Alicja: Trintellix / Brintellix / vortioxetine

[Alicja]

On 9/10/2018 at 10:02 AM, Jules1234 said:

I was on the trintellix a little over a month. It’s worth mentioning that I have a highly sensitive central nervous system. About 10 years ago doctors thought I may have MS bc of the neuropathy and weird sensations I experience, but after extensive testing the conclusion was my CNS is on high alert. I’ll go long stretches when it’s calm too. When I was on the trintellix I immediately experienced a lot of sensations - like someone was grabbing my arm, or buzzing on my ankles or all over neuropathy. A lot of that has subsided since I stopped taking it. 

I do moderately drink alcohol but haven’t since I’ve been so nauseous. When I wake up in the morning I have a brief moment (20 seconds or so) when I feel okay, and then I’m hit with the nausea and anxiety again. 

I’m taking .25 of Ativan almost every day for when the anxiety is unbearable. I know it’s not recommended but I need something to help me through this period. Also fish oil, probiotic and just started magnesium glycinate last night (one capsule). My GI doc suggested I start an acid blocker to see if that helps with the nausea.

im 38/female and petite, so not eating enough takes an immediate toll on my body/weight.

i also two little kids and a full time job and feel like I can hardly function.

Emotionally one of my big hang ups is that I feel worse now than I did a couple weeks ago, though that seems standard of the windows/waves theory.

After 6 weeks on Trinnelix at 10 mg the neurological type sensations have been insane. I am 3 months in dealing with this now. Worst part is I don't know if any of what I experienced was due to a bad reaction to the ssris or some underlying condition that was brewing already inside me. All I know 6 weeks in on trinnelix and I'm in a hospital with muscle enzyme breakdown called rhabdomyalysis. SSRIs can be a cause but so can some crazy neurological muscular disease among other things.  I had to cave in and went on zoloft 0.5 mg to be increased to 0.25mg and clorazapam 0.5 mg last week as in my mind since all this happened I now convinced myself that I have ALS and every day has been pure hell. Dr. Google has been fun. I no longer have self control. I cried daily today was one of those days after my conversation with my GP. I still don't know what is wrong with me and if Zoloft will give me the same issues as trinnelix 6 weeks from now and if once again I'll end up with rhandomyalysis. Clorazapam stopped my body twitches, which is great but my doctor gave me no reassurance as this is also a medication given to people with neurological issues hence my earlier breakdown.  I already know I don't have MS clean brain MRI and CT Scan. I'm just waiting on a cspine MRI which will happen this saturday. I'm only lucky to be getting tests at this rate due to some connections through friends and family as I could not imagine living like this for another 3 months. Next is neuro appointment and waiting on the nerve study which I'm petrified of. I had spinal surgery as a kid so who knows. My problems started while on trinnelix and then a week after stopping it cold turkey after really poor advice. I took myself to the hospital 2x last week as I had burning sensations down my arm with electrical shock feeling that was new. My blood work is now good no muscle breakdown issues. They also told me to take ativan every 4 hours which is the dumbest thing I've heard.  This was the advice I received from the emergency room doctor. I went back to my family doctor and told her I need to function so she gave me clorazapam until zoloft kicks in.  symptoms are gone for the most part but I question why based on what I learned about the medication. As good as I felt prior, I suddenly feel like **** again and I'm noticing little twitches. I feel like my CNS is on a spin cycle in a washing machine that I just can't get out of naturally.

 

Sorry I don't know how to add the meds under the quote so will have to put it in this way...

APRIL 25 TO JUNE 5, 2019 TRINNELIX 10 MG

CLORAZAPAM 2X PER DAY 0.5 MG SINCE AUGUST 22, ZOLOFT .05 MG SINCE AUGUST 22

 

[WiggleIt]

Hello Alicja,
 

Welcome to SA!  We're glad you found us, but of course we wish you were not in a position where you were going through all of this.  Thank you so much for all the detail you gave us.  I'm trying to figure out why your intro topic is posted as a reply to someone else's topic, but one of the mods who's better with tech may need to figure that out.  Instead, I'll do my best to give you some introductory info right now...

