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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by SLS on July 9, 2018, at 21:22:28
Hi, All.
I had a bad reaction to Trintellix. It is hard to describe. Trintellix left me dazed and with anxiety in the pit of my stomach. My mind was numb and it felt like there was some sort of ringing in the center of my head. Inner tension. Dysphoria. All I wanted to do was to lie on the couch and bury my head in a pillow. I tried to sleep all day long. I didnt want to move. It was getting worse day by day. I discontinued the drug a week ago and there are still residual negative effects. They are dissipating slowly. Trintellix has a 66 hour half life.
Initially, I had wanted to switch from Parnate to Effexor. My doctor suggested that I try Trintellix first since he had some success with it in TRD and it was something that I had never tried before. It was the logical move. I began taking Effexor today. I expect a better outcome.
- Scott
Posted by rjlockhart37 on July 9, 2018, at 22:34:32
In reply to Bad reaction to Trintellix., posted by SLS on July 9, 2018, at 21:22:28
effexor is better, its a potent anti-depressant ....stimulant like effects, never taken it but i've read good reviews on it, just stay within treatment only thing with effexor if you off is withdrawal thing, but i don't think you'll have much problems
Posted by rjlockhart37 on July 9, 2018, at 22:37:09
In reply to Bad reaction to Trintellix., posted by SLS on July 9, 2018, at 21:22:28
trillitex is a serotonin antidepressant, if you were on parnate, it would of effected serotonin less, that's why maybe you had the hazy feeling, effexor SNRI, its a stimulant like AD, hope it works well, keep updated
Posted by Christ_empowered on July 10, 2018, at 9:23:13
In reply to Re: Bad reaction to Trintellix., posted by rjlockhart37 on July 9, 2018, at 22:37:09
sorry about this. i don't know what all you're on, but as you know, adding remeron (or I think wellbutrin, sometimes) to effexor can result in more symptom reduction, now and then even full on remission, in some people. my only "issue" with using wellbutrin would be the seizure risk and blood levels of everything else...could get tricksy...maybe ritalin?
a poster here swears by savella or whatever the brand name for the new milnaciprin is, in the US. a former shrink recommended amoxapine for me. have you tried it? -if- one responds, its supposed to happen within 2 weeks or so, kind of like today's 'atypical'+antidepressant cocktails (faster response, more symptom reduction, etc.).
ok. again, I am sorry about this. its always a let down when something fails miserably, especially a new, modern pharmaceutical option. back to the golden oldies...
Posted by Lamdage22 on July 11, 2018, at 5:32:11
In reply to Re: Bad reaction to Trintellix., posted by Christ_empowered on July 10, 2018, at 9:23:13
Good to hear. Hang in there
Posted by Lamdage22 on July 11, 2018, at 5:33:30
In reply to Re: Bad reaction to Trintellix., posted by Lamdage22 on July 11, 2018, at 5:32:11
i mean its good that you figured it out that it isnt heping. That may mean you will be better soon.
Posted by bleauberry on July 11, 2018, at 7:48:56
In reply to Bad reaction to Trintellix., posted by SLS on July 9, 2018, at 21:22:28
Wow that's sad news, Scott. I had my fingers crossed that something at least half decent would come from that med.
I've been struggling to think of good ideas. Effexor makes as much sense as anything, I guess. Other than that I might have thought maybe Prozac+Ritalin, Prozac+Zyprexa+Ritalin, something that puts more emphasis on dopamine than your previous treatments did. I think the entire psychiatric community is off target by making serotonin their primary thingy. It should be dopamine first, norepinephrine second, and serotonin third, in my opinion.
Firing. I think there needs to be more firing. Not necessarily more neurotransmitters. But more activity. More shooting out of neurons and going to reuptake and shooting out more. Basically normal brain operation except turbocharged. Adderall or Ritalin could help accomplish that. I just think Ritalin is a way better med for psychiatry than Adderall is.
Add in maybe 3 anti-inflammatory herbs, maybes 2 or 3 antimicrobial herbs, and maybe 2 basic supplements to beef up the detox system, and I think those 3 strategies could make whatever meds you take get you a lot better results. But slow. Talking 3-9 months to see anything.
Hang in there!
Posted by Lamdage22 on July 11, 2018, at 12:01:57
In reply to Re: Bad reaction to Trintellix. » SLS, posted by bleauberry on July 11, 2018, at 7:48:56
No dopamine please. He has been manic/psychotic in the past. Dopaminergic meds have had a bad influence in my life.
Posted by Christ_empowered on July 12, 2018, at 9:11:34
In reply to Re: Bad reaction to Trintellix., posted by Lamdage22 on July 11, 2018, at 12:01:57
i respect the herbal side of "alternative health," but I really do personally recommend vitamin supplementation, Orthomolecular style.
