Help Diagnosed with Psychotic Depression and prescribed Aripiprazole and Vortioxetine. Should I take the meds?

[ForgottenAgain]

Yesterday I had my first appointment with the MH Community team's psychiatrist. It was a bit more than 2 hours where I basically retold my whole life story and discovered that the Crisis Team had taken my history wrong on some parts.

Contrary to the Crisis team psychiatrist who only cared whether I wanted to die or not, this one was concerned for the fact that I had years of hearing voices when I was a late teen and that from October last year I had hallucinations and delusions. She said the return of psychotic symptoms was significant and that I could have a relapse.

We talked about the medication I was given from the Crisis team (200mg Sertraline and 3mg Risperidone) and how it made me gain weight, killed my emotions and ruined my libido therefore killing the intimate relationship with my boyfriend. I told her I stopped the meds cold turkey because of this, and because I was abandoned by the Crisis team and had no psychiatrist afterwards. She scolded me for stopping the meds, even though that's what saved my intimate relationship and having had sex again having made me feel a bit better

Because of this she suggested me taking Aripiprazole and Vortioxetine. I asked to read the side effects before agreeing to be medicated, to which she reacted in a negative way, annoyed and quickly telling me to call back today if I want the meds.

For context, I haven't had psychotic symptoms for almost 2 months now, and I've been off the meds for that time. I'm very sad, I cry every day and I passively think about suicide, obviously I know that isn't normal but since the experience with the previous meds I'm left wondering if these meds are worth it. What are they supposed to do to me? With the previous meds I didn't feel happy, I felt numb, is that much better than being sad? What am I getting in exchange here?

It may sound dumb but I also think about the ocasional gin I like to drink, which gives me around 2 hours of happiness. Do I really want to give that up for...being numb? I read through the side effects of one of the meds, the majority of them don't even have a category (common, uncommon, rare, etc) they just say it can't be measured.

Has anyone taken these meds? How was your experience? With so many people here having life long consequences from meds I became scared...and I guess I may be preferring the devil I know rather than the one I don't...

 

[AnxietyHangover]

Hello,

I used to take Aripiprazole (brand name Abilify, etc.) and it worked great for me. No side effects that I could notice, and the bugs and the car alarms stopped. I would definitely recommend it to you that you at least try it. In my opinion it's a fairly safe antipsychotic.

Vortioxetine I didn't take but from what I was able to read online looks like a fairly safe drug, so I would try that too. If you notice sexual side effects just ask the doctor for another antidepressant like Bupropion.

Regards.

 

[real human being]

You should know that antidepressants and antipsychotics can have some severe side effects that can even be long lasting after you stop taking the medication. Antidepressants cause emotional blunting for the vast majority of users. PSSD (Post SSRI Sexual Dysfunction) is a possibility.

You can also read more here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061256/

 

[ForgottenAgain]

You should know that antidepressants and antipsychotics can have some severe side effects that can even be long lasting after you stop taking the medication. Antidepressants cause emotional blunting for the vast majority of users. PSSD (Post SSRI Sexual Dysfunction) is a possibility.

You can also read more here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061256/

Thank you for that info and for the link. That's the reason why I'm worried about starting meds even though the psychiatrist didn't spend any time talking about side effects, she was really annoyed that I even asked to look at side effects first.

One thing I don't like is how I have never seen PSSD as a side effect on meds like Sertraline which I know are SSRIs

 

[real human being]

Thank you for that info and for the link. That's the reason why I'm worried about starting meds even though the psychiatrist didn't spend any time talking about side effects, she was really annoyed that I even asked to look at side effects first.

One thing I don't like is how I have never seen PSSD as a side effect on meds like Sertraline which I know are SSRIs

Psychiatry is a messed up industry. I'd hardly even call it a science. I'm really sorry about your situation. I wish we all had better help and better options.

 

[LittleJem]

If I remember rightly, vortioxetine has less sexual side effects than the others.

PSSD is horrifying but it is rare.