I want to make sure we're talking about the correct med.  You wrote "trinnelix."  Did you mean "trintellix"?  I'm not picking on your spelling, I promise!  Just want to make sure we are on the same page with the meds we're discussing before we dive deeper.

For your signature, you can follow these instructions to get it to show up in the right place (underneath the dialogue):

a.) Look at the top right of the page where your name appears
b.) Click on your name and you'll see a pull-down menu appear
c.) Under that menu, click on Account Settings    
d.) You'll get taken to a new page.  Look at the left side of that page
e.) Click on Signature
f.) Fill out a short list of your medication history in the box that pops up
g.) Click Save and then you can go back to the rest of the site and keep chatting

As far as the neurological symptoms go, we on SA have experience the whole gamut of neurological symptoms, and tons of us have come out the other side with recovery of the neurological symptoms, so please do have heart!  The electric shocking sensations you described are normal for withdrawal (WD)—and for adverse reactions.  Possibly, you're dealing with a double whammy (adverse reaction and WD), which is a possibility with psych meds.  It may be strange to read the word "normal," because, after all, what's normal about shocking sensations?  But, rest assured, people have recovered from such sensations, and they are "normal for withdrawal."

You mentioned rhabdomyolysis, and, in my personal (non-medical, non-professional) opinion, it sounds like it's not a bad idea to keep monitoring that with a medical professional.  I don't know if anyone here on SA would be able to tell you for sure whether the meds caused it, and I won't be so presumptuous as to make a guess.  Did doctors tell you that they suspected the meds caused it?  In my personal experience, doctors can be fanatically in denial about side effects caused by meds, so I don't know if you'd get a straight answer from doctors, either.  Regardless, it is an excellent sign that your bloodwork came back normal and no more muscle breakdown was detected.  What kind of doctor is following up on your rhabdomyolysis?   

Many, many people on SA have also had brain MRIs to rule out MS in withdrawal.  It's also great news that yours was clear.  When will you hear back on the cspine MRI?  

Don't be scared of the nerve conduction testing.  I had it done, too, and I lived

I'm going to ask one last question before wrapping up and recapping, as I don't want to overwhelm you in your first steps on SA.  Here's the last q:  With your muscle twitches, are they large, visible twitches that cause your limbs/body to jerk visibly and involuntarily?  Or is it more like an internal twitching sensation that does not cause your limbs to involuntarily move?  

Okay, let me recap next steps for you...

1.) Use the instructions above to fill out your signature
2.) Let us know if trintellix is what you were on, or if it was something else with a similar name
3.) Let us know more detail about the muscle twitches (visible or non-visible, cause limbs to move or not?)       
4.) Please read about the windows and waves pattern of recovery:

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

5.)  Please read some recovery stories, so you can see it's possible!

https://www.survivingantidepressants.org/forum/28-success-stories-recovery-from-withdrawal/

Others will also be along to chat with you!

Warmly,
Wiggle
   

 

[Altostrata]

Welcome, Alicja.

 

Rhabdomyalysis is a serious adverse effect of some drugs. It is drug-induced, it is not ALS. If your doctor doesn't know what to do about rhabdomyalysis, you need a different doctor. And you should not be taking any drug that might cause it.

 

On 8/28/2019 at 4:59 PM, Alicja said:

SSRIs can be a cause but so can some crazy neurological muscular disease among other things.  I had to cave in and went on zoloft 0.5 mg to be increased to 0.25mg and clorazapam 0.5 mg last week

 

You are taking half a milligram of Zoloft? Please check the dosage.

 

Why is your doctor insisting you take an antidepressant? If you haven't felt any benefit from it, I wouldn't even put it in my mouth.

