gotmoxie: Trintellix

[gotmoxie]

I was prescribed Brintellix in 2015, they changed the name to Trintellix and I've been taking it since.  I had dropped my dose to half a pill but went through a major life stressor 2-3 weeks ago and had a doctor and a social worker tell me to increase my dose back to the full 10 mg I'm prescribed which I wish I hadn't done.  For about a week I was taking the full 10 mg after being on approx 5 mg, hard to cut these pear shaped suckers in half.  Went back down to half a pill, then missed one dose and have had bad side effects.  Experiencing suicidal thoughts from the medication, irritability, brain fog, diarrhea, ticks & twitches mostly on my left side, occasionally on the right side - left eye, sometimes arm or leg.  I gained over 20 pounds, managed to lose 15 from exercise and living off of green juice, carrot juice, bone broth but if I eat real food the weight comes back quick.  Explosive diarrhea was so bad I was fine with living off mainly carrot juice anyway.  Decreased libido, inability to climax (thankfully only sometimes), extreme fatigue, memory loss.  After all these symptoms on and off the last year, what just did it for me was finally really being happy and not being able to FEEL happy.  That was terrible.  I want off ADs.  

 

Going to try to take 3/4 of a pill for a couple weeks now an see how that goes.  Anyone with experience with this particular AD?  I don't know that I can afford a refill any more, this one is crazy expensive and I don't want to fight with the manufacturer again to get another round of free drugs.  I've got about a 3 month supply so hopefully I can use that to do a 6-7 month taper down.  I took Paxil in 2001, had terrible side effects and was switched to Zoloft.  After a year or so I got off it, I think I went to a half a pill, then to 1/4 when I quit that one.  I did well for several years, had a midlife crisis l when I turned 30.  I'm 35 now and have been on Brintellix less than 3 years and really want to get off meds.  Wish I could get a good therapist, but currently no insurance coverage and don't have much in the way of spending money.

 

Edited March 1, 2018 by ChessieCat

[ChessieCat]

Ho gotmoxie and welcome to SA,

 

SA recommends tapering psychiatric drugs by no more than 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  This is because the brain is physiologically dependent on the drug, not physically dependent like caffeine or nicotine.

 

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

To search for other members using this drug, click on the site logo, top left, and then type in the drug name in the search bar on the top right.

 

Patience is needed to get off these drugs.  We suggest throwing out the calendar and listening to your body and your symptoms.  If after 4 weeks you don't feel stable or life circumstances are a bit more stressful than usual (for example the Christmas period, winter time, or job change) it is better to stay at that dose for a bit longer until things settle down.

 

I'm going to give you lots of links to check out.  Please don't feel overwhelmed, just work your way through them one at a time as you feel able.

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

Tips for tapering off Trintellix (vortioxetine), previously called Brintellix

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Windows and Waves Pattern of Stabilization

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

Tapering Calculator - Online

 

It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.

 

Even with a careful and slow taper you will most likely experience times of discomfort.  It is best to learn and use Non-drug techniques to cope

 

There are many existing topics and discussions on this site.  You can use the site search function at the top right, or use a search engine and include survivingantidepressants.org in your search string.

 

As I said, lots of information, but I really want you to have what you need.

 

This is your own Intro topic where you can ask questions and journal your progress.  We suggest that members visit each others Intro topics so that can support and encourage each other.

 

Edited March 1, 2018 by ChessieCat

[gotmoxie]

Thank you so much for the links!  I'll read through them as I am able.  So many side effects from these drugs...I've noticed changes in my vision and in my sense of smell that come and go.  I've also had a lot of issues with my gut health this past year - I had a fungal infection, then a bacterial infection.  I just want to be healthy again.  I haven't done much research on magnesium, I'll start reading up on that.  I won't be able to do a 10% taper, as I'm just doing the best I can to reduce my dose with a pill cutter.

[mammaP]

Hi Gotmoxie, welcome from me too. Trintellix tablets can be made into a liquid with water for easier tapering. Once you get the hang of it, it is really easy. It's just taking that first step and getting the equipment together that's hard. And working out the numbers, I am useless at that but manage ok using larger volumes of water which is easiest. Here is a topic on making a liquid. 

