Not sure where to post, please help!

[Ethansmom]

I've been anxious and panicky for the past 3 years. I've tried so many meds. First got stabalized on prozac with the help of xanax. Stupidly went off of that because i was gaining weight and i have body issues.   Now i've been through the merry go round of meds.

I've been taking Klonopin daily 2MG for a year now (all while trying different SSRI'S/SNRI's, etc.)  I feel like i'm about to have a panic attack every morning. I have been prescribed Tritellix 5MG -- i'm only taking half of that since i'm sensitive to meds. 

Has anyone had luck with this med to treat panic/anxiety???   I have xanax, which i feel acts differently than xanax. Should i switch back to that while waiting for the trintellix to kick in? I'm so worried i'll never feel better.

[BrianOCD]

You're going to probably have to take higher dosages of it.

It's the anxiety that's causing you to worry and be sensitive, once the drug knocks out the anxiety, you look back and see how silly it was to be so worried.

That's generally been my experience anyways.

If you just started taking Trintellix I wouldn't make any more changes, see how that works first beforehand...

[HydroCat]

4 hours ago, Ethansmom said:

I'm so worried i'll never feel better.

This is what I feel everytime when meds start to work but not “there yet”. I think that this is the exact feeling because of which psych meds come with a risk-of-suicide warning.

Still searching for the right combination, but I have been balanced for enough time to know that it does get better.

It takes time, research, trial and error but it is worth it.

Can't say that Trintellix worked for me, but it had no side effects even at max dose and was really easy to stop.

[Ethansmom]

Thanks for your response. I did receive free samples of trintellix  from my psychiatrist so it’s worth a shot . Only taking 2.5 for now and then moving up to 5 mg in a few days. I’m taking it slow . It’s only been 3 days so far. I pray this gets rid of my anxiety and depression. 

[Ethansmom]

I plan to up my trintellix to 5 mg on Monday. I hope it doesn’t give me panic attacks. My doctor my add a super low dose of aero quell to the mix, but I’m so afraid of antipsychotics . Scared of more weight gain and feeling zombified. I’d rather feel like a zombie than panicky though. Anyone have much with a small dose of seroquel? I really want to get off benzos but I’m not stable yet. I’m a mom, wife and work full time . Controlling anxiety is a full job in itself !

[Iceberg]

Usually weight is ok when low dose especially if as needed or short term 

[Ethansmom]

Thank you iceberg. I’m hoping trintellix will work

[browri]

@Ethansmom Trintellix CAN work for anxiety, but it doesn't work for everyone. Some people's anxiety gets better, some people get worse, and some people feel like they're taking a placebo. Trintellix is confusing, but when it works, it REALLY works. And it's now my favorite AD and the only one I'll ever go back to if I go off ADs at any point in time.

Don't be too resistant to antipsychotics (APs) though. For some people, anxiety is a GABA problem that just needs a good kick of Xanax/Ativan/Klonopin. However, some people have a real dopamine problem, where excessive dopamine signaling can lead to anxiety and panic. I've felt that Rexulti has significantly reduced my anxiety and panic symptoms. This may be due to its effect at dopamine receptors, but it's also very potent at adrenergic receptors which really help to loosen up the "tight chest" feeling that you can get in touch situations. For example, getting into a near accident in the car would normally make my heart race and feel like I have a hole in my chest, but on Rexulti I maintain my cool. Granted I am taking Depakote as well. So take it with a grain of salt. We're all different so our mileage may vary.

As for how to deal with Trintellix. Keep a few things in mind. It has a VERY long half-life of 66 hours, which means you have to be at the same dose for 2 weeks until it reaches "steady" blood levels. In my experience starting Trintellix at 5mg for a few weeks and increasing to 10mg, it caused my to feel restless, hyper, maybe anxious. I couldn't really put my finger on it. Maybe I was a bit irritable. It was like that for the first 3-5 days on 5mg and then again for 3 days at 10mg, but when I increased to 15mg I started to feel some calm and 20mg even calmer. I didn't really feel any improvement in my depression until I hit 15mg, but I wasn't sure I wanted to stay on Trintellix permanently until I had been on 20mg for about 2-3 weeks. This is one of the longer ones. It does take time. Be patient with it, and it will hopefully treat you kindly. I personally have no real complaints about side effects at all. When I started it, it would give me a bit of dyspepsia (over-acidic stomach, basically) for a few weeks but that leveled out. I never got nauseous. It hasn't really caused any weight gain, and the sexual dysfunction is only really slightly bothersome at 20mg. I'm on 10mg now for the summer and have no real issues with sexual dysfunction whatsoever.

Also, like @HydroCat said, Trintellix is very easy to stop because of the long half-life. So dose decreases won't be agonizing like some other ADs.

Edited May 15, 2018 by browri

[mmaryland]

Haven't read anything about Trintellix Bien specifically effective for social anxiety disorder or social phobia, there are other antidepressant medications which are more specifically indicated for this type of anxiety disorder. Paxil  is usually touted in the psychiatry community as highly effective for social anxiety even in severe cases. I know it definitely helped me a lot when I was struggling with social anxiety in my college years.  I think Zoloft  it's also pretty effective for social anxiety disorder but not as great as pack soul. These are both SSRI antidepressants just like Prozac is.  is there a reason you are trying Trintellix before older medications that have been tested tried and true for social anxiety disorders? 

[browri]

@mmaryland is right. Trintellix hasn't really been PROVEN to work for anxiety disorders. There was one study done where vortioxetine was trialed for generalized anxiety disorder using duloxetine (Cymbalta) as an active comparator. Duloxetine fared better than vortioxetine. However, the problem with that study is that it used a full 60mg dose of duloxetine but only used 5mg and 10mg doses of vortioxetine and didn't allow patients to go to 15mg or 20mg on vortioxetine. Considering that in trials for depression they had to dose people to 20mg before it really made a statistically significant difference compared to other antidepressants. However, when I started, I felt like it didn't put a dent in my depression until 15mg but really made a difference at 20mg. Now it seems to function quite well for me at 10mg. Granted we are in Spring/Summer now. So I usually don't need as much of an AD in my cocktail for these months until August/September.

Prozac and Zoloft are generally stimulating in my experience, and Trintellix has been pretty stimulating as well. Paxil would be more calming and is pretty much the gold standard for depression with prominent anxiety. Since you've already started Trintellix, I would really recommend sticking it out to 20mg for several weeks and then see how you feel. But otherwise, I would want to talk to my pdoc about Paxil.