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Finnishgirl: Starting tapering in drug-resistant situation?


Finnishgirl

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Hi all! New to this site :)

 

This is my history:

 

Citalopram for OCD 2008-2012
Drug free 2012-2015
Citalopram for anxiety 2015-2016
Drug free 2016-2017 (pregnancy)
Sertralin for OCD 10/2017-04/2019
Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore.

 

Since that, only very weak effect of meds on depression and OCD. Depression was easier when I nursed my youger boy. Started again in 05/2021 and was severe last summer. Was hospitalized for a week and I wanted to try ECT which only had a very short-lived effect. After that tried Wellbutrin which had some effect nyt also made me a total robot and caused uncomfortable feeling in my body. Currently on 150mg Wellbutrin and 10mg Trintellix.

 

I have started to think that I may have developed a some kind of tolerance for meds. Have tried sertralin, venlafaxin, escitalopram, voxra and Trintellix for depression and they have not worked even though tapering off sertralin initially started my depression which I never had had before (only OCD/anxiety). Ssri's have not worked anymore for OCD either, whereas before they worked like charm. Now I have started to wonder if I should try to completely wean off the meds... I am wondering if they are doing me more harm than good by now. All the startings and stoppings and changings of medications have maybe caused a tolerance? What do you think are my options now? 

 

And Voxra = Wellbutrin/bupropion, in case someone wonders.

Edited by Kiasofia
Updated info

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • ChessieCat changed the title to Finnishgirl: Starting tapering in drug-resistant situation?

So currently I take bupropion 150mg and Trintellix 10mg (not 20mg). Effective dose is 20mg (because bupropion doubles Trintellix's dose).

 

This is a bit proplematic because if I taper bupropion, I effectively also taper Trintellix at the same time. It might be hard to know how the concentration of Trintellix changes exactly when tapering (might even be individual differences on that?). I also would not want to lengthen the time of usage of bupropion because I have used it only for less than 6 months and have never before used anything that affects dopamine and/or noradrenaline. It also does not help at all and causes an uncomfortable feeling in my body. So I would not want to taper Trintellix first because it takes such a long time. Do you think it would be harmful to cold turkey bupropion? In my own country's ssri-withdrawal group people have not had bad reactions to cold turkeying it. It is common in my country because we only have 150mg and 300mg extended release available.

Edited by Kiasofia

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

Welcome @Finnishgirl

Going on and off psychiatric drugs can be dangerous for some people, but you seem to have done relatively well. It is common to get "depression" as a withdrawal symptom. This is not actual depression, but the brains reaction to going off a psychoactive substance, which is what these drugs are.

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

It is also natural for the body to build up tolerance to drugs and that they then no longer have the same effect. We understand this well when it comes to illegal drugs, like heroin, yet don't tend to see that it's the same with drugs used as medicine. Trying different drugs will have limited effect, and result in the same outcome over time. So I understand and support your wish to get off of these drugs. You are also taking a drug combination that could cause serotonin syndrome, and tapering is therefore wise.

 

Did you feel any different when you switched from escitalopram to trintellix?

Did you feel any different when you increased bupropion from 150mg to 300mg and back down to 150mg?

 

In your signature it says you reinstated (started taking again) bupropion in July. Had you taken it before?

 

It seems that about half of those taking SSRIs can quit cold turkey, however the other half will get serious withdrawal symptoms if they do this. The "depression" you got is an example of serious withdrawal. The more times a person has gone on and off these drugs, the more likely they will have trouble. We therefore recommend a slow taper of no more than 10% of current dose every 4 weeks. Some must taper even slower, and some can taper faster. Cold turkey is not recommended for anyone as it is harmful for you central nervous system (CNS), and can lead to long term withdrawal problems.

Why taper by 10% of my dosage?

With the exception of tapering strips produced in the Netherlands, no country has doses that allow for tapering safely. We must learn how to make these doses our selves:

How to make a liquid from tablets or capsules

Using a scale to weigh and measure doses

Tips for tapering off buproprion (Wellbutrin, SR, XR, XL)

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

About what drug to taper first:

Taking multiple psych drugs? Which drug to taper first?

 

The search function on this site doesn't work very well.  The best way to search this site for specific information is to use your favorite search engine. Type in survivingantidepressants.org then the symptom, treatment, supplement or information you wish to search for.

 

To make sure someone sees your post write @ and then start typing their username so it becomes blue like this @Kiasofia

 

This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here.

Please stay in touch and let us know how you are doing.

 

These are my opinions based on my own experience and what I have learned, not medical advice.

 

If you would like to get a response from me directly please type @Kiasofia some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

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@Kiasofia

Thank you so much for your kind and extensive reply!

 

Answers to your questions:

1. "Did you feel any different when you switched from escitalopram to trintellix?"

 

Yes, when I started on 2,5 mg (effectively 5mg) Trintellix and lowered my dose of escitalopram from 15mg to 5mg, I experienced a week of heightened mood (almost hypomania at some point). And when I upped the dose to 5mg and again to 10mg, both times I experienced a few days of better mood. Then it went away. This same happened to me when I first started escitalopram in 2019 (this happened after the sertralin poop-out when reinstating, and after a subsequent trial of Venlafaxine).

 

Now I feel a bit worse than on escitalopram, but the difference is not very big. 

 

2. "Did you feel any different when you increased bupropion from 150mg to 300mg and back down to 150mg?"

 

Yes, I got more energy after upping, but on the higher dose I had a total lack of any emotions and a worsened uncomfortable physical feeling in my body (I also have this same feeling on the current, lower dose but it is less intense). My actual mood has not changed during bupropion treatment, only my energy level. I actually feel like bupropion is more like a stimulant than an actual antidepressant, if you think of depression as a mood disorder.

 

3. "In your signature it says you reinstated (started taking again) bupropion in July. Had you taken it before?" 

 

I took it for 3 weeks in June, but felt no real effect  so my doctor stopped it. This was a different doctor than the one that prescribed bupropion in the first place (it was in the hospital). Then when I went back to the hospital in July, it was reinstated by the hospital doctor. Before that, I have never taken bupropion. I have not felt anything when stopping bupropion or lowering the dose.

 

4. It seems that about half of those taking SSRIs can quit cold turkey, however the other half will get serious withdrawal symptoms if they do this.

 

I wasn't actually talking about cold tyrkeying Trintellix, only about possibly cold turkeying bupropion which I have used only for a relatively short time. The reason for thinking about this option is that I have come to the conclusion that it is pretty hard to know how Trintellix's blood concentration changes when lowering the dose under the smallest effective dose (150mg). My current psychiatrist did not know this and I have not found an answer myself. Therefore, it might be very difficult to keep the dose of Trintellix stable when tapering bupropion. Also, I would not want to taper Trintellix before bupropion, because it would take such a long time to get rid of Trintellix and that would prolong the usage time of bupropion by a lot (from 6 months to 1,5 years). 

