# New drug Trintellix (vortioxetine) with my Zoloft Journal!



## gilmourr (Nov 17, 2011)

So I'm giving this a test run with my Zoloft of 150 mg (seems like I can't go higher without inducing lethargy and complete exhaustion).

I'm taking 5 mg of vortioxetine to avoid getting an NRI effect. I will titrate higher and higher but I think 5 mg should be fine to get a SRI and post synaptic serotonin receptor effect.

We'll see how it goes. Really long half life though at 66 hours though.


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## butterz (Aug 8, 2013)

Brinti is a SSRI are you sure you can mix this with zoloft?
Does your doc think this is safe?


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## gilmourr (Nov 17, 2011)

butterz said:


> Brinti is a SSRI are you sure you can mix this with zoloft?
> Does your doc think this is safe?


It's a SSRI with features on post synaptic serotonin receptors. Zoloft inhibits Vortioxetine which is why I started low on the dose.

You won't know until you try it but it's reasonably safe (I'd give it like a 90% safety profile).


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## UltraShy (Nov 8, 2003)

butterz said:


> *Brinti is a SSRI* are you sure you can mix this with zoloft?
> Does your doc think this is safe?


Brintillix isn't an SSRI. It an atypical antidepressant.

According to the interaction checker at drugs.com one MAJOR interaction is found: *Using sertraline together with vortioxetine can increase the risk of a rare but serious condition called the serotonin syndrome,...*

I have no experience with it, so I have no idea if one should take that warning seriously or not. There are other major interactions that I entirely ignore, like how I've taken 60mg of Adderall within the last day with 75mg of Nardil and I'm not dead even though drugs.com, and many other interaction checkers & warnings, say I should be.

Offhand, I don't see why the mix should be deadly. How does it raise serotonin any more than a larger dose of either drug individually? I've taken 300mg of Zoloft and lived to tell about how it didn't work and I've heard of Zoloft being used up to 400mg for OCD.


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## Learydp01 (May 2, 2013)

For all intents and purposes, it's an SSRI. It targets specific 5-HT receptors, so they gave it a fancy new name (serotonin modulator and stimulator/SMS), but it's still mostly serotonin reuptake inhibition, and in my experience, being on one still feels almost exactly the same as every other SSRI.

The theory behind SMS's is that certain serotonin receptors are either neutral or counterproductive towards treating depression, so it's a partial agonist of some receptors and and antagonist of others.


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## gilmourr (Nov 17, 2011)

Learydp01 said:


> For all intents and purposes, it's an SSRI. It targets specific 5-HT receptors, so they gave it a fancy new name (serotonin modulator and stimulator/SMS), but it's still mostly serotonin reuptake inhibition, and in my experience, being on one still feels almost exactly the same as every other SSRI.
> 
> The theory behind SMS's is that certain serotonin receptors are either neutral or counterproductive towards treating depression, so it's a partial agonist of some receptors and and antagonist of others.


I can't see how it would be counterproductive. A SRI inhibits transporters which build up more serotonin in individual synapses. It acts as an AGONIST for whatever post synaptic receptors it has highest affinity with. This med would antagonize certain receptors that may lead to a therepeutic change


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## gilmourr (Nov 17, 2011)

UltraShy said:


> Brintillix isn't an SSRI. It an atypical antidepressant.
> 
> According to the interaction checker at drugs.com one MAJOR interaction is found: *Using sertraline together with vortioxetine can increase the risk of a rare but serious condition called the serotonin syndrome,...*
> 
> ...


And yeah atypical antidepressant is just some name they gave it. It has highest binding affinity with serotonin transporters which makes it a SRI at least. It also has other functions. NRI at high doses.


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## Learydp01 (May 2, 2013)

gilmourr said:


> I can't see how it would be counterproductive. A SRI inhibits transporters which build up more serotonin in individual synapses. It acts as an AGONIST for whatever post synaptic receptors it has highest affinity with. This med would antagonize certain receptors that may lead to a therepeutic change


I'm not saying that the medication itself is counterproductive, I'm saying that certain, specific 5-HT receptors may play a counterproductive role. For example, activation of 5-HT3 is thought to contribute to the feelings of nausea and vomiting that SSRI's often induce.