I'd say try the meds - you can always come off them.

 

[itsover246]

Pssd suffer here can confirm it's a fate worse than death hence why I'm here. My mind is totally broken and my body is malfunctioning. How's your diet look if your eating processed junk try cutting it all out you'd be surprised how much what we eat can have an effect on us. If you'd wanna take it a step further consider a keto or carnivore diet there's so many people out there that's had great success with their mental and physical health issues on these diets. Try going to Holland and Barrett tell one of the staff the issues you like help with and they'll recommend you all sorts of supplements and vitamins that could help. These are the options I wish I'd have exhausted before taking meds but if you feel you've explored all alternatives and you can't cope go for the medication. It should always be the last resort

 

[ForgottenAgain]

Pssd suffer here can confirm it's a fate worse than death hence why I'm here. My mind is totally broken and my body is malfunctioning. How's your diet look if your eating processed junk try cutting it all out you'd be surprised how much what we eat can have an effect on us. If you'd wanna take it a step further consider a keto or carnivore diet there's so many people out there that's had great success with their mental and physical health issues on these diets. Try going to Holland and Barrett tell one of the staff the issues you like help with and they'll recommend you all sorts of supplements and vitamins that could help. These are the options I wish I'd have exhausted before taking meds but if you feel you've explored all alternatives and you can't cope go for the medication. It should always be the last resort

Thank you for your comment, it was exactly PSSD that was on my mind. I'll explore those options, although now the psychiatrist has done a 180 and said that actually I don't have psychotic depression. I think she doesn't know what she's doing...

If you wanna read about it, here is the thread: https://sanctioned-suicide.net/thre...t-know-what-theyre-doing.165639/#post-2531709

 

[needthebus]

I wrote something really long, but the short answer is neither medicaion is at all like Risperidone. Many people hate Risperidone and both medications have very low side-effects, so there's probably not harm in taking both and they may help you. It's unlikely to impact your ability to have sex and enjoy sex, but rarely people report problems from SSRIs, some of them serious. You could take them and stop taking them if you had side-effects that you feel uncomfortable with.



Here's the long version:


I am not a doctor.

Aripiprazole doesn't have the same weight gain as other atypical antipsychotics. Most people have good experiences on it. You may still twitch a small amount on rare occasoin, have mild sexual side effects, and it could lead to TD but it's unlikely to. It tends to improve people's moods, so if you are miserable, it's not a terrible idea to be on it at least short-term if not for a while. The difficult thing with these meds is that once you start taking them, if you refuse you can be labeled as non-compliant and not following doctors orders, etc. You already got some of that with her scolding you, which was probably really annoying. I totally get why you stopped those at the time, because it was affecting things. People who take Aripiprazole end up feeling better without a lot of weight gain. It's also a mild anti-psychotic with less action on dopamine receptors, but also less side-effects.

If you've had years of hearing voices, Aripiprazole may help even if that's stopped for now. Vortioxetine is an SSRI and SSRIs often don't have a great impact on younger people, like 18-22, so just be careful if you are in that age range. SSRIs can sometimes be problematic for people 18-22 or people who have mood disorders, so just make sure to discuss that with your doctor if you could be in either category. Some people also get permanent side effects like reduced libido from SSRIs but it's very very rare and would probably be less likely with Vortioxetine because of a lower side effect profile. It also depends on how suicidal you are: if you feel like you are close to ending things, and are above 22, you may want to take both right away. If you are under 22, SSRIs may be riskie because 18-22 year olds sometimes have unpredictable reactions to SSRIs, particularly 18 and 19 year olds. Vortioxetine doesn't seem to be a harsh SSRI, but it seems to not do a lot in terms of how effective it is. Aripiprazole is a very effective medication for many so it may not matter if Vortioxetine isn't great.

Your depression could in part be a negative symptom of schizophrenia (a negative symptom is an absence of something that should be there, like feeling pleasure) and Aripiprazole could help with that.

