Do Psychiatric Meds and TRT Mix?

Pharma / TRT Testosterone Replacement
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So this is my first post on this website, and I’m just looking for some insight.

I’m 25-year-old, 5’10” male who has been dealing with symptoms of low testosterone for a while, specifically *really awful depression, low sex drive, awful sleep, and an inability to build muscle no matter how hard I exercise and well I eat.

My testosterone was tested in 2015, and again in 2016, where it was in the mid 350’s. This past September it was tested again, and it was at 283 ng/dL. Really low based on the averages for my age, and regardless of the numbers I had all the symptoms of low T.

Saw an endocrinologist for this in 2015, and she basically told me something along the lines of “once you work out more the fatty tissue will convert to muscle.” But it’s kind of hard to build muscle when you don’t have enough of the hormone that encourages muscle mass and bone density. Thankfully, I moved, my PCP saw my charts and was shocked at how low it was, and wanted me re-tested.

On top of that, I’ve been taking pharmaceuticals like Adderall and Prozac for a while, and finally dumped them three weeks ago. So three weeks ago I quit the Prozac and Adderall cold turkey, and haven’t even hit the gym in about three weeks.

Have been really tired dealing with the withdrawals, but chose to get off of the meds because I wanted to see what my T levels are without any pharmaceutical interaction. I’ve been lagging on most things in life, and getting T checked was one of them. Thankfully, I had my testosterone checked on Friday and am waiting on the results.

See a shrink, have a therapist, but I’m still not feeling right. Saw the endo in October, and we’re nine days into April and I’m just getting started. Overall, I’m just not feeling like I’m where I should be. Got back on the Adderall a few days ago, and I’ve been dealing with really debilitating psychomotor retardation. I can’t think, and even when I’m at the gym I feel like punching everything in sight. At least before when I’d go to the gym I had hope and a more positive emotional state, now I feel like my brain’s foggy and just feel incredibly hopeless.

TL;DR: Anyone have experience getting off of pharmaceuticals for depression and getting on TRT, and had success stories of the like?

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A few years ago I began to withdraw off of Klonopin after 30 years for my Tourette’s syndrome and ADHD which help for awhile, over the years my sex drive diminished and doctor felt it was time to come off. On the desk next to me in the doctors office was a study about what these medication do to you and how they can cause permanent damage to your hormone production by sedating the pituitary gland and making permanent changes to the way your brain works.

The 10 month slow taper is what cause the most damage, LH production decreased with every small taper until I was left with little to no testosterone. My brain had changed so much it couldn’t function without the Klonopin which I’m told affects the pituitary gland and changes the way it works.

TRT has done more for me than any medication all with no side effects, concentration is amazing and most ADHD symptoms are mostly gone. Everyone I’ve ever known who takes SSRI’s have one thing in common, they are overweight and the cause is a hormone deficit caused by these drugs. They change the way our brains function, that means LH production which can interfere with testosterone production.

I started TRT almost a year ago and have been put on some pretty terrible protocol by doctors who are clueless, these protocols are most designed to fail you. The most effective protocol for the majority of guys is 50mg twice weekly, note that everyone will need a protocol designed around your labs, problem is most doctors often fail to order the proper labs because they simply don’t know what labs to order.

I’m certain this will happen to you because doctors really don’t learn anything about TRT in medical school, so you need to educate yourself so you can spot a quack doctor when you see one and vet him/her. Any doctor that recommends an injection one every two weeks or doesn’t monitor estrogen, run the other way and don’t look back.

They prescribe TRT without knowing the half life of the hormone their prescribing which on average is 5-8 days, this makes injecting one every two weeks complete and utterly stupid.

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Wow, I definitely didn’t know that. Thanks a lot for the info.

I’ve been overweight almost all my life, until I started working out with one of my friends in 2011. Went from 226 lbs to less than 160 in a little over a year, but I was still “skinny fat” with little muscle. I looked better and felt better, sure, but aesthetically I wasn’t making muscle gains anymore, to the point that the goal of gaining muscle seemed so far-fetched that my goal just went from that to fat loss, since all I saw efficacy with was cardio

I’m calling my doctor today or tomorrow to get the results of my labs. Overall, I’m just not feeling as clear-headed as I was on the SSRI, but your story definitely helps me out, because I’m incredibly tempted to just get back on them. I know the SSRI didn’t cause the low testosterone, but I’m almost certain that it hasn’t helped either

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Definitely check SHBG, its probably high from the adderall use. It could be choking off what little free testosterone you do have.

5

Please carry on with your case in your other thread and drop this one.

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@unknownsupply, this ^ is not necessary.

This thread is a perfectly acceptable topic that’s separate-but-related to your general situation and there’s nothing wrong wth continuing the discussion here, especially in the chances it’s of use to other people.

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If only in cases like this they did not morph into split cases. New guys never seem to know in advance.

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Welcome to T Nation. You’ll find a lot of very good people on here and hopefully you’ll learn some new things that’ll help you in your day-to-day life.

