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  1. Hi everyone I have serious Bipolar II depression, and my pdoc recently put forth the idea of trying a new drug, Trintellix (Vortioxetine). It hasn't been on the market for very long, and as the old adage goes, "Wait for a new drug to be out for 7 years before you take it." Well, this one has been on the market for 3, so I'm trying to learn more about it and I'm having a hard time finding anyone who's actually taken the drug. My main concern is the number of receptors it hits. First-generation anti-depressants typically only hit 1 receptor. Newer anti-depressants, like Effexor, hit 2. But Trintellix hits 7, and that worries me. It worries me because I'm prone to having withdrawals from just about every drug I've ever been on, and I am also medication-resistant, which means I go on a new drug, it may work for a few months, then it "poops out" and I have to come off it, thus experiencing the withdrawals. Effexor was awful to come off of, and it only hits 2 receptors. This new drug hits 7! It almost reminds me of an atypical anti-psychotic in terms of how many receptors it hits. It's as if Big Pharma decided to package what is essentially an anti-psychotic as an anti-depressant to get away from the stigma that anti-psychotics have developed over the years given their side effects. When I came off of Zyprexa, I had the worst experience of my life and ended up in the emergency room. It took 2-3 months for the W/D to stop. Is Trintellix anything like Zyprexa, or any other anti-psychotic for that matter? From what I can tell, Trintellix hits 7 receptors, and Zyprexa hits 31 ... does that sound about right? I got this from Wikipedia: Trintellix: Target Affinity Functional activity Pharmacodynamic action Ki (nM) IC50 / EC50 (nM) IA (%) SERT* 1.6 5.4 — Inhibition NET* 113 — — Inhibition 5-HT1A* 15 200 96 Agonist 5-HT1B* 33 120 55 Partial agonist 5-HT1D* 54 370 — Antagonist 5-HT3* 3.7 12 — Antagonist 5-HT7* 19 450 — Antagonist β1-adrenoceptor 46[6] — — — Zyprexa: Receptor Ki (nM)[63] Biologic action and notes[64] 5-HT1A 2282 Antagonist. 5-HT1B 585 ? 5-HT1D 1061 ? 5-HT1E 2209 ? 5-HT2A 2.4 Inverse agonist. May underlie the "atypicality" of the newer antipsychotics like olanzapine. May contribute to sedating effects. 5-HT2B 11.9 Inverse agonist/antagonist. 5-HT2C 10.2 Inverse agonist. May underlie the appetite-stimulating effects of olanzapine. 5-HT3 202 Antagonist. Possibly responsible, at least in part, for its antiemetic action. 5-HT5A 1212 ? 5-HT6 8.07 Antagonist. 5-HT7 105.2 Antagonist. α1A 112 Antagonist. Likely responsible for the orthostatic hypotension seen with its use.[64] α1B 263 Antagonist. α2A 315 Antagonist. α2B 81.8 Antagonist α2C 28.9 Antagonist. M1 26 Antagonist. Likely the chief receptor responsible for the anticholinergic effects seen with olanzapine's use.[64] M2 63.5 Antagonist. M3 52.67 Antagonist. Possible role in type 2 diabetes side-effects.[65] M4 17.33 Antagonist. M5 7.5 Antagonist. D1 70.33 Antagonist. D2 3.00 Antagonist. Likely responsible for the therapeutic effects of olanzapine against the positive symptoms of schizophrenia.[64] D2Long 31 Antagonist. D2Short 28.77 Antagonist. D3 47 Antagonist. D4 14.33 Antagonist. D5 82 Antagonist. H1 2.19 Inverse agonist. Likely responsible for the sedative effects of olanzapine.[64] H2 44 Antagonist. H4 >10000 Antagonist. So it appears that Zyprexa hits a whole swath of the brain that Trintellix doesn't touch, so it's not like Zyprexa or other anti-psychotics then? It's still overlapping over the same 7 receptors as Trintellix, which makes me think that tardive dyskinesia could potentially be an issue. Trintellix has only been out for 3 years, so the number of patients from whom such statistics would point to tardive dyskinesia are unavailable simply because not enough people have taken the drug. Zyprexa, by comparison, has been on the market for much longer and likewise we have better stats as to the likelihood of developing tardive dyskinesia. Another thing, since it's so new, it hasn't been properly studied as to how it treats anxiety and OCD, both of which I have severely. Do any of you know if it helps with OCD/anxiety? Have any of you taken Trintellix? Can you share your experiences with me, and if you had any withdrawals coming off of it? Can anyone speak to the above information I provided regarding the receptors? If a single-receptor AD causes me W/D (such as Prozac), and a double-receptor drug like Effexor was even worse (way worse), what will a 7-receptor drug do? As always, thanks guys troop
  2. Hi guys, I'm reading parts of a book (linked below) that notes how SSRIs are sometimes known for impeding the absorption of other meds that are being taken concurrently. It notes that Luvox is the worse SSRI regarding this. The book says that Klonopin and Xanax are two of the drugs that interact with Luvox through "CYP 3A4 inhibition." Does this mean that Klonopin and Xanax are less likely to work when taken with Luvox? By extension, would this mean that any other meds taken together with the Luvox will probably not be absorbed as well by the body? Page 536, along with Table 32.29-2: https://books.google.com/books?id=ubG51n2NgfwC&pg=PA536&lpg=PA536&dq=Luvox+inhibiting+CYP1A2&source=bl&ots=tn2I5qAjuY&sig=T7tJZyksY4cc1kjyeSsnZMoL0Xs&hl=en&sa=X&ved=0ahUKEwjvn_Cz9rHJAhWM5yYKHRX_BMoQ6AEIQjAF#v=onepage&q=Luvox%20inhibiting%20CYP1A2&f=false I came across another source that says that Luvox inhibits CYP1A2, which it said included "caffeine and other drugs." What does this mean? Does it make a person less sensitive to caffeine? More sensitive? "You're right about Luvox inhibiting CYP1A2 for sure. My psychiatrist says this makes it a less attractive option." http://www.socialanxietysupport.com/forum/f30/switching-from-luvox-fluvoxamine-to-prozac-fluoxetine-666234/ I don't know anything about "CYP ..." enzymes. What are these CYP things that are being referenced? I'm switching from Prozac to Luvox, hence this research. Let me know what you guys think about all this, thanks! troop
