I found this chart on reddit some time ago, I thought to repost it here as well
I did a bit of searching but I don’t really understand what QTc prolongation is. Can anyone help me understand?
Escitalopram and Trazodone here. Out like a light on the latter. Only way I can function.
I’m glad Buproprion has few side effects from this chart.
However, for those considering it, here’s some missing side effects:
- Can increase libido. (A lot.)
- Can reduce weight. (A lot.)
- Can reduce your appetite/eating. (A lot.)
I’m not saying these are pros or cons. Each person should assess how these side effects will affect their own situation.
I tried many of those with no success, until tried Duloxetine and the response was optimal. Each persons has different reactions.
My wife tried fluoxetine (Prozac), and it really impacted her libido and weight gain. She was also very drowsy, but that’s not listed. She’s now on bupropion (Wellbutrin) and is just living her best life. We were late 20’s when she started taking it so the libido impact is super important to us. The biggest thing she says about Wellbutrin is that it can cause a little irritability with alcohol, and she’s glad she didn’t start that at the same time as adderall since it’s kinda the same.
Needs a column for “makes you feel like you are Being John Malkoviching as you linger behind your own eyes and watch another version of yourself interact with the world while being confused about who is actually controlling your vessel”, and put Bupropion at a 12.
That… explains a lot about a few months of my life
That shit is trippy as fuck to me, and not in a good way. More of a Twilight Zone sorta way.
I took Bupropion exactly once, and that day happened to coincide with the day of a first date. There was not a second date. I’d say something to her, but it wasn’t me, it was the “me” who was standing about three feet in front of me. I swear to Cotton Eyed Joe I could see the back of my own fucking head.
I didn’t get it nearly that acutely, but I made several stereotypical “crazy person sketches” of my view through my glasses with all the visible objects being written words instead of objects, trying to convey how lifeless and disconnected I felt from my own sensory input
a few years later I learned that’s called “dissociation” and it’s not supposed to happen 🫠
Duloxetine made me really tired. Fatigue to the deepest level. I tried for two months but did not ease, had to switch back to sertraline. Any anecdotes of similar? Anyone find a good one? Was trying to get off sertraline due to weight gain slowly over a long time.
Bupropion is interesting here. I’ve been on and off since I was literally a child. Last go-round I was on Effexor, Wellbutrin, and Adderall. Gained 40 lbs but I’m still not sure if that was the medication or I was on the medication because of life stress and it was the life stress. Would love to see more of these charts, I think it’s really well laid out and easy to read and compare.
If y’all have had really bad side-effects look into pharmacogenomic testing, it can help rule out bad medicines before you try them
I had one done a while ago and it marked a ton of medicines that I had already tried, (and had bad effects from) and a bunch I hadn’t tried yet. Since then, I’ve had much fewer bad experiences
notes
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the one I did had a specific brand name but I don’t remember what it was. (It was a while ago) I’m pretty sure this is what it was though
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you might have to remind your doctor about it when they’re prescribing medications, this still isn’t very well known afaik
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this isn’t sponsored/paid/other bullshit, this is an actual recommendation (though I felt like one of those ‘ask your doctor if !@#$ is right for you’ american commercials the entire time writing it)
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Had a doctor tell me I should never feel the antidepressant. Should be a background thing. Thought that was good advice.
Setraline leveled me the fuck out.
It’s kinda funny how much medicines’ effects can vary from person to person, I tried sertraline and had absolutely no difference, whereas my mother and my sister take it and it works for them
Seems to be missing the entire MAOI class (moclobemide, selegiline, phenelzine, tranylcypromine, isocarboxazid), and most tricyclics (clomipramine, imipramine, nortriptyline, et al)
Is this chart actually used in prescribing patients? I find that concerning. I have abnormal metabolism on several of my CYP enzymes, plus I have other medications that are ligands of them as well.
For instance, there are people who have multiple gene copies of rapid metabolizing enzymes. They may not get any side effects, but may also not get any benefit.
An intermediate metabolizer may get a better response at lower doses and not have to worry about side effects at all.
Compared with someone who has two inactive copies of the primary metabolic enzyme, they may end up with significant side effects and no benefit at low doses.
The only way to know your metabolism is genetic testing. (Which they have studies for, and some insurances cover).
Can confirm, bupropion causes insomnia.
I sometimes have to take nighttime benadryl to help me sleep.
Been on it consistently for over a decade now and have always been funky with sleep. I started back in undergrad when the pressure of life left me spiralling out of control, and have since always thought I was just a weird sleeper.
I have insomnia semi often, usually anxiety-induced, but I’ve never thought that it could be the bupropion directly.
Very curious, and good to know.
An off label use for Trazadone is as a sleep aid. At doses under 150 mg it doesn’t really work as an antidepressant but will make you drowsy. I’ve been prescribed it before as the first step before Ambien
We have it for our dog. We got it first when she was spayed and needed to chill out in order to not rip stitches and now we have it to give before stressful situations (guests, vet, etc). It definitely makes her more tired, but she will still fight through it to be crazy.
So I have never had depression but I am aware that Sertraline is probably the most common. Is there some higher rate of effectiveness it has over the less alternatives with less side effects? Is it just that it’s cheaper?
The issue with mental health and medications is that different root causes can create different symptoms in different people, and different medications have different effects in different people. The understanding of what those root causes even are is very limited, let alone trying to figure out what the root causes are in a specific person.
We know that certain medications have certain effects on symptoms, generally speaking, but identifying which one, at which dose, suits that specific person with a collection of reported symptoms that look like depression or anxiety or whatever, often in combination, is trial and error.
Of course, in the US, where healthcare is “fuck you, I got mine,” cost does also play a role. Shouldn’t, but does. Another thing to take into account is what other medications you’re taking, and whether they interact poorly with one another.
Sertraline is the generic for Zoloft, and it’s been FDA-approved since 1991. That’s a good long time, and if you’re going to prescribe an SSRI, it makes sense to give more weight to something that has a long history, for the sake of both effectiveness and side effects.
Research, and more anecdotal than I can count, including a number of my own, shows psilicybin (I use ground magic mushrooms) at slightly-less-than ‘feel high’ doses 4 days a week (aka micro or threshold dose) equals, or surpasses efficacy of any of that list.
No side effects.
Shit works, and you don’t have to “get high” and lose your moral compass, etc.
If you abuse psilicybin, it just stops working. You really can’t get addicted to it at all. Also there is NO ‘lethal dose’. You can’t die from it.
Fuck Rx!
