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What Causes Irritability, Increased Crying And Negative Thoughts After Taking Fetzima?

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Posted on Mon, 3 Aug 2015
Question: been on Wellbutrin SR 300mg and Celeexa 40 mg fpr major depression ; felt hedonic and maybe into serotonin syndrome symtoms; discussed with md and trial of brintellix , only lasted 4days due to intense nausea ....started on Fetzima for 7wks now , concern depression worst irritable, crying a lot (haven't done this much in yrs,),negative thoughts ,despair again .....should I go back to Celexa, but down to 20mg? Even husband says way off...ideas ...thanks
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Answered by Dr. Chintan Solanki (11 hours later)
Brief Answer:
yes you can go back to celexa with low dose or imipramine is other option

Detailed Answer:
Hello,

Thanks for writing to us.

You are suffering from depression. History of serotonin syndrome is there. Brintellix and fetzima do not suit you.
In my opinion you can restart celexa(if it was effective in past for depression) with 10 mg and gradually increase the dose.
Other option is Imipramine which is tricyclic antidepressant (TCA). It is very useful specially in aged people when SSRI (selective serotonin reuptake inhibitor)do not work or not suitable. However with TCA also dry mouth, constipation and postural hypotension are common side effects.
And other option is Mirtazapine or desvenlafaxine which are SNRI(serotonin norepinephrine inhibitor).

And non-medicinal approaches are also there.
ECT - Electro convulsive therapy.Specially in severe depression when medicines are not useful.

Psychotherapy - CBT(Cognitive behavior therapy). It is useful alone in mild to moderate cases and in combination with medicines in moderate to severe cases.

Discuss these options with your treating psychiatrist and change treatment.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

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Practicing since :2007

Answered : 2406 Questions

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What Causes Irritability, Increased Crying And Negative Thoughts After Taking Fetzima?

Brief Answer: yes you can go back to celexa with low dose or imipramine is other option Detailed Answer: Hello, Thanks for writing to us. You are suffering from depression. History of serotonin syndrome is there. Brintellix and fetzima do not suit you. In my opinion you can restart celexa(if it was effective in past for depression) with 10 mg and gradually increase the dose. Other option is Imipramine which is tricyclic antidepressant (TCA). It is very useful specially in aged people when SSRI (selective serotonin reuptake inhibitor)do not work or not suitable. However with TCA also dry mouth, constipation and postural hypotension are common side effects. And other option is Mirtazapine or desvenlafaxine which are SNRI(serotonin norepinephrine inhibitor). And non-medicinal approaches are also there. ECT - Electro convulsive therapy.Specially in severe depression when medicines are not useful. Psychotherapy - CBT(Cognitive behavior therapy). It is useful alone in mild to moderate cases and in combination with medicines in moderate to severe cases. Discuss these options with your treating psychiatrist and change treatment. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.