Jerommeke - Which drug to taper (vortioxetine/sertraline)

[Jerommeke]

Hello, I'm Jerommeke and coming from the Netherlands, 35 years old.

I was on Venlavaxine for 6 year (till August 2023). Decided to come off, did a taper of three months. Once I was on the zero base-line I did got very bad mental symptoms like baby-crying and panic attacks. At that moment, nobody told me it were withdrawal symptoms. Apparently I needed some of this chemical stuff... Which was wat doctors told me.
After that I've tried different depressants (Bupropion,citalopram, Sertraline, Vortioxetine). Due to unacceptable sexual side effects I switched after a period of minimal 8 weeks to the next one. Without any problem. I've used Sertraline from March 2024 till 7 September 2024 (from 50 to 12.5mg) and did a cross switch to Vortioxetine from 1 September till 1 October. But due to severe anxiety and again sexual side affects I decided to quit again. I wanted to life a couple months without to see how life would go. I also followed some really good psycho therapy (Schema therapy).
 

Now, three weeks later, I'm still very sick, having flu-like-symptoms, headaches, dizzy and brainzaps. Also very bad sexual dysfunction (even worse comparing when I was on an antidepressant) My mental state is fine so far.

I've had never heard of PSSD or discontinue syndrome (my doctor calls it this way) till some weeks ago. I did not know tapering should be done very slowly and can take multiple years to finish.

My question is, if I reinstantiate drug into my body. Should I start with a low dose of Vortioxetine (which was terrible and I've never been stabilised on) or should I restart with a low dose of sertraline? Or just sick out the illness and hope sexual function comes back (doctor advice).

I look forward to hear your opinions or advice!

Edited October 24, 2024 by Emonda
Amended title

[Emonda]

Welcome @Jerommeke

 

On 10/24/2024 at 1:15 AM, Jerommeke said:

Due to unacceptable sexual side effects I switched after a period of minimal 8 weeks to the next one.

 

This would make me question if I wanted to reinstate any of them. If the side effects were troublesome last time, I'd expect them to be at least as problematic this time.

 

On 10/24/2024 at 1:15 AM, Jerommeke said:

due to severe anxiety and again sexual side affects I decided to quit again

 

Some people simply respond adversely to these medications relatively quickly. Perhaps you are in that camp.

 

On 10/24/2024 at 1:15 AM, Jerommeke said:

Schema therapy

 

I am familiar with this, and I too found it helpful.

 

On 10/24/2024 at 1:15 AM, Jerommeke said:

Now, three weeks later, I'm still very sick, having flu-like-symptoms, headaches, dizzy and brainzaps. Also very bad sexual dysfunction (even worse comparing when I was on an antidepressant)

 

These sound like typical WD symptoms from all the changes you have made: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

On 10/24/2024 at 1:15 AM, Jerommeke said:

I did not know tapering should be done very slowly and can take multiple years to finish.

 

Sadly, most of us have found this out the hard way, too.

 

On 10/24/2024 at 1:15 AM, Jerommeke said:

My question is, if I reinstantiate drug into my body. Should I start with a low dose of Vortioxetine (which was terrible and I've never been stabilised on) or should I restart with a low dose of sertraline?

 

These two links are worth reading:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

Kindling

Given your multiple changes in a short period of time, I don't know what the right thing to do is in your situation. One of the other volunteers may add their thoughts.

On 10/24/2024 at 1:15 AM, Jerommeke said:

Or just sick out the illness and hope sexual function comes back (doctor advice).

Recovery from ADs and tapering is not linear. There are good days and not-so-good days/weeks/months. This is referred to as the Windows and waves pattern of stabilization.

 

I hope these initial comments are of some help.

Emonda

[Jerommeke]

@Emonda thanks for your reply, really appreciate it! I have read the given links. Very valuable, but it also scares me.

For now I stick to the plan of not taking anything. I only need 24/7 acetaminophen for the intense headaches and noise in my head. My doctor advised me this afternoon to start taking duloxetine, but I don't trust the advice because their lack of knowledge. As long as my mental state stays a little bit stable I should be able to sick this out. However the whole status and process really frightens me. Hope on some little signs of light these weeks..!

[Jerommeke]

My mental state has become a mess. I’m all day full of tears and have no idea how to continue like this. I’m a single dad who has no support nearby and has to care parttime of my kids. Im very anxious en affraid I will traumatize them…

 

Can please someone shine his lights what and how much is best to reinistate? 

[Emonda]

Hi @Jerommeke

How are you doing today?

 

I've asked the small team offline for their input.

 

Better days are always ahead. I've been where you are. It's not nice, but things will improve with time and patience.

 

I'll come back to you when I hear from the others.

 

Emonda