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Brintellix- Is anyone else actually taking this?


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#201 Katygirl

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Posted 04 March 2014 - 05:21 PM

Cake, can you talk to your doctor and see if this is what should be expected? Maybe your final taper was too soon for your unique chemistry? Maybe go back to where you were last at 10 days ago, stabilize, and then continue to taper at a slower pace once you feel better?


#202 horsediva

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Posted 04 March 2014 - 05:50 PM

Katy I was having a little setback each time so I've been trying my best to pull thru- I've been off the effexor for 10 days total. I really don't want to go back on it knowing how hard it was to come off! I just keep feeling worse though :( in so devastated because I was doing so well on the brintellix! Has anyone tapered off effexor? Should I give it more time? I feel like I should be getting better at this point.

 

I tapered off Effexor years ago, and was put straight on an SSRI. I remember it being horrible, even though I was only at 175mg of Effexor. Your dose was much much higher so I'd give it more time. 

 

I had my psychiatrist appt a few hours ago. Psych upped me to 20mg Brintellix just for the hell of it. I also got one of those coupons, thank goodness. 


**Dx: Panic disorder, treatment resistant MDD**

**Current Rx: 20mg Brintellix and basically living off of 4mg Zofran, Ginger tablets, Aviane (birth control), Marshmallow root, Serotonin Dopamine liquesence, Arsenicum pellets**

**Past Rx: Prozac, Wellbutrin SR, Effexor XR, Zoloft, Cymbalta, Celexa, Lexapro, Abilify, Lamictal, Vistaril, Ambien CR, Lunesta, Klonopin, Valium, Xanax, Ativan, Latuda, Adderall**

 

 

Other tests I've had - I have had my hormones checked (several, several times) - especially thyroid (nothing). I've had an upper GI endoscopy to test for celiac disease and the results came back inconclusive. Not to mention, the doctor performing the operation had to OD me on Benadryl and Versed to even remotely make me less aware of the procedure. Last, but not least, I've had a gallbladder scan which came back at 44% and apparently anything above 30% is normal. 

 

"Be the bird they can't catch"


#203 Geaux Tigers

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Posted 04 March 2014 - 07:03 PM

Katy I was having a little setback each time so I've been trying my best to pull thru- I've been off the effexor for 10 days total. I really don't want to go back on it knowing how hard it was to come off! I just keep feeling worse though :( in so devastated because I was doing so well on the brintellix! Has anyone tapered off effexor? Should I give it more time? I feel like I should be getting better at this point.

 

Cake, you've definitely touched on something hauntingly personal to me— the Effexor withdrawal I'm about to have to endure myself; I'm hoping the Brintellix is enough to offset the major depression associated with it. I split my Pristiq 50mg. in half today.

 

I'm sorry to hear that vortioxetine therapy is letting you down, but I've heard venlafaxine has one of the harshest discontinuation (withdrawal) syndromes of any psychiatric drug out there. You're very brave making it this far, I commend you for that— keep going!

 

I think you may see the venlafaxine withdrawal symptoms alleviated with time; thus, this would allow you to grasp a more beneficial response to Brintellix.

 

Good luck, Cake, and please let me know how your treatment progresses!


Edited by Geaux Tigers, 04 March 2014 - 09:51 PM.

DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 


#204 Geaux Tigers

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Posted 04 March 2014 - 07:25 PM

So took my first pill a couple hours ago. A little dizzy at the moment but not too bad. stomach is also a little upset but like i mentioned before I think I might have IBS(or something they havent diagnosed) and it could be that. Seem to have good and bad days and its usually worse in the mornings. Gonna taper down off remeron(usually not that hard of a drug to get off of) over the next few days and  go it alone with brintellix and good ole clonazepam.

 

Good luck with your mirtazapine taper; you're putting a lot of faith on a Brintellix remedy!

 

I hope that vortioxetine is less sedating without inducing hyposomnia, and it will alleviate your anxiety more effectively than Remeron. Potentially, it could allow a lower clonazepam intake.  

