Brintellix (Vortioxetine) is considered an atypical antidepressant that was co-developed by pharmaceutical companies Lundbeck and Takeda. Most consider Brintellix to be a new antidepressant as of 2014 due to the fact that it was approved by the FDA in September of 2013. In clinical trials, it proved to demonstrate substantial efficacy for the treatment of major depression among adults.
Analyses of randomized trials suggested that this drug superior in efficacy to Celexa, Viibryd, and Zoloft and more tolerable. Although it outperformed other antidepressants in this comparative analysis, most research indicates that no single antidepressant is best compared to others. In any regard, doctors and patients alike always want to try the latest “flashy” medications to treat depression; especially when analyses suggest it is more effective than the older crop of drugs on the market.
Although Brintellix’s unique mechanism of action as a “serotonin modulator and stimulator” may elicit a favorable antidepressant response in many individuals, some people just don’t tolerate it well. It is widely known that just like every other antidepressant, Brintellix’s side effects can be difficult to deal with. For others, it just may not work well enough to treat their depression in order to justify its usage. In these cases, a person will likely want to withdraw from the drug.
Factors that influence Brintellix withdrawal
There are several factors that play an important role in influencing withdrawal symptoms. The primary influential factors include: time span, dosage, speed of tapering, and individual variation.
1. Time Span
How long did you take Brintellix? Logic suggests that the longer you take a particular drug, the more changes it makes to your brain and nervous system. On the other hand, the shorter the time span over which you took this particular drug, the less changes it will have made to your functioning. If you had taken this medication for years, you would have likely built up some sort of tolerance and possibly needed to increase the dosage, which solidifies drug-induced changes.
Expect to have a protracted withdrawal period if you took Brintellix over an extended period (e.g. years). If you only took Brintellix for a couple months, your brain and nervous system will likely recover at a quicker rate than if you had taken it for a longer duration. Those who take the drug for a few days may only exhibit minor withdrawal symptoms for a short period.
2. Dosage (5 mg / 10 mg / 15 mg / 20 mg)
Most people start out taking 10 mg of Brintellix per day. Dosage is then increased to 20 mg per day as long as the individual is able to tolerate this increase. In clinical trials, higher dosages of Brintellix such as 20 mg demonstrated superior antidepressant efficacy over lower ones. Therefore, it is likely that most people will be titrated upwards to the maximum dose that they can tolerate in order to treat depression.
If you are taking the full 20 mg per day or greater, expect your nervous system to incur a greater degree of drug-induced alterations, and inevitably a more severe withdrawal. If you were taking a lower dose of the drug, your nervous system should heal at a quicker rate. This is why as a general rule of thumb, it is a good idea to take the minimal effective dose of any drug.
3. Cold turkey vs. Tapering
The rate at which you taper off of Brintellix will influence your withdrawal experience. Those who quit cold turkey generally deal with an onslaught of difficult symptoms quickly and for longer durations than those who taper. While tapering can certainly take a significant amount of time, it is usually recommended due to the fact that it is easier on your nervous system.
Tapering allows your nervous system to slowly adjust back to functioning without the medication. If you quit cold turkey, you may create chaos within the nervous system due to the fact that it had been receiving the drug, and now has to learn how to restore normative functioning. In general, tapering is always recommended when discontinuing antidepressants to minimize the severity of withdrawal.
4. Individual Variation
Why does Brintellix withdrawal last a few weeks for Person A and months for Person B? It all boils down to individual variation. This includes all of the factors listed above such as: time span, dosage, how quickly tapering was conducted. It also includes: genetics, physiology, habits, diet, stress, whether the person is taking other medications, etc.
In many cases a person who is taking another drug with Brintellix may mitigate some of the withdrawal symptoms with that other drug. Similarly, if a person stops taking Brintellix to transition to a different medication, that other drug will likely offset some of the severe withdrawal symptoms and may influence the withdrawal duration.
Brintellix Withdrawal Symptoms List
Below is a list of withdrawal symptoms that you may experience upon discontinuation of Brintellix. Understand that not everyone will experience every symptom listed below. The number of symptoms experienced as well as the severity is highly subject to individual variation.
- Anger: When quitting any antidepressant, it is common to experience anger. The drug has likely altered your neurotransmission, making it difficult to produce adequate levels of serotonin. Outbursts of anger were reported as a “common” discontinuation symptom in clinical trials. Fortunately, you will likely notice your anger subsiding as you plod through withdrawal.
- Anxiety: Upon discontinuation of any drug that has influenced serotonergic functions within the brain, you may feel anxiety. The anxiety may be mild or more extreme during the early stages of withdrawal. If you feel more anxious than usual, and have recently stopped this drug, it is likely due to the fact that your neurochemistry needs to readjust, specifically that which involves serotonin.
- Brain zaps: Many people experience electrical shock sensations called “brain zaps” when they quit taking an antidepressant or skip a dose. In most cases, these can be lessened by conducting a gradual taper off of Brintellix. Despite the fact that these are highly uncomfortable sensations, they will eventually pass.
- Concentration problems: Some individuals may notice a slight degree of cognitive enhancement from this medication. Upon discontinuation, not only will the enhancement disappear, but you may actually notice significant concentration problems. This is mostly a result of your brain trying to function without the drug. In the meantime, you’ll likely experience “brain fog.”