 

If the clonazepam is helping, I'd take that. I wouldn't take an SSRI such as Zoloft, which might hinder your healing from rhabdomyalysis.

[Alicja]

I am actually on .25 mg of zoloft x3 pills so looks like.75 and clonazepam at .5 mg. I feel more jittery on these drugs, my joints hurt. I been on it 3 weeks now and I am scared I might have the same cpk issue as before. I'm seeing a neuro tomorrow and a rheumatologist on wednesday. I'm back on taking these pills because I'm having major health anxiety. I don't want to be on any pills. Since having rhabdo i had twitches, leg cramps, no clinical weakness. I had body jerks, burning arms on and off. My MRIs came back clean. Now on zoloft i feel like at times i have Parkinson's

 

Edited September 10, 2019 by ChessieCat
removed quote

[Alicja]

I' m a 35 year old female with a history of anxiety and I had spinal surgery due to scoliosis at age 13/14. I have rods in my spine. Over the years I had some spasms in my back which have made me stiff while trying to straighten out. These were linked to my periformis muscle. I still have a slight scoliosis so my body is not aligned well. In winter my vitamin d levels were very low at 25. I experienced massive work related stress anxiety for the past 2 years which increased in April. I had massive burn out and was overworking myself and not eating or hydrating well. I started having panic attacks and insomnia

At the end of April 2019 went on anti anxiety medication, brintellix which caused bruises on my legs. Overall I felt good on the medication. I was also taking supplements, LGlutamine, Vitamin b, probiotic, magnesium. By the end of June 2019 I went to the ER due to very bad leg pains. The weekend before I had these symptoms I did a lot of very hard labour around my house and walked for 2 h. Im not very active. Also the week before I drove 8 hours straight with very short stops in between. I did the same trip back 10 hours after 3 days.
Initially I ignored the leg soreness as just lactic acid build up but by thursday night I realized it was not normal. I thought I developed a blood clot. Turned out my CPK muscle enzyme was at 11, 200 so my muscles were breaking down. I was diagnosed with rhabdomyalysis cause unknown. Had to stay in the hospital for 3 days on intense IV fluid flushing. My CPK levels have been consistently down at normal since discharge which is a good sign. Rhabdomyalysis can be caused by intense workout, crush injury, ssri's which i was on but it is also linked to muscular/neurological issues. During this time I also quit my anti-anxiety meds cold turkey as apparently 4 days was enough according to my doctor. I believe I had withdrawals. Brain fog, insomnia, resless leg syndrome, vertigo those stopped.

For about a week and a bit after hospital discharge I was okay then the following happened:

A week after hospital discharge, I decided to go down 23 flights of stairs and carried my friends 18 month old son around a mall. Not the smartest decision after muscle breakdown. The following day my calfs were inflamed. I could barely walk on my left leg. I rushed to the doctor to check my CPK which were normal. My legs were ok and I was able to walk fine.After that week everything went downhill.

