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Greetings everyone,

I have been meaning to post this for a couple weeks now and finally got some free time. Let me start by saying I switched from Paxil to Trintellix due to sexual side effects. I've been on 20mg a few days now and not any side effects that I notice, neither did I have any initial side effects at 5mg or 10mg. 

My reason for this post is to receive feedback from others about how trintellix did or didn't work for them, when went well and not so well, and I really want to get a better picture of how effective it is/was for others.

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My experience:

5mg/10mg/20mg did nothing.

No effect. No side effects. No withdrawal.

There was a tiny improvement in mood every dosage change, for about two days. (Placebo effect maybe)

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Posted (edited)

Same as @HydroCat felt absolutely nothing, went up to 20mg. I was told by my pdoc it's sort of like a "weaker version of Prozac"

Edited by Blahblah

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I’ve found it helpful and mentally stimulating in a good way, though I had to knock it back to 15 mg because the 20 made me feel too intense. It’s been part of my cocktail for five years. No real side effects for me, other than the dose-related agitation. It’s maybe not ideal for me based on my newer bipolar diagnosis, but mostly it’s been good.

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i got really agitated on Trintillex, - i swapped over from effexor - went from 5 to 10 to 20, then back to 15.  I started out OK - but that may have been the effexor still having some effect on my mood - 6 weeks after being totally off effexor and on 20mg Trintellix i was really unwell.  Tried 15mg for a week, but ended up swapping over to Lexapro which suits me better (but not as good as my first 17 years on effexor)

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The first week I started getting some motivation back. I cooked and cleaned my room. It's been two weeks now and things are kinda back to where they were before but SSRIs do take time to work. 

 

Weird thing though is that I get nauseous after taking it when I eat next. If I take it at 8AM and have breakfast at 10, nausea. If I don't eat until 2, nausea. Once it's passed I'm good. 

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I havent noticed any motivation from Trintellix so far. My motivation comes from Deedrine. I am on week 2 and a half and dont really feel anything. Gonna wait it out for 4 more weeks to see if this med really does anything

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On 6/21/2019 at 1:21 PM, Unstrung Harp said:

It’s maybe not ideal for me based on my newer bipolar diagnosis, but mostly it’s been good.

Actually a group of researchers in Italy did a study and found that for many, Trintellix can actually further stabilize the mood when taken with a mood stabilizer. There has been a published case report of antidepressant-induced hypomania from Trintellix, but no mood stabilizers were in play in that case.

They are actually studying Trintellix now as an adjunct for negative and cognitive symptoms of schizophrenia as well as adjunct for bipolar depression. On the one hand I say "fingers crossed" hoping that the data is good, then on the other hand that means they just get to extend their marketing exclusivity which keeps Trintellix out of reach for those who need it.

I personally love Trintellix. 10-15mg is usually good for me. I find that the top end AND bottom end of the dose range are both agitating for me but right in the middle at 10-15mg it's calming for me while still providing some good stimulation in combo with my stimulant. However, I do go to 20mg in the Fall/Winter months if I get into a really deep depression. Trintellix pulls me out of it. I've been on it now since 2017 in varying doses. I love it.

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On 6/22/2019 at 1:49 AM, Persona_Is_Life said:

 Weird thing though is that I get nauseous after taking it when I eat next. If I take it at 8AM and have breakfast at 10, nausea. If I don't eat until 2, nausea. Once it's passed I'm good. 

According to what I've read about it, nausea is a common side effect of Trintellix.

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Just now, CrazyRedhead said:

According to what I've read about it, nausea is a common side effect of Trintellix.

I finally found out WHY this happens. It's a bit technical but it explains a lot.

So Zofran (ondansetron) is a 5HT3 (serotonin receptor, type 3) antagonist. This is how Zofran reduces nausea. Trintellix is also a 5HT3 antagonist and much more potent than Zofran. However, what they found is that when initiating Trintellix treatment in patients that weren't already taking an SSRI (antidepressant naive), for the first few weeks, Trintellix behaves as a PARTIAL AGONIST at 5HT3 receptors. After the first 2 weeks, it changes to total insurmountable inhibition of the receptor. This could explain nausea that occurs with treatment initiation, but it doesn't explain why nausea persists for some people beyond the first 2 weeks.

