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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 31. This is the beginning of the thread.
Posted by mrm36014801 on April 19, 2014, at 10:18:39
Hello.
My diagnosis has always been major depression and the primary symptom I suffer from is a lack of energy, a sort of enervated fatigue.
Can anyone say if either Viibryd or Brintellix are "energizing" or "activating" (as opposed, to say, "sedating)?
Thank you.
Posted by phidippus on April 19, 2014, at 15:49:29
In reply to Is Viibryd or Brintellix 'energizing'??, posted by mrm36014801 on April 19, 2014, at 10:18:39
I found Viibryd very energizing. I just started Brintellix so don't know about it yet.
Eric
Posted by Louisiana Sportsman on April 19, 2014, at 16:46:04
In reply to Is Viibryd or Brintellix 'energizing'??, posted by mrm36014801 on April 19, 2014, at 10:18:39
> Hello.
>
> My diagnosis has always been major depression and the primary symptom I suffer from is a lack of energy, a sort of enervated fatigue.
>
> Can anyone say if either Viibryd or Brintellix are "energizing" or "activating" (as opposed, to say, "sedating)?
>
> Thank you.
>
>I am disqualified to deliberate vilazodone [Viibyrd (Forrest)]; contrary, au courant is Day 46 of vortioxetine [Brintellix (Lundbeck)] 1TPOQAMCF; Days 1-29, I administered 10mg., and for the past 17 days, 20mg. I can felicitously share my introduction to vortioxetine.
I have not experienced any aggrandizement of sedation since initiation. Due to 5-HT3 antagonism, there is a negligible release of histamine (sedating neurotransmitter), but it seems to be off set by the concomitant dopamine and norepinephrine release.
In terms of activation, I generally prefer for my medications to be energizing as well. My prior ADs were Zoloft (most DA release of the SSRIs) and Effexor/Pristiq (NE reputake inhibition). Antidepressants, besides MAOIs, bupropion (Wellbutrin) and possibly NE heavy desipramine, are generally not something someone takes for the energizing effects.
One of my PDOC's main concerns when prescribing Brintellix was possible sedation due to my treatment resistant bipolar anergic depression and ADHD. She said it would not likely be a factor she was right. If anything, it is an activating AD since I am able to take in the morning (I prefer to take all my medication in the morning, if reasonable), and it has treated me well.
To elucidate, I rank Brintellix among the ADs I've been on. I put wayy too much thought into this, by the way. :D
Zoloft: 8.1/10
Wellbutrin XL 450mg. (Aplenzin 522mg.): 6.0/10
Pristiq 50mg. (Effexor XR 75mg.): 6.7/10
Brintellix: 8.9/10Verdict: Neither sedating, not activating unless you want to count relief which translates to more activity. A good AD, but I suggest:
Try Brintellix only after you have failed a proven SSRI and two other antidepressants from two different classes. If an AD is tolerated, then that AD should be augmented with an atypical antipsychotic before trying Brintellix. Something like: Cymbalta -> Paxil -> Lexapro + Abilify AND then Viibyrd or Brintellix can be justified, and I would still hypocritically recommend a researched AD instead.
Good luck!
Posted by Louisiana Sportsman on April 19, 2014, at 17:00:43
In reply to Re: Is Viibryd or Brintellix 'energizing'?? » mrm36014801, posted by phidippus on April 19, 2014, at 15:49:29
> I found Viibryd very energizing. I just started Brintellix so don't know about it yet.
>
> Eric
>You posted while I had my reply window up for awhile.
I found Brintellix more activating than Wellbutrin, and I think that says a lot. But, I just don't consider it more energizing, e.g. PNS effects. Wellbutrin is more energizing in that aspect.
If I were to take something to perk me up, bupropion, especially SR, is a valid consideration more energizing. But, that doesn't mean it gave me the motivational lift, if that makes sense, like 47 days of Brintellix.
But, Brintellix is more energizing compared to both sertraline and venlafaxine.