Since June 17, I started twitching in my left bicep. The twitches spread to other parts of the body: legs, feet, back, ribs, you name it I had it. The twitches are daily some days worse than others. They are not constant and happen when I'm at rest or when I'm not moving the area. Initially I had these weird sensations in my legs as if I had bugs crawling inside or bubling. That has since ended. I also have cramps in my legs after walking or numbness primarily in the left leg. This also comes and goes. I did have a band like sensation around my head that's gone. I had one tiny tongue twitch. I have gastro issues. Before being on medication I had IBS.  I started having a a right hand tremor that comes and goes. On July 23 i had a massive facial twitch on my left side. I was crying so much that day and felt my nerves building up inside me when I found out my MRI and nerve study will not happen until November. After I stopped crying the twitch happened. I thought I was having a stroke. Sometimes still get a bit of a twitch around the crease of my mouth, my eye lids are more shaky when I close them and I had a bit of a twitch to my left eye lid. I had to take predisone steroid for 5 days as my face did droop a bit. I also have tingling in my hands that come and go and burning sensations in my arms. I had electrical like sensations running from my elbow to my fingers once at night. I already had autoimmune tests and muscle related blood tests all came back normal. I had a brain mri and cspine mri, a ct scan of my brain all normal.  One of the ER doctors wrote peripheral neuropathy as his diagnosis which scared me even more. He wrote that my leg reflexes are hyper but im symetrical on both sides and I'm still within the 2 to 3 range which I read is normal. During my time off brintellix I developed high anxiety thinking I have MS or ALS. I had daily crying spells. ER doctor told me to take lorazepam every 4 hours so I went to my doctor as I felt that was too much. She gave me clorazapam to take 2x per day. I was also prescribed zoloft and went from .25 mg to .75 mg over the past 3 weeks. I went to a neurologist who reassured me I have absolutely no neurological conditions and believes my symptoms are caused by high anxiety and sensitivity to ssris. Since I increased the Zoloft dose I feel wired as if I'm on some crazy drugs,  I'm talking fast and have more body jerks and body tremors. The neurologist told me to go down to .50 mg. I feel extremely jittery. I don't want to be on these drugs they are messing up my system.  I feel very scared of what is happening to my body.

[Alicja]

Brintellix from April 25 to June 5, 2019

At 10 mg stopped cold turkey after reducing to 5 mg in 3 days

Lorazapam 5 mg as needed

Zoloft since September 4, 2019 to present from 25 mg to 75 mg went back to 50 mg as of September 11, 2019

Clorazapam 2x per day since September 4, 2019 to present. Last dose taken on September 8, 2019

Edited September 10, 2019 by manymoretodays
removed quote, information is in post above

[Alicja]

Hi Wiggie

Thank you for the information

In response to your question about the twitches I had both. I was cleared by a neurologist for any neurological conditions and told me not to waste my time with the nerve conduction study. Most doctors that I seen which is about 7 in total told me I have anxiety no neurological issues. I am keeping my appointment in November for the nerve conduction study but trust the neurologist in his assessment. I will be seeing a rheumatologist to discuss the rhandomyalysis tomorrow. All my MRIs were clean as well. I am now on Zoloft had to reduce it to 50 mg as 75 mg was causing more symptoms.

 

Edited September 10, 2019 by ChessieCat
removed quote

[manymoretodays]

Hi Alicja,

I just moved your 2nd introduction, titled "Sensitivity to SSRI's" back here to your main introduction.  It's right above your last post now.  I removed the quote too, as it's all in the previous post up there.

 

We like to keep members to one introduction per member.

37 minutes ago, Alicja said:

Brintellix from April 25 to June 5, 2019

At 10 mg stopped cold turkey after reducing to 5 mg in 3 days

Lorazapam 5 mg as needed

Zoloft since September 4, 2019 to present from 25 mg to 75 mg went back to 50 mg as of September 11, 2019

Clorazapam 2x per day since September 4, 2019 to present. Last dose taken on September 8, 2019

Can you go here:  Account Settings> signature and then just put in the information above.

Also see: Please put your withdrawal history into your signature

 

Welcome aboard from me too, Alicja.

This is your main introduction, you've introduced yourself to the community now, and can ask questions specific to your case here, as well as communicate with moderators and other members too.

 

And how are you doing today? 

After you get the signature in place.

Could you tell us what you have been taking and at what time of day.

Just note time on the left.  And then on the right, the drug(again by name, and dosage).  Also on the right note your symptoms too, as they are occurring throughout the day. 

 

I'm happy to get you more information from the site, as well, on your drugs, and some general information, on tapering and WD(withdrawal). 

Let me know.

Did you decide to continue with the Zoloft then?  Often, dependencies can occur with AD's in a short time. 

Is it or the brintellix helping with anxiety?  Are you still on the brintellix too?  I can't tell,  in your recent post it looks like you might have come off of it on June 5th?  The notes will clarify this too for us.

