Can these affect HRT (SSRI and other drugs)?

synonymous

New member
I'm on Mirtazapine (SSRI), Fluvoxamine (NaSSAs), Zopiclone (Tranquilizer similar to Ambien), Alprazolam (Xanax)

At 1pm(ish) I take a half 7.5mg tab of Zopiclone and 0.5mg of Xanax.
Before bed I take Zopiclone 7.5mg, Xanax 1.5mg, SSRI 50mg, NaSSAs 30mg.

I'm 35 now. I had sudden onset of panic attacks, the first of which led me right into the ER literally thinking I was dieing and on my way out. I don't think I'd ever been so scared in my life. Of course, nobody thought it was anything until several months of more panic attacks. I had a bad case of depression for a month. I say this because in all my life I had never felt so much grief and mental pain for NO REASON. There were times I had to leave the living room, take a shower and curl up into the fetal position and cry. A horrible feeling that eventually went away. I don't know if I could've go on like that and I have no idea why it went away, on it's own, without meds. Doctor had me on different meds AFTER all that, then 6 months later took me off cold turkey saying I was fine. He didn't tell me there would be withdrawal symptoms (I was on a different cocktail, Xanax and Paxil I think). I suffered from severe insomnia and was put on a variety of tranquilizers. At one point I was popping around 16 pills before bed. Long story short, this new doctor was a pill pusher and I wanted OUT. On my own I managed my way down to about half a tab of Xanax but then a few weeks later had a severe attack. I was making the cuts in meds too quickly (I would find this out later). So, now I'm on the above cocktail and slowly cutting away. The cuts hurt, I have headaches for a week sometimes 2, trouble sleeping well (Usually will sleep 5 hours, be awake for 2 and sleep another 3 or 4). BUT it's progress to getting off these drugs.

I've asked my urologist, an endocronologist and a fertility doctor all if these drugs affect HRT. First 2 doctors said not likely. Fertility doctor said that it could but that he was more concerned about my swimmers and the SSRI (Was told to have sex, only if need be, to get my swimmers into better shape since apparently the SSRI can affect them. I was keen, wife wasn't so much.)

Anybody on here have a good source of knowledge for this? Anyone else on similar meds (If you don't mind sharing)? I was kind of hoping that HRT would help with the withdrawal from these meds. Part of me thinks that some of those anxiety issues and depression had something to do with low T levels or high E2 or something. BUT I'd just be guessing.

If you're wondering why the tranquilizer at 1pm, it's inter-dose withdrawals. The meds clear my body and start to crave it midday to the point I can get panicky and feel all sorts of horrible. When I take this small dose, I feel 'normal'. Not sleepy at ALL. If my wife (Or any other person I know for that matter) took half a pill of Zopiclone, they'd be out cold.
 
You mixed up Mirtaz and Fluvoxamine...Flovox is the SSRI...Mirtazapine (Remeron) isnt an SSRI...Completely different mechanism of action. Wouldn't be my first choice, or even close, for anxiety or panic..Since it has a huge influence on Noradrenaline (agonist)...Luvox is the mildest of all the SSRI's and is a good choice. Personally, I would drop the Remeron and just work with the Luvox. If you decide the cut the Remeron out, dont be shocked if your sleep sucks for a day or two...It's a strong H1 antagonist (anti-histamine)....although, 30mg of Remeron should be more activating at that dose...that's really when the noradrenaline begins to ramp up...which can obviously make panic worse.

As for your question about HRT....the only influence that is possible...and likely IMO...is a boost in prolactin. As you utilize these meds to hit 5-HT receptors, you will begin to tank dopamine...As your dopamine lowers, your prolactin goes up...it's a common side effect. Utilizing something like Wellbutrin (DNRI), adderall, or a dopamine agonist (Prami, requip) will counteract this effect.

Overall, I think the NA agonist in remeron is probably causing your more problems with anxiety than you'd have without it. If it's not something you want to drop then I'd recommend dropping the dosage back down to around 15mg or less, where you'd have less noradrenergic effects. This may allow you to come off the xanax easier.

Regarding the xanax withdrawal. If you're really having a hard time coming off of it, have your doc switch to valium...the longer, much longer, half life will allow for a smoother taper.
 
You mixed up Mirtaz and Fluvoxamine...Flovox is the SSRI...Mirtazapine (Remeron) isnt an SSRI...Completely different mechanism of action. Wouldn't be my first choice, or even close, for anxiety or panic..Since it has a huge influence on Noradrenaline (agonist)...Luvox is the mildest of all the SSRI's and is a good choice. Personally, I would drop the Remeron and just work with the Luvox. If you decide the cut the Remeron out, dont be shocked if your sleep sucks for a day or two...It's a strong H1 antagonist (anti-histamine)....although, 30mg of Remeron should be more activating at that dose...that's really when the noradrenaline begins to ramp up...which can obviously make panic worse.

