Antidepressants good or bad?

My doctor wants me to go on duloxetine. Been extremely depressed for years and repeating my first year of Uni for the third time because I've been having trouble motivating myself to attend even one lecture. Don't really want to take meds but if things don't improve this year I've resolved to kill myself

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duloxetine mellowed me out pretty good. Before it I would go between sperglord bouts of anger to general apathy to wanting to kill myself. Once I went on it, I stopped wanting to kill myself and I don't rage as much. I have my off days, but after a day or two I'm usually back to normal and can function to a certain degree.
Though the side effects can be a bit annoying
>Lost most of my libido
>Have a harder time cumming
>Sweat more
Otherwise I think they're fine

Depends. Prozac gave me 10h long disassociation episodes. Whihc I enjoy, but sadly wagie gotta work.

Bad. They're basically chemical lobotomy. All of them have bad permanent side-effect from long-term use. Moreover, the response rate is approximately 30% for the usual conditions and there is no evidence for within-class switch improving chances. Worse, across-class switch has nearly no evidence, and less evidence the more trials are attempted.
While effectiveness can be improved greatly with the use of some adjuvants, i.e. in adjunctive therapy, this only applies to select antidepressents (including duloxetine, fluoxetine, escitalopram, and buproprion), and the adjunct drugs used are sometimes enough as monotherapies, i.e. the antidepressent isn't actually helping. Moreover, I posit that in any case where adjunctive treatment works, it's because a completely different treatment should be applied (typically using anti-psychotics).

Duloxetine is a little strange in that it is both an snri and an anxiolytic. snri's do not impact "anger" and it is not a mood stabilizer (like lithium is), but anxiolytics are known to have mood-stabilizing effects in low-serotonin conditions. It is likely you would have similar relief from being on benzos, such as clonazepam 5mg+, or THC extracts 5-10mg daily depending on tolerance.

Is it alone or in combination with Olanzapine?

So you're saying I shouldn't take duloxetine? I've been trying to fix myself without aid for the last 4 years and things have only gotten worse so I'm getting even more desperate. And since it's the NHS it would take months to see something like a therapist

Its weak feminine shit that won't solve any of your problems, you need to be less feminine not more
Don't try to take the easy way out, you need to realise you're suffering because your body is trying to tell you you're in a bad place.

Set some goals you want to complete and work towards them, get more healthy start eating right, stop defaulting to instant gratification and you will feel alot better.

Try it for a month, worst case scenario nothing changes and you just wasted a small ammount of time that would pass by regardless, best case scenario you actualise yourself.

>Is it alone or in combination with Olanzapine?
Alone. I suffer from severe ahedonia. I already disassociate normally. It just made the episodes worse. I was prescribed prozac by a GP because queues to get an appointment with a psychiatrist are in the months-long.

>So you're saying I shouldn't take duloxetine?
No. If you weren't on it yet I would tell you to try as many things as is practical given your current state of mind before going for it. Since you're already on it and you were lucky enough that it showed effectiveness, you shouldn't just quit outright. I'm saying you should look for ways to discontinue it 'eventually' while retaining chemical assistance to keep yourself 'mellowed out' as you say. The ultimate goal would obviously be not to have to rely on any drug if at all possible.

By 'things have only gotten worse', do you mean that duloxetine is losing effect? If so it would be a good time to try adding weed to this. Careful not to do too much weed, it's anxiogenic if you dose too high despite being anxiolytic when dosing low enough. Generally don't go over 20mg THC (note: THC, not total mass) no matter what. You can also look for benzos, but that's usually not as easy to find as weed. If you take enough to get the giggly-high, you should have a "glow" the next day where you feel fine and your emotions are in check.
If this happens, you're in business. You can go to a pharmacist for help weaning off the duloxetine. If you want a pharma/legal solution, ask your doctor for benzos, but they might be squeamish with the dose so you'll have to figure out what to do there.

If you mean that you remain controlled with the drug but your life is spiraling out of control, you need a different kind of help.

>If you weren't on it yet
I'm OP. As in I've been trying other ways to regain my composure in life but have only continued to flounder and fail. Something is wrong with my brain that isn't just some behavioural mishap. I was a really industrious and ambitious person before graduating highschool--I was learning piano, a langauge, studying hard, doing all the extracurricular stuff, going out ect.--but after slipup that invite idlness into my life I found myself unable to even get out of bed most days, finding even basic tasks beyond me. I started University and I didn't even attend a single lecture, I didn't meet anyone, I joined no clubs, I do nothing but sit in my small filthy room starving in my bed. My parents were concerned so I advised to attempt Uni again the fresh the next year. Thinking I would be more dilligent and active this time I start with more optimism but the same thing happened. I attended one lecture and not another, I could even force myself to pay my room bills even as I was getting late fees. I felt I not control over my own attention and impossibly lazy. Another year of university paid for and wasted. In a couple months I'm starting again, I fear the same thing will come to pass. I've tried all sorts of methods of fixing myself. I tried to go out and meet people, I tried eating healthier, but when you struggle to even get out of your bed it's hard to maintain even the smallest improvements. Small steps would be nice but I've been running backwards. My parents told me to that professional help would be in my interest so they put me on the phone with a doctor and he told me that i'm depressed.