 

 

Love, peace, healing, and growth,

manymoretodays(mmt)

Edited September 10, 2019 by manymoretodays
additional

[manymoretodays]

Good job!  You got the signature done!  I was just going to do it for you.....

Excellent!

[Alicja]

Thank you manymoretodays for your response. I discontinued brintrellix on June 5. I am now on Zoloft 50 mg that I take at 2 pm. I do not think I will continue with the Zoloft and will need to discuss it with my doctor tomorrow. I just went down to 50 mg as of yesterday as I was on 75 mg 4th day in. I noticed becoming very hyper, had more body jerks in limbs, muscle and joint pain, increase in body twitches from before. Today I woke up very tired by 11 am I was hyper again, talking fast, before my 2 pm dose my left arm had tremors when I put pressure on it against the chair rest, I started to feel dizzy and my face had a tremor on the left side. I also had right hand tremors. I took my medication. Had a cry spell on my way home from work. Before I took Zoloft I was obsessed for 2 months that I had ALS but was reassured I have no such thing. The obsession made me go back on medication even though my symptoms came in waves after stopping brintellix and I was getting better with some of the physical symptoms. I only went back on meds because I had bad panic attacks. Since taking Zoloft the physical sensations are amplified again. I am also getting headaches and flu like sensations in the morning on Zoloft.

 

Edited September 10, 2019 by ChessieCat
removed quote added name

[Altostrata]

3 hours ago, Alicja said:

I will be seeing a rheumatologist to discuss the rhandomyalysis tomorrow. All my MRIs were clean as well. I am now on Zoloft had to reduce it to 50 mg as 75 mg was causing more symptoms.

 

Rhabdomyalysis is a serious adverse effect from some drugs or drug combinations.

 

On 9/3/2019 at 10:28 AM, Altostrata said:

Why is your doctor insisting you take an antidepressant? If you haven't felt any benefit from it, I wouldn't even put it in my mouth.

 

If the clonazepam is helping, I'd take that. I wouldn't take an SSRI such as Zoloft, which might hinder your healing from rhabdomyalysis.

 

This is my best advice. I would not risk exacerbating rhabdomyalysis. If you've been taking Zoloft only since September 4, you can go off fairly quickly. Since you just reduced to 50mg, I would take it for 5 days and reduce to 25mg, wait 5 days and cut that in half, take it for 5 days, take 6.25mg for 5 days, then quit.

 

You need to take up their medical error, resulting in rhabdomyalysis, with your doctors.

 

I don't think there's anything I can add. If I were you, I would not take a psychiatric drug again, your body has given you a warning.

[manymoretodays]

On 9/3/2019 at 11:28 AM, Altostrata said:

Why is your doctor insisting you take an antidepressant? If you haven't felt any benefit from it, I wouldn't even put it in my mouth.

 

If the clonazepam is helping, I'd take that. I wouldn't take an SSRI such as Zoloft, which might hinder your healing from rhabdomyalysis.

 

Hi Alicja,

So, doctor tomorrow.  Was the clonazepam helping at all?  We often have members who will come off the benzo's last, and it may be that you would have gotten some WD symptom relief from the clonazepam, rather than the Zoloft.  Your signature is listing clorazepam.  Do you mean clonazepam?  And then in your signature, you note that you are on it at present, as well as that you went off of it on the 8th of September?  It might help a lot right now.  And then, when the time comes, you can carefully taper off of it.

 

And then, keep in mind that some of your symptoms, at present, are related to WD from the votioxetine/Tritellix/Brintellix that you came off of in June, after just over a month on it.

More about this:

Brain Remodelling

What is withdrawal syndrome.

 

Dr.Glenmullen’s withdrawal symptom list.

 

The Windows and Waves Pattern of Stabilization

 

Even though you only had a brief usage of it, your nervous system may have become dependant.

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.

