Ma205 Viibryd withdrawal then reinstatement mess- HELP

[Ma205]

Hi new here desperately looking for a help.

Iv been on and off ssris (never successfully longer than a few weeks) for 18 years. Was recently on Viibryd for several years and doc was to switch me to Prozac using a bridge. As soon as Prozac and started tapering V, I started with all day panic attacks. Thought serotonin syndrome, so after 2 weeks of this stopped both and then the panic attacks got worse accompanied by all typical awful withdrawal symptoms. I was off 10 days total before I gave in an reinstated V at 5 mg. Felt immediate relief. Next day, worse again. A few days later to 10, again immediate relief then worse. Keep repeating until 25 mg. I wake up at 4 am with adrenaline rushes that throws me into a restless panic daily. By evening, I feel like myself. I have to take Lunesta to sleep and take 0.25 mg Ativan at 4 am. The intrusive, SI thoughts are insane during the day. I feel so screwed, had to leave my job. Do I just come off viibryd? Did the reinstatement make things worse? I have no idea what to do and 3 psychs Iv seen say “they’ve never seen this before”. Also hypersensitized to everything including caffiene, alcohol, all herbals legit EVERYTHING. Please any advice I will take. 

[Altostrata]

Welcome, @Ma205

 

Sorry you're going through this. Were any of your psychiatric prescribers trained at Harvard?

 

What times o'clock do you take your drugs, with their dosages? How do you feel before and after each dose?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Ma205]

hi new here and in desperate need of help! 

Iv been on and off ssris (never successfully longer than a few weeks) for 18 years. Was recently on Viibryd for several years and doc was to switch me to Prozac using a bridge. As soon as Prozac and started tapering V, I started with all day panic attacks. Thought serotonin syndrome, so after 2 weeks of this stopped both and then the panic attacks got worse accompanied by all typical awful withdrawal symptoms. I was off 10 days total before I gave in an reinstated V at 5 mg 6/1. Felt immediate relief. Next day, worse again. A few days later to 10 on 6/5 again immediate relief then worse. 6/19- 20mg same thing. Was wondering if the morning panic was due to withdrawal as I was taking the dose at noon. MD suggested increasing to 25 mg and splitting twice daily. At the same time started Lunesta to sleep as trazodone, seroquel, Benadryl all adverse side effects. I wake up at 4 am with adrenaline rushes that throws me into a restless panic daily. By evening, I feel like myself. I take 0.25 mg Ativan at 4 am because if I don’t I feel I will die. The intrusive, SI thoughts are insane during the day. I feel so screwed, had to leave my job. Do I just come off viibryd? Did the reinstatement make things worse? I have no idea what to do and 3 psychs Iv seen say “they’ve never seen this before”. Also hypersensitized to everything including caffiene, alcohol, all herbals legit EVERYTHING. Please any advice I will take. I started feeling more depressed and forgetful since starting lunesta 7/7. I was having windows every few days now haven’t had one for over a week and I’m so hypervigilent, headaches, dizziness, vision issues, restless and feel pumped with adrenaline after both am and pm viibryd doses now. Thank you for any and all advice ! 

[Frogie]

@Ma205

 

I merged your topic together with your introduction. Please only one introduction page per member so it makes it easier to respond to you. Thanks!

[Ma205]

 

4 am-wake up with adrenaline surges, impending doom, tremors continues all day 

8 am-viibryd 10 mg 

11 am- panic worsens, headaches, dizziness

2pm- starts to clear just slightly “sometimes” 

5 pm-panic manageable

6pm- take 10 mg viibryd 

7pm-headache

9pm- feel activated, take Lunesta 3 mg. 
 

I split my dose, as I was having awful side effects after dose at lunch and we thought maybe am panic was withdrawal symptoms, but doesn’t appear to be. 

Edited July 31, 2023 by Ma205

[Altostrata]

It appears you are having adverse effects from both your Viibryd doses.

