JoJo1812: Tapering off Trintellix is very difficult

[JoJo1812]

@Addax Thank you for the encouragement Addax. I had several days of misery, but somehow managed to pull my self out.  Such a scary thing to always be on the edge of oblivion, teetering.  

[Addax]

3 hours ago, JoJo1812 said:

I had several days of misery, but somehow managed to pull my self out.  Such a scary thing to always be on the edge of oblivion, teetering.

Glad to hear you’ve pulled out of it! It is scary. Between the uncertainty and symptoms, I honestly think the whole thing is one of the scariest things I’ve experienced.  

[JoJo1812]

Over the past few months, I have been feeling much better since I began tapering my Wellbutrin SR 300mg/day.  Beginning in April, I began tapering down by 10% every 2 weeks.  Panic attacks went from constant throughout the day to just 1 a week.  All was well until about two weeks ago when I began to have major issues sleeping along with the accompanying moodiness and brain fog. Now my emotions go up and down the extremes by the hour or by the minute.  I was watching a sad movie on Sunday and I broke down because I was literally feeling the emotional pain of the characters. I go from blissful to angry to happy to sad in minutes.

 

Obviously, I have tapered a bit too fast and need to adjust my plan.  I'm aware that the symptoms of the dosage changes can take a few weeks to arise.  I'm wondering how I should take into account my other two medications: Gabapentin 1,200mg/day and Prozac 30mg/day.  Am I possibly feeling the effects of the reduced Prozac uptake due to the reduction in Wellbutrin?  Is there a remedy to this?  How should I handle Gabapentin?  My long-term slow plan is to get off all meds very slowly over the next two years.

[JoJo1812]

Switched Prozac providers may be causing a major setback.  I had to change insurers and this made me get my Prozac from a different pharmacy chain.  I made the made change on 6/30/2023, but for the past few days I have felt like I have been set back to when I was at my peak of panic attacks.

 

Should I just push through and hope my body adjusts to the new Prozac or should I make a major push to my provider - not sure what the response will be.

[Addax]

Hi jojo1812.

Swing by and saw your last two posts… I’m guessing your taking Fluoxetine, the “generic Prozac.” If that’s the case then switching your pharmacy could verywell result in a change in manufacturer. I’m guessing you know that. But yeah, that can mean there are some minor differences that, while tapering and withdrawaling, can shake things up sometimes.  In all likelihood, you will adjust and things will settle down. However, how quickly or slowly that will happen isn’t possible to know.  As far switching back to the previous pharmacy and manufacturer and the potential that will help alleviate your recent uptick in anxiety, I don’t know. Hopefully, someone else will chime in on that.

 

On 6/19/2023 at 8:25 PM, JoJo1812 said:

Am I possibly feeling the effects of the reduced Prozac uptake due to the reduction in Wellbutrin?  Is there a remedy to this? 

This is absolutely possible. The combination of the two can cause an increase in plasma concentration of the prozac/Fluoxetine. So as you reduce your Wellbutrin, there maybe a concurrent reduction in the plasma concentration of Fluoxetine.  As far as a remedy, there isn’t one in terms of how the two drugs interact, but slowing your taper/ making smaller reductions is always a good bet when your looking to reduce withdrawal symptoms.  These kinds of interactions is why tapering one drug at a time is important.

 

[JoJo1812]

Feeling like things are falling apart again.  Having lots of memory issues and making major mistakes at work - not remembering even doing them.  Sleep is hard to get - I fall asleep ok but wake up after 5 hours and HAVE TO  get up because I keep thrashing in my bed.  Angry. Very angry. And sad. I was able to find a pharmacy that has the same fluoxetine I was taking up until 10 days ago, which is good news.  Yet I wonder if I am suffering any effects from my Welbutrin tapering. I started tapering from 300mg 3 months ago - I have been at 60% for a month now.  Very fearful of backsliding.

[JoJo1812]

7 weeks ago I moved from sea level to 7,200ft in altitude.  Does anyone know of any interactions between altitude and SSRIs?  I have been feeling "dead" for a few weeks and figured it was just getting acclimated to the altitude - I even went to the doctor last week.  My blood work and vitals were great.  However, I have been feeling a major depressive crash.

[JoJo1812]

I have really been struggling and I'm hoping someone is out there that can help me find some answers about medicine and high altitude.  I posted several days ago, but my symptoms have been getting worse.

[FireflyFyte]

Have you made any other changes aside from the altitude? Drops in medication? Alcohol use? Intensive exercise?

[JoJo1812]

The issues began a few weeks ago.  I have not made any changes to my limited exercise schedule, and I have not drunk any alcohol (in a recovery program for 20+ years).  I feel like I am on nothing.  

 

Last week I went to urgent care and got checked out with bloodwork - all good.  The doc never heard of altitude affecting antidepressants.

 

A week ago I finally started a transition to a new manufacturer of Bupropion. Changing from Solco to ScieGen. Two years ago I left my HMO of 10 years (job loss), which meant I had to get my meds from other places.  I was able to find the same manufacturers of two of the three meds, but Bupropion has been nearly impossible.  I finally decided to transition to ScieGen which is widely offered at Walmart.  For 7 days I have been at 90% Solco and 10% ScieGen.  Just switched to 80%/20% yesterday.  Due to my current emotional state that began long before the med shift, I don't think it is the main cause.

 

All I know is that something is wrong.  I'm sobbing in a coffee shop because my hope for this to end is running out.

[FireflyFyte]

On 1/24/2024 at 2:03 PM, JoJo1812 said:

All I know is that something is wrong.  I'm sobbing in a coffee shop because my hope for this to end is running out.

 

It is possible that you are experiencing The Windows and Waves Pattern of Stabilization and are currently in an extended wave.

 

When was your last reduction of medication?

[JoJo1812]

Thank you so much for responding.

 

My most recent reductions:

Bupropion 1/4 -2%; 12/11 -2%

Prozac 11/1 -10%; 10/1 -10%

Gabapentin 12/3 -2%; 11/1 -2%

 

I am likely in a wave, but my windows are not good either.  Waves are miserable, yet in my windows, I still feel terrible and full of symptoms.  For years I have not experienced a period of time when I was free of strong anxiety.

 

Grateful for you, Jonah

[JoJo1812]

Has anyone experienced any side effects of anti-depressants that led to nerve pain in the face? (trigeminal neuralgia) Possibly from extended use of Gabapentin?