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## butterz (Aug 8, 2013)

Maybe I'll try brinti in the future too but I am not really convinced of it.
They're making such a fuss about it as if it's something entirely different. 

I don't know if taking 2 ssris in moderate doses is the same as taking 1 ssri at a high dose. They could also affect each other's metabolism and create side effects this way.


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## gilmourr (Nov 17, 2011)

Learydp01 said:


> I'm not saying that the medication itself is counterproductive, I'm saying that certain, specific 5-HT receptors may play a counterproductive role. For example, activation of 5-HT3 is thought to contribute to the feelings of nausea and vomiting that SSRI's often induce.


My bad, I have no idea how I read your post so incorrectly. I don't think that's ever happened to that degree.


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## gilmourr (Nov 17, 2011)

butterz said:


> Maybe I'll try brinti in the future too but I am not really convinced of it.
> They're making such a fuss about it as if it's something entirely different.
> 
> I don't know if taking 2 ssris in moderate doses is the same as taking 1 ssri at a high dose. They could also affect each other's metabolism and create side effects this way.


It is something entirely different lol.

It is a SRI that works on post synaptic serotonin receptors. Antagonizing or agonizing certain receptors can make the difference.

For metabolism issues just review a CYP450 P interactions table and see if one inhibits or induces the other. My zoloft inhibits a bit of the metabolism for the drug which is why I'm taking a lower dose since it builds up.


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## UltraShy (Nov 8, 2003)

Learydp01 said:


> For all intents and purposes, it's an SSRI.


Does that mean it comes with all the standard SSRI sexual side effects that are so loved by everyone?


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## gilmourr (Nov 17, 2011)

Day 2- Just noticed I've been more tired than usual and napping. I normally do this when I increase my Zoloft to higher doses, so I figure it's just the SRI function.

I also feel a little bit more depressed than usual. Not much nausea or anything, though it did upset my stomach for a bit yesterday.


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## Learydp01 (May 2, 2013)

UltraShy said:


> Does that mean it comes with all the standard SSRI sexual side effects that are so loved by everyone?


Yes. The funny thing though, when the drugs first came out, the companies claimed that they didn't. Viibryd used to boast on it's website that it was the antidepressant that had no sexual side effects - it appears they've taken that part down.


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## swim (Apr 4, 2011)

It will be introduced here soon too but I don't know whether it affects NE or not.


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## swim (Apr 4, 2011)

Learydp01 said:


> Yes. The funny thing though, when the drugs first came out, the companies claimed that they didn't. Viibryd used to boast on it's website that it was the antidepressant that had no sexual side effects - it appears they've taken that part down.


well at least vilazodone doesn't mess with the cyp2d6 so way less drug interactions than vortioxetine.


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## butterz (Aug 8, 2013)

gilmourr said:


> Day 2- Just noticed I've been more tired than usual and napping. I normally do this when I increase my Zoloft to higher doses, so I figure it's just the SRI function.
> 
> I also feel a little bit more depressed than usual. Not much nausea or anything, though it did upset my stomach for a bit yesterday.


Sounds like it's already starting to do its magic. 










Maybe the strategy of Brinti is simply to make you so tired that you don't care
about being depressed anymore.


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## SSRIManiac (Jun 14, 2014)

I have tried Vortioxetine and it was horrible.


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## gilmourr (Nov 17, 2011)

SSRIManiac said:


> I have tried Vortioxetine and it was horrible.


What dosage did you start at? Why was it horrible? Be as detailed as possible please


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## gilmourr (Nov 17, 2011)

Day 3 - Gives me an inner restlessness feeling. I definitely feel more anxious and on edge taking it which is good TBH because things that normally work make me feel anxious as **** to begin with. 

Gonna drop my dose of Zoloft down though because I think the SRI is too high ATM with 150 mg of zoloft + 5 mg of vortioxetine. I'm just way too tired.


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## butterz (Aug 8, 2013)

Sounds a bit scary. What if this is serotonin syndrome?


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## gilmourr (Nov 17, 2011)

butterz said:


> Sounds a bit scary. What if this is serotonin syndrome?


Lol, it isn't.


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## gilmourr (Nov 17, 2011)

Day 5 - I don't seem to have any side effects from the Trintellix (vortioxetine). I'm still going to wait another 4-5 more days before moving up to 10 mg.

