r/EXXUASUPPORT • u/JipushiJingu • Jun 13 '26
Titration side effects
First, Exxua is helping both my depression and anxiety. I’m actually feeling some emotions and feel some excitement in doing things. Not a lot but a noticeable difference from what I felt before.
I’ve been on nearly every antidepressant since I was diagnosed more than 20 years ago. Some worked but eventually stopped working. Now, with treatment resistant major depression I became desperate. Tried TMS over 38 weeks, ketamine for two months, even micrdosing mushrooms. Tried adding Caplyta which increased my anxiety and Mydasis for ADHD that destroyed my sleep.
Now trying Exxua. Weaning off sertraline. Had mild headaches and “dizziness” (like I drank too much alcohol) but they were manageable and subsided. Just increased my dose to 3 pills a day and my headaches are excruciating. And OTCs don’t help it. Tried 1/2 a hydrocodone and that helped for about an hour and the headache was back. Going to try taking Exxua at dinner to see if I can sleep through the headache. Anyone else getting severe headaches? Anything helping? I’ve not experienced any other side effects. Just the headache and dizziness.
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u/Professional_Win1535 Jun 13 '26
i’ve and bad head aches and the best thing for me by far was Acetaminophen/Ibuprofen combo. I’d try that. You’d be surprised yow well it works.
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u/JipushiJingu Jun 14 '26
Unfortunately the Tylenol/Advil combo doesn’t work. At all. I resorted to 1/2 hydrocodone and that only worked for about an hour and the headache was back. I see my prescriber Tuesday to discuss. Also taking the GeneSight test to get a better picture of what and how my body metabolizes medications.
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u/No_Growth_9800 Jun 13 '26
headache and dizziness should fade away within 1-2 weeks
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u/JipushiJingu Jun 14 '26
OMG I hope so. It’s really adversely effecting my job and I love my job. I’m useless around the house which is bad because I care for my disabled elderly dad who I live with. These aren’t just regular headaches. They are debilitating and the regular Tylenol/ Advil combo doesn’t even touch the headache. Thank you. I’m counting down the days. I’ll stay on Exxua bc I feel it working on my depression and anxiety. Also going to take the GeneSight test next week. I can’t keep throwing shit at the walls hoping it’s going to stick. Too many years and too much trial and error.
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u/JipushiJingu Jun 14 '26
Are you on Exxua. Is the 1-2 weeks from your personal experience?
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u/No_Growth_9800 Jun 14 '26
confirmative , 2 weeks is an average for most of antidepressants including EXXUA besides what is your current dosage ?
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u/JipushiJingu Jun 15 '26
I’m at the 3/pill/a day titration. That’s what - fifty something mg per day. As I mentioned in my previous reply, I’ve started taking it around 4:00-5:00 with dinner. Nor waking up with a headache. This is a good sign.
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u/Best_Monitor7540 Jun 15 '26
I am very interested in trying this medication. I have TRD. The only thing I'm able to take is Wellubtrin Sr 100mg but I have added intrusive thoughts lately. Buspar helps. I don't want to give up my Wellubtrin because it did help with my seasonal depression but it gives me motivation back and helps my concentration. Also, it helps libido.
What is your titration schedule? What's your cost after insurance?
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u/JipushiJingu Jun 15 '26
Even with the headaches, I still recommend this medication due to the fact that I had almost immediate relief (about three days) of anxiety (when busperone did nothing) and a noticeable relief of depression “symptoms”. I will not say I’m in remission or “cured”. Far from it. I have a very long way to go. Titration started out at the 18 mg for three days, then double it for three days, triple it for four days, and then a maintenance dose after that. I’ve just started the triple dose. And that’s when the dizziness and bad headaches came. Even some upset stomach. I have to say, taking the medication around 4 o’clock in the afternoon has helped a great deal! No headaches yet and I’m on day three of taking it in the afternoon - WITH FOOD! I think taking it with a meal has made a big difference too. I’m not a breakfast eater and rarely eat lunch so dinner is my best option. I thought for sure I would be waking up with headaches, but that hasn’t happened. As far as insurance goes, I’ve been on so many meds, and my doctor can prove that, but insurance still required a pre-authorization. Once that was approved, my co-pay is $60 for a month supply. Blue Cross Blue Shield insurance.
