Lucy: venlafaxine withdrawal

[Lucy]

Hi all

 

I am tapering off 150mg venlafaxine. I have been going relatively slowly - I started with a 10% reduction monthly, but when I got to 75mg things seemed to get easier and let’s face it I got complacent - I went from 75mg to 66mg, 3 weeks later 66mg to 57mg. All ok.

 

Then after 2.5 weeks I dropped from 57mg to 50mg - then I hit a huge wall of withdrawal symptoms. Firstly my brain felt like it was stuffed with cotton wool. Then I developed awful insomnia. I increased to 54mg. A few days later I developed excruciating back pain. I had blood and urine tests - all clear - and my GP advised me to go back up to 57mg, which I did 5 days ago.

 

I am now ping ponging through a miriad of withdrawal symptoms - uncontrollable crying, white hot rage, back pain, tingling/burning in my spine, pressure in my head, urinary frequency, crazy vivid dreams, diarrhoea, tingling in my hands and feet, nausea. I am signed off sick from work.

 

My plan is to stick it out at this dose for as long as I possibly can, in the hope that the symptoms settle. I’m taking fish oil, magnesium and zinc supplements, avoiding caffeine, trying to eat healthily, trying to go for a short walk each day, reading lots of validating stuff on the net, resting lots...

 

Most of the time I feel like I can just about cope but at times of course it all gets overwhelming. Do you think I’m doing the right thing by sticking at this dose for a while? Any advice would be much appreciated.

 

Edited December 3, 2018 by ChessieCat
added spacing

[ChessieCat]

Hi Lucy and welcome to SA,

 

SA's recommended tapering protocol is no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?   When the drug is taken away too quickly this can result in withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

You have done the right thing by increasing the dose by a small amount.  It's good that the doctor did not advise you to updose by too much, which is what most doctors seem to do, so you have been very fortunate.

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  The idea of updosing isn't to get rid of the withdrawal symptoms completely but to bring them to a bearable level.  It would be best if you stay at 57mg for a bit longer and give the brain a chance to catch up with the doses changes.

 

Q:  Has your sleep improved since you increased your dose?  If yes, that is a good sign.

 

If no, please see this topic:  Sleep problems - that awful withdrawal insomnia

 

It is going to take a few months for you to stabilise before you start tapering again.  It is worth noting that many members find that the lower their dose gets the slower they need to go, reducing by less and/or holding longer.  Why taper paper: dose-occupancy curves

 

It's also good to know about the:  Windows and Waves Pattern of Stabilization   It's a good idea to keep daily symptoms notes on paper which can help you to see how your symptoms are responding to the updose:  Keep Notes on Paper and Rate Symptoms Daily to Check Patterns and Progress

 

 

Please create your drug signature using the following format. 

 

Please make it nice and simple by following these instructions (NO diagnoses or symptoms please - thank you):

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

Here are some helpful topics:

 

Tips for tapering off Effexor (venlafaxine)

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Non-drug techniques to cope

 

Keep it Simple, Slow and Stable

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

This is your own Introductions topic where you can ask questions about your own situation and journal your progress.  Please remember to update your drug signature whenever you make a change so it remains current.  Thank you.

[Lucy]

Thank you so much, that is all very helpful. It gets so difficult to know which way is up, especially in the mornings when all I can do is cry. Trying hard not to resort to any other pharmaceuticals which are bound to compound the problem in the long run, but so hard when you’re feeling terrible. I’m so grateful for this site.

[LarryS]

Welcome Lucy

I also am tapering from Venlefaxine, but you are at a lower dose than I.  It pays to be patient and go slow.  If in dought, hold for a few more weeks until you feel stablized.

I have been also feeling more back pain recently.  I know it may be partly due to a previous bulged disk.  My current pain is not as sharp as when I had the bulged disk, but it does wear on me and can cause even mild head ache.  

Do you have any previous back issues that would contribute to your current back pain?

You can do this.  Well wishes.

[Lucy]

Hi Larry, thanks so much for your message. Yes I did damage my back a little when I was pregnant so I guess it could be exacerbating an old injury. I had an amazing sports massage this afternoon on my back so I’m hoping that will help. I seem to get a good window each evening when I feel quite a bit better so that’s giving me hope. Still a long way to go before I feel strong again and over this dip. Where are you at with your taper? And where in the world are you? I’m in Devon in the uk. Warm wishes to you.

[Lucy]

Re: venlafaxine withdrawal - I’m really struggling to stabilize. All going well until I reduced to 50mg 4 weeks ago. Since then I’ve developed awful insomnia, back pain, diarrheoa, difficulty concentrating on any day to day task, low and tearful. Went back up to 57mg 1 week ago. No improvement yet. Should I just sit it out at this dose, or think about increasing some more? I have a doctor’s appointment tomorrow - she knows nothing about withdrawal and I don’t know what to do next. Please help, I am so worried.

[Songbird]

Hi Lucy, I've merged your new topic in with this one.  Please post all your updates here in your introduction topic, so that all your information is kept in one place.

 

Please can you update your signature with specific doses and dates, so that we can clearly see your tapering information.  You could look at my signature for an example.

 

It might take a while to feel significant improvement from the updose, and longer to restabilise.  I know it's hard, but you need to be really patient.  It's good that you are getting some windows in the evening. 