I moved down to 100 mg of Zoloft. I feel like I might be a bit more depressed but it isn't unmanageable yet. 

I just want my brain to function again so that I can do some work. Tired of playing games and watching NetFlix. I just can't absorb anything so it's almost pointless to try


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## butterz (Aug 8, 2013)

how long has this been going and what have you tried already?


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## gilmourr (Nov 17, 2011)

9th day. Still no side effects it seems. It may be making me more tired with the Zoloft, but it might just be the Zoloft.

I'm undecided whether I'll move up to 10 mg tomorrow or 14 days in.

Does anyone understand why they would make a pill that has 5HT3 antagonism? I read that a LOT of people have nausea (I don't yet) and it seems that antagonizing the receptor would upregulate 5HT3 receptors and cause nausea long term.


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## butterz (Aug 8, 2013)

This sounds scary.

Maybe Lundbeck's currently working on an anti-nausea pill to counter the long term side effects of vortioxetine.


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## gilmourr (Nov 17, 2011)

10th day, taking 5 mg again since I had a very large depressive low this morning to the point where all I could do is sleep. I can't even explain how bad it felt but luckily it passed and now I'm back to a more moderate depressive level.

I continue to be on 5 mg + 150 mg of Zoloft. I intend to go up to 10 mg shortly...sometime between day 10 and 14.


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## butterz (Aug 8, 2013)

Have you tried zoloft + wellbutrin or zoloft + nortriptyiline?
This would also be an option. 
Or zoloft + remeron.


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## gilmourr (Nov 17, 2011)

butterz said:


> Have you tried zoloft + wellbutrin or zoloft + nortriptyiline?
> This would also be an option.
> Or zoloft + remeron.


I've tried Zoloft + wellbutrin and it made me more depressed since NRI's always are awful for me.

Same thing with nortriptline. Wellbutrin was worse.


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## butterz (Aug 8, 2013)

That's weird. Do you have a theory why this is? Or does your doc have one? What happens when you take a NRI?


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## Caedmon (Dec 14, 2003)

Lithium +/- Provigil an option?

Lots of day-to-day experiential reports. Have you ever tried activity tracking? Explanation:
http://www.web4health.info/en/answers/bipolar-self-monitor.htm
Thorough explanation:
http://en.wikipedia.org/wiki/Behavioral_activation

Example:
http://media.psychology.tools/worksheets/english_us/cbt_daily_activity_diary_en-us.pdf? I have done this before, with hourly breakdown, and didn't always start on a Monday so I just used blank columns, and had hours listed from 6 AM to 1 AM (if I were up late). I don't use it anymore but it was helpful at first, to discover the acute impact of events and activities. I wrote 1-3 words on what I did that hour + a number from 0-100 on how strong the depression felt.

There are a million ways to do this. Another one:
http://healthypsych.com/wp-content/uploads/2014/02/CBT_Activity-Log.pdf

Print a couple and try it for 2-4 weeks. Longer if you feel like it. It's usually very illuminating. You can track anxiety too. Or any feeling, really.


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## gilmourr (Nov 17, 2011)

Lithium and provigil definitely can work. Provigil kept me awake with Zoloft but it seemed to sometimes cause more mental instability. It definitely was the best stimulant (even though it isn't) slash wakefulness medication I've tried. It might be different with lithium. I should give that a go next. 

I'll also try the experiential reports even though I'm fairly certain im not bipolar given that my mood spikes only when I'm playing games, and even then it's not much of a spike


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## gilmourr (Nov 17, 2011)

Day 11, decided to up my dosage to 10 mg. I can go back down if it's too powerful or makes my depression worse. I currently don't have any side effects or effects at 5 mg and it might be just a bit too weak.


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## SSRIManiac (Jun 14, 2014)

gilmourr said:


> What dosage did you start at? Why was it horrible? Be as detailed as possible please


I started at 10mg and in a matter of a week I felt worse. More depressed and really down about myself. I kept telling myself I suck in my head.


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## gilmourr (Nov 17, 2011)

SSRIManiac said:


> I started at 10mg and in a matter of a week I felt worse. More depressed and really down about myself. I kept telling myself I suck in my head.


Well the good thing is that I'm not experiencing that. Side effects are minimal atm.

