Psychotropic medication discussion thread

Gerald Torres2 said:No, that’s actually the whole problem. I’m only taking Wellbutrin and Xanax, and my goal is to get off the Xanax entirely and just stick to an antidepressant. The thing is, Wellbutrin doesn't touch my anxiety or my panic attacks at all.

Whenever these setbacks occur, we are looking at a relapse.
You need to be just as blunt with your psychiatrist as you are with us: tell them clearly that the Wellbutrin isn't touching your anxiety.
At that point, they will either introduce a new AD to supplement what you're already on, or they might even prescribe
an antipsychotic just to settle that anxiety down.

Scott Alvarez22 said:Gerald Torres2
please, don't let yourself get worked up over this!
Zoloft is exactly that, but it’s a slow burn; it takes time to kick in. If you were looking to step things up from Zoloft, you might look toward Pfizer or Eli Lilly, though I haven't personally ventured down those paths yet.
Regarding Effexor, the documentation states something like this:

Effexor tablets are indicated for the treatment of depression, including cases where depression is accompanied by anxiety.
Effexor is utilized in the treatment of:

All types of anxiety disorders: generalized anxiety disorder, panic attacks, social phobia…
Mixed forms, specifically anxious-depressive disorder.
Various neurotic depressive disorders (I say neurotic because in bipolar disorder, or what used to be called manic-depressive psychosis, the depression and anxiety are entirely different in terms of psychodynamics and everything else).
Hypochondriasis—which is a notoriously difficult disorder to treat and a heavy burden for the patient to live with. I really ought to write a more detailed post about that in a separate thread. These are individuals who constantly feel they are suffering from various ailments—one day it's this, the next it's that—they go for medical checkups far too often, yet there's no organic evidence of illness. Still, they persistently experience symptoms like stinging pains, shortness of breath, or chest tightness.
Recent studies also suggest the medication might be useful for severe forms of premenstrual dysphoric disorder (I'll touch on that topic more deeply some other time).
Certain conditions manifesting within categories of various "personality disorders," such as Borderline Personality Disorder or similar emotional instability profiles.

Furthermore, with Zoloft and similar drugs (after about six months), you definitely develop a dependency, which is why you need to taper off very gradually over several months. Apparently, with Effexor, you can transition immediately if you stop Zoloft on the same day, meaning you don't necessarily face that agonizing withdrawal period.

So, HOW do you keep depression and anxiety under control? That's precisely why I posted here in the first place—because I honestly don't know!

The issue isn't that you get addicted to antidepressants; it's the benzodiazepines that cause addiction. You never abruptly quit an antidepressant because doing so completely wreaks havoc on your brain chemistry. The reason we taper off gradually is simply to allow the
brain to adjust to a new equilibrium, not because the patient is "addicted" to the medication itself.

redranger2 said:The issue isn't that you get addicted to antidepressants; it's the benzodiazepines that cause addiction. You never abruptly quit an antidepressant because doing so completely wreaks havoc on your brain chemistry. The reason we taper off gradually is simply to allow the
brain to adjust to a new equilibrium, not because the patient is "addicted" to the medication itself.

But what is the actual distinction between having your "brain chemistry" altered by a drug—leading to withdrawal symptoms when you stop—and being physically addicted to a substance?😕

redranger2 said:Whenever these setbacks occur, we are looking at a relapse.
You need to be just as blunt with your psychiatrist as you are with us: tell them clearly that the Wellbutrin isn't touching your anxiety.
At that point, they will either introduce a new AD to supplement what you're already on, or they might even prescribe
an antipsychotic just to settle that anxiety down.

My therapist actually told me to stick with the Xanax, claiming that only a third of people end up getting hooked on it. That's not good enough for me. I spent eighteen months trying to get off Misar, and I have absolutely zero desire to go through that cycle all over again—it's the exact same trap. Honestly, I'd much rather they just add Zoloft to my treatment. Even though it's in the same class as Seroxat, which I couldn't stand, there's no guarantee it'll affect me the same way. My regular doctor is too busy right now, so I'm stuck dealing with the social worker for the time being...🙂

redranger2 said:The issue isn't that you get addicted to antidepressants; it's the benzodiazepines that cause addiction. You never abruptly quit an antidepressant because doing so completely wreaks havoc on your brain chemistry. The reason we taper off gradually is simply to allow the
brain to adjust to a new equilibrium, not because the patient is "addicted" to the medication itself.

