Shortened to say - if you can, have Pharmacogenetic Testing to see which meds might work for you. When you see a professional, ask if they can carry out this test while you are under treatment.
Speaking from experience, the right diagnosis and meds that jibe with your genes work better than those that don’t.
All the best,
Em
And my experience is that many physicians (all?) don’t want to do testing, and I think it’s because they are watched by the insurance companies and if they order too many tests, they get dinged and possibly ejected from covering their patient subscribers. The only time I’ve heard of testing for people on drugs was for patient drug trials, where testing is part of the process to get approval.
Physicians that don’t do periodic testing don’t do their patients any favors, but the practice is widespread. They get support for pushing pills because the insurance company doesn’t have to pay for therapy, but at what cost. One pill I was on ‘required’ periodic liver enzyme testing which never happened, and generally there was no follow up care/questioning except for refills. Given the recent incident with a patient on SSRIs, maybe physicians should buck the insurance companies and do more follow ups and follow through.
I tried to go off of lexapro last year (for 6 months) because I was tired of being reliant on a pill and noticed no performance differences. I am back on it because I was mentally unstable and simply not functional every day. It almost immediately brought me to a functional state. Not to say it’s perfect but it was clear there is no way I can function without it anymore. Just my experience.
This is another thread where I think it’s extremely important to seek professional help for these issues rather than looking for advice online.
For anyone reading this, please know that we prioritize mental and physical well-being over performance on a bicycle. 
So is it best to delete this thread?
Hey Owen,
I started on Sertraline (generic Zoloft) about 18 months ago, and it has made a tremendous difference in my overall quality of life. The tradeoffs have been worth it for me, personally.
That said, it does blunt a lot of what made me ultra-competitive in my racing past, and I think that may have factored into my re-evaluation of life priorities in March of last year when I retired/quit endurance sports racing. That said, those feelings that led to that had been a long time coming; maybe the sertraline pushed me over the edge. Maybe it was unrelated.
I haven’t experienced the weight gain and stuff like that, outside of the fact that yeah, I’m doing a lot more strength training, back on Creatine, and not riding 15 hrs a week anymore, so of course I’ve put on weight, but it’s good weight. Happy with my body comp.
Two notes that I had to figure out:
Timing of when I take my daily pill - it really unsettled my stomach for about six weeks there, so I needed to take it with food. I started out taking it right before bed, but have switched to now I take it around noon. Generally in the mornings I’m well-medicated with my caffeine anyway. But once you get into the habit, you don’t notice the ups-and-downs as you do early on.
NEVER EVER EVER EVER EVER take it dry, especially before bed. That thing just sits in your throat and burns like nothing I’ve ever experienced before. Kept me up two nights for several hours just uncomfortable, even sitting up, drinking water, didn’t really help it until the pill dissolved.
Overall though, it’s made a massive difference in my quality of life. I take it for OCD/ADHD tendencies that run in my family; mom, sister, and I are all on SSRIs and they help us!
That’s been my experience. I’ve tried to ween myself off of lexapro a few times over the years and was never able to get it to “stick”.