reviews about people having success with it for depression and/or (social) anxiety
• KSM-66 (Ashwagandha) => read some reviews about people having success with it for depression and/or (social) anxiety BUT tried one KSM-66 product from Amazon for more than 2 weeks daily and never had success with it or any symptom reduction sadly...
• Taurine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• L-Theanine => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me, maybe I have to increase dosage to a mega dose?
• Silexan/Lasea (Lavender extract) => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily
• Rhodiola Rosea extract => read some reviews about people having success with it for depression and/or (social) anxiety BUT never worked for me even after trying it for more than 2 weeks daily as well as only as needed
• Akuamma
• Wild Lettuce
• Skullcap
• Mulungu
• Passion flower
• GABA (plain powder supplement of GABA, infamous for not crossing the BBB so not being able to have any psychoactive effects)

Sure, last resort for me is also still:

• stronger MAOIs as Nardil or Parnate (I already tried the weaker MAOI "Moclobemide"/"Aurorix")
• Ketamine therapy
• rTMS
• ECT

I have combined much of the information into one post to make it easier for you to look through everything. Also if you look through the sub look for "Information" posts in yellow and "Resources" in orange.

The Basics

Most Common Antidepressants

• SSRI's - Works on Serotonin
  • Sertraline (Zoloft)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluvoxamine (Luvox)
  • Vilazodone (Viibryd)
  • Vortioxetine (Trintellix)
• SNRI's - Works on Serotonin and Norepinphrine
  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor)
  • Desvenlafaxine (Pristiq)
  • Levomilnacipran (Fetzima)
• SNDRI's - Works on Serotonin, Norepinephrine, and Dopamine
  • Nefazodone (Serzone)
  • Ansofaxine (Ruoxinlin) --- Available in China, coming to U.S. in 2024
• Atypical/Misc.
  • Bupropion (Wellbutrin) <--- NDRI, works on Norepinephrine and Dopamine
  • Mirtazepine (Remeron)
  • Esketamine (Spravato)
  • Bupropion/Dextromethorphan (Auvelity)
  • Gepirone (Exxua) --- Available in USA in early 2024
  • Zuranolone --- Now Available in USA
  • Trazodone --- Used mostly as a sleep aid
• Tricyclic
  • Amitriptyline (Elavil)
  • Imipramine (Tofranil)
  • Nortriptyline (Pamelor)
  • Clomipramine (Anafranil)
• Meds for Anxiety
  • Gabapentin (Neurontin)
  • Pregabalin (Lyrica)
  • Propranolol
  • Buspirone (BuSpar)
  • Hydroxyzine (Vistaril)
• Mood Stabilizers
  • Lamotrigine (Lamictal)
  • Depakote
  • Lithium
  • Oxcarbazepine (Trileptal)
  • Carbamazepine (Tegretol)
  • Antipsychotics (seroquel, abilify, risperdone, vraylar, rexulti)

What to Expect When Starting Antidepressants
When you are first prescribed antidepressants you are usually started on a low dose as your body needs to adjust to the medication. You usually have more side effects when you first start. These side effects may include, nausea, drowsiness, headache, lower libido, and increase in anxiety to name a few. These will usually subside over the first few weeks. If at any point you have suicidal ideation or thoughts you need to contact your doctor immediately as this is a side effect not to mess with. Also just because you don't have a follow up appointment for a month later if you are having problems call the office up and talk to a nurse.
Antidepressants are not a medication that works immediately. The brain has to adjust to the changes and it reacts rather slowly. You may notice some changes after 2 weeks, but they can also take up to 8 weeks to start working. I say this is the time to give your brain a little help with some lifestyle improvements. Add some regular exercise as studies have shown this to help depression and anxiety. Try improving your diet. Start by removing junk food/drinks. There was a study just done that showed that artificial sweeteners actually increase anxiety. Finally make sure you are getting plenty of sleep. Your brain needs that time to recover from out stressful lives. If after 8 weeks you are not noticing any kind of improvements it is time to contact your doctor about changing your dosage or trying a new medication. Don't be frustrated by this as it is normal for people to have to try a few before finding the one that works best for you.
When you start noticing improvements it usually isn't an overnight event. The changes are gradual and you may not notice it. Sometimes if you journal or rate how you feel it can help. You may start to notice you don't feel so awful or you feel like you want to start doing activities that you had been avoiding. Also make sure to communicate with your doctor how you are doing. You may need to gradually increase your dose to find what is optimal for you.
People often ask how do antidepressants actually work. I came up with a good analogy based on how my doctor explained it. People seemed to like it so you can find it here: https://www.reddit.com/AntidepressantSupport/comments/14bjnrh/explaining_how_antidepressants_work_with_an/
Additional info about Antidepressants

