Ninabird: Effexor withdrawal?

[Ninabird]

On 5/15/2022 at 11:30 PM, ChessieCat said:

ou might also be interesting this this interview with Altostrata which was recorded late last year:

 

Thank you for attaching this! I appreciate it. Sorry for the delay in responding. Haven't felt so fantastic lately.

[Altostrata]

On 5/17/2022 at 4:05 PM, Ninabird said:

@Altostrata

I take all of my medication at 6:30am. 30mg Cymbalta, 10mg liquid Lexapro, .5mg Estradiol and .25mg Klonopin. My evening .25mg of Klonopin at 6:30pm. So, yes, I still take the Klonopin. I will taper off Klonopin after I finish my Lexapro taper. 

 

 

This is an unusual drug schedule. Given your drug-drug interactions, it may very well be that some of your mid-day symptoms are from the drug combination ramping up. Please post daily symptom notes 24 hours at a time. 

[Ninabird]

@brassmonkey Thank you very much.

 

I was talking to my therapist yesterday and I was sharing how I feel. I feel like I am climbing Everest. Right now I have managed to climb to basecamp #2. Restarting my taper from Lexapro is the climb to basecamp #3. Starting klonopin taper will be a long haul to basecamp #4. The healing will e getting to the top of Everest. I may stay on Cymbalta for a while to give my brain and body time to heal. Then it will be time to descend from Everest(tapering off of Cymbalta) 

I HAVE come a long way in the last year. A LOT of crummy things have happened and I am still here. 

 

This site has been a GODSEND!All of you Mods are beyond angels here on earth. I even have my Psychiatric nurse practitioner on this site. 

 

 

[Ninabird]

1 minute ago, Altostrata said:

This is an unusual drug schedule. Given your drug-drug interactions, it may very well be that some of your mid-day symptoms are from the drug combination ramping up. Please post daily symptom notes 24 hours at a time. 

@Altostrata

Take meds at 6:30am (anxiety4)

8am feel a little wonky 

9am head feels full/tingling

10am start to feel like not wanting to get started/mentally off

12pm anxiety(4)

1pm feel like crying, mentally off

2pm head feels achy

3:30 symptoms intensify for a half hour

4pm start to calm down a bit

5pm Anxiety(3)

(take evening klonopin) 

6:30pm

7:30 -10 feel ok 

 

This was yesterday 

 

[Ninabird]

@Altostrata

 

I am also in the process of switching back to pill form after an unsuccessful crossover to liquid Lexapro. Today I am feeling so weird in my head. Brassmonkey communicated that I should expect some symptoms from any change. Feeling mentally off is scary. I am going to 3/4 pill to 1/4 liquid tomorrow. After a few days I will with to 100% pill form. 

Altostrata, I don't mean to sound pathetic but I just need reassurance that I am going to be ok. 

[Altostrata]

In your daily notes, please specify what drugs you are taking when and at what dosages.

[Ninabird]

@Altostrata

 

 

6:30 am 

 

klonopin .25mg

estradiol .50mg

lexapro 10mg 1/2 liquid 1/2 tablet

(changing to 3/4 tab 1/4 tab Sunday for 4 days) 

cymbalta 30 mg 

 

6:30PM .25mg Klonopin

[Altostrata]

Thanks. Now please incorporate your drug information into your daily notes. I need to see how you feel before and after each dose, and any significant symptoms in between.

 

7 hours ago, Ninabird said:

klonopin .25mg

estradiol .50mg

lexapro 10mg 1/2 liquid 1/2 tablet

(changing to 3/4 tab 1/4 tab Sunday for 4 days) 

cymbalta 30 mg 

 

 

It's not surprising that someone who is taking all these drugs at the same time, or even at different times, might feel "weird in the head".

[Ninabird]

10 minutes ago, Altostrata said:

 

It's not surprising that someone who is taking all these drugs at the same time, or even at different times, might feel "weird in the head".

My goal is to get back on the pill form of Lexapro and start to resume the taper. Once off that then start Klonopin taper. 

[Ninabird]

14 minutes ago, Altostrata said:

 

Thanks. Now please incorporate your drug information into your daily notes. I need to see how you feel before and after each dose, and any significant symptoms in between.

 

Ok. I started yesterday. Will a few days be enough or a full week? 
 

Question for you: two weeks ago I started on the liquid lex to get ready to resume my taper. I have to go back to pill form. I did not tolerate the liquid at all. Now I’m having increased anxiety and symptoms switching back. Is this to be expected? Today I had two anxiety rushes and haven’t had those in over a month. 
 

Thank you, @Altostrata

[Altostrata]

13 hours ago, Ninabird said:

Now I’m having increased anxiety and symptoms switching back.

 

I need to see this in the context of your daily notes. We'll need you to post daily notes so we can understand your symptom pattern.