But from what I've seen, it’s entirely different for everyone. Some people find it impossible to get off Zoloft even with a slow taper, while others just cut their dose in half every week until they're done... I guess... who knows which category I fall into.

Anthony Lopez8 As I have previously noted:
What exactly is the distinction between experiencing a shift in your brain chemistry that triggers withdrawal symptoms upon cessation, versus simply being physically addicted to a substance? 😕

There is a fundamental distinction.
Once you find yourself spiraling into a dependency on benzodiazepines, the symptoms of withdrawal begin to manifest with a rather relentless, heavy persistence.
It functions quite differently than standard antidepressants or antipsychotics. For instance, my own experience with antipsychotics was a completely different ordeal altogether.
I managed to taper off without much trouble in just a week, though doing it while on benzodiazepines made the entire process significantly more drawn out and grueling.
That is precisely why tapering off any kind of medication becomes such a grueling ordeal. It isn’t just about the physical dependency; it’s the psychological warfare that follows when you try to reclaim your own chemistry from a pill. Once you've relied on something to steady your nerves or balance your mood, stepping away feels less like a recovery and more like walking a tightrope without a net. You realize far too late how much of your perceived stability was actually just a chemical illusion, and trying to find your footing again is an exhausting, uphill battle.
One shouldn't attempt to rush such a transition abruptly, lest you trigger a systemic shock that ripples through the entire body—and the brain along with it.

Gerald Torres2 said:But from what I've seen, it’s entirely different for everyone. Some people find it impossible to get off Zoloft even with a slow taper, while others just cut their dose in half every week until they're done... I guess... who knows which category I fall into.

That's certainly true. Everyone reacts to medication differently, so the symptoms of
withdrawal tend to vary wildly.
Beyond the physical, there's a significant psychological component at play. When you're on a prescription, there's a certain sense of security, but the moment you stop, you're left fearing that every old demon is going to come rushing back.
Even now, I still carry a Xanax in my wallet—it serves as a sort of psychological safety net
that gives me peace of mind; knowing that if things start to spiral, the pill is right there next to me.

Gerald Torres2 said:My therapist actually told me to stick with the Xanax, claiming that only a third of people end up getting hooked on it. That's not good enough for me. I spent eighteen months trying to get off Misar, and I have absolutely zero desire to go through that cycle all over again—it's the exact same trap. Honestly, I'd much rather they just add Zoloft to my treatment. Even though it's in the same class as Seroxat, which I couldn't stand, there's no guarantee it'll affect me the same way. My regular doctor is too busy right now, so I'm stuck dealing with the social worker for the time being...🙂

For me, Cipralex cleared up the panic attacks and anxiety, even if I still deal with occasional relapses. Usually, my doctor bumps up the dosage, things improve for a while, and then we end up sliding back down to the previous dose until the next flare-up occurs.🙂

You really need to talk to your doctor; it doesn't matter if they work at a community health center, you can still find some truly excellent professionals there.
They will understand once you explain that despite this current treatment, you
are still struggling. They might even suggest a combination that works better than what you're currently doing
with the Zoloft.

redranger2 said:

Anthony Lopez8 As I have previously noted:
What exactly is the distinction between experiencing a shift in your brain chemistry that triggers withdrawal symptoms upon cessation, versus simply being physically addicted to a substance? 😕