 

Also, I have found a lot of reviews in my country's ssri-withdrawal group stating that cold turkeying Voxra/bupropion is quite easy / very easy. 

 

 

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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Correction to my own reply "I have not felt anything when stopping bupropion or lowering the dose.":

 

-> I haven't felt anything else than a lowering energy level and lowering of the side effects (lack of emotions and uncomfortable physical feeling). But not any other withdrawal effects. I have only felt how the effect of the drug lessens and the side effects lessen. Of course these can also be at least partly withdrawal effects, who really knows :D But anyway, I haven't felt anything serious from lowering bupropion intake in fast pace.

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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And to specify: Bupropion is not an SSRI but an NDRI (affects only norepinephrine and dopamine). Trintellix is not an SSRI either literally speaking, but practically it works like an SSRI to a large extent (it reuptakes serotonin similarly than SSRI's but also modulates serotonin receptors' function in other ways). So I kind of take this as an SSRI withdrawal since I have taken SSRI's for such a long time and Trintellix is basically an SSRI.

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

Can you please update your signature so it shows the dates you started and stopped bupropion in June?

 

I don't think it's that important what category drug it is. The way these drugs work is not well understood, and very well misunderstood (thread here).

 

If you enter the drugs you are taking here: https://www.drugs.com/drug_interactions.html you will see they should not be taken together.

 

All psychiatric drugs effect the central nervous system so no psychiatric drug should be quit without tapering. How fast the taper can be is very individual.

 

I found this post helpful to understand what is going on and why tapering is important:

How Psychiatric Drugs Remodel Your Brain

 

Here is a good mini documentary about withdrawal: https://www.bbc.co.uk/programmes/p086fjk7

 

Please learn all you can about withdrawal and safe tapering. Coming off these drugs can cause many different withdrawal symptoms, often leading to doctors thinking the original condition is returning or that another mental illness has emerged. More drugs are then added and the loop continues.

These are my opinions based on my own experience and what I have learned, not medical advice.

 

If you would like to get a response from me directly please type @Kiasofia some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

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Yes I know this. It would be ideal to taper bupropion but the earlier mentioned problem of Trintellix's blood concentration remains. Also, based on what I have read, tapering typically becomes harder the longer you stay on the drug. So I would not want to triple the time of usage, knowing tapering Trintellix would take about a year (minimum). But anyway, thank you for your info. I will read more on this. My own country's ssri-withdrawal group's moderator had the opinion that bupropion can be cold turkeyd with a substantially lower risk than ssri's so I will still have to consider this.

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

You will find many stories on the forum of people struggling with Wellbutrin withdrawal after quitting cold turkey. It is worth continuing testing with small reductions to see how the body reacts, rather than putting the body and brain through the trauma of cold turkey. The only way to "cure" withdrawal is to reinstate the drug (this should be a much smaller dose than the last dose you took), but this doesn't work for everyone and then they have to just wait it out. The best is to avoid ending up in this situation.

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Also be aware of this: NEVER SKIP DOSES TO TAPER

 

Please take your time to read and learn and explore the forum.

 

Do stay in touch and let us know how you are doing.

These are my opinions based on my own experience and what I have learned, not medical advice.

 

If you would like to get a response from me directly please type @Kiasofia some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

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Based on what I read here, it would be wise to taper bupropion first because it is an "accelerator". But this leaves me with the problem of simultaneous tapering, because Trintellix is effectively also tapered when tapering bupropion. Do you have any reasonable solution/suggestion how to avoid this problem? Or is it even a problem at all to taper two drugs at the same time? Based on what is recommended in my country's group, it might not be wise. 

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

When someone is on more than one drug, tapering the one drug can affect the other. This is a common concern when taking multiple drugs. The important thing is to monitor for symptoms and slow down or pause a taper if withdrawal symptoms come.

 

Some choose to first taper completely off one drug, then the other. Some taper down a ways on the first. Then pause it and taper the other one. Back and forth so the dosages aren't too far a part. Some do choose to taper all at the same time, though this is not recommended. The problem with tapering all at the same time, is knowing which is causing withdrawal, and which drug's dose should perhaps be increased or paused. It's harder to know what is going on and what action to take. So this is generally not advised, but there are those who prefer it. They tend to have spent some time tapering the drugs separately first and getting to know their withdrawal symptom patterns.

 

Be aware that the lower doses are harder to taper than higher doses. This explains why: 

Why taper? Importance of gradual change in plasma concentration

These are my opinions based on my own experience and what I have learned, not medical advice.

 

If you would like to get a response from me directly please type @Kiasofia some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

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Thank you for your reply again! I will continue my research :)

 

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator
10 hours ago, Finnishgirl said:

This is a bit proplematic because if I taper bupropion, I effectively also taper Trintellix at the same time.

So this would make cold turkey quitting bupropion extra problematic, if you then are still on Trintellix. It looks like both drugs are activating and that they increase the effect of each other. Reducing the one drug by less than 10% at a time would therefore be recommended.

 

It seems the experience on the forum is that bupropion is harder to taper than trintellix, so then it could be best to start tapering bupropion first.

These are my opinions based on my own experience and what I have learned, not medical advice.

 

If you would like to get a response from me directly please type @Kiasofia some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

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@KiasofiaBupropion is a stimulant very similair to amphetamine so I would say it is definitely more activating than Trintellix which is closely related to ssri's. This is also my personal experience of these two drugs. It is known that on effective doses of bupropion, bupropion effectively doubles the blood concentration of Trintellix so I would double my dose of Trintellix if cold turkeying on bupropion. That is the only way to keep the blood concentration of Trintellix as stable as possible. It is not known how the interaction of the drugs works below effective doses (below 150mg) so there is no way to know how the concentration changes if tapering bupropion. In the worst case, there is a threshold level or several thershold levels where Trintellix's blood concentration changes suddenly. Anyhow, Trintellix is tapered by half by the time bupropion is tapered to zero. There is no way to know what happens to Trintellix in between.

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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8 hours ago, Finnishgirl said:

Tapering out of tolerance/poop out, postive experiences?

 

I would like to hear positive experiences from people who are tapering / have tapered out of poop out / tolerance. My depression started as a withdrawal symptom from ssri (never had had depression before). After that nothing has helped to stabilized the situation. I think this is some kind of tolerance/poop-out. I would like to hear from people that have had success with tapering out of tolerance. @brassmonkey? Any other people? 

