You Are What You Eat

So, now that I've a cocktail of five drugs, I'm interested about what, exactly, I'm putting in my body. I mean, what's the difference between the three sets of anti-depressants I'm on?

According to Crazy Meds, Wellbutrin XL is a multiple reuptake inhibitor, which means:

These drugs affect more than one neurotransmitter, usually serotonin and norepinephrine. Serotonin, norepinephrine and dopamine are the big three neurotransmitters responsible for a lot of depression issues. My wild-ass guess / rule of thumb is that imbalances of one or more of these three are responsible for 80% of the depression issues people suffer from. It's all just a matter of figuring out exactly the extent of the tweaking and what neurotransmitters you exactly need to tweak.

As for Remeron, it's a tricyclic anti-depressant. According to McMan, that means:

They work by preventing two neurotransmitters - norepinephrine and serotonin - from being absorbed by the brain cell's receptors, and can be a life-saver where other medications have failed. Some experts contend that because these meds have strong action on two neurotransmitters, they may be more effective than the newer generation of antidepressants, which largely zero in on only one. But owing to the fact that tricyclics are imprecise weapons that take out unintended targets such as opioid receptors and histamine receptors, patients are at risk for a range of unwanted side effects. Overdoses can be fatal.

Yay for fatal overdoses.

So, now, what's the Zoloft for? Apparently, it's an SSRI, or a selective serotonin reuptake inhibitor. Nice to know that the three are at least three different kinds of anti-depressant. Still, here's what Crazy Meds says:

These drugs don't make you produce more serotonin, rather they make your neurons soak for a longer period of time in the serotonin you already produce.

But is that the same thing?

That depends on the person and the sensitivity of your 5HT receptors. Sometimes it's the same effect, sometimes not. When not it could be sub-par (to the point of being useless) or too much.

These days serotonin is the first line of attack in conquering depression, and the most likely neurotransmitter to really mess you up if your problem is actually bipolar and not unipolar depression. While these are not happy pills, for unipolar depression they are often quite effective at keeping depression at bay. In addition to depression, SSRIs are frequently good for panic/anxiety disorders and some are good for OCD as well. SSRIs are sometimes good for the more common forms of premenstrual dysphoric disorder (PMDD).

Basically, the psych nurse is trying to cover all bases, it seems. I don't know how I feel about that. Wellbutrin and Remeron are in my system and have been for a while now. The Zoloft is the one that'll take nearly a month before I can possibly see any benefit.

I'm not even ready to touch the debate about anti-depressants and bipolar disorder. Maybe it means I don't have it. Maybe the fact I'm not having an adverse reaction means I've something else: major depression, unipolar depression, what have you. Sometimes, I think I'm drug resistant. Because I've been on Zoloft, on Effexor, Prozac, Cymalta, Trazadone, and one or two more I can't remember because it was long ago. They either seemed to help, then pooped out, or didn't help at all, or made me suicidal. Now I'm on nearly every type of anti-depressant, except an MAO inhibitor, which no one uses anymore, and a mood stabilizer.

It makes you think: if this doesn't work, what the hell will?