 

http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

[gotmoxie]

So I'm trying to come off Brintellix (formerly Trintellix).  I was on 10 mg, have been cutting the pills in half for several months, just now started cutting them into thirds and taking a third of a pill once a day.  I've had IBS that comes and goes that's been pretty bad for almost a year now.  I'm just now finding articles that link serotonin and IBS.  I've also been reading about bacterial infections, fungal infections.  I was prescribed an anti-fungal for 3 months that seemed to help, but now my IBS is flaring up again.  intense stomach cramps/abdominal pain, several days of diarrhea followed by constipation, my stomach gets so bloated that sometimes I gain 2 pant sizes from the bloating.  Has anyone else dealt with these same issues?  If so, what did you do?  I'm hoping once I get completely off the antidepressants the IBS symptoms will subside, but that will be another month at least, if not longer, I don't want to stop suddenly.  I read online that a functional medicine doctor can help? I started taking probiotics specific for IBS, they are crazy expensive but seem to help somewhat, not sure as I've only been taking the probiotics for about a week.   Looking for advice from someone who has gone through this and made progress...   

[Gridley]

Hello, gotmoxie, and welcome to SA.  

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

Please include the dates of your taper, the rate at which you tapered, and whether you did every-other-day dosing.  Please keep your signature as simple and easy to read as possible.

 

It appears from your post that you are tapering very fast.  At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
  

Before you begin tapering what you need to know

Why taper by 10% of my dosage?

 

Brain Remodelling

 

Tips for tapering off Trintellix (vortioxetine), previously called Brintellix

 

When you taper too fast, you can end up with some very unpleasant withdrawal symptoms.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

Please be aware that sometime withdrawal symptoms don't appear immediately after a too-fast taper.

 

Delayed onset of withdrawal symptoms

 

I suffered from ulcerative colitis for years and so I am very sympathetic to your situation.   I take VSL3 probiotic, which was designed to treat ulcerative colitis and Crohn's, and it may be helpful to you too.  My doctor prescribed VSLDS (double-strength) and my insurance luckily paid for it.  There is also the regular strength VSL3.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

[gotmoxie]

Thanks for the info.  I have posted before, I just haven't done my signature.  Honestly I don't remember the dates and dosages, just that I've been on this med about 2 or 3 years, I think? I stayed at half a pill for 2-3 months or longer before starting to cut them into thirds.  I had been cutting them in half, upped to full pill per Dr. instructions for about 2 weeks during a stressful situation, but that wasn't working well for me, wish I hadn't listened to the Dr. so I went back to cutting them in half.  I had some experience with stress related IBS before being Rx the Brintellix.  That went away when I removed myself from the situation, which occurred probably 5-6 years ago.  Now I don't believe my IBS is purely stress related, I think it's due to the antidepressant, an infection, or some other health issue I haven't been able to figure out.  What type of doctor did you see for ulcerative colitis?  Just a primary care doctor?  Have you been to a specialist?  I purchased the VSL3 and S. Boulardii probiotics and have been taking them both twice a day for a week now.

[Gridley]

I went to a gastroenterologist for years but nothing he did or recommended helped.   I got my GP to prescribe the double-strength VSL.

[Kittygiggles]

Hello everyone,

 

I'm having a tough time with suspected IBS and/or diverticular disease. I would write about it here but I thought I would link to the latest post in my thread. I haven't found a solution yet but will update here and in my thread when I do. I am trying daily probiotics to see if I get some relief. I also welcome any advice, thank you. 

 

Note to mods: I am not sure if linking my thread here is okay so please let me know if not, and of course, remove it. 

 

 

Wishing you all relief from your digestive problems and long windows 

[Justcope]

Hi. 

I’ve had IBS in the past but haven’t had an issue with it for ages. I’ve noticed since tapering off, when I’m in a window, I start to get IBS symptoms then heart burn, then a wave seems to hit- anxiety is back, poor sleep. I’m starting to see this as a cycle. I think when I’m feeling good, I get a bit slack, eat a bit bad, relax on the exercise etc. I think this sets off the IBS? I have food sensitivities so I’m guessing that doesn’t help. I’m starting to realise- especially during ADWD, that we really need to keep our diet in check... thoughts? 

[ChessieCat]

Hi gotmoxie,

 

I've merged the second Intro topic you created with your first Intro topic.  Each member has only 1 Intro topic.  This is where you ask questions about your own situation and journal your progress.

[Dan998]

On 5/16/2018 at 4:09 PM, Kittygiggles said:

Note to mods: I am not sure if linking my thread here is okay so please let me know if not, and of course, remove it.

 

We encourage members to make friends and support each other. It is entirely appropriate for you to do this when you feel you have something in common.