 

Edited by manymoretodays
none done, member quote added

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Hi Finnishgirl,

I put your stand alone topic above, here in your Introduction, ^,  and then also at the end of a similar topic that we have going.

 

Tolerance or "poop-out" or Tachyphylaxis

 

And how are you doing now?  It's been a little bit of time since you posted.   Any updates for us all?

And best,

L, P, H, and G,

mmt

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Hey!

 

And thank you for your reply! I decided to quit WB cold turkey after all (about 5 weeks ago). I haven't had any withdrawal symptoms at least this far. I also started tapering Brintellix by 10 percent 1,5 weeks ago. Heading for at least a 1,5 year taper, and longer if needed. At the moment the hardest thing is trying to find hope, since I already feel quite bad because of the depression and am afraid things will get even worse as I taper (even if tapering very slowly).

 

BUT this depression has felt "off" the whole time and even my therapist thinks it is mainly because of the meds. We haven't found any triggers to it except ssri withdrawal and tolerance. Anxiety is more my "thing" and was before meds. I have learnt to deal with it pretty well but this depression really feels like a "brain disease" triggered by meds (I don't believe unmedicated depression is a brain disease but this one triggered by meds certainly seems to be). No matter how hard I have worked on my thoughts in therapy and managed to make them more positive, this underlying apathy, loss of energy and anhedonia just stick no matter what I try to do (working on my thoughts, behavioral activation, excersice).

 

I am trying to enforce my hope now by finding positive experiences from here :)

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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@manymoretodays tagging you, forgot it above

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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Oooh, and hey there Finnishgirl,

If I were you I think I might slow down and begin to proceed with caution.

Tell me more though, about what prompted your CT off Wellbutrin?  Were you having extreme adverse effects at all? 

WD symptoms are not always apparent right away.

When did all the symptoms you report begin?

 

How are you doing right now, and over the past 4-5 weeks?

maybe if you could break it down a bit, when you began to feel all these symptoms below.  Some of their intensity might be related to WD too.  Medications did make me feel worse, and different in many ways too.

7 hours ago, Finnishgirl said:

BUT this depression has felt "off" the whole time and even my therapist thinks it is mainly because of the meds. We haven't found any triggers to it except ssri withdrawal and tolerance. Anxiety is more my "thing" and was before meds. I have learnt to deal with it pretty well but this depression really feels like a "brain disease" triggered by meds (I don't believe unmedicated depression is a brain disease but this one triggered by meds certainly seems to be). No matter how hard I have worked on my thoughts in therapy and managed to make them more positive, this underlying apathy, loss of energy and anhedonia just stick no matter what I try to do (working on my thoughts, behavioral activation, excersice).

 

 

We do support a more harm reduction philosophy here, in regards to tapering, and just can't condone CT's or super fast tapers FT's.

There are those lucky few, that can get away with that.......maybe.......but we've seen such horrible stories of WD, and lived our own........I mean, enough said.

 

The rule of 3KI's, simple, slow, stable

 

I sure would not be beginning your next taper off yet another drug right now either, if I were you, or in your shoes.

 

Were you able to read some of the many informational, educational links that Kia sent to you above?  Is there a reason you did not begin a more judicious taper from your Wellbutrin?

 

What has your own research told you, or did you have any to share with us?

 

Why were you put on Brintellix?

7 hours ago, Finnishgirl said:

And thank you for your reply! I decided to quit WB cold turkey after all (about 5 weeks ago). I haven't had any withdrawal symptoms at least this far. I also started tapering Brintellix by 10 percent 1,5 weeks ago. Heading for at least a 1,5 year taper, and longer if needed. At the moment the hardest thing is trying to find hope, since I already feel quite bad because of the depression and am afraid things will get even worse as I taper (even if tapering very slowly).

 

Update your signature too please, with recent changes.  Just go to AccountSettings/signature and then don't forget to hit Save when done.

 

There is plenty of hope. 

I do think that you need to slow on down.  It's possible that you are expecting these rapid tapers of yours to make you feel better?  I mean we often do come up with things that are not real sensible.......for example, I once began a taper after a loved ones suicide, and figured that I could not feel any worse, so why not?  I too, was new to learning more about WD, and tapering.  I just knew that drug(s) that they kept giving me, were making me so much sicker, or worse.  Well, for me.......it didn't work out well.  I went to the hospital for help once acute WD set in, and wound up on 2 different drugs.

 

So....moral of that story ^, is that I don't think there are short cuts to doing a taper right.

 

Anyway, tell me/us some more Finnishgirl.  There are some questions up there for you to answer. 

 

There is plenty of hope, and so sorry that you have found yourself in a rough spot of mood.  I am glad you are working on some non-drug coping and therapies now. 

And I am being hard on you for a reason, and that reason is, I do not want you to inadvertently make things harder for yourself.  We've all been there, and done and made mistakes when wanting to get off our drugs.  So please don't feel chastised too much.  I've been there too.

And send you all the hope and healing in the Universe and beyond!

 

Best, L, P, H, and G,

mmt

 

 

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Hi FG,

 

I responded on the other thread to your questions but wanted to write to you on your main thread as well.

 

7 hours ago, Finnishgirl said:

No matter how hard I have worked on my thoughts in therapy and managed to make them more positive, this underlying apathy, loss of energy and anhedonia just stick no matter what I try to do (working on my thoughts, behavioral activation, excersice).

This is exactly how I felt - major apathy, loss of energy and anhedonia.  It was just awful and nothing would change it for me either.  Just do the best you can do, one day at a time.  You are going to be okay.

-1/06 - 3/07 Cymbalta. Fast taper; withdrawal symptoms after 4 mos (didn't realize was WD)

-10/07: 100 mg Zoloft; 1 mg Klonopin - tapered off Klonopin
-Tried several times to slowly taper Zoloft by 10%, then 5% every 4-6 weeks; could never get below approx. 40 mg - spring 2012 experienced major WD symptoms due to stress; tried to updose but no relief, back on Klonopin 1 mg.
-Switched over 5-6 mos from Zoloft to Citalopram. Finished Zoloft 1/13; Citalopram 35 mg and 1 mg Klonopin.
-8/13: 27 mg Citalopram; 1 mg Klonopin

-11/14: 12.6 Citalopram - began to have bad withdrawal symptoms; out of desperation increased to 1.25 mg Klonopin at the beginning of December.  12/13/14 16 mg Citalopram - going to stay here to try to stabilize; stabilized on 16 mg Citalopram after 4-5 months

-7/15 - 3/16: reduced to 15 mg; ~ 2 months later w/d hit hard (probably r/t stress); 6/16 updosed to 20 mg Citalopram and trying to stabilize. Updosed to 1.5 Klonopin as well. Stabilized on 20 mg Citalopram after 4-5 months

8/17-9/17: feeling withdrawal symptoms at 20 mg Citalopram (due to stress) - slowly increased to 25 mg. No change in symptoms after 6 months (? tolerance ?)  - decided to start citalopram taper February 2018 (still on Klonopin 1.5 mg).