 

You need to get your IBS symptoms evaluated by a gastroenterology specialist. Advise him or her of all medications you're taking, including vortioxetine, as well as the severity and duration of your symptoms. Consider a higher fiber intake, if anything. 

 

Please let me know how your vortioxetine therapy progresses, quiet storm!


Edited by Geaux Tigers, 04 March 2014 - 09:52 PM.

DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 


#205 Geaux Tigers

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Posted 04 March 2014 - 07:34 PM

 

Katy I was having a little setback each time so I've been trying my best to pull thru- I've been off the effexor for 10 days total. I really don't want to go back on it knowing how hard it was to come off! I just keep feeling worse though :( in so devastated because I was doing so well on the brintellix! Has anyone tapered off effexor? Should I give it more time? I feel like I should be getting better at this point.

 

I tapered off Effexor years ago, and was put straight on an SSRI. I remember it being horrible, even though I was only at 175mg of Effexor. Your dose was much much higher so I'd give it more time. 

 

I had my psychiatrist appt a few hours ago. Psych upped me to 20mg Brintellix just for the hell of it. I also got one of those coupons, thank goodness. 

 

 

(horsediva, in regards to the information you specified earlier in the thread— it can be extracted from vortioxetine's PI sheet. I'm glad that ondanestron is effective for your gastrointestinal symptoms regardless of its competing mechanism of action with vortioxetine at 5-HT3 receptors. Truly, medication and interactions in the body are so complex! You can't get an accurate picture of mechanism of action from receptor binding profiles alone.)

 

I'm sorry Effexor withdrawal was horrible for you as well, but it seems you got past it— this gives me (and perhaps Cake too?) some hope!

 

I'm curious to see how you respond to 20mg. Please let me know how things progress.

 

Best of luck to you with Brintellix, horsediva!

 

 

 

 


Edited by Geaux Tigers, 04 March 2014 - 09:52 PM.

DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 


#206 horsediva

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Posted 04 March 2014 - 08:49 PM

 

 

Katy I was having a little setback each time so I've been trying my best to pull thru- I've been off the effexor for 10 days total. I really don't want to go back on it knowing how hard it was to come off! I just keep feeling worse though :( in so devastated because I was doing so well on the brintellix! Has anyone tapered off effexor? Should I give it more time? I feel like I should be getting better at this point.

 

I tapered off Effexor years ago, and was put straight on an SSRI. I remember it being horrible, even though I was only at 175mg of Effexor. Your dose was much much higher so I'd give it more time. 

 

I had my psychiatrist appt a few hours ago. Psych upped me to 20mg Brintellix just for the hell of it. I also got one of those coupons, thank goodness. 

 

 

(horsediva, in regards to the information you specified earlier in the thread— it can be extracted from vortoxetine's PI sheet. I'm glad that ondanestron is effective for your gastrointestinal symptoms regardless of its competing mechanism of action with vortoxetine at 5-HT3 receptors. Truly, medication and interactions in the body are so complex! You can't get an accurate picture of mechanism of action from receptor binding profiles alone.)

 

I'm sorry Effexor withdrawal was horrible for you as well, but it seems you got past it— this gives me (and perhaps Cake too?) some hope!

 

I'm curious to see how you respond to 20mg. Please let me know how things progress.

 

Best of luck to you with Brintellix, horsediva!

 

 

 

 

 

 

 

Tigers, I know. But I didn't think Brintellix would murder me anxiety wise. 

