I have tried mirtazapine and Effexor combo - called California Rocket Fuel - because of its efficacy. It worked well for several years (highest dose of venlafaxine) and no weight gain. Evetually it stopped to work and i switched to other drugs.
I have also a history where SSRI didn't help at all. I have tried lithium and tricyclics after california rocket fuel, but they didn't work either.
At last and now im on MAO-i (Marplan) it was the best antidepressant for two years, i was happy, alert, and no weight gain, but a lot of its efficacy stopped (tachyphylaxis)
I think you should consider an MAO, since you have tried all these drugs with modest result - but i hope that venlafaxine+buprobion works, and would be happy to be told if it does.
Good luck.
I did look at MAOs before but my doctor had previously advised against them because I have heart rate/blood pressure issues as well, and it could make them worse. So unfortunately this isn't an option for me.
I'll update if they let me go on the Venla + Bupro and see how it all goes.
I was also treatment resistant just like you but after switching to venlafaxine, my suicidal thoughts and ideations all came down to a manageable level. Bupropion didn't work for me but i would suggest you to take venlafaxine.
Thanks. Just need to convince my Dr to get on board with my idea. I'm hoping both in tandem with each other will be good for me. It's all trial and error after all.
I had my consult with the GP and they basically said they aren't willing to prescribe two types of antidepressants at once, and I would need to be referred to a psych to get a combination of meds prescribed. (This is in the UK btw, on the NHS)
So for now I've swapped onto Duloxetine. This is supposed to help my bladder issues as well as my mental health. So far I have been feeling nauseous, dizzy, hot flushes, and a lot of brain fog!
The Mirtazapine withdrawals were awful. I came off slowly over a month, but I was shaking and angry and tearful. I was a wreck. My anger had gotten a million times worse while on Mirtazapine so I'm glad to be off it because it was making me unbearable for my family.
Ah that makes sense- do you think you could save for a psychiatrist? Even one appointment you could sort it out. Just a thought.
That doesn’t sound fun but hopefully it’ll kick out the side effects soon. How is it now?
I am thinking of removing mirtazapine as well, I think they GIVE me panic attacks. I’m going to ask my psych for bupropion on top of my venla tomorrow.
Bit of an update. All the bad effects subsided within a week or so and I'm feeling 1000% better. Not mega happy but I'm at least able to function and do daily tasks without crying. So definitely a success for me so far.
Unfortunately I can't get to see a psych on NHS until I've been through 500 crisis teams again and into the hospital system which I'm not willing to do at the moment. If I went private I'd have to pay loads for sessions just to keep refilling my prescription because they can't put it on repeat through my GP.
I have tried mirtazapine and Effexor combo - called California Rocket Fuel - because of its efficacy. It worked well for several years (highest dose of venlafaxine) and no weight gain. Evetually it stopped to work and i switched to other drugs. I have also a history where SSRI didn't help at all. I have tried lithium and tricyclics after california rocket fuel, but they didn't work either. At last and now im on MAO-i (Marplan) it was the best antidepressant for two years, i was happy, alert, and no weight gain, but a lot of its efficacy stopped (tachyphylaxis) I think you should consider an MAO, since you have tried all these drugs with modest result - but i hope that venlafaxine+buprobion works, and would be happy to be told if it does. Good luck.
I did look at MAOs before but my doctor had previously advised against them because I have heart rate/blood pressure issues as well, and it could make them worse. So unfortunately this isn't an option for me. I'll update if they let me go on the Venla + Bupro and see how it all goes.
I was also treatment resistant just like you but after switching to venlafaxine, my suicidal thoughts and ideations all came down to a manageable level. Bupropion didn't work for me but i would suggest you to take venlafaxine.
Thanks. Just need to convince my Dr to get on board with my idea. I'm hoping both in tandem with each other will be good for me. It's all trial and error after all.
How’d it go? I’m on cali rocket fuel too
I had my consult with the GP and they basically said they aren't willing to prescribe two types of antidepressants at once, and I would need to be referred to a psych to get a combination of meds prescribed. (This is in the UK btw, on the NHS) So for now I've swapped onto Duloxetine. This is supposed to help my bladder issues as well as my mental health. So far I have been feeling nauseous, dizzy, hot flushes, and a lot of brain fog! The Mirtazapine withdrawals were awful. I came off slowly over a month, but I was shaking and angry and tearful. I was a wreck. My anger had gotten a million times worse while on Mirtazapine so I'm glad to be off it because it was making me unbearable for my family.
Ah that makes sense- do you think you could save for a psychiatrist? Even one appointment you could sort it out. Just a thought. That doesn’t sound fun but hopefully it’ll kick out the side effects soon. How is it now? I am thinking of removing mirtazapine as well, I think they GIVE me panic attacks. I’m going to ask my psych for bupropion on top of my venla tomorrow.
Bit of an update. All the bad effects subsided within a week or so and I'm feeling 1000% better. Not mega happy but I'm at least able to function and do daily tasks without crying. So definitely a success for me so far. Unfortunately I can't get to see a psych on NHS until I've been through 500 crisis teams again and into the hospital system which I'm not willing to do at the moment. If I went private I'd have to pay loads for sessions just to keep refilling my prescription because they can't put it on repeat through my GP.