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take your HAPPY PILLS user

After a few sessions and some protest about antidepressants on my part he tells me that something like a therapist would take months to get an NHS appointment with and that's where we are now. Tomorrow I'm seeing him again and we're to discuss whether I want to start duloxetine. I don't even feel like a person anymore, 3 years of sitting in my room learning nothing, doing nothing: I can feel my brain rotting from inactivity. I do nothing but idle and consider suicide. Sorry for the novel, but that's the whole story--my life is quietly spiralling. Second post for word limit

>or THC extracts 5-10mg daily depending on tolerance
I use THC recreationaly and find that 10+ MG will render me pretty much unable to function in any meaningful sense other then vibing out with some music. I couldn't work while on anything around 10 MG, but in all honesty: It's working fine enough for me being on low dose of Duloxetine and I don't need to jump through the hoops to get on something controlled like benzos.

Try asking for the formulation with olanzapine (it's sold by eli lilly under the name Symbyax).
If that works try to change to escitalopram + aripiprazol. If that fails, remove aripiprazole and add clonazepam. If that still doesn't work, back to pure Symbyax you go.
The reason you'll want to change is that olanzapine can increase your risks of sudden cardiac death, heart failure, and life-threatening infections.
Normally you should be seeing effects right away as those drugs act very fast. You could find relief on the same day you swap to those formulations, so if there's no improvement after 2 weeks you can move on to the next step. Your pharmacist will be able to give you more precise instructions. When changing antidepressent (e.g. from fluoxetine to escitalopram), it can take 8+ weeks to measure effects, as you're surely aware.

If you explained that you had dissociative episodes before, whoever gave you fluoxetine is a certified moron. Could have chosen literally any other ssri instead (not that you need an ssri, you need either an snri or an anti-psychotic or both).

Been on and off for a decade. Prozac and Topiramate atm. General feeling of blank, nothing and apathy. I admit it beats swings of manic panic and sudden urge to drive a knife into things.

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LMAO. Neither good or bad, they are useless because they are placebos that only work for 20% of patients, and that is arguable. Not to mwntion the secondary effects

>I use THC recreationaly and find that 10+ MG will render me pretty much unable to function in any meaningful sense other then vibing out with some music.
That's good. 10MG is the 'beginner' psychoactive dose. For people who respond favorably to it, reducing the dose to 5MG gives usually no psychoactive effect but provides the same relief as 10MG does.
However, if you were already using before you went on duloxetine, you are not one of these people.
You can see with your doctor what other options he would be willing to give you and try those out if you feel like it.
If you're feeling adventurous, there are ketamine clinics in the UK.

I'm not psychotic, I think. I just lose the will to move or do anything, then I retreat inside my mind and I lose track of my senses, not because they aren't there, but because I'm hyperfocused inside my head. Sometimes I lose track of time in this state. The more depressed I get the more I retreat inside my mind. Prozac just made it just longer.

MAOIs are bretty gud. Just watch your diet

Have you tried therapy? Sounds like you should do that before you look into chemical assistance.
Do try drugs before you try anti-depressants desu senpai. If you've tried all you could, or all you could handle, then go for anti-depressants.
Though they only work 30% of the time, that's still better than 0% isn't it?

It's funny that you say 10mg is the "Beginner" dose, but I've gone as high as 40 MG and the high/psychoactive affects didn't feel any more intense. And I get what you're saying and if I feel the need to offset my dose with THC I'll cut it down to 5mg, but as of right now:
once a day 30mg of Duloxetine and about 2-3 times a week of 10-20mg of THC before bed seems to keep my mellow and functional

It can be trial and error. I've been on escitalopram, fluoxetine, and fluvoxamine, which all had no effect on me. Next was buproprion which made me get very suicidal. Now I'm on mirtazapine which hasn't taken effect yet other than making me drowsy.

Although they're called anti-psychotics, they are used for anxiety, insomnia, depression, and more. Dissociation is a common feature of schizophrenia, various stress disorders, bpd, depression and so forth. The formulation with olanzapine is a pretty obvious match, and it would still be a match if you so much as felt anxious talking to people which, given you/re on Any Forums, I assume is the case.
Fluoxetine is known to be able to worsen dissociation episodes caused by dopamine disregulation. The only ssri that has solid evidence of an effect for dissociative disorder based on meta-analysis of RCTs is Paroxetine. Another drug that can help is Naloxone.

MAOIs are fucking awful, they're basically never used anymore because virtually nobody complies with treatment due to horrid side-effects.
They're more effective than ssri's and snri's in very specific cases though.