• Wellbutrin can cause an increase in anxiety.
• Trazodone and Mirtazapine both can be used to help with sleep
• If the antidepressant causes insomnia you may want to try taking it in the morning, and if you take it in the morning and you are drowsy try switching it to the evening.
• Even though Trintellix and Viibryd are considered SSRI's they have a different mechanism of action so if other SSRI's don't work for you those two could still help you.

Information Bias on the Internet
When people start looking up antidepressants and want to see how they have worked for other people they find all of these horror stories about terrible side effects. Please remember when someone has a negative experience they are more likely to complain or are looking for help. Look at the number of stories you read and think about the fact that tens of millions of people take antidepressants. The people for whom they are working don't go online to tell people about their experience. They are back to enjoying their life. I have found that drugs.com has a more rounded reviews. Also if you are having anxiety be careful about reading some of the horror stories as all they do is end up increasing your anxiety.
Tapering Antidepressants & Withdrawal
If you ever decide you are going to stop antidepressants it is very important to taper off of them very slowly. The longer you have been on them the slower you want to taper. The reason for this is the brain gets accustomed to the effects of the medication and it expects those effects on neurotransmitters. This causes dependence, not addiction. So if you yank the medication away from the brain it will result in withdrawal which can be awful. You can experience nausea, dizziness, headaches, brain zaps, emotional highs and lows, insomnia, agitation, etc. So you need to slowly over time take the medication away. Doctors are taught in school that tapering can be done in a short time and withdrawals only last a couple of weeks. This isn't true. Research has shown that the 10% method of tapering has been found to be one of the safest methods. This is taking the dose you are taking at that time and subtracting 10% each month. This is a long process, but the goal is to get off the medication with the least amount of withdrawal. If you were taking 100mg this is how your tapering schedule will go. 100, 90, 81, 73, 66..... For more information on tapering and how to make these custom doses you can visit survivingantidepressants.org.
Withdrawal is something you want to avoid, but if you find yourself going through there are some things that you can do to get yourself out of it. Withdrawal is most common when going off a medication cold-turkey or tapering too fast. There is no timeline for how long withdrawal will last, it could be weeks or months. One way to possibly get your self out of it is going back on a lower dose than you were last on. This is called reinstating. You let your brain stabilize and once you feel better give yourself 2-4 weeks to heal properly. Then you want to begin tapering off again. People also report that taking Fish Oil can help with recovery from withdrawal.
Sites and more information on tapering and withdrawal. https://www.reddit.com/AntidepressantSupport/comments/10krlmd/sites_and_resources_for_tapering_antidepressants/
Switching from one Antidepressant to Another
There are 3 methods doctors will use when switching from one antidepressant to another. Many times it is just the doctor's preference to which they recommend.

1. Direct switch - the doctor gives you an equivalent dose of the new medication and you stop the original and the next day you start the new one.

Dose Equivalence: 40 mg fluoxetine 350 mg bupropion 40 mg citalopram 75 mg pristiq 20 mg escitalopram 40 mg paroxetine 150 mg fluvoxamine 50 mg mirtazapine 100 mg sertraline 500 mg nefazodone 150 mg venlafaxine 125 mg amitriptyline 125 mg imipramine 115 mg clomipramine
Drugs not listed do not have any reputable source for dose equivalency. Doses are rounded up.

1. Taper and washout - you slowly taper off the old medication give your body 2 weeks without any medication and then you start the new one and titrate up.
2. Cross taper - As you taper off the old medication you titrate up on the new medication. The doctor will usually give you a schedule. If you are taking 100mg of Med A. and wants you to go to 200mg of Med B. Week 1 -- 75 of A and 50 of B, week 2 -- 50 of A and 100 of B....

