paradine7: almost there, but ...

[paradine7]

Hello Everyone!

 

I feel like I am joining this community as part of the "last mile" of my journey to finally kick these SSRI in the teeth and I am excited to share and interact with everyone.   At the same time, I'm incredibly scared as my support system (excluding my wife) doesn't believe that I should be off meds.   I am from a family of physicians and my psychiatrist is very stuck in the "chemical imbalance" theory, as is my family.  

 

Yup... just like everyone else I started getting medicated as a kid as part of the ADHD brigade, and then I was diagnosed with OCD (while taking ritalin of course).   I am sure I took a bunch of SSRI as part of my regiment, but I don't remember specifics.  ADHD faded away (or wasn't really there to start with) as I stopped believing it was a problem.  And at about 21, anxiety started to fade in.   Over the past 15 years (36 now), I've been on viibryd, zoloft , lexapro, and now trintelix.  Interestingly, I never did truly feel like I had the anxiety kicked.   

 

The biggest problem for me with the SSRIs has been anhedonia, lack of emotion, and loss of libido.   After a time, these became untenable in my marriage -- and life just was not that fun... and at the time I was on 200Mg of Zoloft.   I figured it was time to look for a change.   I never really tried to change the underlying behaviors causing anxiety -- I mean I did CBT, Meditation, etc, but really never got into the deeper stuff.   I never really realized that meds might not be a long term fix.   

So my psychiatrist thought we would taper off and switch to something else.   And so I tapered off of 200Mg of Zoloft successfully, and said no more SSRIs.   It took 8 months to get off of Zoloft, and I was doing really well for about 5 months with really no issues.  

 

And then COVID hit.  And then I had to move.  Then my job became incredibly lonely.   Specifically my wife and I are both starting businesses so there is a ton of stress there.   

So I started panicking, and not sleeping, and just having general anxiety.   But at that point, I had made a choice to never be reliant on the SSRI, and I still have that resolve.  

 

This time I starred taking a dose of Trintelix with the purpose of learning how to deal with my anxiety.   That was about 4.5 months ago.  Of course my psych has tried to push it up and up.  Which I went along with and made me miserable.  At one point I was at 15mg.    So I've dropped it down to 5mg which is the minimum dose.   And here I am for the last 1.5 months. 

 

At the same time I've been on Trintelix, I've been working through a program called "Unwinding Anxiety" which is a program by a MD/PHD psychiatrist named Judson Brewer and have had tremendous results.  After all 5Mg of Trintellix is supposed to be subclinical, right?   I've had 3, 4, and 5 day windows -- and many days I have windows of many hours.   This while things really haven't resolved that completely ---

 

- wife still starting her business and pre-revenue

- savings is going down

- getting my business on track

- COVID

- US election craziness

 

So here I am on that last 5Mg of Trintellix.   Sex drive is gone.   I do have emotions and feelings.  

 

Couple things I could use some thoughts on if anyone would be so kind to weigh in:

 

1.  I've been in a bit of a panic the past few days.  I've been sick (physically) and anxiety kicks up then.   I've read part of Unhinged and a few chapters of Anatomy of an Epidemic.   One of the scariest idea is that these SSRI's do actually work.  What if they do, and I have altered my brain chemistry enough that I can't do more than 5-6 moths without them anymore.    The Anatomy book might refute this idea or I might missed a central point.    But anyone else been scared by that too?

 

2.  Has anyone felt like Anxiety and self improvement has become a major part of their identity?   As my mind quiets down, I get really scared and don't know where to go with it.  Almost don't know who I am without the anxiety/meds. 

 

 

Thanks!

 

-paradine7

 

Edited October 19, 2020 by Shep
removed excess white space

[Shep]

Hi, pardine. Welcome to SA. 

 

It wouldn't surprise me if a lot of your anxiety was drug-related. There may also be dietary issues and other lifestyle causes. During withdrawal, many people have issues with drops in blood sugar, so make sure you're eating a healthy, clean diet with plenty of water to stay hydrated. Low blood sugar can also cause anxiety. 

 

I'm glad you're already familiar with Robert Whitaker's Anatomy and the harms these drugs can cause. 

 

12 hours ago, paradine7 said:

 I am from a family of physicians and my psychiatrist is very stuck in the "chemical imbalance" theory, as is my family.  

 

You may want to share this information:

 

CEPUK - Major milestone: Royal College releases new guidance on stopping antidepressants

 

Again, chemical imbalance is a myth. Stop the lies, please.

