Vortioxetine - feeling so anxious and low

[welshdory]

Hi there. I have suffered with anxiety and depression for years now. I have tried so many different meds. citralopram, prozac, sertraline, escitralopram and most recently 3 weeks on 10mg of vortioxetine. This seems to be the worst by far, I am feeling so anxious and very tearful. I am also incredibly snappy and irritable. Have anyone else experienced this on this med?.

I am starting to feel I am beyond help now as I've already tried several meds and none seem to help.

I am currently having CBT.

Any advice or suggestions greatly received x

[panic_down_under]

Hi there. I have suffered with anxiety and depression for years now. I have tried so many different meds. citralopram, prozac, sertraline, escitralopram and most recently 3 weeks on 10mg of vortioxetine.

How long were you on each of these antidepressants (ADs), what was the maximum dose you took and why did you stop taking them?

This seems to be the worst by far, I am feeling so anxious and very tearful. I am also incredibly snappy and irritable. Have anyone else experienced this on this med?.

These are all not uncommon initial side-effects of most serotonergic ADs caused by an increase in serotonin activity. They usually diminish after a few weeks as bio-feedback mechanisms kick in and down-regulate serotonin synthesis and expression. Ask your GP to prescribe something to help you cope with the side-effects, especially the heightened anxiety, as white-knuckling through them is counterproductive.

I am starting to feel I am beyond help now as I've already tried several meds and none seem to help.

There are no hopeless cases, only doctors with limited imaginations. SSRIs are not the only ADs, nor, arguably, are they the most effective. If vortioxetine turns out not to be the right med for you I suggest you try one of the TCAs, either amitriptyline, or imipramine.

I see from previous posts that you had some success with escitalopram in the past, but that you had some type of reaction when you began taking it for the third time. That is, unfortunately, not rare. For reasons which aren't really understood ADs, especially the SSRIs, may become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control, or not working at all. They may also produce more severe, and/or different, initial side-effects each time too. Two studies, Amsterdam JD, 2016 and Amsterdam JD, 2009, found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC, 2018; Amsterdam JD, 2009; Leykin Y, 2007; Paholpak S, 2002).

Therefore, given your relapse history I think once you find an AD that works well for you should consider remaining on it permanently.

I am currently having CBT.

That's great!

[sparky10]

[QUOTE=welshdory;2000868]Hi there. I have suffered with anxiety and depression for years now. I have tried so many different meds. citralopram, prozac, sertraline, escitralopram and most recently 3 weeks on 10mg of vortioxetine. This seems to be the worst by far, I am feeling so anxious and very tearful. I am also incredibly snappy and irritable. Have anyone else experienced this on this med?.

I am starting to feel I am beyond help now as I've already tried several meds and none seem to help.

hi,

like you I have tried many meds in the past. I started on vortioxetine around the same time as you. First week 10 mg but it was too much so have reduced it to 5mg for two weeks. The anxiety seems to be getting worse day on day and it certainly hasn’t made me feel any better.
im wondering whether to continue as it has been one of the worst for me aswell.

[panic_down_under]

like you I have tried many meds in the past.

If memory serves you were starting doxepin a while ago. How did that go?

I started on vortioxetine around the same time as you. First week 10 mg but it was too much so have reduced it to 5mg for two weeks. The anxiety seems to be getting worse day on day and it certainly hasn’t made me feel any better.

It takes 4-12 weeks for ADs to kick-in once you're on a therapeutic dose - 10mg+ for vortioxetine - and they may make things worse at the beginning. Talk to your GP about the anxiety as there are things you can take to ease this while waiting for the AD to kick-in.

im wondering whether to continue as it has been one of the worst for me aswell.

That's up to you, but it takes time for ADs to work and they may produce unpleasant side-effects at the beginning. Side-effects are also not necessarily down to the drug itself. Psychology can play at least a big a role as chemistry. An anxious mind is very capable of producing our worst side-effects nightmares given half a chance.