For those that have persistent nausea and are taking higher doses of Trintellix, activation (agonism) at 5HT1A receptors and partial agonism at 5HT1B receptors could mediate the nausea that persists after reaching steady state. This is more common on higher doses like 15-20mg. I don't have any real trouble with nausea at 10mg except for some minor dyspepsia, which can easily be misconstrued for nausea.

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Trintellix really didn't agree with me, but it was quite obvious. I had a huge increase in hopelessness and suicidal ideation (a possibility for many antidepressants, but I hadn't personally encountered it before). I also had a sharp decrease in appetite to the point where I actively didn't want to eat.

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13 hours ago, Ion said:

Trintellix really didn't agree with me, but it was quite obvious. I had a huge increase in hopelessness and suicidal ideation (a possibility for many antidepressants, but I hadn't personally encountered it before). I also had a sharp decrease in appetite to the point where I actively didn't want to eat.

Curious what dose your pdoc started you on and how long you were on it. Trintellix has a long half-life and the titration up can be rocky for some and a total placebo for others. I started at 5mg for several weeks before going to 10mg. The manufacturer guidelines say to START at 10mg and go down to 5mg at Week 2 if 10mg isn't well tolerated. If it is tolerated, then immediately proceed to 20mg on Week 2. This is excessive in my mind, because I know I only need 20mg during a genuine episode. Perhaps their goal was to ensure episodes don't recur (patients achieve remission) and that's probably more likely on the 20mg dose but it's also not where you want to be 100% of the time. They've shown in studies that 10mg does have a robust antidepressant effect for many people, making the 20mg dose unnecessary.

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1 hour ago, browri said:

Curious what dose your pdoc started you on and how long you were on it. Trintellix has a long half-life and the titration up can be rocky for some and a total placebo for others. I started at 5mg for several weeks before going to 10mg.

It was a while ago, so my memory isn't clear, but based on some receipts it appears that it was 5mg for a week then went up to 10mg and stayed at that dose for 4 weeks. At 5 weeks my pdoc stopped/changed the med.

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1 hour ago, Ion said:

It was a while ago, so my memory isn't clear, but based on some receipts it appears that it was 5mg for a week then went up to 10mg and stayed at that dose for 4 weeks. At 5 weeks my pdoc stopped/changed the med.

I wonder how you would have done on the 20mg dose. Oh well, if the combo of bupropion/levothyroxine works for you, no reason to fix what ain't broke. ;)

 

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5 hours ago, looking for answers said:

ive taken all doses

+energy

+mood boost

+cognition

Mehhh on mood boost

no side effects

hang in there

I can second the improved cognition, I felt able to think more abstractly and felt like it almost helped with my ADHD symptoms. I don't think I got much energy from Trintellix, but I also had minimal side effects and definitely a mood boost, not any anti-anxiety effects tho so you might want to go elsewhere if you decide to try an antidepressant for anxiety. Too bad that Trintellix is pretty activating as it triggered a 2-3 week manic episode,  I was hypersexual, opened 2 credit cards in my Dad's using his SSN and name, then spent over $1,000 on the AMEX and another $1,200 on the CapOne mastercard, I barely slept so I looked high more than half the time because I had gotten a couple hours or no sleep at all. Man bipolar disorder is freaing exhausting,  it's difficult for me to hold a job, and I have been denied for SSDI twice despite my 6+ medical conditions that are pretty severe: hypersomnia, idiopathic insomnia, ADHD, Panic Attacks, Social Phobia, Bipolar 1, and Epilepsy. I am filing again soon, and will keep filing until I get approved (probably won't be for 10 more years).

