Posted by Dispossessed on April 28, 2015, at 19:43:09
Hello,
Ever since discontinuing an SSRI a couple of years ago I have experienced some form of akathisia/agitation - sometimes its bearable, other times its not - and is preventing me from working and doing a lot of other things. My initial diagnosis was OCD (Pure O) and neurotic depression.
My current meds are as follows:
20mg fluoxetine. I've tried pretty much every other SSRI - they all didn't agree with me, making me extremely restless etc. Fluoxetine is the 'least worst' of all the SSRIS - it has the greatest antidepressant effect (possibly due to 5HT2C antagonism) and generally helps the OCD even at this dose. However, has caused moderate to severe sexual dysfunction.160mg propranolol. Limited effect. Taking it to counteract activating effects of SSRI. Few side effects.
300mg pregabalin. Worked well at first then seemed to wear off. Sexual dysfunction.
3.75mg mirtazapine. Helped me sleep, slight improvement regarding restlessness. However, weight gain even at this low dose. So I'm coming off it.
The question I am asking is what should I replace the mirtazapine with? I'm thinking either something like 25mg trazodone (for its 5ht2a antagonism) or 5-10mg amitryptline.
The main symptoms I am trying to treat are:
- restlessness and inability to sit still
- muscle pain
- sense of dysphoria
- jaw clenching and sleep bruxismI also have a number of other issues like poor concentration/memory and sexual dysfunction, but to be honest I'd prefer to get this agitation/akathisia/restlessness/whatever it is under control. Benzos would work well but sadly in the UK, the NHS will not prescribe them for long-term use any more.
Thanks a lot for your help!
poster:Dispossessed
thread:1078526
URL: http://www.dr-bob.org/babble/20150407/msgs/1078526.html