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sjc02060: SJC story - now trying Vortioxetine taper


sjc02060

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Hey, It's been quite the ride to say the least. Everything started with a bad drug reaction to an estrogen blocker (self prescribed - my fault). Who could have thought pharmaceuticals would be so damaging! I'll just write my story as a timeline. I am a 30 year old male.

 

Oct 2019 - I decide to try low doses of anastrozole (0.25mg every other day) to lower my estrogen levels. This was for bodybuilding purposes to increase testosterone. Really stupid. I actually felt very good for the first week but at week 2 or 3 I had a bad reaction. One night got total insomnia and anxiety. Stopped taking the drug.

 

Jan 2020 - Struggled through the months. Anxiety and insomnia didn't improve. At end of month started to get very depressed. Start of suicidal ideation. Worked with psychologist, Dr and endo. Everyone telling me its all in my head and its impossible for persistent side effects from a medication.

 

Feb 2020 - Was prescribed Ambien for sleep. Tried it once and it triggered an intense panic attack. Dr signposted me to psychiatrist but didn't see one (yet). He also prescribed me few pills of 0.5mg Clonazepam for sleep. Didn't help much at all.

 

March 2020 (Tried Mirtazapine and Trazodone) - So depressed at this point I couldn't carry on. So took time off work and moved back with parents. Didn't think I would make it. At this point I was making plans to kill myself. I had a pretty good method but luckily family and girlfriend kept me going. Tried Mirtazapine (I literally wanted to hang myself the day after trying this, and aching testicles). Trazodone (Caused ED which luckily stopped a few weeks). Gabapentin (Just made me feel high).

 

April 2020 (Started Clonazepam 2mg) - As last ditch effort I tried 2mg Clonazepam every night and amazingly depression and anxiety lifted for just over a week. It was a big weight off my shoulders but then the depression came back in waves. Also at this time my mother developed severe akathesia - we suspect it was Benadryl.

 

June 2020 (Tapered to .5mg Clonazepam) - I started to work again intermittently when my moods were ok. I was flip flopping between suicidally bed-ridden depressed and feeling ok every 2 or 3 weeks. It was around this time when my father committed suicide. He was struggling taking care of my mother as her akathesia didn't improve.

 

August 2020 (Started Vortioxetine, Clonazepam -> Diazepam 10mg) - After funeral I had another severe dip in mood. I just couldn't carry on like this so I booked appt with Psych and asked him to prescribe me vortioxetine. It seemed like the med with least side effects. Also switched to diazepam because it's easier to taper.

 

October 2020 (Vortioxetine 15mg, Diazepam 7.5mg) - Had a few ups and downs. I guess it took a while for the AD to start working. This was the last point that I have had intense suicidal depression.

 

Jan 2021 (Vortioxetine 15mg, Diazepam ~3mg, T3 50ug) - Working with functional medicine Dr and lots of testing showed I had stupidly high reverse T3 (like double the upper range). Dr prescribed me T3 to reduce T4 -> Reverse T3 conversion. This definitely helped a lot. This helped stabilize me and feel better. Also I had off the range high Cystathionine in urine which implied my detox systems were not good and, among other things, pointed to me having mercury poisoning. So I started Andy Cutler chelation protocol with Alpha Lipoic Acid. I think this has helped, but won't talk about that here.

 

May 2021 (Vortioxetine 15mg, Diazepam 0mg, T3 50ug) - Completely off diazepam now. Taper was pretty fine, didn't really have any issues. I was micro tapering with mg scale, shaving a bit more every day.

 

August 2021 (Vortioxetine 15mg, T3 50ug) - I want to start to taper Vortioxetine. I feel pretty good, not 100%. My main concern is my sleep is not back to normal yet but I still manage to sleep 6-7 hours, but its not very deep and I wake up. My plan is to shave off the pills very slowly aiming to taper to 10mg in a few months, haven't decided yet. I'll update here.

 

SJC

2020 Clonazepam nightly: Apr 2mg, May 0.5, July switch to Diazepam

2020 Diazepam nightly: July 10mg slow taper to 2021 May off

2020 Vortioxetine: Aug 5mg -> Oct 15mg

2021 Vortioxetine: Aug slow taper down

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Started dry cutting vortioxetine yesterday. I'm aiming to reduce to 12.5mg in 4 weeks. Feeling fine so far.

