If Trintellix, classed as an atypical antidepressant, did not yield the desired results, you may be considering Trintellix tapering as the next step of your overall health plan.
The antidepressant Trintellix, FDA approved for MDD in adults6 is intended only as a prescription antidepressant when other antidepressants have not worked. Do not despair. Antidepressant medication may not have been what you really needed in the first place.
Does Your Diagnosis
Alternative to Meds has more than 15 years of experience as an antidepressant tapering help authority. Using holistic therapies and Environmental Medicine, we have published evidence demonstrating the wonderful success of the majority of our clients in beating not only their dependence on medication but beating their depression symptoms as well.
15 Years Experience by Professionals Who Understand Your Journey.
As stated above, the antidepressant Trintellix is intended only as a prescription antidepressant when other antidepressants have not worked, rather than a first-line treatment choice.1 This would probably mean that a person taking Trintellix had tapered off another antidepressant medication before starting to take Trintellix. Perhaps this process went smoothly, or perhaps it did not go as easily as hoped. Tapering Trintellix, as is the case with many drugs, can be difficult without good planning and expert guidance. It is always advisable to be aware of FDA recommendations, information, and cautions regarding starting and stopping Trintellix or other prescription drug treatments.6
Two Most Common Reasons for Tapering Trintellix
In general, there are two main reasons people might consider tapering Trintellix or other types of medication. One is that the drug did not bring the relief that was hoped for. In the case of Trintellix in particular, the drug is FDA approved only for the treatment of MDD in adults, (major depressive disorder) and only when other drugs have not worked in prior treatment.5,6
However, sometimes the lines become blurred when it comes to selecting a particular drug or class of drugs for treatment and can result in “off label” prescribing. While the practice is not illegal, it is a little like experimenting outside the lines, outside the guidelines laid down and published in FDA and drug manufacturer literature. The results can be unpredictable. Unfortunately, desperately trying to quit one drug and switch to another is not as uncommon as one might think. According to research by Keks et al published in the Australian Prescriber, up to two-thirds of patients diagnosed with major depressive disorder fail to respond adequately to the first antidepressant, and are usually switched to a different one. Three-quarters of those whose prescription was switched also fail to achieve remission of symptoms on the second drug. The process can repeat many times.1,7
Another common reason for wanting to discontinue a drug is that the side effects became intolerable. Anyone in this predicament experiences the need for careful, conservative Trintellix titration. Intolerable side effects probably represent the most common reason a person may desire to get off Trintellix. It may be helpful, if you find yourself in this type of situation, to realize that many others have experienced similar problems. You are not alone.
In either circumstance, this scenario could have repeated multiple times, switching from drug to drug, trying to wean off Trintellix or another drug to avoid side effects such as nausea, headaches, diarrhea, sexual dysfunction, insomnia, or others. This is a potentially frustrating and sometimes scary difficulty to find oneself in. More information on Trintellix withdrawals and other side effects can be found below.
Trintellix Tapering Guidelines
Alternative to Meds Center recommends inpatient treatment if possible, for tapering Trintellix. We have the capability and expertise that will make your experience comfortable and safe. However, we understand that inpatient care is not available to everyone. For the latter, it is imperative to seek medical guidance so you can travel the journey safely, guided by competent and sympathetic help.
To correctly configure reducing dosages, ask your doctor to prescribe the lowest dose pills available. Incremental adjustments may require cutting the pills. For Trintellix the pills are the 5 mg pink, a 10 mg off-white, 15 mg orange, and the largest, 20 mg brown (all are elliptical-shaped pills).8
For example, if you start your taper from 20mg and want to reduce very conservatively by 10% as a starting point, you could combine 1x15mg and cut a 5mg in half for a total of about 17.5mg. Speak with your doctor who can help determine what adjustments are right for you.
Ensure enough time elapses between dose adjustments, to settle out at each new level. This will vary from person to person, but at least one or two weeks at each level would be a conservative approach.
Even using a very conservative timeline, withdrawals may emerge.11 Use the frequency and severity of symptoms to help determine whether the taper needs to slow down or is going along okay.8
Symptoms that emerge during Trintellix withdrawal are similar to other antidepressants, and may occur after abrupt discontinuation as well as during more gradual titration, and are not necessarily dose-dependent, according to research by Siwek et al, published in Pharmaceuticals Journal in 2021.11 Discontinuation symptoms may include:
psychosis including visual and audio hallucinations
increased suicidal thoughts
depersonalization, derealization — feeling one is outside the body and a sense that things around you are not real
Depression is classified in the DSM (diagnostic manual) as a disease that has some or all of the following characteristics: depressed mood, thoughts about suicide or death, sadness, hopelessness, fatigue, loss of interest generally in life including loss of interest in sex, sleep disturbances such as insomnia or sleeping too much, increased or decreased appetite, significant weight loss when not dieting, prolonged irritability, anger, persisting unexplained aches and pains, anxiety, agitation, cognitive impairment sometimes called “brain fog,” inability to concentrate, think clearly or quickly, inability to make decisions, slowed body movements, and other unwanted conditions.
Amazingly, these, among others, are also known side effects of antidepressant drugs such as Trintellix.
