# Depression Meds Question



## AgentD (Dec 27, 2010)

My husbands doc (medical doc not Psychiatrist) recently switched him from his 
Celexa to Vybrid. The Celexa was no loner working. The Vybrid starts off with 7 days of 10mg then you up it to 20mg for 7 days then to 40mg. He hasn't gotten to the 
40mg yet. However his doc told him if the 40mg was working a little to good then he could bump himself back down 
to the 20mgs. I asked him if he asked the doc what did she mean by the 40 mg working a little to good? He said he didn't ask. So
my question is what does it mean if a medication is working a little to good? Anyone have experience with that?
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## Kurosity (Dec 22, 2011)

"Too good" could mean a number of things. I think that you should just call the doctor and ask them what they meant. The horse's mouth and all that.


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## AgentD (Dec 27, 2010)

I guess I could, but with not knowing this doc from a
hill of beans and confidentiality issues not sure what they can
can and can't tell me. But yeah I might see. 

Anyone else with this experience?
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## Jamison (Feb 10, 2011)

" Too good" might mean hypo mania. Some people can have that reaction to higher doses of certain medications. 
To the person taking it, hypo mania might seem like a good thing because they feel awesome and are getting stuff done etc. but really
That's not always a good thing. You could always call your local Pharmacy too and ask them. They sometimes know more than doctors.
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## Runs like Dog (Feb 25, 2011)

Viibryd is very new (FDA approved 2011)- some kind of new SSRI - Reacts adversely to many drugs. Specifically not recommended for Bipolar disorder. 


Serotonin Syndrome: Agitation, hallucinations, coma or other changes in mental status; coordination problems or muscle twitching; fast heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting or diarrhea; muscle stiffness or tightness.

_Abnormal bleeding: VIIBRYD and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin.

Seizures or convulsions.

Manic episodes: Greatly increased energy; severe trouble sleeping; racing thoughts; reckless behavior; unusually grand ideas; excessive happiness or irritability; talking more or faster than usual.
_
Low salt (sodium) levels in the blood: Elderly people may be at greater risk for this. Symptoms may include headache; weakness or feeling unsteady; confusion, problems concentrating or thinking or memory problems. (RLD's note: this is statistically quite rare)


Many drugs can interact with vilazodone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with Viibryd, especially:

any other antidepressant;

bosentan;

buspirone;

imatinib;

lithium;

St. John's wort;

tryptophan (sometimes called L-tryptophan)

an antibiotic--clarithromycin, nafcillin, rifabutin, rifampin, rifapentine, telithromycin;

antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;

heart medication--nicardipine, quinidine;

hepatitis C medications--boceprevir, telaprevir;

HIV/AIDS medication--atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir;

migraine headache medicine--sumatriptan, zolmitriptan, and others;

pain medication--fentanyl, tramadol; or

seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone.

This list is not complete and many other drugs can interact with Viibryd. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

In contrast to other SSRIs currently on the market, initial clinical trials showed that vilazodone did not cause significant decreased sexual desire/function as with many other antidepressants, which often cause people to abandon their use: FDA approves Clinical Data Inc's antidepressant | Reuters

Patients report initial gastrointestinal symptoms which subside after 2 weeks. 

While it's an SSRI it's neurochemical action is more similar to drugs like Abilify which are not antidepressants. 

Patients that report any weight gain report significant weight gain.


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## AgentD (Dec 27, 2010)

Wow that sounds like it came right off the pamphlet it came with. I'm aware if all those things. I just thought "too good" might means something else
I was unaware of. I'll be calling the Pharmacy tomorrow just to see. Thanks though!
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## mablenc (Feb 26, 2013)

Husband got manic episodes with an antidepressant, I wish they had warned me to look out for the signs.
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## Wiltshireman (Jan 23, 2013)

I have always been wary of the long-term use of "anti depressant" drugs without them being backed up / supported by the "talking therapies".

That said if your husband’s doctor has advised a change in medication he should follow that professional advice. As for the "a little too good" comment I would assume the doctor is warning of the possibility that the medication could in larger does fail to provide the stability your husband wants.


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## CallaLily (Jan 13, 2011)

"A little to good" comment makes me think it might make him to hyped up. There is such a thing as medication induced hypo mania. To the one hyper it might appear they are feeling great, kinda like on a high. But over all its probably not for the best.


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## Runs like Dog (Feb 25, 2011)

mablenc said:


> Husband got manic episodes with an antidepressant, I wish they had warned me to look out for the signs.
> _Posted via Mobile Device_


If it's Lexapro that's known to happen - tooth grinding too.


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## Runs like Dog (Feb 25, 2011)

AgentD said:


> Wow that sounds like it came right off the pamphlet it came with. I'm aware if all those things. I just thought "too good" might means something else
> I was unaware of. I'll be calling the Pharmacy tomorrow just to see. Thanks though!
> _Posted via Mobile Device_


It largely does - I italicized a section because those are unlike most other SSRIs. Also the drug interactions are different.


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## mablenc (Feb 26, 2013)

Runs like Dog said:


> If it's Lexapro that's known to happen - tooth grinding too.


Yes it was, my husband was replaced by an impulsive out of control as$hole for a few months he told me he was not feeling like himself but I though it was the depression and told him to stick to it. Once he was off them he was back to normal. Still there was damage caused.'
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