scruffywriter: Vortioxetine Withdrawal

[scruffywriter]

Hello All…

 

Over the years I’ve been plied with most SSRIs there are, in an attempt to combat depersonalisation / derealisation disorder. About three years ago I was put on Vortioxetine (aka Brintellix). It did help with the DPDR but I’m just fed up of feeling nothing at all now and having no enthusiasm for anything. I decide to start reducing my dose about two weeks ago and so far the experience has been horrendous. So far side withdrawn effects are -

 

• Strong head zapping / weird head sensations.
• Strong feelings of panic - agoraphobiac type symptoms.
• Short temper - generally being unpleasant to people around me.
• Constant feeling of tensions - especially in the mornings.
• Relentless tiredness.
• Mental confusion.
• Very low mood

 

What’s worrying me is that this is just dropping to 5mg. Withdrawal got so bad yesterday I nearly abandoned the idea of getting off them. Would love to hear from anyone with experience of coming off this one.

 

Best wishes to all….

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  It sounds like you reduced by too big of a reduction. I do need to know what your original dose of vortioxetine was, before you did the reduction to 5 mg. 

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase. Here is an example: 

 

March 12, ’22: Lexapro 5 mg, Xanax 0.5 mg, Trazodone 50 mg

March 29, ’22: Lexapro 4 mg, Xanax 0.5 mg, Trazodone 50 mg

April 17, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 50 mg

May 19, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 25 mg

 

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Your Drug History in Your Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Vortioxetine

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

I believe you would be helped by doing an updose. Going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to updose.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

After you have increased your dose and stabilized, then I would wait a while to really allow my nervous system to recover.  Then, I would attempt a very slow harm reduction taper using the methods I have described above.  Please let us know what you decide to do.  

[Emonda]

Hi @scruffywriter

Greetings from AUS. We are withdrawing from the same AD, and I can completely relate to your situation.

 

You mentioned you dropped to 5mg, but I am unsure what you dropped from. If you complete the drug signature referred to by getofflex, that would help the moderators help you.

 

If you have 'just' dropped from the next pill size up (10mg), that's a 50% drop and would likely lead to precisely what you are experiencing. Only 24 hours ago, I dropped my dose by 2%, and I already feel irritable, tired and have a tightness across my chest, like an elephant is sitting on me.

 

Eighteen months ago, I dropped from 15mg to maybe 5mg over six weeks and felt dreadful. I was breaking a 15mg tablet by sight....wildly inaccurate. I subsequently up-dosed and found stability/relief from the symptoms at 7.5mg. I stumbled across this website and followed their advice of no more than a 10% reduction of the most recent dose per month. Eighteen months later, I have successfully reduced my dose by 78%.

 

You can get off these ADs, but you need to do it very, very slowly.

 

Hope this encourages you in some way.

[scruffywriter]

Hi @Emonda

 

Thanks of rate reply. It was very encouraging. What you highlight there is exactly what I did. I dropped from 10mg to 5mg. It's been about 4 weeks now and if anything the withdrawal has gotten worse. I'm going to do what you suggest and increase a little to try to stave it off. All not helped by the fact that I'm supposed to be starting a new job in a month. I think I need to find some stability for that. The drugs were originally prescribed to try to help with depersonalisation disorder To be fair they did help with that but introduced a whole load of other problems. 

 

[getofflex]

If it were me, I would try updosing to 7.5 mg of vortioxetine. Please see my post above for information about reinstating.  Also, please put the date in which you dropped from 10 mg to 5 mg in your signature. Thank you.

[scruffywriter]

Hi, 

 

It does say in my signature May 2023: Reduced Vortioxetine to 5mg. I don't remember the exact date. All I remember it is that it was May. 

[getofflex]

OK.  Was it early, mid, or late May? 

[scruffywriter]

It was late May. I'll update the sig to reflect that. 

[Emonda]

Hi @scruffywriter,

I'm glad that was a little encouraging.

 

13 hours ago, scruffywriter said:

I'm going to do what you suggest and increase a little to try to stave it off.

 

I'd be guided by getofflex regarding the amount to increase to.

 

Can you buy Vortioxetine in liquid in the UK? We can only purchase tear-shaped tablets in AUS, so I have to crush the tablet into minuscule particles, mix in water in a syringe and remove an amount to be left with the desired dose. Doing it by sight would be too variable.

 

Once you stabilise, hold for some months, especially with the new job. I held at 7.5mg for maybe five months. I felt better much sooner than that, but I feared falling apart again. From there, go slow! As I mentioned above, I am reducing by 2% roughly every week for four consecutive weeks before holding for another two weeks. At times, I have held for longer as I felt fragile.

 

Wishing you well.

[scruffywriter]

Hi @Emonda

 

I don't know if you can get it in liquid form. I'll ask the doc about that. I have the little tear-shaped pills you mention. I have increased the dose this morning as everyone has suggested. I'm going to wait a few weeks for things to stabilise and then start the gradual tapering. Upping the dose has certainly helped today. That horrible feeling of perpetual panic has subsided somewhat. It's a bit disappointing that I've had to take a step backwards but at least I'm able to function a bit more today.  I remember my doctor saying when he suggested these tablets that I didn't need to worry. I could just stop them whenever I wanted! I think the problem with Vortioxetine for we was that the side effects were much slower to kick in. With all the other drugs they tried me on, I had a reaction to them straight away so came off them quite quickly. With these it took longer and I was dependent on them by the time the side effects became a problem for me. Oh well. Onwards and upwards!

[Emonda]

Hi @scruffywriter,

 

11 minutes ago, scruffywriter said:

I'm going to wait a few weeks for things to stabilise and then start the gradual tapering.

 

I'd give yourself longer than a few weeks. You mentioned you're starting a new job next month, that can be stressful. Give yourself a little more time (months) before tapering.

 

13 minutes ago, scruffywriter said:

Upping the dose has certainly helped today. That horrible feeling of perpetual panic has subsided somewhat

 

That's a fantastic sign... definitely withdrawal symptoms you were experiencing rather than a relapse, given the very quick response to the up-dose. Someone on here may correct me, but I think it would take two weeks + to feel the full benefit of the up-dose.

 

16 minutes ago, scruffywriter said:

It's a bit disappointing that I've had to take a step backwards but at least I'm able to function a bit more today

 

Another member recently said that up-dosing is sometimes a tactical retreat and regrouping required to win the war (successfully getting off ADs). I think that's a great way of looking at it.

 

21 minutes ago, scruffywriter said:

I remember my doctor saying when he suggested these tablets that I didn't need to worry. I could just stop them whenever I wanted!

 

They almost all say that. It's what they seem to be taught...but it's not true...if it were true, this community would not be needed.

 

22 minutes ago, scruffywriter said:

Onwards and upwards!

 

Yep, and make sure you do that slowly. Sing out any time you need to.

[getofflex]

I'm glad the updose is helping.  Do please record this dose change in your signature box, so we can keep track of you, and not give you wrong advice - thank you.