As for your question about HRT....the only influence that is possible...and likely IMO...is a boost in prolactin. As you utilize these meds to hit 5-HT receptors, you will begin to tank dopamine...As your dopamine lowers, your prolactin goes up...it's a common side effect. Utilizing something like Wellbutrin (DNRI), adderall, or a dopamine agonist (Prami, requip) will counteract this effect.

Overall, I think the NA agonist in remeron is probably causing your more problems with anxiety than you'd have without it. If it's not something you want to drop then I'd recommend dropping the dosage back down to around 15mg or less, where you'd have less noradrenergic effects. This may allow you to come off the xanax easier.

Regarding the xanax withdrawal. If you're really having a hard time coming off of it, have your doc switch to valium...the longer, much longer, half life will allow for a smoother taper.

what else do you know about these meds for anxiety ?
I've used paxil for anxiety over the years and it has worked...
If you are on TRT, are you lowering serotonin ?
no one really knows how the 2 work...
I've lowered my dose from 20 mg to 15 mg and on TRT...
Trying to see what I can do....
 
What else do I know? More than anyone should...
Glad that Paxil has been effective for you...
No, the use of test is not linked to lowering serotonin...If anything, Testosterone has a protective effect against depression, which would indicate a boost of serotonin...Not to mention, how much better people feel mentally when they start TRT. There are a few studies out there showing an increase at the 5-HT2A receptors with the use of test...
Take your time lowering the dose...
 
This is very interesting, I was on Zoloft for 20 years and tapered off of it just prier to starting TRT. I got a really good boost when I started TRT but now that I am six months in I find myself extremely depressed all the time. I would like to talk to my doctor about going back on but was unsure if there would be an issue between the Zoloft and my TRT treatment. I have also read that SSRI's drive your metabolism into the gutter and being over weight that is the last thing that I want to do.
 
This is very interesting, I was on Zoloft for 20 years and tapered off of it just prier to starting TRT. I got a really good boost when I started TRT but now that I am six months in I find myself extremely depressed all the time. I would like to talk to my doctor about going back on but was unsure if there would be an issue between the Zoloft and my TRT treatment. I have also read that SSRI's drive your metabolism into the gutter and being over weight that is the last thing that I want to do.

Do you know what your E2 level is currently? If all is good with E2 and T levels and you are dialed in correctly, I would look at Wellbutrin, rather than zoloft...or even a combo of the two. Wellbutrin isn't associated with weight gain and it can negate the weight effects of an SSRI.
 
Thanks BigBen, I have an appointment with my primary care physician today and will speak with him about it. My E2 is really good, 25 when I last had it checked.
 
This is very interesting, I was on Zoloft for 20 years and tapered off of it just prier to starting TRT. I got a really good boost when I started TRT but now that I am six months in I find myself extremely depressed all the time. I would like to talk to my doctor about going back on but was unsure if there would be an issue between the Zoloft and my TRT treatment. I have also read that SSRI's drive your metabolism into the gutter and being over weight that is the last thing that I want to do.

I've used both wellbutrin and paxil while on TRT....
was told to dump wellbutrin....I think the two were too much....
Wellbutrin worked well for me, helped me workout and had great focus.
I only took 150 mg. There was a brand here that I used...it was generic and it released wuicker than the standard wellbutrin.....even pharmacist told me he has patients complaining it was releasing too fast.
paxil feels more calming to me....
wellbutrin is more stimulating for me.
This is what I observed.
Why r u depressed bro ?
 
Wellbutrin is available in immediate release, standard release (8 hour half life), and extended release (24 hour half life, i think).....I would look for the SR version of it because you can take it in the morning and not have it intefere with your sleep if you find it to be activating.
 
You mixed up Mirtaz and Fluvoxamine...Flovox is the SSRI...Mirtazapine (Remeron) isnt an SSRI...Completely different mechanism of action. Wouldn't be my first choice, or even close, for anxiety or panic..Since it has a huge influence on Noradrenaline (agonist)...Luvox is the mildest of all the SSRI's and is a good choice. Personally, I would drop the Remeron and just work with the Luvox. If you decide the cut the Remeron out, dont be shocked if your sleep sucks for a day or two...It's a strong H1 antagonist (anti-histamine)....although, 30mg of Remeron should be more activating at that dose...that's really when the noradrenaline begins to ramp up...which can obviously make panic worse.