Supplements: fish oil; magnesium; vitamin D3; curcumin

Citalopram taper:  2/2018 - 12/2019: 25 mg - 11.03 mg I 2020: 10.89 mg - 7.9 mg I 2021: 7.8 mg - 5.26 mg

2022: 1/5/22: 5.2 mg (1.25%); 1/12/22: 5.1 mg (1.25%)

 

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16 minutes ago, manymoretodays said:

Oooh, and hey there Finnishgirl,

If I were you I think I might slow down and begin to proceed with caution.

Tell me more though, about what prompted your CT off Wellbutrin?  Were you having extreme adverse effects at all? 

I took a risk knowingly with Wellbutrin because I had used it for such a short period of time and because of a liver interaction of the two drugs, it is not safe to taper Wellbutrin while still on Trintellix. Also, I did not want to prolong my usage of Werllbutrin by many multitudes by tapering Trintellix first. I have never before really used anything that affects noradrenaline and dopamine so intensely, so I did not want to create another downregulation of receptors by a long period of usage. Also, I am active in my own country's withdrawal group and people tended to have quite good experiences with stopping WB cold turkey (we don't have immediate release available). I know this is not advisable and I contemplated it a lot but this is the decision that felt best in my situation.

 

I had some adverse effects too (total lack of any emotions, trouble falling asleep and uncomfortable feeling in my body). Wellbutrin and Trintellix also have a major interaction risk, though they are commonly prescribed together...

16 minutes ago, manymoretodays said:

WD symptoms are not always apparent right away.

When did all the symptoms you report begin?

 

These symtpoms started when I tried to wean off escitalopram (way too fast with doctors advice), that was spring 2019. Symptoms were easier when I breastfed my younger son (those hormones give me energy) but I still felt off. Then when I stopped breastfeeding symptoms started worsening again about a year ago and here we are. :( Wellbutrin did not really help, it gave me a little bit of energy but also very uncomfortable side effects.

 

 

16 minutes ago, manymoretodays said:

How are you doing right now, and over the past 4-5 weeks?

maybe if you could break it down a bit, when you began to feel all these symptoms below.  Some of their intensity might be related to WD too.  Medications did make me feel worse, and different in many ways too.

 

 

We do support a more harm reduction philosophy here, in regards to tapering, and just can't condone CT's or super fast tapers FT's.

There are those lucky few, that can get away with that.......maybe.......but we've seen such horrible stories of WD, and lived our own........I mean, enough said.

 

The rule of 3KI's, simple, slow, stable

 

I sure would not be beginning your next taper off yet another drug right now either, if I were you, or in your shoes.

 

Were you able to read some of the many informational, educational links that Kia sent to you above?  Is there a reason you did not begin a more judicious taper from your Wellbutrin?

 

What has your own research told you, or did you have any to share with us?

 

Why were you put on Brintellix?

 

Yes, I probably hold the dosage here for a little bit longer to see if I start having any effects from stopping Wellbutrin. Good advice!

 

I was on Trintellix because escitalopram did not really help with depression so my doc changed it. With hindsight, this was propably really stupid/unnecessary but I still had hope I could stabilze more before tapering. 

 

 

16 minutes ago, manymoretodays said:

Update your signature too please, with recent changes.  Just go to AccountSettings/signature and then don't forget to hit Save when done.

 

There is plenty of hope. 

I do think that you need to slow on down.  It's possible that you are expecting these rapid tapers of yours to make you feel better?  I mean we often do come up with things that are not real sensible.......for example, I once began a taper after a loved ones suicide, and figured that I could not feel any worse, so why not?  I too, was new to learning more about WD, and tapering.  I just knew that drug(s) that they kept giving me, were making me so much sicker, or worse.  Well, for me.......it didn't work out well.  I went to the hospital for help once acute WD set in, and wound up on 2 different drugs.

 

So....moral of that story ^, is that I don't think there are short cuts to doing a taper right.

 

With Trintellix I have planned a long taper of 18-24 months (and of course even longer if necessary). Trintellix is basically an SSRI and I have a long history on SSRI's and also have noticed that there probably is something wrong with my serotonin syste (withdrawal, tolerance etc.). 

 

16 minutes ago, manymoretodays said:

 

Anyway, tell me/us some more Finnishgirl.  There are some questions up there for you to answer. 

 

There is plenty of hope, and so sorry that you have found yourself in a rough spot of mood.  I am glad you are working on some non-drug coping and therapies now. 

And I am being hard on you for a reason, and that reason is, I do not want you to inadvertently make things harder for yourself.  We've all been there, and done and made mistakes when wanting to get off our drugs.  So please don't feel chastised too much.  I've been there too.

 

Yes, I know and I appreciate this very much. I read all the linked materials above and some more and really do know that tapering should be done slowly. This situation with the liver enzyme interaction was just tricky (there is no way to know how the blood concentration of Trintellix changes when Wellbutrin is reduced below 150mg). But I shall proceed with caution from here and hold the dosage of Trintellix for a longer period of time to see that I remain stable. :)

16 minutes ago, manymoretodays said:

And send you all the hope and healing in the Universe and beyond!

 

Best, L, P, H, and G,

mmt

 

 

 Thank you so much for the best wishes and I wish you the same! What are your nicknames L, P, H and G? :)

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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49 minutes ago, wantrelief said:

Hi FG,

 

I responded on the other thread to your questions but wanted to write to you on your main thread as well.

 

This is exactly how I felt - major apathy, loss of energy and anhedonia.  It was just awful and nothing would change it for me either.  Just do the best you can do, one day at a time.  You are going to be okay.

Yes! Those are definitely my worst symptoms. This also feels quite "bodily" and has felt the whole time since 2019. When I developed depression in withdrawal, I also had these weird pains in my fingers and toes. I have also noticed that these pains vary by intesity with my depression symptoms which is a bit weird. When I breastfed my younger son, I had less depression and did not have these pains. Now when depression has been worse again after I stopped breastfeeding a year ago, these pains are back.

 

A lot of times I can think quite positively and stay hopeful and quite positive but this underlying sensation of apathy/anhedonia won't ever leave and feels totally disconnected from my thoughts and things that I do. In a sense, it feels quite chemical.

 

Thank you for your kind  and helpful replies! ❤️ I will reply later to your other reply!

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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8 hours ago, Finnishgirl said:

What are your nicknames L, P, H and G?

