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  • Q&A with Australian Health Practitioners

    Changing from SNRI to SSRI please help

    I had a major breakdown last year in august and since then my psychiatrist has been trying to find the right meds for me. I have tried 3 types of SNRI effexor xr 300mg pristiq 50mg and currently Im on cymbalta 180mg. None of them work for me cymbalta is the only one I noticed a positive change but it has stopped working and now I suffer from extreme fatigue.
    My psych wants to switch me to Lexapro next week but I haven read many positive reviews about this drug.
    I'm just wondering if the snris don't work for me will i have a better chance with the SSRI ???
    Please help me I am at the end of my teather with meds
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  • 1

    Agree

    Anthony Berrick

    Psychologist

    I'm sorry to hear that you've been struggling and haven't had great results from your medication so far. It may be that switching to an SSRI makes a difference - everyone responds differently to different meds - unfortunately, you probably won't know until you try it.

    Perhaps you could talk to your psychiatrist or GP about seeing a psychologist as well. If you haven't had much success with medication alone, it might be time to take a different approach. The research indicates that receiving psychological therapy for depression, in addition to taking medication, produces the best results. In particular, psychological therapy appears to be better at preventing relapse than medication.

    All the best.

  • 1

    Thanks

    lane

    Healthshare Member

    I have had a similar experience, although I changed in the end from SSRI to SNRI. I have tried Cymbalta in the past & exactly the same thing happened to me, positive changes for a bit and then it seemed to stop working. While I was on Cymbalta had really bad fatigue. Before trying SNRI's I was on Lexapro for 6 yrs or more. I didn't find it made things a lot better but it helped when I was taking the maximum dose. One good thing about it was it seemed to have way less side effects than others & didn't cause fatigue, although did cause increased sweating/night sweats. Have generally found SNRI's more helful with depression. Pristiq wasn't doing much for me at first, but since it's been increased up to 150mg is definetly better.

    I have been really fatigued for years & was always getting constant colds/infections. A Dr checked my Vitamin D level & it was drastically low! This can cause or worsen depression, fatigue and also cause/worsen a lot of other health problems, as being low really affects your immune system. Ended up being put on a high dose of Vitamin D for months. Now my level is optimal, i've stopped getting colds/infections, feel less fatigued & has helped depression. Would definetly suggest asking to get yours checked if you are indoors a lot. Going out in the sun more has helped my mood too!

    I've had major depression for more than a decade. Have found that it takes a real combination of approaches together to improve things. A supportive Psychologist who you develop trust with is probably the best thing. Medication helps as well. Having a good support network e.g helpful friends and family goes a long way. I didn't have this so joined groups on www.meetup.com Getting out to do fun, social things & meeting nice people, even when i felt the worst, has probably been the most helpful of all. Also, finding hobbies i enjoyed, especially ones with excercise like dancing has lifted my mood a lot.

    Also noticed diet played a role in how bad or good i felt. Eating more of the healthy fats, like salmon fish, avocados, olive oil etc helps the brain, which helps medication work better. Eating bananas when your feeling low helps a little bit.

    But yeah, I think it really takes a combination of approaches to help things. I hope you end up finding the right meds and that things improve for you :)

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    I think that matching the “right” anti-depressant to the “right” person is more of an art than a science. In my case the first one that I was on was, for me, worse than useless (bad suicidal ideation) but what I am on now is, for me, great.

    I strongly endorse Anthony's suggestion about seeing a psychologist as well as taking medication.

    There is good evidence that a combination of those approaches is often more effective than either is on its own (for sure that has been my experience).

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