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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 61. This is the beginning of the thread.
Posted by Chris O on April 14, 2014, at 18:36:39
Hello, everyone. I'm on Day 10 of 20mg/day of Brintellix trial. I've seen a few musings on the dr-bob boards regarding the sexual side effects of Brintellix. I'd like to put in my two cents. For me, I can say that the sexual side of effects of Brintellix are very strong. I'm a 47-year-old man. Not taking any other meds at this time. My main issues are long-term (lifetime) generalized anxiety and depression, probably brought on due to an incredibly stressful childhood (from which I am still recovering).
What I notice in terms of the sexual side effects from Brintellix (at the risk of being too graphic) is strong decrease in sexual desire and pleasure, and fairly strong anorgasmia. This side effect seems to line up with the insert in the Brintellix samples, which said that 32% of men taking Brintellix 20mg a day in trails had similar side effects. What's so frustrating to me is that this decrease in sexual desire and pleasure seems somehow related to my anxiety and depression. Brintellix has also decreased my anxiety and depression noticeably in the last ten days. As others have noted on this board, it's ridiculously annoying that the very drugs that would allow us to be more social and enjoy life more, connect with others more, also take away our ability to do these things. On another frustrating side, I also notice that I am losing a sense of what I am doing battle with internally on Brintellix (all kinds of patterns I am trying to change from my childhood), which would seem to be a good thing (forgetting painful things), but which (to me at least) is making me more comfortable with those patterns (which is something I do not want).
Anyway, I hope this information is helpful to someone on the dr-bob boards. Even if Brintellix ends up working for me, I know I cannot pay for it at this point. So, I guess I'll cross that bridge when I come to it. Anyone else experiencing these types of sexual side effects on Brintellix?
Chris
Posted by rjlockhart37 on April 14, 2014, at 20:44:51
In reply to Brintellix 20mg: Fairly strong sexual side effect, posted by Chris O on April 14, 2014, at 18:36:39
i wrote a post about regular Prozac and the new ones like brintellix
http://www.dr-bob.org/babble/20140307/msgs/1062057.html
the thing is brintellix is not totally a SSRI classic, it's a serotonin modulator....it's hard to explain, but it's the new wave of new antidepressants.....peronally i'm not really hyped up about trying the new wave craze that will be happening soon in the medical research unless it will bring drastic change to the mood, better than prozac, better than most of the medication's i've tried....
new age of antidepessants are coming in the coming decade....
but one thing you can always add that's a crued way to treat is increased caffeine and sexual herbs you can get at the store....but some of them are most just causing agitation....believe me, those herbs that are stimulats, yombie, they can really cause bad reactions.....so,...ask you doctor about wellbutrin, or low dose of dexedrine
new antidepressants are new, and also have new side effects
r
Posted by Louisiana Sportsman on April 14, 2014, at 20:51:55
In reply to Brintellix 20mg: Fairly strong sexual side effect, posted by Chris O on April 14, 2014, at 18:36:39
This is Day 41 of my Brintellix prescription; however, for the past 12 days, I have administered 20mg. vortioxetine 1TPOQAMCF in place of my prior 10mg. trial.
I have not experienced any sexual side effects even after I doubled my dosage on March 31st. Thankfully, this is a different response than my prior antidepressant experience with venlafaxine extended-release. A reason I switched to Brintellix immediately from Effexor XR was because of anorgasmia.
Catch-22: I'm happy that you too have experienced a positive experience with Brintellix in terms of the decreased anxiety and depression, but I wish that the unfortunate side effects would dissipate ASAP! :(
Posted by Chris O on April 14, 2014, at 20:52:47
In reply to Re: Brintellix 20mg: Fairly strong sexual side effect, posted by rjlockhart37 on April 14, 2014, at 20:44:51
Hey, Rich:
Thanks for the reply and words of wisdom. When I first took SSRIs, back in the late 90s (and when they worked for me), I did combine Prozac and Celexa with Wellbutrin (though that's tricky in my case as I have a lot of anxiety symptoms). I think it took away some of the sexual side effects, but it's hard to remember, especially since my sexual life has been so un-rich for so long. Anyway, I've never tried Yohimbe (I know about it), but I suspect it would aggravate my anxiety symptoms due to its stimulating qualities. I'll ask my psychiatrist what he thinks. And I do drink a lot of caffeine (mostly yerba matte and green tea). But that does not seem to do anything, or at least, not so far. We'll see.
