Discussion Anyone else treatment-resistant?

[stilhavinightmares]

A relatively newer medication called Auvelity. (Brand name)

Thanks for sharing! I hadn't heard of this one. I had a feeling it involved bupropion though (Wellbutrin), I just had similar symptoms with an increase of Wellbutrin. Siiighhhh lol

 

[NoLightRemains]

Thanks for sharing! I hadn't heard of this one. I had a feeling it involved bupropion though (Wellbutrin), I just had similar symptoms with an increase of Wellbutrin. Siiighhhh lol

The sad thing is I took Wellbutrin YEARS ago and had no luck with it. I guess I just sort of forgot that it didn't help at all. Makes sense that a combination medicine with it really messed me up for a solid week. Oh well, never again!

 

[stilhavinightmares]

The sad thing is I took Wellbutrin YEARS ago and had no luck with it. I guess I just sort of forgot that it didn't help at all. Makes sense that a combination medicine with it really messed me up for a solid week. Oh well, never again!

It's always worth trying again! Our bodies change so much. If I didn't re-try meds that haven't worked in past years, I would have barely any meds left to try. But I hear you, and I commend you for trying it because I know you know how much it sucks ass.

 

[JM2RXA]

I've tried countless first line, second line, third line, whatever off label and more that's been prescribed.

I found Pregabalin to be amazing as an anxielytic, but nothing touches my mood.

My newest addition is Sodium Valproate (Depakote) but aside from withdrawal symptoms I see no therapeutic benefit from any of them.

Therapy I've had mixed results with, I find that the likes of CBT are useless in my case and I'll regularly point out that a safety plan only works if you want to keep yourself safe and follow it.

Ultimately, therapy is only ever going to be an immediate short term success whereas what I need is long term.

There has been discussion about ECT but it would require me being an inpatient because of the anesthetic and me living alone, something that they aren't prepared to admit me for at the minute.

 

[NumbItAll]

15 years and counting of crippling depression. Antidepressants ranged from ineffective to catastrophic (I'm too traumatized to keep trying new ones). Therapy never changed anything. I've made some lifestyle improvements over the years but nowhere near enough. I guess things technically have "gotten better," but I'm still waiting for it to be "worth it." It is well past the point of delusion to think that's actually possible though, so I'm basically rotting for no reason.

 

[d3c96524be95]

I've also been under lots of different medications over the last 15 years (SSRIs, SNRIs, TCAs, antipsychotics, BZDs, antihistamine, and other anxiolytics …). Only anxiolytics (particularly BZDs) had a positive outcome for me as they indeed helped my sleep a bit and made me feel slightly less anxious, but you have to be cautious with BZDs as they turn out being counterproductive in the long run (because they may induce dependence and tolerance, or even worsen depression symptoms). They're not that different from recreational drugs.

However, any treatment meant to fight depression varied from very annoying to completely unbearable for me. They only worsened my quality of life (which was already quite poor), and I can only relate to what @NumbItAll already said. Given the terrific experiences I underwent with some of them (especially one derealization episode which led to the greatest fear I have ever experienced in my life), I am very reluctant to try out new ones. As you're supposed to see the first positive effects after 2 to 3 months in treatment (while adverse events begin after just a few days), your doctors will be very prone to keep on the treatments regardless on the adverse events you undergo. They'll constantly reassure you that the side-effects will fade and that you'll get better soon. It's only after about 6 months that your practitioner will acknowledge that the treatment is indeed not effective and they'll try to substitute it or add new ones. From that point, you're up to 6 more months of suffering. And so on…

But IMHO there are more issues with those treatments:

• They're usually associated with withdrawal symptoms, which means you cannot abort them whenever you're bored that your doctor just doesn't care.
• Some side-effects can continue months or years after you've stopped the treatment. It's even documented that some men who took SSRIs for extended period of times never fully recovered their sexual functions. As far as I am concerned, I started experiencing anorgasmia soon after starting Escitalopram and it lasted at least two years after I stopped. It's definitely better now, but I'm not even sure I have completely recovered yet, 5 years later.
• Some of the side-effects are considered usual symptoms of depression. Consequently, my psychiatrists told me countless times that some symptom S (which coincidentally began just after starting their medication) was in fact due to the depression and not to the medication. This is utterly irritating and demeaning.

