BrintHelix: vortioxetine / Brintellix / Trintellix withdrawal

[BrintHellix]

Hello everyone,

 

Short history:

I have a long history of On/Off misc. antidepressant use for various periods, icluding SSRIs & SNRIs and atypicals. In previous times, when I went off medication I didn't experience withdrawal but I guess that this bombardment of my brain with various chemicals left it scarred and vulnerable.

My first withdrawal occured when I went off 150mg of Effexor XR (Venlafaxine). I took it for only 2 months (July-August 2015) and I experienced withdrawal over the course of 6 months (September 2015 - February 2016), in which I was pretty much disabled and all I did was wait until things will get better.

 

Current state:

After a reoccurence of severe depression, I felt desperate and went back on antidepressants. The psychiatrist suggested Vortioxetine (Brintellix/Trintellix), a "brand new" drug.

I started from a dose of 5mg which I took for 1 week, then went up to 10mg which I took for 2 weeks, after that I went up to 15mg, severe itching ensued so I dropped back to 10mg. I stopped taking it after 1 week without tapering because Vortioxetine has a long half life. All in all, I took it for 4-5 weeks, and have been off it since August 2016.

About a week after discontinuing, a myriad of symptoms appeared: Tight muscles in head/traps/shoulders/stomach, hot flashes, extreme irritability and agitation, impaired cognition (no concentration, focus, memory etc...), anhedonia, no motivation, akathisia, jaw pain. In general, I feel like my brain has been fried.

Currently, I feel very confused and discouraged. Sometimes it seems that it's getting slightly better, sometimes I feel that no change occured and I'm still experiencing the symptoms in the same strength.

I haven't tried any other medications apart from Propranolol in an effort to reduce the akathisia but it didn't help.

I'm extremely hopeless, I cannot continue my life in this manner.

I will meet the psychiatrist in the next week to discuss reinstatement, although I feel it will be the final nail in my brain's coffin.

 

If anyone has any suggestions or can share his/her Vortioxetine experience I would be happy to hear.

 

Thanks

[mammaP]

Hi Brinthellix, welcome to SA. I am sorry to see that you are still suffering like this.  When you had a recurrence of severe depression before staring brintellix that would actually have been withdrawal from effexor still occurring.  People who stop drugs without tapering slowly enough are told that their illness has relapsed and they need the drugs for life to prevent future relapse. This is not the case, it is withdrawal which somes in windows and waves. The only drug that helps withdrawal is the drug that was withdrawn, After so long off it is possible that you will be sensitised and no longer tolerate it so if you do try it again  you will be best trying a very cery small amount to see if you will be ok with it. We don't recommend reinstatement after so long. I suspect that you are still suffering from all the different drugs, and especially effexor withdrawal. Your nervous system is working hard to regain homeostasis and you are improving which is a really good sign. Recovery tends to come in windows and waves, which is what you are describing. If you take good care of yourself like you would if you had a serious illness you will help your recovery.  I will get some info for you so that you can understand the process. 

 

What is withdrawal syndrome? 

http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

Windows and waves

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

Many people are helped by taking fish oil and magnesium

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/?view=findpost&p=100596&hl=magnesium

 

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

 

 

 

 

[BrintHellix]

Thank you for your reply mammaP,  I'll try the magnesium and fish oil. 

[BrintHellix]

Hi all,

I've been exploring the possibility of trying Biperiden or other anticholinergics in order to try and reduce my feelings of agitation, restlessness, and akathisia.

Does anyone here have experience using this as a "relief" drug?

Do you think I should suck it up and stay away from medicine until I get better?

 

Thanks

[Altostrata]

Welcome, Brint.

 

You're in unknown territory taking a drug like Biperiden. We haven't seen these drugs be helpful, but few people try them.

 

Please see What is withdrawal syndrome?

 

Think of it this way: If your nervous system has been upset by going on and off drugs, would confronting it with another drug settle it down?

 

The tight muscles, hot flashes, etc. indicate you are indeed feeling the aftereffects of going off vortioxetine. Taking a little bit of it, maybe 1mg, might help. Do you have any left?

[BrintHellix]

Hi @Altostrata,

Regarding Biperiden - I'm pretty desperate so I'm considering all sorts of options.

I've got a pack of 10mg pills but cutting them into 1mg doses doesn't seem practicle. Also, I'm afraid of going back on Vortioxetine because it will basically restart my withdrawal in the best case or make my situation worse with adverse reactions. Damn meds.

[Altostrata]

Adverse effects are dosage-related, it's less likely you'll get adverse effects from a small dosage.

 

A little vortioxetine will not restart your withdrawal, it may reduce or eliminate the withdrawal symptoms. You'd stabilize on it for some months, then very carefully taper off by tiny amounts.

 

We can't advise you on Biperiden, sorry.