I think the third option is the best as it is more of a gradual transition. If you get bad side effects from the new medication it is also easier to go back to your old medication. No matter the method there is a couple weeks in there where it can be kind of rough. You are stopping something your brain is accustomed to and adding something new that it has to adjust to.
Treatments Beyond Medication
If you have tried numerous medications and just can't find anything that helps there are few treatments that you can look into. You may even want to try some of these things before trying meds. Some of these do have higher side effect risks.

1. Talk Therapy - alongside your antidepressant or independent of taking a medication. This is about the safest thing you can do.
2. Life Style Changes - Exercise, Diet, etc. Again this is very safe and can be always used in conjunction with other therapies.
3. Ketamine - This is a medication, but is usually a treatment when meds don't work.
4. TMS, in 2023 we should see a new protocol for TMS called SAINT which is supposed to be more effective and involves less sessions. As of 2024 this is being done in California and Massachusetts.
5. ECT - This is usually done as a last resort, it has some significant side effects such as short term memory loss. Do your research before considering.
6. Stellate Ganglion Blocks - This is fairly new as far as being used for mental disorders.

Lifestyle Changes to Improve Mental Health

Medication can be helpful, but it is not the only way to improve your mental health. Here is a list of some things that can help you on the road to improved mental health.

1. Exercise -- Regular exercise is really helpful. Studies have shown that it can improve depression/anxiety. More intense exercise has been found to be more helpful for anxiety. Exercise can help produce endocannabinoids which can make you feel better. It is sometimes described as "runner's high". Plus if you can get out in the sun for your exercise that is good as sunlight helps Vitamin D. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-truth-behind-runners-high-and-other-mental-benefits-of-running Here is a new study on the benefits of physical activity on depression. https://www.psypost.org/physical-activity-and-mental-health-exercises-therapeutic-potential-for-depression-highlighted-in-new-meta-analysis/
2. Speaking of sunlight many people will suffer from seasonal depression in the winter as their levels of Vitamin D drop due to the lack of sunlight. If you are in a northern climate when you go out in the winter the only skin exposure may be the little area on your face. To combat this you may wish to look into light therapy during the winter months. https://www.insider.com/guides/health/mental-health/light-therapy
3. Improve your diet. Cut out junk food/drinks. There is a link below about which foods help depression/anxiety and which ones aren't good for it. https://www.medicalnewstoday.com/articles/318428
4. Make sure you are getting enough quality sleep. Your brain needs that down time to rest and recover. If you feel like you are getting enough sleep, but are always exhausted talk to your doctor about having a sleep study done. They have kits you can do at home. I found out I had central sleep apnea and my oxygen levels were around 80% for half the night.
5. Socialize, keep the brain active. Try activities that challenge your brain. Suduko, crossword puzzles, trivia, etc.
6. You also may want to try some type of talk therapy or learn some different coping skills and methods of relaxation such as deep breathing exercises.
7. Volunteer. You are helping others and sometimes seeing just by giving your time to people and seeing how it helps them can be rewarding.
8. You may even want to consider getting a pet as they are supposed to be beneficial for depression. You can even go one step further and get and Emotional Support Animal (ESA). They are specifically trained and are allowed to go with you on airplanes and other public places. Some are even trained to recognize certain side effects in medications. For more information you can visit this site: https://www.certapet.com/service-dog-for-depression/

This was published during the pandemic, but has many helpful ways to help improve your mental health. Medications can be very helpful, but there are so many different things that can improve your overall mental health. As a bonus they don't come with side effects. https://neurosciencenews.com/resilience-mental-health-19986/
Talks about lifestyle changes to help with mental illness and other therapies like light therapy. Some doctors hand these out to patients. https://www.psycho.farm/resources
All of these are tools that we can use to improve our mental health. Medication may help, but it is also a tool and you need to help it out by working on yourself. I wish everyone the best on their journey!!!