You're point about the "newness" of meds like Brintellix is well made. But I'm so desperate (and most SSRIs have failed me over the past eight years) that I'm willing to try things with a low side effect profile (versus MAOI inhibitors and TCAs), and Brintellix seem to fit that bill. I tried Viibryd for about eight months in, I think 2012, and it was just like, nothing. This is far better than Viibryd, though still "off" in many ways. I guess I'll give it a two month trial (or however long my p-doc will give me free samples) and see how it goes. I don't know what else to do. I'd be in serious trouble if my wife wasn't handling a lot of crap in my life right now.
Hope all is well with you, man!
Chris
Posted by Chris O on April 14, 2014, at 21:03:20
In reply to Re: Brintellix 20mg: Fairly strong sexual side effect, posted by Louisiana Sportsman on April 14, 2014, at 20:51:55
Lousiana Sportsman:
Thanks for the reply. Yeah, it's annoying. And it is bizarre how some people get side effects on these meds, and some people have, basically, none. Possibly, there is something unique occurring on a very individualized level with all of our receptors, brains, or there is something beyond receptors and simple brain chemistry involved in our symptoms. Otherwise, we could all take the same drug and have the same results.
Brintellix is having a similar anorgasmic effect as Effexor, but what's even stronger than Effexor is a complete dampening of sexual desire and orgasmic pleasure. It's interesting, to say the least. And, since my desire is dampened (and my sex life with my wife has been off for so long), the anorgasmia does not really bother me. It's also interesting that the antidepressant/anti-anxiety effect is not strong enough (yet? I hope!). I feel better, but only marginally so (but it's better than nothing, and better than the last several SSRI trials I've failed). So, at least it's something. Great that it's working so well for you, though.
Chris
Posted by LouisianaSportsman on April 14, 2014, at 21:53:18
In reply to Re: Brintellix 20mg: Fairly strong sexual side effect » Louisiana Sportsman, posted by Chris O on April 14, 2014, at 21:03:20
Hey, Rich, I have NO IDEA how I missed your March post about Brintellix. Thank you so much for the pharmacology "porn". I will most definitely review those articles when I get a chance. I certainly appreciate you sharing those. Awesome, man.
I agree, Chris! It's so strange how medications effect Person A like such and Person B the completely opposite way. That's the problem with psychoactive medications, right? Your first paragraph couldn't be more accurate.
I can't believe that vortioxetine is WORSE than the notorious venlafaxine preparations in terms of sexual malfunctioning. Interesting, indeed.
May you compare it to Effexor's efficiency in terms of an antidepressant/anti-anxiety effect? Has any medication performed better than Brintellix for you thus far, and would you consider that as maintenance?
I was hoping that at least the antidepressant/anti-anxiety effect from vortioxetine would be aggrandized enough for you to perhaps, lets get real here, consider an impotence agent (I have no experience with them) such as a PDE5 inhibitor?
The best option with psychiatric medications would perhaps be amphetamine salts. I suggest that anyone take advantage of psychostimulant if they're seeing a psychiatrist if they don't have conflicting issues or health problems with them.
I think bupropion, amphetamine salts or a modafinil are beneficial at least off-label for most psych patients to take advantage of since "normal" people lack that opportunity.
What medications are you currently prescribed right now, Chris?
Posted by LouisianaSportsman on April 14, 2014, at 22:36:26
In reply to Re: Brintellix 20mg: Fairly strong sexual side effect, posted by LouisianaSportsman on April 14, 2014, at 21:53:18
I read "Electrophysiological Investigations on the Role of Selected Serotonin Receptors and
the Serotonin Transporter on Serotonin Transmission in the Rat Brain" which is a study by Maurice Lecours who works at the University of Ottawa, Institute of Mental Health Research. Rich posted this study back in March:First of all, Chris, you might find this excerpt "interesting", haha:
"Clinical trials examining the use of vortioxetine for the treatment MDD have indeed demonstrated that vortioxetine separates from placebo, it is comparable to venlafaxine but with less aversive side effects, and it is effective at preventing relapse (Jain et al., 2013; Alvarez et al., 2012; Boulenger et al., 2012)."
