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Effexor to Brintellix or agomelatine?


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Hi everyone,

I have been on effexor for about 15 years - up and down between 75 and 225.  I thing it has done it's course - i have no motivation and don't get that 'well being ' feeling that i had before meds and when i first started E.  I have tried to come off a few times and get slammed with anxiety and depression in an increasingly short period of time - the last time it was 2 weeks off.  I am a little worried it is withdrawal from E rather than return of depression - i could never understand why it was happening in shorter periods every time i came off.

Last visit when i talked with my Pdoc, i expressed my concern about 'upsetting the apple cart' by changing meds - i mean I am stable, just not 'enjoying life'.  She suggested agomelatine because i can start taking that at the same time as being on E. since then i have done a lot of research and can't find much really good on agomelatine.  

I had thought about Brintellix.

i kind of want to come of E as I have (probably incorrectly) blamed Effexor for my frequent relapses - I almost hate it because of it's short half life and would like to be stable on something else.

Can I please have some feedback???

 

Edited by surfer girl
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On 9/2/2018 at 2:17 AM, surfer girl said:

Hi everyone,

I have been on effexor for about 15 years - up and down between 75 and 225.  I thing it has done it's course - i have no motivation and don't get that 'well being ' feeling that i had before meds and when i first started E.  I have tried to come off a few times and get slammed with anxiety and depression in an increasingly short period of time - the last time it was 2 weeks off.  I am a little worried it is withdrawal from E rather than return of depression - i could never understand why it was happening in shorter periods every time i came off.

Last visit when i talked with my Pdoc, i expressed my concern about 'upsetting the apple cart' by changing meds - i mean I am stable, just not 'enjoying life'.  She suggested agomelatine because i can start taking that at the same time as being on E. since then i have done a lot of research and can't find much really good on agomelatine.  

I had thought about Brintellix.

i kind of want to come of E as I have (probably incorrectly) blamed Effexor for my frequent relapses - I almost hate it because of it's short half life and would like to be stable on something else.

Can I please have some feedback???

 

I like Trintellix a lot, and it helped me through a pretty severe winter depression. I'm not on antidepressants at this point, but if I ever had to go back on them for an episode, Trintellix is the way to go for me.

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  • 3 weeks later...

Really the only reason I stopped was because it was Spring time and I was starting to get mixed. I'm getting into a cadence of only taking antidepressants in the Fall and Winter if I can and just managing with mood stabilizers in the Spring and Summer. But if I ever need to go back on an AD my pdoc and I agree Trintellix is the way to go for me. There's a good chance I'll be starting back up on it in 6 weeks if I keep headed slowly downhill. It's always kind of inevitable for me to get seasonal depression.

If not Trintellix then I would choose Pristiq as a second choice if insurance wouldn't approve Trintellix. Other than that I don't really agree much with the other ADs except maybe Prozac.

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Thanks everyone... I came down to 150mg and was hoping to  move down to then transition to another medication - however I became quite anxious and depressed again and with my Dr we decided to go back up to 225 , stabilise (hopefully ) and then move down again with a clear plan to change - this last time it was just something that we talked about fleetingly in a session.

Has anyone got any insight into depression emerging whilst coming off effexor - is it withdrawal that will resolve with going up in the antidepressant - will I  respond to another antidepressant?  I seem to have this dysfunctional thought that other antidepressants will not be strong enough to overcome the clutches of Effexor

I am a little concerned about aglomelatine because it has such a different mode of action.

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3 hours ago, surfer girl said:

Thanks everyone... I came down to 150mg and was hoping to  move down to then transition to another medication - however I became quite anxious and depressed again and with my Dr we decided to go back up to 225 , stabilise (hopefully ) and then move down again with a clear plan to change - this last time it was just something that we talked about fleetingly in a session.

Has anyone got any insight into depression emerging whilst coming off effexor - is it withdrawal that will resolve with going up in the antidepressant - will I  respond to another antidepressant?  I seem to have this dysfunctional thought that other antidepressants will not be strong enough to overcome the clutches of Effexor

I am a little concerned about aglomelatine because it has such a different mode of action.

I just stopped it totally a few days ago and switched to Cymbalta.  I was on high dosages for about 7 years 300mg Effexor.  The last year I was on about 150mg effexor before coming off now...

It hasn't been very comfortable obviously, but I'm managing better than I thought I would.  I hope that the Cymbalta kicks in just enough to cover up the Effexor withdrawals, but I expect the next week will be a rocky ride.  The Effexor for me had pooped out though, it was holding the panic attacks and anxiety off and maybe even the depression but I just felt "blah" on it, having crying spells and mood swings... Just decided, like you, I wasn't very happy on it.

I'm really really dizzy almost all the time and expect this could be from either medication and I expect it to go on for a little while...

Edited by BrianOCD
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7 hours ago, BrianOCD said:

I just stopped it totally a few days ago and switched to Cymbalta.  I was on high dosages for about 7 years 300mg Effexor.  The last year I was on about 150mg effexor before coming off now...

It hasn't been very comfortable obviously, but I'm managing better than I thought I would.  I hope that the Cymbalta kicks in just enough to cover up the Effexor withdrawals, but I expect the next week will be a rocky ride.  The Effexor for me had pooped out though, it was holding the panic attacks and anxiety off and maybe even the depression but I just felt "blah" on it, having crying spells and mood swings... Just decided, like you, I wasn't very happy on it.

I'm really really dizzy almost all the time and expect this could be from either medication and I expect it to go on for a little while...

I know you've been on Effexor for a while and had some difficulty with it. Personally I liked Cymbalta much better, and I was also taking 60mg. It's really the perfect dose. I believe the prescribing information allows for up to 120mg, but there wasn't significant increase in benefit for most people in trials for doses above 60mg.

10 hours ago, surfer girl said:

Thanks everyone... I came down to 150mg and was hoping to  move down to then transition to another medication - however I became quite anxious and depressed again and with my Dr we decided to go back up to 225 , stabilise (hopefully ) and then move down again with a clear plan to change - this last time it was just something that we talked about fleetingly in a session.

Has anyone got any insight into depression emerging whilst coming off effexor - is it withdrawal that will resolve with going up in the antidepressant - will I  respond to another antidepressant?  I seem to have this dysfunctional thought that other antidepressants will not be strong enough to overcome the clutches of Effexor

I am a little concerned about aglomelatine because it has such a different mode of action.

Most likely what you're experiencing is just withdrawal. You're better off talking to your pdoc about cutting over to another antidepressant directly, like a direct conversion. When I switched from generic Effexor XR to generic Cymbalta. I just took 150mg of Effexor one day and then the next day started Cymbalta at 60mg and stopped taking the Effexor. May have had a few brain zaps here and there, and I was slightly excitable the first few days but it really wasn't terrible at all. Cymbalta 60mg may be closer to 300mg of Effexor in relative affinity or potency. Anyone here that could shed light on that based on their experience?

Alternatively, your pdoc may advise a Prozac-assisted titration. Adding in 10mg of Prozac while tapering off of another antidepressant with difficult withdrawal effects like Effexor or Cymbalta is pretty effective for some people. My pdoc did this for me coming off of Cymbalta when I was switching to Lamictal. This was right when my diagnosis changed from MDD to BP2. He started me on Lamictal immediately, dropped my Cymbalta dose to 30mg and added in 10mg of Prozac. Then the second week we got rid of the Cymbalta altogether and just left the Prozac. Then the third week I took Prozac every other day. Week 4 I stopped. All the while I was titrating up on Lamictal which is a rocky titration process as it is, and from what I recall now it wasn't as terrible as I thought it was going to be.

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