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  • Pretty strange considering fluoxetine makes me sleep waayyy too much

  • I suffer from persistent depressive disorder with occasional major depressive episodes (aka "double depression"). These are just some notes in case anyone can relate. I also just find this kind of thing interesting...

    • Bupropion (300mg qd for ~1-1.5 yrs): I felt no difference at all in my energy/interest levels, but also no noticeable negative effects.
    • Diazepam (5-10mg prn): Barely perceptible effect at 5mg but felt slightly intoxicated at 10mg. Sometimes helpful to break out of dissociation during double-depressive episodes.
    • Duloxetine (60-90mg qd for ~9 months): I felt no noticeable positive effects - only anorgasmia, insomnia, and restless leg syndrome the night of dosage adjustments.
    • Escitalopram (10mg qd for 3-4 months): made me feel nauseous for ~30s every day without fail, and made me feel completely grey - no positive or negative feelings whatsoever.
    • Trazedone (25mg prn): Effective for me as a sleep aid; no experience with chronic use as an antidepressant.

  • I did a bit of searching but I don't really understand what QTc prolongation is. Can anyone help me understand?

    • During your heart’s electrical conduction there are different phases. You have the contraction of the atria. The little pumps above the ventricle (main pumps) whose role is to help fill up the ventricles. The contraction of the ventricles. The main pumping part of your heart that pumps the blood to both your body and your lungs. And the repolarisation of both the atria and the ventricles. Basically the heart muscle reseting for another beat.

      The atria contract first and repolarise first. On an ECG (heart trace) the atrial contraction corresponds to the P-wave. The little wave at the front. The atrial repolarisation occurs during ventricular contraction so you can see it on the ecg. When the ventricular contraction occurs you see the sharp up and down squiggles on the ECG. This is the QRS complex. Following ventricular contraction there is ventricular repolarisation. This occurs after the QRS complex and looks like a really big P-wave. This is the T-wave.

      QTc prolongation is when the T wave takes a long time to occur after the QRS complex. When it gets too bad it is dangerous because the electrical energy that occurs in the T wave can set off another contraction of the heart. This contraction occurs outside of the normal pattern of the heart and the heart does not pump effectively leading to something called torsades de pointe which can develop into ventricular fibrillation leading to cardiac arrest (your heart not really pumping any blood).

      Here is a labeled picture of an ECG ignore the u-wave its not really relevant and does not always occur.

      Here is a picture of the heart showing the location of the atria and ventricular Heart

    • https://en.m.wikipedia.org/wiki/QT_interval

      The QT interval is a measurement made on an electrocardiogram used to assess some of the electrical properties of the heart. (...) An abnormally long or abnormally short QT interval is associated with an increased risk of developing abnormal heart rhythms and sudden cardiac death.

      QTc stands for QT corrected for heart rate, the medication that increases QTc will increase the risk of certain dangerous heart conditions.

  • Needs a column for "makes you feel like you are Being John Malkoviching as you linger behind your own eyes and watch another version of yourself interact with the world while being confused about who is actually controlling your vessel", and put Bupropion at a 12.

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