There is a fundamental distinction.
Once you find yourself spiraling into a dependency on benzodiazepines, the symptoms of withdrawal begin to manifest with a rather relentless, heavy persistence.
It functions quite differently than standard antidepressants or antipsychotics. For instance, my own experience with antipsychotics was a completely different ordeal altogether.
I managed to taper off without much trouble in just a week, though doing it while on benzodiazepines made the entire process significantly more drawn out and grueling.
That is precisely why tapering off any kind of medication becomes such a grueling ordeal. It isn’t just about the physical dependency; it’s the psychological warfare that follows when you try to reclaim your own chemistry from a pill. Once you've relied on something to steady your nerves or balance your mood, stepping away feels less like a recovery and more like walking a tightrope without a net. You realize far too late how much of your perceived stability was actually just a chemical illusion, and trying to find your footing again is an exhausting, uphill battle.
One shouldn't attempt to rush such a transition abruptly, lest you trigger a systemic shock that ripples through the entire body—and the brain along with it.

Fair enough. In my own experience, getting off benzos was seamless, stepping down from antipsychotics was a bit of a struggle, but quitting antidepressants? That was an absolute nightmare—easily the most prolonged and exhausting process I've faced. In fact, I would go so far as to say the withdrawal from antidepressants was almost entirely physical; my mental state barely even played a role in the discomfort.
However, it wouldn't be intellectually honest of me to take my personal history and draw a sweeping generalization that you can get addicted to antidepressants but not to benzos. 🤷

Pfizer and the initial side effects

My own experience:
Right at the start, within about an hour of taking it, it hits you much like Xanax does. You’re looking at nausea, restlessness, tremors, dizziness, drowsiness, blurred vision, tinnitus, and all that good stuff... which, predictably, sends anxious people into a complete tailspin because they genuinely fear their condition is worsening instead of improving.
The trick is to just ignore these sensations and constantly remind yourself that this is just the Pfizer working its way through your system, not some permanent neurological breakdown. There is no point in fighting these symptoms; it's an exercise in futility. I suggest you just accept them, let the nausea and the jitters wash over you, and wait it out. It passes eventually.

That’s why I recommend a gradual tapering off of things like Xanax once you’ve finally made peace with the side effects of the Pfizer.

HOW TO TAPER OFF PIZER

Even though I haven't quite managed it myself—not even after six years—I think I’ve figured out why it’s so difficult. Because the Pfizer carries such frequent side effects (that restlessness, the nausea, the shakes, the brain fog, etc.), it breeds a deep sense of insecurity in the user. Over time, many people end up retreating from life's daily social demands, pulling inward to cope.
Once the Pfizer stabilizes and those side effects either vanish or become a predictable, manageable baseline, that's when you have to start forcing yourself to live. You need to begin doing the things you would have done before medication, or the things you used to do, despite whatever lingering discomfort remains.
Once you have regained a full social life—meaning those fears and anxieties have finally subsided—that is when you can begin the slow, very gradual process of weaning yourself off the Pfizer.

Anthony Lopez8 said:Fair enough. In my own experience, getting off benzos was seamless, stepping down from antipsychotics was a bit of a struggle, but quitting antidepressants? That was an absolute nightmare—easily the most prolonged and exhausting process I've faced. In fact, I would go so far as to say the withdrawal from antidepressants was almost entirely physical; my mental state barely even played a role in the discomfort.
However, it wouldn't be intellectually honest of me to take my personal history and draw a sweeping generalization that you can get addicted to antidepressants but not to benzos. 🤷

There really is no universal rule here; it clearly varies from one individual to the next.
My therapist was quite clear with me, suggesting that addiction isn't the issue with antidepressants,
rather, the tapering process has to be handled with extreme patience because the brain simply needs
sufficient time to recalibrate its own chemistry, and those symptoms are just the fallout of that adjustment.
Since you cruised through your benzo withdrawal and I struggled through mine, it proves there's no
standardized pattern at play.🤷

David Bishop4 said:Bok to you too! 🙂 Thank you so much for the advice. I honestly had no idea that you weren't supposed to split them; it's the first I've heard of it, and I tend to avoid reading the fine print because I don't want to trigger any side effects through autosuggestion. 🙂 If you don't mind me asking, what was your diagnosis? And which Misar dose are you taking? Does it leave you feeling a bit groggy? Also, how does your combination of the regular dose and the fast-acting version work for you—does it actually help?

