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Hi all. Would like opinions please. I've been on Viibryd for a little over 6 weeks. Went up to 40mgs, then back to 30mg now 20mgs (pdoc thought it might have been too stimulating for me at higher doses). I'm starting to feel stable throughout the day most days, but almost always have breakthrough anxiety multiple times a day, in which the .50mg of Lorazepam isn't working to control. Although my depressed  mood/sadness has seemed to lifted a bit, the suicidal thoughts are hanging on for dear life. This promoted my pdoc to add Lithium 900mg a little over 2 weeks ago. I also take 200mg Seroquel and 600 nuerontin at bed to help with insomnia.

Anyway, I really don't think the current cocktail of the Viibryd 20mg and Lithium 900mg is working for me. I would think that I should be a lot less anxious than I am and not be having suicidal thoughts at this spot in my "recovery".  I guess I should mention that I just started intensive therapy  (3 times a week). I know that therapy often makes things worse before they get better, but I'm pretty uncomfortable. 

Over the years, I have been on Cymbalta, Wellbutrin, Paxil, Zoloft, Lexapro and Effexor with not much luck.

I would really like to ask my pdoc to be put on a TCA. I've never tried that class of anti-depressant so I'm hoping maybe I'll respond better to a TCA than the abysmal results I've had with SSRI, SNRI and now SMS. Or, is it even worth asking for a change now that I'm in therapy?

I would really appreciate opinions and recommendations. Thank you so much!

Edited by FlightyGoatGirl
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7 hours ago, FlightyGoatGirl said:

Hi all. Would like opinions please. I've been on Viibryd for a little over 6 weeks. Went up to 40mgs, then back to 30mg now 20mgs (pdoc thought it might have been too stimulating for me at higher doses). I'm starting to feel stable throughout the day most days, but almost always have breakthrough anxiety multiple times a day, in which the .50mg of Lorazepam isn't working to control. Although my depressed  mood/sadness has seemed to lifted a bit, the suicidal thoughts are hanging on for dear life. This promoted my pdoc to add Lithium 900mg a little over 2 weeks ago. I also take 200mg Seroquel and 600 nuerontin at bed to help with insomnia.

Anyway, I really don't think the current cocktail of the Viibryd 20mg and Lithium 900mg is working for me. I would think that I should be a lot less anxious than I am and not be having suicidal thoughts at this spot in my "recovery".  I guess I should mention that I just started intensive therapy  (3 times a week). I know that therapy often makes things worse before they get better, but I'm pretty uncomfortable. 

Over the years, I have been on Cymbalta, Wellbutrin, Paxil, Zoloft, Lexapro and Effexor with not much luck.

I would really like to ask my pdoc to be put on a TCA. I've never tried that class of anti-depressant so I'm hoping maybe I'll respond better to a TCA than the abysmal results I've had with SSRI, SNRI and now SMS. Or, is it even worth asking for a change now that I'm in therapy?

I would really appreciate opinions and recommendations. Thank you so much!

Based on the meds you're currently taking, are you diagnosed as bipolar? If that is the case, older tricyclics can trigger manic episodes, which lithium could possibly prevent, but the risk is there nonetheless. I do remember Viibryd being pretty stimulating and I was manic most of the time because I wasn't taking a mood stabilizer.

Have you tried Lamictal?

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6 weeks is not particularly long for a med trial. It's like the minimum for where they start to look at whether it is going to work, but meds can take longer than that, especially antidepressants. SSRI can take 2 months for the full benefit to be felt, although I hear Viibryd is not a standard SSRI. I would just give it more time, if your pdoc does not suggest a change.

i haven't ever taken a TCA so can't comment on them. I haven't really felt antidepressants to be sufficient for my anxiety disorder, although they help a little.

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15 hours ago, mcjimjam said:

6 weeks is not particularly long for a med trial. It's like the minimum for where they start to look at whether it is going to work, but meds can take longer than that, especially antidepressants. SSRI can take 2 months for the full benefit to be felt, although I hear Viibryd is not a standard SSRI. I would just give it more time, if your pdoc does not suggest a change.

i haven't ever taken a TCA so can't comment on them. I haven't really felt antidepressants to be sufficient for my anxiety disorder, although they help a little.

Since most of the waiting time on antidepressants has to do with waiting for serotonin receptors to be desensitized, Viibryd being a 5HT1A agonist tends to cut down on that lag time a bit. I noticed significant improvements at about 2 weeks and felt mostly all the way better by 4 weeks. However, it did make me hypomanic, caused a bit of weight gain, and gave me the most overactive gut you could possibly imagine. Who needs voices in your head when you can actually have conversations with your gut ALL DAY, and diarrhea to boot. This all aside though, it did lift my mood pretty quickly. So if the OP is at 6 weeks and has already made it to 40mg, it most likely won't get much better beyond 6-8 weeks. But indeed YMMV.

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Thank you. I appreciate your advice. and just to clarify, no, I am not bipolar. My pdoc put me on Lithium because apparenty research has shown it has that it can decrease suicidal thoughts in unipolar depression. I'm not so sure if it is or not, to be honest. 

Browri, I'm glad you had mood improvements on Viibryd, but the stomach issues really stink. I felt the same when I started the Lithium.  

I was REALLY hoping the Viibryd was going to work for me, but alas it seems as though it's just not the drug for me. Although, to be fair, I only stayed on Viibryd 40 mgs for 2 weeks before we started messing with the dosages. It just doesn't seem to have that "umpfh" to lift the depression and definitely isn't doing anything for the anxiety :(

Mcjimjam, 

do you have any med suggestions?

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