And vice-versa. I'm taking vilazodone and lamotrigine (anti-epileptic), and they're just barely working.
Not all doctors are familiar with its use in this way. When I had to switch doctors after mine retired, I had to educate them in its use so that they would continue prescribing it.
It is also not an automatic approval by insurance companies. However, if denied by your insurance, you can get it at a fairly reasonable price using GoodRX.
If you're still struggling after what you're already one, and have gone through a few other options (and maybe even if you haven't) then I would highly recommend talking to your doctor about this.
Something to keep in mind though is that this will, mostly in the first week, impact your sleeping patterns. Taking it first thing in the morning would be the best time, and perhaps ask your doctor about using an over-the-counter sleep aid such as diphenhydramine during initial usage.
Just asking this out of curiosity, because I'm also someone who consistently experiences antidepressive effects from modafinil. Though for me it's typically more of a feeling that lasts for about 1 - 4 hours after use rather than a steady, stable mood lifting effect.
Interestingly almost everything that induces sleep harms the actual sleep quality. However I remember reading that GHB appears to improve sleep architecture, although I’ve never tried it personally
Probably not a good idea to experiment personally with GHB because it's Class I in the US and associated with date-rape, but it's worth considering in studies and research.
It does seem to be the case that disordered sleep is the keystone of depression; I can also confirm missing one dose of mirtazapine at night feels exactly like an alcohol-induced hangover in the morning. I suspect depression accumulates during sleep.
Interestingly, mirtazapine is a powerful H1 antihistamine that induces sleep at lower doses that are swamped by noradrenergic effects at higher doses. I would guess patients on mirtazapine have fewer incidents of seasonal allergies.
2. Using GHB/Alcohol/Marijuana to help you feel more rested really depends on if the person has a medical condition or not. All of these drugs will suppress REM sleep (so will your typical SSRI), which for the average person may not be a good thing. However, those with narcolepsy have a much higher rate of REM sleep, preventing their body from going into deep sleep and thus (says the hypothesis) they don't get the awakeness/alerting benefits from sleep.
Interestingly, those with depression and PTSD also have increased rates of REM sleep, so there is an interesting question of causality there.
Citation needed about the SSRI part, because one typical side effect of SSRIs is unusually vivid dreams.
I agree that the two data points are paradoxical, and I'm not sure what to make of it. Personally I have a much larger than average amount of REM sleep (confirmed by professionals when I was tested for narcolepsy/daytime sleepiness), but I do not have vivid dreams and seldom recall dreaming at all, despite talking and moving in my sleep. Nevertheless it's quite interesting.
One hypothesis could be that less time in REM sleep leads to more intense bursts of REM, thus more vivid dreams? Or perhaps I am lacking knowledge and there is more to dreams than REM sleep.
Melatonin isn't too bad for actual sleep I think, but almost all supplements give you way too much - something like 1/3mg is enough. It does give me really bad dry eyes in the morning for some reason.