Can I cut Viibryd in half?

[js1803]

So, I've just been prescribed 40mg of Viibryd.. up from 20mg.. I tried it once and the symptoms are pretty uncomfortable.

So, do any of you know if this pill can be cut? Is the pill time released? Will my body absorb the medication faster than normal if I cut it in half?

I want to take 30mg of it. The pill isn't scored, so I know it might be hard to get the dosage I want, but I'm willing to take that chance to not take the full 40mg.

Help please.

[panic_down_under]

So, do any of you know if this pill can be cut?

Afaik, it isn't time-release. But ask your pharmacist and pick up a pill-cutter while you're there as they are more accurate than knives, and much less bloody, ime.

[MyNameIsTerry]

If the pill isn't scored the manufacturer hasn't given an indication the med is homogenised. So, there is no guarantee of an equal level of it dispersed throughout the pill and splitting can mean unequal dosages.

I can't see a record of timed release so I would assume they aren't sold in that form.

But you need to do some research on whether they are homogenised. This will likely be mentioned in the drug licensing information. I'm not sure we use this in the UK to check it out but Googling that med with keywords like "FDA licence" should find you the docs.

---------- Post added at 07:20 ---------- Previous post was at 07:06 ----------

Here's the FDA licencing doc:

https://www.google.co.uk/url?sa=t&source=web&rct=j&url=https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/022567s001lbl.pdf&ved=0ahUKEwicmtm6jLDUAhVJYVAKHXqZBPEQFggoMAE&usg=AFQjCNFAVscO0D5i3YYC_VjKhJhqdWpcMQ&sig2=Dl_2tw4Bl197PrzewO-djg

They are immediate release as it states in there. No mention of homogenisation but it may not need to be mentioned.

[js1803]

Thank you for the info. I called my pharmacist and he said it's not time release and it should be okay to cut in half.

He didn't know what I meant by homogenised. What is that?

I did buy a pill cutter yesterday, and I cut it twice to make 30mg. I did notice it irritated my insides a bit. I still had a bad night with it moreso then when I did when I just took a 10mg+20mg, but could of just been me, I received a very bad phone call yesterday My father is hates life, said he was going to end himself... blames me and my mom that I ruined his life and because of my condition now with my anxiety. He just a very negative person and I'm stuck with him right now because of my anxiety disorder.

I just want this med to work. I think I'm going to try 20mg in morning and 20 at night. I did a little better with that combo. 40mg is just too much for me right now. It's such a money scam that they don't make 30mg.

[MyNameIsTerry]

Sorry to hear about your family situation. That's all you need at a time like this!

They don't make 30mg because the dosing regime doesn't allow that dose from what I read. They jump straight from 20-40mg. It's the same with many meds.

Homogenisation just means the active drug has been equally dispersed through the pill. If it hasn't been and you cut it into quarters, there would be different volumes of the active drug in each quarter and potentially even none in some. Pills can also have layers for additives but with a homogenised med there will be at least one layer with it in and this is why you cut through the pill top to bottom rather than down the sides so that you don't have to work out what layer has what in.

I'm quite surprised the pharmacist didn't know that. It's pretty basic and it's not a med only term.

Meds can also have enteric coating to pass the stomach so these can't be cut or the med won't make it past the stomach and may cause irritation. I don't recall seeing it mentioned when I looked yours up. It will say on the box or in the leaflet if they are.

The simplest way to think about it would be a hamburger. The meat (active drug) is equal throughout in it's layer with the bread (additives) on either side. That's a layer example.

For a non layer example, just think of the meat slice on its own. The additives are just mixed inside the meat in this one.

Both of those would be an example of homogenisation in a med. You can cut from top to bottom into halves & quarters safe in the knowledge it's a half or quarter of the active drug that you will get in each piece.

A non homogenised example would mean a misshapen slice of meat where it's not the same height all the way through. When you cut that one up you know each piece differs.

If you ever want to be even more accurate you can weigh the pieces. A jewellery scale does this easily as they deal with very small weights. I use one when I encapsulate various supplements to check the weight of the powder I've added. They only cost a couple of pounds on Ebay. But you have to remember you are weighing the active drug plus any additives so you weigh the whole pill first so you know the overall starting weight.

You don't need to do this, it's more for people tapering off when they are reducing by 10% at a time but since I've explained the rest, it's just a bit extra that might come in handy another time.

[js1803]

Thx for the info. I quit this med today. 20 wasn't enough and 40 was too much. I tried it with a new med burspar and felt like it made my anxiety worse during sleep and my depression worsened. I tried cutting in hal but it burned my insides and it felt like my body absorbed it quicker.

Too many side effects and worst of all my weight jumped up so fast because this med Gave me uncontrollable hunger and it always made me sick. I'm done with it I seriously gained 12 pounds in 1.5 months. That's just insane and I don't need that

I'm going back to Zoloft and going to try it in combo with the burspar, I really need a break through . It's becoming too much to handle. I just hope the muscle tension stays tolerable, the only good thing about the viibryd was it eased the muscle pain and tension, but I think I'd rather be in pain than to have uncontrollable weight gain.