2020 Clonazepam nightly: Apr 2mg, May 0.5, July switch to Diazepam

2020 Diazepam nightly: July 10mg slow taper to 2021 May off

2020 Vortioxetine: Aug 5mg -> Oct 15mg

2021 Vortioxetine: Aug slow taper down

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  • Moderator

Hi @sjc02060

 

Welcome to SA. Sorry to hear about what happened to you with the adverse reactions, and your family's misfortunes with drugs. I hope you are managing ok emotionally.

 

Have you read our topic on tapering, Why Taper By 10%? You sound like you are already familiar with tapering, but there are some good tips in there even for people who know what they are doing. You are planning a 20% cut in 4 weeks. Your body may be ok with that, but generally we recommend tapering by 10%. Tapering slowly helps minimize both symptoms and symptom severity, ensuring you can remain functional while you get off the drug. Reducing more quickly than 10% can be too fast for many people, and as you get to lower doses you may want to slow the reduction even further, since receptor occupancy of these drugs tends to decrease more rapidly at lower doses. Here are some tips specific to tapering Vortioxetine

 

Some drugs and supplements can interfere with metabolism and can also have psychotropic effects (antibiotics, steroids, some supplements, coffee, nicotine etc.). It would be very helpful if you could create a drug history in your signature like this one. This link will take you directly to the signature. Signatures generally look like this: 

 

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

This will allow any moderator or member to quickly see your history and where you are in your taper, and thus be able to help more easily without too much reading (most people here are volunteers and have other jobs).

 

In the meantime, you might find some of these non drug coping techniques helpful to ease your symptoms. Hope you start feeling better soon : )

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

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  • Moderator

One thing I will note: the medical profession (and integrative medicine) tend to want to fix any health problems with drugs or supplements, but the evidence for these drugs improving health is often not very good. There are very few drugs that actually improve health, and even fewer that have a substantial ability to improve things. (Health improvement best measured by reduction in all-cause mortality risk in a very large, randomized controlled trial). Generally there are thought to be maybe 50-200 medical treatments with very large treatment effects, but that is out of 100K+ possible treatments. And of course that is only the approved treatments. Many treatments do not undergo rigorous testing and are approved based on smaller trials using surrogate endpoints (very imperfect measures of health, like antidepressants). In this way, they can be approved for a small, short term improvement on symptoms, while their overall effect on health is unknown (often it is harmful).

 

The oncology space, where anastrozole originates, has some very toxic drugs. I note that depression as an adverse effect is "very common" (10%+ incidence). Needless to say anastrozole for anything other than its indicated use is likely to have detrimental effects on health. But the same can be said for many other drugs prescribed both off-label and even for their intended use. If you want to learn a bit more about this, and look into the evidence for your own medications / supplements, I'd recommend "Ending Medical Reversal" by Vinay Prasad and Adam Cifu, which details the extraordinarily high bar of evidence a medication or supplement needs to meet to conclusively demonstrate it improves health, and how few actually meet this bar when tested (most companies never even bother to test them at this standard, since they either know they will fail or suspect they will). There are some examples given in this video of drugs that were claimed to be beneficial but weren't, featuring the aforementioned Prasad. Very difficult to improve on human biology, since it's complexity is beyond our understanding at this point. I don't really have time to read about T3 usage, but you may want to look into this further once you are in a comfortable place with the vortioxetine. 

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

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Hi @DataGuy

 

Thanks a lot for your responses. Lots of helpful stuff. After reading the guide I'll do a 10% cut instead to be safer. I'm pretty familiar with tapers as with diazepam I did a 0.5mg cut every 2 weeks until I jumped. Nice to have this forum with more structured methods for tapering.

 

I think the vortioxetine taper will be tougher than diazepam because I feel it having more of a therapeutic benefit. At least I think it does.

 

On your second note, I agree with everything. I guess I was conditioned to believe that whatever side effects caused by a drug would cease after stopping.. Just like the side effect of drinking is being tipsy for a few hours. You don't expect to be drunk for years. Now I view them as complete poison. So many stories of people getting burned by finasteride, accutane, ADs, benzos, etc etc. And me by a few small doses of an Aromatase Inhibitor. All this should be in standard literature.

