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Posted (edited)

I saw my pdoc today...She is finally going to try me on a new med that  I've never had before.

She has recommended a change from WB to Trintellix.

What I'll be starting tomorrow will be an 8 day taper off Wellbutrin......100mg SR 2x day for 5 days, then 100mg SR once a day for 3 days, then stop WB......The next day I'll be starting 5mg Trintellix for 7 days, then go up to 10mg until I see her again next month.

Does this sound too fast or not?........Also, don't know really what to expect from Trintellix....I've heard and read it can cause GI side effects..

Anybody ever actually tried it, and what was your experience?

All advice and opinions welcome...!!

Also, reaching out to @mikl_pls, @browri @argh  @notloki @Iceberg.....What do y'all think?

Edited by CrazyRedhead

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I did a (2-month?) trial on Trintillex, with no effect on me at all, I was only on Lamictal at the time. I was told it's like "Prozac light" with more of a cognitive boost. Good luck!! Might be great if you're sensitive to side effects (I usually have some) but with this, nada!

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Posted (edited)

@Blahblah, thanks for your input......Wow, you had no side effects, that's wonderful, but also I'm sorry it didn't help you.............I've already tried most of the usual suspects, so it won't hurt to give it a whirl, I guess.

Edited by CrazyRedhead

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I had a pretty terrible time with Trintellix both times I took it. It worsened my depression and anxiety significantly and made me so nauseous I couldn't eat. But everyone is different. It didn't help my mom at all (but didn't do bad things to her), and it really helped my dad quite a lot at just 5 mg—we had to have him switched to something else though because of financial reasons (parents are on Medicare and can't use copay coupons with Medicare to my knowledge).

@browri swears by Trintellix as it works extremely well for him. He has been taking it for a while now.

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I know that my pdoc thinks it is very good for depression as long as anxiety isn’t the main issue. I don’t think it is necessarily too fast because you need it to transition fast enough to pick up the slack that the Wellbutrin may leave behind. I’d be worried if she didn’t leave you on 10 for awhile but that doesn’t seem to be the case. I think a lot of people find it not sedating (although not necessarily as activating as Wellbutrin can be) but it seems like a logical move and worth a shot. Probably possible that you get some start up anxiety/jitters but YMMV

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Posted (edited)
40 minutes ago, mikl_pls said:

I had a pretty terrible time with Trintellix both times I took it. It worsened my depression and anxiety significantly and made me so nauseous I couldn't eat. But everyone is different. It didn't help my mom at all (but didn't do bad things to her), and it really helped my dad quite a lot at just 5 mg—we had to have him switched to something else though because of financial reasons (parents are on Medicare and can't use copay coupons with Medicare to my knowledge).

@browri swears by Trintellix as it works extremely well for him. He has been taking it for a while now.

I'm sorry it didn't work for you, and for your dad's situation.....Seems like it works for some, others not so much...

Oh well, I'm going to give it a try, see what happens.....Thanks for letting me know your experience.

Edited by CrazyRedhead

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6 minutes ago, Iceberg said:

I know that my pdoc thinks it is very good for depression as long as anxiety isn’t the main issue. I don’t think it is necessarily too fast because you need it to transition fast enough to pick up the slack that the Wellbutrin may leave behind. I’d be worried if she didn’t leave you on 10 for awhile but that doesn’t seem to be the case. I think a lot of people find it not sedating (although not necessarily as activating as Wellbutrin can be) but it seems like a logical move and worth a shot. Probably possible that you get some start up anxiety/jitters but YMMV

I have bad depression and bad anxiety....Both about equal in severity.....I don't know yet if she will try to increase to more than 10mg....Guess it depends how I do.

Start up anxiety is a PITA, but I've tried enough meds to know it eventually goes away, most of the time, anyway.

Yes, I think it's worth a shot, too....Thanks for your perspective.

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2 hours ago, mikl_pls said:

(parents are on Medicare and can't use copay coupons with Medicare to my knowledge).

Not co-pay coupons but services like www.goodrx.com, where you pay full retail less their discount are OK because you are not going through medicare, just paying cash. 

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3 minutes ago, notloki said:

Not co-pay coupons but services like www.goodrx.com, where you pay full retail less their discount are OK because you are not going through medicare, just paying cash. 

I see. Well in that case it would be cheaper to just get it through Medicare. The copay used to be $60 for him with Trintellix, but it went up to $80, and that's why he switched. He's on Zoloft now and is doing quite well with it. The Trintellix really did help him cognitively though—he likely has some degree of dementia that has set in, no one has "confirmed" it yet, and really no one but our pdoc and his heart doc recognize it.

1 hour ago, CrazyRedhead said:

I'm sorry it didn't work for you, and for your dad's situation.....Seems like it works for some, others not so much...

Oh well, I'm going to give it a try, see what happens.....Thanks for letting me know your experience.

Yep! To each their own with their own brain chemistry lol... I really hope it works for you! If you get to 10 mg and you feel a bit overstimulated or too nauseous, it might be good to step back down to 5 mg for a little while longer, or probably take the 10 mg every other day. This would be of course provided that you talk to your pdoc about it first. I'm not trying to tell you how to take your medicine lol. Best of luck!

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When I switched meds, countless times, my pdoc put me on a very fast tapering schedule and it worked. The “recommended” titration times are often way longer than is actually needed, for the medicine companies to leave a wide safety margin.

As for Trintellix itself, it was basically a placebo for me, so I can't tell anything about it.

Good luck with the new med.