Yeah, I totally get that thing about autosuggestion. I HAVE to read everything, otherwise I end up panicking over a simple aspirin or something 😁 but when I weigh it up, I suppose it's probably better to know a few things. 🙂

Anyway, I deal with anxiety and depression—mostly the anxiety side, along with panic attacks. For the last few months, I've been taking Misar SR at 1 mg in the morning and evening, plus 0.25 if I really need it. Before that, I was on the IR version three times a day at 0.5 mg, and honestly, the extended release seems to work better. It's a bit tricky, though—on a bad day, it feels like it's not enough so you have to pop another IR, but then on a good day, you might get too sleepy... it's never quite perfect, I guess. Personally, the SR definitely works better for me.

Last week they switched my antidepressant from Citalopram to Lexic and dropped my SR down to 0.5, so I can't say I'm feeling great right now since I'm dealing with a bunch of side effects... but hopefully, things look up in the long run.🙂

Melissa Sanchez59 said:Yeah, I totally get that thing about autosuggestion. I HAVE to read everything, otherwise I end up panicking over a simple aspirin or something 😁 but when I weigh it up, I suppose it's probably better to know a few things. 🙂

Anyway, I deal with anxiety and depression—mostly the anxiety side, along with panic attacks. For the last few months, I've been taking Misar SR at 1 mg in the morning and evening, plus 0.25 if I really need it. Before that, I was on the IR version three times a day at 0.5 mg, and honestly, the extended release seems to work better. It's a bit tricky, though—on a bad day, it feels like it's not enough so you have to pop another IR, but then on a good day, you might get too sleepy... it's never quite perfect, I guess. Personally, the SR definitely works better for me.

Last week they switched my antidepressant from Citalopram to Lexic and dropped my SR down to 0.5, so I can't say I'm feeling great right now since I'm dealing with a bunch of side effects... but hopefully, things look up in the long run.🙂

It feels like we're almost reading from the same script. 🙂 I'm also hoping that everything eventually settles into place. Does your mental state generally feel even worse when you first start a new antidepressant? Today is only my fourth day, and I'm feeling incredibly restless and anxious... If you don't mind me asking, how old are you? And by the way, I still can't wrap my head around why you aren't supposed to break those SR tablets... it seems so strange.🙂

redranger2 said:There really is no universal rule here; it clearly varies from one individual to the next.
My therapist was quite clear with me, suggesting that addiction isn't the issue with antidepressants,
rather, the tapering process has to be handled with extreme patience because the brain simply needs
sufficient time to recalibrate its own chemistry, and those symptoms are just the fallout of that adjustment.
Since you cruised through your benzo withdrawal and I struggled through mine, it proves there's no
standardized pattern at play.🤷

I agree that when it comes to these matters, there isn't a single rule that applies to everyone.
As for what your therapist told you, honestly, that's the standard script you hear from almost every psychologist out there. I have to wonder if they're being fed this falsehood during their residency at some Ivy League medical school or what the real issue is, but the notion that "antidepressants can't possibly cause physical dependency" is one of the most widespread delusions in the entire field. I've listened to plenty of nonsense from various so-called "experts," but this particular myth is something they all seem miraculously stubborn about, even though the lived experiences of a massive number of patients suggest otherwise. 🤷

David Bishop4 said:It feels like we're almost reading from the same script. 🙂 I'm also hoping that everything eventually settles into place. Does your mental state generally feel even worse when you first start a new antidepressant? Today is only my fourth day, and I'm feeling incredibly restless and anxious... If you don't mind me asking, how old are you? And by the way, I still can't wrap my head around why you aren't supposed to break those SR tablets... it seems so strange.🙂

Look, those are extended-release tablets—they're designed to work for 12 to 24 hours depending on how you take them.
There’s obviously a reason a doctor would prescribe those specifically instead of just some "standard, quick-acting" pill, right?
They’re typically used for things like Generalized Anxiety Disorder, where your body is basically stuck in a state of anxiety 24/7.

fadedbear92 said:Look, those are extended-release tablets—they're designed to work for 12 to 24 hours depending on how you take them.
There’s obviously a reason a doctor would prescribe those specifically instead of just some "standard, quick-acting" pill, right?
They’re typically used for things like Generalized Anxiety Disorder, where your body is basically stuck in a state of anxiety 24/7.

