hendrkf Posted March 13, 2019 Posted March 13, 2019 I was on Prozac for 25 years, was switched to Lamictal after a hypomania experience on Prozac (1st one in entire time on Prozac). I transitioned from Prozac to Lamictal and had about two weeks of Prozac withdrawal symptoms before the Lamictal started working. However, the side effects of Lamictal were unacceptable and was then switched to Trintellix (10mg) and Wellbutrin (450 mg) with some depression/anxiety during the transition process. I have only been on Trintellix since early January 2019 and Wellbutrin was added in mid February. I want to get free of antidepressants to try to reclaim my life. Would appreciate recommendations on how to do a very gradual taper away from the Trintellix/Wellbutrin combo. Prozac(20 mg -40 mg):1992 - May 2018; Trazodone (50mg-100mg) for sleep: 2008 - May 2018; Lamictal (100 mg--200 mg) May 2018- Dec. 2018; Trintellix (5mg -10 mg); Jan 2019 - present; Buproprion HCL XL (150 mg then 450mg.): Feb 2019 - present
Moderator Emeritus ChessieCat Posted March 14, 2019 Moderator Emeritus Posted March 14, 2019 Hi Hendrkf and welcome to SA, Thank you for creating your drug signature. The mods need to be able to see your drug history at a glance whenever you post. The information you have provided is very helpful so please copy and paste the existing information in your drug signature and post it here in your topic. Thank you. Once you have done that please create a simplified drug signature using the following format. Keep it simple. NO diagnoses or symptoms please - thank you. details for last 2 years - dates, ALL drugs, doses summary for older than 2 years - just years and drug/s Account Settings – Create or Edit a signature One of the other mods will follow up and post. Please post telling us that you have created your drug signature so that we don't miss seeing it. Thank you. This is your own introductions topic where your can ask questions about your own situation and journal your progress. * NO LONGER ACTIVE on SA * MISSION ACCOMPLISHED: (6 year taper) 0mg Pristiq on 13th November 2021 ADs since ~1992: 25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq: 50mg 2012, 100mg beg 2013 (Serotonin Toxicity) Tapering from Oct 2015 - 13 Nov 2021 LAST DOSE 0.0025mg Post 0 updates start here My tapering program My Intro (goes to tapering graph) VIDEO: Antidepressant Withdrawal Syndrome and its Management
hendrkf Posted March 14, 2019 Author Posted March 14, 2019 My Topic is incorrect: I am currently on Bupropion HCL XL, NOT Wellbutrin Prozac(20 mg -40 mg):1992 - May 2018; Trazodone (50mg-100mg) for sleep: 2008 - May 2018; Lamictal (100 mg--200 mg) May 2018- Dec. 2018; Trintellix (5mg -10 mg); Jan 2019 - present; Buproprion HCL XL (150 mg then 450mg.): Feb 2019 - present
Administrator Altostrata Posted March 15, 2019 Administrator Posted March 15, 2019 Welcome, hendrkf. On 3/13/2019 at 2:27 AM, hendrkf said: I was on Prozac for 25 years, was switched to Lamictal after a hypomania experience on Prozac (1st one in entire time on Prozac). I transitioned from Prozac to Lamictal and had about two weeks of Prozac withdrawal symptoms before the Lamictal started working. However, the side effects of Lamictal were unacceptable and was then switched to Trintellix (10mg) and Wellbutrin (450 mg) with some depression/anxiety during the transition process. I have only been on Trintellix since early January 2019 and Wellbutrin was added in mid February. I want to get free of antidepressants to try to reclaim my life. Would appreciate recommendations on how to do a very gradual taper away from the Trintellix/Wellbutrin combo. What was the cause of the hypomania episode? Did you inadvertently skip a dose, or accidentally take 2 doses in a day? What were the side effects of Lamictal? How did you go off Lamictal? How do you feel on Trintellix and Wellbutrin? This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted.