TBH, I suspect more and more that antidepressants are not very helpful against depression at all, not just for me or a small subset of unresponsive persons. SSRIs and SNRIs were initially sold by pharmaceutical companies under the unproven claim that depression was due to a chemical imbalance in certain neurotransmitters, yet decades later this theory is still not backed by any strong scientific evidence. SSRIs and SNRIs in depression perform barely significantly better than placebos (some studies even suggest that there is no statistically significant difference with placebo). I'd easily argue that the efficacy is mostly contextual at this point and can be explained by many different factors unrelated to any intrinsic effect (such as publication bias, amplified placebo effect, or the fact that the scales used to measure depression such as HRSD are inherently contextual, meaning that pretty much any contextual change (such as a chemical imbalance induced by a drug in your brain) could affect positively or negatively your score at such test while not profoundly changing your state of mind). Moreover, the fact that doctors often need to combine lots of different molecules and keep treatments going for months "until they're effective" (in spite of the lack of scientific evidence) are huge placebo redflags to me. Those are very common fallacies used in pseudo-sciences and pseudo-medicines.

Sorry, that first message was way too long and opinionated. BTW, I'm not encouraging anyone to not try or to stop their medications. Interpret this as: hey, if it doesn't work, it's probably not your fault. Maybe you're just less suggestible than the average person.

 

[NumbItAll]

I've also been under lots of different medications over the last 15 years (SSRIs, SNRIs, TCAs, antipsychotics, BZDs, antihistamine, and other anxiolytics …). Only anxiolytics (particularly BZDs) had a positive outcome for me as they indeed helped my sleep a bit and made me feel slightly less anxious, but you have to be cautious with BZDs as they turn out being counterproductive in the long run (because they may induce dependence and tolerance, or even worsen depression symptoms). They're not that different from recreational drugs.

However, any treatment meant to fight depression varied from very annoying to completely unbearable for me. They only worsened my quality of life (which was already quite poor), and I can only relate to what @NumbItAll already said. Given the terrific experiences I underwent with some of them (especially one derealization episode which led to the greatest fear I have ever experienced in my life), I am very reluctant to try out new ones. As you're supposed to see the first positive effects after 2 to 3 months in treatment (while adverse events begin after just a few days), your doctors will be very prone to keep on the treatments regardless on the adverse events you undergo. They'll constantly reassure you that the side-effects will fade and that you'll get better soon. It's only after about 6 months that your practitioner will acknowledge that the treatment is indeed not effective and they'll try to substitute it or add new ones. From that point, you're up to 6 more months of suffering. And so on…

But IMHO there are more issues with those treatments:

• They're usually associated with withdrawal symptoms, which means you cannot abort them whenever you're bored that your doctor just doesn't care.
• Some side-effects can continue months or years after you've stopped the treatment. It's even documented that some men who took SSRIs for extended period of times never fully recovered their sexual functions. As far as I am concerned, I started experiencing anorgasmia soon after starting Escitalopram and it lasted at least two years after I stopped. It's definitely better now, but I'm not even sure I have completely recovered yet, 5 years later.
• Some of the side-effects are considered usual symptoms of depression. Consequently, my psychiatrists told me countless times that some symptom S (which coincidentally began just after starting their medication) was in fact due to the depression and not to the medication. This is utterly irritating and demeaning.