I hear what you're saying, I really do; I’m just pointing out how silly it feels that they aren't supposed to be broken apart. I have the 1 mg dose, and even taking just half a pill left me feeling completely drugged. Besides, I’m not anxious all day long (well, maybe ever since I started those ADHD medications, but before that, even 0.25 mg of Xanax didn't touch my anxiety, especially when I actually had to go somewhere). Honestly, there were plenty of times when full-blown panic attacks would still break through regardless.

fadedbear92 said:Look, those are extended-release tablets—they're designed to work for 12 to 24 hours depending on how you take them.
There’s obviously a reason a doctor would prescribe those specifically instead of just some "standard, quick-acting" pill, right?
They’re typically used for things like Generalized Anxiety Disorder, where your body is basically stuck in a state of anxiety 24/7.

I'm currently using Misar, psychotherapy, and alternative methods. I want to try everything before going back to the antidepressants I used before—can't even remember the side effects. But I wanted to ask something else. Is it possible that Misar causes nervousness? For me, the best combo is taking it with Lexic. I've been on Lexic for about 4 months, and Misar for about a month and a half because my doctor said it's better for anxiety. Or maybe I'm just hooked on the Lexic and that's why. Taking 0.5mg of Misar three times a day and about 6mg of Lexic daily.

David Bishop4 said:It feels like we're almost reading from the same script. 🙂 I'm also hoping that everything eventually settles into place. Does your mental state generally feel even worse when you first start a new antidepressant? Today is only my fourth day, and I'm feeling incredibly restless and anxious... If you don't mind me asking, how old are you? And by the way, I still can't wrap my head around why you aren't supposed to break those SR tablets... it seems so strange.🙂

I'm not sure why they can't be broken, but I assume there's a solid reason since they're made that way—it's actually kind of hard to snap them compared to those "normal" ones with the little score line down the middle... and honestly, my doctor was super explicit about it, like, she said I can always take two 0.5mg doses if needed, but I definitely shouldn't split a stronger one...

I'm 25, and I've been dealing with stuff this intense for maybe 5 years now, but I finally decided to actually do something about it about six months ago. I'm not counting the time a few years back when I was just taking Ambien because my doctor didn't even think to look for the actual cause of my long-term insomnia. 🙄

This is my second antidepressant. With the first one, I think I fell into the worst depression of my life during those first couple of weeks, but I kept steadying myself with Misar, so I didn't really deal with anxiety then. Now it's kind of the opposite—I'm not in total crisis, but my nerves are constantly on edge like they were before medication. I'm not sure how much of that is from switching meds or just drastically cutting back on the Misar... plus, I've had constant dizziness for 5 days now. And the depersonalization/derealization is just terrifying. Just waiting for 😢

David Bishop4 said:I hear what you're saying, I really do; I’m just pointing out how silly it feels that they aren't supposed to be broken apart. I have the 1 mg dose, and even taking just half a pill left me feeling completely drugged. Besides, I’m not anxious all day long (well, maybe ever since I started those ADHD medications, but before that, even 0.25 mg of Xanax didn't touch my anxiety, especially when I actually had to go somewhere). Honestly, there were plenty of times when full-blown panic attacks would still break through regardless.

They could always just write you a prescription for 0.5 Misar SR, then you won't have any issues with splitting pills, and if you really need it, you can just take two.

restlesstrucker15 said:They could always just write you a prescription for 0.5 Misar SR, then you won't have any issues with splitting pills, and if you really need it, you can just take two.

I definitely plan to, but I won't be able to get to it until next Saturday, which feels like nearly two weeks away. Otherwise, I might try checking in with my primary care physician.