 

I'm curious to see how I respond to 20mg as well, but also a bit skeptical and nervous. I really need all the luck I can get! :)


**Dx: Panic disorder, treatment resistant MDD**

**Current Rx: 20mg Brintellix and basically living off of 4mg Zofran, Ginger tablets, Aviane (birth control), Marshmallow root, Serotonin Dopamine liquesence, Arsenicum pellets**

**Past Rx: Prozac, Wellbutrin SR, Effexor XR, Zoloft, Cymbalta, Celexa, Lexapro, Abilify, Lamictal, Vistaril, Ambien CR, Lunesta, Klonopin, Valium, Xanax, Ativan, Latuda, Adderall**

 

 

Other tests I've had - I have had my hormones checked (several, several times) - especially thyroid (nothing). I've had an upper GI endoscopy to test for celiac disease and the results came back inconclusive. Not to mention, the doctor performing the operation had to OD me on Benadryl and Versed to even remotely make me less aware of the procedure. Last, but not least, I've had a gallbladder scan which came back at 44% and apparently anything above 30% is normal. 

 

"Be the bird they can't catch"


#207 Geaux Tigers

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Posted 04 March 2014 - 09:44 PM

Tigers, I know. But I didn't think Brintellix would murder me anxiety wise. 

 
I'm on Day 2, and I can't say that I've noticed ANYTHING at all from vortioxetine administration.
 
That's good, because I definitely don't want the anxiety like you experienced, but I don't want to miss out on any therapeutic benefit!
 
Can you describe the anxiety that Brintellix gives you in more detail, and how it differs from Past Rx? Do you find that your alprazolam intake increases now that you're on vortioxetine therapy?
 
I can't give you enough good vibes, I really hope that 20mg. is the remedy you need. I think you made the right choice to titrate to it having been on 10mg. monotherapy for so long.
 
Good luck!
 
(Edit: Created a 'signature' that details my 'cocktail' if anyone is wondering how concomitant my Brintellix therapy is with other psychiatric medications that I take QD.) 

Edited by Geaux Tigers, 04 March 2014 - 09:50 PM.

DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 


#208 horsediva

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Posted 05 March 2014 - 12:28 AM

 

Tigers, I know. But I didn't think Brintellix would murder me anxiety wise. 

 
I'm on Day 2, and I can't say that I've noticed ANYTHING at all from vortioxetine administration.
 
That's good, because I definitely don't want the anxiety like you experienced, but I don't want to miss out on any therapeutic benefit!
 
Can you describe the anxiety that Brintellix gives you in more detail, and how it differs from Past Rx? Do you find that your alprazolam intake increases now that you're on vortioxetine therapy?
 
I can't give you enough good vibes, I really hope that 20mg. is the remedy you need. I think you made the right choice to titrate to it having been on 10mg. monotherapy for so long.
 
Good luck!
 
(Edit: Created a 'signature' that details my 'cocktail' if anyone is wondering how concomitant my Brintellix therapy is with other psychiatric medications that I take QD.) 

 

 

Tigers,

Honestly, I have panic disorder, and throughout my five years all these meds have seemed to barely keep my anxiety under control (they never touched the severe depression). I guess Prozac was holding back the worst of the anxiety (barely) and I never realized it (was helping my anxiety a ton) until I came off because I am having the worst anxiety ever. Sick to stomach, twitching and tense muscles, vertigo, headache, feel like crying out of the blue, body is ice cold and numb (especially face), rapid heat beat, hyperventilating, shaking uncontrollably like a leaf, insomnia and then extreme exhaustion, severe depersonalization/derealization and so much more. 

 

 

I do have some Xanax, but do not take it as it does not touch my anxiety or do anything for me. None of the benzos actually help me, nor have any effect on me. I always thought that was very weird, but no one else seems to think so. Occasionally I will take it and hope it helps my anxiety; it doesn't. 