  3. I started taking gabepentin and it helped the symptoms I was having tremendously, but it's had so many side effects that i've had to go on medical leave from my job! my psychiatrist had me lower my lexapro fromj 40mg--which is about twice the normal highest dose, but I've been on that dose for years and it's helped a lot!!--to 20mg just last week. And i'm on less than half the normal dose of gabepentin. So, now i'm all sad and crying and depressed and i don't know if it's the lower dose of lexapro or me. i'm bummed out and worried about some stuff and i get this way anyway sometimes, so I don't know how to tell the difference. it's frustrating. i really need the gabepentin, but every since i started taking it, i've been kind of a mess. UGH!!!
  4. Hi. This is my first post and I would appreciate an outside perspective/opinion. Early last year I moved into a flat-share. I got on very well with on of the girls. We spent a lot of time together hanging and became very, very good friends quickly. After a while, we became involved with each other and quickly enough our relationship grew stronger and more meaningful. So meaningful that I asked her to marry me at the turn of the year. She said yes. Since then, things have changed every so slightly. We argue a lot now and very easily. To me she seems to be more sensitive – when compared to before I asked her. Also, I sense some attempts to control me. Again I don’t know which is why I need an outsiders opinion. Since we got engaged, as I mentioned, we argue a lot now and very easily. With time the arguing has become worse/more regular. At first, I’d say she wasn’t ‘that’ sensitive and now she seems more sensitive. If I say something wrong or do something wrong i.e. - If I am answering a work phone call after work, she will tell me to put it down. If I say no, I cant, its work, she will become upset. When I do finish the phone call, she has to know all details immediately and why I had to answer the call (only my line manager – the CEO (small company) will call me after work). My response is usually - sorry, its my boss and its work. - Another example, if I say ‘I love you’, she always says ‘I love you more’. If I don’t respond she will say, way to let a girl know that you care for her… then she will be upset. (I also hate the fact she says that, very nice thing to say to your fiancé) - Final example, slightly different – I was asked by friends to go out for a drink. This was the first time ever in our relationship – I live in a different city to my friends. We had a week long argument about it where she was saying things like – I am inclined not to like these people. I don’t know these people so how do I know if you’re going to be ok. So how long will you be out for? When will you be back? That night I came home early to avoid an argument. But she still started one. I feel like I have to answer any questions she asks with the exact answer she is expected otherwise she will be upset with me so now when I do answer her question I stutter a bit in fear of her becoming upset… omg I have just realised what I am typing… grow a set of balls! One thing I find she does as well is when im texting she will ask who I am texting if she cant see the screen of my phone. When I say who she will ask what they wanted – is it me or is that normal (oh and this is every text – actually, if my phone vibrates she will say you’ve got a text. Halve the time its an email (clear to me by one vibration) and if I say no it’s a vibration, she will become irate with me). An example was last night, she was on the ipad playing a card game. I received a text from my uncle and started texting back. I knew she had stopped playing and started watching me because she had the sound on the ipad turned on and I couldn’t hear any cards being dealt, etc… whilst I was texting. As soon as I stopped, the cards started making noises again. Furthermore to that, if I am on facebook (very rarely) and I am reading the latest ‘news feed’, she WILL say to any update from a girl who could be classed as attractive as ‘a dirty slut’ – the usual line is ‘why are you friends with so many slutty girls’… WTF! These are ppl I went to school with. I've not seen 95% of my 'facebook friends' since then! One girl I had to state in ‘What capacity’ I knew the girl – she is dating a guy I played football with who is a twin… she was not impressed with my answer and so… became upset with me and since has asked me about it and (to me) is clearly looking for inconsistencies in my answers. Oh and appraently all the girls i work with (four in total) are all sluts (well except on - she is mid fourties, has a husband and two kids). The other three are either between 1 to 6 years older than me. If she slags one of them off and i say thats a bit harsh... 'why are you defending her!' 