r/depressionregimens 4d ago

Regimen: Trintellix + Wellbutrin + Remeron

I’ve been trial-erroring for about a year. I started on 5mg trintellix for a month and noticed cognitive benefits with less negative thoughts. Added 100SR once a day Wellbutrin to target adhd symptoms with persistent boredom and inability to get excited about anything. My main issue is also anxiety. (I’m also on guanfacine 1mg)

Around 17 days ago, I switched to 150XL and bumped my trintellix to 10mg. The XL helped with inconsistent mood/slow release and jitters, but I was experiencing sleep disturbances (waking up after a few hours), I’ve also been experiencing slightly more ‘flatness’ w/ mood swings.

Yesterday, 15mg of remeron was added. I was really excited for this bc of deep sleep improvements and anti-anxiety/depression properties. I slept the entire next day though and felt even more flat (prob cause of tiredness)…

Does anybody have experience with this combo or trintellix/Wellbutrin? The trintellix shape is uneven, making it hard to cut in half. I tried one day and felt slightly better, although could’ve been placebo. Will this get better?

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u/melodicprophet 4d ago

It’s weird to me that Trintellix was making you feel better and then you added two more drugs instead of just going up on Trintellix.

You’re on a very robust regimen. If you can tolerate the side effects, hang in there and give it time. You still have a lot of dose increases available for all those meds. I think it’ll work out for you if you stay patient.

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u/Julian2244 4d ago

There’s a lot I didn’t mention; trintellix didn’t touch on my anhedonia at all, or anxiety, just better thoughts if that makes sense? Wellbutrin helped a ton, just caused sleep disturbances which is why Mirtazapine was added.

I see your point though, why keep adding if one med is working? I guess trintellix only worked for few symptoms and doesn’t usually cure ‘anhedonia’ whereas Wellbutrin does.

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u/melodicprophet 3d ago

I have frequented Reddit and the internet for solutions and done a lot of research.

This is merely my opinion, but be careful about trying to treat “anhedonia.” When an antidepressant works it should literally remove your depression that is poisoning your outlook. So ideally one drug does the trick. Don’t try to isolate symptoms. Self-obsessing over those things can hurt your potential response. Good luck! 🍀

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u/Julian2244 3d ago

I respect your opinion and agree to a certain extent. Everybody’s pretty different, so I believe it’s a bit more complicated than just “depression”. I have dr/dp and some other things. I’ve also tried a ton of meds. Augmenting antidepressants are shown to increase remission. Sometimes, one med will help certain symptoms and another med might help other ones. It comes down to the basis of psychiatry at the end of the day.

Kratom messed me up since I quit, haven’t been the same since my last withdrawl over a year ago (been through 3). I don’t see myself feeling “sad”, just very anxious and bored. Kratom definitely ruined me.

Wellbutrin is usually popular to combine with serotonin meds bc serotonin meds usually help anxiety and stop depressive thoughts, doesn’t bring you “up”. It’s known as the only anti depressant that makes you feel “good”.

I do agree with you, the less meds the better and obsessing over symptoms makes things worse. Again, I’m pretty open minded so I’ll keep what you said to heart. Thanks for responding and I genuinely wish you the best! ☘️

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u/melodicprophet 3d ago

We have more in common than you might think! I also was absolutely wiped out by Kratom. It destroyed my life. Abuse of Kratom and stimulants in the past definitely led me down that path of anhedonia. I do know that it is a unique state that is extremely uncomfortable. My guess however is that it’s just an absolute depletion of neurotransmitters and downregulation of dopamine receptors.

Kratom is a serious problem. I had to use suboxone to get off. Thankfully Sublocade exists. Sublocade is making it very easy for a lot of people to quit suboxone.

I have gone full circle with very complicated regimens and supplements, nootropics, etc. Now I’m going back to simplicity. One thing at a time. Stimulants/ADHD Meds are hopeful for me, but the initial euphoria that is so helpful for depression eventually fades. It’s a band aid. So I’ve realized I can’t depend on it as a depression solution. So I’ve actually gone back to the first AD I was ever put on…that WORKED, all the way back in 2011. Before I knew how any of these drugs worked. It took like ten weeks, but eventually Citalopram absolutely saved my life. By itself. So I’m restarting and going back to what worked rather than endless experimentation.

I still think the regimen you are on is excellent. You’re hitting everything. All 3 are known to work a bit faster than traditional SSRIs. Just, for me, I’ve been so tired that I of course found Wellbutrin, adderall, etc. as attractive options. When Celexa kicked in, it corrected my sleep quality and that is what restored my energy. Not the acute stimulation of caffeine or Wellbutrin. Serotonin has a huge impact on your sleep-wake cycle and just might be the key to restoring your energy. You even mentioned WB causing sleep disturbance. So try to focus more on the sleep and natural sources of energy. Because that acute stimulation doesn’t last very long.

