It started with wanting to get rid of side effects.
When I was first diagnosed with social anxiety disorder and panic disorder, the psychiatrist suggested 10 mg of Paxil--my very first antidepressant. And the first thing I did after the appointment was to get a new notebook to keep a diary of my day-to-day progress under this new drug.
I bought the diary with me at my next follow-up appointment. The verdict? Paxil worked. After a few weeks, I was slowly making progress. I was able to look people in the eye and hold a conversation. I didn't feel as stiff around my coworkers and I was able to speak above a whisper (for once, I didn't have to keep repeating myself). And my panic attacks were less frequent and more manageable with the help of breathing exercises.
But there was one noticeable side effect: the fatigue. Paxil provided great sleep, but it also left me drowsy throughout the day. I would try to fight sleep at my work desk. On one occasion I almost fell asleep at my desk. Then I would come home from work and take a long nap. And when I wasn't home, I was thinking about my next opportunity to sleep. This was my new life.
I tried humor at least. Hey, no need to worry about panic attacks and social anxiety when I'm sleeping all of the time (my psychiatrist didn't laugh at that. Well, I tried)
"Antidepressants can be very sedating," he explained. "Fatigue is a very common side effect and Paxil is a very strong medication. Maybe we can change your medication to something with less side effects."
So we agreed to other antidepressants that wouldn't leave me drowsy and tired all of the time. I tried Effexor (slightly better, but still drowsy), Pristiq (still drowsy), Cymbalta (still drowsy), and then Celexa (didn't work for my anxiety. And still drowsy).
That was when my psychiatrist decided that it was time for a drastic change.
The New Experiment
This was around the time my psychiatrist had suggested Trintellix. A new medication, Trintellix is usually used to treat depression but can also be used to treat anxiety disorders as well. What he liked best about Trintellix was that it was marketed as a medication with less side effects compared to other antidepressants and people reported less drowsiness while on it. We agreed to start off at 10 mg that same day.
Trintellix felt like a miracle drug that first day. In fact, I would say it was the best antidepressant I had ever been on. After taking it for the first time, my social anxiety and general anxiety literally disappeared within a few hours. Not only was I able to talk to people, but I was friendly and animated.
The best part about Trintellix was the lack of drowsiness. For the first time in years, I wasn't tired or anticipating a nap in my car during lunchtime. When I got home, I couldn't wait to tell my husband about my day and he was just as happy as I was over the fact that I wasn't taking an after work nap. Instead of going to sleep, we watched a movie together and I impressed him with my new burst of energy. In fact, I was so restless, I started to clean that night.
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But to my surprise, I continued to clean past my bedtime. My husband didn't know what to say as he watched me mop the kitchen floor. At one in the morning.
Looking back, I didn't realize that that was the first warning.
The New Side Effect
Trintellix isn't approved for social anxiety disorder, but based on my anecdotal evidence, it may as well should be. My job as a librarian involves customer service and working with others, so it can be a mentally exhausting job when you have social anxiety. Thanks to Trintellix, I was friendly and bubbly to customers, and I was going a full month without a panic attack or a depressive episode. And best of all, I also had energy to complete tasks after work. I would even call my husband at work to tell him that I went an entire day without taking a nap. With Trintellix, life seemed good.
And then the anger started.
A few weeks after being on Trintellix, I started to notice a new side effect. Instead of drowsiness, I was now irritable, and the most minor inconveniences would set me off. Usually, I'm a quiet, calm person; it takes a lot to make me angry. But I found myself now having to bite my tongue and control my mood swings at home and at work. I would find myself snapping at my husband. Before Trintellix, I didn't experience road rage. After? The driver before me was driving too slow and I cursed and ranted until I practically saw red. Even as I cursed out the driver, I was shocked at my behavior and wondered what had changed. And Trintellix was the only change.
And after two months, I had a panic attack at the pharmacy. It wasn't just a regular anxiety attack that I was used to. It was a meltdown. I became the stereotypical irritable customer (not my usual demeanor) taking my anger out on the pharmacy technician when they messed up my prescription. I even became hysterical and even started to cry at the counter, despite the fact that I knew my behavior was ridiculous. Out of embarrassment, it was the last time I filled a prescription at that pharmacy. And after careful consideration, it was last day I took Trintellix.
Getting off of Trintellix
I was on Trintellix for three months. The next time I visited my psychiatrist, I told him about the good (no more drowsiness), but I also had to tell him the bad (the mood swings). He became alarmed when I told him that I felt "manic" on some days.
"I'm glad you told me that," he said, while taking notes. "That's not a good sign at all. So, I think the smartest thing to do is to take you off of Trintellix."
And just like that, the mood swings and frequent irritability stopped.
That was how I went back to taking Paxil. My panic attacks are less frequent and severe, and it keeps my social anxiety to a minimum. I still experience drowsiness and my husband jokes about my 5 pm naps, but I'm able to fight it a little better with the help of a good diet and exercise.
Trintellix is different for everyone. Some people might experience manic episodes and mood swings while taking it, but some may not. Everyone is different, so be sure to take note of changes whenever you try a new antidepressant. If in doubt about a side effect, tell your doctor about your worries immediately.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.