[panic_down_under]

I tried it with a new med burspar

Did your doctor prescribe this to be taken with Viibryd?

The serotonin 5-HT1a receptor agonist Buspar (buspirone) can increase the effectiveness of SSRIs and other serotonergic antidepressants and reduce some of their side-effects, particularly sexual dysfunction. It works so well that two new antidepressants were recently released which combine the actions of a SSRI and 5-HT1a agonist in the one pill. One of them is Viibryd (Brintellix/Trintellix (vortioxetine) is the other)!

Perhaps the side-effects have been so severe because the two meds combined are overstimulating 5-HT1a pathways, rather than the Viibryd per se. Such an overstimulation would likely account for the gastrointestinal symptoms as the enteric nervous system controlling the gut seems particularly sensitive to 5-HT1a agonists (they can trigger histamine release by enteric cells). GI side-effects have been noted at the high end of the Viibryd dose range and the recommended maximum dose may have been set at least partially in recognition of this.

[js1803]

Yes he prescribed it with the viibryd and it just went all down hill from there. It was already going downhill with the viibryd 40mg made me feel wired, uncontrollable hunger, sick, rush like feeling. It felt like to much seretonin. 30mg I did better, but that's not possible.. Social security prob won't cover it anyway when I lose my state insurance, so what's the point.

So I stopped viibryd. I took 50mg of sertaline and 5mg of burspar. Feeling horrible. I feel hopeless. I want to throw the burspar away now because each time I take it I become severely depressed, and the Zoloft, well it didn't help me in the past with the tenseness so I'm about ready to stop all together again but it' just goes from bad to bad.

Burspar just gets me really depressed and I don't if it's just me or the drug.

[panic_down_under]

Yes he prescribed it with the viibryd and it just went all down hill from there.

Sigh! :weep:


So I stopped viibryd. I took 50mg of sertaline and 5mg of burspar. Feeling horrible.

You can't judge an antidepressant by what it does in the first few weeks. They can produce some very unpleasant side-effects at the beginning, plus you'll still have some residual side-effects from the Viibryd too.


I feel hopeless. I want to throw the burspar away now because each time I take it I become severely depressed, and the Zoloft, well it didn't help me in the past with the tenseness so I'm about ready to stop all together again but it' just goes from bad to bad.

If possible get another doctor, or preferably a psychiatrist to review your treatment.

[js1803]

Yea, I'm seeing a psychiatrist. I think I like him because he's available to talk whenever I have trouble via text

I get severe depression when I take the burspar. and other symptoms, but severe depression. Now that's worn off, i'm feeling a bit better now. I don't like it.

I called him yesterday asking to try something else, and he told me I'd tried everything so, big bummer.

I guess im crazy. It could be the med that causes the big depression, or it's just me calming down to severe depression and I cant handle it, so I stay in panic mode for 2+ years plus to protect myself from it via pain and anxiety ears ringing, enhanced vision, muscle pain, can't breat all the time, feel the ****in stomach all the time. who knows, I cant figure out the anxiety. I think theres something wrong, that I feel like my body is in panic for 2+ years, and I can't calm down.

sorry.

[panic_down_under]

I called him yesterday asking to try something else, and he told me I'd tried everything so, big bummer.

I doubt that is true. Can you recall what you've tried, how much you took and for how long, and what was the result?

[js1803]

Trintillix, Lexapro, Pristiq, Viibryd, and Zoloft.

Trintillix way to expensive.
Viibryd, 6-7 weeks, never again. Expensive, severe weight gain, nausea, uncontrollable hunger, just way too many symptoms. However, it was effective in relieving muscle tension.
Lexapro 4 weeks, made me angry, hospital in-patient, doesn't relieve muscle tension, nor anxiety.
Pristiq - 4 weeks, relieved muscle tension, but gave me more energy which i don't need and I couldn't stop movin on it.

So, I'm back on the zoloft, I tried it for 4 weeks, was ineffective in relieving muscle tension and anxiety thus pain, but not many side effects, I felt okay with it mood wise, but it didnt seem to help with my usual symptoms.. I just wish it helped with the muscle tension/anxiety. i'm having fun coming off the viibryd,and I can feel the muscle tension coming back. Hopefully it won't come back full force. I don't feel like eating uncontrollably anymore .

I did that gene test.. unfortunately, everything was in the red/yellow except for pristiq. What supplements are safe to take with zoloft so I can maybe take the edge off?

[panic_down_under]

Trintillix, Lexapro, Pristiq, Viibryd, and Zoloft.

So basically just some SSRIs plus a SSRIish SNRI and your psychiatrist has exhausted his options?! Better find a new one asap then, imho. There's still the SNRIs duloxetine (Cymbalta), milnacipran (Savella) and levomilnacipran (Fetzima), a handful of TCAs and a MAOI or two.


So, I'm back on the zoloft, I tried it for 4 weeks, was ineffective in relieving muscle tension and anxiety thus pain, but not many side effects, I felt okay with it mood wise, but it didnt seem to help with my usual symptoms.