Posted by SLS on April 20, 2014, at 8:15:53
In reply to Re: Is Viibryd or Brintellix 'energizing'??, posted by Louisiana Sportsman on April 19, 2014, at 17:00:43
> > I found Viibryd very energizing. I just started Brintellix so don't know about it yet.
> >
> > Eric
> >
>
> You posted while I had my reply window up for awhile.
>
> I found Brintellix more activating than Wellbutrin, and I think that says a lot. But, I just don't consider it more energizing, e.g. PNS effects. Wellbutrin is more energizing in that aspect.
>
> If I were to take something to perk me up, bupropion, especially SR, is a valid consideration more energizing. But, that doesn't mean it gave me the motivational lift, if that makes sense, like 47 days of Brintellix.
>
> But, Brintellix is more energizing compared to both sertraline and venlafaxine.
>What about anhedonia or the loss of interest and motivation? How does the Brintellix affect these symptoms? I don't think that bupropion usually improves them.
- Scott
Posted by porkpiehat on April 20, 2014, at 16:19:55
In reply to Re: Is Viibryd or Brintellix 'energizing'?? » Louisiana Sportsman, posted by SLS on April 20, 2014, at 8:15:53
Day 7 of Brintellix. I actually find it to be a little sedating. I might start taking it at night.
Posted by Christ_empowered on April 20, 2014, at 19:49:15
In reply to Is Viibryd or Brintellix 'energizing'??, posted by mrm36014801 on April 19, 2014, at 10:18:39
could you take Ritalin or Provigil, maybe with an AD?
Posted by Louisiana Sportsman on April 22, 2014, at 13:59:02
In reply to Re: Is Viibryd or Brintellix 'energizing'??, posted by Christ_empowered on April 20, 2014, at 19:49:15
> could you take Ritalin or Provigil, maybe with an AD?
I take Brintellix in the morning with both Dexedrine 60mg. and Provigil 600mg. (.01mg. of d-amp for every 1mg. of modafinil which works well).
Maybe that's why I can't accurately comment on the sedation?
I highly suggest you augment 150mg. Nuvigil and 20mg. Focalin XR concomitantly. These might benefit you in a lot of ways, these are commonly prescribed to those with a lack of energy and fatigue, and I think they should have been prescribed first-line.
Posted by porkpiehat on April 27, 2014, at 10:27:27
In reply to Re: Is Viibryd or Brintellix 'energizing'??, posted by Louisiana Sportsman on April 22, 2014, at 13:59:02
I am now on day 14 of Brintellix. I guess I would hone my description of "sedating" to demotivation. And it is similar to the SSRI apathy that I've had in the past that the Lamictal always seemed to cure.
In other words, I could just stay in bed knowing that I have stuff to do and not care...not pursuing my hobbies or friends. etc. I'm sure you all know the drill.
Seeing as I am giving Brintellix a "trial run", I don't want to start adding other drugs until I have a handle on it.
But, yes, adding ritalin does seem to make sense.
Posted by porkpiehat on June 10, 2014, at 12:30:59
In reply to Re: Is Viibryd or Brintellix 'energizing'?? » mrm36014801, posted by phidippus on April 19, 2014, at 15:49:29
> I found Viibryd very energizing. I just started Brintellix so don't know about it yet.
>
> Eric
>Eric:
I am about to do the opposite...I found Brintellix to be demotivating/dulling and kind of "isolating" on an interpersonal way. The latter was very disturbing and pdoc blames it on all the post-synaptic (full antagonism of 5ht1-a or whatever) actions of Brint.She expects viibryd to work more like a traditional SSRI for me.
How is your Brintellix experience vs your Viibryd experience? Did you find it numbing/isolating at all? Were the sexual SE's better than SSRI's?
I'd love any feedback you could offer!
Thanks
Posted by sk85 on June 10, 2014, at 14:00:31
In reply to Viibryd vs. Brintellix » phidippus, posted by porkpiehat on June 10, 2014, at 12:30:59
> I am about to do the opposite...I found Brintellix to be demotivating/dulling and kind of "isolating" on an interpersonal way.