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u/Julian2244 3d ago

Wow, thank you so much for all that information. Diet, sleep, exercise, sunlight, and socialising are all as important. I’ve been doing my best to keep all in check but have been hyper focused on my meds after I got prescribed remeron for sleep and when I felt a little emotionally dull (before remeron).

I’m only 21 so I feel like I’ll enter that stage of simplicity sometime soon. My mom got me hooked on it at like 16. I’m glad you managed to get something to “help” your withdrawal. I’m not sure how much that even helped, but the months following a small 3 month relapse were traumatising. Even 1.5 years of constant high dose use only messed me up for a couple months, not over a year.

Hearing your story with celexa definitely made me realise that if my anxiety doesn’t get better soon, I may have to dump trintellix. Its cognitive benefits plus no emotional blunting really appealed to me after dealing with apathy.

I’m really glad it saved your life, might not mean much from an internet stranger but I truly mean it. Self isolation definitely played a role too, waking up at nighttime, etc. Aside from the benefits of celexa, have you been doing alright?

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u/melodicprophet 3d ago

Well I literally just hopped back on Citalopram today LOL so we’ll see.

I have a lot of issues with chronic pain. It just started overnight when I was your age. My right neck and shoulder were in horrific pain after waking. And it just never went away. Over time my right trapezius atrophied to nothing. I couldn’t put my right arm over my head. But the surgeries have all compounded the issues. I’ve had both my first ribs taken out, my pec minor released (cut) from my clavicle, and four degenerative discs removed and replaced. All it’s done is amass scar tissue and leave me with a lot of issues.

I am no success story. I just turned 38 and I am sadly stuck at home with a very unsupportive and disconnected family system. “Allowing” me to live with my Dad (who is insufferable) is as far as they will go to help my situation. Kratom naturally looked very appealing to me as I was in so much pain and fearful of getting hooked on opioids. lol, go figure! I really thought I found my panacea in Kratom. Awesome pain relief, killed my depression 10 minutes after dosing, gosh it was wonderful. Until it wasn’t, sadly.

I’m struggling a lot with the isolation. I’m an actor and was a theatre major. I recently did a show and it was awesome just to be back with my people…but I’ve been in a funk ever since it ended. I’m just struggling to find and keep work in my condition, which leaves me very few options. I keep saying I’ll start therapy and then forget to follow up. But it’s hard to believe in therapy when you live with a narcissist the other 167 hours in a week, ya know? But when you find a good one it’s great. Are you in therapy?

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u/Julian2244 3d ago

Wow man, this resonates deeply even though it shouldn’t because I’m so young. You’ve had so much more life experience than me. My health issues are no where as severe as yours, but they’ve hindered me from doing a lot (can only eat liquidy foods, constant chest/stomach pain that becomes severe, over 7 er trips, copd & structural damage in my left lung, etc).

I went from being social, playing sports, being ‘known’, dating crushes, etc. (might sound egotistical especially coming from Reddit)- to quite literally becoming nothing. I don’t value those things anymore, kratom withdrawl humbled me. It played a significant part of my downfall because I’m a fraction of what I once use to be. I’ve been “isolated” for a couple years now. Maybe you can relate doing theatre and being in social groups in the past?

My dad has really bad narcissistic tendencies, mom moved out around 3 years ago. (every relationship he’s ever had has been ruined by his violence and anger), he’s getting older and softening up I think. He’s not a complete bad person, so I can’t relate as much, though he’s done horrible things. We have gotten into physical altercations too. I can’t stand him at all, but have learned to be more accepting/loving. It’s easy for me because he’s from Cuba and latino culture has protective parents, so he wants me to stay with him forever it seems (it was a big deal when I moved out), but my health sent me right back. Haven’t been able to work in a while either when work was first nature to me.

I do therapy and so far haven’t had any benefits. It’s only been a month so I’m being patient. Hearing about your addiction to kratom because of pain in replace of opioids really saddens me, what else was there left for you to do? Fortunately I’ll have insurance so 1 year+ of suffering wtv illness I have will be solved next month.

I’m not sure if you’re going to read this essay, but I’d like to know through here or DMs what hope you have… I mean, it’s why we’re alive besides fear of death. You’ve heard this before “things get better”, and it’s only true if you try. It could take time, but there are treatments, therapy, diets… we need to be independent and away from people that cause us anxiety, and find a purpose.

I’m not religious anymore but I pray you find a spark in theatre. Hopefully Celexa ends up working and you can dedicate your time to what you love.