Has anyone gone through multiple switches of antidepressants in short period of time

[MarmadukeM]

As the title says really - I am on day 17 of Vortioxetine and although mood wise I can see the benefit I am waking during the night with sweats and anxiety and then in the morning I have to get up due to the anxiety feelings. Haven’t had full nights sleep in weeks despite sleeping tablets and I only have 4 days left then no more sleeping tablets and I just have to get on with it.
im worried as sleep is so important for my mental stability plus it’s horrible waking with this anxiety. I can’t stay on this medication if these are going to be permanent side effects (I thought they’d improve after 2 weeks but no). I know I can ask to swap to something else but as I’ve been on three in last month I’m also concerned it will destabilise me - but I really think I need a more sedating type.
so anyone been similar and chopped and changed over short period of time? Should I just be more patient? And if so, for how long? Any experiences will be very appreciated Thanks xxx

Yes, me. After multiple attempts at trying ssri I can confidently say they don't agree with me - I find them too activating, make existing insomnia even worse and increase anxiety ten fold. Sertraline sent me loopy and like you, I stuck them out for a month to see if it improved, but nope. Now on mirtazapine as they seem to be only ones I can tolerate; have you tried those? Problem being they haven't pulled me fully out of depression or anxiety so my gp is trying to find something that can augment them but that's proving a battle too!

Three in a month seems an awful lot. If you switch as much as that you risk having a mixture of withdrawal effects plus the effects of the new drug. The side effects do wear off and the benefits are slower to emerge a minimum of 4 and ideally 6 or 8 weeks is a decent trial. However if you already know you cannot tolerate this then maybe ask for mirtazapine as it does act differently and is sedative.

Zopiclone sleeping tablets didn’t work for me. My consultant recommended trying antihistamines that make you sleep and they are really helped.

I think you need some professional help from your GP or a referral if theyll give you one. People’s responses are very individual and it’s important the right medical solution is found for you. Also treating depression in someone who is unipolar (standard depression) is different from in people who are bipolar. If SSRIs are making you feeing increase in anxiety beyond the initial introduction phase it’s important to check and be sure depression is unipolar.

All the best. Well done for reaching out for help. Try and keep asking till you find what works.

Thanks for the replies. - I have a diagnosis of bipolar type 2 so take quetiapine and pregabalin as well but I do think that this is why I am so easily tipped into anxiety type side effects. Yeah I was actually in mirtazioine which was great for sleep but unfortunately I became depressed whilst taking it hence the trial of venlefaxine that was hideous so lasted grand total of 5 days and now this Vortioxetine. I think I’m going to have to give it a bit longer, I’m actually under the crisis team and it’s them who’ve initiated the medication change but I think they just want me off their books now and are kind of dismissive of my concerns about these side effects. I get massively derailed if my sleep isn’t good so you’d think they’d want that under control but they don’t seem too concerned but personally it’s causing me quite a bit of anxiety x

Also that’s good advice re antihistamines- I was going to try them once the zopiclone runs out but I’ll have to run it past team first incase it’s a problem in relation to the other meds I take. X

Could you try increasing the quitipine? Does that not help to balance the activating effect of the antidepressants? What dose are you on, as it can go up to 800mg I think ?

I’ve just asked them and they’ve put me up from 300 to 350 so hopefully that will help x

I hope it works for you. I appreciate how frustrating it is when you don't respond well to meds - I'm the same, everyone seems to respond so well without horrible side effects, and there's people like us who just don't! Keep my fingers crossed for you.

Yeah last year I did 3 switches in a month but I have been on antidepressants for over 20 years so have a good sense of what will probably help and not, understandably doctors not keen. Ended up on escitalopram and pregablin which is helping to a degree.

It’s hard to argue the toss with them isn’t it? But at the end of the day it’s us who are walking round feeling like total shite. Being told to just give it a few more weeks makes you want to cry eh? I couldnt care less if I had headaches, dry mouth, constipation or whatever side effects but if my sleep gets disrupted and I develop horrible anxiety then I’m not really going to be all that enthusiastic about the medication! Hopefully the quetiapine will help a bit and the side effects will wear off. @Blanketenvy which meds did you try unsuccessfully? And what were the side effects that meant you weren’t able to tolerate?

TBH antidepressants are not recommended in bipolar at all these days. Many psychs would have recommended increasing the quetiapine or adding lamotrigine rather than any antidepressant at all but obviously you should talk to your real life team.

@ThePure is this because they cause more problems than they solve? I can see the logic there x

Yes that’s it. They have been shown to be ineffective in bipolar depression and to cause more mood instability especially powerful dual action ones like VFX and vortioxetine.

@ThePure i wonder why they still give them then? I do agree I feel worse on Vortioxetine. Well I’ll see how I get on and it’s something to think about going forward. X

It's a strange one tbh. There have been a fair few posters on here with bipolar who take antidepressants but seemingly always alongside an anti psychotic or mood stabilizer. So they must have some place in treating it. It's good you're under the m/ h team and not just gp as they'll know their stuff!