 

We provide peer support for going off psychiatric drugs and coping with withdrawal symptoms. As you do not appear to have withdrawal symptoms but have adverse effects from your new drug combination, if you want to continue with psychiatric drug treatment, you will need to take your questions to your prescriber.

 

Please let us know when you want to reduce your drugs.

[Ma205]

I am reducing my doses, sorry. I was on 25 down to 20 at this time for the last week. 

[Altostrata]

Sorry, I got confused. 

 

Please list your drug change events from the Prozac bridge to now, with approximate date for each event.

[Ma205]

5/10-viibryd 15 to 10 start 10 prozac

5/17-adrenaline surges, panic attacks all day decreased viibryd to 7.5

5/20-stopped viibryd as NP thought serotonin syndrome

5/23-stopped Prozac as symptoms continued 

w/d symptoms of gut stopping, vision loss, cardiac issues, paresthesias, panic, akathesia

6/2-reinstated viibryd 5mg-w/d gone but panic, adrenaline and akethesia continued

6/7-10 mg-better x 1 week then symptoms returned

6/13-15 mg-same thing

6/22-20 mg-same thing but physical akathesia went away

7/7-viibryd 25 mg split it 2x a day- became more activated with worse vision changes, dizziness, nausea and panic after doses. 
7/7-started Lunesta to sleep

taking 0.25 Ativan prn.

7/26-reduced am viibryd dose to 12.5 from 15

7/27-started propanolol 10 mg BID-takes away adrenaline/fear/panic, but increasing restlessness after dose sometimes and doesn’t always work. 
8/1-plan to titrate viibryd am dose to 10 mg 
 

[Altostrata]

Thanks.

 

On 8/1/2023 at 3:39 PM, Ma205 said:

8/1-plan to titrate viibryd am dose to 10 mg 

 

I am confused. Your post last Monday shows you were already taking 10mg in the morning.

 

Since it appears 25mg/day is too much, it makes sense to get back to a more comfortable daily dose, probably lower than 20mg, since you're still having an adverse reaction after each dose.

 

Is it your intention to go off this drug or to continue it for therapeutic reasons?

 

On 7/23/2023 at 1:02 PM, Ma205 said:

I have to take Lunesta to sleep and take 0.25 mg Ativan at 4 am.

 

How long have you been taking Lunesta and Ativan every day?

[Ma205]

Hi I was going off approximate dates as best I can. I started Ativan daily probably 7/1 and Lunesta daily 7/7.
 

[Altostrata]

Please put your drug history in your signature.

 

I would expect your daily symptom pattern to show some variation.

 

14 hours ago, Altostrata said:

Is it your intention to go off this drug or to continue it for therapeutic reasons?

 

[Ma205]

My intention is to go off, yet I can’t seem to stabilize. I can’t fit my entire drug history and symptom history all in my signature. It says max 12 lines I just abbreviated it. My symptoms vary daily. I don’t seem to be improving at all. I don’t feel depressed, just incredibly panic stricken everyday.

[Ma205]

8/1- dropped to 20 mg

8/2- AWFUL day. Uncontrolled crying due to anxiety for 7 hours 

8/3-better, but fighting grueling anxiety. Hot/cold regulation issues starting again, no appetite, nausea, dizziness, buzzing feeling in my nerves 

[Altostrata]

When did you start Viibryd, and what drug were you taking before that?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and any significant symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can help identify symptoms that are adverse effects from one or more of your drugs.

[Ma205]

I am at a complete loss as to what has happened to me. I think it’s kindling, but no doctor will admit to this.

 

November-February-put in medical menopause for ivf 

February-started steroids and immune suppressants and many other meds (like 12) for ivf. In addition to my viibryd and trazodone id been on 6 years.
march-got pregnant and miscarried. All meds stopped including steroids

april-suddenly developed hypersensitivity to every med including viibryd and trazodone, caffiene, alcohol

may-doc tried to bridge to Prozac. Developed insane adrenaline rushes, constant fight or flight. Ended up CT, as thought was serotonin syndrome. 
June-reinstated viibryd with adverse effects but relief of withdrawal symptoms

august- still dealing with adrenaline , fight or flight, barely surviving every day. 