Lab work and tests

This lists out some blood tests that can be done to see if something else is contributing to your depression. I'm sure their are others, but this gave a little explanation why you would check out some of these. This may not eliminate depression, but it may find something that can be treated and can decrease the amount of depression. https://www.optimallivingdynamics.com/blog/13-important-blood-tests-to-get-done-if-you-have-depression
Many times people ask about the genetic tests and are they helpful. These will tell you how you metabolize the medication, but that plays no role in whether it will be effective for you. The one helpful thing is the MTHFR gene mutation, but your GP could do this lab at a much lower cost. I actually just ordered this test for myself and even if insurance doesn't cover it, the cost is $188. The below article explains in detail why the FDA actually recommends not using these. An upcoming blood test will be able to show in a couple of weeks if a medication will work for you. https://www.health.harvard.edu/blog/gene-testing-to-guide-antidepressant-treatment-has-its-time-arrived-2019100917964 https://neurosciencenews.com/depression-antidepressant-biomarker-19863/

Sexual Side Effects

The is one of the most unfortunate side effects to antidepressants. Some things to remember is if you have sexual side effects on one medication it does not mean you will have them on all of the medications. Some people say that the effects are the worst when you first start the meds and can slowly recover after a few months. You may also realize this, but untreated depression and anxiety can have an effect on your sexual performance and libido. So for some people treating their mental disorder actually improves sexual issues.
This really dives into exactly what causes the sexual side effects, which medications are more likely to cause it, and ways to treat it. As of note nefazodone is another medication that is known not to cause sexual side effects. As well as the upcoming medication Ruoxinlin (ansofaxine). Nefazodone I also believe the new medication Auvelity is supposed to have lower sexual side effects. AuvelityMed https://psychscenehub.com/psychinsights/sexual-dysfunction-with-antidepressants/
Rate of incidence of sexual side effects of some of the medications. The average for SSRI's is 59%, but there are other antidepressants that have much lower sexual side effect percentages. https://pubmed.ncbi.nlm.nih.gov/11229449/
Nefazodone, mirtazapine, wellbutrin (bupropion), Auvelity, viibryd, and Trintellix (vortioxetine) are they medications with the lowest rate of sexual side effects. Wellbutrin is often added to an SSRI to relieve some of the sexual side effects.
Here is a guide I put together about sexual side effects: https://www.reddit.com/AntidepressantSupport/comments/14bicp1/guide_to_antidepressant_sexual_side_effects/

Side Effects & Medication Interactions

If you really want to read about the side effects of each medication pdr.net has some of the most comprehensive information. It even lists the rate of incidence of each side effect. It also lists out the interactions with other medications. Drugs.com has probably some of the best user reviews of each medication. You can even look how a medication is rated for depression, anxiety, ocd, etc. None of the information contained in this guide should be a substitute for your doctor. You should always run any type of medication change by your doctor and keep him/her in the loop on side effects you are having. Including supplements you are thinking of adding. There are some supplements that just don't mix good with antidepressants. You should be upfront with the doctor about how you are feeling. Always let them know about side effects. Most importantly it is your health so you deserve to have a say in your treatment plan. Don't be afraid to speak up if you are uncomfortable with something because it is your health.

I LOOOOOOOOOVE my psych, he is amazing, he came here on a "genius visa" and has done numerous studies and published over 30 peer reviewed research papers related to molecular biology/neurotransmitters (also my major in school which is cool!!) I started seeing him in March. The previous doctor I had (about 5 years, starting at 15) seemed to be clueless. I swear when I would come in and say I haven't been feeling well, she would throw darts at a board to pick what to try next! Finally after over 8+ combinations, changing doses, and little to no patient-doctor relationship to make me feel like my feelings were understood, I left. This new doctor also gave me my official diagnosis; my original psych diagnosed me MDD w generalized anxiety and when I told her I had been researching bipolar disorder and I feel like the symptoms match a lot of my experiences, she literally said "That could be, we could try something for that too" ??!!!! ANYWHO........... my new psych has been working closely with me to undo the mess my previous one caused, starting by stopping the SSRI and antipsychotic I was on, leaving me just with lamictal. We played around with the dose, and I personally cannot handle more than 200mg of that drug. I have had extremeeee crying spells, out of thin air, almost daily, for the last 2-3 weeks, and made an emergency appointment yesterday to see him as it was getting unbearable and messing with my mood at work. Because we know I cannot tolerate more lamictal, he prescribed me trileptal to take ON TOP of the lamictal, to increase my overall dose of mood stabilizers but avoid increasing the lamictal more. Has anyone else ever been treated with two drugs from the same class at the same time, and if so, what triggered your doc to try that and how did it work out for you? I feel like I am doing so well with my irritability, fatigue, and antisociality, it really just comes down to the crying spells being the most unbearable uncontrolled symptom currently. I just want to find something that works !!