Hmm...
But, what I found most interesting from the study were these following excerpts:
"These findings indicate that either the co-administration of an SSRI in addition to a 5-HT3 receptor antagonist or a multimodal agent that acts as a SSRI and 5-HT3 receptor, such as vortioxetine, could enhance 5-HT neurotransmission to produce AD and antiemesis effects, similar to that of litoxetine, after long-term administration."
To me it suggests that augmenting a SSRI may be a good idea because you got to keep this excerpt in mind:
"This study has demonstrated that selective 5-HT agents alone, such as escitalopram, and multimodal agents, such as vortioxetine, alter 5-HT neurotransmission through different receptors and exert different actions, via transporter and/or receptor activity, on the serotonergic system in the hippocampus consistent with other antidepressant strategies and with a unique pharmacological profile."
Additionally, I think you need to consider that compared to other SSRIs: "vortioxetine has a low occupancy for the 5-HTT, escitalopram was used at a dose of 5 mg/kg in order to better mimic the effects of low occupancy alone."
I'm suggesting, based upon these excerpts from the study, Chris, that maybe you should trial whichever SSRI worked best for you in the past to augment the pharmacological effects of vortioxetine? Why not the one they used in the study? (Lexapro) Maybe the combination of the two could theoretically provide a more potent antidepressant/anxiolytic effect?
Just a theory.
Posted by ed_uk2010 on April 15, 2014, at 13:36:52
In reply to Brintellix 20mg: Fairly strong sexual side effect, posted by Chris O on April 14, 2014, at 18:36:39
> Hello, everyone. I'm on Day 10 of 20mg/day of Brintellix trial. I've seen a few musings on the dr-bob boards regarding the sexual side effects of Brintellix.
Hi Chris,
Considering that the effects of vortioxetine 20mg seem fairly potent for you, I think it's well worth considering a dose reduction.
Posted by Chris O on April 15, 2014, at 15:37:50
In reply to Augmenting to Brintellix: Theory Based on a Study, posted by LouisianaSportsman on April 14, 2014, at 22:36:26
Hey, Sportsman:
Thanks for all the feedback. Wow, you know a lot more about antidepressant pharmacology than I do! I guess the gist of Brintellix for me thus far is ... it's still not a very strong antidepressant/anti-anxiety relief. I just had to spend part of the day with my mother (the cause of, basically, my f'ed up PTSD condition), and Brintellix, nope, it's not going to cut it. Nor is it giving me the energy I need to work, to get out of this hole of dependance that I always find myself in.
I visit my p-doc tomorrow. As I think I said before, I'll probably give this a 6 week trial (or whatever he thinks is fair), but at 2.5 weeks, it's still feeling pretty weak. I guess adding on other drugs is one option (you mentioned Stablon, a drug with which I have little familiarity, but the Wikipedia article makes it sound promising). I don't know. I appreciate your effort in communicating all this information to me.
Chris
Posted by Louisiana Sportsman on April 15, 2014, at 20:05:01
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » LouisianaSportsman, posted by Chris O on April 15, 2014, at 15:37:50
The stuff I earlier deliberated about is my hobby, Chris. For example, my dad knows all about firearms and ammo and stuff, and I'm sure he could "out-smart" me in that department and I can likewise "out-smart" him when it comes to psychopharmacology. He posts on forums about them like I do about my hobby so I guess he gets satisfaction from discussing it too.
BUT!
Chris, real talk, bro.
People are going to disagree with me for not being "politcally correct", but so be it.
My philosophy is: your time here on earth is limited, and you need relief from your depression and aforementioned PTSD condition *without delay*.
Look, do you think your PDOC is giving you SIX weeks for this medication that will FAIL you for YOUR benefit? No. He will just figure out what to do with you in ~3.5weeks.