The no psychotic symtoms for 2 months and crying all the time is difficult, because when a person quits using drugs, legal or illegal, their brain rebels against that with sadness and so it's hard to know if you feel sad because you are off drugs or because of something else. It would be important to know if you were an illegal drug user at the time you heard hallucinations. If you are able to exercise every day, eat healthy, and force yourself to be social and do things (even voluntering) and you can be alright, then it's probably better not to be on harsh drugs that can cause permanent side effects, but you're crying every day and visiting this place, so it's probably appropriate to be on those psychiatric drugs. You could also try to do both: take medicaiton and exercise and eat healthy and volunteer and titrate off medication later if you feel better and see if you keep feeling okay. There's unlikely to be any permanent problems caused by Aripiprazole. I have extremely negative opinions of psychiatry, but Aripiprazole is a decent drug that helps some people.

You sound pretty sad, you're here, and Aripiprazole isn't a terrible medication, especially since years of hearing things that aren't there is not typical for most people. I don't know how harsh Vortioxetine is, it could be bad or good, but Aripiprazole is mostly a good drug, according to almost everyone and the anti-psychotic action it has is mild, not harsh. It would be the sensible thing to recommend to someone who has occasional periods of mild psychosis. It could end up preventing you from having more psychosis later if you take Aripiprazole.

Do you feel like you could talk to your doctor about trying one first and then the other if needed to minimize the side effect profile? You could probably just take both. Aripiprazole affects multiple neurotransmitters also, so it may have some anti-depression effect anyway. But your doctor may be right about using both depending on how bad things are.

https://en.wikipedia.org/wiki/Vortioxetine, if you look at the chart in this page, Vortioxetine is not that much more helpful than a placebo. It also seems to have a fewer sexual side effects than other drugs. So people who took this medication reported having sexual side effects 16% of the time, but people who just took a pill with nothing in it except sugar reported sexual side effects 14% of the time. That means it didn't actually have many sexual side effects and people just tend to report them because they were in a study. So your doctor was probably listening to your concerns about sexual side effects and prescribed a less effective SSRI that had fewer side effects, but I'm not sure if that's right. Some people have complained about SSRIs causing long term decreased libido. You could look that stuff up if you wanted, but this doesn't seem like a harsh drug likely to have a lot of side effects. There's no chart on https://en.wikipedia.org/wiki/Aripiprazole about whether it's more effective than a placebo, but people generally consider it a drug that does mostly good things without a lot of side-effects.

Also Risperidone is a horrible medication. It has terrible side effects and ruins people in so many ways, it's just awful. Aripiprazole is not like that at all. You don't need to be that worried about Aripiprazole based on your horror story with Risperidone, because pretty much everyone who takes Risperidone has a horror story. They also never adaquately warn people how awful Risperidone will be. It's evil how they give that to so many people. Aripiprazole is not like that at all. Vortioxetine is unlikely to be harsh also.

I'm not a doctor, but what you were prescribed wiil likely be nothing like the hell you got with Risperidone. It could possibly help you. Many people have good reactions to Aripiprazole and the SSRI could somehow go well with Aripiprazole. Just make sure to let your doctor know if you have any reactions and on some level trust yourself and if these things make your feel worse, they may not be good options. Sometimes people get better and neither medication is harsh or bad like Risperidone.

Regarding alcohol, because your liver will already be processing medications, any drink will be like 3 drinks because it will get filtered out less quickly. The problem with gin and sadness is that things like that have a delayed effect. So you may drink Gin Monday and feel better, feel okay Tuesday and Wednesday, but then you may feel much much much worse on Saturday even after the gin left your system because of the impact on your brain. Try sobriety (or at least mostly sobriety) and healthy eating and exercise and find something you care about and you may end up feeling better. The medications could make it easier to do this.

Just if you do start to feel better, really try to exercise because it has one of the best anti-depressant effects, and it's so hard to do when really depressed. Like I haven't exercised at all recently and totally need to do that, but I'm too sad. Good luck! It sounds like you want to get better and sometimes people get better. It won't be like Risperidone.