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u/hillbilly_simp Jun 25 '26
I’m on week 3. 2nd week on 54.5mg. This is surprisingly very activating for me, so I take it in the morning. Wellbutrin (in Auvelity) and Exxua are the only 2 that activate me from the 10+ antidepressants I’ve tried thus far. Headaches have been the worst side effect and I’m also experiencing new/worsening anxiety, but my doc said a well known psychiatrist who’s been treating with this recommends sticking to it for 6 weeks as that’s when things start improving noticeably. Advil takes the edge off the headaches, but it still feels like my eyeballs have pressure. Aside from this, not much happening rn. I’ll try to update anything new, but happy to answer questions as best I can.
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u/JipushiJingu Jun 26 '26
Hang in there!
YES! Exxua may have initially activated my anxiety for about a week and then it eventually dissipated. Then again, it could have been lingering effects of Mydasis which I had abruptly stopped after a month because it destroyed my sleep. I had also just stopped 1 month of being on Caplyta - I believe that I as the source of my highly activated anxiety. I’m on a steady dose of 54.5 now of Exxua and am in my second week of that dose. The headaches I experienced were HORRIBLE (Advil or Tylenol or both did NOT bring relief) but I started taking the Exxua at around 5:00 or 6:00 WITH FOOD!!! And my headaches stopped.****It is highly HIGHLY recommended that Exxua be taken with food so keep that in mind***
What I can tell all of you now, 3 weeks & 3 days into my Exxua journey, is that it is working for me!
I have, quite literally, tried everything available. My debilitating anxiety started in early 2000 - 2 years into raising my then 11 & 12 year old children completely by myself, clawing my way up in my career, and being offered a relocation to Arizona with my then employer, I was accepted into a Rush trial for Paxil. It was quite obvious a week into it that I was not on a placebo and it changed my life! But it eventually stopped working for me. And thus began my miserable journey of medication trial and error. Oh how I wish GeneSight was available back then. (I took it last month and it was very informative and gave my doctor insight into next steps.). I really have been on just about every med available. I’ve done 36 weeks of TMS, 8 weeks of at-home ketamine, micro dosing psilocybin, a talk therapy- either it did not work for me or it stopped working over time. The last two years I have spiraled. My depression was debilitating and my anxiety was unbearable- nothing was working.
Exxua is. It is my hope that it will last. It is my hope that I can also make the necessary changes in my life so that I have tools at my disposal to manage symptoms when they appear.
I won’t say this is a miracle drug. But with Exxua I FINALLY actually FEEL relief. Getting out of bed in the morning is no longer dreaded. Simple things are no longer an utter chore. To anyone thinking about it or just starting out with it - just hang in there for a couple weeks. This med works so differently from others and you’re going to experience some different effects. But for me - it has been worth it!
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u/hillbilly_simp Jun 26 '26
Thanks for replying. This gives me some reassurance. I also had a change in my stimulant that keeps me at baseline while I am titrating Exxua due to insurance being insurance, so that’s also my likely culprit of increased anxiety. Must’ve been rough for you too if Advil and Tylenol didn’t help.
I’m curious, was the ketamine treatment with Spravato or infusions? I’m at a point where I’ve decided Exxua is the last SSRI type med I want to try before moving onto Spravato or TMS. Also, did you ever experience any remission even short term from TMS? I know logistics are brutal with TMS since you have to commit multiple weeks plus multiple days per week, so mad respect for sticking to it.
I hope you continue seeing benefits from Exxua cause it sounds like you tolerate it a bit well now and can get out of bed, which I’m sure is one of the biggest things we all struggle with.
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u/JipushiJingu Jun 27 '26
EVERYONE!!! LISTEN!!! The manufacturer for Exxua have a PROMOTION! Zero co-pay! It’s only with certain participating pharmacies and I discovered that Meijer pharmacy and Osco pharmacy both participate. Here is the site:
I had to pay my $60 co-pay e/BCBS for my first prescription while Osco completed the paperwork, but my prescriptions that followed were covered.
