Posted by Jay2112 on August 28, 2023, at 22:13:14
In reply to Partial response to vortioxetine (Brintellix), posted by undopaminergic on August 16, 2023, at 4:45:14
Hi U/D,
Glad you are feeling a bit better. Could you not add a small, even tiny, dose of pramipexole? Did the pramipexole predispose you to a mania or psychosis? Otherwise, I think that would be a spot-on combination. I, too, found Brintellix to leave me with a similar set of feelings as you described, with that poverty of thought. Or, how about Ritalin? I believe you had said you had a positive response to that med.
Just keep at 'er. I believe with the number of meds that reach so many neurochemicals, and so many parts of the brain, mental health is reachable with persistence and creativity. I know...'mental health' means many different things to all of us. But...I think you get my drift.
p.s. Besides pramipexole and Ritalin, have you tried any other dopamine agonists?
Best,
Jay
> Hi all,
>
> With reference to an older thread I started about vortioxetine (Brintellix; Trintellix), which is found at: https://www.dr-bob.org/babble/20220917/msgs/1121240.html
> 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
>
Humans punish themselves endlessly
for not being what they believe they should be.
-Don Miguel Ruiz-
poster:Jay2112
thread:1122171
URL: http://www.dr-bob.org/babble/20230117/msgs/1122191.html