Quoting the psychiatrist answer to the question. “Your premises are incorrect.
Mania is not caused by excessive dopamine, nor is depression caused by low dopamine.
Bipolar disorder is intrinsically different in its mechanism of action than unipolar, or major depression.
Our understanding of depressive illnesses is that they are genetically predisposed, and environmental traumas, life experiences, psychological losses and the like trigger them, and neurotransmitters are involved in the genesis of those illnesses.
The antidepressants we use to treat those disorders cannot correct the inherited genetics, nor remove the triggers to those illnesses, but aim to correct the neurotransmitter changes.
Bipolar disorder is a disorder similar to epilepsy, but instead of ion channels being disrupted in the motor cortex in epilepsy, the disruption occurs in the limbic system, resulting in mood swings.
Calcium and sodium channels are opened excessively, similar to what happens in seizures, and mood swings occur. As with treating seizures, we use medications to control seizures, such as Depakote or Lamictal, which closes the calcium channels, and stops the seizures, or manic episodes.
Lithium works by substituting for sodium, another ion channel actor. Lithium is just above sodium on the periodic table of elements, which means they share the outer electron valence shell, and can substitute for each other.
In bipolar disorder, lithium ions substitute for sodium, block the excessive channel transmission, and the mania subsides.
Too little release of Dopamine is involved in ADHD in the prefrontal cortex, and too much release with psychosis.
Too little release of dopamine in the substantial nigra, due to withered dopamine fibers, causes Parkinson’s disease.
In the periphery, dopamine is a vasoconstrictor, used in acute, severe blood loss.
Disorders of the brain are complex, and the specific mechanism of action, as well as the location, are crucial elements in understanding.
Lastly, as for mixed episodes, we believe it is a combination of several ions overflowing that are involved in mixed states in bipolar disorder, often needing multiple medications to stabilize the person.”(psychiatrist)
Is the answer the psychiatrist give out true and valid. Like is the science accurate?