**Dx: Panic disorder, treatment resistant MDD**

**Current Rx: 20mg Brintellix and basically living off of 4mg Zofran, Ginger tablets, Aviane (birth control), Marshmallow root, Serotonin Dopamine liquesence, Arsenicum pellets**

**Past Rx: Prozac, Wellbutrin SR, Effexor XR, Zoloft, Cymbalta, Celexa, Lexapro, Abilify, Lamictal, Vistaril, Ambien CR, Lunesta, Klonopin, Valium, Xanax, Ativan, Latuda, Adderall**

 

 

Other tests I've had - I have had my hormones checked (several, several times) - especially thyroid (nothing). I've had an upper GI endoscopy to test for celiac disease and the results came back inconclusive. Not to mention, the doctor performing the operation had to OD me on Benadryl and Versed to even remotely make me less aware of the procedure. Last, but not least, I've had a gallbladder scan which came back at 44% and apparently anything above 30% is normal. 

 

"Be the bird they can't catch"


#209 Geaux Tigers

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Posted 05 March 2014 - 03:31 AM

 

 

Tigers, I know. But I didn't think Brintellix would murder me anxiety wise. 

 
I'm on Day 2, and I can't say that I've noticed ANYTHING at all from vortioxetine administration.
 
That's good, because I definitely don't want the anxiety like you experienced, but I don't want to miss out on any therapeutic benefit!
 
Can you describe the anxiety that Brintellix gives you in more detail, and how it differs from Past Rx? Do you find that your alprazolam intake increases now that you're on vortioxetine therapy?
 
I can't give you enough good vibes, I really hope that 20mg. is the remedy you need. I think you made the right choice to titrate to it having been on 10mg. monotherapy for so long.
 
Good luck!
 
(Edit: Created a 'signature' that details my 'cocktail' if anyone is wondering how concomitant my Brintellix therapy is with other psychiatric medications that I take QD.) 

 

 

Tigers,

Honestly, I have panic disorder, and throughout my five years all these meds have seemed to barely keep my anxiety under control (they never touched the severe depression). I guess Prozac was holding back the worst of the anxiety (barely) and I never realized it (was helping my anxiety a ton) until I came off because I am having the worst anxiety ever. Sick to stomach, twitching and tense muscles, vertigo, headache, feel like crying out of the blue, body is ice cold and numb (especially face), rapid heat beat, hyperventilating, shaking uncontrollably like a leaf, insomnia and then extreme exhaustion, severe depersonalization/derealization and so much more. 

 

 

I do have some Xanax, but do not take it as it does not touch my anxiety or do anything for me. None of the benzos actually help me, nor have any effect on me. I always thought that was very weird, but no one else seems to think so. Occasionally I will take it and hope it helps my anxiety; it doesn't. 

 

 

Hopefully this -oxetine will be as effective (hopefully respond to it more than barely!) as fluoxetine (Prozac) in terms of baseline anxiety maintenance (help a ton).

 

So, you are experiencing these discontinuation symptoms right now while on Brintellix? It seems like its mechanism of action (5-HT [SERT] reuptake inhibition) would make fluoxetine withdrawal less frustrating?

 

Once again, you can't match up pharmacology reports to real-life experiences, e.g. you are extremely treatment resistant and do not respond positively to most medications. I'm sorry that not even benzodiazepines can allieviate your panic disorder (anxiety); one thing you could try if you haven't already (I don't see it listed as a Past Rx, but it could be an 'etc**') is Lyrica (pregabalin) or Neurontin (gabapentin), I have found both prescriptions to be very efficacious for eliminating anxiety.

 

I hope that you start to feel better on Brintellix maintenance, horsediva, but would you consider cessation of vortioxetine in place of fluoxetine pending results of this trial? I would consider that as an outcome if you and your PDOC decide that Brintellix is not a remedy because at least you have experienced some positive results with Prozac.

 

Trust me, I know where you're coming from with these symptoms you presented; especially regarding the anxiety and severe depression and derealization. I couldn't imagine being completely treatment resistant like you are; at least, I do get positive effects from my psychiatric medication therapy, but it is simply not enough. Hang in there, you're doing good. 

 

I hope you feel better ASAP!


DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 


#210 Geaux Tigers

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Posted 05 March 2014 - 04:22 AM

horsediva, I was interested in your case, so I backtracked on this thread a little bit, and I have a few comments I want to make to you:

 

You may need to consider finding a different PDOC.