 

If you keep daily notes about your symptoms and rate them out of ten, you'll be able to look for patterns over time.  Here's an example (note this is a made up example):

 

23 June

7 a.m. woke up, anxiety 3/10

8 a.m. ate breakfast, took 20mg Prozac tablet

10 a.m. anxiety 7/10, nausea 3/10

12 p.m. ate lunch, anxiety 5/10, nausea 1/10

2 p.m. anxiety 4/10, nausea 2/10

6 p.m. ate dinner, took magnesium tablet 200mg, anxiety 2/10, no nausea

8 p.m. anxiety 1/10

11 p.m. went to bed, anxiety 2/10, difficulty falling asleep for 2 hours

4 a.m. woke up, no anxiety, went back to sleep for 3 hours

[Lucy]

Hi Songbird, thank you for this advice. It’s reassuring to know I am doing the right thing by sticking to this dose. I have decided to stick to it for a good 6 months once all withdrawal symptoms have gone away. I have looked at my calendar and updated my signature. It has enabled me to see that I tapered way too fast from 75mg to 57mg and I think that’s what has destabilized me. I also stopped the antipsychotic quickly because, once I was at a lower dose of venlafaxine, the amisulpride  it caused me the horrible side effect of an emotionless/dead-feeling brain, which lifted once I was no longer taking it. I’ve had no psychotic symptoms since stopping the amisulpride - I feel they were only ever caused by a higher dose of venlafaxine - now I’m on a lower dose I’m hoping I won’t need it. The hardest withdrawal symptom to bear is the insomnia. Would you be 100% against trying a benzo to help me with sleep? I’ve tried Phenergan (promethazine) but it didn’t seem to make much difference. I’m taking fish oil, magnesium, co-enzyme Q10 and zinc supplements. Currently my withdrawal symptoms are: diarrhoea, abdo and back pains, insomnia, pressure in my head, tingling in feet and hands, tearfulness, confusion. But I seem to have one or two small windows each day when I feel much better.

 

Thank you so much for your help.

 

Lucy

[Songbird]

It's best to avoid adding benzos as they can end up causing worse problems eventually.

 

Is the insomnia just feeling wide awake, or is it the anxiety kind?  See: Tips to help sleep - so many of us have that awful withdrawal insomnia

 

Why are you taking zinc supplements?  Have you had a zinc test?  Zinc can be stimulating, you might try cutting out the zinc supplements for a while, or taking a much smaller dose.  See: Supplementing with zinc

 

Have you tried melatonin at all?  A small dose can help encourage your body to sleep.  See: Melatonin for sleep

 

I highly recommend relaxation exercises and sleep hypnosis.  See:  Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

 

[Lucy]

Thanks Songbird.

 

Re: insomnia - I feel tired but wired. My thoughts feel out of my control. I guess there is some anxiety. I take zinc because when I tapered off venlafaxine way too fast a couple of years ago (following my psychiatrist’s advice), I lost my sense of taste and smell. Subsequently I read that a zinc deficiency can cause this. For the past 2 nights I’ve resorted to using promethazine (phenergsn) to help me sleep - I just couldn’t bear the insomnia. I will ask my GP about melatonin. I’ve decided to reinstate 25mg amisulpride - my risk of psychosis is high and it seems like a good insurance policy for now. I feel so yucky. Looks like I’m in for a bleak Christmas, like I had in 2014. No idea how I will survive this. My worry is if I end up having to reinstate much more venlafaxine I’ll become suicidal again. I’m so grateful for your support.

[LarryS]

Hi Lucy

[LarryS]

I see that you asked me a couple of questions.  

You may simply click on my name or picture to take you to my introductions page, to find out more about me.

My location appears below my picture.

 

How are things going for you.  It has been a while since you posted.

[Lucy]

When to start tapering venlafaxine?

 

Hello. I have been on venlafaxine antidepressant for a number of years. Last year I tapered too fast and ended up having to reinstate 225mg. I've been on this dose for 11 months and have been stabilised on that dose for most of that time. Do you think I'm ok to start a slow taper yet? My doctor told me to wait 18 months to two years but that seems like a very long time and I can't see the advantage myself. Thank you.

Edited May 27, 2020 by ChessieCat
added topic title

[ChessieCat]

Hi Lucy and welcome back.  I've moved your new post to your Introduction topic.  This keeps all your information in one place and is the best place to ask questions and journal your progress.

 

Are you taking any other drugs?  It's important that we have all this information so that we can make suggestions based on your own situation.

 

Please create your drug signature which allows us to see your drug history at a glance.  Please read this post which explains what information is required:  please-summarize-your-withdrawal-history-in-your-signature  Click on this link to go to your own signature:  Account Settings – Create or Edit a signature

 

_______________________________________________________

 

PLEASE NOTE:  The following is information based on your last post and does not take into account any other drug and/or dose changes that you might have made during the last year that we have not yet been made aware of.  If you have made changes in the last year then please ignore the following information.  Once you have advised us of those changes then we can provide information based on that.

 

If you are feeling stable then if you want to you could try reducing your dose.  SA recommends reducing by no more than 10% of the previous dose followed by a hold of 4 weeks to allow the brain to adapt to not getting as much of the drug. 

 

Please read Post #1 of this topic:  tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine

 

Because you are on a high dose, making a reduction of 10% (ie 225mg x 0.9 = 202.5mg) would probably be all right.  In fact because of the high dose you could round it down to 200mg.  This topic has information which might help you to understand this:  Why taper paper: dose-occupancy curves.  Generally it is as the dose gets lower that you need to keep the reduction to 10% or less.

 

If you are concerned about reducing to 200mg, you could try a smaller reduction to test to see how things go.  For example, a 5% reduction.  A 5% reduction would be 225mg x 0.95 = 213.75mg.  You could round it up to 215mg or down to 210mg if it is easier to get the dose.