# Trintellix horror



## Dylan2 (Jun 3, 2012)

*Trintellix+Cannabis horror*

I had a terrible experience by mixing vortioxetine (Trintellix) and cannabis.

I've been experiencing derealization and other issues for the past six horrible days. It feels like I'm in a movie, watching someone in my body as he interacts with people. I don't always act when I should. I stand in the kitchen waiting for the guy in the movie to do something. But I'm the guy. It's also been hard to focus, speak, and remember things. And it's like I experience decreased FPS... I miss frames as people move towards me. Suddenly they're in my face.

This morning I forgot my daily dose of Trintellix and 12 hours later I'm starting to feel kinda normal. I looked at the literature and found that both Trintellix and THC inhibit activity at the 5-HT3 receptor. Heightened activity at this receptor can cause seizures. Maybe derealization is like the opposite of a seizure?

So I want to quit Trintellix cold turkey. I haven't been using cannabis since the event happened six days ago. But I think my 5-HT3 receptors need a chance to warm up again. Any thoughts? Experiences? I would also be curious as to what the amateur pharmacologists (lols) in this forum think of the combination of cannabis and Trintellix.

Thanks! : )

*Edit: I don't mean to scare people away from Trintellix. It can be a very helpful medication for depression. Just be careful what you mix it with.*


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## jaiho (Feb 14, 2015)

Don't you mean Cannabis horror?
Was Trintellix working before you smoked cannabis?

A DP episode induced by cannabis can last quite awhile, its likely wearing off now. I wouldn't quit Trintellix just yet.


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## Dylan2 (Jun 3, 2012)

jaiho said:


> Don't you mean Cannabis horror?
> Was Trintellix working before you smoked cannabis?


Trintellix was working very well for months. Mostly for my depression though, not so helpful with my social anxiety. But my social anxiety is controlled fairly well by CBT.



jaiho said:


> A DP episode induced by cannabis can last quite awhile, its likely wearing off now. I wouldn't quit Trintellix just yet.


There doesn't seem to be much research on longterm derealization following cannabis exposure. I came across a bunch of anecdotes of it lasting months or years though. I realize I might just be experiencing spontaneous remission. I think it's somewhat unlikely though, given my dramatic recovery. I was in Hell this morning, then around the time I would normally feel withdrawal symptoms from missing a dose of Trintellix, BOOM, I'm no longer in a movie.


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## jaiho (Feb 14, 2015)

Trintellix is still well within your system after 12-24 hours.
You're probably thinking its because of the medication, but DP/DR from cannabis is usually because your anxiety has increased.
In my experience DP/DR is when anxiety has reached a point that you can no longer tolerate and the mind disconnects from the body, a disassociation as a coping mechanism.

If it doesn't go away maybe look at augmenting Trintellix to get it more effective? Perhaps nortriptyline or wellbutrin.


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## Dylan2 (Jun 3, 2012)

jaiho said:


> Trintellix is still well within your system after 12-24 hours.
> You're probably thinking its because of the medication, but DP/DR from cannabis is usually because your anxiety has increased.
> In my experience DP/DR is when anxiety has reached a point that you can no longer tolerate and the mind disconnects from the body, a disassociation as a coping mechanism.


Yes there's still plenty of Trintellix in my system. This was 36 hours later though. 12 hours since missed dose and I take it once a day. 12 + 24 = 36. I feel somewhat normal now and I'm hoping I'll feel even better in the coming days.

The odd thing about the derealization is that I experienced no anxiety at all for the first four days. In contrast to almost everything I've read. I was however stressed out over the past two days about the possibly of the symptoms being permanent. The lack of anxiety gives further credence to the 5-HT3 idea, in my opinion.



jaiho said:


> If it doesn't go away maybe look at augmenting Trintellix to get it more effective? Perhaps nortriptyline or wellbutrin.


Thanks for the tips! I'll be talking to my doctor tomorrow about options. I was on Zoloft for a while and found it was amazing for my social anxiety but made it hard to focus on school work due to the fatigue side effect. Might try that again. Wellbutrin didn't work for me in the past.