Edited June 4, 2018 by Dan998

[Poulesportive]

Hi gotmoxie and everyone,

 

Just chiming in to say that I have had all kinds of digestive/IBS problems that I am convinced are from Zoloft (made worse when switched onto Prozac by my psychiatrist), and in the 21 days I was on CT withdrawal from antidepressants, they got worse...and then a lot better. My digestive system seemed to be healing very quickly when I was off the drugs. But my brain could not hack the withdrawal, so I was prescribed Cymbalta, which my psychiatrist says is sometimes prescribed for IBS (not that I recommend this AD, just that this is info he gave me). 

 

In my case, an endoscopy and colonoscopy revealed nothing diagnosable, just inflammation. Tapering and dietary changes are my only options at this point. While trying to taper off Cymbalta (which is brutal), I found a link on SA to a wholistic psychiatrist named Kelly Brogan, her site is kellybroganmd.com. She supports tapering and offers lots of free info on her website about diet, meditation, exercise - I have made some of the dietary changes she recommends (which are also made by many people here on SA, e.g. take out gluten, etc) and they help. Frankly just cutting junk out of my diet helped.  

 

I hope you post about which probiotics you end up taking. I am drinking kefir as my start with probiotics. Good luck to you!

[gotmoxie]

4 hours ago, Justcope said:

Hi. 

I’ve had IBS in the past but haven’t had an issue with it for ages. I’ve noticed since tapering off, when I’m in a window, I start to get IBS symptoms then heart burn, then a wave seems to hit- anxiety is back, poor sleep. I’m starting to see this as a cycle. I think when I’m feeling good, I get a bit slack, eat a bit bad, relax on the exercise etc. I think this sets off the IBS? I have food sensitivities so I’m guessing that doesn’t help. I’m starting to realise- especially during ADWD, that we really need to keep our diet in check... thoughts? 

 

Justcope - idk if you are male or female, but I've noticed the cycle of IBS can be tracked by tracking my menstrual cycle.  It's definitely related to hormonal changes.  

 

IBS generally consists of flare ups.  I've had swollen glands in my throat and extreme fatigue, I thought it was part of the IBS but now I've found a name for that too, CFS Chronic Fatigue Syndrome.  I will tell you I never had food sensitivities until the IBS started a year or so ago.  The dietitian started me with an elimination diet, no dairy, no gluten, no peanuts, no soy.  Everything she has recommended I purchase so far has had the non-gmo label on it.  The USA apparently has like 70% or more GMO food now She also told me not to eat anything raw, as we think I have a bacterial infection.  I found a great granola bar recipe I toast nuts, oats.  I can eat fruit that's been frozen.  It's nice to have an excuse not to eat salad for a little while Also no beer or whiskey.  I have noticed that the gluten is really killing me, when I eat gluten I bloat out 2 pant sizes, I look at least 5 months pregnant very uncomfortable and embarrassing.  Hope maybe the dietary recommendations I've been given may help someone else?  I switched to Ripple milk with pea protein and it tastes good, easier to digest than cow's milk.  I also spoke to someone else who said they had to cut out all gluten and all dairy for an entire year but they eventually got better, not sure if that person was ever on ADs or not.  Last summer when I had a really bad flare up all I ate was green juice, yogurt, bone broth, hummus with snap peas or pretzel crisps I lost weight and felt some relief.  I've been incorporating the green juice, Suja makes some good ones, just check labels for sugar, and bone broth again.  

 

Makes sense that our gut flora is out of balance, as serotonin is made in the gut, and the drugs they put us on alter serotonin levels, which likely is altering the bacteria living in the gut. 

I read this article before I started seeing the dietitian. http://drhyman.com/blog/2010/09/16/5-simple-steps-to-cure-ibs-without-drugs/

I started taking digestive enzymes with meals, s. boulardii, prebiotics called fructo-Oligosaccharides, and the VSL 3, 2 capsules twice a day and noticed significant improvement in my symptoms.  I finished up the bottles of those and now when I see the dietitian Wednesday she's going to add her supplements, as I've now stopped taking those.

 

Also, I had hair loss, like receding hairline and clumps of hair falling out at age 35.  I went to a Natural product store that sells pure essential oils and purchased a hair growth oil concoction they created with rosemary and all sorts of other essential oils I massage into my scalp and they also recommended an herbal capsule, 4 capsules = 1000 mg calcium, 500 mg magnesium, 50 mg zinc & silica and herbs, not sure which herbs but pretty sure she said fennel is in there.  The combo of massaging oil into my scalp 3 x week and the capsules did help my hair to grow back in, I have since purchased more oil.  The capsules seem to help me sleep better at night and I've read that magnesium and zinc both help with depression, interesting that I didn't realize this until after I started taking the capsules.