 

There are also a number of great journal articles on this site:

 

From journals and scientific sources

 

Also, we should look to the history for answers:

 

History We Can’t Overlook Anymore: Details Before the Anti-Depressant Era

 

 

12 hours ago, paradine7 said:

At one point I was at 15mg.    So I've dropped it down to 5mg which is the minimum dose.   And here I am for the last 1.5 months. 

 

At the same time I've been on Trintelix, I've been working through a program called "Unwinding Anxiety" which is a program by a MD/PHD psychiatrist named Judson Brewer and have had tremendous results.  After all 5Mg of Trintellix is supposed to be subclinical, right?   I've had 3, 4, and 5 day windows -- and many days I have windows of many hours.

 

I'm glad to read that you are having windows, but we recommend going no faster than 10% per month, based on the prior month's dose (not the original dose). Please see:

 

Why taper by 10% of my dosage?

 

Tips for tapering off vortioxetine (Trintellix, previously called Brintellix)

 

As for the concept of "subclinical," two points to keep in mind: (1) you're looking for an "effective" dose - one that staves off withdrawal, not one that keeps your serotonin (or any other neurotransmitter) at a specific level, since they can't be measured and (2) these drugs can be more concentrated at the lower doses, as described in this post:

 

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

How quickly did you go from 15 mg to 5 mg? I'm concerned you may get hit with delayed withdrawal, which can come on several months after either coming off an antidepressant or reducing down too quickly. You may want to read some of Dr. Stuart Shipko's articles on antidepressant withdrawal on the Mad in America site (Robert Whitaker's website):

 

Mad in America - Dr. Shipko

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

 King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

As you provide more information, we can better guide you in your taper. 

 

 

 

[paradine7]

Here I am.... it's November 23 and I am 23 days into 2.5Mg of Trintellix.   The pills are incredibly hard to cut.  

My main issues are headache, and just a general feeling of emotional pain that is really hard to describe.   Something I never had before SSRI's.  

It's like a full body feeling of pain --- like somethings just broken.   I had been equating that with anxiety, but I am not going to any longer as body sensations are just body sensations. 

 

Otherwise, I am clear headed and generally able to do what I need to get by.   The body sensations are scary though.  

 

I know I am tapering too quickly, i just want this **** out of my system.   i thought 5 to 0 would be easy.  Apparently it's not.  

[ChessieCat]

Thank you for creating your drug signature.

 

It would be a good idea to do hold until you reach:

 

Stability

 

WDnormal

 

Whilst you are holding on your current dose I suggest that you research ways to get smaller doses so you can taper by no more than 10% of the current dose.

  

On 10/7/2015 at 12:30 AM, erer said:

 

Make your own vortioxetine liquid

The active ingredient in the tablets, vortioxetine, is slightly soluble in water. This means you or a compounding pharmacy can make a liquid suspension from vortioxetine, see How to make a liquid from tablets or capsules

• A liquid will be a suspension, not a consistent or "homeogenous" solution. 
• Vortioxetine is highly soluble in ethanol and a substance called DMSO, as are many psycho-neuro-active prescription medications. Ethanol is readily available in vodka. You can get oral or medical grade DMSO from many sources. If you have questions about this, feel free to post them in this topic.

 

Have a compounding pharmacy make custom capsule dosages or a liquid or for tapering
Compounding pharmacies can make capsules of the drug in any dosage or a liquid from the tablets. You will need a prescription written for the custom compound. The only drawback is this can be expensive.

 

 

 

[Shep]

10 hours ago, paradine7 said:

I know I am tapering too quickly, i just want this **** out of my system.   i thought 5 to 0 would be easy.  Apparently it's not.  

 

It's not about getting the drug out of your system. If that were the case, protracted withdrawal would not exist. It's about the damage caused by withdrawing too quickly. A slow withdrawal is like going down the stairs. A quick withdrawal or a cold turkey is like jumping out the third floor window. 

 

Please see:

 

How psychiatric drugs remodel your brain

Edited November 24, 2020 by Shep
fixed typo

[paradine7]

Thank you for your responses  @Shep and @ChessieCat.   

 

Had a really tough day today as well.  Just felt like I couldn't get in touch with my "self."  The pain and anguish aren't like anything I have known before.  

My wife reminds me that I didn't have these symptoms even 20 days ago and that I was doing fine.  These body sensations are all new.  

The anxiety is generally okay otherwise -- but it's easy just to get anxious about the body sensations in themselves.   Hoping they kick out soon.

 

Starting with a new therapist tomorrow.   I've been with my prior one for 4 years.   It was time to move on...

[ChessieCat]

14 minutes ago, paradine7 said:

but it's easy just to get anxious about the body sensations in themselves.