5 hours ago, Ion said:

Trintellix really didn't agree with me, but it was quite obvious. I had a huge increase in hopelessness and suicidal ideation (a possibility for many antidepressants, but I hadn't personally encountered it before). I also had a sharp decrease in appetite to the point where I actively didn't want to eat.

How long have you been taking it so far? How about other medications for your mental health? I know lithium carbonate is very effective for suicidal ideation/thoughts, but that would be a convo between your Dr. and you as the patient. Be honest and tell the Dr. you feel hopeless and suicidal, I am sure he will prescribe something to help with the major depressive symptoms. No psychiatrist wants their patient leaving the office still having suicidal thoughts and depressive symptoms because then if suicide did occur, the Dr. could be forced to go to trial, and possibly have his medical license revoked.  Honestly though, I recently started Zyprexa at 5mg now I take 10mg at night and I wish I would have been on Zyprexa 4 years ago because it has been working so wonderfully. I finally feel normal and stable, my thinking is more coherent, I have more motivation, and just being stable is feels so weird to me now, in a good way, because I am so used to being manic and destroying my life with bad decisions and criminal activity. In my experience, Rexulti was amazing at relieving depressive symptoms almost 100% by day 2 or 3. Maybe bring Rexulti up to your Dr. He might not be familiar with it because it is newer, but definitely start out slow or you will most likely experience akathisia and feel the need to constantly walk around or pace the floors. I started at 2mg and quickly asked my Dr. to give me a sample starter pack with had 14 days worth, 7 of 0.5mg and 7 of 1mg. After that you could stay at 1mg if it's helping or get an increase to 2mg. What I am seriously considering is getting prescribed Symbyax, Zyprexa and Prozac pill combination, as the Zyprexa would prevent Prozac mania and I would not have to take 6mg of Xanax a day since Prozac works pretty well for anxiety disorders, though not at good as Paxil but there's no Zyprexa/Paxil combo pill so I will see if my Psychiatrist is feeling like Symbyax might be a good choice (BTW I usually just ask about or simply mention a med and she just goes with it; love my liberal doctor) however, she is strict with all benzos and even z-drugs like Ambien, so I get my Xanax from a different doctor. Yea she gets frustrated when she looks at the PDMD and sees that I filled Xanax XR 3mg #60, Xanax 1mg #90, and Xanax 2mg #90 within like 7-12 days of each other 🤦‍♂️this is why I plan to not have another psychiatrist visit with her for at least a month or else I'll get lectured about filling benzos and dextroamphetamine (Zenzedi) 30mg #90 plus Klonopin brand name #90 just a month ago. I even had to sign a benzo contract after I got caught Dr. shopping my first time around get RXs for Xanax. So she might even tell me that she won't see me as a patient anymore since half the meds I take for mental health are not written by my Psychiatrist 🙄

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18 hours ago, mmaryland said:

Too bad that Trintellix is pretty activating as it triggered a 2-3 week manic episode

Yeah I can't quite figure out that 5mg dose. It's pretty agitating for me and I usually have to increase back to 10mg to start calming down.

18 hours ago, mmaryland said:

I was hypersexual, opened 2 credit cards in my Dad's using his SSN and name, then spent over $1,000 on the AMEX and another $1,200 on the CapOne mastercard, I barely slept so I looked high more than half the time because I had gotten a couple hours or no sleep at all. Man bipolar disorder is freaing exhausting,

Hell yeah it is!

18 hours ago, mmaryland said:

What I am seriously considering is getting prescribed Symbyax, Zyprexa and Prozac pill combination, as the Zyprexa would prevent Prozac mania and I would not have to take 6mg of Xanax a day since Prozac works pretty well for anxiety disorders, though not at good as Paxil but there's no Zyprexa/Paxil combo pill so I will see if my Psychiatrist is feeling like Symbyax might be a good choice

Believe it or not, even though Symbyax is now available as a generic, most insurance companies still won't cover it. I have really good insurance and mine won't cover it. You'd be better off just taking 10mg of olanzapine and 20-40mg of fluoxetine and calling it a day.

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