 

I've done a lot of research online and decided to hire a functional medicine doctor/dietitian.  I've heard other people also say the gastroenterologist did nothing to help them, so I started with her almost a month ago now.  She is working on a 3 month plan for me now.  I told her I'm tapering off ADs and about all of the other issues too.  I also track my menstrual cycle and we realized that whatever is causing the IBS is affecting my hormones as well.  I notice that my fatigue and IBS symptoms are worse both at the beginning of my cycle and during ovulation.  It helps to know that, because when I feel bad, I check my cycle and then know that I'll feel better in a few days.  I have been cutting my Trintellix into fourths, about to start cutting the fourths in half now.  I have noticed my mood has improved as I taper off the ADs and alter my eating habits.  Starting to have good days and bad, instead of almost all bad days.

[Kittygiggles]

Update 

I found a great deal of relief (up to 100% on some days with an average of about >70% reduction in pain most days). I attribute this recovery to a few possibilities but of course it could all be withdrawal/fluoxetine:

 

1. Prebiotic (Beta-Galactooligasaccharide) and a new probiotic(Lactobacillus Acidophilus)
2. The relief from knowing that my abdominal pain is almost certainly not serious (from a gastroenterologist consultation), which can lead to ignoring the symptoms responsibly
3. A slight (but significant) increase in my hypothyroidism medication, levothyroxine
4. Continuing my normal, healthy diet (no processed foods and avoiding wheat)

 

There's a little more detail in my thread but the main points above are probably all that's relevant:-

 

[gotmoxie]

Still feeling a lot of detox symptoms.  The more research I've done, the more I think a lot of my health problems are from the copper IUD.  Who knows which caused what.  I have read up on copper toxicity as well.  I quit taking the last little chips of my antidepressant the same time as having my copper IUD taken out about 3 weeks ago.  I'm having more good days, but still having weird detox symptoms and bad days too.  I am definitely sensitive to gluten now, test results prove it and I was feeling pretty good until I accidentally ate gluten, then was feeling like crap for 2 days.  I ended up firing the dietitian when she billed my credit card three grand, that's totally insane, now I'm fighting to get that money back.  My lab results showed I'm low in all the things in the b12 Lipo shot they're doing at the mall, so I bought a package of those and not only have the b12 shots helped my digestion, they've also lowered my blood pressure back into normal ranges, which is awesome!  I'm realizing now how much I've been isolating myself.  Realizing now that I need to start getting out and making new friends, but going out anywhere costs money, and I've spent so much on the shots, supplements, and healthy organic foods that I'm super broke now...sometimes you just need someone to talk to....and it's not realistic to pay a therapist $60/hour to have someone to talk to...

taking now:

b12 shots 1x week

fish oil

NAC - N acetyl cysteine - I cycle it, sometimes I need a day off from it when detox symptoms are worse

Cerevive supplement with 5-htp & gaba

vitamin D3 & K2

L-Glutamine powder

Vitamin C powder 

Magnesium powder

Prebiotic

Acidophillis probiotic 

a women's probiotic

Rephresh gel

Eliminating processed foods, incorporating more greens and vegetables, just added chicken into my diet.  Slowly going to start eating meat again. 

 

[Hellbutrin]

On 7/12/2018 at 1:07 PM, gotmoxie said:

Still feeling a lot of detox symptoms.  The more research I've done, the more I think a lot of my health problems are from the copper IUD.  Who knows which caused what.  I have read up on copper toxicity as well.  I quit taking the last little chips of my antidepressant the same time as having my copper IUD taken out about 3 weeks ago.  I'm having more good days, but still having weird detox symptoms and bad days too.  I am definitely sensitive to gluten now, test results prove it and I was feeling pretty good until I accidentally ate gluten, then was feeling like crap for 2 days.  I ended up firing the dietitian when she billed my credit card three grand, that's totally insane, now I'm fighting to get that money back.  My lab results showed I'm low in all the things in the b12 Lipo shot they're doing at the mall, so I bought a package of those and not only have the b12 shots helped my digestion, they've also lowered my blood pressure back into normal ranges, which is awesome!  I'm realizing now how much I've been isolating myself.  Realizing now that I need to start getting out and making new friends, but going out anywhere costs money, and I've spent so much on the shots, supplements, and healthy organic foods that I'm super broke now...sometimes you just need someone to talk to....and it's not realistic to pay a therapist $60/hour to have someone to talk to...