 

One comment insinuated that he has basically given up on your therapy. It seems like the sales representative for Brintellix came by his office one day, and he decided to throw it at you since it's brand new as an alternative to your Prozac. I know you've consulted with him about side effects, including itchiness, but I highly doubt that he knows anything beyond what I've read in the PI sheet myself. 

 

 

 

I have been on all meds for the last five years except Lithium, TCAs, and MAOIs. Benzos do not touch my anxiety which I find odd, even at high doses. For the last year I have been repeating meds and other cocktails.

 

Why are you repeating medications that you know don't work? It seems like the PDOC has run out of ideas because his usual suspects didn't work.

 

You need to find someone who is able to administer alternative prescriptions professionally, and those prescriptions may include medications such as MAOIs and TCAs (like clomipramine). I also don't see Remeron (mirtazapine) on your Past Rx. Also, what is wrong with lithium? It is a shame that you haven't evaluated a drug from these classes in five years of psychiatric therapy. 

 

There are many avenues for treatment resistance. 

 

The EMSAM patch is purported to be very safe, but I would consider Parnate or Nardil if that doesn't work, or perhaps even first-line. You definitely have a case for MAOI therapy. I most highly recommend you look into it with a more professional PDOC. 

 

Also, I'm not sure if the spectrum of possibilities has been addressed beyond the very basic list of medications you provide on your signature. 

 

How well does your anxiety respond to beta blockers? Perhaps you could augment Brintellix with pindolol for an increased pharmacological anxiolytic effect? In terms of your severe depression, have you considered a dopamine agonist such as Mirapex ER (pramipexole) to relieve symptoms? 

 

I'm trying to get across to you that there is still hope for you!

 

I hope that you can find someone who is willing to work with your treatment resistance in order to find a solution to ameliorate your symptoms. I highly suggest that you consider various treatment options, including a new PDOC, if necessary.  


DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 


#211 Blue Toad

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Posted 05 March 2014 - 09:07 AM

It can very hard to find a p-doc with experience beyond the typical treatments, especially if you don't live in a major city.

#212 Unstrung Harp

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Posted 05 March 2014 - 09:53 AM

It's been 3 nights now of taking the full 20mg of Brintellix. My mood and anxiety for the past few days has been a bit spotty, but I also just titrated down further on my nortriptyline to only 25mg, and I suspect that is causing some of the bumpiness. Also juggling many things I have to get done, and am stressed about that. More GI effects this past week --- transient nausea at random times, some constipation/IBS symptoms (I'm trying to manage that with diet). My overall impression is that I have more energy, survive on less sleep, have less daytime sleepiness and more mental clarity on the Brintellx relative to the nortriptyline (though the nortiptyline definitely affected my mental clarity, so I can't assume it's all the Brintellix).

 

It's been about 3.5 weeks since I've been taking the full 20mg dose. I've had some recent setbacks in terms of mood and possible side effects, but I'm not sure if they are attributable to the Brintellix. The stomach/digestion stuff has gotten a bit rougher over the past few weeks, with an increase in transient nausea and IBS symptoms. I also have been having these bouts of intense all-over body aches in the past two weeks. In full disclosure, my son has been sick since yesterday with a stomach virus that's been going around, and today I feel like I might be getting it, so there's a chance that that's been brewing for a while and that's what's been going on (my cursory reading tells me norovirus doesn't incubate that long, but I'm trying to keep an open mind). There's of course also the possibility that there's something else going on health-wise. I do not relish the idea of cutting back on the Brintellix to see if that's responsible, so I'm going to see if I can deal with whatever it is and hope it gets better soon. My sense of taste is also a bit off, which apparently has been observed in Brintellix, but it was also a bigger issue with the nortriptyline, so I'm thinking it's some residual effect of that or related to the stomach stuff. Otherwise -- mood : meh. Motivation: meh+. Concentration and ability to write: still much better than before. I overextended myself a bit in recent weeks and have had some disheartening family news, so that is likely contributing to my mood state.


