Done Deal! Konan #NDri to #Lecce from #OHLeuven. Contract until 2028. He will be in Italy tonight. Expected medicals for tomorrow morning. #transfers

Hey folks 👋

We meant to write this post earlier today, but ended up doing other things, so we're writing this now on our phone in bed 😅

We are currently on the max dose of sertraline daily (200 mg). It's helped a little with depression, a bit less with anxiety, and not at all with executive dysfunction.

We've previously also been on the max dose of venlafaxine extended release (375 mg). We came off this because it didn't work.

Until recently, we had been taking a low dose of bupropion extended release (150 mg) daily alongside the sertraline. It really helped with energy levels for a while, but it lasted only a few months at best. It also caused us to push ourselves too far several times and eventually burn out.

We are trying to ideally find a single medication that will help boost our serotonin, noradrenaline, and dopamine levels, but it doesn't help that most of these are not prescribed by the NHS. Those that are tend to be stimulants used for ADHD, which we presently do not have access to.

We've done a lot of research into the different classes of antidepressants (e.g., sSRIs, SNRIs, sNRIs, NDRIs, SNDRIs, TCAs, TeCAs, atypicals, etc.), but the only available options we see as being worth any attempt are paroxetine (sSRI) and vortioxetine (SMS). We really don't want to try another SNRI like duloxetine or older classes of meds.

Sharing any experiences you've had would be very much appreciated 🩷

#AuDHD #depression #anxiety #ExecutiveDysfunction #sSRI #SNRI #sNRI #NDRI #SNDRI #TCA #TeCA #SMS #antidepressants

Hey folks 👋

For those who don't already know, we're currently signed off work due to depression, anxiety, and burnout.

Our employer is supportive, but there are multiple, fundamental, ongoing issues with the organisation that no amount of individual support can resolve. We cannot go into more detail.

During the last 2 and a bit weeks, we've done a mixture of resting and doing tasks we've been meaning to do for ages, but neither had the time nor spoons to do.

We're still on 200 mg sertraline (an SSRI) daily, but we've made the switch from taking 150 mg bupropion (an NDRI) daily alongside to 40 mg atomoxetine (an sNRI, not an SNRI) daily alongside. We're slowly titrating up to the recommend 80 mg dose.

As we came off the bupropion steadily, we definitely felt it (i.e., mood; executive function; energy etc.), but the effects are levelling off as our atomoxetine dose steadily increases.

The bupropion had helped us for a while, both with our mental health and some ADHD struggles, but could only do so much. As such, we decided to make the unorthodox switch to atomoxetine.

Bupropion is an atypical NDRI and antidepressant: it boosts noradrenaline and dopamine (to a lesser extent). However, it's only prescribed off licence for ADHD, as it's not been shown to be effective. Atomoxetine, conversely, is mainly used to treat ADHD in people who do not respond well to stimulants, such as methylphenidate. It directly boosts noradrenaline and indirectly boosts dopamine in the prefrontal cortex by a decent amount.

Since we do not tolerate any stimulants well (even caffeine), atomoxetine is our best bet in terms of an ADHD med that also helps with our mental health.

Unlike bupropion, it doesn't have any major interactions with sertraline (only moderate), and we can take 40 mg propranolol tablets alongside to help keep our anxiety under control, rather than turning straight to 10 mg diazepam tablets.

So far, we're doing well with the switch, both physically and mentally, but it'll be a while before we know for sure whether this the ideal medication combination.

We are still very much in low power recovery mode, so don't expect anything much or consistent from us.

A last note to sign this off: from the above listed drugs, the only one we can currently get via the NHS is sertraline. We may be able to get atomoxetine through the NHS in the future, but that's dependent on us ever actually getting a formal ADHD diagnosis 😮‍💨 The waiting lists are rather long... even when using the Right To Choose a mental health service provider.

Apologies for any typos.

#MentalHealth #depression #anxiety #burnout #neurodivergent #ADHD #AuDHD #NHS #NHSEngland #sertraline #SSRI #bupropion #NDRI #atomoxetine #sNRI #serotonin #noradrenaline #dopamine #RightToChoose #propranolol #diazepam #stimulants #methylphenidate