taking now:

b12 shots 1x week

fish oil

NAC - N acetyl cysteine - I cycle it, sometimes I need a day off from it when detox symptoms are worse

Cerevive supplement with 5-htp & gaba

vitamin D3 & K2

L-Glutamine powder

Vitamin C powder 

Magnesium powder

Prebiotic

Acidophillis probiotic 

a women's probiotic

Rephresh gel

Eliminating processed foods, incorporating more greens and vegetables, just added chicken into my diet.  Slowly going to start eating meat again. 

 

I'm thinking about taking my IUD out as well. I'm just nervous that it could cause a wave. How are you feeling after having yours out? It looks like you're doing everything you can to promote a healthy body, and I agree that trying to get out will likely help you to feel better.

[les625]

Gotmoxie,

  How is everything going? Have you successfully come off the Trintellix?

[gotmoxie]

Thanks for checking in!  I am completely off the Trintillex, have not taken it since June/July.  I also stopped taking the GABA/5-HTP.   That did seem to help immediately after coming off the AD, if I didn't take it I was crying uncontrollably.  I found an old bottle of Lorazapam and have taken 1/4 to 1/2 a pill probably twice this month for anxiety.  I was diagnosed with Leaky Gut, IBS/IBD, Gut Dysbiosis.  I've slowed my b-12 injections down to once every 2 weeks, they are so expensive, and I have made some progress with my health.  My anxiety has been very bad this week, but just like before, it coincides with my cycle, and I've got major life changes on the horizon.  I still have fatigue, but not as bad as it was, I have managed to start going for 30 minute walks and have started lifting 7.5 lb weights once a week when before I could barely close the lift gate on my car.  Looking to slowly increase exercise.

 

Currently taking:

multi-vitamin with probiotics

b-12 injection with choline/inositol, l-carnitine  every 2-4 weeks (all of these showed low on blood/stool test)

Glutathione injection - this one hurts like a @#$%, I bought a 4 pack, 2 more to go, alternating with the b12 injections, this seems to help me feel more 'normal'

I finished the Metagenics GI Replenish for Malabsorbtion - my body couldn't tolerate this the first few months, but now the gas/bloating is tolerable, may re-purchase, not sure yet.

herbal capsule, 4 capsules = 1000 mg calcium, 500 mg magnesium, 50 mg zinc & silica and herbs, not sure which herbs but pretty sure she said fennel is in there.

Vitamin D3 & K2 together in one capsule (both of these showed low on blood/stool test)

I was taking digestive enzymes with every meal, I stopped, but will start taking at least one a day again, they seemed to help

Haven't been taking fish oil, but I purchased more and want to add it back in again soon.  (blood/stool test showed EPA was low)

 

Hellbutrin, do you have the copper IUD? or hormonal?  If it's copper I'd say definitely take it out ASAP.  There is a copper toxicity facebook group I joined that's been helpful.  I'm making improvements but still dealing with gut dysbiosis, malabsorbtion, etc.  Six months almost, still not regular BMs.  I rarely have D now though, thank goodness.  I still get really bad bloating, had to buy stretchy work pants because I continue to bloat out 2 pant sizes.  I had major vision changes over the last several months, and a couple months after stopping meds/IUD removal was having weird changes in my sense of smell too.  That seems to have resolved.  I seem to be shedding hair at a normal rate now, and see new hair growth, which I'm super excited about, I hope it continues to grow back in!  I'm still dealing with health issues but have not been able to afford to go to a doctor because the dietitian I went to is a scam artist and after agreeing to a 3 month treatment plan for $1500-something she charged me credit card $3000 and they are holding me responsible still, after filing a complaint with multiple agencies.  Stress definitely aggravates health issues.  I've talked to other people who have told me that it's taken people they know a full year of gluten free/dairy free to heal the body.  I'm just thankful that I am making progress....  Of course Merry Christmas to me, my apartment complex is not renewing my lease, and rent went up $200/month in this area.  I'm not making enough to live as it is, so the stress is not helping with recovery.  So I guess the goal is to get a higher paying job by the end of February so I will know where to move when my lease is up in March.  I'm just praying I can handle all of this without having a breakdown or having to go back on meds.  I'm a bit nervous about how I'll be able to handle a new job, a new living situation, possibly a roommate, and still manage my health issues.