Switching to Trintellix or Low Dose Naltrexone (LDN)

Hi @elwoodsdad. You may have noticed I moved your discussion from Just Want to Talk to the Depression & Anxiety in hopes that you can connect with others who take this medication. Just click VIEW AND REPLY in your email and you'll be sent to your post.

That must be frustrating to have so many side effects with this medication.

I wanted to introduce you to fellow Connect members @windwalker @depressionsurvivor and @nansmith as they have mentioned this medication in the past.

I also wanted to share this thread on Trintellix and nausea to see if it can be of any help: https://connect.mayoclinic.org/discussion/trintellix-nausea/

It's great that you will be seeing your doctor tomorrow. How long were you on duloxetine before switching?

Thanks for getting me properly slotted in order to stimulate response. I was on duloxetine for over 5 or 6 years, or possibly more, and I initiated the discussion about a change with my physician in hopes there was a newer/better bit of pharmacology for my dysthymia, hence the trintillix. Interestingly, I have changed the time of my dosage from first thing in the morning to the last thing at night. Given the half life of trintillix, the negative response is materially less. I am interested to discuss this with my physician. I owe him the courtesy of letting him practice psychiatry, and I am eager to live a less tumultuous life.

I’m taking Duloxetine and Trintellux together. Trintellix was added to my arsenal about 1 month ago. I’m on a low dosage of 10mg. I too have been taking Triintellix in the morning but wonder how f night time is best. I started off at 5 mg but can’t really tell that it’s working. I’ve not really noticed any side effects. Any ideas out there? I take 90mg of Dulixetine and have for years. I’m wondering how long it typically takes for the Trintellix to take effect if I s going to be affective for me.

Hi, @petangelkat1 - welcome to Mayo Clinic Connect. Seems wise to ensure you are taking your new medication, the vortioxetine (Trintellix), in the best possible way.

I've not taken this particular antidepressant, so can't speak from experience. I will mention, however, that when I started bupropion (Wellbutrin) years ago a pharmacist I asked indicated I'd need to wait 2-3+ months to really settle into it and see how it worked for me.

I'd like to bring into this conversation a few members who have mentioned this antidepressant and may have insights related to the timing of taking the medication and how long it might be to take to effect. Please meet @karen00 @beckysn @ronniekep @nansmith @depressionsurvivor @bipolar4ever. @gailb may also have some thoughts for you.

@petangelkat1 - along with the interaction with other patients who have taken vortioxetine (Trintellix), is there a pharmacist where you filled your prescription who might advise you on these questions? Or, would your prescribing doctor's staff have any input on this for you?

My physician has changed me from trintillix to Prozac. I have yet to take the Prozac as I don’t know when to take it. Two capsules daily is a bit ambiguous, and I have a call in. I had been taking trintillix the last thing at night, and I slept 8.5 hours straight through. Did the same tonight and it is 4 a.m., and I’m still awake. I made a bad decision to try to squeeze some sleep from trintillix, and I’m paying for it. The switch to Prozac is represented to be less eventful, but I am not pleased. I think I’m going to wait a day before changing to Prozac since the half life of trintillix is about 60 hours. I believe my system isn’t handling the buildup of the medication. Darn, I felt so good today with a good nights sleep. It will happen again. I’m just wired.

I went 24 hours without sleep after the last try at trintillix (the very last try, ever). I took no anti-depressants at all yesterday, but took a two hour nap. Had issues settling down last evening, but with the help of an understanding wife, and an extra clonazepam, I slept 121/2 hours. I will start 20 mg. of Prozac Saturday morning. Letting the trintillix work it’s way out of my system. It has a 60 hour half-life, so I can start Prozac reasonably fresh. This has been a horrid experience, and I am hopeful the corner has been turned. Trintillix is a good drug, just not for me. If you are taking it without issue, keep it up. If you are having issues with any anti-depressant, please be pro-active. See your prescribing physician and work out an option. Hoping this change works for me. Not being pro-active guarantees unnecessary distress, and can be fatal. Brain chemistry is not an exact science, but neither is any medical procedure, or prescription.

My physician switched me to Prozac. Easier transition. Said I was the first patient he had on trintillix who had suicidial ideation. Trintillix is either wonderful or it is not wonderful. I am in the latter group.

Two days on Prozac. No more flu-like, light headed feeling, and my disposition is better and more normal, according to my wife. Important opinion. Had a difficult night last night with insomnia, but a larger than prescribed dose of clonazepan settled me. I am very uneasy about this part of this transition since it has been part of the trintillix issue as well. I don’t want to continue living like this, and hopefully, the chemistry will settle things. Self destruction is a very selfish act.

I took Prozac before. It can cause insomnia so I took it in the morning.

I am also taking it in the morning. No naps. No caffeine after noon. No alcohol. Still having issues with insomnia. Sometimes I have it, sometimes not. Still some trintillix working its way out I think.