Sorry to chime in but would you care to elaborate? In what way isolating?
Posted by phidippus on June 11, 2014, at 18:26:07
In reply to Viibryd vs. Brintellix » phidippus, posted by porkpiehat on June 10, 2014, at 12:30:59
I couldn't get very far with the Brintellix-it began to destabilize my mood. SO, my experience of it wasn't fair.
I didn't have any problems with Viibryd.
Eric
Posted by porkpiehat on June 11, 2014, at 18:41:07
In reply to Re: Viibryd vs. Brintellix, posted by sk85 on June 10, 2014, at 14:00:31
> > I am about to do the opposite...I found Brintellix to be demotivating/dulling and kind of "isolating" on an interpersonal way.
>
> Sorry to chime in but would you care to elaborate? In what way isolating?I felt very alienated and indifferent to people. I would ask a question and as soon as they answered I could care less. another guy described it a living trapped in a box with your thoughts and everything else is just outside it. To be blunt I didn't care about anyone...and I didn't care much about my hobbies or other things. I did have a good sex drive though!
This experience was similar to the way I felt on Abilify and Latuda, both which share a similar mechanism (I can't recall it exactly off the top of my head...5ht1-a antagonism maybe). Made me feel like I might be a psychopath out of sheer disinterest in other people.
Posted by porkpiehat on June 11, 2014, at 18:43:02
In reply to Re: Viibryd vs. Brintellix » porkpiehat, posted by phidippus on June 11, 2014, at 18:26:07
> I couldn't get very far with the Brintellix-it began to destabilize my mood. SO, my experience of it wasn't fair.
>
> I didn't have any problems with Viibryd.
>
> EricAnd so you had no dulling apathy type effect? Can I ask why you stopped Viibryd?
Posted by phidippus on June 11, 2014, at 22:20:11
In reply to Re: Viibryd vs. Brintellix » phidippus, posted by porkpiehat on June 11, 2014, at 18:43:02
I didn't experience any apathy on Brintellix.
Viibryd pooped out on me.
Eric
Posted by sk85 on June 13, 2014, at 13:30:57
In reply to Re: Viibryd vs. Brintellix, posted by porkpiehat on June 11, 2014, at 18:41:07
> > > I am about to do the opposite...I found Brintellix to be demotivating/dulling and kind of "isolating" on an interpersonal way.
> >
> > Sorry to chime in but would you care to elaborate? In what way isolating?
>
> I felt very alienated and indifferent to people. I would ask a question and as soon as they answered I could care less. another guy described it a living trapped in a box with your thoughts and everything else is just outside it. To be blunt I didn't care about anyone...and I didn't care much about my hobbies or other things. I did have a good sex drive though!
>
> This experience was similar to the way I felt on Abilify and Latuda, both which share a similar mechanism (I can't recall it exactly off the top of my head...5ht1-a antagonism maybe). Made me feel like I might be a psychopath out of sheer disinterest in other people.Wierd. I haven't experienced any apathy of this sort. And it's not a 5-HT1 antagonist, in fact it's an agonist and 5HT1 agonists are usually associated with anxiolysis and antidepressant effects.
Posted by meffect on August 19, 2015, at 19:49:38
In reply to Re: Is Viibryd or Brintellix 'energizing'??, posted by Louisiana Sportsman on April 19, 2014, at 16:46:04
> > Hello.
> >
> > My diagnosis has always been major depression and the primary symptom I suffer from is a lack of energy, a sort of enervated fatigue.
> >
> > Can anyone say if either Viibryd or Brintellix are "energizing" or "activating" (as opposed, to say, "sedating)?
> >
> > Thank you.
> >
> >
>
> I am disqualified to deliberate vilazodone [Viibyrd (Forrest)]; contrary, au courant is Day 46 of vortioxetine [Brintellix (Lundbeck)] 1TPOQAMCF; Days 1-29, I administered 10mg., and for the past 17 days, 20mg. I can felicitously share my introduction to vortioxetine.
