Meds Experiences Thread!!

Stimulants in general suppress your appetite. Unfortunately that effect usually doesn't go away.

 

wellbutrin completely fucked my appetite the whole time i was on it. (which was less than 6 months, because it also completely fucked my mental health in general... it was not a good fit for me.) i used Ensure for a while because putting food in my mouth was a hard NOPE at times, but i could slug back one of those little shakes no problem.

 

Ensure is really a godsend sometimes.

 

I'm not sure about this, but I wouldn't be surprised if modafinil was one of those drugs that causes you to burn through vitamin B6 faster than a healthy diet can possibly replace. Which would make it work great for a bit, then stop working, then make you feel terrible until you stop it for a while. This would be a doctor question.

ETA: If this is indeed the case, supplements would fix it.

 

From wikipedia:

B6 is required to make many neurotransmitters that psychopharmaceuticals affect, and also histamine. Without it you will not have a very good day.

Also from wikipedia:

If you run out of B6, modafinil will probably not work because it may rely on at least two of those B6-dependent things (dopamine and histamine) to do its thing.

I’m unclear on how this all works, but iirc, my psychiatrist has indicated that SSRIs, which also affect the reuptake of a B6-dependent neurotransmitter, often cause people to become deficient in B6 in a way that a balanced diet cannot adequately compensate for. This makes it seem as if the medication was working and then gradually lost its effectiveness. (Which is not wrong, because you can block the reuptake of as much serotonin as you like to no real benefit if there wasn’t enough serotonin in the first place.) This is remedied with the administration of B6 supplements. OTC health store stuff seems perfectly adequate in most cases afaik, but a doctor would be the one to advise whether any or all of this is a correct understanding on my part, and how to dose the B6 correctly if so.

 

I've been on escitalopram for a couple months now, maybe more like 4 actually, and finally realized that I haven't had any periods since starting it. Which is awesome, but kind of weird? I've looked it up and "irregular menstrual cycle" is a possible side effect, so I guess this is normal? I've also gained like 20 pounds which isn't as awesome cause I seem to have more hangups about weight than I thought I did but I'm doing ok.

 

if your period has stopped altogether i don't think that's a very good sign my guy.

 

...

i've been sitting at my computer for several minutes now, and i really can't for the life of me think of a more tactful way to ask this, but is there any possibility you might be, y'know, pregnant?

because i hear that is a rather common occurrence that those two symptoms are associated with.

 

just wanna make sure you can rule that possibility out is all

 

Nah there's no risk of that lol but thanks for the concern

 

I had pretty irregular periods after starting citalopram, but they've (unfortunately) become more regular with time. I never missed three months in a row, though. I think two was the max for me, and for a long time (several years) I had six-week-apart periods, which was pretty okay with me.

 

Probably final modafinil update: welp, it turns out it messes with my HRT, my latest bloodwork results are in and the estradiol levels are cut in half. I guess I'll try to convince a psychiatrist that I'm not Just Here For Study Drugs and get something without interactions, then.

 

Oh wow, that’s bad. I’m sorry it didn’t work out for you.

Good luck with the doctors. That’s absolutely infuriating when they treat patients like that. We’re just trying to live our damn lives, you medically licensed dispensers of scientifically unsupported moral judgment.

Do you happen to have any citations about the interaction? Not because I doubt you, it’s just interesting, and possibly very useful information to have on hand in a community with so many trans people with ADHD.

 

It interacts with a bunch of metabolic enzymes, think reverse grapefruit juice. Most studies about this were about birth control, but the half-life of estrogen HRT is also probably affected - probably not usually as much as they were for me, I just got unlucky I guess. It depends on genetic factors.

 

Modafinil: Literally the opposite of grapefruit juice; shows up to the liver party and chats up damn near every enzyme *except* CYP2D6; puzzling evidence involving cats.

But seriously, that’s very interesting. Thank you.

There definitely is variability. It’s almost impossible to prevent all metabolic interactions if you’re taking several drugs, in no small part because of CYP2D6 specifically. A lot of the time it’s manageable, but some things definitely are not, and it’s not necessarily predictable.

 

I just came across this, which is pretty interesting. Essentially, according to this meta-analysis from a few years ago (which should probably be taken with a grain of salt, but they cite FDA data), antidepressants are barely more effective than a placebo - it's just that a placebo is very effective.

 

the most recent metanalysis, which compares 21 antidepressants (check for yours!) says the opposite: all antidepressants they looked at were more efficacious than placebo

(the most efficacious one is apparently amitryptiline, one of the old tricyclics)

this debate has been going back and forth for years. the evidence continues to remain mixed, and will remain mixed. antidepressants as drugs have a number of qualities that makes them hard to placebo-blind effectively, and the field of psychopharmacology is riddled with bias.

(it may be noted that Kirsch, who palin cites, very well himself might have been biased to find in favor of the placebo effect, because the placebo effect itself is his primary area of research; he’s not a clinician)

nevertheless, the current most comprehensive metanalysis (522 studies, >100,000 individual patients) finds in favor of efficacy

 

This is going to sound awful, but has anyone had any experiences with 2-fluoromethamphetamine aka 2-FMA? I just learned it was Technically Not Illegal Yet in France, and I didn't know where else to stick this.