hendrkf Posted March 15, 2019 Author Posted March 15, 2019 What was the cause or the hypomania episode: I really don't know what caused it. Before the hypomania started, I had been in a very depressed state for about 40 months. (This was while I was on Prozac 40 mg and taking Trazadone 100mg. It started very quickly one day around Thanksgiving. I have never experienced such a state before. It actually felt great. Tremendous mental energy, desire to interact with people, etc. It also caused many less than ideal changes: I talked incessantly, started up two new small businesses, went though an irresponsible spending spree. I was a different person than my wife of 15 years had ever seen and she my my adult son were very concerned. The hypomania lasted about 5 months, when over about a three week period I crashed into a horrible depression. What were the side effects of Lamictal? I gradually increased the Lamictal dose to 100 mg over a one month period as I decreased the Prozac dose. I had horrible Prozac withdrawal symptoms for 3-4 weeks, evidently until the Lamictal kicked in. Those subsided but after being on Lamictal for 4 months, the side effects that I had were: Extreme brain fog, eye blurred and double vision, significant balance problems and complete cessation of all sexual function/desire. The reason I had been switched to Lamictal to begin with was because of the one hypomania incident and my new psychiatrist believed that Lamictal had the best anti-depressant effects of the various drug choices for mood stabilization, perhaps not the best mania properties, but since my mania was considered hypomania, mania prevention was a secondary concern. How did you go off of Lamictal? I transitioned to Trintellix from Lamictal over about a month period, starting with 5 mg and moving to 10 mg., as the Lamictal dose was decreased. I had severe anxiety episodes during this transition, but they subsided as the 10 mg Trintellix dosage kicked in. I still had very low energy levels, so Bupropion HCL XL was started. The dosage was increased from 150mg to 300 mg over a couple of weeks and recently increased to 450mg. How do you feel on Trintellix and Bupropion XL? I have felt okay on this combo, more energy, no real depression or anxiety. Side effects: emotional blunting, lack of motivation, muscle tremors Over the last 4-5 weeks I have been researching anti-depressants and withdrawal, which has led me to this website and several other related ones. I have learned a lot of things about anti-depressants recently that I should have known, but never did. After being on Prozac for so long, and suddenly going through two significant depressions with a 6 month hypomania period, shocked me as I guess I thought it would always work and there was no downside to being on the medication so long. I never realized how physically dependent I was on anti-depressants until the terrible withdrawal symptoms I had transitioning from Prozac to Lamictal. I am 63, retired, in fair physical condition, no negative issues in my life and many positives, yet I have had a horrible last 18 months because of anti-depressants. Now I feel as though I am at a crossroads. Do I stay on these meds for the rest of my life and hope this regimen doesn't stop working and I have to switch to another, or maybe suddenly be resistant to all medications? or... Do I try to gradually try the micro-tapering process to try to get off of all of these drugs. I worry that my normal brain function may have been permanently impacted by over 25 years on antidepressants and that the withdrawal process may be horrible and ultimately leave me in a worse state. So... I am trying to learn as much as I can about the withdrawal process, so I can make the best decision going forward. Prozac(20 mg -40 mg):1992 - May 2018; Trazodone (50mg-100mg) for sleep: 2008 - May 2018; Lamictal (100 mg--200 mg) May 2018- Dec. 2018; Trintellix (5mg -10 mg); Jan 2019 - present; Buproprion HCL XL (150 mg then 450mg.): Feb 2019 - present
Administrator Altostrata Posted March 15, 2019 Administrator Posted March 15, 2019 If I were you, I would not accept the side effect of tremors. Have you had any liver function tests recently? Please put ALL your current drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php and copy and paste the results or a link to them in this topic. You may find it interesting to check interactions of your past drug combinations, too. Your psychiatrist calling lamotrigine an antidepressant made me laugh. They'll call anything an antidepressant. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted.
hendrkf Posted March 16, 2019 Author Posted March 16, 2019 I wasn't clear in my post. My psychiatrist was clear that Lamictal was a mood stabilizer but one that also had the best anti-depressant effect compared with other mood stabilizers. Prozac(20 mg -40 mg):1992 - May 2018; Trazodone (50mg-100mg) for sleep: 2008 - May 2018; Lamictal (100 mg--200 mg) May 2018- Dec. 2018; Trintellix (5mg -10 mg); Jan 2019 - present; Buproprion HCL XL (150 mg then 450mg.): Feb 2019 - present
hendrkf Posted March 16, 2019 Author Posted March 16, 2019 There is a major interaction that my psychiatrist mentioned, but didn't seem concerned about. He said that bupropion will double the effective blood levels of Trintellix. Seems like the implications are that if I decrease bupropion dosage it will ALSO reduce the trintellix levels. May be very challenging to unwind this combo. Interactions between your drugs Major buPROPion vortioxetine Applies to: bupropion, Trintellix (vortioxetine) BuPROPion may increase the blood levels and effects of vortioxetine. You may be more likely to experience side effects, including a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. Contact your doctor if you experience increased side effects or your condition changes during treatment with these medications. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. The link: https://www.drugs.com/interactions-check.php?interaction_list_id=183357755&drug_list=440-0,3490-18003 Prozac(20 mg -40 mg):1992 - May 2018; Trazodone (50mg-100mg) for sleep: 2008 - May 2018; Lamictal (100 mg--200 mg) May 2018- Dec. 2018; Trintellix (5mg -10 mg); Jan 2019 - present; Buproprion HCL XL (150 mg then 450mg.): Feb 2019 - present
Finnishgirl Posted November 13, 2021 Posted November 13, 2021 @hendrkf How did you do this? I have the exact same combo as you have (had?) and trying to think how to start tapering. The problem is that nobody knows how the interaction of these drugs is when you lower the dose of bupropion under the smallest effective dose (150mg). So it might be that you are actually taperin Trintellix at the same time you are tapering bupropion. I have used bupropion for such a short time that I was even thinking about cold turkeying, since keeping the Trintellix's blood concentration steady while tapering bupropion seems very challenging if not even impossible. I have not found any scientific evidence on the blood levels of Trintellix when taking under 150mg of bupropion. And my psychiatrist does not know either what will happen. Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Used Ativan then for 4 moths an tapered down in a few weeks with no problem. Built tolerance and interdose wothdrawal early on Ativan even with 3/day dosing. Since that, depression meds have had no effect. Until Jun/2021: escitalopram 20mg (monotherapy), Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects), Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg, Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix) Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg) Dec/8/2021 : Trintellix 18mg, August 2022: crash at 5,8 mg Trintellix, hospitalized September 2022: Trintellix 20mg, Ativan 1mgx3, mirtazapine 7,5mg, October 2022: Stupid rapid taper attempt of Trintellix 20mg -> 10mg -> 7,5 mg. Back up to 15mg 10/16/2022. Trintellix: 12/12/2022 13,94 mg (-7%); 1/9/2023 13,0mg (-7%)
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