DX: Atypical major depression, GAD, panic, social anxiety, migraines
RX: Brintellix (15 mg); buspirone (45mg); clonazepam (.5 mg PRN); alprazolam (.5 mg PRN)


#213 quiet storm

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Posted 05 March 2014 - 12:40 PM

2nd day, nothing major to report. Slept OK last night. But I cut down to 7.5mg remeron so i'm sure thats still helping with sleep. Clonazepam might be helping as well. I'm just gonna stick at 7.5mg remeron for a few more days and then stop.


There's a shadow just behind me, Shrouding every step I take, Making every promise empty, Pointing every finger at me...


#214 horsediva

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Posted 05 March 2014 - 02:09 PM

horsediva, I was interested in your case, so I backtracked on this thread a little bit, and I have a few comments I want to make to you:

 

You may need to consider finding a different PDOC.

 

One comment insinuated that he has basically given up on your therapy. It seems like the sales representative for Brintellix came by his office one day, and he decided to throw it at you since it's brand new as an alternative to your Prozac. I know you've consulted with him about side effects, including itchiness, but I highly doubt that he knows anything beyond what I've read in the PI sheet myself. 

 

 

 

I have been on all meds for the last five years except Lithium, TCAs, and MAOIs. Benzos do not touch my anxiety which I find odd, even at high doses. For the last year I have been repeating meds and other cocktails.

 

Why are you repeating medications that you know don't work? It seems like the PDOC has run out of ideas because his usual suspects didn't work.

 

You need to find someone who is able to administer alternative prescriptions professionally, and those prescriptions may include medications such as MAOIs and TCAs (like clomipramine). I also don't see Remeron (mirtazapine) on your Past Rx. Also, what is wrong with lithium? It is a shame that you haven't evaluated a drug from these classes in five years of psychiatric therapy. 

 

There are many avenues for treatment resistance. 

 

The EMSAM patch is purported to be very safe, but I would consider Parnate or Nardil if that doesn't work, or perhaps even first-line. You definitely have a case for MAOI therapy. I most highly recommend you look into it with a more professional PDOC. 

 

Also, I'm not sure if the spectrum of possibilities has been addressed beyond the very basic list of medications you provide on your signature. 

 

How well does your anxiety respond to beta blockers? Perhaps you could augment Brintellix with pindolol for an increased pharmacological anxiolytic effect? In terms of your severe depression, have you considered a dopamine agonist such as Mirapex ER (pramipexole) to relieve symptoms? 

 

I'm trying to get across to you that there is still hope for you!

 

I hope that you can find someone who is willing to work with your treatment resistance in order to find a solution to ameliorate your symptoms. I highly suggest that you consider various treatment options, including a new PDOC, if necessary.  

 

Tigers, 

 

Thank you so much for your suggestions. I will definitely take those to heart, as some of those medications I have never heard about. Unfortunately, I cannot find a new PDOC. We got stuck on really crappy insurance and there's only two PDOCs on it - both of whom I have already seen. This guy I am seeing now, is better than the first one I saw. However, both will not touch the older drugs. I cannot afford right now at all to go out of network, but also the other PDOCs are hours away. 

 

He has given up on me. He's told me that the last seven appointments I had with him. Hell, the other day he told me that I was the sixth or seventh person he had put on Brintellix to see if I would get a response. Apparently, everyone else has had amazing responses. I haven't. Of course. :( 

 

And yes, that's exactly why he's repeating medications. Lithium, he didn't put me on because of how it can affect you. Remeron, he didn't even consider for me because I already have massive problems with too much weight gain and severe fatigue so he said there was no use trying it. Same reason for Seroquel. 

 

As I said above, I've never even heard of beta-blockers for anxiety. That was never an option, or even suggested by either one of these PDOCs I've had. 