 

Oh....I get lazy with my typing fingers.  Those stand for Love, peace, healing, and growth. 💜

 

8 hours ago, Finnishgirl said:

I took a risk knowingly with Wellbutrin because I had used it for such a short period of time and because of a liver interaction of the two drugs, it is not safe to taper Wellbutrin while still on Trintellix. Also, I did not want to prolong my usage of Werllbutrin by many multitudes by tapering Trintellix first. I have never before really used anything that affects noradrenaline and dopamine so intensely, so I did not want to create another downregulation of receptors by a long period of usage. Also, I am active in my own country's withdrawal group and people tended to have quite good experiences with stopping WB cold turkey (we don't have immediate release available). I know this is not advisable and I contemplated it a lot but this is the decision that felt best in my situation.

 

June through December......I come up with 6 months.

And yes, I'm seeing that here https://www.drugs.com/interactions-check.php?drug_list=3490-18003,440-203&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication&professional=1

 

Eek still though from me, as 6 months is sure long enough to form a nice physiological dependency situation.

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.

 

I mean that's the basic explanation I often use ^.  I don't know how we can tell that 6 months of usage would related to less dependency, so to speak, than say 6 years of usage.

 

And I am no great fan of Wellbutrin.  I was once on it for 24 hours I think........which would have been one dose?  And was bouncing off the walls.  I even called poison control to ask if there was anything I could do, my immediate adverse reaction was that bad.  I was perhaps different in some respects to you at that time though.......I'd been through a whole merry go round of drug(s) after coming off an MAOI inhibitor.  I did not have a clue about WD back then.

 

Were you getting any of the side effects, or adverse effects from either drug, as far as you could tell?

  

8 hours ago, Finnishgirl said:

Wellbutrin did not really help, it gave me a little bit of energy but also very uncomfortable side effects.

 

Oh, okay......what were the side effects?

 

 

And then, if you don't mind telling.......what does a day look like now?  I mean are you functioning at an okay level?

It might really help to take an objective look now.  And just note the times of day on the left, and then on the right, your drug(s), as well as any symptoms before and after your one and only drug now, the Trintillex.  If you are willing, do note the name and dose on the right.

 

I have seen members sometimes make fast transitions down and off, of a drug before, and do okay......if they have to, I don't think I have ever witnessed a CT though.

There are ways to go about a faster taper.

You can read more about it in the tapering topic for Wellbutrin.  Once the XL is cut it then become immediate release.........and so then you do need to split the dose in one day.

Are those people in the group doing okay long term.  I mean after a couple of months?

 

I am just worried Finnishgirl.  Let me worry a little bit, while hoping hoping for the best for you.   I just don't want to see you crash and burn.   You've had or done a lot of big changes since June of 2021.  And seem to keep doing them, and okay I'm editing in a bit, after reading some more of your responses........I do see that you've already answered as to why you have done what you are doing.

 

And then, of course it's not all about tolerance and poop out anymore, or even "drug resistance".  There got to be some WD going on.  I don't even like that term "drug resistance" to be honest.  I was never drug resistant.....it's just that most of the drugs with me, caused symptoms I had never had before.  And then hey, come to find out, and looking at the studies done to get some of these drugs out for usage.......I found out they don't work for all that many.  We just are not ever given full disclosure on what to expect, or the realistic picture of drug efficacy,  before we follow some doctors instructions.

 

So if anything........tell me about what a day is like. 

And then good, I do see you stopped breastfeeding/nursing too, about a year ago. 

How did that effect you.  And again, apologies.......as you have already answered that above.

 

Most that I have seen with tolerance or poop out.........just go with a more gradual approach, while staying fairly functional......or in my estimation......phenomenally functional!  I'm often impressed with some of our members fortitude.

 

That's probably enough from me for now.

I do see you are doing your best to get on with things, and seem you seem to be pretty cognitively capable right now.  No real brain fog has set in then??  And thank you Finnishgirl......for attending so well to all my queries. 

 

I've got strong Finnish blood myself, just saying, as an aside.  We are strong however!

 

Love, peace, healing, and growth,

mmt

 

 

 

Edited by manymoretodays
some soapboxing, and a few edits, as I found answers in the above posts

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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6 hours ago, manymoretodays said:

 

Oh....I get lazy with my typing fingers.  Those stand for Love, peace, healing, and growth. 💜

 

Oh, okay :D Thank you! ❤️ I thought you asked opinon also from someone else because the color of text changed :D

 

6 hours ago, manymoretodays said:

 

June - November with one month break so 4-5 months depending on how you count. 

 

6 hours ago, manymoretodays said:

Eek still though from me, as 6 months is sure long enough to form a nice physiological dependency situation.

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.

 

I mean that's the basic explanation I often use ^.  I don't know how we can tell that 6 months of usage would related to less dependency, so to speak, than say 6 years of usage.

 

And I am no great fan of Wellbutrin.  I was once on it for 24 hours I think........which would have been one dose?  And was bouncing off the walls.  I even called poison control to ask if there was anything I could do, my immediate adverse reaction was that bad.  I was perhaps different in some respects to you at that time though.......I'd been through a whole merry go round of drug(s) after coming off an MAOI inhibitor.  I did not have a clue about WD back then.

 

Oh that sounds nasty :( I also had this very uncomfortable feeling in my body and felt total lack of any emotions, I basically felt like a robot. Also I had trouble falling asleep at night. But nothing so seriour you had.

 

How did you react to other drugs when you were in WD from the MAOI?

 

6 hours ago, manymoretodays said:

 

Were you getting any of the side effects, or adverse effects from either drug, as far as you could tell?

  

 

Oh, okay......what were the side effects?

 

 

Above :)

 

6 hours ago, manymoretodays said:

And then, if you don't mind telling.......what does a day look like now?  I mean are you functioning at an okay level?

It might really help to take an objective look now.  And just note the times of day on the left, and then on the right, your drug(s), as well as any symptoms before and after your one and only drug now, the Trintillex.  If you are willing, do note the name and dose on the right.

 

I have seen members sometimes make fast transitions down and off, of a drug before, and do okay......if they have to, I don't think I have ever witnessed a CT though.

There are ways to go about a faster taper.

You can read more about it in the tapering topic for Wellbutrin.  Once the XL is cut it then become immediate release.........and so then you do need to split the dose in one day.

Are those people in the group doing okay long term.  I mean after a couple of months?

 

 

 

 

I am just worried Finnishgirl.  Let me worry a little bit, while hoping hoping for the best for you.   I just don't want to see you crash and burn.   You've had or done a lot of big changes since June of 2021.  And seem to keep doing them, and okay I'm editing in a bit, after reading some more of your responses........I do see that you've already answered as to why you have done what you are doing.

