Thewayshegoes: Difficulty tapering Effexor. Trying to stay positive.

[Thewayshegoes]

I have made the decision to bridge to Celexa. I had a delayed reaction and suffered some pretty nasty symptoms. This taper is making me go insane. Literally.

 

Does anyone have any experience tapering Celexa, and how does it compare with the behemoths Effexor and Paroxetine?

 

Thanks.

[ChessieCat]

Tips for tapering off citalopram (Celexa)

[Altostrata]

21 hours ago, Thewayshegoes said:

I have made the decision to bridge to Celexa. I had a delayed reaction and suffered some pretty nasty symptoms. This taper is making me go insane. Literally.

 

Does anyone have any experience tapering Celexa, and how does it compare with the behemoths Effexor and Paroxetine?

 

Thanks.

 

What kind of delayed reaction?

[Thewayshegoes]

2 hours ago, Altostrata said:

 

What kind of delayed reaction?

 Just that it took a bit longer for wd symptoms to appear than usual. Thought I was in the clear then BAM. 

[OldDodgy]

@Thewayshegoes

 

Hi, 

I just want to encourage you that with the experience of the SA group backing you, I think you have reason to be optimistic, even though your current symptoms might be foul. Simply because the Admins have the experience to help you. 
 

Back in the day I was bounced from paroxetine to sertraline, citalopram for escitalopram——all without tapering or cross dosing.
 

My memories were of some pretty grim physical side effects but they then CT the escitalopram and put me on an antipsychotic and mirtazipine.  Fortunately I was introduced to a group and shadowed SA and came off all potent psychotropic meds in a measured way. 
 

The physical symptoms have abated over time with support and understanding, and I hope this happens for you too. 
 

Wishing you well

 

OldDodgy 

[Altostrata]

On 3/31/2022 at 9:40 PM, Thewayshegoes said:

 Just that it took a bit longer for wd symptoms to appear than usual. Thought I was in the clear then BAM. 

 

What was the reduction that caused this to happen?

 

Paroxetine is probably the worst antidepressant to taper.

[Thewayshegoes]

3 hours ago, Altostrata said:

 

What was the reduction that caused this to happen?

 

Paroxetine is probably the worst antidepressant to taper.

20mg to 19mg

Really? Worse than Effexor? Eeek
 

[Altostrata]

Paroxetine is so difficult, people often resort to bridging. This topic explains how to cross-taper to another drug. 

 

[Thewayshegoes]

Just curious, what is the general timetable for withdrawal symptoms, like when they ought to appear and how long they should stay before disappearing?

[Altostrata]

For paroxetine, withdrawal symptoms can show up a few hours after dosage reduction. Mild symptoms would be those that go away in a few days. But if they get worse over a few days, they're not mild.

[Thewayshegoes]

20 hours ago, Altostrata said:

For paroxetine, withdrawal symptoms can show up a few hours after dosage reduction. Mild symptoms would be those that go away in a few days. But if they get worse over a few days, they're not mild.

 Okay cool. Thank you.

My w/d reaction was delayed by like 10 days. I reduced, was fine for awhile, then bam. There it was. I had to miss a dentist apt because I was running a fever when they took my temp (usually my first w/d symptom is running a low grade fever for a few hours). Covid test negative. Fever abated, and the symptoms following have been mild in intensity. Cognitive sluggishness, transient anxiety, strange dreams, transient dizziness/vertigo, low mood, overall kinda yucky feeling. I'm okay, I've experienced much much worse in terms of withdrawal. I'm not in distress. In any case, I think this is my cue to hold and not try to taper further until I've completed my bridge. When I do the bridge, I'm going to hold on the bridge drug awhile to let my CNS get used to it. At this point, no rush. 

[Thewayshegoes]

Doc prescribed Hydroxyzine for anxiety, 50mg. What is everyone's experience with this?

I know it has serotonergic activity so I'm hesitant to make too much of a habit of taking it during my w/d. I took it once and noticed my w/d symptoms to improve somewhat and my anxiety to improve considerably. I want to sleep.

I really dont want to be taking something that prolongs or interferes with the healing process. 

[ChessieCat]

I suggest that you do a drug interaction check for all drugs you are currently taking.

 

Drug.com Interactions Checker
Medscape Drug Interaction Checker

 

Q:  Are you currently taking Prozac?  There is a serious interaction (for Prozac and hydroxyzine) - I used the Medscape checker.

 

 

Edited April 15, 2022 by ChessieCat
added drug names with serious interaction

[ChessieCat]

Have you tried magnesium?  Melatonin?

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

Sleep problems - that awful withdrawal insomnia

 

Magnesium

Melatonin

[Altostrata]

Please use search in the Symptoms and Self-Care forum to find discussions of hydroxyzine.