[BrintHellix]

Thanks @Altostrata

How can I take a dose of 1mg if the minimum is 5mg?

They don't sell a liquid version in my country. 

Do you think I should go back on 5mg?

[BrintHellix]

So I've gotten hold of a prescription for 5mg (the lowest dose), haven't taken anything yet. 

I really can't tell if I'm getting better. 

I'm thinking of taking 5mg for a few months so I can stabilize and take it from there but really scared of adverse effects or a worsening of the symptoms. 

Should I go back on it or should I keep waiting for things to get better?

[mammaP]

If it is vortioxetine tablets that you have, you can make a liquid with water. It is quite easy when you get used to it. You could dissolve one tablet and have 4 doses from it. The 5th dose would not be enough because too much will be lost with evaporation. You only took it for 4-5 weeks and had reactions because they increased the dose too high, that was a year ago so the starting dose will need to be very tiny in case you react again. 

 

This is the topic for tapering vortioxetine

http://survivingantidepressants.org/topic/10246-tips-for-tapering-vortioxetine-trintellix-brintellix/

 

Edited August 23, 2017 by mammaP

[BrintHellix]

I feel like my brain has been literally fried. Constantly agitated and unrelaxed, in a fog, no concentration or motivation, feeling like permanent damage has been done. 

Don't know what to do anymore, I don't feel like there is a point to continue living in this state. 

[BrintHellix]

I gave in. I couldn't take it anymore and went back on the minimal dose of 5mg. I'm hoping to stabilize and try again in a few months. 

[ChessieCat]

On 15/08/2017 at 6:06 PM, Altostrata said:

The tight muscles, hot flashes, etc. indicate you are indeed feeling the aftereffects of going off vortioxetine. Taking a little bit of it, maybe 1mg, might help.

 

These drugs are strong and it is generally suggested to try a very small dose when reinstating, especially after such a long time off a drug, such as 1mg as suggested by Altostrata (this site's owner).

 

Please read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

If you have only taken 1 or 2 doses of 5mg it will be okay to reduce it to 1mg.  The information was provided above to get a 1mg dose in the quoted post below.  mammaP also stated that your should start with a small dose.

 

On 23/08/2017 at 7:19 PM, mammaP said:

If it is vortioxetine tablets that you have, you can make a liquid with water. It is quite easy when you get used to it. You could dissolve one tablet and have 4 doses from it. The 5th dose would not be enough because too much will be lost with evaporation. You only took it for 4-5 weeks and had reactions because they increased the dose too high, that was a year ago so the starting dose will need to be very tiny in case you react again. 

[BrintHellix]

Akathisia Relief

 

Hello,
I'm going through severe antidepressant induced akathisia and I just don't possess the concentration to conduct a search.
Can you please recommend substances that helf relieve it?
I'm willing to try any kind - prescriptions, OTC, supplements, everything.

Thanks

 

Edited June 12, 2019 by ChessieCat
added topic title

[Lloyd]

From the articles ive read, benzodiazepines are used for the relief of akathasia. Talk to your doctor first though. Also benzos are addictive and can slowly stop working over time so use caution and only under supervision from your doctor.

[ChessieCat]

akathisia-vs-restlessness-anxiety-agitation

 

[Altostrata]

16 hours ago, BrintHellix said:

Akathisia Relief

 

Hello,
I'm going through severe antidepressant induced akathisia and I just don't possess the concentration to conduct a search.
Can you please recommend substances that helf relieve it?
I'm willing to try any kind - prescriptions, OTC, supplements, everything.

Thanks

 

 

Hi, Brint. We hadn't heard from you since 2017, what's happened to bring this on?

[BrintHellix]

7 hours ago, Altostrata said:

 

Hi, Brint. We hadn't heard from you since 2017, what's happened to bring this on?

Currently, I'm tapering off Lexapro. I guess that the fact that I've tried many meds and went through many withdrawals made my nervous system very sensitive so even though I'm tapering very slowly, the withdrawal akathisia is bad.

[Benzhelp]

 

Hi BrintHellix,

 

Thanks for the update. I’m so sorry you are suffering, akithisia can be so awful. Symptoms do heal with time so hang in there.

I find taking healthy food, adequate hydration and sleep helps mainly. 

Have you tried Omega 3 fish oil and Magnesium? These are gentle on the nervous system and recommended on this site. 

High Antioxident foods and maybe supplements like vitamin E complex and vitamin C helps me heal, I can’t say how it will work for others though, since each of us are different. I am always careful when trying new supplements, testing with smallest doses to see how I react. This is a helpful link:

 

https://www.survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

Wishing you Healing, Blessings and Love <3 Please take gentle care <3

 

[Altostrata]

Brint, what's been your tapering schedule over the last 6 months? With these symptoms, please do not taper further.