 

Yes, I think all I have been through are definitely a combination of WD and some kind of tolerance. The worst point in time, though, for me was BEFORE these latest drug changes in May, June and July when I was even hospitalized. I just couldn't take it anymore that the depression was worsening again after it getting better already while breastfeeding... 

 

If I try being very obejctive, I think my functioning and mood are a bit better now than they were in the summer but I do not give credit to these meds. More to my good therapist and ways to cope with the very difficult situation + understanding now what has happened to me and what I can perhaps do to make things better (start tapering slowly). In the summer I was just totally hopeless and did not function, just lay in bed a lot and my husband took care of children. Now I am able to even work a little bit and am taking care of children quite normally. Of course I still struggle a lot but it is not so bad as it was then. I think the most important thing is accepting the situation and having some kind of plan now. That gives me hope ❤️

 

 

6 hours ago, manymoretodays said:

And then, of course it's not all about tolerance and poop out anymore, or even "drug resistance".  There got to be some WD going on.  I don't even like that term "drug resistance" to be honest.  I was never drug resistant.....it's just that most of the drugs with me, caused symptoms I had never had before.  And then hey, come to find out, and looking at the studies done to get some of these drugs out for usage.......I found out they don't work for all that many.  We just are not ever given full disclosure on what to expect, or the realistic picture of drug efficacy,  before we follow some doctors instructions.

 

Yes, I also know this. For me, the drugs used to work even "exceptionally" well before for OCD. Now they haven't worked for that either, anymore. When I breastfed, I had quite severe OCD, although I am nowadays quite skilled at dealing with even quite bad OCD (thanks therapy). I don't know why, but I don't tend to have depression and OCD at the same time, maybe there is just so much of worrying/rumination that can take place at the same time :D

 

 

6 hours ago, manymoretodays said:

 

So if anything........tell me about what a day is like. 

My normal day is basically being with my younger sone (and quite often the older too because he has had flu almost the whole autumn). I do chores and activities with kids and then sometimes I do a little bit of work from home while my husband takes care of the kids. I do deal with having this apathy/anhedonia/loss of energy a lot but I still manage to deal with it and do stuff. I don't have this hopelessness/crying that much anymore. I used to be totally hopeless wreck in the summer, crying all the time. Now I am kind of used to the situation and also have more hope.

 

6 hours ago, manymoretodays said:

And then good, I do see you stopped breastfeeding/nursing too, about a year ago. 

How did that effect you.  And again, apologies.......as you have already answered that above.

 

Most that I have seen with tolerance or poop out.........just go with a more gradual approach, while staying fairly functional......or in my estimation......phenomenally functional!  I'm often impressed with some of our members fortitude.

 

This is very good to hear! I am planning to be slow with tapering Trintellix :) Now I don't think it is very useful to ruminate a lot going off Wellbutrin, but just be cautious about staying stable and proceeding with tapering only after a couple of months, so that it leaves time to see what happens after the CT. Luckily, at least by now I haven't noticed any changes, except the effects and side effects of WB ofcourse going away.

 

6 hours ago, manymoretodays said:

 

That's probably enough from me for now.

I do see you are doing your best to get on with things, and seem you seem to be pretty cognitively capable right now.  No real brain fog has set in then??  And thank you Finnishgirl......for attending so well to all my queries. 

 

I've got strong Finnish blood myself, just saying, as an aside.  We are strong however!

 

Love, peace, healing, and growth,

mmt

 

 

 

 

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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@manymoretodays 

 

And hey, wonderful that you have Finnish roots. We have a lot of "guts" ("Sisu" in Finnish which is also my youngest son's name). You know, Russians and everything :D

 

 

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

Oh my gosh, the Russians!  And the Finnish atrocities!  And nice.  Yes, guts!  Awesome. 💜

 

6 hours ago, Finnishgirl said:

This is very good to hear! I am planning to be slow with tapering Trintellix :) Now I don't think it is very useful to ruminate a lot going off Wellbutrin, but just be cautious about staying stable and proceeding with tapering only after a couple of months, so that it leaves time to see what happens after the CT. Luckily, at least by now I haven't noticed any changes, except the effects and side effects of WB ofcourse going away.

 

Yes, no reason to ruminate about the Wellbutrin.  Sorry about that.  Tis the season?  I don't know. 🙈

 

I am kind of interested to see if any of the staff, or Altostrata(the founder here) has seen an adjustment made like the one you did with your Trintillix.  Based on the CyP450 knowledge of metabolism.  I found that really interesting.  So I did bring your story/case up for other staff to see.  I hope that's okay.

 

And yay!  Because that sounds like a really good report of functionality right now FG.  Not to discount how hard you are working at coping.

7 hours ago, Finnishgirl said:

My normal day is basically being with my younger sone (and quite often the older too because he has had flu almost the whole autumn). I do chores and activities with kids and then sometimes I do a little bit of work from home while my husband takes care of the kids. I do deal with having this apathy/anhedonia/loss of energy a lot but I still manage to deal with it and do stuff. I don't have this hopelessness/crying that much anymore. I used to be totally hopeless wreck in the summer, crying all the time. Now I am kind of used to the situation and also have more hope.

 

And yay, on no more hopelessness and less crying.  Sheesh, the crying alone can be exhausting.  I have certainly been a real water works of emotion myself before.

 

You can search on site too, if you want to find topics going on apathy, anehedonia, loss of energy/fatigue.  There is a search box in the upper right of the screen you use to do this.  I too, have had periods of fatigue or just exhausted......sometimes it feels like I have gotten overwhelmed a bit even.  In the past 5 years though, I honestly think it has improved.  A lot.  Possibly it's my coping that has improved, but I don't think it is just that.  So hoping that gives you hope too.  It's been an interesting journey for me, off medications/drugs......the road to getting there, and then the road once off. 

 

Happy Holidays.  And Winter Solstice too!

 

L, P, H, and G,

mmt

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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23 minutes ago, manymoretodays said:

Oh my gosh, the Russians!  And the Finnish atrocities!  And nice.  Yes, guts!  Awesome. 💜

 

 

Yes, no reason to ruminate about the Wellbutrin.  Sorry about that.  Tis the season?  I don't know. 🙈

 

No worries and I totally understand since you see so much of the troubles of fast tapering an cold turkeying all the time. This was also not a very easy decision to make and I did know its risks. But I did not want to make my journey with Wellbutrin a story of many years which it would have been in case of tapering off Trint first. 

 

And hey I am with you on this "season thing", we don't have basically sunlight at all right now in Finland. I guess today is actually the shortest day of the year. It sure is quite rough :D

 

 

23 minutes ago, manymoretodays said:

 

I am kind of interested to see if any of the staff, or Altostrata(the founder here) has seen an adjustment made like the one you did with your Trintillix.  Based on the CyP450 knowledge of metabolism.  I found that really interesting.  So I did bring your story/case up for other staff to see.  I hope that's okay.

