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Re: Partial response to vortioxetine (Brintellix) undopaminergic

Posted by SLS on August 16, 2023, at 8:44:11

In reply to Partial response to vortioxetine (Brintellix), posted by undopaminergic on August 16, 2023, at 4:45:14

Hi, UD.

I am extremely optimistic for you. I know that I have said this ad nauseam, and drove people away by my mania, but patience is crucial. An ultimately successful treatment often starts with a brief improvement during the first two weeks (often within 7 days), only to disappear. However, my doctors at the NIH told me that this is considered by them to be a "blip improvement", and predictive of eventual success.

Unless you feel worse or have intolerable side-effects that don't mitigate over time, it is worth sticking with it - at least for 6 weeks. During this period of latency, use whatever you know that eases your symptoms palliatively, just as long as it won't interfere with the therapeutic actions of vortioxetine. That will necessitate guesswork that I think you are more qualified than me to evaluate.

Vortioxetine, as I'm sure you are aware, hits almost every serotonin receptor, some as an agonist and some as an antagonist. Initially, researchers were focused on 5-HT7 receptors. I don't know if the consensus on this has changed.

I don't know if you believe that prayer serves any purpose, but I prayed for you anyway.

The best of luck!

- Scott

> Hi all,
> With reference to an older thread I started about vortioxetine (Brintellix; Trintellix), which is found at:
> Incidentally, SLS was very involved in that thread.
> In the thread referenced above, I documented several very promising initial reactions I had to vortioextine. After a while, the episodes of improvement (in mood and cognition) ostensibly petered out. It is possible they disappeared objectively, or that the improvements became "assimilated" into a new baseline, so that I just wouldn't notice them any longer.
> Now I've started 15 mg/day (in the morning), and I've had *very* promising responses again. The most obvious reaction is improved mood, and this time it's not limited to short episodes. Then there is also improved motor function, and slight improvements of memory.
> But perhaps the most remarkable development is an anti-anhedonic improvement, which I find remarkable because the only (other) drug I've had that has affected the anhedonia is pramipexole (Sifrol; Mirapex). I'm now (it seems) experiencing feelings of reward in response to completing tasks. These rewarding feelings are not as dramatic as with the pramipexole, but they seem to be much more frequent -- the tasks are often minor, such as completing a short meeting (which I'm not even emotionally invested in).
> My apathy in terms of a subjective lack of energy is much ameliorated, but I'm still suffering from poverty of thought.
> On the flip side, I'm also more responsive to negative experiences. I'm more affected by failures, disappointments, and/or deteriorations, such as a negative change in surroundings.
> I've taken the 15 mg dose of vortioxetine for somewhat more than a week now. The reactions did not come directly in response to increases in the concentrations of the drug, which they would have if it were a (dopaminergic) stimulant. It's more like there is a gradual effect, such as perhaps an indirect increase in dopaminergic neurotransmission in reponse to the prolonged serotonergic actions of the drug.
> -undopaminergic

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.




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