[Thewayshegoes]

Thanks, all. I decided to hold off on the hydroxyzine. I dont want serotonergic activity while I'm tapering.

Anyway, I thought I'd announce that I am switching to Fluoxetine in the next few days. I've hit a brick wall with Effexor and can't go any further. I initially suggested Citalopram to my doc due to it being a less activating and more "pure" (selective) SSRI than Fluoxetine. She assured me that Fluoxetine is by far the least problematic taper. Wish me luck.

[Thewayshegoes]

My only issue is how activating prozac is. I've been having issues with hypomania as a part of withdrawal. I fear prozac may exacerbate that.

[Thewayshegoes]

I can't help but feel immensely discouraged. 2 months ago I attempted tapering by a very small amount and got hit hard. I tried to "ride it out" as I've tried to do before and just couldn't. I reinstated 1 week ago and things have been gradually improving. But this is the 3rd time in the last 8 months this has happened. I'm just stuck here. Tapering is already too difficult to do as is. If my system has been "sensitized" by these attempts, and it's now even harder, it is then impossible. I'm giving up and staying on Effexor. My doc and I have been discussing a switch to fluoxetine, but I'm not even going to do that. Maybe down the road if I feel up to it I'll cold turkey and brace for impact. But I'm just not playing this game any longer; tapering by very small amounts and being hit with ridiculous withdrawal. Thanks for all your help everyone.

 

This site is so doom and gloom. Alto suggests tapering carefully, so I taper by miniscule amounts. Withdrawal hits hard. Alto says reinstate but it might not work. Withdrawal symptoms should be mild and short lived. But any reduction at all causes outrageous symptoms. So what do I do? Taper so slowly it takes 30 years to discontinue, and even then withdrawal is unbearable?

 

This is maddening and I'm done with it.

[OldDodgy]

@Thewayshegoes

 

I am so sorry you feel so lost and fearful. 
 

I hope you find some peace very soon. 
 

OD 

[Onmyway]

2 hours ago, Thewayshegoes said:

I can't help but feel immensely discouraged. 2 months ago I attempted tapering by a very small amount and got hit hard. I tried to "ride it out" as I've tried to do before and just couldn't. I reinstated 1 week ago and things have been gradually improving. But this is the 3rd time in the last 8 months this has happened. I'm just stuck here. Tapering is already too difficult to do as is. If my system has been "sensitized" by these attempts, and it's now even harder, it is then impossible. I'm giving up and staying on Effexor. My doc and I have been discussing a switch to fluoxetine, but I'm not even going to do that. Maybe down the road if I feel up to it I'll cold turkey and brace for impact. But I'm just not playing this game any longer; tapering by very small amounts and being hit with ridiculous withdrawal. Thanks for all your help everyone.

 

This site is so doom and gloom. Alto suggests tapering carefully, so I taper by miniscule amounts. Withdrawal hits hard. Alto says reinstate but it might not work. Withdrawal symptoms should be mild and short lived. But any reduction at all causes outrageous symptoms. So what do I do? Taper so slowly it takes 30 years to discontinue, and even then withdrawal is unbearable?

 

This is maddening and I'm done with it.

Hi @Thewayshegoes

So sorry to hear you have been suffering with withdrawal even at low dose tapering. I am in the same boat - can manage about 3% а month.

 

It is absolutely your choice to stay on the drugs. We don't advise people one way or the other, we just assist them if they choose to taper properly. And you won't be alone in picking that road. 

 

just out of curiosity is anything else interfering with your withdrawal, other psych drugs (street or prescribed), alcohol, supplements and vitamins? All those can set people back. The most notorious one is alcohol. But even vitamins like D and B can be quite bad.

 

Hope you feel better soon

omw

[ChessieCat]

Others that might cause issues are antibiotics or prescriptions drugs/creams/drops containing steroids or allergy medications.

[Thewayshegoes]

7 hours ago, Onmyway said:

Hi @Thewayshegoes

So sorry to hear you have been suffering with withdrawal even at low dose tapering. I am in the same boat - can manage about 3% а month.

 

It is absolutely your choice to stay on the drugs. We don't advise people one way or the other, we just assist them if they choose to taper properly. And you won't be alone in picking that road. 

 

just out of curiosity is anything else interfering with your withdrawal, other psych drugs (street or prescribed), alcohol, supplements and vitamins? All those can set people back. The most notorious one is alcohol. But even vitamins like D and B can be quite bad.

 

Hope you feel better soon

omw

3% per month would be wonderful! Lol

 

Ugh sorry everyone about my woe is me rant. I was feeling very lost. 

