phillyfan24: Lexapro taper too fast/reinstatement too high a dose?

[ChessieCat]

I think it might be worth adding in an extra cross over combination.  However you need to consider whether you are able to measure the tablet dose consistently.

[phillyfan24]

Wondering if someone could help me out. Have been in quite a wave since switching to 10mg tablet and 7.5mg liquid. I am noticing an uptick in DP/DR, fatigue, and memory problems...basically all my baseline symptoms. 

 

My question is I just realized that before taking the prescription liquid, I have not been shaking the bottle (just pouring a small amount into container to measure with syringe, then pouring left over amount back). Should I be shaking it every time? I want to think this is a pretty homogenous solution and that the active particles wouldn’t all sink to bottom, but I truly have no clear. I didn’t see anything in my pamphlet about shaking. Am I overthinking this?

[phillyfan24]

At around 17.4mg...10mg tablet, 7.4mg liquid (unfortunately my syringe is 10mL, so I had to go between the 3.6 and 3.8 mark, hence 3.7mL and the 7.4mg of liquid)...Been a month and am finally starting to feel like i am back to baseline..baseline being the constant DP/DR/brain fog, terrible memory, excessive fatigue. The liquid definitely induced a pretty significant wave (I even did a crossover), but I was able to truck through and do well starting the new job. My plan is to stay at this exact dosage for a few months to see if i can maybe begin to get some windows...I do not think i have had a window yet over this past year I have been dealing with this, but I have never held at a constant dose for more than 2 and half months, so I am hopeful that in a couple months maybe my dp/dr will decrease

[phillyfan24]

Question for mods... it has been exactly 7 weeks since I switched to liquid (10mg tablet, 7.4mg liquid). I thought I was feeling better last week, but I am in pretty rough shape right now in terms of my usual symptoms along with significant increase in depression and anxiety. My liquid refill is due to be picked up tomorrow. Would you recommend I continue to use the liquid, or switch back to pills and cutting them up? 

[phillyfan24]

It has been about 2.5 months of being on 17.4mg, about 4 months since on a relatively "consistent dose" - was on 17.5 for 1.5 months, 17.4 mg for 2.5 months...and nothing has changed unfortunately...constant DR and brain fog with significant fatigue. Some increases in anxiety and depression here and there, but this is mostly due to my fog and DR and the lack of progress i am feeling. The fog and DR is 24/7 with no alterations in intensity throughout my day... i have also not had anything that i would call a window since i tapered off fast and reinstated 14 months ago, which is really upsetting because it seems most get these where they feel at least some let up in symptoms.

 

Due to the lack of windows that it seems most get, I decided to try a 2% taper starting on Monday (Nov 18th), and yesterday/today I have noticed an increase in all my usual W/D symptoms, so I guess it is fair to say I was not stable? Pretty upsetting, but i am going to go back to the 17.4mg and continue to hold at this dose...hopefully I didn't throw things off too much with this trial...Also have been questioning if maybe i should updose, say to 20mg celexa, but am unsure.. prob grasping at straws.

@Altostrataany thoughts or suggestions? 

[Altostrata]

On 10/2/2019 at 6:59 PM, phillyfan24 said:

Wondering if someone could help me out. Have been in quite a wave since switching to 10mg tablet and 7.5mg liquid. I am noticing an uptick in DP/DR, fatigue, and memory problems...basically all my baseline symptoms. 

 

My question is I just realized that before taking the prescription liquid, I have not been shaking the bottle (just pouring a small amount into container to measure with syringe, then pouring left over amount back). Should I be shaking it every time? I want to think this is a pretty homogenous solution and that the active particles wouldn’t all sink to bottom, but I truly have no clear. I didn’t see anything in my pamphlet about shaking. Am I overthinking this?

 

Please ask the pharmacist about shaking the liquid, also how to store it.

 

If you reduced the dosage and now feel worse, you're probably not ready to taper. 2.5 months is not a long time for reinstatement.

 

How have your overall symptoms changed since May, before you started Celexa?

[phillyfan24]

Thanks for the response alto. Overall, it is hard to tell comparing to before I started the celexa, but to be completely honest it feels like things are the exact same, which is why I decided to see what happened if I made a small cut. The fact that I’m not getting any windows is what is most concerning for me. My DR and brain fog have been present since I fast tapered a year ago

[Altostrata]

If your symptoms got worse when you started the liquid, the liquid isn't agreeing with you. What times of day do you take your drugs? How do you feel before you take them compared with the hours after you take them?

