 Hey guys, welcome back to my YouTube channel. This is Daniel Rosal here bringing you this video from my usual location in my home office here in Jerusalem in Israel and before you go any further in this video Let me just say firstly. Thank you to whoever left a comment someone left me a comment recently They said your your night backdrop is night. This is my this is my nighttime mode When I have these little RGB lights in the background, but they said why don't you try? Putting a bit of light on the backdrop. So whoever left that comment appreciate this suggestion I did take your lighting advice to heart I have not only one but two lights on me at the moment on the rear side of my desk I have my backdrop lights and I have actually a light going back there as well So I'll be interested to see when I watch this video back myself whether the lighting tinkering actually made any difference But thank you I love being a small youtuber because it means that I get to actually read all the comments that come in and Take them on board and I really appreciate the engagement from folks. So I don't want to talk about today Today's video is firstly the unfortunately I do have to put the disclaimer because it's just too risky to talk about anything related to mental health and medication without doing this this video is not a substitute for going to your doctor if you do have if you do feel that you need to be on a psychotropic medication or multiple medications or even this combo of medications Go talk to your doctor because they know about it a thousand times more than me and probably anyone else You're going to find talking to you on the internet But I do think that patient perspectives are important Which is why I occasionally upload videos about this stuff because personally you it made a huge difference to me when I Finally summoned up the courage to start Lexapro what got me over my hump was actually a YouTube video and for whatever reason the person who made it was a young female influencer And something about the video said made me think well, you know what if she Can summon up the courage to go on this medication then I can too So I do think there's value in these videos even if they're not Professional advice because that's really the purview of doctors. So the video that I want to make today is specifically about taking together Search really sorry an SSRI in this case eschatalopram and a tricyclic in this case amy tryptolin And I know that I was very very scared to start this combo So I want to just kind of talk a little bit about that why I've started this combo now Etc. So the first thing let's start with the SSRI So this is Lexapro Chemical name eschatalopram. I'm based in Israel. Hence the cool Hebrew writing over here. It's called its local trade name Cypralex or Cypralex in Hebrew And like many people I am on this medication for Anxiety and depression basically so yeah It took me a ridiculous amount of time from when a doctor said You should try this drug to when I said as I as I just said, you know what? This is what could be worse than being anxious every day I don't I just give this a shot and I've personally had a great experience with Lexapro I work my way up to 20 milligrams Which is the maximum dose that can be prescribed by a GP I've heard that sometimes psychiatrists will prescribe higher doses like 30 or even 40 milligrams Especially for people with OCD but the kind of standard maximum is 20. So I'm at the maximum dose of this drug I have had side effects. I'm not sure whether I'd like to get into that now Let's just say the typical side effects that men experience on an SSRI Unfortunately have also experienced aka a bit of dysfunction in the bedroom department But besides that a bit of weight gain or I'd say rather it's been harder to lose weight I haven't been eating very well recently. I've been eating too much takeout I've been working too hard and just not taking very good care of myself. So I Would say it's been the weight gains been faster than it usually would be or that's how I've experienced it But I've just started a one-hour a day biking regime So I'm using my exercise bike and trying to sort of get myself back down to a healthier weight So that's why I'm on Lexapro pretty standard anxiety depression I would say it's probably why the vast majority of people take this drug. Now. Why am I also on Amitryptolin? I've just started this medication a few days ago Firstly, I just want to say thank you to the state of Israel because this as you can see is a Teba medication and There are many deficits to living in Israel and I don't want to make this video about Israel because I realize it's a little bit controversial and a sensitive subject for many folks But we do have a very good medical system here and these drugs are cheap relative to what they would cost in other countries So definitely one benefit about living here. So anyway, why am I taking Amitryptolin on top of Lexapro? So it's because I have been suffering for the past few years from something