**Dx: Panic disorder, treatment resistant MDD**

**Current Rx: 20mg Brintellix and basically living off of 4mg Zofran, Ginger tablets, Aviane (birth control), Marshmallow root, Serotonin Dopamine liquesence, Arsenicum pellets**

**Past Rx: Prozac, Wellbutrin SR, Effexor XR, Zoloft, Cymbalta, Celexa, Lexapro, Abilify, Lamictal, Vistaril, Ambien CR, Lunesta, Klonopin, Valium, Xanax, Ativan, Latuda, Adderall**

 

 

Other tests I've had - I have had my hormones checked (several, several times) - especially thyroid (nothing). I've had an upper GI endoscopy to test for celiac disease and the results came back inconclusive. Not to mention, the doctor performing the operation had to OD me on Benadryl and Versed to even remotely make me less aware of the procedure. Last, but not least, I've had a gallbladder scan which came back at 44% and apparently anything above 30% is normal. 

 

"Be the bird they can't catch"


#215 quiet storm

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Posted 05 March 2014 - 02:39 PM

Beta blockers are useful for the physical symptoms of anxiety. They arent going to do anyhting for the mental part.


There's a shadow just behind me, Shrouding every step I take, Making every promise empty, Pointing every finger at me...


#216 Blue Toad

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Posted 05 March 2014 - 03:49 PM

I'm not feeling so great today either. Anxious.

#217 horsediva

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Posted 05 March 2014 - 06:12 PM

I'm not feeling so great today either. Anxious.

 

Hope you feel better ASAP, Blue Toad. :(


**Dx: Panic disorder, treatment resistant MDD**

**Current Rx: 20mg Brintellix and basically living off of 4mg Zofran, Ginger tablets, Aviane (birth control), Marshmallow root, Serotonin Dopamine liquesence, Arsenicum pellets**

**Past Rx: Prozac, Wellbutrin SR, Effexor XR, Zoloft, Cymbalta, Celexa, Lexapro, Abilify, Lamictal, Vistaril, Ambien CR, Lunesta, Klonopin, Valium, Xanax, Ativan, Latuda, Adderall**

 

 

Other tests I've had - I have had my hormones checked (several, several times) - especially thyroid (nothing). I've had an upper GI endoscopy to test for celiac disease and the results came back inconclusive. Not to mention, the doctor performing the operation had to OD me on Benadryl and Versed to even remotely make me less aware of the procedure. Last, but not least, I've had a gallbladder scan which came back at 44% and apparently anything above 30% is normal. 

 

"Be the bird they can't catch"


#218 Blue Toad

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Posted 05 March 2014 - 07:06 PM

Thanks, HorseDiva.  I was out and about today, several appointments, and maybe that triggered something, but I also felt hot and weird -- sort of freaky, very annoyed at people's conversations, found myself scowling a lot.  Came home took some extra clonazepam and am doing better.  



#219 Kajakat

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Posted 05 March 2014 - 09:04 PM

To the ladys... Are the hormones from your menstrual cycle interacting with your moods? Could this be causing some of the problems discussed in this thread? And peeps who are going off an NSRI to go onto Brillintex gotta remember there is no "N" in Brillintex so your brain may be missing the "N". This is just my observation from reading the thread and my experience with NSRIand SSRIs.

#220 Geaux Tigers

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Posted 06 March 2014 - 07:16 AM

 

horsediva, I was interested in your case, so I backtracked on this thread a little bit, and I have a few comments I want to make to you:

 

You may need to consider finding a different PDOC.

 

One comment insinuated that he has basically given up on your therapy. It seems like the sales representative for Brintellix came by his office one day, and he decided to throw it at you since it's brand new as an alternative to your Prozac. I know you've consulted with him about side effects, including itchiness, but I highly doubt that he knows anything beyond what I've read in the PI sheet myself. 