 

[Hollowman]

I wrote something really long, but the short answer is neither medicaion is at all like Risperidone. Many people hate Risperidone and both medications have very low side-effects, so there's probably not harm in taking both and they may help you. It's unlikely to impact your ability to have sex and enjoy sex, but rarely people report problems from SSRIs, some of them serious. You could take them and stop taking them if you had side-effects that you feel uncomfortable with.



Here's the long version:


I am not a doctor.

Aripiprazole doesn't have the same weight gain as other atypical antipsychotics. Most people have good experiences on it. You may still twitch a small amount on rare occasoin, have mild sexual side effects, and it could lead to TD but it's unlikely to. It tends to improve people's moods, so if you are miserable, it's not a terrible idea to be on it at least short-term if not for a while. The difficult thing with these meds is that once you start taking them, if you refuse you can be labeled as non-compliant and not following doctors orders, etc. You already got some of that with her scolding you, which was probably really annoying. I totally get why you stopped those at the time, because it was affecting things. People who take Aripiprazole end up feeling better without a lot of weight gain. It's also a mild anti-psychotic with less action on dopamine receptors, but also less side-effects.

If you've had years of hearing voices, Aripiprazole may help even if that's stopped for now. Vortioxetine is an SSRI and SSRIs often don't have a great impact on younger people, like 18-22, so just be careful if you are in that age range. SSRIs can sometimes be problematic for people 18-22 or people who have mood disorders, so just make sure to discuss that with your doctor if you could be in either category. Some people also get permanent side effects like reduced libido from SSRIs but it's very very rare and would probably be less likely with Vortioxetine because of a lower side effect profile. It also depends on how suicidal you are: if you feel like you are close to ending things, and are above 22, you may want to take both right away. If you are under 22, SSRIs may be riskie because 18-22 year olds sometimes have unpredictable reactions to SSRIs, particularly 18 and 19 year olds. Vortioxetine doesn't seem to be a harsh SSRI, but it seems to not do a lot in terms of how effective it is. Aripiprazole is a very effective medication for many so it may not matter if Vortioxetine isn't great.

Your depression could in part be a negative symptom of schizophrenia (a negative symptom is an absence of something that should be there, like feeling pleasure) and Aripiprazole could help with that.

The no psychotic symtoms for 2 months and crying all the time is difficult, because when a person quits using drugs, legal or illegal, their brain rebels against that with sadness and so it's hard to know if you feel sad because you are off drugs or because of something else. It would be important to know if you were an illegal drug user at the time you heard hallucinations. If you are able to exercise every day, eat healthy, and force yourself to be social and do things (even voluntering) and you can be alright, then it's probably better not to be on harsh drugs that can cause permanent side effects, but you're crying every day and visiting this place, so it's probably appropriate to be on those psychiatric drugs. You could also try to do both: take medicaiton and exercise and eat healthy and volunteer and titrate off medication later if you feel better and see if you keep feeling okay. There's unlikely to be any permanent problems caused by Aripiprazole. I have extremely negative opinions of psychiatry, but Aripiprazole is a decent drug that helps some people.

You sound pretty sad, you're here, and Aripiprazole isn't a terrible medication, especially since years of hearing things that aren't there is not typical for most people. I don't know how harsh Vortioxetine is, it could be bad or good, but Aripiprazole is mostly a good drug, according to almost everyone and the anti-psychotic action it has is mild, not harsh. It would be the sensible thing to recommend to someone who has occasional periods of mild psychosis. It could end up preventing you from having more psychosis later if you take Aripiprazole.