 

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I took it for about five years with good results. It helped stimulate me cognitively, controlled my depression for the most part, and gave me some more energy. I did find the relatively standard dose of 20mg to be too agitating, so my Pdoc put me on 15mg, which was fine until my insurance company recently started pushing back against my taking a non-standard dose (three 5 mg pills instead of one or two 10 mg pills). So they insisted after some pushback from my doctor that I had to be on a ten and a five, and then pay two separate copays of $50 each a month. I needed some med changes anyway, so got off of it. But overall I liked it at 15mg. Of course, YMMV. I hope it works out for you.

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Posted (edited)

Thanks everyone for your input....!!......

After tapering off the WB this coming week, I will be starting the Trintellix at 5mg next Saturday, stay at 5 mg for a week, then move up to 10mg.......If the 10mg seems too much too soon,  I will definitely call doc and ask if I can stay on 5mg a bit longer before increasing.

Edited by CrazyRedhead

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Posted (edited)

  Just wanted to add my experience on brintellix (trintellix in some regions).

 

I noticed a clear lack of effect from cigarettes for a bit, but it passed for me. (Not sure if it has been investigated for smoking cessation)

Some foods take on a weird and not very pleasant taste. This did not pass for me.

Reading back through my journal I also noticed some headaches, although I'm not sure how much brintellix added to it.

Didn't do much for my depression, and still had me taking naps during the day.

 

Keep in mind that these were my reactions.

I hope it works out for you,

- parm

Edited by parm
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2 hours ago, parm said:

Keep in mind that these were my reactions.

I hope it works out for you,

- parm

Thanks, parm, for relating your experiences.......I appreciate it.!!

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1 hour ago, CeremonyNewOrder said:

it did nothing whatsoever for me (good or bad)

I'm sorry it didn't help you, but thanks for the input...

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On 10/3/2019 at 5:48 PM, mikl_pls said:

I had a pretty terrible time with Trintellix both times I took it. It worsened my depression and anxiety significantly and made me so nauseous I couldn't eat. But everyone is different.

I find it validating that someone else had the same problems with it that I did. Still I think there is a good chance that it will work well for you, @CrazyRedhead, and I'm crossing my fingers for you

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41 minutes ago, Ion said:

Still I think there is a good chance that it will work well for you, @CrazyRedhead, and I'm crossing my fingers for you

Thanks, Ion....!!

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It perked me up, I needed a boost to get through winter and it helped.  I did have some nausea starting out, but it was not severe and got better after a week.  The only bummer side effect was that it made me have an aversion to coffee, I couldn't stand it anymore.  It was weird.  The reason I stopped taking it was because it cost $1000 for a refill (that is with the discount coupon) when my prescription plan changed in January.  So now I have to look at the upside that I can enjoy my coffee again.  I hope it works for you!

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@CrazyRedhead how is your taper going? Sorry I didn't chime in sooner. This is like the first time I've signed onto CB in several weeks. I do hope it is going well.

No doubt if you've been on Trintellix for a few days you already know what kind of side effects you are personally experiencing. If you want to talk about any of them, I'd be glad to oblige. One of the ones that is oft complained about is the nausea, which for me pretty much went away after a few weeks. For some people it doesn't. Now whenever I experience it, I kind of feel more like it's dyspepsia and acid reflux, it doesn't feel like your typical "omg I'm about to hurl." That level of nausea never really happened to me.

However, @mikl_pls is definitely right. I swear by Trintellix. I've tried Zoloft, Celexa, Wellbutrin, Viibryd, Pristiq, Effexor, Cymbalta, Lexapro, Prozac. I think Paxil, Luvox, and Fetzima are the only other major ones I haven't tried (no tricyclic experience here). For me, Trintellix bests all the others. However, if for whatever reason I couldn't take Trintellix anymore, I would probably go back to Pristiq or Prozac.

Something to keep in mind with the 5mg dose is that it can be activating. I remember the first time I took Trintellix, the first 2 weeks of 5mg I was kind of snappy/reactive and irritable. Increasing to 10mg calmed things down a bit, and ultimately that winter I went to 15mg which was even more calming. Oddly enough though, for me, 20mg feels like it starts to move back in the opposite direction towards stimulating yet still calming at the same time. Like a bell curve. Idk all I can say is that after taking Trintellix almost continuously since 2017, I have come to the conclusion that Trintellix is not your average antidepressant. That doesn't mean it's going to work for everyone, but it does mean where literally everything else has failed to provide complete relief, that doesn't mean you should discount Trintellix as a viable option.

On 10/3/2019 at 5:06 PM, Iceberg said:

I know that my pdoc thinks it is very good for depression as long as anxiety isn’t the main issue.

Interestingly enough, they've done several studies on Trintellix with anxiety. They've even compared it directly to Cymbalta, and in truth it actually failed to truly best Cymbalta in generalized anxiety disorder. HOWEVER, they did another study where the only patients who were accepted were those that had very high anxiety baselines (high basal anxiety), specifically those where anxiety and depression were both present but anxiety was the more major and core problem to the patient's condition. In this study, Trintellix helped significantly. So it would seem that for those patients with anxiety that occurs acutely but who most of the time have lower anxiety levels overall, could potentially have their anxiety worsen with Trintellix. This is yet another example of the kind of weirdness that Trintellix exhibits as a medication. Its patient population can be oddly specific, yet for those people, Trintellix works like nothing else does. And for those that don't fit inside that box, it doesn't mean Trintellix won't work for you, but from what I've read at that point the chances of it working are like 50/50.

Read the two following articles, and you'll get an idea of what I mean about oddly specific patient populations. Pre-treatment function is indicative of how you may respond to Trintellix. It would seem that Trintellix has more anxiolytic efficacy when the patient is actively working or pursuing an education.

https://www.ncbi.nlm.nih.gov/pubmed/29081307

https://www.psychiatryadvisor.com/home/topics/anxiety/pretreatment-functioning-associated-with-anxiolytic-efficacy-of-vortioxetine/

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