[Ninabird]

Has anyone experienced any trouble with drinking mineral water? I love it and have my own Soda stream. I only use it for the mineral water but I drink.......50oz or so a day. I also drink a lot of regular filtered water as well. I gave up Diet Coke last December and the carbonation from the mineral water is what I love. Any help would be great. 🤪

[Ariel]

@Ninabird

 

I keep running out of "hearts" for all your sweet messages. 

You are so good at leaving little hellos, it's like finding loving post-its stuck to the fridge, on the bathroom mirror, by the door. 

Thank you for filling our house with light <3

 

 

 

[Ariel]

7 hours ago, Ninabird said:

Has anyone experienced any trouble with drinking mineral water?

What trouble are you experiencing, exactly?

[Ninabird]

7 hours ago, Ariel said:

15 hours ago, Ninabird said:

water?

What trouble are you experiencing, exactly

Wondering if it could worsen WD symptoms

[Ariel]

Hi @Ninabird

 

 

 

16 hours ago, Ninabird said:

Has anyone experienced any trouble with drinking mineral water?

22 minutes ago, Ninabird said:

Wondering if it could worsen WD symptoms

 

I used to drink unflavored carbonated mineral water and stopped a few years ago.

 

It did not worsen withdrawal symptoms per se.

 

However, carbonated beverages -- even unflavored, natural mineral water (homemade or store-bought) -- are hard on tooth enamel. (Something about the pH balance, I think.) 

 

Withdrawal generally challenged my dental health. Teeth, gums, saliva, mouth are part of the digestive system. My hunch is that because withdrawal influenced my gastrointestinal functioning and gut health, this was made manifest in dental health as well. 

 

In order to facilitate optimal conditions for dental health I cut out the fizzy water entirely. I don't miss it. 

In retrospect, bubbly water was in large part an acquired taste; drinking it had become a habit. I no longer crave it or think about it ever. 

(Withdrawal in essence replaced effervescence with quiescence.) (Please excuse my self-indulgence, I'm too tired to resist.)  

 

It is possible that excessive intake of carbonated beverages could exacerbate withdrawal-related digestive discomfort such as bloating, gas, belching, etc. I don't know whether gastrointestinal symptoms are an issue for you; they are quite common in withdrawal.

 

I'm no expert as to whether or not 50 oz. of carbonated water a day is a lot or too much. It seems you've got plenty of wiggle room to play around with methodically decreasing intake and observing what happens. Do you feel differently at 35 oz.? 25? 10? zero? etc. (I believe it would be safe to decrease by more than 10% at a time.) Home experiment: carbonated-water taper. Take notes and let us know how it goes! I'm curious. 

 

Wishing you and your dogs a well-hydrated, ebullient day,

A.

[Ninabird]

23 minutes ago, Ariel said:

ebullient day,

Having to look this word up….. “ ALEXA!!!” 🥸

 

I need to try to give up sugar. Last night I ate hot tamales, a few red hits and a handful of Woppers candies. I know this can’t be helping me. @Ariel is sugar bad for WD? 

[Pollyjay]

Thinking of you Ninabird! 

 

I noticed that drinking carbonated "sparkling water" seemed to set off a bad case of acid reflux for me. 

[Ninabird]

2 minutes ago, Pollyjay said:

acid reflux

I do get that from time to time. 
 

@Pollyjay

is sugar bad for WD?

[Ninabird]

@brassmonkey @arbor @getofflex @Altostrata

 

During WD should I give up sugar completely? 
 

@Altostrata I’ll be inputting my daily notes today. 

[getofflex]

Sugar is probably better avoided or reduced during withdrawal.  Personally I'm able to tolerate sugar in small amounts, but each person is different.  How do you feel after you eat sugar?  

 

Here is our thread about sugar and withdrawal: 

 

https://www.survivingantidepressants.org/topic/1165-sugar-its-effect-on-mental-health-and-withdrawal/#comment-10509

 

[Ninabird]

1 minute ago, getofflex said:

How do you feel after you eat sugar?

If I eat too much, I can feel anxiety bouncing around. 
 

 

[Ariel]

2 hours ago, Ninabird said:

I need to try to give up sugar. Last night I ate hot tamales, a few red hits and a handful of Woppers candies. I know this can’t be helping me. @Ariel is sugar bad for WD? 

 

Personally, I cannot tolerate sugar in withdrawal. My nervous system is way too sensitive to sugar's stimulant properties, and my brain is vulnerable to a sort of "addictive" response. When I eat sugar it feels like my brain's "reward center" lights up like a switchboard, except the connections are so iffy that light bulbs are flashing and exploding in fizzles and smoke. A while later, when the sugar reaches my gut, things get even more chaotic and uncomfortable. I won't bore you with the gory details but it ain't pretty; and as opposed to the brain bonanza, which is relatively short-lived, the gut debacle can last many hours, even days. Sugar also drastically decreases my sleep quality, gives me full-body sweats, makes me feel wired and on edge and jumpy (heightened alert response), sends my system into hyperarousal. It does nothing good, really. 

