# Help and Advice > Related Illness/medication/alternatives >  Duloxetine combination for treatment resistant dep

## Snowangel

Hi I'm new here. Been on anti depressants for depression and anxiety for over 20 years. I've managed finally to reduce my Duloxetine sufficiently to try augmentation with another drug. My mental health team asked me today, had I looked at different meds to augment with Duloxetine. I'm very interested to here what combinations others have tried. I've been on Duloxetine 120 mg and quetiepine 100, some affect but still very low and anxious. I'm down to 75 mg Duloxetine now and 15 mg quetiepine, so am in a very good position for my psychiatrist to try another strategy.

Lithium has been mentioned. As its a mood balancer it worries me that I won't be able to feel happy. ( not that I ever do anyway).

Mirtazipine has been mentioned.

Aripiprazole, but can't take it because of impulse control side affects, and I'm a recovering alcoholic, 18 months sober.

Any info would be gratefully appreciated

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## S deleted

I’m on Duloxetine 120 and Mirtazapine 45. Duloxetine is the best drug for me so far regarding my mood and the Mirtz helps me to sleep. It’s not perfect but it all keeps me relatively stable.

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## Snowangel

Thank you xxx

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## Paula

Hi and welcome. Ive not taken duloxetine but have taken lithium and mirtazapine.. Mirtazapine is a very effective AD for a lot of people. Ive had it in combination with various ADs and with lithium. It makes you very drowsy so is normally taken at night - so if you struggle with sleep its a good one to try. The biggest side effect it has is that it does cause weight gain - and most people have this side effect. Dont ever take the soluble tablets - they taste foul  :O: 

Lithium is a mood stabiliser. It doesnt work until theres a sufficient level of lithium in your bloodstream so youll be getting frequent blood tests to begin with to increase the dose til its at the right level.  Of all the meds Im on, lithium is the one Id never let them stop as its the key to my health.  However, it does come with risks of a lot of side effects. It can affect your thyroid, your liver, kidneys etc. Lithium toxicity is a risk too so youd need bloods every 3 months to check all these factors. Lithium is also contraindicated with all sorts of other medications inc anti inflammatories - it doesnt play nicely.

Given all this, Ive been on lithium for over a decade which, I think, speaks volumes to how effective it is for me - Id rather deal with all the side effects than stop taking it. But when my psychiatrist first talked to me about it, she told me to go away and research the drug before we made a decision as its not an easy drug to deal with.

When Im well, I do feel the full range of emotions but they are easier for me to deal with itms. Hope this helps

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## S deleted

Of course just cos it works for me doesn’t mean it will have the same effect on everyone.

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## Snowangel

Thank you so much xxx

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## Suzi

Hi and welcome. I think it's great that you've been given the time to investigate and to look around. It's good that you've got a sensible care team.

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## Snowangel

Today they told me 'I'm not the doctor'!!

Any tried buspirone and Duloxetine for depression and anxiety

Hank you

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## Snowangel

Can anyone please advise what they have tried combining with Duloxetine . I've been looking at Wellbutrin , but need info to take with me to psychiatrist. I really don't want to take something that's going to make me put weight on. Or buspirone ? 
I have depression and anxiety and it's time for a med change.

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## S deleted

It’s probably best to discuss the best option for you with your doctor.

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## Suzi

I'm sorry you had that.

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## Suzi

There are so many medications that it could be possible to add in, but each person will have their own experiences of each one - citalopram for example has worked brilliantly for others, whereas for my husband it was horrific.... Definitely go and talk things over with a psych - they will know which ones tend to go together well...

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## Jaquaia

I've merged your threads as they are on the same topic. It's just to keep the forum tidy-ish.

I can't take duloxetine as it makes me ill but I know that Stella  takes mirtazapine alongside her duloxetine, and I've had mirtazapine alongside sertraline. There is also an academic study ongoing about the use of mirtazapine in addition to another AD in treatment resistant depression.

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Suzi (20-02-18)

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## EJ

I take lithium and mirtazapine together. I've been taking lithium for about twenty years. I can certainly feel emotion. It is a great leveller of mood and might work where other drugs have failed. Duloxetine made me very very sick so I was taken off it it very quickly. Best of luck in finding a combination that works for you.

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