[phillyfan24]

2 hours ago, Altostrata said:

If your symptoms got worse when you started the liquid, the liquid isn't agreeing with you. What times of day do you take your drugs? How do you feel before you take them compared with the hours after you take them?

My symptoms did get worse when I started the liquid, but I feel like they eventually went back to my baseline-tho it took a long time. I take my medication at 8pm every night. I had switched to the mornings when thjs all began, but there were too many days I had almost forgot to take my meds in a rush to get to work so I decided to continue at night. I will say that I feel no different before taking them compared to after taking them. That’s what is so frustrating for me. I don’t have any times of feeling better or getting windows like most do. Even after holding for 2.5 months (once on lex and once on celexa) at the same dose twice in the process I have not had a single window. 
only thing I have noticed is lately I have been waking between 4-6am and it takes more than usual to fall asleep, however this did not happen when I slept over at my friends over the weekend, so it may not be medication related. 
 

i would be totally Ok Going back to tablets, as the liquid does cost more, but wouldnt a switch back to tablets further destabilize my system? What would you advise?
I keep telling myself that this is not a medication side effect, but withdrawal, as I never felt this brain fog in my life - before meds or during- only after my initial 25%. I really hope going down 2% for a week does erase the hold I’ve been doing for 2.5 months 

[phillyfan24]

I also wonder if my “feeling worse” while tapering over the weekend was just due to being a stressful situation.  I was at a thanksgiving party with friends and a bunch of people I didn’t know, which def increases my social anxiety. Also, everyone was drinking except for me and it def made me wish the way things used to be. And lastly, I always take my medication at 8pm, but did not get to leave until 10pm so I took my medication later than usual. Idk if his played into everything. 
 

So overall, not sure what to do. I’m willing to follow mods advice- should I continue to hold or go back to tapering? Updose? Switch back to tablets? I drive myself crazy constantly wondering and researching what I should do. I start CBT next week so this should hopefully help. 

[Altostrata]

Yes, taking Celexa irregularly could cause odd symptoms.

 

The brain fog could be withdrawal or side effects. Lexapro and Celexa are siblings.

 

What is your sleep pattern?

[phillyfan24]

1 hour ago, Altostrata said:

Yes, taking Celexa irregularly could cause odd symptoms.

 

The brain fog could be withdrawal or side effects. Lexapro and Celexa are siblings.

 

What is your sleep pattern?

Yeah I’ve been going back and force about WD or side effects but I never had the brain fog until the first cut-that’s why I lean WD but not sure. Sleep wise, I sleep very good. During week with work, I slee 9:30-7, and weekends I’ll sleep 10/11 hours and take a 1-2 hour nap during the day. Just constantly exhausted. I also go to gym 4x/week and have been doing some cardio and weights, but due to fatigue/lack of energy I’ve only been doing 30-40 min sessions. 

[Altostrata]

First, you need to be very regular in taking your drug. If you're not, we'll be confused about withdrawal symptoms while you're tapering.

 

It's possible that the fatigue is a side effect of Celexa. A lot of people get this.  It may reduce as you reduce the drug -- but you have to get your schedule regular first.

[phillyfan24]

5 minutes ago, Altostrata said:

First, you need to be very regular in taking your drug. If you're not, we'll be confused about withdrawal symptoms while you're tapering.

 

It's possible that the fatigue is a side effect of Celexa. A lot of people get this.  It may reduce as you reduce the drug -- but you have to get your schedule regular first.

So you think I should continue with tapering? Do you think brain fog will get better as well? I do take the celexa at a regular schedule as I have alarm on my phone. This past weekend was one outlier over the past 3 months, as I didn’t drive myself and had to wait for my friend to leave unfortunately. 
 

do you also think I should continue with liquid or go back to cutting my pills?

 

lots of questions, but I truly do appreciate all your help 

[BigPharmaStinks]

50 minutes ago, phillyfan24 said:

So you think I should continue with tapering? Do you think brain fog will get better as well? I do take the celexa at a regular schedule as I have alarm on my phone. This past weekend was one outlier over the past 3 months, as I didn’t drive myself and had to wait for my friend to leave unfortunately. 
 

do you also think I should continue with liquid or go back to cutting my pills?

 

lots of questions, but I truly do appreciate all your help 

Feel free to PM me so I can tell you more about my experience and my insight. 