called functional dyspepsia so I'm just going to give a little bit of info that I've learned myself Amitryptolin is one of the tricyclic antidepressants The tricyclics were basically what doctors had to prescribe before the advent of SSRI selective serotonin reuptake inhibitors and SNRI's selective sorry serotonin and nor norepinephrine reuptake inhibitors So these are basically older antidepressants. They came on the market in the 1950s versus Prozac that came on the market in the 1980s and tricyclics unlike SSRI's or called SSRI's because they basically all work in similar ways Prozac Which is fluoxetine serotrilline escitalopram, you guys can probably tell I've geeked out on this stuff a little bit So they all work pretty much in a similar mechanism of action Tricyclics however are named because of their chemical bond, which has three bonds hence try now The big question is well, why did psychiatry go from using tricyclics like amitryptolin to SSRI's like lexapro So I've also geeked out on this and I can tell you guys a little bit about this with again the disclaimer that if you Really want to know more go to a doctor will basically try Cyclics were less selective in terms of the neurotransmitters they targeted so for instance Amitryptolin is has I believe again correct me if I'm wrong effects on histamine and it has strong anticholinergic properties and basically when they came up with this newer class of antidepressants the drugs were Ironically or well not ironically sometimes a bit less effective, but They were much more zoned in on targeting The right neurotransmitters Serotonin and some some have a little effects on dopamine So these earlier drugs like amitryptolin or tryptolin Imipramine all the different tricyclic antidepressants basically because they were less selective They had a lot more side effects and patients at a harder time tolerating them The side effects with these drugs tend to be and stuff like Urinary urinary retention Fatigue to a much greater extent than the SSRIs And there's a few other ones. I won't really get into that So basically there is a good reason why medicine has moved on from the from the tricyclics. However Low dose at tricyclics at used doses below what would be used for psychiatric Indications like depression and anxiety these older drugs actually remained the drugs of choice for basically Nerve disorders and that seems to be what I've been stuck with when I had my gallbladder at three years ago I expected to be just back to my Usual digestive cells recently and I never quite recovered from the surgery I've been having like a ton of bloating and burping since so my gastroenterologist said Try amy-tryptolin and take 10 he actually prescribed 20 milligrams to take once a night now After I saw my gastroenterologist and I was terrified of taking this old-school anti-depressant. I Actually caved in and saw my psychiatrist first and I said look I'm in a bad place I'm really depressed my stomach isn't a mess and I accept I need to go on a medication I just need something to get me out of this hole and Don't regret doing that But my psychiatrist who I saw and you don't actually need to see a psychiatrist But I really wanted a specialist because of what I thought maybe balancing these two drugs. He said Take lexapro. It'll solve all your stomach problems now something that you might find yourself in if you have both a nervous disorder such as maybe migraines or even you know nerve pain from diabetes and You have developed a mental health disorder like anxiety or depression Like me if you have both going on at the same time you might find yourself And I hope you don't but just to forewarn anyone and what I found myself in which was a weird tug-of-war between two different medical specialties My psychiatrist was absolutely insistent that lexapro would basically fix my stomach And he would not listen to my gastro who said take amy-tryptolin He said these are old antidepressants. It's stupid. Don't take that stuff So I said, okay, I'll listen to my doctor and I went on lexapro hoping it would kill two birds with the one stone For me what I can say is that it made it's been an amazing drug firstly when I started getting my anxiety and depression under control it's really been life-changing and I think I definitely had Anxiety and depression for many years before I saw treatment I do think that anxiety and depression play a contributory role in Functional gastro disorders like functional dyspapsia or IBS But in my case I can say that no matter how great my anxiety got and there's a point where it just can't get much better Right, you're functioning pretty well without anxiety and depression in your life for me It just didn't really solve the stomach stuff. So after giving it six months on the highest Legal dose of 20 milligrams. I Finally said well if my psychiatrist isn't going to be amenable to working with my needs and what the other doctor prescribed I'm gonna have to go back to the gastro. So Now there's a lot of scary info online