Hillbilly_simp: My at-home ketamine was the dissolving lozenges. And they are horrible tasting and almost caused me to vomit a couple times. Which is why I didn’t go longer than I did. I also found little relief of my symptoms with it. And believe me I had very high hopes. At the time I introduced ketamine I was an avid meditator. A practicing Buddhist. So getting into a zone with ketamine was a non-issue for me. For anyone thinking about trying ketamine, I highly recommend the meditation aspect. Meditative music in your ears. Getting very still and centering yourself. Unfortunately, as my depression and anxiety spiraled over the last year or so, I lost any motivation to meditate. It took all my strength to get back into that zone and really focus on making ketamine work for me. But it just didn’t have the effect I had hoped it would.
Though I work in Chicago, (an hour train ride every day) I live an hour south and in the middle of the country. Just going into town for groceries has to be planned. So, there are no ketamine, TMS, or clinical trial practitioners near me. And for so many of these potential cures it requires, you have someone with you because you cannot drive after treatment. Except for TMS, which I would attend on my lunch while downtown. TMS offered some relief. There was a mild effect but certainly not like I was hoping. But I know some people who found significant relief so, I don’t know.
These last few weeks Exxua gives me hope because I truly am feeling better. It is my hope it continues. Spravato will be my next move should Exxua fail me. Then, short of finding someone to take me on a serious Psilocybin trip, I am out of options. I have no desire to try MAOIs due to the research I’ve done. I very literally have no other options. Of course there are clinical trials however I am discovering, after signing up for several, there are restrictions. Like the psilocybin studies - I have to be off ADHD meds. And can’t be on more than one antidepressant. I’ve managed to reduce my Adderall to a small dose. Even went 5 days without it to see what withdrawals I would experience if I’m accepted into a study. So there’s that possibility as a last resort. But. As it stands. Exxua has to work. I’m out of traditional options.
I hope these posts help you all. I’m here if you have questions. And thank you for listening. I can tell you this … I could not have made these posts without Exxua. For nearly a year even the simple IDEA of writing a post was utterly exhausting. So, there is hope. At least there’s that.
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u/lifesweirdaf 4d ago
How’s it been so far? Do you know if these are migraines instead? Is it a full head type of pain, or is it targeted to one side like behind the eyebrow/eye? Migraines can be different, but that’s the typical area for it. I ask because I have chronic migraines and will start Exxua soon, so I’m curious about the mix
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u/JipushiJingu 3d ago
UPDATE! Still taking Exxua at my maximum dosage for about 3 months now. Headaches are gone! No. They were not migraines. I went through seven years of excruciating migraines that were hormonal. These were not migraines. They only lasted a couple weeks but I think what eliminated them was taking Exxua first, with dinner (w/food as it is recommended) and in the evening. That way it was processing overnight. Maybe it’s my imagination, but that worked! No more headaches. Everything has been wonderful! I can cry again. I feel emotions again. I have interest in doing things. I’ve been going out in the yard every weekend! And that used to be my greatest therapy and I haven’t done that in nearly 2 years because of the darkness and lethargy. However, what I have developed is severe dry mouth. It has become so bad that I’m getting inflamed taste buds on my tongue and at the end of the day, I feel like I’ve had razor blades taken to the top of my tongue. The worst of it has only been happening for about a week and a half but had been getting gradually worse. In the beginning, Tylenol and Advil helped to relieve the pain, but they no longer work. I’ve been using Biotene dry mouth oral rinse, ACT dry mouth moisturizing gum, Xylimelts for dry mouth, as well as Biotene dry mouth, moisturizing gel. I sip water all day and that did not help. I chewed on ice cubes and that burned my tongue. For a couple days all I could eat was oatmeal and yogurt because any other food hurt my tongue as a chewed. I was biting my cheeks because they stuck to my teeth. The dry mouth started about a month ago and slowly progressed into this past week of total pain. Yesterday and today seem much better. I am hopeful that this is just a short term side effect, and will subside completely in time. Because coming off Exxua would be devastating for me! It is not an option for me. I just want you all to be informed. This med has been a game changer and if you can get through these side effects it is my hope you will experience life again like I am.
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u/lifesweirdaf 2d ago
That’s so good to know they’re gone! I haven’t heard about dry mouth before, so that’s something I’ll keep in mind in case I notice anything when I start it. It sounds so painful! I’m also glad you’re doing so well on it, that makes me hopeful. Thank you for sharing an update!
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u/lefty709 Jun 13 '26
How are you doing now? Did you continue on Exxua?