 

 

 

I have been on all meds for the last five years except Lithium, TCAs, and MAOIs. Benzos do not touch my anxiety which I find odd, even at high doses. For the last year I have been repeating meds and other cocktails.

 

Why are you repeating medications that you know don't work? It seems like the PDOC has run out of ideas because his usual suspects didn't work.

 

You need to find someone who is able to administer alternative prescriptions professionally, and those prescriptions may include medications such as MAOIs and TCAs (like clomipramine). I also don't see Remeron (mirtazapine) on your Past Rx. Also, what is wrong with lithium? It is a shame that you haven't evaluated a drug from these classes in five years of psychiatric therapy. 

 

There are many avenues for treatment resistance. 

 

The EMSAM patch is purported to be very safe, but I would consider Parnate or Nardil if that doesn't work, or perhaps even first-line. You definitely have a case for MAOI therapy. I most highly recommend you look into it with a more professional PDOC. 

 

Also, I'm not sure if the spectrum of possibilities has been addressed beyond the very basic list of medications you provide on your signature. 

 

How well does your anxiety respond to beta blockers? Perhaps you could augment Brintellix with pindolol for an increased pharmacological anxiolytic effect? In terms of your severe depression, have you considered a dopamine agonist such as Mirapex ER (pramipexole) to relieve symptoms? 

 

I'm trying to get across to you that there is still hope for you!

 

I hope that you can find someone who is willing to work with your treatment resistance in order to find a solution to ameliorate your symptoms. I highly suggest that you consider various treatment options, including a new PDOC, if necessary.  

 

Tigers, 

 

Thank you so much for your suggestions. I will definitely take those to heart, as some of those medications I have never heard about. Unfortunately, I cannot find a new PDOC. We got stuck on really crappy insurance and there's only two PDOCs on it - both of whom I have already seen. This guy I am seeing now, is better than the first one I saw. However, both will not touch the older drugs. I cannot afford right now at all to go out of network, but also the other PDOCs are hours away. 

 

He has given up on me. He's told me that the last seven appointments I had with him. Hell, the other day he told me that I was the sixth or seventh person he had put on Brintellix to see if I would get a response. Apparently, everyone else has had amazing responses. I haven't. Of course. :(

 

And yes, that's exactly why he's repeating medications. Lithium, he didn't put me on because of how it can affect you. Remeron, he didn't even consider for me because I already have massive problems with too much weight gain and severe fatigue so he said there was no use trying it. Same reason for Seroquel. 

 

As I said above, I've never even heard of beta-blockers for anxiety. That was never an option, or even suggested by either one of these PDOCs I've had. 

 

 

 

** I mean to post this yesterday, but I never submitted it. **

 

How old are you, horsediva? I'm just wondering.

 

Real talk, these pills might just be my groove and not yours, but maybe you should consider driving hours away to another PDOC (hopefully within your insurance network), OR do what I did for awhile (always use a PDOC for psychiatric treatment!): find a professional GP that will listen to you with his discretion and prescribe you treatment based upon your advice? 

 

I agree with your PDOC's evaluation of lithium, mirtazapaine, and quetiapine.

 

Patients with a dx of 'Panic Disorder' will typically evaluate a beta blocker at their panic attack onset for relief of physical symptoms. This could signal that 'relief' is coming, and that could calm you down coefficient with anti-adrenergic effects of the beta blocker. That's why I thought you might have conducted beta blocker therapy in the past. 


Edited by Geaux Tigers, 06 March 2014 - 09:54 AM.

DX: ADHD-PI, Bipolar NOS, BPD, OSDD

RX: Adderall IR (amphetamine salts) 60mg.; Aplenzin (bupropion hydrobromide) 522mg.; Brintellix (vortioxetine) 10mg.; Lamictal (lamotrigine) 200mg.; Latuda (lurasidone) 80mg.; Nuvigil (armodafinil) 250mg.; Neurontin (gabapentin) 1,200mg.; Trokendi XR (topiramate) 100mg.

LX: Monroe, LA

 






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