Submitting this post now, so you'll see it ASAP, and consider this advice before your visit tomorrow.
I think you should demand an alternative treatment than vortioxetine because I would.
Posted by Louisiana Sportsman on April 15, 2014, at 20:48:18
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » LouisianaSportsman, posted by Chris O on April 15, 2014, at 15:37:50
To anyone who disagrees:
PDOCs, not so much on here which why I prefer this forum over any other, but more-so elsewhere have an almost "god-like" position.
Umm, OK, sure, I will admit that I didn't take the route the PDOC did in getting the credentials, but that's because I chose to do other things with my time. My advice should NOT EVER be taken over the advice over a patient's own PDOC who treats them, but anyone else, I don't care what degree you have, is fair game in terms of the advice game. Why should I bow down to anyone but the patient's PDOC? All I can do is give my opinion. Some forums seem to want to spank you for it. It's not I can write scripts. We're adults re.
And being a PDOC is not like some sort of revered talent or anything. I mean, pick up a book. They're human, I'm human, and I'm willing to bet that I actually know a lot more than a lot of them and vice versa. It's just how society is structured. I'm not sure why so many people would put so much confidence into a man they barely know based upon a degree from a university that they've never attended. They seem scared to even bring up counterarguments, alternative treatments, ask why this is being prescribed or what it does in depth or what you desire. It's like this man you just met is like royalty because he took some exams you didn't take.
My PDOC, however, she is awesome. I would never feel uncomfortable telling her ANYTHING. It says a lot about a patient-PDOC relationship when the patient feels comfortable enough to share the abuse of one of their medications and want to get off the script (Lyrica) and know that she would realize "hang on a sec, why would he bring this up if he wasn't genuine about wanting to get Lyrica? He's smart, he knows the game. D-amp must be therapeutic and not abusive for him." I feel like most patients would never ever tell their doctors what I told her if they were prescribed Dexedrine as well and people would say they were "stupid" if they did. That's very sad, but PDOCs have brought it upon themselves. If I admitted that to most PDOCs in the USA, I would have had my script of d-amp revoked FOREVER. I was later prescribed Neurontin by this doctor at a much lower dosage because I basically told her it was the best and that I thought gabapentin would be less abusive and that I would tell her if I abused it again. Guess what? I abused it again. Guess what? She writes Xanax XR to replace it with. Patients should feel comfortable talking about anything with their PDOC, and I felt like pointing out an extreme example. lol some people would probably stop going to their PDOC of many years if their insurance suddenly cut him or her off their coverage in a heartbeat, but not me...
Your PDOC may very well think 6 weeks is appropriate, but Brintellix is one of the faster working antidepressants. You should know rather it's going to be something that will work for you.
Significant sexual side effects with no positive anxiolytic response to compensate after 2.5 weeks? Let's get real. Your doctor is probably clinging on to six entire weeks because there may be a lack of ideas.
Looks like you need a MAOI since you've trialed all of the other options. I'm not sure Stablon is offerered where you live at, Chris?
Have you looked into the EMSAM (selegiline) patch? In terms of MAOIs, the side effect profile is less harsh and it doesn't have diet restrictions. If you remain on Brintellix, have you considered augmetation of a pramipexole to it? Both are good options.
Make sure you give the 12mg. EMSAM a chance since it acts differently at that dose.
If you don't want to fight with your PDOC, see if you can initiate Mirapex (pramipexole). It can be dosed up to 4.5mg./day and it can work in the lower dosage range too. Then with that on board, you can continue you it or not with EMSAM.
Posted by Louisiana Sportsman on April 15, 2014, at 21:09:36
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » Chris O, posted by Louisiana Sportsman on April 15, 2014, at 20:05:01
My suggestion is to essentially tomorrow:
*discontinue Brintellix 20mg.
*prescribption of EMSAM transdermal patch at 6mg. (0.25mg./hr.)
*prescription of Mirapex ER (if your insurance has a QDD limit on the ER; then use IR): #90 0.375mg. This allows you to be trialing a very effective 2.25mg. daily dosage or over-dosage on Days 21-30.