This is my 2nd day on 10 mg and I think 13th day altogether and I seem to only have mild headaches that go away with advil.

I'm getting quite tired so I might cut down on my Zoloft as I raise the dose of Vortioxetine.


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## butterz (Aug 8, 2013)

What does your doc say how high you can go with both drugs?


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## gilmourr (Nov 17, 2011)

butterz said:


> What does your doc say how high you can go with both drugs?


I'm seeing a GP that pretty much trusts my opinion with regard to medications since I do the research on them and haven't ever ****ed up. Never even been to the ER and had depression remission for a year so I guess that's a sign I'm doing something right. So how high? Well I don't want it to act as a NRI, so 100% not past 20 mg. Either 10-20 mg max, then I'm off to try something else.

Yesterday I took 10 mg Trintellix and 100 of Zoloft. Wasn't as tired yesterday but now I'm feeling some afternoon sleepiness. Maybe it was from going out last night. No depressive crash yet since lowering my Zoloft.


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## butterz (Aug 8, 2013)

If vortioxetine can really cause long term nausea by upregulating the receptors then I'm really speechless I mean how stupid is this!? :mum
Who wants to take this crap then?


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## gilmourr (Nov 17, 2011)

butterz said:


> If vortioxetine can really cause long term nausea by upregulating the receptors then I'm really speechless I mean how stupid is this!? :mum
> Who wants to take this crap then?


I didn't say it does that, but usually antagonizing a receptor creates more receptors in the long run. It still may have a net anti-nausea effect.

Another 100 mg Zoloft + 10 mg of Vortioxetine today. No effects. Bit tired. Not nauseous..yet.

5 hours later I don't seem to have any nausea. I do feel pretty wired + tired though.


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## Ben12 (Jul 8, 2009)

Hey Gilmourr, have you tried Tianeptine sodium salt or Tianeptine sulphate?


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## gilmourr (Nov 17, 2011)

Ben12 said:


> Hey Gilmourr, have you tried Tianeptine sodium salt or Tianeptine sulphate?


I haven't yet, but I believe it's a SSRE. I just can't see it being good for me if SSRI's have all been closer to remission for me than anything. NRI's make me crazy so I would think having a lower serotonin to norepinephrine ratio might make things worse.

EDIT: Oh wow, its been updated that apparently it's not a SSRE anymore...wtf.

I 100% will get this then given that it works on mu opioid receptors and how percocets always get rid of my depression. Know of any good places to buy stablon? Can't get it in Canada. Have to ship it.


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## gilmourr (Nov 17, 2011)

Ben12 said:


> Hey Gilmourr, have you tried Tianeptine sodium salt or Tianeptine sulphate?


I read up a bunch on Tianeptine tonight and decided to order 2 grams of it (sulphate). What's good is I can take it with zoloft. I really don't want to have to go off zoloft even though its effect is like 50% of what it used to be. I don't want to be even lower than where I am now and that's where I'll be if I go off Zoloft.


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## gilmourr (Nov 17, 2011)

Day 15 - 10 mg of Vortioxetine, 100 mg of Zoloft. I feel like my mood is descending which may either be from the vortioxetine or the lack of as much zoloft...but I had to lower my Zoloft dose since I had too much serotonin reuptake inhibition. It was leaving me super sedated.

I forgot how difficult almost anything is when your mood descends. I'm in a place where everything irritates me atm and I don't want to do anything


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## Ben12 (Jul 8, 2009)

gilmourr said:


> I read up a bunch on Tianeptine tonight and decided to order 2 grams of it (sulphate). What's good is I can take it with zoloft. I really don't want to have to go off zoloft even though its effect is like 50% of what it used to be. I don't want to be even lower than where I am now and that's where I'll be if I go off Zoloft.


I ordered the sulphate version as well. Yeah it's got some opioid properties which is an excellent change from the typical antidepressants that are prescribed these days. I hope it works well for you. I've read a lot of positive things about it. The sulphate version looks promising too. I like how they've developed a longer acting version of the drug.


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## gilmourr (Nov 17, 2011)

Ben12 said:


> I ordered the sulphate version as well. Yeah it's got some opioid properties which is an excellent change from the typical antidepressants that are prescribed these days. I hope it works well for you. I've read a lot of positive things about it. The sulphate version looks promising too. I like how they've developed a longer acting version of the drug.