 

Understanding how the body sensations are caused by the anxiety can be helpful:

 

From https://www.getselfhelp.co.uk/anxiety.htm

 

[paradine7]

Thanks for the support everyone. 

 

Been waking up early the past few days despite any need/want/desire.   Up at 430 for no reason.   Mind isn't racing at the time until i lay there for 20 minutes.    Feels medication related. 

 

Body sensations are continuing but seem to abate when i access mindfulness. 

 

Started a new therapy yesterday.    IFS. Think it could be really helpful. 

 

Seriously screw these drugs. 

 

 

[paradine7]

Day 29 of 2.5Mg of Trintellix.   Man this is brutal.   Every day has just been generic pain in parts of my body.   The pain cuts into my soul.  Like the pain anchors deeper trauma that needs to be squeezed out.  

Don't remember what it was like to feel "normal" and not sure if I ever have.   That's not true though.  I was doing great for a while on no medication.....

 

BUT...  I started sleeping through the night again and am getting spontaneous erections from time to time.  That is all a positive.  

 

 

[ChessieCat]

Whilst you are holding on your current dose and I think it would be a good idea to hold for several months because you made a 50% reduction, you could be investigating ways to get the doses you need to do a no more than 10% taper.  This topic has some helpful information.

 

Tips for tapering off vortioxetine (Trintellix, previously called Brintellix)

 

[paradine7]

I have done this poorly, and I accept that.   I've been at 0 everything since probably the 10 or 15th of January.     Went from 2.5 to 1.25 to 0 over the period between December 1st and Jan 31st.  

I did not follow the 10% rule and I accept that has been stupid.   When I did this withdrawal prior with Sertraline, the drop from 50-25-0 was not bad, so I guess I felt it would be easy to do it again.   Also got on the trintellix over a period of 3 months -- so couldn't imagine it taking me 5 or more to get off of it.  

  

The reality is that a part of me is a hard-driving get **** done kind of guy and takes no prisoners -- the rational patient part of me that sits and plans and draws out long term strategies lost that battle.  I am okay with that but generally still need the support.    I know 10% was the way to go, but I literally just couldn't take it anymore.   I hope I won't alienate those that would help me.   Part of my journey is accepting that I am imperfect.   And knowing I will get through this.  

 

Trintellix should however, be illegal.  Or at least a class II highly addictive controlled substance. 

My biggest issue has been some brain fog and secondarily having some trouble sleeping.   

Waking in the middle of the night.  I also physically "look" like I am in drug withdrawal.   

This will pass.

 

I broke up with my psychiatrist yesterday.  She was playing the narrative that I had a "chemical imbalance" and "needed" the seretonin.   That didn't play well with me.  She also most certainly did not believe in SSRI withdrawal.  She also put a family member of mine on five meds.... I don't need that kind of energy in my life.   I have been interviewing new psychiatrists... (all of whom want

$500+ for intakes) in a system where there is almost no reimbursement for small business entrepreneurs.   There has been literally 1 of 15 (even out of network) that still enjoys the profession for the patient and not the ego trip.    He's booked til end of February and by that point, I'll be free of this stuff.   No sense paying $550 for someone to tell me I don't need medication and run some basic bloodwork.  Honestly, the psychiatrists are kind of dumbfounded when you tell them you just want them there as a support and that you don't want them pulling out their rx pad...  Part of me is telling me that I don't want access to the meds anymore.   They have been a tragic part of what has otherwise been a beautiful life....

 

So my support system is my wife + brother-in-law, therapist, my mens group, and this board.   My parents loosely so.   Those are the only people that really know or understand that I am on this journey.  Very hard to be in a situation where nobody around me has actually done this.   So this board is an important outlet for me.  I know some of sounds depressing.... but there is comfort in being able to share my story somewhere.   Even if I am not conforming to the "right" path here knowing that a few people will read it means a lot to me.  

 

I am truly excited for what is coming.   I love the glimpses of myself that I see when I am real and in my self.  My therapy (internal family systems) will and is changing my life and helping me accept many of the things about me that caused all of the depression and anxiety in the first place.       I truly feel like I am healing and I hope I can continue to share that journey here.

 

[DaBro]

Hi @paradine7  not sure if it helps but I quit Zoloft on Nov 1 2018 and my WD symptoms really started in Nov 2019, so a 1 year delay in paws. I’m just mentioning it as you’re focused on the Trintellix, but some of your symptoms could be delayed WD from the Zoloft too. The recovery strategy is probably the same for both SSRIs though. Healing will happen. 

[paradine7]

Thanks DaBro.   I appreciate the thought.   I am sorry that happened/is happening to you.  