Hey y'all. Long-time lurker, first time poster. As the title suggests, I am a 25 M with a diagnosis of Schizophrenia which began when I was 18 y/o. While I've suffered immensely from this illness, I am in a place now where I can confidently say that I am no longer sick. I just graduated with honors with a Bachelor's in computer science from an esteemed university. This post is going to be a very long one but I REALLY think that it's worth the read. A quick disclaimer, I have high functioning schizophrenia so I'm not sure if these tips would help someone with a more severe illness. Anyways, I'm gonna break this into four parts: Medication, Therapy, Supplements, and Lifestyle.
Medication
I have had trials with a total of six different antipsychotics, four different antidepressants, and two different mood-stabilizers. I understand that everyone responds differently to meds, but I'm just giving my two-cents here. I am borderline obsessed with neuroscience and how psych meds affect the brain so at least hear me out.
Antipsychotics
Clozapine - on this drug now (500mg). By FAR the most powerful antipsychotic that I've tried. Doctors rarely prescribe it because of a miniscule chance of a blood disorder and because it requires monthly bloodwork (doctors can be lazy too). Weak dopamine blocking properties (D2 receptor blockade is the mainstay of antipsychotic pharmacology) and weak 5HT2A antagonism (mechanism of all atypical antipsychotics). To give an idea, stimulants increase dopamine activity which can lead to psychosis and 5HT2A agonism occurs with psychedelics like LSD. Antipsychotics essentially do the opposite of stimulants and hallucinogens (grossly oversimplified) which can induce psychosis. Continuing, It is a chemical relative of benzodiazepines and I believe they share similar pharmacological effects. Benzos work on the GABA-A receptor (GABA reduces anxiety/excitation) and Clozapine has been shown to interact with the GABA-B receptor. (https://pubmed.ncbi.nlm.nih.gov/21753741/) If you have ever tried smoking weed under the influence of a benzo, you would know how effective it is in reducing the paranoia from THC. Also been shown to interact with the NMDA receptor which is NOT a mechanism of action of any other antipsychotic and may lead to its superiority in treating positive symptoms. It is a co-agonist at the glycine site of this receptor and increases its function. Going back to the stimulants and hallucinogens, dissociatives like Ketamine block the NMDA receptor and can induce psychosis. I am highly against using Clozapine only as a last resort. It should be first line treatment IMO. I feel stable on it without feeling numb or overly sedated. Yes, it is the most sedating antipsychotic, but there are ways to work around this. Anyways, that was long-winded so on to the next one.
Abilify - would recommend for less severe cases of the disorder. The least sedating/powerful but also the least effective. It is a partial agonist of the D2 receptor (every other antipsychotic is an antagonist). Essentially, partial agonists stimulate the receptor but not as much as an agonist and with not as much blockade as an antagonist. Pathological gambling is a known side effect, but I believe that any compulsive behavior can be a side effect (was ripping four Juul pods a day when I was on solely this drug) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700874/). Again, would recommend for people with minimal positive symptoms.
Risperidone - the most numbing of the previous two with much higher occupancy at the D2 receptor as an antagonist. Also much higher occupancy at the 5HT2A receptor. Based on my research, it seems to be the most commonly prescribed for first episodes. Definitely better than Abilify for positive symptoms but way worse for the cognitive and negative symptoms. Felt like a zombie on this one, but a stable zombie. Raises prolactin (hormone that rises in pregnant women) which can lower testosterone for men. Also, for some reason, whenever I ingested caffeine on this one I would get intense paranoia (not the case with Clozapine or Abilify). I THINK that this is due to D2 hypersensitivity (caffeine stimulates the D2 receptor which leads to its effects on wakefulness).
Halodol - wasn't on this one long-term but took it as needed while in the hospital. Is a typical antipsychotic (older) with higher occupancy at the D2 receptor than Risperidone (more numb). Would not recommend that anyone takes this med, unless you are trying to induce mental anguish.
Antidepressants
Lexapro - on this one now as well (20mg). SSRI with the most selectivity for the serotonin transporter of all of them. If you are unfamiliar with SSRIs, they increase the presence of the neurotransmitter serotonin in the synaptic cleft thereby increasing serotonergic activity in the brain. Serotonin is associated with feelings of well-being and contentment. As you all probably agree, the less stressed and anxious you are, the less likely you are to experience symptoms. Also good for OCD and social anxiety (commonly co-occur with schizophrenia) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769378/). Would definitely recommend (as I would for any SSRI). Only side effect is slightly less libido (ways around this also).