TBH, I suspect more and more that antidepressants are not very helpful against depression at all, not just for me. SSRIs and SNRIs were initially sold by pharmaceutical companies under the unproven claim that depression was due to a chemical imbalance in certain neurotransmitters, yet decades later this theory is still not backed by any strong scientific evidence. SSRIs and SNRIs in depression perform barely significantly better than placebos (some studies even suggest that there is no statistically significant difference with placebo). I'd easily argue that the efficacy is mostly contextual at this point and can be explained by many different factors unrelated to any intrinsic effect (such as publication bias, amplified placebo effect, or the fact that the scales used to measure depression such as HRSD are inherently contextual, meaning that pretty much any contextual change (such as a chemical imbalance induced by a drug in your brain) could affect positively or negatively your score at such test while not profoundly changing your state of mind). Moreover, the fact that doctors often need to combine lots of different molecules and keep treatments going for months "until they're effective" (in spite of the lack of scientific evidence) are huge placebo redflags to me. Those are very common fallacies used in pseudo-sciences and pseudo-medicines.

Sorry, that first message was way too long an opinionated. BTW, I'm not encouraging anyone to not try or to stop its medications. Interpret this as: hey, if it doesn't work, it's probably not your fault. Maybe you're just less suggestible than the average person.

A lot of great points here especially about side effects and withdrawal. Honestly the term "side effect" bothers me sometimes because if a drug is causing horrible misery then that's more of an "effect" than a "side effect." Withdrawal is barely even acknowledged and I think a lot of psychiatrists don't know how serious it can be. It even has its own fancy clinical term: "discontinuation syndrome" to distinguish it from non-approved drugs. The guidelines are usually that it lasts a few weeks and is "self-limiting" even though it can last months or even years and be completely devastating in severe cases. But of course that's just a "relapse" even when it's brand new symptoms that are unique to the prescribed drug.

As for efficacy, I find this analysis to be interesting:

• Without antidepressants: About 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks.
• With antidepressants: About 40 to 60 out of 100 people who took an antidepressant noticed an improvement in their symptoms within six to eight weeks.

In other words, antidepressants improved symptoms in about an extra 20 out of 100 people.

If that holds true then I'm glad people are being helped, but I'm not impressed by a 20% success rate considering all the risks involved. It also means 40% will continue taking antidepressants based on placebo and potentially subjecting themselves to side effects and/or future withdrawal effects for no reason. This is also showing efficacy over a short term (six to eight weeks); it's not really clear how antidepressants hold up over a longer term. Finally, psychotropics are prescribed recklessly on a trial-and-error basis with seemingly no regard for risk and pure tunnel vision on a pharmaceutical solution. If psychiatrists actually knew how they worked, they could test for a chemical imbalance or whatever and prescribe the correct thing to treat it, but of course that was always nonsense. I have heard of some kind of blood test to gain a better idea of what might work, but I have no idea whether there's any legitimacy to that.

 

[lionetta12]

"Treatment resistant" here refers to someone who has tried multiple treatments (especially medications) for mental illness but has not seen improvement. (It is not the same as refusing or resisting treatment.)

I have treatment-resistant depression. I've tried just about everything under the sun. Starting this thread to see if I can connect with anyone else in a similar situation. I know well it's a shitty place to be in.

It's been confirmed for me by several psychologists and doctors, but I'm still trying to recover one last time. I'm feeling alright so far, struggling a little due to my broken toe at the moment, but trying to keep my spirits high and to fully recover from wanting to suicide, slow and steady.

 

[your pathologist]

Treatment resistivity has been listed on my psych ward paperwork before.
After 10+ antidepressants
5+ mood stabilizers
And 4 or so Antipsychotics.
I have Bipolar 1 with Psychotic tendencies.
They even tried Electroconvulsive Therapy.. which made my memory so bad i struggled to read and retain anything and was confused about memories and personality related likes/dislikes.
In the State i live in [USA] they offer ECT when all other therapy is inconclusive.
I currently participate in psychotherapy and medicine manipulation because ive been told i will always need medications to regulate my mental illness.
I fluctuate between severe depression and alcohol abuse.
I guess i still qualify as treatment resistant.

 

[JuliaOnTheNet]

My post is about medication for Depression Treatment.

I've tried therapy and 4 different antidepressants for years, they either didn't help or helped at first but got less effective while side effects stayed which led me to quit them. I also got cut off my mirtazapine prescription when I was at the height of my drug abuse and once I ran out ( I didn't manage to taper) I had 4 weeks of withdrawal from being on 45mg Mirtazapine a day.