 

I am at a brick wall with my current drug. My last taper was 20 to 19.625 (1.8%). I presented with hypomania, dissociation, panic/anxiety, visual disturbances). Alto advises us to reinstate if such symptoms appear, then taper by a lower amount. But I decided to try to ride it out. Gave up after 2 months with no relief.

 

I'm just beaten down and it's hard to stay optimistic. Doc and I have been talking about a switch to Prozac. Idk when I'll be ready. 1 week back on 20mg and I'm feeling much better but still a little woozy. Reinstatement has historically worked for me. Let's hope that holds true.

 

No supplements. Occasional (every 2-3 months) alcohol use. No drugs. I do take hydroxyzine occasionally. I try not to.

[Thewayshegoes]

Just so we're clear moving forward: if I reduce dose and severe w/d sets in, it's abort mission and reinstate immediately, don't try to ride it out. Correct?

 

Also, is it normal for w/d symptoms to be unpredictable? Every time I've experienced them they've had a different presentation.

[Onmyway]

yep. WD symptoms can be unpredictable. 

It is up to you to decide whether to reinstate or not, we can't make that decision for you - you know the risks and the benefits. We generally advise a small updose rather than going back to your previous dose. 

 

Effexor is hard to withdraw from. Prozac bridge is possible, we don't advise it as it can also go wrong but sometimes people have no other options. You can read the thread on it and decide for yourself. 

 

We find that alcohol can really set people back and intensify withdrawal a lot so we advise full abstention for many years. Again up to you what you do with that recommendation. 

[OldDodgy]

@Thewayshegoes

 

Hi. As ever On my way is super! 
 

I have withdrawn some folk on Effexor at ten percent but surely slowly is often necessary as you have found. 
 

I am afraid it’s a bumpy road. Or was for me. 
 

I only got off stuff with very intense support from a previous group. Every time I tripped they saw me through. 
 

Wishing you well 

 

OD 

[Thewayshegoes]

38 minutes ago, Onmyway said:

yep. WD symptoms can be unpredictable. 

It is up to you to decide whether to reinstate or not, we can't make that decision for you - you know the risks and the benefits. We generally advise a small updose rather than going back to your previous dose. 

 

Effexor is hard to withdraw from. Prozac bridge is possible, we don't advise it as it can also go wrong but sometimes people have no other options. You can read the thread on it and decide for yourself. 

 

We find that alcohol can really set people back and intensify withdrawal a lot so we advise full abstention for many years. Again up to you what you do with that recommendation. 

My last Prozac bridge attempt was a cross taper. I got massively overactivated. I already find Prozac to be activating (was on it some years ago, could tolerate it), and I think mixing it with Effexor was all bad. But from what I understand I could be "sensitized" and will be too activated regardless, as if this ridiculous process needs to be even harder. If I can't bridge to prozac, I'm screwed as far as tapering goes.

 

I went back to my previous dose because I literally cannot measure any smaller a dose. 

 

Oh so now you're going to take drinking away from me too? What else can't I have?

 

 

[Thewayshegoes]

20 minutes ago, OldDodgy said:

@Thewayshegoes

 

Hi. As ever On my way is super! 
 

I have withdrawn some folk on Effexor at ten percent but surely slowly is often necessary as you have found. 
 

I am afraid it’s a bumpy road. Or was for me. 
 

I only got off stuff with very intense support from a previous group. Every time I tripped they saw me through. 
 

Wishing you well 

 

OD 

I appreciate the support. Thank you.

[FindRest]

I’m sorry you’re struggling so much with Effexor. It’s an awful drug to WD from. I’ve read your topic here, and didn’t see any reference to some important variables. I have a few important questions for you:

 

What form of Venlafaxine are you taking? Is it immediate release or extended release? Beads or tablets?

 

How are you measuring/preparing your doses?

 

Are you aware that immediate release needs to be taken twice a day, 12 hours apart?

 

Are you aware that if you are cutting an XR tablet or mini-tab, it too must be taken twice a day, 12-hours apart?

 

If the last two scenarios fit you and you are not taking them twice a day, 12 hours apart, then the withdrawal symptoms would be unbearable. Effexor is bad enough to taper when done correctly.

 

I just want to make sure you were aware of the above.

[ChessieCat]

Yes, FindRest is correct about twice a day dosing.  Post #1 of the Tips for tapering off venlafaxine (Effexor) discusses this in details.

 

When you take a drug that has a short half life you may experience interdose withdrawal.  Signs of this happening:  there is a daily  pattern of you feeling worse symptoms prior to taking your drug (this may be several hours or more depending on the half life and how fast you metabolise the drug) and after you take your dose you gradually start to improve.