>
> I have not experienced any aggrandizement of sedation since initiation. Due to 5-HT3 antagonism, there is a negligible release of histamine (sedating neurotransmitter), but it seems to be off set by the concomitant dopamine and norepinephrine release.
>
> In terms of activation, I generally prefer for my medications to be energizing as well. My prior ADs were Zoloft (most DA release of the SSRIs) and Effexor/Pristiq (NE reputake inhibition). Antidepressants, besides MAOIs, bupropion (Wellbutrin) and possibly NE heavy desipramine, are generally not something someone takes for the energizing effects.
>
> One of my PDOC's main concerns when prescribing Brintellix was possible sedation due to my treatment resistant bipolar anergic depression and ADHD. She said it would not likely be a factor she was right. If anything, it is an activating AD since I am able to take in the morning (I prefer to take all my medication in the morning, if reasonable), and it has treated me well.
>
> To elucidate, I rank Brintellix among the ADs I've been on. I put wayy too much thought into this, by the way. :D
>
> Zoloft: 8.1/10
> Wellbutrin XL 450mg. (Aplenzin 522mg.): 6.0/10
> Pristiq 50mg. (Effexor XR 75mg.): 6.7/10
> Brintellix: 8.9/10
>
> Verdict: Neither sedating, not activating unless you want to count relief which translates to more activity. A good AD, but I suggest:
>
> Try Brintellix only after you have failed a proven SSRI and two other antidepressants from two different classes. If an AD is tolerated, then that AD should be augmented with an atypical antipsychotic before trying Brintellix. Something like: Cymbalta -> Paxil -> Lexapro + Abilify AND then Viibyrd or Brintellix can be justified, and I would still hypocritically recommend a researched AD instead.
>
> Good luck!dude... I wish i could talk like you. I love big words that have thoughtful expressive meaning
Posted by meffect on August 19, 2015, at 20:41:22
In reply to Re: Is Viibryd or Brintellix 'energizing'??, posted by Louisiana Sportsman on April 22, 2014, at 13:59:02
> > could you take Ritalin or Provigil, maybe with an AD?
>
> I take Brintellix in the morning with both Dexedrine 60mg. and Provigil 600mg. (.01mg. of d-amp for every 1mg. of modafinil which works well).
>
> Maybe that's why I can't accurately comment on the sedation?
>
> I highly suggest you augment 150mg. Nuvigil and 20mg. Focalin XR concomitantly. These might benefit you in a lot of ways, these are commonly prescribed to those with a lack of energy and fatigue, and I think they should have been prescribed first-line.
>Holy fing hell. This blows my mind. I can hardly tolerate 50mg of provigil without flipping the hell out
Posted by meffect on August 19, 2015, at 20:56:17
In reply to Re: Viibryd vs. Brintellix, posted by sk85 on June 13, 2014, at 13:30:57
I've been on Viibryd for a while now. It's the only SSRI I've been able to tolerate. I would love to try Brintellix it's near $1000 for a 3 month supply, so I have never tried it
Celexa = Tired, sleep all day, anhedonia
Lexapro = Same as Celexa
Cymbalta = Anxiety
Pristiq = Anxiety
Zoloft = pretty good, i like the DA+ but, it produced anhedonia pretty quickly after I started taking it. also major anorgasmia
Prozac = want to crawl out of my skin
Wellbutrin = panic attack anyone?