*initiate a low-dose benzodiazepine (e.g., Valium or Klonopin) to help with titration.
Good luck! Keep me posted.
Posted by Chris O on April 16, 2014, at 0:49:41
In reply to Re: Augmenting to Brintellix: Theory Based on a Study, posted by Louisiana Sportsman on April 15, 2014, at 21:09:36
Sportsman:
Hey, thanks again for that feedback. But I wasn't clear with respect to my p-doc situation. My current psychiatrist is extremely flexible and open. The 6-week thing with regard to Brintellix was just my guess-gestion, not his. I added the phrase "whatever he thinks is fair" as I trust his judgement in this area (how long to take something before giving up). Actually, my psychiatrist wanted me to try Nardil (or a TCA) over two years ago and I've been completely wimpy about it. I started the MAOI diet, like, 3-4 times, and every time I picked up the prescription, I never took it. So, the blame is on me here. Anyway, I'll let you know what happens. Not sure if I should augment with Brintellix as I am getting at least some antidepressant effect (which I haven't gotten for some time). At the same time, there's something missing.
Chris
Posted by SLS on April 16, 2014, at 6:52:32
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » Louisiana Sportsman, posted by Chris O on April 16, 2014, at 0:49:41
> Not sure if I should augment with Brintellix as I am getting at least some antidepressant effect (which I haven't gotten for some time).
That's encouraging.
> At the same time, there's something missing.
Let's hope that the antidepressant response grows more robust over time. If you are still missing something after a few more weeks, you might want to consider augmenting with desipramine or nortriptyline. There are quite a few other options, though. Wellbutrin, Remeron, Lamictal, and even low-dose lithium come to mind. Have you tried Abilify? It seems to work as a dopamine system stabilizer (DSS) via dopamine D2/D3 receptor partial agonism.
- Scott
Posted by ed_uk2010 on April 16, 2014, at 13:29:10
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » LouisianaSportsman, posted by Chris O on April 15, 2014, at 15:37:50
Sorry Chris, I thought you said you'd only taken vortioxetine for 10 days? Did you mean you'd been on 20mg for 10 days?
Posted by Chris O on April 16, 2014, at 19:34:07
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » Chris O, posted by SLS on April 16, 2014, at 6:52:32
Scott:
Thanks for the suggestions. As I told the Sportsman (and perhaps you too some time back; can't remember), I probably should have tried a TCA or MAOI inhibitor years ago, but I just keep wimping out on it, especially on Nardil. I started the MAOI diet at least three times in the past two years, got the Nardil prescription, but never started taking it. I took Wellbutrin with Celexa, gosh, it's 14 years ago now. I was teaching high school at the time, and that combo was working to a degree, but ... I did lose my job when I was on those meds, despite the fact that they were working. Just not strong enough, I guess.
I've never tried Lamictal or lithium or anything used to treat mood disorders because I've always thought my main condition was anxiety and depression, particularly an inability to stop ruminating. It's also a very physical tension for me. For instance, one way I can tell the Brintellix is working is that it is much easier for me to do certain stretches (and to exercise) while on it. This is something I noticed when my Celexa-Wellbutrin combo worked 14 years ago as well. I have not tried Abilify, nor have I tried anything in the amphetamine class. I guess everything is worth a try at this point.
I'll keep you posted.
