T Nation

Do Psychiatric Meds and TRT Mix?


Wow, this is really helpful, thanks.

Do you know what your testosterone levels were like before the med and after?

I still haven’t fully read KSman’s stickies fully, but plan on doing so stat.

In my case, I was given Prozac as an anti-anxiety but they also worked to take the edge off. Kinda gave me energy and helped me be more ignorant to my depression. Killed sex drive, but at the time I began taking them was taking 23 college units (6 classes) and was in a committed relationship with my textbooks.

However, I also realized that it helped my mood, and like you said, it really took the edge off. I felt more positive emotion than negative, and felt a lot more centered. Couldn’t feel “great” and really, really excited, but also couldn’t get low. Felt robotic and objective, which I guess was okay with me. Now, without it, I feel like my temper is a lot shorter. For instance, my bench is terrible (I’m 5’10" ~185 and benched 95 lbs for 10 reps x2, and 97.5 for 3 reps)… really bad numbers. Ended up bitching about it to one of my really good friends, and they reminded me that it takes commitment to make gains, which I know is obviously true, but I wasn’t making gains before when I was committed.

Needless to say, I responded rather hastily and immediately felt terrible and regretted it. I feel like on Prozac I would’ve just been fine. Now, if I was on Prozac that conversation probably wouldn’t have happened since it regarded TRT, and I specifically got off of Prozac in order to get on TRT, but I digress. Same thing with hanging out with friends, since I don’t have the energy, I don’t seem to want to go.

Regardless, I’m more hopeful that testosterone will do more for me than antidepressants ever have.


The main thing to remember with antidepressants is that different people react to different drugs in different ways. Prozac might be OK for you, but Sertraline might not work.

My total testosterone levels were OK, I think in the 450 to 500 range. But I had high SHBG, so my free fraction was lower than a lot of people here. I was eventually diagnosed due to high LH and FSH levels.

If you need actual numbers, they’re in my thread.

I don’t know if TRT is a great treatment for depression, but it can help, and there have been some positive studies.


I’d love to give you advice, but this is your health and mental health. I’m not familiar with testerone supps so I really would rather stear you to see a dr. I am by no means where I’d hope to be because I am still not cleared to drive which is mindfucking awful except I love to bake and cook and hook my neighbors up and they help me in return, and I also have people take me to recovery centers and hospitals to “give back” And I volunteer whenever I can. At the moment, I’m not working though…I keep myself busy 100% of time because I have drs appts, work out, can’t drive, have a house to keep clean with two crazy shedding dogs, and don’t need the constant stress. I’m here if you need to talk, but I’d rather not give you medical advice when I don’t know your situation. If you suffer from depression, I don’t know what might trigger you and would hate to do that. Admitting and asking for help, really takes balls! Well done! Plz talk to your dr cuz they are much more qualified than me. As I said I’m here and can give :hugs: but I don’t want to cause you any harm​:hugs:


and many doctors are under the belief the half life of Testosterone enanthate is close to ten days rather than 4.5 days, which is ridiculous. When doctors prescribe insulin to diabetics they give them enough so they can regulate their blood sugar, imagine if instead of doing that they gave them a huge dose of insulin, rendering them into a severely hypoglycemic state and then waited a few days/weeks until the diabetic is severely hyperglycemic and then do the same thing over and over again… That’s how TRT is practiced in Aus and in the UK, it’s so, so stupid. The half life of the SSRI fluoxetine is 1-3 days, but doctors prescribe the medication to be taken on a daily basis, if it was like TRT doctors would prescribe the drug to be taken like once every 15 days or so, it’s just ridiculous. Primoteston shots every 3-4 weeks are the norm here, EVERY FOUR WEEKS for a compound with a 4.5 day half life!


Oh wow, I haven’t tested my SHBG, but that’s good to know as I’m probably doing one last test before starting the therapy. FSH and LH were 3.6 miU/mL (1.6-8 ref range) and 3.3 miU/mL (1.5-9.3 ref range) respectively. Which is apparently normal according to the lab work, but I’m not sure if it actually is.

If you don’t mind me asking, for your depression therapy, is that treated with medications as well? I really don’t want to go back to SSRI’s, hopefully I can figure out how to function without them, but if I do I want to be informed on how they can impact my overall health (physical and mental) and fitness goals.


Nah, that’s no worries! I appreciate the help, I’m trying to get as much info as I can before I begin, just so that I don’t regret not knowing anything prior to starting. Quite confused if you can’t tell.

That’s awesome! In the least creepy way, I wish I could be one of your neighbors :slight_smile:

My depression actually really doesn’t have any triggers, it kind of washes over me in a sort of apathetic way where I don’t feel much. It’s pretty sad (well, it’s depression… guess it’s supposed to be). I.e. today eating dinner by myself I just felt this wave of emptiness inside of me and had to get myself to the gym to do some cardio in order to get out of that funk.

Glad you’re keeping yourself busy and taking care of your mental and physical health. One of the best things you can do, and same to you, here if ya need help.