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## DarkHoarse (May 17, 2017)

I have a good friend who suffered from depersonalization/derealization, and he said that each time it began or got worse corresponded with a time where he had smoked weed, so I'm sure there is some merit to your theory. He also said he was treated with SSRI's for the depersonalization as it was very bad, and eventually achieved full remission on them, so maybe the Zoloft might be a good idea. I personally did feel a little more disassociated with reality while I was on Trintellix for 3 months, but it was nothing to the extent that your describing. Luckily that was just a short term side effect for me (as soon as I stopped taking it I felt normal again).


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## Captainmycaptain (Sep 23, 2012)

Countless people, including myself, have experienced long term derealization after a particularly bad experience smoking weed. For me, it went on for two years in high school, seeing everything as a movie while I walked down the halls and in class. This feeling completely destroyed my last two years in high school. I don't remember if being in that derealization state caused me to start avoiding people or I was doing it as shame for not having friends and didn't want people to say bad things about me after I passed them in the halls, but I was a ghost at that high school for the last two years and people would sometimes say to me, "I didn't know you still go here." 

The derealization started to go away after I started university. Unfortunately, this was the point when my OCD started to control every thought and action of my life. In fact, I showed the beginning signs of OCD in high school during the derealization phase, where I would feel compelled to tap the railways of the school a certain number of times before reaching the end. During this entire time, I had never heard of OCD and thought I was the only person having these thoughts and compulsive behavior. I wasn't until I read a chapter in Howard Stern's Miss America where he talks at length about grappling with OCD while on the radio, that I understood that other people have the same problem. That was quite a relief. He also mentioned on the radio that the OCD started shortly after accidentally taking four hits of acid when he was only supposed to take one. I have no doubt that my experience on marijuana spawned my derealization, depersonalization, withdrawal from people and OCD. In short, from my experience and from other stories I have read, derealization after marijuana use can go on for upwards of two years. It's not a permanent feeling, however.


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## sad1231234 (Jul 10, 2016)

You gotta be really careful and wary about what drugs/medications/alcahol that you mix together. This might not be so relevant but although i never took drugs i still experience derealization frequently, not to that extent but enough to know that something is wrong with me. Either way, do be cautious of what you take.


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## Dylan2 (Jun 3, 2012)

DarkHoarse said:


> I personally did feel a little more disassociated with reality while I was on Trintellix for 3 months, but it was nothing to the extent that your describing. Luckily that was just a short term side effect for me (as soon as I stopped taking it I felt normal again).


Thanks for sharing your experience. I actually just looked at the product monograph for Trintellix and found that derealization/depersonalization are listed as infrequent side effects. I had no idea. I'm glad your side effects cleared up!


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## Dylan2 (Jun 3, 2012)

Captainmycaptain said:


> Countless people, including myself, have experienced long term derealization after a particularly bad experience smoking weed.


Thank you for sharing your story! So you're no longer experiencing the derealization? But now you're stuck with OCD and SAD? No fun


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## naes (Nov 1, 2013)

Interesting. I'm on it atm b/c i've been depressed on lexapro (which i have been on for a long time) but trintellix is worse than lex. Plus, it touts itself as not having sexual side effects, but that is bogus so far.


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## Dylan2 (Jun 3, 2012)

naes said:


> Plus, it touts itself as not having sexual side effects, but that is bogus so far.


Yes, that was bogus in my experience. Trintellix has been great for my depression though.


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## Dylan2 (Jun 3, 2012)

Update. It's been 13 hours since I started to feel normal. I'm continuing to improve. Definitely not feeling like I'm in a movie anymore. My psychiatrist advised me to skip a few doses of Trintellix and then start up again at a lose dose. Sounds good to me.


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## naes (Nov 1, 2013)

Dylan2 said:


> Update. It's been 13 hours since I started to feel normal. I'm continuing to improve. Definitely not feeling like I'm in a movie anymore. My psychiatrist advised me to skip a few doses of Trintellix and then start up again at a lose dose. Sounds good to me.


Ho many mg were you put on originally?


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## Dylan2 (Jun 3, 2012)

naes said:


> Ho many mg were you put on originally?


10mg for a few months. 20mg (which is the max dose) for roughly a year. 10mg was ok in most areas but didn't help with my slowed speech and movement relating to my depression (DSM psychomotor retardation). I experienced sexual side effects at both doses.


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