[Altostrata]

If you've taken Celexa inconsistently, you need to get on a regular schedule to let your nervous system settle down before tapering again.

 

6 hours ago, phillyfan24 said:

And lastly, I always take my medication at 8pm, but did not get to leave until 10pm so I took my medication later than usual.

 

This sort of thing can cause symptoms in a sensitized nervous system. A couple of hours can be significant.

[jozeff]

Hi phillyfan,

 

Hoe are you doing lately???

 

Cheers Jozeff

[phillyfan24]

Well i havnt updated in a long time and its been nothing but bad. I was down to ~14mg in january. I had a mental breakdown at work and in fear of losing my job my parents talked me into calling my doc and asked for sdvice. He switched me to 10mg trintellix late jan. The switch actually went smooth. I had planned to stay here for a good amount of time to see if things improvrd. Then my brother OD’d (long story short hes OK but got arrested-there was a periodnof time we did not know if he was alive). All hell broke loose and feeling more suicidal than ever my parents wanted to take me to hospital, which i denied. Instead of hospital we went back to the psych, who upped my trintellix to 20mg which i had been on for 7 weeks. It improved my mood (less rushing thoughts/mind chatter/obsessions)  but i began to develop insomnia or the usual cortisol rushes at 5am everyday after about 4 weeks,  unable to fall back asleep. The dpdr never changed either. A few days ago, i had figured the insomnia could most likely be a side effect of trintellix, as prior to my baseline was extreme farigue and always sleeping. Thus, i cut my dose to 17.5 mg to see if it would help. I had significant anxiety and further insomnia within a day and i quickly went back up to 20mg, where i am at now and waiting to get back to my crappy baseline. These past few days since attempting to cut have been the worst i have been in a long time. Crying daily, continuing to wake at 5, significant anxiety like ive never had in WD before, panic attacks which ive never had before, and feeling more suicidal than ever. I just want to give up but i am stronger than that. 

 

Idk what i am looking for and i realize that i have messed up and went against advice here, so i hope i am still accepted. I was in much better shape in january. Less symptoms, less dose, and one less med added. Im sure im experiencing side effects of trintellix and poss wd of celexa. I wish so badly i was just back at the 14mg of celexa and could have held or did a tiny uodose instead of a drastic switch. I feel like the last year of tapering has been flushed i am back to square one. Since i tried to do a cut and failed miserably i guess i am stuck at 20mg trintellix for the time being - feeling crappier than ever. 

 

If anyone has advice i am all ears, if not i completely understand-i know this is solely my fault. 

[Dizzy4]

Oh my God my heart is breaking for you. I have been wondering about you 😢

[Altostrata]

I am sorry things have gone downhill for you, phillyfan.

 

Have you discussed the adverse effects you've had from Trintellix with your doctor? Surely increased anxiety is not an objective of treatment. See https://www.drugs.com/sfx/trintellix-side-effects.html

 

Quote

 

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of low sodium levels like headache, trouble focusing, memory problems, feeling confused, weakness, seizures, or change in balance.
• Signs of bleeding like throwing up or coughing up blood; vomit that looks like coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; abnormal vaginal bleeding; bruises without a cause or that get bigger; or bleeding you cannot stop.
• Trouble sleeping.
• Very bad dizziness or passing out.
• Sex problems like lowered interest in sex or ejaculation problems.
• A severe and sometimes deadly problem called serotonin syndrome may happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

 

 

Also see https://www.drugs.com/pro/trintellix.html

 

It's a good idea to read up on adverse effects of any drug you might take, particularly if it makes you feel worse.

 

Please be aware if you say you are suicidal to almost any medical authority, they will feel it's their duty to get you on drugs.

 

While people are in a bad spot, thinking of suicide is not necessarily a sign of illness. If you don't want to have those thoughts, wave them away. They're just thoughts, they're your own thoughts, not coming from somewhere else. You don't have to act on them. You don't even have to pay attention to them or make them into a reason for hospitalization.

[phillyfan24]

1 minute ago, Altostrata said:

I am sorry things have gone downhill for you, phillyfan.

 

Have you discussed the adverse effects you've had from Trintellix with your doctor? Surely increased anxiety is not an objective of treatment. See https://www.drugs.com/sfx/trintellix-side-effects.html

 

 

Also see https://www.drugs.com/pro/trintellix.html

 

It's a good idea to read up on adverse effects of any drug you might take, particularly if it makes you feel worse.