I'm researching Tianeptine to see what's the best dose to use. It seems like 40 mg/day is standard. There's a lot not known about this drug though it seems given that people thought it was a SSRE before.


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## gilmourr (Nov 17, 2011)

Day 18 - very surprised by the lack of side effects being on Zoloft 100 mg and 10 mg of vortioxetine. The wait for something to happen is brutal and frustrating. My sleep seems to be worse. I just dream so horribly that I have no energy.


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## butterz (Aug 8, 2013)

isnt it dangerous to order drugs online? how do you know you even get the real stuff? what if it's fake or impure?


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## gilmourr (Nov 17, 2011)

The person is like a moderator on reddits stack advice forum. Plenty of good reviews. It's fine


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## gilmourr (Nov 17, 2011)

Still on 10 mg of vortioxetine. Haven't experienced any new side effects except the nausea which is pretty random at times. Have a wedding to go to in like a few weeks so I'm not sure whether to increase my dose in the next week.


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## butterz (Aug 8, 2013)

I am on 5mg vortioxetine.
Last night I got really annoying muscle twitching in my leg muscles!
This is definitely from the drug.

What's also strange is that last morning upon waking up I had the typical brain zaps! How is this possible? How can you have brain zaps when you're on a SSRI and not withdrawing?


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## gilmourr (Nov 17, 2011)

It has a long half life. When you stop taking your SSRI it'll leave your system fast unless it's Prozac. With a slow replacing SSRI it'll take a few days to catch up like 5-7. Take a low dose of your old SSRI until your zaps go away


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## butterz (Aug 8, 2013)

@ gil

Do you worry about the safety of vortioxetine? I read a few warnings that one shouldn't go on brand new drugs cause there might be unknown side effects or interactions. This worries me. I don't want to be a lab rat.


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## gilmourr (Nov 17, 2011)

butterz said:


> @ gil
> 
> Do you worry about the safety of vortioxetine? I read a few warnings that one shouldn't go on brand new drugs cause there might be unknown side effects or interactions. This worries me. I don't want to be a lab rat.


No it's fine. If it makes you significantly worse then stop it. Titrate slowly.

I'm becoming more depressed on vortioxetine which I guessed might happen if I went up to 10-15 mg since it hits as an NRI. Might have to stop it.


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## butterz (Aug 8, 2013)

Where do you get this that it starts to act as a NRI at 10-15mg?

I cant really imagine that it's a potent NRI compared to real NRIs or NDRIs.


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## gilmourr (Nov 17, 2011)

So I'm 26 days in and don't seem to be feeling any differently and don't have side effects aside from a more disrupted sleep cycle and maybe some minor minor nausea. 

Taking 15 mg today. If it induces depression I'll know that it functions as a NRI at that dose and will revert to 10 mg for a while longer.


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## butterz (Aug 8, 2013)

How much zoloft are you still using?


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## gilmourr (Nov 17, 2011)

butterz said:


> How much zoloft are you still using?


Currently 100 mg.


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## gilmourr (Nov 17, 2011)

I'm pretty disappointed in this drug TBH. 28 days in and I haven't felt like ANYTHING. I get some nausea here and there but it's mild/moderate sometimes. 

It might just be that the half life is so long (66 hours) that the side effects are VERY negligible (until it builds up). 

I've reduced my Zoloft dose to 75 mg now because I moved up to 15 mg of vortioxetine. 

ATM I would consider this the most useless drug I've tried so far. Closest thing to placebo I've tried.

I will probably give it 10 days at 15 mg and if nothing happens that'll be 38 days... I might just stop it. Studies show 10,15,20 mg differences are hardly large besides side effects. Plus Luvox looks like a decent pick.


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## SSRIManiac (Jun 14, 2014)

gilmourr said:


> I'm pretty disappointed in this drug TBH. 28 days in and I haven't felt like ANYTHING. I get some nausea here and there but it's mild/moderate sometimes.
> 
> It might just be that the half life is so long (66 hours) that the side effects are VERY negligible (until it builds up).
> 
> ...


Why don't you try Vortioxetine by itself then? It could be that you're Not experiencing its fully benefits b/c of Zoloft..