 

With all things considered I'm doing quite well. Not missed a day of work since November last year and have got most of my life back. Just the insomnia and fatigue holding me back a bit. Before all of this I slept soundly throughout the whole night, and could run a half marathon every weekend! Oh well, it's been worse :)

2020 Clonazepam nightly: Apr 2mg, May 0.5, July switch to Diazepam

2020 Diazepam nightly: July 10mg slow taper to 2021 May off

2020 Vortioxetine: Aug 5mg -> Oct 15mg

2021 Vortioxetine: Aug slow taper down

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  • Moderator

@sjc02060 glad to hear you are handling things well. Yes, I think most of us are indoctrinated into the culture of drugs from a young age. The science behind it is beyond the understanding or interest of most people, so we just accept that doctors prescribe them, therefore they must be good with the risk and benefit carefully weighed. Unfortunately, not true. But most people cannot be bothered to look into it until it's too late. 

 

I hope you find the taper easier than you expect. On this site we typically taper antidepressants first, followed by benzos last, since withdrawal tends to be very activating and the benzos act as a brake on your nervous system. But if you are doing ok after the benzo taper, maybe it will work to your advantage. We'll see. 

 

The therapeutic effect of most antidepressants is around 2 points over placebo on the Hamilton Depression Scale (HAM-D), a 52 point scale. So the benefit is not huge for the average person. I think both patients and doctors tend to misinterpret withdrawal symptoms as a sign they "need" the drug, or that they are relapsing. This is what doctors are taught, so that is what they tell most patients. For the most part they are ignorant of withdrawal. Here is a study from some Cochrane authors noting the absolute expected benefit of antidepressants from the latest large meta-analysis. 

 

"The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21)."

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

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  • 2 weeks later...
On 8/19/2021 at 4:25 PM, DataGuy said:

@sjc02060 glad to hear you are handling things well. Yes, I think most of us are indoctrinated into the culture of drugs from a young age. The science behind it is beyond the understanding or interest of most people, so we just accept that doctors prescribe them, therefore they must be good with the risk and benefit carefully weighed. Unfortunately, not true. But most people cannot be bothered to look into it until it's too late. 

 

I hope you find the taper easier than you expect. On this site we typically taper antidepressants first, followed by benzos last, since withdrawal tends to be very activating and the benzos act as a brake on your nervous system. But if you are doing ok after the benzo taper, maybe it will work to your advantage. We'll see. 

 

The therapeutic effect of most antidepressants is around 2 points over placebo on the Hamilton Depression Scale (HAM-D), a 52 point scale. So the benefit is not huge for the average person. I think both patients and doctors tend to misinterpret withdrawal symptoms as a sign they "need" the drug, or that they are relapsing. This is what doctors are taught, so that is what they tell most patients. For the most part they are ignorant of withdrawal. Here is a study from some Cochrane authors noting the absolute expected benefit of antidepressants from the latest large meta-analysis. 

 

"The mean difference between antidepressants and placebo on the 17-item Hamilton depression rating scale (range 0–52 points) was 1.97 points (95% CI 1.74 to 2.21)."

Very interesting stuff. I definitely think the AD helped me at my worst though, especially with the suicidal ideas. Now that I'm stable, maybe it's only 2 points above the baseline I would be if I was no longer on the drug.

 

I'm current just under 14mg daily now. Been feeling fine aside from slightly off on Wednesday. Which was really annoying because I had a job interview. Luckily that went well and will do final rounds next week.

2020 Clonazepam nightly: Apr 2mg, May 0.5, July switch to Diazepam

2020 Diazepam nightly: July 10mg slow taper to 2021 May off

2020 Vortioxetine: Aug 5mg -> Oct 15mg

2021 Vortioxetine: Aug slow taper down

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  • ChessieCat changed the title to sjc02060: SJC story - now trying Vortioxetine taper

On and held at 13.5mg for last 5 days or so. Feeling fine so going ahead with another 1.5mg off over the next 4 weeks.

2020 Clonazepam nightly: Apr 2mg, May 0.5, July switch to Diazepam

2020 Diazepam nightly: July 10mg slow taper to 2021 May off

2020 Vortioxetine: Aug 5mg -> Oct 15mg

2021 Vortioxetine: Aug slow taper down

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