Provigil = irritable and feel like crap
Paxil = Tirrreed
Nardil = hypomanic borderline manic
Parnate = horrible nap urge
Fetzima = AHHHHHH NE is not my friend
Dexedrine = works great. calms me down and doesnt give me any anxiety. only confidence, which I lack. though I only took it for a couple months
Abilify, Latuda, Saphris, etc = akathisia even at low dosages
seroquel = no akathisia but.. i feel like a dead husk of a personbasically it blows my mind that an SSRI, viibyrd, has been the only thing that even comes close to helping me. It does make me a little tired, but caffeine can easily pull me out of it. I do have trouble sleeping with viibyrd though, even when I take it in the morning. I need benzos galore and ambien just to get to sleep
I could end up developing anhedonia over time. We'll see. Lexapro didnt give me anhedonia in the begining so... viibryd might be the same. Wish I had experience with Brintellix to give you
Posted by phidippus on August 20, 2015, at 5:29:32
In reply to Re: Viibryd vs. Brintellix, posted by meffect on August 19, 2015, at 20:56:17
What is your diagnosis?
Eric
Posted by meffect on August 20, 2015, at 10:23:09
In reply to Re: Viibryd vs. Brintellix » meffect, posted by phidippus on August 20, 2015, at 5:29:32
> What is your diagnosis?
>
> Eric
Wish I knew. The doctors i've been too don't like to give out diagnosis. Without a doubt though, from im empirical evaluations, i have MDD thats not caused by any particular life-event, rather its persistent and has been my whole lifeI used to think I had BPD, maybe I do, because I have extremely strong emotions towards everything. The SSRI's pretty much take away 80% of that issue though
Posted by phidippus on August 20, 2015, at 11:48:25
In reply to Re: Viibryd vs. Brintellix, posted by meffect on August 20, 2015, at 10:23:09
The SSRIs take away all the strong feelings but probably leave you very happy to the point of losing judgement.
I do believe you are bipolar and need antidepressant therapy alongside mood stabilization.
Eric
ps. how did you respond to dextroamphetamine?
Posted by meffect on August 20, 2015, at 21:16:36
In reply to Re: Viibryd vs. Brintellix » meffect, posted by phidippus on August 20, 2015, at 11:48:25
> The SSRIs take away all the strong feelings but probably leave you very happy to the point of losing judgement.
>
> I do believe you are bipolar and need antidepressant therapy alongside mood stabilization.
>
> Eric
>
> ps. how did you respond to dextroamphetamine?I tried dexedrine spansules and vyvanse. I liked at first because I was able to focus and get a lot done. the spansules , if I took them at 8:00am, I started to have come down effects at about 11:00am. The vyvanse lasted maybe 30minutes to 60minutes longer before the come down. The come down was pretty brutal for me... and taking a second dose did not act the same as the first dose; it only removed the come down effects, but I didnt feel the benefits very much. eventually after taking it for a month it eventually didnt seem logical to take it anymore because the good effects no longer outweighted the bad effects. the come down for me was I get really talkative and anxious. also one time I took dexedrine spansule before I went to an EDM concert, and by the end of the night when the drug wore off, i felt incredibly depressed. Maybe it was because I had alcohol too
anyway basically I didnt find dexdro to be something that I could take long term and be better off for it. I could be wrong though. I gave it a month or two before I quit.
I'm guessing the dexdro was giving me a euphoric effect which I liked, and then when it wore off (the come down), i was a mess. Then after taking it for a month the euphoria stopped and I just felt icky
Posted by phidippus on August 21, 2015, at 10:04:41
In reply to Re: Viibryd vs. Brintellix, posted by meffect on August 20, 2015, at 21:16:36
>I'm guessing the dexdro was giving me a euphoric effect which I liked, and then when it wore off (the come down), i was a mess.
Dextroamphetamine can do this. In moderate doses it can improve affect and concentration, however, blood levels can drop dramaticalyy leaving you at square one.
Eric
Posted by Katussis on November 23, 2015, at 8:51:51
In reply to Re: Viibryd vs. Brintellix, posted by meffect on August 19, 2015, at 20:56:17
You and i may have the same neuro chemistry . Swap notes? I am undergoing experimental treatments . Theese are times of so much potential for uncovering / recovering mental health. Let me know if you would like to exchange our therapy history . It could help preempt assisted suicide! . Thanks.
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