Four weeks is not long enough to be able to draw any conclusions, plus I'm guessing the dose never got much above 50mg, or not for long anyway. If it still isn't working after a couple of months on at least 150mg adding some nortriptyline may help.


I did that gene test.. unfortunately, everything was in the red/yellow except for pristiq.

Well that may have made your psychiatrist a little richer in kickbacks. At this point in their development that's about all antidepressant gene tests are good for.


What supplements are safe to take with zoloft so I can maybe take the edge off?

More to the point may be what supplements work. Try Omega-3s/fish oil for anxiety, exercise would also help, and have you tried magnesium supplements for the muscle tension?

Muscle tension is a common anxiety symptom which often resolves when the anxiety is bought under control. However, there are also quite a few specific muscle relaxants such as methocarbamol (Robaxin), orphenadrine (Norflex) and tizanidine (Zanaflex)? Have any of these been tried in addition to antidepressants?

BTW-orphenadrine is chemically related to diphenhydramine (Benadryl, Unisom). I don't know whether diphenhydramine is in the same league as a muscle relaxant, but it might be worth a shot (clear it with your doctor or pharmacist first). It also has mild anti anxiety properties.

[MyNameIsTerry]

I can give you some info on magnesium to help you avoid the traps if you need it. People tend not to understand what it says on the bottle is nowhere near what the supplements even try to deliver before your body starts to digest it.

[js1803]

So, I think my psych just meant that I've tried all the medications that I'm willing to try. I won't do SNRI because it gives me more energy and I already have enough anxious energy,and it has withdrawal or more severe withdrawal. Cymbalta was mentioned but I'm nervous about taking that. The Viibryd gave me muscles a break.. It was really bad when I was trying the Zoloft which is why i quit it, so I hope that I can stay on it longer this time..

This psych didn't order the gene test, but rather a nurse practitioner in this program i was attending.

I do notice that the muscle tenseness is coming back especially in the morning. Not as bad tho, but overall I'm happy I'm off the viibryd. Too many side effects and I don't have that uncontrollable hunger anymore. However, I'm still struggling though. Anxiety was real bad yesterday. Had an attack in my sleep and then throughout the rest of the day, was feeling everything, like my face, couldn't breathe (story of my life now), kept taking deep breaths. I took the burspar to try it again and I'm not going to take it ever again. It just makes feel like I can't go on anymore.

Today has been a little better. I went for a long walk. Exercise is hard for me because of the anxiety symptoms. It's not like working out before I had this severe anxiety.. It's just I feel everything now. I see everything. I hear everything. My ears ring because they're top notch.. my vision is weird.. I go for a hard walk, I come inside and look up and the ceiling is moving like it's coming to me.

My body is just in a constant panic mode it feels like.. like an alarm that won't shut off. and I feel it every day. I think it's because of my inability to calm down. When I try to let go, relax every muscle, and be like a dead stick, I get this fear current throughout my body. It's like my mind it's scared to relax.. it doesn't feel right.

It's all because of what happened 2 and a half years ago. If I laid down, relaxed, I thought i'd die. I thought I'd die if I stopped moving. And somehow that's stuck with me and I haven't been able to calm down since. At least that's what I think is happening to me.

I just hate the breathing issue. It's a problem all day long... like it's manual. Like I'm in control, and I think it's the reason why I have all these symptoms.

If you can recommend a supplement, i'll give it a try especially if it helps with muscle tenseness.

I need to find something to take the edge off that will be safe with zoloft. Before meds, I was taking this product called Anxie-T when i wasn't on any meds.. I think it helped, but wasn't enough to help me with my severity, but im afraid to take it now in combination.

[panic_down_under]

I won't do SNRI because it gives me more energy and I already have enough anxious energy,

Don't use your experience of Pristiq (desvenlafaxine) as a guide to your likely reaction to the SNRIs I've mentioned. Although primarily a serotonin inhibitor, Cymbalta is a much more potent norepinephrine/noradrenaline (NE) reuptake inhibitor than Pristiq and Savella and Fetzima inhibit NE reuptake reuptake more strongly than they do serotonin.


It's not like working out before I had this severe anxiety.. It's just I feel everything now. I see everything. I hear everything. My ears ring because they're top notch.. my vision is weird.. I go for a hard walk, I come inside and look up and the ceiling is moving like it's coming to me.

What you're describing sounds like derealization. It is a fairly common anxiety symptoms, as is the related depersonalization.


I was taking this product called Anxie-T

The only ingredients that might have some positive affect on anxiety are the Kava and magnesium, but the amounts are low. The GABA is definitely snake oil (http://www.nomorepanic.co.uk/showthread.php?t=196239) and the evidence for the other ingredients is weak.

[js1803]

Derealization... well I don't feel out of body nor do I feel like things aren't real. I feel like my body is in panic mode and it won't turn off. Thats the only explanation I can come up with to explain my ears ringing, the weird vision, and every symptom I go through every day.