So if taking a drug such as Trintellix did not provide relief for these types of symptoms, it might be time to consider how to get off Trintellix and try other approaches, as opposed to other drugs, to address the problem. Other approaches that don’t involve drugs at all, can be found below in this article.
Trintellix Titration With Inpatient Support
Alternative to Meds Center has helped many people to extricate themselves from such a tangle of methods of treatment that were not as effective as was needed. How to wean off Trintellix safely and gently is a subject that deserves attention to detail, and understanding what is going on when you taper off antidepressants. Our treatment plans are based on testing and the discovery and treatment of root causes. We do not believe that simply masking symptoms results in optimum treatment results. Trintellix titration (as with other medications) does not have to introduce further complications or harsh symptoms. We specialize in safely tapering Trintellix as well as other medications, with great success. More on our Trintellix cessation protocols can be found below.
Trintellix Side Effects
According to the drug manufacturer, the most commonly reported treatment-emergent side effects given as reasons for stopping Trintellix include nausea, constipation, headache, dizziness, constipation, and vomiting.10 Other more severe side effects that consumers and caregivers are advised to watch for while taking Trintellix include suicide attempts, increased suicidal thoughts, intentional self-harm, serotonin syndrome, violent behavior, akathisia, worsened depression, mania, psychotic symptoms such as hallucinations, hypomania, trouble sleeping, drop in sodium blood levels, sexual dysfunction, dry mouth, and many others.2,5,9,10,11
These are much the same side effects for virtually all other antidepressants on the market. Such side effects can be difficult to manage and may make this type of treatment unworkable. It is possible that weaning off Trintellix can open the door to other, non-drug-based treatments, that may be more effective, and less intrusive in helping you reach your mental health goals.
Cautions Regarding Trintellix and Pregnancy
The drug manufacturer indicates that if Trintellix is taken during the last trimester of pregnancy, the baby may be born with a condition known as PPHN, which means persistent pulmonary hypertension of the newborn, a persistent breathing difficulty.3 This may be another very good reason to consider Trintellix tapering for a woman who is planning to become pregnant, and who wants to avoid potential birth complications for the infant.
As John B. Warren states so succinctly in his article on “Antidepressants and the developing nervous system”, published in the British Journal of Clinical Pharmacology, “When a drug first comes to market, the assessment of the risk-to-benefit ratio is an educated guess” – John B Warren13
The truth is that few-to-no studies have been done on the effects of drugs and pregnancy and most that have been done were done on rats and rabbits, for ethical reasons. However, a 1996 study compared outcomes of various health factors in women who took fluoxetine during pregnancy vs those who did not and found significant differences in rates for premature delivery, admission to special-care nurseries, respiratory difficulty, and other neonatal problems.14 Because the information has to be collected and assessed “after the fact”, it can take years and decades, to come to dependable conclusions. A cautionary stance would be advised when it comes to the health of mother and child, especially concerning novel drugs such as Trintellix. There are non-drug-based remedies for depression that might be well considered before relying on pharmaceutical products which have no definitive history of testing for safety in pregnancy.4
Special Notes About the Name “Trintellix”
Trintellix is one of a group of relatively new antidepressant medications that have been on the market since 2013. Trintellix was first called Brintellix. However, a number of instances were reported where Brintellix was confused with another similar-sounding but entirely different drug, one that was used for anti-blood-clotting. In 2016 the drug manufacturer changed the name of Brintellix, the antidepressant, to Trintellix to avoid more instances of this confusion in the future.15
How to Wean Off Trintellix Safely
Alternative to Meds Center offers a Trintellix tapering program done gradually and comfortably over a two month period of time. Longer programs can easily be arranged if desired. Clients are under the care of our licensed doctors, integrative psychiatrist, nursing staff, and clinicians who are all familiar with the intricacies of getting off Trintellix and other medications comfortably and safely.
Counseling is also offered in many genres, such as CBT, and life coaching, that can help a person regain balance and renewed positive energy for life. Equine-assisted therapy and art therapy are also offered and are very popular with our clients.
We are always finding there is more to understand about how the CNS (central nervous system), hormones, the complexities of brain chemistry, the microbiome, and other important health matters all interconnect. Increasing understanding of such important information can greatly assist a person who is getting off Trintellix. That is why our programs include education components, as well as at-home tools and practical approaches to self-care, which are invaluable for clients as they leave the program.
Alternative to Meds Center provides a comprehensive series of educational modules. The in-class portions of the program aim to empower the client with practical and useful information about natural methods of neurochemistry and microbiome support, the role of nutrition in mental wellness, and many other important subjects useful in self-care. Tapering Trintellix does not have to be torturous or difficult. Using a number of blended holistic therapies, the body and CNS can be brought to a more healthy state, where symptoms can reduce and be completely eliminated. This is especially true when done in a truly caring and compassionate inpatient setting, with 24/7 staff on hand throughout the process.
Find Out More About Our Trintellix Tapering Programs
You or your loved one may benefit from the services we provide to address root causes of troubling symptoms such as depression, and thereby improve mental health naturally. Our programs are more than helping discontinue medication safely. We are all about achieving robust natural mental health without relying on pharmaceutical products. Please contact us at Alternative to Meds Center, to find out much more detailed information about how our Trintellix tapering programs at the center may be the help you or a loved one may have been searching for.
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.