My experience with Viibryd so far / At a crossroads, looking for insights or similar experiences

Yeah, this is a book, but I'm really stuck on why this "worked" then didn't work the way it did. The TL;DR version of what I'm seeking is in bold towards the bottom. Any constructive insight is appreciated!

I'll begin with: Since late 2016, I had been taking Zoloft, and I would say that, along with trying just about every other SSRI under the sun before that (we're talkin 2011-2013), it worked to a degree, but I never really felt truly happier or "better" because of it. It enabled me to function, but at 50 and 100mg, respectively, I felt kind of, as I always described, "like I was in the middle of a Jell-O cube," -- that is, nothing could get to me, but I couldn't really feel much of anything, either. We tried adding Wellbutrin to it to mitigate this and the sexual side effects, no go. Buspar, no go. So, in mid-2023 I wanna say, I started taking 50mg every two days, more or less just to avoid withdrawal. My PCP was okay with this, and I thought nothing more of it for the most part.

In September 2024, I was prescribed Viibryd (the generic, so, Vilazodone) after seeing an NP Psych at my therapist's office. (Since like, October, I've been lurking on this and the other now-"restricted" r/Viibryd sub) She said that since I was only taking what amounted to 25mg a day, that cross-tapering between Zoloft (@ 12.5mg for a week) and 10mg of Viibryd for one week, should suffice. Now, outside of some itching and being irritable for a few weeks, the cross-taper went just fine. However, she neglected to tell me that I needed to go up to the 20mg after a week, and I only knew about it because I read the bottle -- after half of week two had elapsed. No big deal. I've been wanting to write this post for over a week now, but honestly, I have been trying to remember what all of this time was like, and you'll see why that's important in a second.

After the initial period of like two or so weeks, I recall things really "kickin in". It was great, I was energetic, things were super interesting again, and I wanted to live life and wasn't sitting and dwelling on stuff. And my libido came screaming back for the first time in ages, as well. But, that didn't really last, and here's where it gets murky. As I said, I was on this in early September, and it really took effect, I'd say, the first week of October. By mid-October, I kinda felt like my mood had leveled off, and I started to get weird ruminations. (I have MDD and OCD as well as some anxiety mixed in there) Weird for me, anyway. Like, that I felt like a scumbag for owning plastic because that pollutes. Or feeling horribly guilty for our neighbor locking their kids outside till after dark. (Yeah, you read that right. Truly nothing to do with me, but I felt like somehow I had caused it or something) And again, I have oddly little recall of that time, but I do remember neglecting my college coursework and later blaming it on shifting meds. However, I can't recall if that was actually me being genuine, being eerily prescient, or just using it as an excuse.

By, again I want to say, mid-November, things changed, though. Still on the 20mg, my mood started to change. And this is where I can't really explain it accurately. I really want to say, "emotionally blunted," or anhedonic or nihilistic, but I can't even say that for sure. Before ever taking meds at all, in my mid-20s (I'm 44/M, btw) when my depression first really reared its head, as well as a few times since, I consider my depression to be at its worst when it does this combination of existential dread, feeling of being drained of energy, isolating myself and just basically giving up. Example: I start watching a TV show, my mind: "This has already been done, they're either going to live or die, then the show ends, what's the point?" Playing a game: "You're either going to win or lose, who cares?" Even life stuff: Intellectually, I know I gotta keep on that hustle, but my mind is like, "So what, you sell this, you get more money, big fuckin deal." That's what was happening here, for the first time in like, 7 years? And it kind of went back and forth.

Luckily, I had an appointment right before Thanksgiving, and I was pretty much at my lowest then. She seemed to think that maybe I should go UP in dosage, but that blah blah blah, emotional blunting doesn't generally go away if it's caused by the med, etc etc. So we agreed that I'd taper on back down until the next appointment right after Xmas.

So, once again, I tinkered; heading back down to 10mg. Immediately, again, I felt awesome. For like, I wanna say two weeks, I conquered like a whole semester's worth of work that I neglected, I was at a normal level of arousal, things were interesting, the whole nine. The only real difference was that my resting pulse was always around 90. I even went to my PCP and he did an EKG and I was fine.

Then it happened again. My mood, my "give-a-shit" took a nosedive and I was in existential hell again. At that same time, everyone in my house was incredibly ill like, in rotation almost, and I wound up getting something completely different, myself. They all had the flu, I had some kind of monster cold or sinus infection, and that's initially what I thought this was. I went to my therapist on Friday, started feeling like garbage by Saturday, and by the time it resolved on, say, Wednesday, I realized that what I was feeling was not part of the physical illness I picked up.