- Depression: Taking an antidepressant may help depression, but when you quit, not only can you expect your original depression to return, you may actually experience a more severe version. Pre-drug depression and discontinuation depression are typically two different experiences. When you discontinue Brintellix, your brain will be chemically imbalanced as a result of the drug – thus leading to a different, potentially more severe depression.
- Depersonalization: Do you now feel like you are “not yourself?” If you feel depersonalized, it is likely due to your brain attempting to sort out the chemical changes that were created by the drug. If you are highly stressed, this may further enhance the feelings of depersonalization. Just know that you will eventually feel like yourself again; it may take some time.
- Dizziness: A very common withdrawal symptom associated with every antidepressant is that of dizziness. Your brain had become accustomed to receiving the drug for its functioning, and when you discontinue, certain neurological functions become altered – leading to dizziness.
- Fatigue: Regardless of whether this drug had a pro-energy effect or made you tired, fatigue often ensues upon discontinuation. This is a medication that affected both serotonin and norepinephrine. Your nervous system had relied on the drug to provide it with some sort of energy, and when you quit taking it, your nervous system was still expecting it – thus leaving you tired.
- Flu-like symptoms: Some individuals may feel achy, have a headache, feel nauseous, and may vomit upon discontinuation. The combination of all withdrawal symptoms may feel somewhat similar to the flu. Although it’s likely not nearly as severe as the flu, it certainly can make you feel sick.
- Headaches: Most people experience some sort of headache when they quit this medication. The headache may be difficult to deal with, but is something that most people have to put up with. If it becomes unbearable, make sure you are drinking enough water, getting plenty of sleep, and eating right. Consider some over-the-counter headache relief if the headache is intense.
- Insomnia: Many individuals find that when they quit this drug, they are unable to sleep at night. In some cases the insomnia can be mitigated with natural supplements like melatonin and/or simply engaging in relaxation prior to bed. Over time, your sleep cycle and circadian rhythm will reset itself.
- Irritability: It is common to feel irritable when you discontinue this antidepressant. Every little “thing” may trigger anger or an irritable reaction, especially during the early stages of withdrawal. Do your best to realize that your feelings of anger and heightened stress will eventually subside. Although you may not be able to control the feeling of irritability, you can control how you express it.
- Mood swings: Another reportedly common symptom of withdrawal is that of mood swings. Certain days you may feel alright, and others you may feel like total crap. One minute you’re angry, the next you are agitated and depressed. Understand that mood swings will continue to occur until your neurochemistry recalibrates itself.
- Muscle tension: Another extremely common symptom to experience during withdrawal is muscle tension. Additionally, your muscles may also feel sore, achy, and weak. The tension may make it difficult to relax or stay calm. Engaging in relaxation exercises and/or practicing progressive muscular relaxation can be helpful.
- Nausea: You may feel more nauseous than usual after you’ve quit Brintellix. In most cases, the nausea doesn’t last more than a couple weeks. Most people that experience nausea notice that it substantially decreases by the second or third week of their withdrawal.
- Runny nose: Most antidepressants do not result in a “runny nose” upon discontinuation, but this one does. You may need to stock up on some tissue if this is a problem and over time, it will subside. This is a relatively odd withdrawal symptom, but apparently one of the more common ones associated with Brintellix discontinuation.
- Suicidal thoughts: It is common to experience an increase in suicidal thoughts during withdrawal from Brintellix. It should be stated that you should seek immediate medical attention if you are unable to cope with these thoughts. If you had these thoughts prior to taking this drug, you likely won’t be able to distinguish between those resulting from withdrawal and those resulting from your original depression. However those that hadn’t experienced these thoughts pre-drug and now do after quitting will understand.
- Sweating: If you sweat profusely during withdrawal, realize that this is your body’s way of detoxifying itself. Your nervous system may be slightly shocked now that it is attempting to function without the Brintellix. Concurrently your hormone levels may be altered as well (e.g. cortisol) which may contribute to the sweating.
- Vomiting: In some cases, people can actually feel so nauseous that they vomit upon discontinuation. The vomiting doesn’t generally continue for more than a few days. This is a very uncomfortable symptom that is fortunately less common than others.
Note: It is known that Brintellix stays in your system for between 13 and 16 days after you’ve discontinued. For this reason, many people notice that discontinuation symptoms often become more severe during the second or third week of withdrawal.
How long do Brintellix withdrawal symptoms last?
Everyone wants an exact timeframe for how long the withdrawal process should take when discontinuing Brintellix. Unfortunately, data is lacking to establish a composite or average withdrawal period from this medication or any other. As a general rule, I would recommend waiting at least 90 days before reevaluating your withdrawal symptoms.
Some people are likely going to feel better before the 90 day marker, while others will take even longer to experience healing. For many individuals, getting quality sleep, eating a healthy diet, exercising, and finding ways to stay socially connected can help speed up withdrawal. Various supplements also can be utilized to help mitigate the severity of some withdrawal symptoms.
In all cases, it is a good idea to focus on taking things one day at a time, realizing that you will eventually heal and return to homeostatic functioning. During withdrawal, it is highly recommended to seek out the help of a quality therapist so that you can cope with whatever symptoms you are experiencing. If you have withdrawn from Brintellix or are currently in the process of withdrawing, feel free to share in the comments section below.