I started Vortioxetine 10 mg about a month ago. When I started seeing DrG I have Vortioxetine in mind as a newer antidepressant that I wanted to try. I had researched the newer or more novel medications as well as looking back to Tricyclics and MAOIs as potential options.

Vortioxetine is apparently a serotonin modulator and stimulator (SMS) rather than a traditional Selective Serotonin Reuptake Inhibitor (SSRI). The most success I’ve had was with Duloxetine, which has a different mode of action. That is a Serotonin and Norepinephrine Reuptake Inhibitor (SNRI). From what I can see, there is little new in the way of SNRIs available, hence me looking to Vortioxetine.

DrG was clear from the outset that he;s a very by the book, risk averse and careful doctor. He was not one to ‘think outside the box’. Initially I certainly felt he was travelling a well worn path with how he managed condition.

We doubled my Duloxetine. I felt at first that I was getting better. My confidence lifted as did my interest in life. I’ve since come to recognise this as the effect of optimism. Trying something new gives me hope, which lifts my mood but that soon peters out – as it did in this case.

We then discussed alternative meds. Vortioxetine was on the table but DrG was clearly a fan of Fluoxetine (good old Prozac). He explained that the recommended doses for most meds had increased and was confident that I would respond better compared to the lower dose I had been prescribed back in 2001 when I’d only been on 20mg. I’ll write about Fluoxetine in another post but it wasn’t a success.

Back to the drawing board and this time I asked for Vortioxetine. In my desperation I can spend hours scouting the internet looking for treatments and options to help bring me some quality of life.

Vortioxetine gets broadly decent reviews from users, on forums including Reddit. Messaging boards like these can be red herring because they tend to be frequented by people like me – who are not doing well, are looking for hope and trying to overcome the feeling of isolation. People who have responded well to medications are more likely to be enjoying their life than spending it on mental health forums.

All the same, there are some very positive stories about the effect of Vortioxetine on depression and even anxiety (which it is not something it is licensed or promoted for).

The maximum does of Vortioxetine is 20mg. I have started on 10mg. Unfortunately I have seen no improvement in my mood whatsoever. I’m due to see DrG next week and I’ll be asking to increase my dose to 20mg.

According to my friend Dr Reddit this could be a game changer. Several posters there have said they saw little improvement until increasing to 20mg. My fingers are crossed and I live in hope but I have a lifetime to disappointments and false dawns with my mental health and treatments.

What I will say is the side effects when starting Vortioxetine have been negligible. The traditional side effects like insomnia, extra anxiety, palpitations, dry mouth, shakiness and the like were not present.

My appetite has increased. This makes me nervous. I has struggled with my weight all my life and my self esteem has taken a constant pounding. I was bullied for being overweight as a child and I hate being the ‘fat guy’. At my heaviest I was 19.5 stone. Through exercise and careful diet I got down to 16 stone but then the weight loss plateaued.

When I started on the Fluoxetine last year I started using weight loss jabs to counter any weight gain / increased appetite issues. Mounjaro was my GLP1 med of choice. Remarkably my weight had dropped down to 13 stone over that time. For the first time my appetite became relatively limited.

I don’t want my weight to go back up. I’m anxious about it doing so but I’m back to being much hungrier than I have been since starting Mounjaro. I’ve also started suffering some gastrointestinal side effects – sickness and very bad diarrhea – since starting on Vortioxetine.

This can’t be a coincidence. Vortioxetine lists nausea, vomiting and diarrhea amongst its side effects. I suspect there has been some interaction between the two at some level.

Right now I’m pressing on and seeing what happens. I’m bought some Pepto Bismol Ultra to help settle the diarrhea and have increased the time between Mounjaro injections from one week to two. We’ll have to wait and see if an increase of Vortioxetine to 20mg makes thigs worse. I am hoping it doesn’t increase my appetite further.

One final thing. Vortioxetine is a newer medication and as such is still on patent. That makes it expensive. I no longer ask my NHS GP to support my mental health. Continuity of care has proven a challenge. I find myself having to explain my self and my life story to a new doctor at every medication review. As such, I’ve moved to a private GP service for support.

Given that, my prescriptions are private prescriptions. For older, off patent, meds the cost is typically the same as NHS prescriptions – just under £10. Vortioxetine is £44 per prescription. If it helps (and that remains a big ‘if’) it’ll be worth it.