 

Yes that is totally okay! I am a fan of Alto and have been through a lot of anti-med / anti-psychiatry stuff lately :D Götzsche, Kirsch, Whittaker, D. Healy, D. Cohen etc... 

 

I am also a soon to be graduating psychologist so these things interest me also on an intellectual level. I hope some years from now when my own dust settles I will be able to make a big fuss out of this in my own country's media and among my colleagues.

 

 

23 minutes ago, manymoretodays said:

 

And yay!  Because that sounds like a really good report of functionality right now FG.  Not to discount how hard you are working at coping.

 

And yay, on no more hopelessness and less crying.  Sheesh, the crying alone can be exhausting.  I have certainly been a real water works of emotion myself before.

 

You can search on site too, if you want to find topics going on apathy, anehedonia, loss of energy/fatigue.  There is a search box in the upper right of the screen you use to do this.  I too, have had periods of fatigue or just exhausted......sometimes it feels like I have gotten overwhelmed a bit even.  In the past 5 years though, I honestly think it has improved.  A lot.  Possibly it's my coping that has improved, but I don't think it is just that.  So hoping that gives you hope too.  It's been an interesting journey for me, off medications/drugs......the road to getting there, and then the road once off. 

 

Thank you for this, this really gives me a lot of hope! ❤️ Do you still have a lot of symtoms left besides some fatique? I see you are off meds already for some years :)

 

I will go and find info on these symtoms. I think they are a mix of withdrawal and tolerance since the symptoms started when trying to taper off escitalopram and haven't really gone away properly after that.

 

23 minutes ago, manymoretodays said:

 

Happy Holidays.  And Winter Solstice too!

 

L, P, H, and G,

mmt

 I wish you the same! :)

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

Link to comment

@manymoretodays

 

And yeah, the adjustment of dose was a way trying to keep things as stable as possible with Trintellix. There is no way to know what happens to Trintellix below 150mg of Wellbutrin so that would have been a quite risky/unstable path to wean off Wellbutrin. There wouldn't have been a way to keep Trintellix stable in that scenario.

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Administrator

Hello, @Finnishgirl You have had these symptoms since attempting to go off sertraline in 2019? How did you feel while you were taking sertraline for 1.5 years?

 

How did you feel while you were taking escitalopram? Did you start escitalopram after you went off sertraline? (Please add start date of escitalopram to your signature. It looks like you also had a long career on and off citalopram. 

 

Your main symptoms are fatigue and emotional anesthesia? We often see this during tapering and after people go off an antidepressant. They can be adverse effects of the drugs or withdrawal symptoms.

 

You might say antidepressants "work" by dulling emotions. Eventually, this is mistermed "treatment-resistant", but it is in fact the effect of going on and off drugs or taking them for a long time. The nervous system is not made of rubber. After a while, it stops responding to the drugs in what you or your doctor might call a beneficial way.

 

Did you discuss your symptoms with your doctors?

 

FYI more information about "poop-out" in post #1 here 

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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10 hours ago, Altostrata said:

Hello, @Finnishgirl You have had these symptoms since attempting to go off sertraline in 2019? How did you feel while you were taking sertraline for 1.5 years?

 

Yes I had these symptoms since that. They started when I lowered my sertraline dose below the least typically effective dose (from 50mg to 25mg). On sertraline I felt "normal" (how normal can you be on drugs, but you know :D).

 

 

10 hours ago, Altostrata said:

 

How did you feel while you were taking escitalopram? Did you start escitalopram after you went off sertraline? (Please add start date of escitalopram to your signature. It looks like you also had a long career on and off citalopram. 

 

Yes I started escitalopram after sertraline. In my own opinion it did not help at all, but my doctor insisted me on staying on it (he "saw it working" in spite of me not feeling it at all). 

I will make the changes to my signature.

 

Yes I had the career. I basically CTed off citalopram in 2012 after bad-quality-therapy and it worked okay. I did not have any symptoms then for a few years. Then I started again in 2015 for sitatuational anxiety (big regrets!). In 2016 I tried stopping again almost abruptly for pregnancy but got OCD again after many years of OCD-free life (maybe a warning sign of CNS instability/withdrawal?). I struggled without meds because of pregnancy then. Then when I started sertraline things stabilized. Then I tried to wean off for the next pregnancy after going to very good therapy for around 2 years. I thought I had made progress a lot. But then when lowering the dose too quickly (100mg -> 75 mg , 75mg -> 50 mg , and 50mg --> 25 mg in only 2 months, holding always one month after lowering the dose).  

 

10 hours ago, Altostrata said:

 

Your main symptoms are fatigue and emotional anesthesia? We often see this during tapering and after people go off an antidepressant. They can be adverse effects of the drugs or withdrawal symptoms.

Yes, I suppose those are the main symptoms. Anhedonia, apathy, loss of energy. 

 

10 hours ago, Altostrata said:

 

You might say antidepressants "work" by dulling emotions. Eventually, this is mistermed "treatment-resistant", but it is in fact the effect of going on and off drugs or taking them for a long time. The nervous system is not made of rubber. After a while, it stops responding to the drugs in what you or your doctor might call a beneficial way.

 

Did you discuss your symptoms with your doctors?

 

Yes I have complained about these symptoms a lot and he has interpreted everything to be just "depression". After I tried coming off sertraline I remember one day feeling really weird very suddenly and after that it never left. I kind of felt like my soul and energy had been ripped off of me. At first there were no psychological symptoms, but after a wile I started to become anxious about the situation.

 

It is really hard for me to know what depression even feels like normally, without drugs, because I have never been depressed before. Actually me and my therapist think I am not very prone to depression as a person. I have a good self-esteem and I am raised as a fairly optimistic person. Also, I haven't had any adverse life events or life circumstances that would have triggered depression. Actually, during the recent years, I have had everything I ever dreamt of, but still feel like ****. It is hard to even describe this feeling because it feels so bodily, not so much psychological. It certainly feels like a "chemical imbalance", which I don't believe natural, non-drugged depression is.

 

10 hours ago, Altostrata said:

 

FYI more information about "poop-out" in post #1 here 

 

I will dig deeper into this, thanks! And thank you for your reply! :)

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

Hi Finnishgirl,

Happy holidays.  Are you celebrating boxing day or Saint Stephen's day today? 

How have you been doing this past week?

Keep us updated.  Thank you.

 

L, P, H, and G,

mmt

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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  • Administrator

It appears to me you developed withdrawal syndrome in 2019. Very often, antidepressants don't "work" after that. This is not "poop-out", your body just doesn't want them.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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@Altostrata

Do you think using an antidepressant now can prohibit me from healing from depression? 