 

Please be aware if you say you are suicidal to almost any medical authority, they will feel it's their duty to get you on drugs.

 

While people are in a bad spot, thinking of suicide is not necessarily a sign of illness. If you don't want to have those thoughts, wave them away. They're just thoughts, they're your own thoughts, not coming from somewhere else. You don't have to act on them. You don't even have to pay attention to them or make them into a reason for hospitalization.

Hey @Altostrata thanks for quick response. I did contact my doctor. He’s clueless. His response was to switch AGAIN. This time to Zoloft. I’m so tired of it. Idk what to do; but right now I am not switching to Zoloft.
 

i was actually feeling fairly decent at 20mg, and only had anxiety (although significant) the day after I cut to 17.5mg. I know it takes a few days to reach steady state, so I wonder if I just got myself worked up. I did also feel off balance and increase in DPDR, thi I know that can be anxiety related. I have thought of maybe trying to tough it out at the lower dose of 17.5mg and hope the insomnia gets slightly better with some time. I also thought maybe it’s celexa WD causing the insomnia? It’s weird because since this began my WD has always been extreme fatigue, and now it’s the complete opposite. I feel wired  Idk just thinking out loud. 
 

 

Do you have any recommendations?

[Altostrata]

What time of day do you take Trintellix? Do you take any other drugs?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

[phillyfan24]

20 minutes ago, Altostrata said:

What time of day do you take Trintellix? Do you take any other drugs?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

I take the trintellix as soon as I wake up at 7am. I had been taking it at 8pm but slowly moved it to the morning due to the insomnia. It didn’t really help much. 20mg trintellix is the only drug that I am on. I can provide notes for today:

 

5:00- wake up and lay in bed until 7 unable to fall back asleep. 
7:00- take 20mg trintellix and eat breakfast (fruit smoothie with whey)

8am- get to work...crying episode while posting above update. Overall just feeling defeated. 
9Am-10am - talked with coworkers, mind taken away from current situation 

11am - first patient (who ironically is also in psych meds for decades and said she had tried to come off and couldn’t so she’s back on). Paying more attention to my increased DPDR. Trouble focusing on convos. 

12noon - second patient (again, someone with psych med history. She CT’d decade use of Effexor 3 months ago as she got pregnant. She has no sx tho as of now...how did we all get so unlucky). Was able to mostly stay focused on current task. 
1pm - quick lunch (salmon) and third patient. Struggled to stay attentive, couldn’t stop obsessing about what to do regarding dose. 
2pm - higher anxiety. Talked to coworkers again and they both asked me if I was OK and that I seem very stressed. Played it off, which I seem to be fantastic at doing 
3pm - finish documentation for work 

4pm - leave and head home 

5pm - higher anxiety, lying in bed watching tv, and trying to figure out dose. Talk to Mom and tell her that switching meds just makes me worse and I need to get off of them slowly. She agreed and wants me to see naturopath, I’m hesitant but glad for her support. 

6pm - shower and another crying episode 

7pm - dinner (turkey and zucchini)

Will update remainder of my night tomorrow and post one for tomorrow. 
 @Altostratawhat do you think regarding my dose? 

[phillyfan24]

As a continuation from yesterday's symptoms diary:

 

8pm-9pm get ready for bed, watch tv, snack 

9pm- bed...fell asleep right away and woke up at initially 3:30. 

3:30-6 - very broken sleep...believe i fell back asleep for ~30 minutes, not even sure

 

I will post todays diary later on or tomorrow morning, but so far, more of the same. I feel very stimulated (worse since dropping down) - significant anxiety like i never experienced before, nervousness, shaky hands/fingers (i seem to have had this in WD previously, poss tied to anxiety now). A little after upping to the 20mg trintellix is when I noticed what i consider insomnia (waking at 5ish and unable to fall back asleep...I never had that before. Not in my previous usual WD state, or when on any other medication...I always felt very fatigued). I just attributed it as a side effect of the trintellix and that it was a more "Activating med" tho I didn't have it at 10mg. Now, even tho i am sleeping much less, I also do not experience much in terms of fatigue throughout my day (Again, not usual for me). As of today, after much consideration, i decided to drop my dose to 18mg. i have been reading up about the adverse effects you sent me Alto and I didn't want to risk another day at a higher dose. I will await further action for your advice. 

[Altostrata]

What is your sleep pattern?