From my experience Viibryd is stronger than Brintellix/Vortioxetine. But it does hit you with side effects after the initial phase, horrible dreams, hallucinations sometimes fainting.:serious:

P.S. I don't think Luvox is any good. It's one of the weakest SSRI's and has a super short half life even shorter than Paxil but it doesn't tend to cause physical withdrawals as badly.

I think what you need is Effexor XR.


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## butterz (Aug 8, 2013)

Maybe vortioxetine is totally weak.
I am only at 5mg but there are no sexual side effects at all which makes
me suspicious. Usually all SSRI make it almost impossible to cum.


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## gilmourr (Nov 17, 2011)

SSRIManiac said:


> Why don't you try Vortioxetine by itself then? It could be that you're Not experiencing its fully benefits b/c of Zoloft..
> 
> From my experience Viibryd is stronger than Brintellix/Vortioxetine. But it does hit you with side effects after the initial phase, horrible dreams, hallucinations sometimes fainting.:serious:
> 
> ...


I don't think it makes any sense why zoloft would be interacting. It is just a SRI for the most part. I just lower the zoloft whenever I increase vortioxetine. The only reason I added vortioxetine was for the post synaptic function.

I've tried effexor XR also.


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## butterz (Aug 8, 2013)

What's so great about post synaptic stuff?


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## gilmourr (Nov 17, 2011)

butterz said:


> What's so great about post synaptic stuff?


There's nothing great about it, it's just another tool I can use. For instance, Zoloft is pretty much all a SRI. If I wanted more reuptake inhibited I'd just increase the dose.

Inhibiting reuptake creates more serotonin to be available in the synapses to bind with receptors. Which receptors it ends up with is probability.

If I can select which receptors to shut down (antagonize) then I can do something to possibly gain an antidepressant response.

EDIT: A very simple response would be to say that SSRI's increase the amount of serotonin, while drugs working post synaptically decide which receptors tehy bind with


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## butterz (Aug 8, 2013)

Thanks for the explanation. But do normal SSRI not also have special effects on different 5HT receptors?
It's not like a SSRI only has SERT inhibition and nothing else. So I'm not sure if Vortioxetine is that much different.


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## SSRIManiac (Jun 14, 2014)

gilmourr said:


> I don't think it makes any sense why zoloft would be interacting. It is just a SRI for the most part. I just lower the zoloft whenever I increase vortioxetine. The only reason I added vortioxetine was for the post synaptic function.
> 
> I've tried effexor XR also.


There's no significant drug interactions through the hepatic; CYP2B6 vs 2D6, but generally speaking you should give it more time on its own because the zoloft is still in the brain interfering with brain chemicals and the outcome is unpredictable when you're on both simultaneously.

Taper a bit more than try Brintellix by itself. If it doesn't work then you may need a different med. I had better response to Viibryd, which is similar.


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## butterz (Aug 8, 2013)

I still see no sense in mixing 2 serotonergic drugs. Seems way too risky to me.


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## gilmourr (Nov 17, 2011)

SSRIManiac said:


> There's no significant drug interactions through the hepatic; CYP2B6 vs 2D6, but generally speaking you should give it more time on its own because the zoloft is still in the brain interfering with brain chemicals and the outcome is unpredictable when you're on both simultaneously.
> 
> Taper a bit more than try Brintellix by itself. If it doesn't work then you may need a different med. I had better response to Viibryd, which is similar.


It's a hard decision because I haven't ever had a response that came into effect after 30 days. It usually is within 2-3 weeks.

I don't believe that it takes 6-8 weeks to show an effect. Cascading effects happen already at 1-2 weeks in and reach full peak at 8-12 weeks. If it's just "starting" to work at 8 weeks then it most likely isn't working.

Whenever I've talked to doctors they all seem to agree that a "maybe" usually means no it's not effective.


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## butterz (Aug 8, 2013)

I also have a feeling that vortio is basically a piece of useless crap.
The only good thing about it is that it doesn't seem to have sexual side effects.
I don't want to go back to an older SSRI and then not being able to jack off.


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## gilmourr (Nov 17, 2011)

I decided to stop vortioxetine today because of the lack of effects and also the sleep disturbance issues. 

I feel that 15 mg was starting to trigger NRI symptoms which are counter productive.

It might be possible that 10 mg might have worked but from my history with drugs I would've seen some effect sooner or anything.