Zoloft - virtually same effect as Lexapro. Not much more to say.
Celexa - pro-drug to Lexapro which means that it is metabolized by the liver into Lexapro which is more potent. Don't know why you would take this over Lexapro because it requires a higher dose for the same effects.
Wellbutrin - was on this one in the past and recently convinced my doctor to prescribe it again (300mg). Completely different than the SSRIs and is in a class of its own. Blocks the reuptake of both dopamine and norepinephrine. Dopamine is responsible for motivation and drive (again, grossly oversimplified), and norepinephrine is responsible for focus and activating the sympathetic nervous system. You're probably thinking, "but dopamine is bad for schizophrenia, right?" and that's where it gets tricky. YES more dopamine leads to an increased chance of positive symptoms, but it also leads to less cognitive and negative symptoms. Would only recommend this drug if you've been stable for over two years (not worth the risk of a relapse). Definitely helps me get out of bed in the morning. Increased libido is also a plus.
Mood Stabilizers
Trileptal - sodium channel blocker which reduces neuronal excitation (similar to what GABA does). It's commonly prescribed for bipolar disorder which is a close-relative of Schizophrenia. Helps a lot with anxiety and is good for the more manic symptoms. Ehh, not sure if I would recommend. Not on it anymore.
Lamictal - on this now (200mg). Again, a bipolar med. Is also a sodium channel blocker but with a completely different chemical structure than Trileptal. Better for the depressive symptoms (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615936/). Also shown to be synergistic with Clozapine at the NMDA receptor and shows promise for derealization (again, very common with schizophrenia). Seems to help a lot.
Gabapentin - I know, I know, I said I was only on two mood stabilizers. That's partially true considering I've never had this one prescribed. A double edge sword. A calcium-channel blocker (similar to sodium-channel blockers) with a potential for addiction. Some doses it helps my paranoia, others it induces it. Always lowers anxiety. but also for some reason increases bizarre thoughts. A known side effect is dissociation. Not everyone would have the same response as me however. Wouldn't recommend this one to a friend.
Again, I'm not a doctor, but I hope that at least one of you can use this info to advocate for yourself with your psychiatrist.
Therapy
This one's is gonna be way shorter, lol. If you couldn't tell, I'm pretty obsessed with psychiatry and feel that I bring a unique perspective since I've actually taken the drugs. Anyways, moving on. I'm currently in therapy for addiction, anxiety, depression, and psychosis. I usually see one addictions counselor, a peer-specialist, and a normal therapist. I also sometimes do group therapy.
I would say that for me, the most helpful thing about therapy is hearing my thoughts out loud (I mean literally speaking them to another person). Sometimes when I'm delusional and actually hear the thoughts in speech, I start to question them more. Also, as opposed to more classic irrational thoughts, getting reassurance that my delusions aren't true actually helps me. Obviously not a complete fix, but I find that it helps.
Another thing I did with a past therapist was exposure therapy. Completely different than classic CBT (cognitive behavioral therapy). I have social anxiety and I worked with my therapist with exposures to elicit my anxiety and then watch it go down. One thing I did was, under the supervision of my therapist, ask a bunch of people on the street what city I was in (a ridiculous question, I know). Guess what? I did it, and I felt great afterwards. Made it easier to socialize at later points in time. Anything that helps social anxiety also helps schizophrenia.
With the addiction piece, I feel like the main perk of seeing someone regularly is holding myself accountable. I've had issues in the past with Adderall, weed, kratom, and phenibut. Whenever I have an urge to use, I think to myself, what will my addictions counselor say if I relapsed? Kinda stops me in my tracks, but again, not a complete fix.
Lastly, I feel like therapy, and group therapy specifically help me with my social skills. I actually had a group designated for helping social skills. Kinda off topic, but there is this thing called mentalism that is actually increased with psychosis and can be a great tool for socializing when harnessed properly (for another post).
So to sum up this section, therapy can help with:

• Challenging delusions
• Facing your fears
• Keeping you off drugs
• Improving social skills

Supplements
Another obsession of mine, lol. At one point, I must've been taking thirty of them (I cut back significantly). I'll only mention the one's that help the most because I could write a book on this.
NAC - the precursor to glutathione, the mother of all antioxidants. Drastically lowers inflammation which is a major player in pretty much every disease (https://pubmed.ncbi.nlm.nih.gov/23110331/). Stabilizes glutamate levels (major excitatory neurotransmitter) and reduces addictions and compulsions. Some users report anhedonia but this has not been the case with me. I do feel slightly more rumination when I go a day without taking it. Taking 2000mg
Ashwagandha - another one of my all time favorites. Works as an adaptogen that helps build your resilience to stress. IMO, the main mechanism of action is through increasing activity at the GABA-A receptor. Feels a little bit similar to a benzo and studies show that its anxiolytic effects are abolished with GABA-A antagonists (https://pubmed.ncbi.nlm.nih.gov/24117067/). Seems to help with social anxiety and delusional thinking. Lowers cortisol and raises testosterone in men. Taking KSM-66 600mg.
Melatonin - I take it every night. Pretty well-known to help with sleep. Pretty much everyone's circadian rhythm is thrown off due to blue light exposure at night and this pretty much fixes it. Helps me feel refreshed in the morning. I take 3mg extended release every night before bed.
Sarcosine - pretty popular supplement for schizophrenics. A glycine transporter inhibitor which blocks the reuptake of glycine and increases its concentrations in the brain. Like Clozapine, it is a co-agonist at the glycine site of the NMDA receptor. Uncertain whether it has an effect when taken with Clozapine. Seems to drastically improve negative symptoms in patients and may even reverse the damage of psychosis (http://www.schizophrenia.com/glycinetreat.htm). Stopped taking this one recently because I'm on Clozapine.
Pregnenolone - less commonly known. A neurosteroid with potent acute and chronic effects. Pretty much the precursor to every hormone in the body. Breaks down into allopregnenolone (extremely strong GABA-A positive allosteric modulator or increaser) and pregnenolone sulfate (activates NMDA receptors and antagonizes GABA-A receptors). I find it weird how these two metabolites have opposing effects, but I think of it as giving your brain more nutrients and resources to function properly, if that makes any sense. Seems to get rid of brain fog. 100mg daily.
Maca Root - energetic and helps with libido. Potentiates dopaminergic and nonandrogenic neurotransmission (similar to Wellbutrin). Helps libido. Increases anandamide in the brain, a naturally occurring cannabinoid that is sometimes called 'the bliss molecule' (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460372/). You've probably taken Tylenol before. Tylenol's main mechanism of action is increasing anandamide. Feel kinda similar tbh. Definitely increases my libido.
Nicotine - not even a supplement but a drug. No, do not smoke cigs or other tobacco products. Vaping is probably bad too. I use nicotine patches and nicotine gum. Proven to reverse hypo-frontality in the brain (less activity in the prefrontal cortex) (https://www.medicalnewstoday.com/articles/315446). Massive boost in cognition when I use it. Mimics the neurotransmitter acetylcholine in the brain which is responsible for memory. Increases dopamine without causing psychosis (kinda why the dopamine hypothesis is complicated). Yes, addictive, but I find that the benefits outweigh the cons.
Caffeine - again, another drug, lol. Shouldn't have to explain this one. Counteracts the fatigue of antipsychotics. I take the pills because they're way cheaper and easier to take. Helps a lot with the Clozapine sedation for me.
I could write summaries on another thirty supplements. If you even made it this far in my article, you're clearly committed to getting a grip on this disease. Alright, last section.
Lifestyle
The simplest section. I'm sure you've heard a million times, "exercise!", or "get enough sleep!" But doing even those two things can help dramatically.
Exercise - the most important thing about an exercise regimen is that you actually do it. I personally workout 5x a week and it is literally my drug of choice. You may have heard the saying, "if exercise were a pill, it would be the most popular pill of all time." I couldn't agree more. Cardio obviously helps lose weight and weight training helps build your muscles (who doesn't want to look good?) Despite being on Clozapine, which is notorious for weight gain, I have a very healthy BMI. Simple but hard to implement. If you have the money, I'd recommend joining a gym.
Sleep - again, an obvious one. Sleep in a dark room. Maybe keep a fan on or some YouTube video of nature sounds in the background to help you sleep. If you don't have to wake up at a certain time, I would say to get as much sleep as you need. Keep your phone/alarm on the other side of your bedroom so you have to physically get up to turn off your alarm. I also keep a caffeine pill right by my bed so I take it right when I wake up.
Sunlight - it's a myth that sunlight is bad for you. Obviously in excess, it can cause cancer, but that's only if it's excessive. It's such a strong mood lifter that it can even cause mania (https://www.treatmentadvocacycenter.org/fixing-the-system/features-and-news/4164-research-weekly-sunlight-and-bipolar-disorder-). Also helps with acne and wakefulness. I try to get 30min of sunlight a day.
Sauna - I 100% realize that not everyone has access to a sauna, but sauna bathing has improved my life by a lot. Potently lowers stress and anxiety and helps with muscle recovery. Again, anything that lowers stress is good for schizophrenia. The way I look at it, every time I use the sauna, I'm telling my body that I'm in danger (extreme heat that could kill you if you stayed in there long enough) and by leaving the sauna telling my body that I'm safe. It's like purposely introducing a stressor only to show your mind and body that you can actually handle it.
Cold Exposure - I belong to a gym with a cold plunge so this is slightly easier for me. Can be very painful, but the lingering effects are worth it. Kinda same idea as a sauna just with opposite temps. If you don't have access to a cold plunge (I'm assuming most of you don't) try finishing a shower with some cold water for 30 seconds.
Meditation - I'll admit, I'm pretty spotty with how much I meditate, but I do find that it helps when I do. Helps not getting caught up in the delusional thoughts by practicing just observing them rather than reacting to them. I personally just sit on a couple of pillows, set a timer for 7 minutes, and sit there with my eyes closed until the timer goes off.
Conclusion
I know, I know, probably the longest post of all time on this sub. I do realize that a lot of this takes money and that some people don't have enough. This took me a long time to write, but I would feel that it's worth it as long as it helps at least one person. If anyone has any questions, feel free to DM me. Peace.