 

I am not going to do the whole long protracted withdrawal thing (I am going to continue to put out positives vibes on that front).   

I have seen stories of very long withdrawals and delayed withdrawals etc on these pages and they are horrific.   But it is hard for me to see myself in those stories - and reading about them could be poison for a mind trying to heal.   My courage and hope comes from my belief that my body will return to normal in quick and due time and I need to be supportive of that belief.

 

That way, I hope I can be posting in the success stories and give others hope.    I am almost there!!   I am sure you are too!

 

 

 

 

 

 

 

 

 

 

 

 

[Shep]

2 hours ago, paradine7 said:

I've been at 0 everything since probably the 10 or 15th of January.     Went from 2.5 to 1.25 to 0 over the period between December 1st and Jan 31st.  

 

 

2 hours ago, paradine7 said:

There has been literally 1 of 15 (even out of network) that still enjoys the profession for the patient and not the ego trip.    He's booked til end of February and by that point, I'll be free of this stuff.

 

Hi, Paradine, please clarify if you are still taking Trintellix. You mention being off it completely as of the middle of January, but then you mention being "free of the stuff" by the end of February. 

 

Did you come off and then reinstate later? 

 

2 hours ago, paradine7 said:

 I hope I won't alienate those that would help me. Part of my journey is accepting that I am imperfect.   And knowing I will get through this.  

 

 

The only thing that alienates those helping you is when members ignore our advice and then expect us to provide unending handholding support. You're not doing that. None of us are perfect. Do the best you can. 

 

2 hours ago, paradine7 said:

Honestly, the psychiatrists are kind of dumbfounded when you tell them you just want them there as a support and that you don't want them pulling out their rx pad...

 

Psychiatrists are just legalized drug dealers and psychiatry is not a legitimate field of medicine. This is a great letter by Dr. Loren Mosher, who sums it up well:

 

Letter of Resignation from the American Psychiatric Association

 

It sounds like you have a really good support system. They may not all understand what you're going through because it's such an experiential experience, but you're managing through this and not alienating those around you. This is good. 

 

I wouldn't seek our psychiatrists as healers. You already have what you need. If you need drugs to taper, you can get them from a GP. No psychiatrist is required. 

 

Again, please clarify if you're still taking any psychiatric drugs and if so, what the dose is. 

[paradine7]

Hi @Shep..   thank you for a wonderfully supportive post.     To clarify, I am on 0mg of Trintellix.  No meds of any kind at this point.   Been that way for two weeks.   

By the end of February, I am stating I will be free of the withdrawal.   Maybe naive, but that's the vibe I am putting out .   Smiling as I write this.  

[Shep]

15 minutes ago, paradine7 said:

By the end of February, I am stating I will be free of the withdrawal.   Maybe naive, but that's the vibe I am putting out .   Smiling as I write this.  

 

Thanks for clarifying, Paradine. Actually, I'd be more likely to subscribe to your vibe if you weren't still seeking out a psychiatrist. 

 

As someone who went rapid taper / cold turkey off my own drugs, I'd like to smile with you. But I'm too concerned about you. Definitely grab onto the non-drug coping skills section instead of seeking out help from a doctor. You may find yourself back in the drug mix again if you aren't able to handle this. 

 

These drugs are notorious for delayed withdrawal, so you may want to reinstate that last 2.5 mg and hold onto it for awhile. I've walked the path of not doing the 10% and it can cost you a lot in terms of employment, relationships, and even your freedom. Withdrawal can be like a trap door that catches you completely off guard. You don't know where you'll land. If you get hit hard with insomnia, you may find yourself in a crisis situation where you may lose your freedom and end up on psychiatric drugs through forced treatment in a locked ward. I've also walked that path. 

 

And if you read my success story (in my signature) and my benzo forum thread, I was full of positive vibes. That can certainly help, but being smart about your taper is actually a better way. I wish I had known more before I stopped these drugs. 

 

3 hours ago, paradine7 said:

I've been at 0 everything since probably the 10 or 15th of January.     Went from 2.5 to 1.25 to 0 over the period between December 1st and Jan 31st.  

 

Trintellix has a half-life of around 66 hours. I'm not exactly sure when you stopped - January 10, 15th, or 31st, but you can use this half-life calculator to figure out how much of the drug is still in your system. 

 

Drug Half-Life Calculator

 

It's your choice, of course, but I would urge a reinstatement to mitigate delayed withdrawal, especially since you're already dealing with insomnia and brain fog - and you likely still have the drug in your system. 

 

A reinstatement would help set yourself up for success. 

 

Anyways, just a thought.