As for your question about HRT....the only influence that is possible...and likely IMO...is a boost in prolactin. As you utilize these meds to hit 5-HT receptors, you will begin to tank dopamine...As your dopamine lowers, your prolactin goes up...it's a common side effect. Utilizing something like Wellbutrin (DNRI), adderall, or a dopamine agonist (Prami, requip) will counteract this effect.

Overall, I think the NA agonist in remeron is probably causing your more problems with anxiety than you'd have without it. If it's not something you want to drop then I'd recommend dropping the dosage back down to around 15mg or less, where you'd have less noradrenergic effects. This may allow you to come off the xanax easier.

Regarding the xanax withdrawal. If you're really having a hard time coming off of it, have your doc switch to valium...the longer, much longer, half life will allow for a smoother taper.

Thanks for the reply. You're right, I mixed them up.

I can't remember why the doctor put me on the Remeron. I think I was still having issues with anxiety and wasn't on HRT yet. I made me WAY too hungry for my own good, which is why I take it before bed. He said it was the 'easiest' to come off of. Not sure if my dose is high or not. I've missed part or my entire dose a few times and not had anything bad happen. Not so with the SSRI. If I missed it, I wake up in PAIN!!

Right now I'm bringing my zopiclone and xanax down to a level where I'm able to cross over into an equivalent of valium. From there I'll do smaller cuts. But first I have to get to that point.
 
Don't forget to look at doing cognitive behavioral therapy as a long term solution to anxiety. SSRI's are great at helping you breaking connections that cause anxiety, but in the long run you need to attack those triggers so you can get off the SSRI's.
 
I've used both wellbutrin and paxil while on TRT....
was told to dump wellbutrin....I think the two were too much....
Wellbutrin worked well for me, helped me workout and had great focus.
I only took 150 mg. There was a brand here that I used...it was generic and it released wuicker than the standard wellbutrin.....even pharmacist told me he has patients complaining it was releasing too fast.
paxil feels more calming to me....
wellbutrin is more stimulating for me.
This is what I observed.
Why r u depressed bro ?



Life I guess, things are not always sunshine and rainbows for everyone! I got my prescription for the wellbutrin yesterday so I am excited to see how it works. I also learned that the severe pain I have been experiencing in my abdomen has a cause, I discovered that I Diverticulitis, so I have to make some serious changes to my lifestyle.
 
Life I guess, things are not always sunshine and rainbows for everyone! I got my prescription for the wellbutrin yesterday so I am excited to see how it works. I also learned that the severe pain I have been experiencing in my abdomen has a cause, I discovered that I Diverticulitis, so I have to make some serious changes to my lifestyle.

what dose ?
 
Don't forget to look at doing cognitive behavioral therapy as a long term solution to anxiety. SSRI's are great at helping you breaking connections that cause anxiety, but in the long run you need to attack those triggers so you can get off the SSRI's.

Right now, I get severe anxiety with dizziness, sweating for no reason. I deal with it. I push through it. I've not taking 'more' of the meds. I've learned to deal with the anxiety in my own way. It's the physical dependency that's got me by the balls.
 
Right now, I get severe anxiety with dizziness, sweating for no reason. I deal with it. I push through it. I've not taking 'more' of the meds. I've learned to deal with the anxiety in my own way. It's the physical dependency that's got me by the balls.

There is pretty much always a reason. You just need to figure out what the triggers are. Have you ever worked witbph a psychologist? They can help you work through this.
 
I was on Zoloft but had to stop a few months after as it gave me libido and Erection issues. Also made me somewhat lethargic and gain some weight while actually eating less. Has anyone tried wellbutrin? I know its not an ssri but Ive read that some people use it for anxiety and OCD even though its not ass effective as an ssri but I guess its not as harsh.
 
I was on Zoloft but had to stop a few months after as it gave me libido and Erection issues. Also made me somewhat lethargic and gain some weight while actually eating less. Has anyone tried wellbutrin? I know its not an ssri but Ive read that some people use it for anxiety and OCD even though its not ass effective as an ssri but I guess its not as harsh.
I've used 150 mg of Wellbutrin SR while on 20 mg paxil...seemed to work.
I'm not sure if Wellbutrin would work with OCD or anxiety....
 
Ya I hear it's really for depression but if you suffer from depression as well as OCD and anxiety as I do, I'm sure that it will at least improve your life somehow. If your happy you won't be as stressed or focus on your compulsions, maybe? So Paxil did not mess with erection, energy or body comp? I just reall wanna stay away from any ssri meds as they are harsh on body IMO. Most mental health drugs are.
 
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