 

I mean, wouldn't the withdrawal depression had eased out little by little in time otherwise? I have been wondering what is wrong with me getting alle this help and still not healing...

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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On 12/27/2021 at 12:01 AM, manymoretodays said:

Hi Finnishgirl,

Happy holidays.  Are you celebrating boxing day or Saint Stephen's day today? 

How have you been doing this past week?

Keep us updated.  Thank you.

 

L, P, H, and G,

mmt

Hey! Thank you, we have St. Stephens Day here in Finland :)

 

Pretty much the same here as last time. I notice that I cry more now since Wellbutrin is gone and it prohibited me from feeling any emotions. Before WB I cried a lot.

 

Also, I have been more hopeless again since I have thought a lot of things when just staying home now during holidays. So lot of rumination, it always happens to me when staying home a lot without a lot of activities.

 

When I found all the antipsychiatry literature I got hope again finally finding something that could explain my deterioration. Now I think that hope is kind of wearing out and I just keep wondering if I am just so flawed somehow that I am stuck in this depression. I have read success stories from here but somehow cannot easily think I could be one of those who could get better when tapering and finally quitting meds. Now I am just pretty scared about the whole tapering and if it does not help but only makes things harder. Ugh, hard to keep up any optimism here. Maybe you have some encouraging words? 😄

Citalopram for OCD 2008-2012, Drug free 2012-2015, Citalopram for anxiety 2015-2016, Drug free 2016-2017 (pregnancy), Sertralin for OCD 10/2017-04/2019. Tried fast tapering in 2019 for second pregnancy, failed (depression started), reinstated, med did not work anymore. Since that, meds have had only very weak effect or no effect.

Last two years:

Until Jun/2021: escitalopram 20mg (monotherapy)

Jun/2021-Jul/2021: escitalopram 20mg + bupropion 150mg

Jul/2021-Jul/2021: escitalopram 10mg + clomipramine 10-75mg (tried to switch escitalopram to clomipramine but too bad side effects)

Jul/2021-Aug/2021: bupropion 150mg (reinstated in hospital) + escitalopram 15mg

Aug/2021-Sept/27/2021: bupropion 300mg (upped dose) + escitalopram 15mg 

Sept/27/2021-Sept/17/2021: Bupropion 150mg (lowered dose) + Trintellix 5-10mg (switched escitalopram to Trintellix)

Sept/17/2021-Dec/8/2021: Trintellix 20mg (dosage doubled after stopping Wellbutrin since Wellbutrin doubles Trintellix's blood concentration with doses 150-300mg)

Dec/8/2021 - now: Trintellix 18mg (HOLDING TO MAKE SURE NO WITHDRAWALS FROM WELLBUTRIN)

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  • Moderator

Hi Finnishgirl,

Sending encouragement to go the distance.  And there may be some time involved.  But you get to learn new practices and meet new people in the process.  So it can be good.
 

On 12/29/2021 at 4:55 AM, Finnishgirl said:

Hey! Thank you, we have St. Stephens Day here in Finland :)

 

Pretty much the same here as last time. I notice that I cry more now since Wellbutrin is gone and it prohibited me from feeling any emotions. Before WB I cried a lot.

 

Also, I have been more hopeless again since I have thought a lot of things when just staying home now during holidays. So lot of rumination, it always happens to me when staying home a lot without a lot of activities.

 

When I found all the antipsychiatry literature I got hope again finally finding something that could explain my deterioration. Now I think that hope is kind of wearing out and I just keep wondering if I am just so flawed somehow that I am stuck in this depression. I have read success stories from here but somehow cannot easily think I could be one of those who could get better when tapering and finally quitting meds. Now I am just pretty scared about the whole tapering and if it does not help but only makes things harder. Ugh, hard to keep up any optimism here. Maybe you have some encouraging words? 😄

 

What bothers you about crying? 

And chances are that what you are going through now, is unrelated to anything you sought treatment for in 2008. 

We get all the "neuroemotions", so to speak thrown out of whack in WD. 

Can you plan for more activities to stay out of your head so much?

Are you going back to work after the New Year?

 

I think you'll get better.  It doesn't happen overnight.  I mean that is an understatement.

 

I'm in the midst of dealing with all the emotions of years past around family now........and then after the death of my Mum.  Sheesh, this is hard.....not to ruminate on too.  My interactions with siblings tend to set me back a bit, each and every time.  So......I just keep trying to stay out of rumination by journaling.  Writing to them via email, after pauses.  And maybe next I might begin breaking from any further Zooms with them.  Because I need to take care of me, and really need a break from them right now.

So anyway.....maybe you too, need to set boundaries or something.

I just had a phone call with one sibling yesterday......and so, this is just where I'm at and how I am attempting to deal and come back to feeling okay.

 

Versus maybe you need more interaction, work or social.

 

It's hard to know.

 

  Lucky me, I've got a funeral to go to today.  That sounds bizarre, in light of trying to be encouraging. 

 

I've also got a new pet that needs my attention.  Really it doesn't but I'm hoping to get it comfy here, and a bit more active.  It's a female kitty, 3-5 years old and I think it had kind of a kennel, and then home where it was still a bit like living in a kennel.  But they kept her outside.  And it's cold now.  Poor baby.  Today is only day 2 with me, and she's staying downstairs in the family room.  I'm hoping to lure her upstairs when I start feeding her up here.

 

I don't know......sometimes my own seriousness makes me laugh......and it just did.

 

Life is meant to be.  What it is. 

 

So most of all though, I would say........stay in the now of things.  That helps.  I need to go get ready for the funeral now.  And while I'm doing that, I'll do my best to plan out the rest of my day.  Making sure to add in things I enjoy and things and people who bring me comfort and help me feel good about being just who I am.  Sometimes, that's just not family.  They are all out of my area, but still.......that's my own recent rumination I guess. 

 

So....write about, talk about, pray or meditate about.......and then voila'........let go.  I'm in the process of all that, almost every day.

 

That's all I've really got for now, and hope it helps.  Hoping to be back round later too.  Got so much on my lists though, it's hard to know for sure.   Kooky, crazy holiday weeks.......why don't we just blame it all on that right now??  I'm game for that.

 

L, P, H, and G,

mmt

 

p.s. thanks for the space, I needed that......

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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  • Administrator
On 12/29/2021 at 3:45 AM, Finnishgirl said:

I mean, wouldn't the withdrawal depression had eased out little by little in time otherwise? I have been wondering what is wrong with me getting alle this help and still not healing...

 

You've gone on and off other drugs since 2019, compounding the nervous system upset. "All that help" might not have been any help at all.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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