I still need my 'atypical' and such, but I'm doing much better. The costs are lower than with heavy herbal supplementation, and I seem to get more mileage out of my psych drugs...
plus, I have 0 EPS, 0 TD, not even stiff gait or major drug-induced dysphoria. I'm thankful.
I don't know how much I buy into -everything- the Orthomolecular people have to say. Not that they're lying or anything, just...as with other forms of alternative health, on the extreme+dedicated end, there seems to be a dogmatic component to it, so basically...
in Orthomolecular psychiatry, some of the 'experts' can seem just as bound by dogma and ideology as the hardcore mainstream shrinks. and yet...
for me, niacinamide and Linus Pauling-level vitamin C (I'm at 20 grams/daily) have made big improvements in my health and "symptoms," etc.
Posted by TriedEveryMedication on July 14, 2018, at 16:06:55
In reply to Bad reaction to Trintellix., posted by SLS on July 9, 2018, at 21:22:28
Posted by SLS on July 15, 2018, at 8:02:20
In reply to how long were you off the parnate for? (nm) » SLS, posted by TriedEveryMedication on July 14, 2018, at 16:06:55
I have been on Parnate several times. My most recent treatment lasted for at least 3 years.
- Scott
Posted by TriedEveryMedication on July 15, 2018, at 12:09:09
In reply to Re: how long were you off the parnate for? » TriedEveryMedication, posted by SLS on July 15, 2018, at 8:02:20
Posted by SLS on July 15, 2018, at 22:33:40
In reply to no, I meant your wash-out period (nm) » SLS, posted by TriedEveryMedication on July 15, 2018, at 12:09:09
:-)
Sorry.
I waited 10 days.
- Scott
Posted by SLS on August 4, 2018, at 7:41:41
In reply to Bad reaction to Trintellix., posted by SLS on July 9, 2018, at 21:22:28
> Hi, All.
>
> I had a bad reaction to Trintellix. It is hard to describe. Trintellix left me dazed and with anxiety in the pit of my stomach. My mind was numb and it felt like there was some sort of ringing in the center of my head. Inner tension. Dysphoria. All I wanted to do was to lie on the couch and bury my head in a pillow. I tried to sleep all day long. I didnt want to move. It was getting worse day by day. I discontinued the drug a week ago and there are still residual negative effects. They are dissipating slowly. Trintellix has a 66 hour half life.I restarted Trintellix 10 days ago hoping that I would be able to tolerate it at low dosages. I spent 7 days at 2.5 mg/day. I then raised the dosage to 5.0 mg/day. After 4 days at this dosage, I experienced the same reaction as I described above. I decided to discontinue Trintellix. I'm not sure what to do next. I am frustrated that I am going around in circles with this stuff. I have a feeling that Trintellix has changed serotonin receptor sensitivity. I might not be able to tolerate another serotonin reuptake inhibitor right now.
- Scott
Posted by ed_uk2010 on August 4, 2018, at 10:07:09
In reply to Bad reaction to Trintellix - Again., posted by SLS on August 4, 2018, at 7:41:41
Hi Scott,
I think what you need to do is have a longer 'washout' from vortioxetine, SRIs and other serotonergic drugs before trying an additional antidepressant (eg. venlafaxine). You should then be able to tolerate it again, starting with a low dose.
In the mean time, might a little bit of a serotonin receptor blocking atypical AP be helpful? - just for a week or two. Maybe olanzapine 2.5mg-5mg at night would reduce the distressing feelings?
Posted by SLS on August 4, 2018, at 10:14:05
In reply to Re: Bad reaction to Trintellix - Again. » SLS, posted by ed_uk2010 on August 4, 2018, at 10:07:09
> Hi Scott,
>
> I think what you need to do is have a longer 'washout' from vortioxetine, SRIs and other serotonergic drugs before trying an additional antidepressant (eg. venlafaxine). You should then be able to tolerate it again, starting with a low dose.
>
> In the mean time, might a little bit of a serotonin receptor blocking atypical AP be helpful? - just for a week or two. Maybe olanzapine 2.5mg-5mg at night would reduce the distressing feelings?
>I'll give that some thought. Thanks.
- Scott
Posted by SLS on August 5, 2018, at 11:20:50
In reply to Re: Bad reaction to Trintellix - Again., posted by SLS on August 4, 2018, at 10:14:05
I discontinued Trintellix. The zombie state that emerged two days ago is subsiding.
- Scott
Posted by ed_uk2010 on August 5, 2018, at 13:46:06
In reply to Re: Bad reaction to Trintellix - Again., posted by SLS on August 5, 2018, at 11:20:50
>I discontinued Trintellix. The zombie state that emerged two days ago is subsiding.
That's good. Glad you're improving. Must admit I was surprised you wanted to try it again. I had a feeling it wouldn't work out.
I think you will feel considerably better over the coming days as it gradually leaves your system.