 

Why did you switch to Trintellix rather than increase Celexa, which you were already taking?

 

What kind of work do you do?

[phillyfan24]

1 minute ago, Altostrata said:

What is your sleep pattern?

 

Why did you switch to Trintellix rather than increase Celexa, which you were already taking?

 

What kind of work do you do?

- My sleep pattern since 20mg trintelix goes like this: no problem falling asleep around 9:30-10:00..Wake up anytime between 4-6 and will not be able to fall back asleep. I realize this is technically 8 hours some days, but for the past 6 years if i ever woke up early i could fall right back asleep. Usually was always sleeping 10 hours at least. 

 

- i switched to trintellix following what I would describe as my first panic attack ever - happened at work ... My parents noticed something was wrong and my dad explained that he had these too until he got on the "right medications." So I had a lapse in judgement and ended up following my psychs recommendation to switch. I know it was the wrong decision - I 1000% wish I had just updosed my celexa, and i regret it so much. I was doing alright on the celexa and was able to use the liquid and was slowly decreasing - I at least had a pretty discernable WD pattern...what i experienced following this last attempt to cut my dose is unlike what I have experienced before. I am trying hard not to beat myself up.

 

- I am a physical therapist/physiotherapist...basically helping people that are in pain via exercise

[Altostrata]

I don't know what to suggest.

 

Your sleep is not terrible.

 

As you've made a switch from Celexa to Trintellix, I hesitate to suggest a switch again to Celexa or anything else. Switching may upset the applecart, it seems you are accommodated to Trintellix and you might get withdrawal from it.

 

If you think Trintellix is causing adverse effects, I guess you might very gradually decrease Trintellix. A decrease of 2.5mg, or 12.5% of your current dose of 20mg, was too much. You might do better with the 2mg decrease. See Tips for tapering off Trintellix (vortioxetine), previously called Brintellix

 

Please let us know how you're doing.

[phillyfan24]

1 minute ago, Altostrata said:

I don't know what to suggest.

 

Your sleep is not terrible.

 

As you've made a switch from Celexa to Trintellix, I hesitate to suggest a switch again to Celexa or anything else. Switching may upset the applecart, it seems you are accommodated to Trintellix and you might get withdrawal from it.

 

If you think Trintellix is causing adverse effects, I guess you might very gradually decrease Trintellix. A decrease of 2.5mg, or 12.5% of your current dose of 20mg, was too much. You might do better with the 2mg decrease. See Tips for tapering off Trintellix (vortioxetine), previously called Brintellix

 

Please let us know how you're doing.

Thanks alto. I’m going to try to stick to 18mg for a little bit. I agree that my body has adjusted to the trintellix seeing the reaction I had when I decreased. I also agree my sleep is not terrible, I’m likely exaggerating because this symptom is so new. I will continue to post daily patterns every few days. Appreciate your help

[phillyfan24]

I’ve been meaning to post some of my journals for past few days:

 

5/4

4:30 AM - woke and went to bathroom-did not fall back asleep until 5:15-5:30ish

7AM -woke and showered,ate breakfast, off to work..racing thoughts about WD, whcih seem to always occur worse so in morning

8AM - 18mg trintellix

8AM-4pm - work. Slow day as usual due to covid. Lunch and fish oil at noon. 

4pm - light workout 

5-7pm - relax in bed, try to focus in tv but continued racing thoughts about my DR

7pm- dinner 

7-9 - play video games with friends = seems to be the one way to distract my mind from everything

9:30- 2mg melatonin and off to bed 

 

5/5

 

12AM - woke up - bathroom and light snack. Fell back asleep quickly. Woke again at 4:30 and fell back asleep. Woke at 6:30 with anxiety and didn’t fall back asleep

7AM - shower and off to work. Usual racing thoughts much of morning

8AM- 18mg trintellix

9AM - noticed I am more tired than usual

11AM - even more tired- hard to keep eyes open. 

12noon - lunch and fish oil

4pm - went home. Ran into neighbor and noticed increased DR. I had felt this throughout the day but this confirmed it. 