Chris
Posted by Chris O on April 16, 2014, at 19:37:19
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » Chris O, posted by ed_uk2010 on April 16, 2014, at 13:29:10
Ed:
Yes, that's right, 20mg of Brintellix for about 12 days now. It's working, definitely. But ... I don't think it's strong enough. Something is off about it. I still feel like hiding, even though it's made things easier in my daily interactions. I've also lost a sense of the thing (let's call it my mother's destruction of my innermost being) that I was fighting inside. It feels like ... I'm allowing "it" (my mother's destruction of my innermost being) to win. Maybe I'm overstating it a bit. : )
Chris
Posted by SLS on April 17, 2014, at 0:06:43
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » ed_uk2010, posted by Chris O on April 16, 2014, at 19:37:19
> Ed:
>
> Yes, that's right, 20mg of Brintellix for about 12 days now. It's working, definitely. But ... I don't think it's strong enough. Something is off about it. I still feel like hiding, even though it's made things easier in my daily interactions. I've also lost a sense of the thing (let's call it my mother's destruction of my innermost being) that I was fighting inside. It feels like ... I'm allowing "it" (my mother's destruction of my innermost being) to win. Maybe I'm overstating it a bit. : )
>
> Chris
Do you feel like a broken man? I do. If anything, I have been broken by the depressive illness itself. My mother did a hell of a job on me, too. However, I became strong enough inside to have conquered most of the issues that arose because of that. The war I have waged against a severe form of bipolar depression has been too much for me after 30 years of failed treatments. I am not the same person. I know that I have had my spirit broken. I am not motivated to do many of the things I should be doing to take care of myself. I am passive and don't really care about anything. I sometimes wonder if Abilify 10 mg/day is producing this amotivation as a side effect, but I recall having more spirit 10 years ago while taking it at twice that dosage. Every man has his breaking point. I probably reached mine. However, I think I can repair myself if I were to feel well for an extended period of time.I know what you mean about hiding. At my worst, I hid from everyone, even if they were simply walking by the house and I could see them through the window. When I would see them, I would hurry to hide around a corner. I really don't understand why. I actually like people. This is the illness itself.
I intend to make Brintellix my next drug to try if I don't respond well to my current regime. Raising the dosage of prazosin has helped a great deal over the last few days. Since I have a history of relapsing after 3 days, this response has not yet proven itself.
Currently:
Parnate 100 mg/day
nortriptyline 150 mg/day
Lamictal 200 mg/day
lithium 450 mg/day
Abilify 10 mg/day
prazosin 40 mg/day
minocycline 200 mg/day
Good luck with Brintellix. It is probably the first drug you have tried that has serotonin 5-HT1a receptor agonism and 5-HT7 receptor antagonism. It binds to a few more serotonin receptors, but I am unsure as to their significance (5-HT1b partial agonism; 5-HT1d antagonism; 5-HT3 antagonism).
- Scott
Posted by LouisianaSportsman on April 17, 2014, at 1:58:17
In reply to Re: Augmenting to Brintellix: Theory Based on a Study, posted by SLS on April 17, 2014, at 0:06:43
, but I am unsure as to their significance (5-HT1b partial agonism; 5-HT1d antagonism; 5-HT3 antagonism).
- Scott
>
>Me too, Scott. I was hoping you would share your thoughts on my theory I posted earlier in this thread?
Posted by SLS on April 17, 2014, at 7:53:18
In reply to Re: Augmenting to Brintellix: Theory Based on a Study, posted by LouisianaSportsman on April 17, 2014, at 1:58:17
> , but I am unsure as to their significance (5-HT1b partial agonism; 5-HT1d antagonism; 5-HT3 antagonism).
>
>
> - Scott
> >
> >
>
> Me too, Scott. I was hoping you would share your thoughts on my theory I posted earlier in this thread?I would love to, except I wouldn't know where to look. Can you provide a link to your post here?
Thanks.
- Scott
Posted by Chris O on April 17, 2014, at 12:16:20
In reply to Re: Augmenting to Brintellix: Theory Based on a Study, posted by SLS on April 17, 2014, at 0:06:43
Scott:
Wow, thanks for that thoughtful bit of empathy. It's very helpful. Yes, I do feel like a broken man. I don't even feel like a man, to be honest. I am not able to be a "breadwinner" in any sense of the word, not even for myself. It's so pathetic. What's even more enraging is that women are still attracted to me, even at the ripe old age of 47. However, once they see my disorder, they generally flee flee flee. Unless they are more broken than me. And don't take responsibility for it. Or super controlling. Super super controlling. Like my mother was. And my wife is, to a degree. Because for controlling women, my issues work. Controlling women can completely manage me, even while they are simultaneously upset with my inability to provide. But if I provided, I would be making more of the financial and other decisions, and many controlling women cannot give up that aspect of control in their life. So, I suspect, if I ever do get better, my current relationship status would dissolve.