I have been to numerous doctors: GP, endocrinology, GI, RE, and 4 psychs who say it is medical and no one knows what happened to me. Could this be kindling due to being on SO many diff meds at once? Even prior to AD withdrawal? 

[Ma205]

Started viibryd 6 years ago. Was on lexapro prior for 2 years. Before that, Prozac for 10 years. 
 

8/4-

4 am wake up adrenaline rush

5:30am-take 0.25 Ativan and 10 mg propranolol. Still getting rushes 

6:30-get out of bed, feel fight or flight and cry uncontrollably until 12 pm

8:30-10 mg viibryd 

12:30-headache 

2pm-dizziness, headaches 

5pm-take 10 propranolol

6pm-have slight window

7-9pm-crying and despair, panic spasms in gut, fight or flight 

9pm-take Lunesta 3mg 

 

 

[Ma205]

8/5

4:30 am-wake up adrenaline rushes 

5:00-take 10 propranolol 0.25 mg ativan

6:45-out of bed, rushes were constant feel on edge/despair

8:30-10 mg viibryd 

8:30-12-cry uncontrollably 

2pm-blurry vision, dizzy.. eat lunch 

5pm-HA, dizziness increasing 

6pm-10 mg viibryd, 5 mg propranolol

6:45-dizziness, HA go away feel at peace rest of the night 

 

Am i withdrawing and reacting to the med at the same time? 

 

 

[Ma205]

8/6

 

4am-wake up adrenaline rushes 
4:30-5 mg propranolol, 0.25 Ativan.
5-6am- dozing and waking to adrenaline rush every 5-10 min. Get up and have headache and blurred vision

9am-10 mg viibryd

10am- fight or flight, overstimulated, fluttery feeling in chest.

12 pm- nausea, dizzy, HA, blurred vision worse, less anxious just feel activated and unwell, Buzzing feeling throughout body, tremors.
5pm-5 mg propranolol. 

6pm- 10 mg viibryd. Feel calmer 

8:30-Lunesta 3mg. Still feel activated 

 

[Altostrata]

Are your symptoms better or worse after your Viibryd dose?

[Ma205]

It seems in the morning they are much worse after my dose. However when I was originally taking the entire dose at noon, I had crazy panic before my dose. So we thought it was related to withdrawal but I think it was mixture of elevated stress hormones because it is still happening despite my dose being split. Idk whether to go back to once daily dosing? The side effects are pretty severe, yet at night I feel I’m withdrawing before I take my dose 😩

[Ma205]

 I also have severe endometriosis and PMDD and I really should be on a continuous birth control pill. Iv been afraid to start but my mood swings during my typical “bad days” are severe. The pill typically makes me always a little depressed. With the potential of me being kindled is this a bad idea to start a low dose pill? 

[Ma205]

Long story short I failed a viibryd to Prozac bridge and ended up cold turkeyed and after a reinstatement have been stuck for 14 weeks with new awful side effects to viibryd and debilitating withdrawal symptoms. I slowly tapered down due to adverse effects and plan to continue to taper, but can’t stabilize at all. 
 

My doctor instructed me to switch viibryd to twice daily to try and reduce withdrawal symptoms, but I feel it made me worse. I am getting such severe symptoms within hours of the morning dose now and when the drug level peaks and I’m worried about what that will do to my brain having “two peaks” per say.

 

Has anyone heard of this or feel I should go back to daily dosing? What is the best way to go back if so? 

[Ma205]

8/7

 

4:30-adrenaline rushes

5:30. 5 mg prop and 0.25 ativan

6:40-Wokeup with rushes

7am- out of bed very on edge, doom, tremors,

 and feel activated like bad 6 cups coffee

9am-10 mg viibryd.

11am- blurry vision started.

12 pm-brain zap.

