Posted by sk85 on July 18, 2014, at 16:06:11
In reply to Re: at 3+ weeks/Brintellix and anxiety » Beckett, posted by porkpiehat on June 23, 2014, at 10:42:26
Haven't posted updates on this one for a while. Partly because my trial with Brintellix is been "dampered" with a lot of other therapeutics I have been trying to use. Still this has been noticed by me during the 8-9 weeks I have been taking vortioxetine:
Month ago tried augmenting with pramipexole and it did not provide the effects I got with it when on sertraline. Only the SEs, so stopped it.
Some more while ago I also purchased a CES (cranial electrotherapy stimulation) unit and experimented with for insomnia but was relatively disappointed as I quickly built a tolerance to its hypnotic potential and did not associate it with significant AD effects either. So, I more or less forgot it and left it aside.
Just out of curiosity I have been using it again while on 10 mg Brintellix. So I cannot say how it directly alters vortioxetine's performance.However, about two weeks ago I started noticing subtle changes for the positive. I have consistantly been less prone to anxiety. Depression has changed more to a certain indifference, not quite apathy, but just to a not-really-good-not-really-bad state. Motivation has been mediocre, anhedonia not very noticeable. Lately I have also become quite more sociable, but this I attribute to somewhat to the decrease in anxiety levels.
Sleep has been quite good all through the way, Brintellix certainly doesn't mess with it as do SSRIs.
Also, noticed that during the day I need less caffeine to get by and all sorts of addictive behaviours (be it smoking or OCD) are more manageable.Overall I can't really say that Brintellix is responsible for the changes. Perhaps the summer period is having an effect or perhaps the CES device is helping to kickstart things, but nevertheless I would not discontinue my 10 mg dose at the moment and would see it continuing.
On a side note. Reading on Brintellix pharmacology some of the things people have noticed make sense in the light how it appears to work. 5-HT7 activation has been reported to increase opioid analgesia:
https://www.jstage.jst.go.jp/article/jphs/116/4/116_11039SC/_article
Some aspects (or forms) of depression are characterized by increased opioid activity (excessive beta-endorphin levels; perhaps leading to long term desensitization and reduced responsiveness in this system):
http://www.ncbi.nlm.nih.gov/pubmed/1503128
Vortioxetine antagonizes 5-HT7 (that seems to be overactivated in depressed states) and perhaps this is a reason why some anecdotal reports and also my own experience during the first weeks was registering it as even bit dysphoric and not helping with sociability (a dip in opioidergic input). Over long term 5-HT7 blocking would however trigger adaptive more balanced opioid activity in the brain (re-sensitizing) and thus improve the already exhausted opioidergic state that is inherent to depression. This is just a speculation though, yet, if any of this is true then vortioxetine in some instances would be expected to kick-in slowly and requiring quite a bit time to reverse some of the damage that depression does to the brain.
poster:sk85
thread:1065908
URL: http://www.dr-bob.org/babble/20140717/msgs/1068498.html