Need some input on whether or not this SNRI sounds like it's working or not...

[HotthenCold]

I know that no one can tell me definitively whether or not my medication is working, but I'm going to lay out what it was like and what it is now like, and see if anyone thinks I might still benefit from a change in dosage or medication altogether?

I've dealt with depression, OCD, and anxiety most of my life. Also, a daily addiction to alcohol and I was using cocaine and MDMA for a few years, on the weekends. I think it matters to specify the amount and frequency because I know that very frequent use has a greater chance of significantly altering brain function. I probably used enough cocaine and MDMA to experience changes, but not enough to have caused trauma. I should also mention that I've been sober for 11 months, so I'm experiencing new emotions, moods, capabilities, and all of the mood swings that come from new found sobriety (not to mention actually having to deal with life instead of blacking it out).

So that's that background.

I started taking an SNRI last year (pristine) 50mg, once daily.

I believe it has improved my overall mood. I still get depressed and still have frequent OCD symptoms, but the degree is less and when I get depressed I am usually able to find some light at the end of the tunnel and I don't linger there as long as I used to. Also I find that I have a lot of really good days, and am able to deal with life and believe that things will get better.

However, as I said before, I still do have frequent bouts of depressive thoughts and OCD symptoms, enough to the degree that it's causing me to wonder if I could expect more from my medication, or if this is just the normal amount of worry and sadness that one is likely to face in this crazy world.

So to summarize:

Felt horrendous for most of my life, especially that few years before this last 11 months. Started medication about 6 months ago. Having lots of good days but still lots of deeply distressing thoughts and OCD symptoms, although they are much less in duration and frequency than before. Should I up my dosage or switch meds, or just try this for a while longer?

Thoughts?

 

[David Baxter PhD]

I started taking an SNRI last year (pristine) 50mg, once daily.

I believe it has improved my overall mood. I still get depressed and still have frequent OCD symptoms, but the degree is less and when I get depressed I am usually able to find some light at the end of the tunnel and I don't linger there as long as I used to. Also I find that I have a lot of really good days, and am able to deal with life and believe that things will get better.

However, as I said before, I still do have frequent bouts of depressive thoughts and OCD symptoms, enough to the degree that it's causing me to wonder if I could expect more from my medication

....

Started medication about 6 months ago. Having lots of good days but still lots of deeply distressing thoughts and OCD symptoms, although they are much less in duration and frequency than before. Should I up my dosage or switch meds, or just try this for a while longer?

First, I assume you are talking about Pristiq (desvenlafaxine), which is similar in many respects to its predecessor, Effexor (venlafaxine).

As to whether you should change medications or increase the dose, this is a discussion you should be having with your physician and/or therapist.

However, I can make some general comments:

First, medication is a helpful and often essential part of your treatment plan but medication cannot do all of the work. Research has consistently shown that the most effective treatment combines medication and an appropriate form of psychotherapy.

Additionally, even with an optimal treatment plan, often a realistic goal is better or more effective management of your symptoms, not necessarily a "cure" or elimination of symptoms entirely. This is especially true of many anxiety disorders and especially OCD.

Third, although by 6 months you should expect to be seeing some benefits of this type of medication, as indeed you appear to be, this is not necessarily the maximal benefits you can expect, which may take up to a year or more.

 

[HotthenCold]

Oops, I am talking about pristiq!! I blame the auto-correct function

That's interesting that optimal effects can take up to a year to be felt.

Thanks for the info, I was recently wondering if it was possible to eliminate symptoms with drugs since I had only ever assumed that it wasn't possible, now I have a clearer understanding of the role of medication!

:thankyou2:

 

[MHealthJo]

As an aside, 50mg is a bottom-range-of-effectiveness dose. I only realised this after chatting with my doc and going up to 100. After going to 100 and chatting later, my doc felt I was getting about the right 'amount' of benefit to expect - much better oomph to start trying more ideas to help myself, get some interest and hope in things, get moving more easily with things.
Being on 50 was a ton better than being unmedicated, but was pretty 'meh' once I felt the benefit of being on 100.

These things are so individual so yeah, chat to your doc about where you're at. Glad you are feeling some benefits though.

 

[HotthenCold]

As an aside, 50mg is a bottom-range-of-effectiveness dose. I only realised this after chatting with my doc and going up to 100. After going to 100 and chatting later, my doc felt I was getting about the right 'amount' of benefit to expect - much better oomph to start trying more ideas to help myself, get some interest and hope in things, get moving more easily with things.
Being on 50 was a ton better than being unmedicated, but was pretty 'meh' once I felt the benefit of being on 100.

These things are so individual so yeah, chat to your doc about where you're at. Glad you are feeling some benefits though.

That's enough of an endorsement for me to talk to my doc and possibly get my dosage up. Anything to feel better, thanks!