Withdrawal wasn't as severe as from drugs like opioids, but it nethertheless was bad and I drank a lot to compensate during it.

Getting off heroin and on Substitution with Suboxone helped me great for a month, like with everything else this faded away. I'm still on it and it'samazing at keeping me clean but yeah.
When that wore off I decided to do Ketamine for DIY treating my SI and Depression and that really helped me from the second dose onwards.

I'm 70kg and I started of with 50-60mg intravenously every 4 days. Then after a few weeks I changed it to every 5 days and after 1.5 months I realised putting it in my veins is dangerous and stupid and I switched to intramuscular. It was really helpful, I had a more positive state of mind most of the time, I had energy to get stuff done which I lacked and most importantly it allowed me to deal with difficult stuff without instantly sinking into despair, SI and self-pity.
My family noticed me doing better as well, which in turn encouraged me as well as they've started being happier to see me. My mom now hugs and kisses me everytime I visit her :)

As with everything the effects of Ketamine also dulled down but it was considerably better than before I started doing it even after 2 months of use and most importantly I have no side effects following the effects of K wearing of. I inject it and feel woozy for about 60-90 minutes and after 3 hours I'm completely sober and I can't see side effects in the following days.

I accidentally threw all my K down the toilet a few weeks ago, and no surprise my depression and SI returned to how it was before, maybe a tiny bit better since I discovered this site. Today my letter is gonna arrive and I really hope it will help me like before

Below I have therapy recommendations for spravato, a ketamine nasal spray medication. I translated it to english just now

 

[booplesnoot34]

Me. I'm actually on my way this moment to start my first transcranial magnetic stimulation (TMS) treatment for my depression. I'm not allowing myself to get my hopes up. They said it doesn't work on trauma-linked depression and if it works at all, it'll only be a moderate reduction of symptoms. I have accepted that I will never get "better." If this doesn't work at all, though, there is no hope left of even reduction.

 

[goodnightmiku]

I am "treatment resistant" as well. I'm doing ketamine treatment in march for the second time. I'm sorry you are dealing with this i know its hell being treatment resistant. I wish you luck and I'm sending hugs.

 

[letmegetout]

Me. I'm actually on my way this moment to start my first transcranial magnetic stimulation (TMS) treatment for my depression. I'm not allowing myself to get my hopes up. They said it doesn't work on trauma-linked depression and if it works at all, it'll only be a moderate reduction of symptoms. I have accepted that I will never get "better." If this doesn't work at all, though, there is no hope left of even reduction.

Please let me know how you get on with TMS im waiting for a start date for rtms but I'm not holding much hope
I'm classed as having TRD, I've tried SO many medications, different therapies, I'm having therapy now and still trying different meds but nothing is helping and I'm waiting for rtms. I also applied for ketamine and VNS trials but haven't heard back yet

 

[letsmokerr]

Wrong subforum with this attitude buddy.



same here. Have tried out regular therapy + antidepressants and it didnt work.
You tried ketamine or "regular" psychedelics like psylocibin yet?
It seems to help 70 - 80 % with TRD.

"Wrong sub forum with this attitude" read the fucking website name

 

[fuqed]

exercise is the best thing for depression in my opinion and everyone wanting recovery could benefit from putting whatever you have on and walking around, doing whatever exercise you want start sweating. i need to exercise more and if anyone wants to pm id be happy to have a accountability buddies and talk about whatever

 

[sufferingextremely]

I intensely want to die for at least some portion of every single day. There is no treatment that will fix me. No such thing exists. I have been mercilessly abused by the most powerful people on earth. It has handicapped me, broken my brain, destroyed my health, murdered my soul, and crushed my spirit. The really sad thing is that the condition that I'm currently in is a big improvement from where I was before, at least psychologically. My physical health is going down the tubes faster and faster, and I'm becoming a vegetable at a fast pace.

 

[The Eeyorish One]

I've gone through basically all the meds, therapy, etc for depression so yeah, same boat there. Anxiety was a relatively easy fix for me though. Buspirone basically cured me of my GAD.