 

I have had to give up sugar entirely, including fruit (fructose malabsorption). This has been part of a process of figuring out how to best support my withdrawal-related digestive issues (including dental). Once I revamped my diet and committed to the change it wasn't difficult. It has been markedly helpful. 

 

There are links between stress and insulin resistance, cortisol and blood sugar. Sugar is considered by many to be a neurotoxin, and has been shown in studies on lab rats to be more addictive than cocaine. Yada yada yada a lot of people who are not in withdrawal find they do better without sugar. (I didn't eat a lot of refined sugar prior but certainly enjoyed fruit several times a day.) In withdrawal these various intense reactions just become much more noticeable and less tolerable. And yes, in case I haven't yet clearly answered your question, sugar can absolutely, unequivocally exacerbate withdrawal symptoms.  

 

Also, some of the candies you mention above have significant additives, incl. food coloring and preservatives. I believe I began to react to those kinds of chemical substances as well, incl. specific red and blue dyes. 

 

Bottom line: trust yourself. As with the sparkling water, it is an easily applicable experiment. See how you feel when you don't eat sugar compared to when you do. Choose which way you'd prefer to feel. There are no big withdrawal sugar rules, really -- everyone is different. It's great that you're paying attention to sensations in your body and noticing how various chemicals make you feel. Listening to yourself is a practice that will serve you well in withdrawal and forever after.

 

If you ever feel like exploring sugar-free diet/lifestyle changes and would like some more information, let me know and I can send links to some videos. 

[Ariel]

P.S. 

If you do give up sugar, your teeth and gums will LOVE you for it. Bonus!

It is remarkable how much my dental health has improved since changing my diet (due to both what I don't and do eat). 

[Ninabird]

@Ariel

 

Ok sweetness, I am going to take the next few days to slowly taper off of sugar as I have read that going of CT can cause problems in itself....ughhh

 

On a side note, you ARE a very talented writer. My goodness how your words flow. It is an utter pleasure reading ANYTHING from you on this site. What a gift you have. 

 

How are YOU doing? How is your WD? 

 

Sending you much respect and positivity.

 

NB

[Ninabird]

@Altostrata

Greetings from the Central Valley! 🙂

 

Alto, the last two plus weeks have been really terrible. Going over to liquid and then going back to pill form have pushed me into a corner that I haven't been in a long time. I am still functioning and pushing myself daily all considering. I won't give up. 

 

Saturday

Woke w anxiety at 6am 

Took .25mg Klonopin Ears ringing, very mild head pressure, sadness

8am30mg Duoloxetine, 10mg Lexapro, .50mg Estradiol (same symptoms as above)

10am weird anxiety feeling in my head w other mentioned symptoms

11am Anxiety (4) and same symptoms and burning sensation in head

12;30pm Anxiety disappears

2-4pm feel ok

4:15 feel DP/DR for a few minutes then it disappears

5-6pm feel ok

6:30pm .25mg Klonopin

7-8:30 feel ok

9pm Head feels full

10pm Bed

 

Sunday

 

6:00 wake w anxiety (4)

6:30 .25mg Klonopin

7:30 am 30mg Duoloxetine, 10mg Lexapro, .50mg Estradiol

Negative thinking, burning in my head

8-9am feel ok very mild headache

9:30 anxious, head feels full

10-11 Feel ok

11am sweaty feet (sorry🤢) burning on chest, feel blah and weepy

1pm feel ok

1;30 middle of head feels achey

3pm mild anxiety rush

3:30-5:30 feel ok some anxiety (2)

6:30 pm .25 klonopin

7-9:30 feel ok

10 bed

 

 

Monday

6:30 wake w anxiety (4) take .25mg Klonopin

7:30am take30mg Duoloxetine, 10mg Lexapro, .50mg Estradiol

8am still have anxiety (3) feeling sad, 

Walked my dogs (1mile)

9am burning sensation on arms and chest, ringing in ears,, anxiety (4), mild rumination

10-11 sad, want to cry but I won't

11-12pm moments of feeling happiness (last a few seconds at a time)Anxiety (4)

1:00pm Anxiety (4) mild ache in my head

2:30 Anxiety (3) 

3pm burning in my head

4pm Anxiety (3)

5pm feel anxious, ears ringing

6:30pm .25 klonopin

7pm Anxiety (1) head feels full

8-9:30 feel ok

10pm bed

 

Tuesday

6am wake up w negative thinking. anxiety (5) 

6:30am Klonopin 

7:30 Take 30 mg Duoloxetine, 10mg Lexapro, .50mg Estradiol.  Still have anxiety, sadness, muscle tension, head feels like it is burning

8am feeling weird mental rushes, hard to explain, maybe its anxiety? Head burning, sadness and feeling frustrated and scared

8-10 High anxiety (5) ears ringing, muscle tension

11am sadness, no motivation, eyes burn, anxiety (5)

12pm Anxiety, ears constantly ringing, spacey

1-3 up and down of symptoms

 

* Have you been asked this before....Should I avoid communal wine at church? I think they have apple juice for those who can't or shouldn't have alcohol. 