Do you feel like you could talk to your doctor about trying one first and then the other if needed to minimize the side effect profile? You could probably just take both. Aripiprazole affects multiple neurotransmitters also, so it may have some anti-depression effect anyway. But your doctor may be right about using both depending on how bad things are.

https://en.wikipedia.org/wiki/Vortioxetine, if you look at the chart in this page, Vortioxetine is not that much more helpful than a placebo. It also seems to have a fewer sexual side effects than other drugs. So people who took this medication reported having sexual side effects 16% of the time, but people who just took a pill with nothing in it except sugar reported sexual side effects 14% of the time. That means it didn't actually have many sexual side effects and people just tend to report them because they were in a study. So your doctor was probably listening to your concerns about sexual side effects and prescribed a less effective SSRI that had fewer side effects, but I'm not sure if that's right. Some people have complained about SSRIs causing long term decreased libido. You could look that stuff up if you wanted, but this doesn't seem like a harsh drug likely to have a lot of side effects. There's no chart on https://en.wikipedia.org/wiki/Aripiprazole about whether it's more effective than a placebo, but people generally consider it a drug that does mostly good things without a lot of side-effects.

Also Risperidone is a horrible medication. It has terrible side effects and ruins people in so many ways, it's just awful. Aripiprazole is not like that at all. You don't need to be that worried about Aripiprazole based on your horror story with Risperidone, because pretty much everyone who takes Risperidone has a horror story. They also never adaquately warn people how awful Risperidone will be. It's evil how they give that to so many people. Aripiprazole is not like that at all. Vortioxetine is unlikely to be harsh also.

I'm not a doctor, but what you were prescribed wiil likely be nothing like the hell you got with Risperidone. It could possibly help you. Many people have good reactions to Aripiprazole and the SSRI could somehow go well with Aripiprazole. Just make sure to let your doctor know if you have any reactions and on some level trust yourself and if these things make your feel worse, they may not be good options. Sometimes people get better and neither medication is harsh or bad like Risperidone.

Regarding alcohol, because your liver will already be processing medications, any drink will be like 3 drinks because it will get filtered out less quickly. The problem with gin and sadness is that things like that have a delayed effect. So you may drink Gin Monday and feel better, feel okay Tuesday and Wednesday, but then you may feel much much much worse on Saturday even after the gin left your system because of the impact on your brain. Try sobriety (or at least mostly sobriety) and healthy eating and exercise and find something you care about and you may end up feeling better. The medications could make it easier to do this.

Just if you do start to feel better, really try to exercise because it has one of the best anti-depressant effects, and it's so hard to do when really depressed. Like I haven't exercised at all recently and totally need to do that, but I'm too sad. Good luck! It sounds like you want to get better and sometimes people get better. It won't be like Risperidone.

Like you said you are not a doctor. Doctors don't even know wtf they're doing. Abilify has a ton of potential life altering side effects.

 

[Soupster]

I would never discourage people from following the recommendation of thier physicians. As has been discussed psych meds work vastly differently depending on the person. It's a crapshoot.

I know several people on Aripiprazole who swear by it. My personal experience with it was terrible. I immediately could not sleep, developed a nervous tic, was highly agitated, had a feeling of dread an doom, could not focus, could not sit still, and had sharp pain in my head. I could not tolerate it for more than 36 hours and was switched to another medication on an emergency basis.

The key to any medication therapy is open and frequent communication with your prescriber and sticking with it until you find what works for you. Don't let them off with, "it's good enough... just deal with it."

 

[Hollowman]

I spent over two decades and tried over two dozen meds. Nothing worked, I'm glad we're not immortal.

 

[Ashu]

Thank you for that info and for the link. That's the reason why I'm worried about starting meds even though the psychiatrist didn't spend any time talking about side effects, she was really annoyed that I even asked to look at side effects first.

These people are complete aliens to us.

One thing I don't like is how I have never seen PSSD as a side effect on meds like Sertraline which I know are SSRIs

We can't expect these reptiles to tell us shit. Look it up. SSRSs destroy people every day, body and soul, for life, particularly their sexuality.

 

[cosimaniehaus]

I dont know anything about the second, but ariprapazol is the best medication treatment I had in 7 years and I took like 25 different types of psych meds. Give it a chance!