1 pm- exhausted, dizzy, vision worse, food sitting undigested in stomach.
2-5 pm-overstimulated, irritable, chills, gut still feels like food hasn’t moved

6:30-10 mg viibryd, small dinner.
9 pm- 3 mg Lunesta

[Altostrata]

Appears the first Viibryd dose is causing adverse effects. What do you want to do?

[Ma205]

It definitely is. Should I move the dose to bedtime? How would I do that safely? 

[Altostrata]

Is there a reason that you don't want to reduce your Viibryd dose?

[Ma205]

I reduced my dose 20% in 2 weeks due to side effects. I don’t think I should be reducing it again right now…

[Ma205]

8/8
 

4:00-rushes, fell back to sleep

5:00-stomach grueling, rushes-take 0.25 mg Ativan and 2.5 mg propranolol

7:00-out of bed very anxious 

8:30-10mg viibryd 

9:30-walk dog and feel slightly better 

12:00-headache, blurred vision, nausea, tremors worse, very activated

1:45-small lunch-tolerated 

3:00-increased panic feelings 

4:00-vertigo episodes 

6:00-still activated, but cleared mentally. Able to listen to music and danced for first time in months 

6:30-10 mg viibryd

9:00-3 mg Lunesta 

[Altostrata]

It doesn't matter that you've already cut the dose by 20%, it appears you're still taking too much Viibryd. The increases to 20mg and 25mg were unnecessary. It may be that increasing to anything over 5mg was unnecessary.

 

There is no reason for you to continue to take too much, you do not have withdrawal symptoms.

[Ma205]

Iv been back on for a 10 weeks. And I do have some minor withdrawal symptoms since cutting back to 20 mg last week-difficulty controlling my temperature, chills, and difficulty eating. I feel like my gut completely stops when I’m coming down or off antidepressants and I can’t eat at all. It’s like gastroparesis. And we increased it due to akathisia so I don’t want to cut too fast and have this return. Do you think cutting 2.5 mg every 2 weeks would be a better method? I don’t want to destabilize my nervous system even more.. 

[Ma205]

8/9-

5:30-Wokeup no rush just anxious and tremors. On/off doze till 7.
7:00- Wokeup full activation in entire body, tremors, severe restlessness, hot/cold sweats.

7:30-0.25 Ativan

8:30-calmer and tremors calmed

9:00-10 mg viibryd

11:00-blurry vision

12:00- anxiety and hyper stimulation, panic, chills, crying

2:00 ate small meal

2:30-calmed after reading and laying in sun.

4:00 feel drugged up, food not digesting-abdominal pain. Head tremor, facial tic (NEW)

6:30-10 mg viibryd- feel calm/sad. Tremors better.
7:30-headache, blurred vision worse. Feel down, tired..

8:30-3 mg Lunesta 

[Ma205]

I guess Iv never mentioned my supplements.. would like to see your take on these. Have been taking for years, but now not sure if related to any new adverse side effects 

 

1pm- 600 mg NAC empty stomach

8 pm- 600 mg NAC

           300 mg ALA

           6 mg melatonin

           Biotin

i found fish oil activating and magnesium I was taking 200-400 mg a day, but noticed it wasn’t helping anything. 

[Altostrata]

You may wish to consider a gradual 10% taper per month of your a.m. dose. Since you're taking 20mg per day, you could taper the morning dose to zero. See Tips for tapering off vilazodone (Viibryd)

 

[Ma205]

My husband and I were talking of this same idea tonight. Do you think the tremors are possibly caused from hypersensitivity to the ssri or the withdrawal? They’re getting worse daily 

[Altostrata]

How often do you take Ativan? Have you been taking it every day lately? When did you start taking it in the morning?

 

As explained earlier, your symptom pattern shows that you have an adverse reaction to the morning dose. Since Viibryd has a very long half-life of 140 hours -- making a split dose unnecessary -- overall, it appears that 20mg per day is too much Viibryd for you.