Increased suicidal thoughts on ADS

[Thetruthwillout1]

Has anyone who has experienced increased suicidal thoughts on antidepressants gone on to find an antidepressant that did not have that affect on them? Or is it a case of if you already have suicidal thoughts then any antidepressant will intensify that? My friend is terrified to try another antidepressant (having tried 6)as they initially cause her to act on her suicidal thoughts.

Yes this has happened me, I was started on it by psychiatrist and after 2 weeks I felt worse and while I know it can take time to get into system it was getting unbearable and my partner was seriously worried about me

I went to the then GP who was the MH specialist, who told me I wasnt giving it a chance, another week passed, he said the same again, finally after being brushed off for the 5th time I went home to end it, partner arrived home unexpectedly and found me running a bath and while it was running I was setting up hairdryer and a heater on an extension lead into the bathroom, he dragged me into the living room and bypassed the GP and rang the mh team who sent a social worker out that afternoon who saw the state I was in, I was given an emergency appointment for the psychiatrist the following morning with the promise I would try to keep safe till then, the psych asked why I didn't go to the GP and consult with them first with this and I explained that the GP had dismissed me 5 times over the 6 weeks and apparently had spoken to the psych who said to remain on it. He changed the medication on the spot (unusual for him) and offered hospital while it was swapped over,

I was on the replacement for 2 years before things started going downhill but I become tolerant to some of those meds and had a track record of that.

It is listed on many ADs as a potential side effect and should be taken seriously,

In my case as far as I can tell the psych gave the then GP a bollocking as they insisted I come in weekly to be seen and given my script for that week. They would only give me the first appointment of the day so 8.20am for someone who was by then very depressed was not good. The GP basically said "you are alive" and wrote the script for that week's meds. I changed practices and have had a lot better treatment since.

My replacement was one that I was familiar with that we were going to give another run to, fast forward another 6-7 years and the same antidepressant as above experience was suggested as an add on to my current one by the temporary psych, I was reluctant to try it but was assured that I would be closely monitored by them this time and I was. I am still on both now, the one I take at night is the one which made me intensely suicidal years earlier

I had more suicidal ideation on paroxetine but then switched to tricyclic ADs and have been fine with them.

Thank you so much for your open and honest reply x
A lot of what you're saying sounds similar to my friend. She has suicidal thoughts but it was when she was starting her antidepressant that she attempted suicide and that's what scares her.
Do you mind me asking what medication you took the 2nd time that worked? Did you not have that initial suicidal urge with that? Also when you say you latterly combined your antidepressants under close supervision, was that in hospital or at home?
You don't need to answer anything you don't want to disclose. It's just my friend definitely wants close supervision if she is to consider trying anything new.

Thank you @thesnapandfartisinfallible that is brilliant and gives us hope. I'll look into that further. Thanks so much

Sorry could I also ask the name if the tricyclic AD you had success with? My friend has tried primarily SSRIs and 1 SNRI.

My problem was with mirtazapine, that was 2008, in 2014 approx I was started on it at night and now take 45mg safely.

I was changed over to Effexor at the time and when it stopped working after 2 years I was changed to Cymbalta which was then boosted with mirtazapine, which is my current antidepressants but I am in a very slow Cymbalta withdrawal to change to Vortioxetine

I did the changeover with the help of the home treatment team, they visited at least once a day and made phone contact at least once a day as well to support any changes in mood and ideation.

I didn't get the initial suicidal urge with that but I was given chlorpromazine to let my body rest as much as possible and basically sleep thru the changeover as my body adjusted from mirtazapine to Effexor.

It made things easier for me and was better than being in the hospital also due to risk the HTT picked up and dispensed my meds to me, day by day, at most on a Saturday afternoon I would be given enough to last thru till Monday but that they would be out on Sunday to watch me take whatever doses that were due.

It meant I couldn't take too many and had to account for all before taking my dose, it took some responsibility out of my hands as I was struggling with it and meant I was closely supervised and other stuff was removed from my home at the beginning as it was a high risk to me. Responsibility was handed back to me day by day and for longer periods towards the end of our time.

The team were visiting daily for just over 3 weeks, it meant that my mood was closely monitored as they were CPNs/ MH SWs and once a week their team psychiatrist visited to review.

I was also aware that if the team felt I was getting worse that they had direct access to a bed on the ward and I would be moved quickly to it. (that happened on a different occasion, they made the decision on a morning that I was a hospital case and they had a bed sorted by afternoon) with the same consultant overseeing all so was good continuity of care.

I was also given the crisis numbers which work around the clock so if I was in crisis at 3 am, it was a pick up the phone and tell them I was with the home treatment team at the minute so they could all link up

I didn't have that initial dip in mood, no although the mood swings were quite something. Everyone was on edge around me for weeks until I stopped snapping at everyone. I take Amitriptyline and am much much more stable than I was on any of the SSRIs. It's not perfect by any means; I get constipated easily, the dry mouth is murder and the first two weeks you alternate between random dizzy spells (mostly in the mornings as you take it at night) and "PMS on crack" type mood swings.

But they work. They take a good 6 weeks to get into your system although you will sleep like the dead from night one. We're talking 16+ hours if left to sleep. The main problem is getting anyone to prescribe them. Expect resistance from GPs. They're old fashioned, notorious for being poorly tolerated and absolutely lethal in significant overdose. Most GP's will reluctantly give you the 25mg to help you sleep but 50 is the minimum therapeutic dose for depression. I started at 25mg and worked my way up until I hit the sweet spot at 100mg. If you do get them prescribed you might have to check in weekly until they know how you're doing with them and long term you may have to have a yearly ECG as one possibly side effect is irregular heart rhythm. I've never had this.

My theory is that people who don't tolerate one type of AD will do really well with another. Probably bullshit but everyone I've ever met who takes Tricyclic ADs has had really bad experiences with SSRIs and the only person I know who has taken a Tricyclic and not tolerated it, ended up doing fine with an SNRI. Your friend might be like me and take easily to them.

I recently tried dialing the Amitriptyline down to 75mg and starting a low dose of Duloxetine with a view to easing me gradually onto the latter. This was at home, not in hospital. I gave up after 4 days as I've never felt so ill. I felt like I was having a stroke. Wasn't fit to drive to work, never mind actually work if I got there and even now a week after going back to Amitriptyline, I still don't feel quite right. Had a panic attack at work, cried unintelligibly at my boss and nearly took a rude customer's head off.
I'm putting my foot down with my psychiatrist when I see her and saying I want to stay on it. I know the risks, I know the possible dangers and I'm willing to take my chances. I realise that she is seriously taking a chance on me by letting me have them but I've sworn that if I kill myself, it won't be with AD overdose (she didn't find that very comforting.) Sorry for the super long post, I wanted to answer all your questions. Feel free to ask anything, I feel like I've tried all the bastard drugs.

Thank you both so much for sharing your experiences. This has given us such an insight and given us hope that there may be an antidepressant that works. It seems so cruel (and dangerous) that it seems to be a case of trial and error but trying an antidepressant from another group may be worth a try.

If there is anything you want to ask me, ask away? I will try and answer as best I can.

I found a basic list from several years ago with a rough run down by section of some antidepressants.

ANTIDEPRESSANTS TRIED
• Citalopram
• Anafranil
• Dothiepin
• Fluoxetine
• Mirtazapine
• Aropax
• Zoloft
• Effexor
• Effexor XR
• Cymbalta