I stopped taking Prozac about two months ago. I’m still taking Adderall (otherwise I would never be able to do my job, sadly). I’m on TRT. Basically I’m an older version of you is what I’m saying. Here has been my experience and perhaps it can help you.

The Prozac seemed unnecessary, which is why I discontinued use. I needed it for a while there, but once I was able to get back into a good routine I didn’t want to have to rely on it anymore. I still have bad days, and sometimes bad weeks. If you suffer from depression—the real, clinically diagnosed kind—then you will always have to fight it. Your whole life will be different than it would be if you didn’t have it. That very fact weighs heavily on my soul sometimes. I’m sure you know that feeling as well. So you must treat it like a chronic illness and always practice good self-care. For some that’s medication. For others it’s working out, or meditating, or being with friends, or or or. Everyone who has been able to overcome it has done so a little differently and I have yet to see a blanket solution. One thing that we know helps is exercise. For me it was like the lights came back on after a long period of darkness. Right now you’re talking about being in a fog when you’re working out, and that tracks pretty closely with some of the withdrawal issues that you’d expect. But that fog lifts eventually, I promise you. Find inspiration somewhere and then let it guide you.

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Alright, thanks. I know my endocrinologist ordered a lot of hormone levels to be tested for the bloods I did on Friday, so I’m 100% calling him tomorrow and hoping he has the results.

It just sucks because ever since I got off the SSRI and Adderall I’ve been feeling more depressed, less motivated, and every little task feels like moving a mountain. At least on the SSRI I felt a bit more “pepped up” and motivated to go to the gym for my general health, and my energy levels were better. Staying off is definitely better long-term, but I hate dealing with these symptoms of low energy. Arguably worse than not being able to make gains. At least when I had energy I could do cardio for and had more self-control. Tasks that were so small a month ago (i.e. grocery shopping, brushing teeth) literally take mental energy to accomplish now. It’s hellish, but I’m gonna keep fighting.

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Thanks, hoping to find some good info on here, and give as much forward as possible. Wow, that’s really helpful. If you don’t mind me asking, what doses were you on for Prozac and Adderall? And what kind of symptoms did you experience?

Talking to friends seems to help a lot, and I was diagnosed with dysthimic disorder by one professional and general depression by another. I’ve never been suicidal though, too many good people in my life to even consider that. I’m also really self-conscious (aren’t we all on here?), and just hate the fact that I’ve put on 10 pounds of what looks like pure fat in a month. Exercise helps a ton, it’s just the getting to the gym that’s the hardest. Beyond the gym even, there’s a fog in my brain and I just feel really mentally “slowed down.” Like someone threw teargas into my brain that hasn’t stopped spreading. The gravity of every task seems so much greater now, and I’m just mentally comparing this time of being on an SSRI compared to the last time I wasn’t on one, and it literally lines up, which tells me chemically not much has changed.

I think SSRI’s are literally a last-ditch for anything, not something that should be given to someone as a first resort, but I’m not too optimistic that this is gonna pass if major lifestyle changes and TRT don’t happen, either.

All in all, I know the cliche is “you get what you put out,” but it’s hard to come to terms with the fact that I’m not getting out for what I’m putting in

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My mistake. Do you think I should bring that here, or the other way around?

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So I believe my Prozac was 20mgs/d. I honestly stopped thinking about it after years of being in it because it was just “take pill before bed”. The Adderall is another story. I’m prescribed 20mgs, twice daily. But I never take that much. It’s almost always half that a day. One of the reasons you feel like shit without it is because it’s a pretty efficient drug when it comes to dopamine release. You just feel good on it. Once you’re used to that it’s not easy to go back to normal. Depending on when you started and how long you were on it could kind of rewire the way your brain processes things. For some people it’s almost a lifetime treatment in a way. I know that I need it for my life now, but I didn’t need it five years ago because I wasn’t required to be focused and cognitively consistent.

I think you have some options in front of you and I like that you’re skeptical of SSRIs. I have a hunch that a decade from now we’re going to start seeing reports drip out about how much more harmful they are for young men to take. I’m not sure that we know the full extent to which those drugs interfere with hormones over the long term, but I would be surprised if they’re as safe as we’ve been lead to believe.

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Some great advice in this thread \m/

You’re doing well considering you’ve stopped Prozac suddenly. I can’t comment on Adderall because I’ve never been prescribed that.

I’ve a diagnosis of Aspergers & depression and I’ve always felt like that since I was 5 or 6 years old.

I started SSRIs at 23 years old & Im now 41.

I started TRT at 38, but I felt my testosterone crash at 23 after a few months on the SSRIs.

I know from blood tests I had healthy testosterone levels pre SSRIs… BUT I was also a basket case pre SSRIs!!

I currently take 75mg of venlafaxine a day (reduced from 150mg) & 30mg mirtazapine a day.

My experience is I probably still need those drugs. My rough plan is to verrrry slowly come off venlafaxine, see how I am, then try coming off mirtazapine. It’s a work in progress, I’ll see what happens!