 

More on Tritellix/vorioxetine here too:  Tips for tapering off votioxetine/Tritellix/Brintellix

^ when you have time, it might help your understanding a bit of what is going on with you, as far as WD symptoms go.  You mention a lot of "anxiety".  How's your sleep going too?

 

I'll include some links that might help you, to talk with your doctor to, as you are becoming more informed.  Don't get your expectations too high though, as far as feeling understood, and consider leaving discussion about what you are learning until later.  You might want to reconsider the clonazepam, if you are not on it anymore.  Do clarify please.

 

And there's Altostrata's more succinct post too, right above mine.  Do attend to that.  Alto's got a whole lot more experience and knowledge around this stuff than I.  It's excellent advice.

 

 

How to talk to a doctor about tapering and withdrawal and what to expect

Does your doctor know you are tapering?

Withdrawal dialogues and encouragement

^ the last link goes to some cartoon type videos and may be most encouraging to you now.

 

Let us know how it goes tomorrow, if you will.  Give us an update when possible.

 

Best, and L, P, H, and G,

mmt

 

 

Edited September 10, 2019 by manymoretodays
formatting, other additional

[Alicja]

I saw my rheumatologist and she thinks I could of experienced a mild serotonin syndrome which caused my rhabdomyalysis. She recommended to taper off ssris period. I saw my family doctor as well and told her about my manic episodes on 75 mg of zoloft: increased, jittery energy, rapid talking, more body twitches, limb jerks, crying spells, shaking. She said 75 mg is a low dose and that I'm not tolerating the ssri's which based on my symptoms. I'm already on 50 mg. She recommended to go to 25 mg by saturday. Is this too soon? but I will stay on the benzo to help with withdrawal as I know this will be a long process given my first experience so I know what is coming.

[manymoretodays]

23 hours ago, Altostrata said:

 

Rhabdomyalysis is a serious adverse effect from some drugs or drug combinations.

 

 

This is my best advice. I would not risk exacerbating rhabdomyalysis. If you've been taking Zoloft only since September 4, you can go off fairly quickly. Since you just reduced to 50mg, I would take it for 5 days and reduce to 25mg, wait 5 days and cut that in half, take it for 5 days, take 6.25mg for 5 days, then quit.

 

You need to take up their medical error, resulting in rhabdomyalysis, with your doctors.

 

I don't think there's anything I can add. If I were you, I would not take a psychiatric drug again, your body has given you a warning.

Hi Alicja.  Reducing to 25 mg on Saturday sounds good.  And good thoughts/ input from your rheumatologist too!  Keep notes as to drug changes and symptoms.  Keep us updated too.  We can help you find more non drug coping skills to lend support too.  Best.  L, P, H, and G,  mmt

[Alicja]

I went to speak to a pharmacist about tapering. He advised me to taper slowly not to use the 5 day advice from my doctor.  It was very much aligned with what I been reading on the website. Since stopping the high dose of Zoloft the leg jerking is gone, the tremors are gone, twitches have been a lot better. Now they are very faint like going away almost. I feel them less. I have been using the benzo here and there to help. I find myself questioning again if this is neurological even though I have seen a neurologist who advised me it is not. What concerns me is that when I first got off the first round of meds I went to physio. He checked my reflexes and they were normal. I been tested by 3 different doctors before and after I started zoloft and suddenly my reflexes are brisk but they are symmetrical so no one is worried but me. I went back to physio today. He checked my reflexes and came to the same conclusion as everyone else. Now the left side of my body seems to be more impacted. During physio, he could tell my left arm had a bit of a tremor and so did my leg in an odd position. He told me it could be muscle endurance issues because my strength is good and I do not have clinical weakness.  I honestly question everything. None of this makes sense to me.

[Alicja]

So I am splitting my zoloft in half now. My muscle twitches are very rare now but at times it feels like I have popcorn under my skin. I was actually off from my zoloft dose for 2 days then when I introduced the half dose one hour later I had a facial tremor and burning in my left arm.