'You're taking her side over mine' (firstly WTF have they done to you, secondly they are not here! How can i take their side - you are arguing with yourself). Despite all over the above (examples) I do love her because she is sooo much fun to be with and we laugh so much. I have said to a handful of ppl that she is me, just with different parts… Last weekend she terrified me… when we first started dating she was anti-depressants, after 4 months she came off them. She know believes she needs to go back on them – first mentioned a few weeks back. I asked her if she would delay that to see if this is something we to deal with together without medication – I know nothing about depression and was relying on her knowledge etc. She say ok. At the weekend, we were lying in bed until she got up and sat on the floor. She then started to bang the back of her head against the wall. I immediately jumped up and asked what was wrong, told her to stop it etc. My ‘sudden’ interest in her (?!?!?!?) compelled her to say – why are you worried, what are you hiding (not the exact words but also conveys the msg). I was confused and had no idea what she was talking about. I felt like she started to verbally attack me whilst I was still confused. We ended squabbling until she told me to fuck off so I went into the other bedroom to sleep. She barged in immediately and started shouting again saying you don’t care, etc, etc, etc. She locked herself in the bathroom and started crying. I felt terrible because she was upset and I thought it was because of me so I went to see her. She let me into the bathroom where I hugged her from behind whilst she faced into the corner of the room. She continued saying things like, you don’t love me, you don’t care about anyone but you, I told you I needed to go back on anti-depressants BUT YOU WOULDN’T LET ME (fucking lie!). She then started saying that I was cruel for not letting her go on the anti-depressants (you’re cruel, you’re cruel, you say nasty things)… I finally managed to calm her down and get her back in bed. Just before we went to sleep she said ‘Well done, you deserve to sleep well’.I asked her what she meant coz I had no idea what she was talking about. She said ‘with your technical skills – you know work’ … WTF!?!? I did not sleep well that night. Since then if feels like theres an elephant in the room constantly and we cant talk about it because she gets so upset. I do not know what to do! And I am freaked out! This is not the person I asked to marry me! Definitely not! WTF! She has admitted on several occasions that she has abandonment issues to which I was let her know I will always be there for her. She also says she loves me too much and that when she is not with me i.e. if I am away with work, that she panics so much that she is always on the verge of a panic attack. Please help me. By no means am I perfect i.e. I get defensive now when she gets upset or is being what I class as overly sensitive. Im now very quick to boil over. I've never know myself to be like this, its unreal! I feel like im carrying a bag of anger with me at all times - i dont like it. But she just isnt the person I asked to marry me. She has also thrusted the ring back in my face twice… WTF! I am exhausted by her constant need for reassurance, her obsessiveness, her sensitivity. It doesn’t feel like I am in a relationship anymore. I know all relationships have tough times but my last one last 6 years and there was many of those during that. I've actually has a cheeky look at available flat/flatshares. I dont want to break up with her as i want to work at this! but i am exhausted and she has said that she won't stop caring for me so much and wont change her way. I asked her to marry me! I also made a promise to her parents when i told them of my intention (to ask her to marry me) - i said i'd care for her. They are living abroad at the moment and her father said they were thinking about moving back because of her (to care for her/be there for her). He said that they are releaved that she has found someone who cares for her so much. Help! She doesn't like therapy, she has been there before and walked out immediately. I dont think she'll agree to that. She is too head strong. Im sorry that this is sooooo long and that there will be an unbelievable amount of errors! Sorry
  5. I was speaking to a guy in my class today and we were taking about the high level of suicide in the area and the discussion led on to anti-depressants and this guy said that anti-depressants are not the answer to depression, that they only hide the problems and don't allow you to deal with them properly. A few other people chimed in and agreed with him. I saw red, and tried to point out that many people with depression do not have an identifiable cause and that anti-depressants save many people's lives. Of course they all talked me down and insisted that anti-depressants don't cure but only push the problems away temporarily. What do you think of this? Is this a common belief? Have you heard people say stuff like this? I'm just thinking that if I was feeling vulnerable when I was having this discussion I may very well take these beliefs on board. Thankfully I understand the importance of taking my medication and know that it helps. But I wonder how many people suffering with depression out there have to listen to these kind of comments, leading them to stop their medication!
  6. I think the crowd here could appreciate this: Nails painted like anti-depressants
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