I Have Been Taking Trintellex For Three Weeks Now First

Brief Answer:
It is not recommend to stop trintellex abruptly but gradual decrease of dose unless you develop allergic reaction to it.

Detailed Answer:
Hello and welcome at "Ask a Doctor" service,

I carefully read your query and understand your concern with not being able to sleep for a few days.
Trintellex is a SSRI drug and it is generally started in small doses and increased gradually as it is happening in your case and the same way it should be stopped (by gradually decreasing the dose in a few weeks) so you do not get abrupt changes in mood and feel very irritable. The only time we recommend patients to abruptly stop it is when they develop allergy to the drug. Trintellex generally does not help directly with tramadol withdrawal but with anxiety or depression (even sleep problems) that might result from tramadol withdrawal.

On the other hand it will take you a few more weeks to see the full effect of the drug as it takes a while to give the medical effect. In the beginning patients may feel unwell the first couple of weeks but with time the side effects tend to go down and the desired effect starts to be more obvious so I would advice you to not just stop it as you already have gone through 3 weeks with it and you should start to soon experience improvement (with anxiety or depression).

Sleep problems you are having are very likely related to tramadol withdrawal so if you stop trintellex very likely you will still have the problems with sleep and might even get worse due to abrupt interruption of trintellex.

There are drugs that can help with sleep and have less risk for dependence, and that can be taken together with trintellex. Zolpidem before bed time is a drug to try to help you sleep. It is quite effective, gives you natural sleep (it enables resting sleep, which will help you feel refreshed in the morning because it allows you to go through the deep sleep phase). You can take zolpidem for a couple of weeks regularly or every other day to help you sleep but with less risk for dependence.

To conclude:
- I understand your struggle with tramadol withdrawal and possible side effects of trintellex
- trintellex will very likely start to show benefits soon while the side effects fade with time. If you need to stop it you can reverse as you started, reducing 5 mg every week or 10 days (it is safer not to just stop abruptly unless you get allergic reaction to it)
- you can take Zolpidem for sleep as it is generally well tolerated and imitates the normal sleep patterns with lower risk of dependence (sometimes it might not completely help in the case of opioid withdrawal but can be tried)
- sometimes specific drugs to treat opioid withdrawal might be needed like buprenorfine. In this case it is a doctor specialized in its use that needs to start it and regularly follow you.

I hope this answers your query. Please feel free to let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj, General and Family Physician

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