CCool, when ya felt down you motivated yourself to work out. Awesomeness. I just got done doing a full body workout. Drinking chocolate milk and making second breakfast atm…eggs with hash browns and chorizo. Never feel alone, because there is always someone more alone than you. I am happily married, but was working a gazillion hours a week and my ex was a douche. When I was with that sigh, mistake, I never felt more alone. Do you have any pets? Their unconditional love is the bestest. My pit/lab mix is so protective of me. I’ve really had to work with him. Editing…my heart meds make me a little volatile at times and won’t let me sleep, sigh…so, I might sometimes come off as a total bitch or dumbass so didn’t want to trigger you and mental health stability is essential to enjoying life and didn’t want to go beast mode on yas. But drs like people mess up, but some meds have serious reactions or side effects. Drs are essential because sometimes depression can simply mean your blood work is off or that you do have “clinical” depression and need meds. Most meds have side effects, but each person is different. Take care and hope you have things that motivate you!


LH and FSH should be at the lower end of the range according to my doctor. So 3.3 or 3.6 miU/L is fine.

If they’re low (below 1.5 miU/L), it indicates that your pituitary isn’t working, and you’re likely to have secondary hypogonadism. If they’re high (above 8 or 9 miU/L) your testes aren’t producing enough testosterone, so your brain is screaming out for more.

I’m not on depression meds at the moment. It’s not too bad, so I can live with it. Don’t worry about using them if they help, I think that there’s too much stigma towards them.


Thanks a lot. Yeah, I definitely do. I already have a therapist and psychiatrist. Just not fully confident with my endocrinologist, he’s a nice guy and all but the vibes weren’t there, so that and trying to make sure I follow protocol properly and doing all the research I can is really all that’s delaying me from starting it stat.

That’s great. I don’t have any pets, but want to get a little kitty soon. Love cats, and dogs :slight_smile: , but don’t have the time / energy to take care of a dog right now.


Ok sweet, that’s really helpful. Was wondering if my hypogonadism was primary or secondary, so that helps to narrow it down to primary. And I also want to get SHBG checked like alphagunner suggested, to see where my free testosterone is.

Alright, that helps. I just felt a lot more centered and didn’t isolate myself at home all the time. Like now, the gym is a must for my mental health, whereas before I could miss a day or two and not lose sleep. I also hung out with friends once a week on the weekends, and now I’m isolating myself in the house because I feel like I’m too low energy / boring and don’t have anything of value to contribute.

Just sucks when who you know yourself to be and the way you feel don’t correlate with each other. Best way of putting it is like someone put a flashbang (CoD reference anyone?) in my brain and I just can’t think. And like I said my fuse is a ton shorter. Hoping the TRT takes care of some of the depression issues, but my life isn’t just the gym.


Awesome sounds like on right track. Cats are way less maintenance. Good luck and keep thinking on positives!


You can also get free testosterone measured directly, it really depends on the labs in question. There is a correlation between low free t and depression.

I don’t think that TRT is a magical cure for depression, but it can help. It was sometimes used as a treatment prior to the development of modern antidepressants, and there is some experimental evidence for it. (The study I saw used 400 mg per fortnight, which would be considered a dumb protocol around here, and had a fairly positive outcome.)

Lastly, I agree about trying to get out more. With depression you need to fight against it.


That helps. The last time I got my free testoterone checked was December 2016 and it was 65.1 pg/mL (ref range 35-155), before that it was 57.1 in September 2015. Yeah, I mean I think I’m dependent on this Adderall just to function throughout the day. I got off of it and Prozac cold turkey, but at least for the first two weeks I could work out and feel positive afterward with coffee, since there was still serotonin in my system.

Now, there’s nothing there and if I don’t go to the gym I might as well not exist. Also don’t feel the urge / need to hang out with friends as much. Feels like it takes too much effort that isn’t worth it. Not sure if I’m getting emo or something.

Absolutely have to fight it everyday. My sleep schedule’s been terrible, too (sleeping from like 8 AM-4 PM…). I know I need to get those things in order to even be able to function in the slightest. Right now I guess I’m also trying to be compassionate with myself so that even if I get little things done like make a few phone calls, get my car washed, and go to the gym I can celebrate the small victories.

Also not sure if the Adderall caused the low testosterone or if it’s been this way for a while. As you guys have read, I’m assuming it’s the latter, and that Adderall didn’t help.


Yes, celebrate any victories. Mental illness is rough. My ptsd and meds gets to me and sometimes I misperceive things, get volatile or do self-destructive things. For instance I felt my relationship threatened so I burned over 1,400 calories on elliptical like a dumbass…had on highest resistant incline did frontwards and backward intervals and I feel much better cuz I got out tension, but I know better (kids self in ass). Life is rough and it’s nice to know there are others that can help you see that everything will be ok it’s just in your head. This site is a good support network, but I have my drs, too but it’s the weekend, and I just felt like I was going to have a mini meltdown earlier. We just have to look at positives. :hugs: edit…don’t worry,I’ll make it up to my body. Two rest days with higher calories every 2 hours.