As Iron Yuppie said, there’s no blanket solution - life is hard (and I don’t think it’s meant to be easy, anyway).

My experience is mental health is holistic & it has 3 parts - mental, spiritual & physical.

I need to do something every day for all 3 parts - I often don’t haha - I’m human & a lazy fooker :smiley:

One benefit of being sensitive & having to do all this stuff is that you can have a richer more nuanced life than those who don’t have to work on themselves.

At 41 I see a lot of people who stop growing & developing at 25 & at 50 are still doing the same shit they did at 25.

Because you have a gun against your head (depression) you have to grow emotionally or you want to die. Pain is a great motivator & a great teacher - although it usually only feels like that in hindsight. In fact if I didn’t feel pain & felt good no matter what, I’d probably just spend my life wanking, eating pizza & playing PlayStation hahaha

You can get as much or as little from your mental health as you want. If you just want to feel ok - that’s hard enough work as it is - but what is also on offer is enlightenment through growth.

It’s possible to go on & do great things because of your depression.

Stick at it mate. A grizzled old army friend taught me the hardest things are perseverance & endurance, but persevere is what we must.

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Wow. That’s great advice man, thank you.

No, I mean I’ve been sleeping at 5:30 AM and waking up at 5 PM… something that I need to change ASAP. I want to start taking classes in the summer, and I got back on the Adderall but that didn’t really seem to help a whole lot. Just seemed to speed me up.

Did the TRT help your depression at all? I’m really putting all my eggs in one basket so to speak, and hoping that it will help me manage my goals and get what I want out of life. One of my friends took Venlafaxine, and I saw firsthand that the withdrawals were pretty hellish for them. Heard that it’s one of the hardest antidepressants to come off of, so good luck when you do. Right now I’m feeling ok because I finally got myself to the gym and did 40 minutes of HIIT, but if I didn’t… things would def be a mess. I just feel like I lost my sense of self when I stopped going for the month, but I also had no cognitive energy to leave the house.

I feel like as soon as I sit down now, I get depressed, so I have to stay active physically or else I can start losing my bearings.

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Oh, ok. Yeah I was at 20mg’s a day, tried tapering down at 10 mg in the fall and that failed, then got back on, and finally decided to bite both bullets after seeing how garbage my stamina was. Plus, I really wanted to make sure I did my labs without the medications in my system.

I actually started taking the Adderall again a few days ago and noticed that it wasn’t even helping much with focus, and it doesn’t give much physical energy, just more of a mental “wired” feeling. Hopefully I can get off of it again soon.

I’m not even sure as to how safe they are, because medicine knows so little about the brain. I’m sure all the studies out there now don’t even account for 2% of what there is to know.

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Yeah TRT helped loads & continues to help loads.

My experience is it gives me the mental & physical normality to get on with the other things I need to do to stay well. It’s not a complete solution - me personally - left to my own devices I have a real spiritual malaise where nothing is good enough.

The TRT helps me work on that. The TRT is very important for me.

It might be all you need or you could need the holistic stuff, but my experience is TRT is a big help.

Like all this stuff ask lots of people’s opinions, keep asking for help & that’ll help you make informed choices on your meds etc

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That’s really encouraging.

I feel you exactly on that. Feel like I’m trying to do too many things on my own sometimes, and then get overwhelmed and drop everything.

Have been especially depressed (low energy, a bit more moody) this past month since I got off the meds, and the results of my most recent labs came in if you want to check that and my other post, and they may have contributed to that.

My dad actually meditates and is really big on that, but I’ve been too stubborn to take him up on doing it with him. In my experience with meditation, I keep thinking “why am I doing this, I feel no better.”

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I feel you.

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I used Escitalopram for a couple months in the past, before my TRT. Luckly I was checking T almost weekly. This is my T progression after starting this SSRI:

Nov 03 - 336 (before SSRI)
Nov 10 - 278
Nov 17 - 174
Dec 01 - 215
Jan 01 - 155

Historically my T levels have always been 300+, so it must have been the meds. I saw a study on rats that got their T halved by SSRI usage.

If you are low T, using SSRI will likely make things worse.

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I reckon most things are better when you work as a team. Most tasks are so much easier if there’s two of you or more.

One thing I’ve found that’s really helped my well being is learning a martial art. That’s more than likely too much for you at the moment, but once your mood has been good for a while, a martial art teaches you so much.

When a 130 pound, 65 year old could utterly demolish me through technique, it taught me a lot of humility, patience, perseverance. I’d never stuck at anything for very long before - accepting it’ll take you many years to get reasonable at something is a great change in perspective!

I’d recommend something very skill based like Jujutsu & also at the same time do something more brute force like kick boxing - the more physical stuff really teaches you about yourself too. It showed me my physical limits were much higher than I believed. It’s some kick ass rite of passage stuff.

The meditation is just practice like weight training, you need to rewire the brain in the same way you rewire your nervous system to deadlift heavy :slight_smile:

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