about combining Medications and if you put these two drugs eschatalopraminesis rye and amy-tryptolin the tricyclic into a Medical interaction checker if you go down the terrible dr. Google route. They'll say it's terrible. It's a very risky combination You're gonna end up with serotonin syndrome Which is a real thing now all I can say is that that really really scared me But I went to two doctors. They went to the gastro. He said it's fine I went to and then I also went to my family doctor with the gastroenterologist prescription and he said it's fine You don't need to worry. It is an outside chance. Here are the symptoms just in case it happens But really I've lots of patients taking both these drugs so I don't think I could have actually gone to this point of Tacking on a second drug the amy-tryptolin if it wasn't for The lexapro because the lexapro brought my anxiety down Just enough that I could not completely freak out about the prospect of taking these two things together I Just want to end up on this. So I'm really I've been on lexapro for six months I've just started taking the amy-tryptolin a week ago So I what I would say is that I have started both drugs and I can sort of do a little bit of Comparison what I would say is that the fatigue starting amy-tryptolin is really really intense So I actually tried to start this medication before Before I saw the acyciatrist and I said I'm gonna fulfill the gastro's prescription And I actually couldn't make it past the second week I was just too tired and I couldn't function on my work I couldn't function at work, but I didn't notice that around the 10-day mark not super long I went from being completely zombified to Being a little bit drowsy and kind of hard to wake up in the mornings or kind of you know when it takes you like a few hours To get out of first gear that kind of a thing It got better quite quickly. So Compared to but I remember also starting lexapro. There was started fatigue But I would say it just wasn't anywhere near the intensity of amy-tryptolin So so far having taken these two drugs just for together for a short amount of time I haven't noticed any untoward symptoms except for the drowsiness that comes with starting amy-tryptolin I haven't noticed any weird symptoms that would suggest any sort of Interaction is occurring and if I did I would just tell my doctor and probably I'm imagining He would probably get me off the amy-tryptolin Before the lexapro the amy-tryptolin if you take you should take it you're depending what your doctor advises It's common to take it at nighttime Because that kind of drowsiness sets in after like an hour and the plus advantages you will sleep like an absolute baby So I think there's definitely this all plays in together I know some people who are on amy-tryptolin actually I take that back. I haven't heard of people taking Two different these two different classes of antidepressants together just for mental health in other words You need you take lexapro and SSRI and then you also take a tricyclic to like give it a bit more effect I'm sure there are lots of people. I've heard that it can be done this kind of I think it's called Augmentation approach, but I have met a lot of people when I was and when I was anxiously obsessively Checking Facebook Facebook groups for other people who had taken lexapro and amy-tryptolin I did actually find a lot of people in similar situations to me who had Anxiety and depression and plus migraines or plus. What else do they use amy-tryptolin for? Diabetic pain plus a bladder disorder and I find lots of folks who are on 20 milligrams of lexapro and 10 20 even 50 milligrams So of course it's up to your doctor what he considers safe But just saying that there's definitely people out there doing this combination. So yeah That's just the video I wanted to make because when I was anxiously Googling this it probably would have helped me if I find someone who was had taken the combo and wanted to talk about it So I don't know if I'm going to manage to stick on the amy-tryptolin for the long term But I hope that I am going to give it. I told my doctor I'd give it six weeks at least to see if it helps with those Stomach symptoms like the burping that is currently going on It's just been kind of a bit of a bit of a plague since I had my gallbladder right anyway Thank you guys for watching after thinking about taking these two drugs in combination I hope it was helpful because I'm not a doctor and all this disclaimer stuff I obviously can't answer your medical questions But nevertheless, I hope it was just useful and perhaps encouraging in your own personal journey of Diagnosis and treatment. Thanks for watching guys, and if you want to get more videos from me They're not all about mental health in fact very few are about mental health But if you are just for whatever reason interested in getting more videos for me hit the subscribe button And you'll get your content delivered to your YouTube feed. Thanks for watching guys. Have a great day over and out