I'm off to try Luvox.


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## butterz (Aug 8, 2013)

I have been on vortio for 10 days and have been taking 10mg since 2 days and I still experience brain zaps in the morning. I have no explanation for this. Maybe it simply means that vortio is totally weak and sucks.


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## gilmourr (Nov 17, 2011)

butterz said:


> I have been on vortio for 10 days and have been taking 10mg since 2 days and I still experience brain zaps in the morning. I have no explanation for this. Maybe it simply means that vortio is totally weak and sucks.


Most likely it means that either the drug has not fully built up in your body or that the dose is too weak and not inhibiting enough reuptake. If you're getting brain zaps it's from lack of serotonin in the synapses. Upping the dosage should help.


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## butterz (Aug 8, 2013)

Gil how you doing? Still on vortioxetine?


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## Learydp01 (May 2, 2013)

Having been on almost every medication where serotonin is the primary neurotransmitter targeted (with the exception of TCA's, I haven't tried those), I'm highly skeptical that manipulating the serotonin receptor sites will produce any significant results. Every serotonergic medication I have tried felt very similar, with some subtle differences. Norepinephrine medications also felt very similar to me; similar sensations, similar side effects, regardless of receptor sites targeted. I know going by the sensation is very unempirical, my experience has absolutely made me biased, it's just my opinion, for whatever it's worth.


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## Learydp01 (May 2, 2013)

That's bizzare that you get brain zaps at such a low dose butterz. It's not unheard of, but it's certainly not common either. Are the SSRI's helping you at all? How many SSRI's (or stimulator/modulators) have you tried? Imo, it might be time to move on to another class of medication.


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## butterz (Aug 8, 2013)

I am at 10mg now have haven't noticed any zaps in the last few days.
Maybe the transition from 100mg zoloft to 5mg vortioxetine caused the zaps but it's still strange.
When I got off lexapro I had zaps. Then when I started with anafranil 10mg the zaps were instantly gone!
Obviously anafranil is strong even at 10mg.


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## gilmourr (Nov 17, 2011)

butterz said:


> Gil how you doing? Still on vortioxetine?


I stopped vortioxetine as it really didn't do anything at 5/10 or 15 mg.

I was on it for over 4 weeks I believe. I couldn't go any higher because it has affinity with NET.

I'm currently trying Zoloft + Luvox.


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## gilmourr (Nov 17, 2011)

butterz said:


> I am at 10mg now have haven't noticed any zaps in the last few days.
> Maybe the transition from 100mg zoloft to 5mg vortioxetine caused the zaps but it's still strange.
> When I got off lexapro I had zaps. Then when I started with anafranil 10mg the zaps were instantly gone!
> Obviously anafranil is strong even at 10mg.


Yeah like I said the zaps are from a reduction of serotonin in the synapses. Increasing the dose will work especially since the half life is so long.

Clomipramine is the 2nd strongest on the market I believe so it makes sense why u never had brain zaps. Number 1 is paxil I believe.


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## Mike111 (Dec 5, 2012)

anyone tried vortioxetine (mostly as monotherapy) for social anxiety with any success ?


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## butterz (Aug 8, 2013)

I believe I have been on 10mg for 3 weeks now and I still get zaps in the morning!

I also do not notice any improvement. But the zaps indicate to me that Brintellix is totally useless.
How is this possible that you get SSRI withdrawal symptoms while being on a freaking SSRI??????


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## jim_morrison (Aug 17, 2008)

butterz said:


> I believe I have been on 10mg for 3 weeks now and I still get zaps in the morning!
> 
> I also do not notice any improvement. But the zaps indicate to me that Brintellix is totally useless.
> How is this possible that you get SSRI withdrawal symptoms while being on a freaking SSRI??????


Isn't 20mg the dose that it worked most efficiently at in studies? Maybe your dose is too low.


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## butterz (Aug 8, 2013)

From what I read it's not sure if 20mg is better than 10mg.
I could go up to 20mg but I really feel like this is useless.


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## butterz (Aug 8, 2013)

I am still on 10mg. But will soon go higher to 15 or 20mg.

Depressionwise I feel no change. But maybe it makes my memory a bit better which would also be cool.

But as an antidepressant it's not really making a difference.


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