5-7pm- shower and relax. Noticed increase in anxiety/racing thoughts-try to not pay attention. Dinner at 7

7-9 - video games with friends 

9:45 -2mg melatonin and bed

 

5/6

 

not a good night sleep wise. Woke up at 12:30,2:30,5:00, and again at 6:30. Cortisol spike/anxiety at 6:30. Did not fall back asleep

7 - usual morning routine and off to work 

8am - overall despair. Thoughts about is my DR ever going to go away, or even get a little better. Take 18mg trintellix

noon - lunch and fish oil

2ish - light workout 

5-7pm - shower and dinner

7-9pm - video games 

9:30 - 2mg melatonin and bed

>another day of notable increase in derealizarion, whcih is common when I am adjusting to new dose

 

Overall my symptoms do not change too much. I will say since the decrease the overall feeling of excess stimulation is gone, so that’s a plus. Seem to be close to stabilizing from the drop, will know for sure when the morning cortisol surge goes away. My main symptom has been derealization which has not let up one bit since the original fast taper off Lexapro ~19 months ago ( I know I have switched meds altered doses etc but I would have hoped a slight decrease of this at some point) Not a single window where this gets better, which is why I think i take it so hard. If I’m being honest with myself, the derealization was a major contributor to the depressions that caused me to switch to trintellix hoping something would help. Just feel stuck with it and it really impacts my work ability. I try my best not to worry about it but with work being so slow I have so much free time. 

[phillyfan24]

more journals, as last two days have not been good:

 

5/7 - 

9:30pm-4:30AM - good sleep, don't think i woke up. Woke at 4:30 and went to bathroom, off and on light sleep until 6:30

7AM- Breakfast and off to work. usual racing thoughts

8aM- 18mg trintellix

8-noon - usual high mid morning anxiety while work is slow. Trouble diverting attention away from WD.

Noon - lunch and fish oil

3pm- light workout 

4-7pm - relax in bed, anxiety, eat dinner

7-9pm- video games with friends

9:30pm - 2mg melatonin and bed

 

- increased anxiety and DR throughout the day

 

5/8 

4:30 wake up and off and on sleep until 6:30

7AM- Breakfast and off to work

8aM- 18mg trintellix

9-12noon - anxiety, try to distract mind but unable to 

noon- leave work (half day)

1-2pm - nap 

2pm - lunch 

3-5pm - crying episode...feeling hopeless and stuck...i feel like crap, have felt like crap for 19 months, and am still on a high dose of meds. 

 

Symptoms have ramped up over the past 3-4 days. Just thinking now, on this past Sunday i began grinding my pills , weighing, and filling capsules to make it easier to transport (i had previously just cut small pieces and weighed them).  I wonder if this is the cause of my uptick in symptoms. Also still wonder if i am on too high a dose still, as although the overstimulation feeling is much better, this anxiety is unlike what i have experienced before

 

[phillyfan24]

Question for mods. It has been just about 3 weeks since the drop to 18mg trintellix. Nothing has changed in regard to the early waking/inability to fall back asleep, as well as the increased anxiety. I can’t help but think I still am on too high a dose of trintellix, since I stupidly jumped up so much and these symptoms only began after the increase. My question is, should I continue to hold and hope things improve, or would I benefit from another small drop fairly soon to see if a lower dose helps these symptoms?

[Altostrata]

It appears your anxiety increases after you take Trintellix in the morning. My guess is it's still too activating for you. You haven't gotten withdrawal symptoms; I'd continue tapering.

 

Your sleep isn't too bad, considering.

[phillyfan24]

14 minutes ago, Altostrata said:

It appears your anxiety increases after you take Trintellix in the morning. My guess is it's still too activating for you. You haven't gotten withdrawal symptoms; I'd continue tapering.

 

Your sleep isn't too bad, considering.

I agree about the sleep, just the complete opposite to what I am used to. Would you recommend a 10% cut? 

[Altostrata]

Tapering by 10% is our rule of thumb for tapering all psychiatric drugs taken for more than a month.

[phillyfan24]

 

10 minutes ago, Altostrata said:

Tapering by 10% is our rule of thumb for tapering all psychiatric drugs taken for more than a month.

That’s what I was thinking. Didn’t know if you would recommend less. Appreciate it alto. I will keep things updated here 

[phillyfan24]

Sorry to bug again, but I have deteriorated even more the past two days. I now have anhedonia and most concerning, inability to get an erection. I am terrified because I have read much about pssd. @Altostrata do these new symptoms change anything regarding the taper or even poss switching back to celexa. I did not have these on the celexa, these are new since cutting trintellix from 20 to 18 three weeks ago. Do I risk this becoming permanent by staying on it? Trintellix is ruining me. Absolutely terrified right now...