The reason I mention this is because, again, as depressed as I ever have been, I've never been one to just lie in bed and want to continue lying in bed. I put this on being sick, but it persisted well past the cold or whatever it was.

Anyway, I saw her at the end of December and she wanted to put me on Lamictal, on the spur of the moment. I know what it is, and while I feel like if I needed it, I'd take it, I don't feel it was worth the risk at this juncture. This was basically coming from notes she took of me saying that I got "moody" a few times; like a teach or counselor telling parents they need to put their kid on Ritalin because they don't want to deal with them. Then she started get frustrated with me and like chuckling and yelling at me, basically indicating that, "I don't want to help myself," because I wouldn't slavishly defer to her judgement. She got pissy and wrote another script for the 10mg V again, and our big 20-minutes-every-month-or-two session was over.

Now, over these two-weeks-and-change, or so, I was in such a bad way, that I found a bottle of Zoloft from last year, and have tried cross-tapering again, with sort of mixed results. So when I went from Z to V, I was taking 12.5mg Z pills (which I think I may have poured out because, "WOO I DON'T NEED EM ANYMORE!" Famous last words.) and the 10mg V, simultaneously. The first day I tried doing V to Z, I took a small hunk (basically an 8th) of a 100mg Sertraline and 10mg of V at once, and I don't know if it was coincidence or not, but I wound up with a horrible migraine. Nothing else that would be emblematic of say, serotonin syndrome, but I've gotten these a few times a year for around 5 years, now, and I try not to, because they're no fun. (And cause my BP to rise so much that I've actually had to go to triage before) So, from there on out, I spaced dosages around 6-12 hours apart. I'd take Z, then V later. My moods were highly variable, and for super brief periods once I reached the 5mg stage. I remember I was having a crushing downshift in mood, took a 10mg V around 1 am, and by like 3, I was laughing at stuff again, was really into some 80s music videos I would've found mundane and blase only a few hours earlier.

Again, I'm saying this for a reason. So, you've read all of this -- or at least skimmed it -- but there's a missing piece of the puzzle. This prescriber left off the eensiest bit of info that was very vital, but which I didn't know until I stumbled upon a post on here, in the last week or so. I was never told to take this with food. Something from the manufacturer's own shtick, and she either didn't know or forgot to say anything about. And, I'm certain that I did not take it with food every time. Nor did I take it at the same time of day, which, from various posts, I also see is sort of a big deal.

Coming off of this to Zoloft, I basically had no side effects. I'm still a little itchy, and my BP has taken some time to readjust, and my moods have really sucked on and off, but I can't imagine things are going to snap into place just like that. However, getting back onto the Z with this new perspective, I do now feel like the Z was blunting, or something. And there were periods where I would get that same level of blunting/nihilism/what have you on that, too.

So, all of this has caused me to re-examine the V, too. (I've even been keeping a journal for about a week now, because I don't want to have to try and remember things that may or may not be incorrect/out of order.) The main bone of contention being that, who knows if I was "half-dosing" myself some of the time by not eating with it, and therefore the lessened bioavailability was making my mood dip, or dip prematurely. Or, taking it at different times of day (which, again, I'm certain I did) also played a role in making things go crazy. Or if I was perhaps simply not taking enough. The other thing that just dawned on me today was that the OCD increase did go away, so perhaps the blunting or whatever would fade, too?

And that's what I'm here to ask. Anecdotally, has anyone had a similar experience -- especially with the, I'm calling it "blunting", stuff, and did it resolve over time, if you stuck it out? The up/down moods thing throws me, too, because everyone including my doctor used the word "activating", and that's exactly what it felt like. Getting it in before anyone uses the word "mania". I've been on at least 5 SSRIs over time, one of which I was on for ~8 years at various strengths, 25 sessions of TMS, buspar and wellbutrin and I've never had anything approaching mania or hypomania.

Also, and I didn't really take this into account in October, but my mood suuuuuucks in the winter. I'm in a state that basically gets no sun in the summer, and my sleep schedule which was already abysmal, has been made even more so by this fucking up my mood.

Lastly, I also take 1.5mg of Ozempic per week. I know that that can screw with all sorts of medication, as far as absorption and timing, but I couldn't really find anyone complaining about that on here. I'm wondering if it interfered with the metabolism of it. Again, anecdotal is the best I'm going to do, because there aren't any studies, and my doctor or a psychiatrist would just be educated guessing.

I really hate to throw out something that might potentially work, just because of "user error" on my part and my prescriber's lack of knowledge. For the first time in a long time, I felt confident and halfway human again. I sort of want to restart it, but I don't know if I want to go through hell again if it truly is causing blunting that won't be resolved unless I stop it completely.

Seriously, if you read this whole thing, you're a champ, and thanks.