Passing For Normal

I was just talking with my best friend this weekend about this. She's been on scary-high doses of antidepressants for years, because after trying them all they found only super-high doses do anything for her. But recently, she missed a dose, then another, then another. And then she started feeling everything again and had a, "holy shit, it's been YEARS" freakout. She was okay for a while, but then she started doing her usual worsening-depression stuff like social withdrawal, waking up at 2am, crying a lot, ruminating on family stuff, torturing herself about her breakup with her husband, and even having passive suicidal thoughts ("it would be so much better if i just didn't wake up and have to deal with this shit anymore"). Now that she's off, she doesn't want to go back on. But as someone who's known her forever and loves her to bits, I can tell a huge difference and I think she was happier and healthier before. She said she was going to go see a doc about a differnt kind of med this week, one that won't make her so numb.

I've been pretty lucky myself. Lexapro worked well for me for years, and then I was fine off meds for years, and now I've been doing well on Zoloft for the last three years. But I know med selection can be really tricky. Some things just plain don't work for some people. If you had a lot of luck with Imiprimine (except for the side effects), then it stands to reason that a combination of serotonin and norepinephrine effects would work well for you. The SSRIs (zoloft, prozac, etc) mostly work on serotonin receptors. Buproprion works on serotonin and dopamine receptors. There is a class of drugs called SNRIs (Effexor, Cymbalta) that are new like the SSRIs and work on serotonin and norepinephrine receptors just like the old TCAs, but with fewer side effects. It might be worth asking your doc about trying one of those?