Posted by SLS on August 5, 2018, at 15:20:12
In reply to Re: Bad reaction to Trintellix - Again. » SLS, posted by ed_uk2010 on August 5, 2018, at 13:46:06
> >I discontinued Trintellix. The zombie state that emerged two days ago is subsiding.
>
> That's good. Glad you're improving. Must admit I was surprised you wanted to try it again. I had a feeling it wouldn't work out.
>
> I think you will feel considerably better over the coming days as it gradually leaves your system.Yeah. 66 hour half-life.
I tried Trilellex again to be sure that my first adverse reaction to it wasn't related to some imbalance caused by Parnate or Parnate withdrawal. I can't afford to leave any stones unturned. I am leaning in the direction of waiting awhile and trying Effexor again starting at 37.5 mg/day, as you suggested.
- Scott
Posted by ed_uk2010 on August 6, 2018, at 15:00:59
In reply to Re: Bad reaction to Trintellix - Again. » ed_uk2010, posted by SLS on August 5, 2018, at 15:20:12
Hi Scott,
Was brave of you to try vortioxetine again, I must say. It's good that you know for sure how it affects you now.
>I am leaning in the direction of waiting awhile and trying Effexor again starting at 37.5 mg/day, as you suggested.
I think it seems very logical, but the wait may be difficult. Is there anything which helps your depression when taken 'as needed'?
Posted by KathrynLex on August 9, 2018, at 11:33:08
In reply to Re: Bad reaction to Trintellix - Again. » SLS, posted by ed_uk2010 on August 6, 2018, at 15:00:59
Trintellix didn't work for me either. It was a little too...something. I felt exhausted and a little manic at the same time, which scared me, and given I took it for anxiety, being more scared than usual was the last thing I wanted. I managed to take it for about three weeks, and once I stopped, I felt significantly better. I'm still searching for the right medication. Lexapro once did wonders for me, so I went back to it, and this time around, it's been incredibly sedating. I spend more time than I care to admit in bed and even though I have trouble leaving the house, I can't summon the energy to care much. (In the back of my mind, I know that's not a good thing.) Soon it's on to Nardil (just as soon as the Lexapro is out of my system). I really hope the Effexor is working out for you.
Posted by SLS on August 9, 2018, at 12:29:13
In reply to Re: Bad reaction to Trintellix - Again. » SLS, posted by ed_uk2010 on August 6, 2018, at 15:00:59
> Hi Scott,
>
> Was brave of you to try vortioxetine again, I must say. It's good that you know for sure how it affects you now.
>
> >I am leaning in the direction of waiting awhile and trying Effexor again starting at 37.5 mg/day, as you suggested.
>
> I think it seems very logical, but the wait may be difficult. Is there anything which helps your depression when taken 'as needed'?I use lorazepam sparingly to deal with the anxiety that emerges in the morning. I usually need only one dose of 1 mg to do the job. This anxiety is not normal for me. I don't know what I would take if the depression itself becomes more severe and is accompanied by suicidal ideation. Maybe Abilify or Zypexa. I really hate to reintroduce something that causes weight gain and might cause some withdrawal effects upon discontinuation. I imagine there is still some Trintellix in my system that could possibly be preventing a relapse into my baseline state. 66 hour half-life. I discontinued it 6 days ago. However, the other drugs I'm taking might prevent a descent into a more severe depression. I am hopeful.
My high-school graduating class had its 40th reunion a few days ago. I didn't go. It would have been intellectually and emotionally destructive. This has been difficult for me to deal with existentially. I am having to reframe the way I see my life historically and change the way I live in the moment. I must alter my hopes, plans, and expectations for the future in order to live better in the present. Oh, well.
- Scott
Posted by ed_uk2010 on August 9, 2018, at 15:00:55
In reply to Re: Bad reaction to Trintellix - Again. » ed_uk2010, posted by SLS on August 9, 2018, at 12:29:13
Hi Scott,
>I imagine there is still some Trintellix in my system that could possibly be preventing a relapse
To me, this doesn't sound very likely. I imagine that your other meds are helping to prevent a more severe relapse, and not vortioxetine. On the contrary, I am hoping that you will actually improve when vortioxetine has completely left your system - you might have less anxiety and clearer thinking.
In terms of a 'washout' from vortioxetine before contemplating an alternative, how do you feel about waiting around three weeks? I was thinking this would give you time to eliminate all of the vortioxetine and then a week to adjust.
Posted by SLS on August 9, 2018, at 18:33:16
In reply to Re: Bad reaction to Trintellix - Again. » SLS, posted by ed_uk2010 on August 9, 2018, at 15:00:55
> In terms of a 'washout' from vortioxetine before contemplating an alternative, how do you feel about waiting around three weeks? I was thinking this would give you time to eliminate all of the vortioxetine and then a week to adjust.
I was thinking the same thing.
- Scott
This is the end of the thread.
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