Posted by undopaminergic on January 7, 2024, at 10:13:06
In reply to Re: Vortioxetine revisited at 20 mg » undopaminergic, posted by SLS on December 8, 2023, at 9:43:46
Hi SLS, and thank you for your reply and well-wishes. I hope you get to continue to enjoy remission.
Unfortunately, the increase of vorioxetine from 15 mg to 20 mg has not helped much, if any.
Now, I'm thinking of gradually replacing the trimipramine with nortriptyline. An alternative is keeping the trimipramine and adding lithium, up to 300 mg or so.
I would not normally have this kind of patience, it's just the situation I'm in. You are lucky to have had access to these world-class psychopharmacologists. Meanwhile, I am the best psychopharmacologist I'm acquainted with, and I don't have powers of prescription. If it were up to me, I'd go back on buprenorphine and methylphenidate, which is the combination that yielded my best (stable) results so far. To that, I'd experiment with adding tranylcypromine and/or lithium, or substituting amphetamine for methylphenidate. Memantine was great at its best, but I feel it is too dangerous (risk of manic impulsiveness) to play with on my own.
-undopaminergic
> Hi, U_D.
>
> You make a perfect example of the patience that I explained was necessary to achieve success.It can take between 2 weeks to 3 months to allow the drug/brain interaction do their work. I hope you now understand why the words I shouted at people were, nevertheless valuable. For those people who continue to avoid me, perhaps you can do *them* a favor. Please have them consider the source - again. It's not a statement regarding I.Q. It is a statement regarding the decades of my exposure to the minds of world-renowned psychopharmacologists in Manhattan, Boston, Bethesda, Princeton, and Red Bank.
>
> Man, I hope you scored a touchdown.
>
> Even if no one else has the motivation to post on Psycho-Babble anymore, please keep me informed of your progress. You have suffered so much and WORKED so hard to arrive at today alive. I told you. I have a special interest in your finding a life worth living.
>
>
> - Scott
>
>
>
> > With reference (for background and context) to my last thread about vortioxetine (Brintellix; Trintellix), at:
> > https://www.dr-bob.org/babble/20230117/msgs/1122171.html
> >
> > After a few months on 15 mg of vortioxetine [VTX], on 05 December 2023, I took the 20 mg dose for the first time. Therefore, it is still early to come to any conclusions. The half-life of this drug is around 66 hours, and it takes more than a week to reach steady-state:
> > https://en.wikipedia.org/wiki/Vortioxetine
> >
> > At first, I was a little disappointed as I didn't notice much improvement, but today I've had a more promising experience.
> >
> > Regarding how I'm feeling at different times, I've long used the terminology that it is "pretty good", "good", etc., but now I'm finding myself using the terminology "pleasant", and occasionally "comfortable". Another thing I've noticed is that my armswing when walking is better -- this is an anti-Parkinsonian effect.
> >
> > I'm speculating that I may be experiencing more of the 5-HT1A agonism, because I haven't felt much change in the symptoms I associate with serotonin transporter blockade, eg. my anorgasmia did not worsen, and my apathy also did not worsen, but even on the contrary. For example, today I had no problems staying out of bed after getting up.
> >
> > Feelings of reward in response to positive experiences, such as completing a task, have returned. Moreover, I've noticed myself looking forward to certain activities such as writing in my diary.
> >
> > This (20 mg) is the highest recommended dose of VTX, and I doubt the doctors are going to increase it more. Assuming that is correct, I have a couple of other things to suggest we try next:
> > (I) add lithium, up to 300 mg, and
> > (II) replace trimipramine with nortriptyline.
> >
> > -undopaminergic
> >
>
>
poster:undopaminergic
thread:1122281
URL: http://www.dr-bob.org/babble/20230117/msgs/1122299.html