Oh, jeez, that’s terrible. Good thing you realized how destructive that is, hope you’re feeling better. Definitely agree that it’s harder to see rationality when the brain’s so fogged up, it’s frustrating. Hard to self-motivate, even worse when you don’t feel like yourself. Keep at it :smiley:


I’m gonna still take another rest day. Had a lot going on and haven’t slept enough. Need to take care of my health and I push myself too much. Yeah, I recognized I was a dumbass but I doubt it’ll ever happen again.


Just as an update, I’m calling my endocrinologist first thing in the morning to schedule a consult for TRT. I do still have some questions to ask him, as I’m not completely comfortable starting just yet, and want to see if he’s willing to order more labs such as cortisol.

If anyone’s interested, these are the symptoms I noticed since getting off of Prozac about 1.5 months ago:

-Less focused. I love the tv show Westworld on HBO, and it took me about 3 hours to watch it since I kept zoning out. I’m not as clear-headed as I was without the pill. On the pill in November when I “binge-watched” it, I finished half the series in less than a week.
-Reading comprehension decreased. When I read, kind of similar to watching TV, I don’t really remember half of what I read. My comprehension is definitely worse.
-Less willing to go out with friends. I still force myself to go to the gym, and used to set aside time once a week, usually on Friday or Saturday nights, to hang out with friends, but ever since getting off I haven’t had the energy to go out.
-On Prozac, I feel like I could empathize more at least on an intellectual level, and without it I feel more mentally dull.
-Panic attacks / more anxious. This is probably from the fact that I still take Adderall, and it definitely ups my anxiety. I realized that I have a pretty significant health anxiety that cleared up with Prozac. I.e., went to a concert a few weeks ago, and after taking a few hits of weed from a joint thought I was dying. I went to the bathroom and literally felt like I was dying, and a group of paramedics checked me out and realized that I had a severe panic attack. I’ve smoked weed on and off for 8 years, maybe once every couple of months now / very rarely and socially, but never noticed panic attacks until recently, which I feel is from the Adderall.
-Less sweaty. This part is good, on Prozac I definitely sweat more which socially was embarrassing.
-Overall my attitude I think has become more negative, and whereas I believe my true self to be full of positive emotion, I feel like I’m a lot more anxious than I’ve ever been before. And on top of that my frustration tolerance, which was pretty normal with the med, has definitely gotten lower. Where I’d normally be frustrated and annoyed with things such as my bench press, I get genuinely upset now.
-Poorer psychomotor skills. My psychomotor skills (how quickly I react to things, grace, coordination) have definitely decreased. In the gym for instance, I feel off balance at times and feel that I wouldn’t have been before.
-Worse sleep. This is probably the worst part. Since things take me longer to do, my sleep has been pushed back significantly. Poor sleep can significantly impact testosterone production and maintaining normal hormone levels.
-Erections have stayed about the same, I haven’t noticed many problems there. But regardless my interest in sex and women is absolutely atrocious. Caring less isn’t normal. Almost like I’ve turned that part of my life off, and full / healthy human beings are somatic & cerebral.

Now, if anyone’s working with their doctor and is having any concerns about their doctor, I found this article really helpful to me in deciding whether or not I should begin TRT with the doctor I currently have: http://www.peaktestosterone.com/First_TRT_Doctor_Questions.aspx


All of the symptoms you just mentioned I experienced when my testosterone was 225, however all are gone now that I’ve started TRT. The Prozac is a band aid for low testosterone, Prozac is rewiring the brain all so you don’t feel the effects of low testosterone.

You’re willing to take a drug, a chemical that isn’t natural to the body which rewire the brain and are concerned about taking a hormone which is natural and is at the heart of why you feel the way you do.


That’s helpful, my testosterone was 224 a little over two weeks ago which is terrible.

Oh no, I’ve actually been off of the Prozac for 1.5 months now. Was just putting that there for anyone interested in what the differences were and how I feel now that my brain’s getting back to baseline without it. I guess I want to make sure I’m not going to risk anything in the future health-wise and want to know as much about the process as I can going into it.

Do you know if testosterone is like an SSRI or other drugs, that in the case that it doesn’t help, I could get off and get back to where I am now? I’m hopeful that this won’t be the case, but I wondered what that was like just for the information.


Testosterone isn’t a drug, it doesn’t have the high that you get with drugs, it’s a natural high. If you can remember a time when you didn’t need drugs and when you felt normal, no anxiety, no depression, that’s what TRT feels like.

Estrogen is the sleep hormone and when my testosterone was low so to was my estrogen, sleep was terrible. I would lie awake in bed at night unable to fall asleep, now I fall asleep and stay asleep for 8 hours.

The speed at which you recovery depends on the skill of your doctor, get an incompetent doctor and you will be forced to quit TRT never truly knowing how it could have changed your life. Insurance doctors are sure to fail at TRT, it’s almost universal.

If you don’t have good insurance don’t waste your time with those doctors, pay out of pocket for a hormone specialist who does TRT day in and day out. Avoid these T-clinics (T-mills) staffed by idiots who pretend like they know what their doing.