 

What times of day do you take your drugs, and their dosages? Are your symptoms better or worse after you take your drugs?

 

What do you mean by akathisia?

[BrintHellix]

On 6/13/2019 at 9:46 PM, Altostrata said:

Brint, what's been your tapering schedule over the last 6 months? With these symptoms, please do not taper further.

 

What times of day do you take your drugs, and their dosages? Are your symptoms better or worse after you take your drugs?

 

What do you mean by akathisia?

My tapering schedule has been awful and hectic. Right Now I'm at 0.5mg of Vortioxetine and 4.4mg of Citalopram (dose equivalent of 2.2mg of Escitalopram which I switched from since it started causing adverse reactions). Currently, I'm not decreasing anything and looking to stabilize on those doses.

Generally, my symptoms get worse for a while when I take the pills (-1) and then they get better (0). If I don't take them at all I practically go insane (-2).

I take the Vortioxetine at night so as to avoid the major effects since it reaches its peak within seven hours. I take the Citalopram in the morning because it reaches its peak within 4 hours so I at least get a few "normal" hours so I can work.

 

By akathisia I mean an inner sense of restlesness, lack of concentration, agitation, anger, and a pressing sensation in my head, which are completely artificial and unconnected to life circumstances. I'll note that I don't suffer from the need to move around part.

I am reluctant to take benzos or switch to other drugs, I don't want to get addicted to something else and my brain is to destabilized to try new drugs. I'm only willing to try supplements or "light" OTC drugs.

[Altostrata]

I need to know the actual times of day you take your drugs, times of day you get symptoms, and what the symptoms are. Is the akathisia feeling worse at any particular time of day?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

[ChessieCat]

4 hours ago, Altostrata said:

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

An example of what Alto needs:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

[BrintHellix]

6 - wake up, feeling akathisia as described above. 

 

6:10 - take 4.4mg of citalopram. 

 

Akathisia more or less the same throughout the day. 

 

22 - take 0.5mg of vortioxetine and go to sleep. 

[BrintHellix]

Anyone tried vaping CBD to manage akathisia?

[ChessieCat]

cannabis-marijuana-thc-and-cbd-or-hemp-oil

 

[BrintHellix]

Akathisia relief after Lexapro CT

 

Hi,

I have a long history of On/Off misc. antidepressant use for various periods, icluding SSRIs & SNRIs.

 

4/2019 - Now: CTed Escitalopram after taking it for 2 months - 20 mg to 0. Began experiencing agitation, irritation, brain zaps, lack of concentration, uncontrollable artificial anger. Tried stabilizing using several regiemes (1. Starting at 10 mg and tapering slowly; 2. Starting at 5 mg and tapering slowly; 3. Starting at 5 mg of Citalopram and tapering slowly), none helped and just made things worse. Even the smallest doses (0.1-0.5 mg) make me feel worse. Currently, after a slow taper I'm at 0 and still experiencing my version of akathisia as described above. 

 

I'm looking to relieve these symptoms so I can manage to work and function.

 

What I tried and didn't work:

- Propranolol

- Benzos - couple of days. Afraid to get addicted so don't want to pursue further.

- B6

- Fish oil

- Magnesium

- Zinc

- H1 blocker - Fexofenadine

- H2 blocker 

- Cannabis (both THC inclined and CBD inclined)

- CBD oil and CBD vaping

 

What are your thoughts regarding using Psilocybin mushrooms at a low to moderate dose in order to try and stabilize the Serotonin system?

Any other suggestions?

 

Thanks

 

Edited June 27, 2019 by ChessieCat
added topic title

[Altostrata]

On 6/16/2019 at 3:22 AM, BrintHellix said:

Generally, my symptoms get worse for a while when I take the pills (-1) and then they get better (0). If I don't take them at all I practically go insane (-2).

 

I'm not seeing these change in your symptom pattern in the notes you posted later on June 16:

On 6/16/2019 at 10:36 PM, BrintHellix said:

6 - wake up, feeling akathisia as described above. 

 

6:10 - take 4.4mg of citalopram. 

 

Akathisia more or less the same throughout the day. 

 

22 - take 0.5mg of vortioxetine and go to sleep. 

 

I need to know your symptom pattern before and after you take citalopram and before and after you take vortioxetine. What are the side effects of vortioxetine that cause you to take it at night?

 

When was it you switched from escilatopram to citalopram? What were the adverse reactions you got from escilatopram? What was the method of the switch? Did the akathisia-like symptom start when you made the switch? If not, when did it start?

 

We can't tell you what to take for "akathisia" and we can't make other suggestions until we know more about what happened and your symptom patterns.

[BrintHellix]

Currently I'm not taking anything. I got off the citalopram and vortioxetine since they made me feel worse. 

I took miniscule doses of both (0.4 mg of citalopram and 0.3 mg of vortioxetine).