 

Also see:

 

dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs

[Altostrata]

On 6/4/2022 at 7:28 PM, Thewayshegoes said:

This site is so doom and gloom. Alto suggests tapering carefully, so I taper by miniscule amounts. Withdrawal hits hard. Alto says reinstate but it might not work. Withdrawal symptoms should be mild and short lived. But any reduction at all causes outrageous symptoms. So what do I do? Taper so slowly it takes 30 years to discontinue, and even then withdrawal is unbearable?

 

I am sorry this is so difficult, as 17,000 registered members beside yourself have found. If we could make it easier, we would.

 

There are people who find going off Effexor to be very difficult. You may be one of those people. You did, however, taper from 75mg to 20mg.

 

On 6/5/2022 at 9:46 AM, Thewayshegoes said:

My last Prozac bridge attempt was a cross taper. I got massively overactivated. I already find Prozac to be activating (was on it some years ago, could tolerate it), and I think mixing it with Effexor was all bad.

 

It's very possible that if your doctor added a "normal" dose of Prozac, such as 20mg, to whatever amount of Effexor you were taking, that you did experience serotonin toxicity. But that's your doctor's fault, not a sign that bridging with Prozac is not possible. FYI 
The Prozac switch or "bridging" with fluoxetine
 

However, you probably should wait to make this switch, to let your last attempt at tapering settle down.

 

On 6/5/2022 at 7:49 AM, Thewayshegoes said:

Occasional (every 2-3 months) alcohol use.

 

It's possible you've been setting yourself back every 2-3 months by drinking alcohol. Again, this is not something we should be blamed for.

 

Very sorry you find yourself in this position with so many others, because doctors are so ignorant about the effects of the drugs they prescribe.

[Thewayshegoes]

On 6/6/2022 at 2:41 PM, Altostrata said:

 

I am sorry this is so difficult, as 17,000 registered members beside yourself have found. If we could make it easier, we would.

 

There are people who find going off Effexor to be very difficult. You may be one of those people. You did, however, taper from 75mg to 20mg.

 

 

It's very possible that if your doctor added a "normal" dose of Prozac, such as 20mg, to whatever amount of Effexor you were taking, that you did experience serotonin toxicity. But that's your doctor's fault, not a sign that bridging with Prozac is not possible. FYI 
The Prozac switch or "bridging" with fluoxetine
 

However, you probably should wait to make this switch, to let your last attempt at tapering settle down.

 

 

It's possible you've been setting yourself back every 2-3 months by drinking alcohol. Again, this is not something we should be blamed for.

 

Very sorry you find yourself in this position with so many others, because doctors are so ignorant about the effects of the drugs they prescribe.

My doc added a small amount, 5mg prozac, to my current dose to let it "ramp up." After about 7 days or so I began feeling very unwell. Anxiety, agitation, restlessness, high temperature. These symptoms (except high temperature) gradually faded over 2 months. I didn't get any of the clonus or hyperreflexia, so my doc dismissed the idea of toxicity. In fact, he dismissed the whole thing altogether. He pressed me on why I couldn't taper Effexor in the 6 weeks his guidelines suggested, and asked that I sign a release so he could talk to my PCP, in order to figure out what was "wrong" with me.

I have a new doctor now.

Anyway, I chalk it up to activation. I find both drugs to be activating on their own. Together, even in small amounts, spelled trouble. I have no idea. This whole thing is maddening. 

What are my options if I've kindled, and I'm hypersensitive to prozac?

[Altostrata]

You cannot drink alcohol.

 

If I understand your signature correctly, you are taking 19.5mg Effexor. You have succeeded in reducing your dose part-way. You will need to let your nervous system settle down from exposure to too much Prozac before deciding on next steps.

 

 

[Thewayshegoes]

1 hour ago, Altostrata said:

You cannot drink alcohol.

 

If I understand your signature correctly, you are taking 19.5mg Effexor. You have succeeded in reducing your dose part-way. You will need to let your nervous system settle down from exposure to too much Prozac before deciding on next steps.

 

 

 

Right. After the last time I drank, the reality became apparent to me. It compounded what I was experiencing. Best to avoid. I think it's best I find other coping mechanisms for the darkness that takes me sometimes.

 

I wanted to ask you, as you have a wealth of knowledge, what do you make of my situation and my Prozac bridge failure? In my attempts to taper I've had to reinstate 3 or 4 times. I'm afraid I've sensitized myself. In any case, I'm holding here a solid 4-6 months at least. This process has worn me down. I'll have to make a switch eventually, because I'm done fighting with this drug.

[Altostrata]

You've gotten down to 19.5mg Effexor, but you've made a lot of drug changes from which you need to recover. It's possible you will be able to taper directly from Effexor (by removing beads) if you let your nervous system settle down for some months, with no additional drugs, alcohol, or other disruptions.

 

Other than that, I cannot tell the future.