Personally, I don't think I've ever been well. My mother was/is a real piece of work--simultaneously overbearing and incredibly broken, completely codependent but never owning any of her damage. Very comfortable relegating all of my issues to something biological. Always asking what drug I am taking. I am getting better and telling her less and less about my life, but I am still so broken and she was basically the only person I had as a (terrible) means of support growing up. I really just wish one of these meds or combination of meds would make me feel good enough to break this bond for good. Essentially, I feel that my condition, while biological, is her "fault." (And my dad's, for not protecting me from her.) But no one in my family seems to own any of this. I figured out long ago that my only means of "escape" was making myself better. I just wish I could make myself better!
I tried prasozin for a couple of weeks before this latest Brintellix trial. It didn't seem to do much of anything for me. A little anxiety relief, but nothing much. I will probably try nortrityline or Nardil if Brintellix does not give me more relief. Or maybe I'll augment Brintellix with something like Wellbutrin to see what happens. I'm talking to my p-doc today.
I hope you can indeed, repair yourself, at some point. I understand what you're saying about needing an extended period of time of feeling "well" to do this. Without that extended period, I got lost inside, lost in projecting my anxiety and depression onto the outside world. It's truly torturous. It's even more torturous that so few people understand it, and fewer people (or substances) can do anything about it.
Your posts are always very helpful. I really appreciate your insights and sharing. Here's hoping for brighter days ahead. Always hoping.
Chris
Posted by LouisianaSportsman on April 17, 2014, at 22:13:56
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » SLS, posted by Chris O on April 17, 2014, at 12:16:20
How did the visit go, Chris?
Posted by Chris O on April 17, 2014, at 23:37:36
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » Chris O, posted by LouisianaSportsman on April 17, 2014, at 22:13:56
I'm going to up the dose of Brintellix to 30mg for the next week, then 40mg for two more weeks (or stay at 30mg--whatever feels better). My p-doc is totally open to what I want to do, but thinks it's good to try to get the maximum benefit from a single drug first before doing poly-pharmacology. I suggested Wellbutrin and he thought that was fine, but wanted to try to a higher dose of Brintellix first. In truth, it is helping me more than, probably, my last five or six trials (Vybriid, Serzone, Neurontin, Paxil, Prozac, Luvox, and a couple more). It's still not enough though. I don't feel like I can go out and get a job, function in the world like I'd like to. But I feel less like hiding, more able to look people straight in the face and talk to them. That's an improvement. And my paranoia has decreased fairly considerably. My GAD and depression tend to produce a strong paranoid streak, mostly due to my physical symptoms, I think. I'm always searching for the cause, asking myself, "What is wrong?" So, I'm going try a few weeks of upping the dose of Brintellix and go from there. Apparently, my p-doc has several other patients who have already done this, so ... I guess I'm not alone here. I'm just hoping it doesn't make my d*ck fall off. And at this point, that doesn't seem to be an exaggeration.
Hey, thanks for the concern. I really appreciate your and Scott's interaction with me on this post. I'll check back in when I have a sense of whether or not upping the dose of Brintellix is helpful.
Chris
Posted by SLS on April 18, 2014, at 6:40:09
In reply to Re: Augmenting to Brintellix: Theory Based on a Study » LouisianaSportsman, posted by Chris O on April 17, 2014, at 23:37:36
Good luck, Chris. I'm optimistic for you, even if you have to add other drugs to your treatment regime.
- Scott
Posted by Beckett on April 27, 2014, at 16:47:49
In reply to Brintellix 20mg: Fairly strong sexual side effect, posted by Chris O on April 14, 2014, at 18:36:39
Hi Chris,
First, how have things been going, and have you augmented? I wanted to throw my two cents in that Emsam is worth trying. I had a favorable response, and I thought it had a positive effect on anxiety, I was also on Xanax at the time, so it is difficult to tell.
May I also ask you about the blunting of feeling you described? Do you think it dampened the ability to experience pleasure across the board? I am hesitating to try any sort of ssri type therapy because I experienced such effect.
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