 

 

 

 

 

[Altostrata]

Did you take the same drugs every day? What drugs are you taking, at what times, and what dosages? I need to see this detail in your daily notes. "Rest of meds" is not enough detail. Need to see Klonopin dosage every time you take it. Thanks.

[Ninabird]

Just now, Altostrata said:

id you take the same drugs every day? What drugs are you taking, at what times, and what dosages? I need to see this detail in your daily notes. "

Rest of meds" is not enough detail. Need to see Klonopin dosage every time you take it. Thanks.

@AltostrataYes. 

6:30 am Klonopin 

7:30am 30mg Duloxetine, 10mg Lexapro, .50mg Estradiol

 

6:30pm .25mg Klonopin

 

 

[Ninabird]

2 minutes ago, Ninabird said:

id you take the same drugs every day? What drugs are you taking, at what times, and what dosages? I need to see this detail in your daily notes. "

Rest of meds" is not enough detail. Need to see Klonopin dosage every time you take it. Thanks.

Fixed it. Sorry, brain is a little fuzzy today. 

[Altostrata]

Thanks for giving drug detail in your daily notes. It appears to me that after you take 30mg Duloxetine, 10mg Lexapro, and .50mg Estradiol at 7:30 a.m., you have an adverse reaction to the drug combination for several hours afterward, which is what we would expect from this strange cocktail.

 

Suggest you change your drug schedule. Since your cocktail is so complex, you'll have to move some pieces around. Did you always take duloxetine with escitalopram? What effect does duloxetine have on you?

[Ninabird]

9 minutes ago, Altostrata said:

Suggest you change your drug schedule.

What would you suggest? If you think it would help ease my symptoms, I will follow your advice to a T

[Ninabird]

31 minutes ago, Altostrata said:

Did you always take duloxetine with escitalopram?

Altostrata, I know it is a weird combo. I was tapering off of Lexapro while cross tapering to Effexor. This was the direction I was given by the substitute Psychiatrist at my clinic. When my original Psychiatrist came back from her sabbatical (6 weeks later) she told me she didn't want me on Effexor because of how hard it is to get off of and had me stop tapering the Lexapro. Had me stop Effexor and start Cymbalta. I was very vocal about my concerns of not tapering the Effexor but she and the pharmacist told me that they were "sister," drugs and a direct cross over wouldn't cause any problems. WRONG. So, to answer your question, yes. I have been taking the Lexapro and Duoloxetine together since February. I no longer see that Psychiatrist. I see a wonderful new PNP. She has held me on what I was put on and is waiting for my CNS to settle down before she starts my taper off of Lexapro. We will mot likely do the Brassmonkeyslide as it seems the most gentle. Thoughts?

[Ninabird]

16 minutes ago, Altostrata said:

What effect does duloxetine have on you?

I don't really know, Altostrata. I was going downhill fast on the Lexapro. I had high anxiety everyday. I was very emotional. I was starting to have increased moments of DP/DR. It was a slow build up. Around the second month of being on the Lexapro I started to get concerned. I kept pushing through because I really wanted to give it a shot and I did NOT want to go through another grueling med change. Since I have been on Duoloxetine, I have noticed that I don't have the anxiety rushes I once had and that my anxiety and mental clarity seem better. Could it be that all I needed was a lower dosage of Lexapro? I don't know. I don't know if that answered your question? 

 

I want to thank you, ma'am for taking the time to help. You have no idea how much it means to me. I developed anxiety 4 years ago after a series of serious life events. I had no idea what I was getting myself into with psych meds. I was in crisis and I needed help. There is no point regretting this decision or that. It is a waste of precious energy.I want to heal and get back to living my life without all of this pain. I am very lucky to have a PNP who is completely on board and supportive of me being on this site and sharing info with her. She is on this site now as well. Thank you from the bottom of my heart for all you do and for those who assist you. I have no doubt that I am in safe hands.

 

 

[Ninabird]

29 minutes ago, Altostrata said:

strange cocktail.

When I stabilize after the switch back to tablet form of Lex, my PNP wants to resume a very slow taper off of the Lex per SA guidelines. 

[Altostrata]

Essentially, you are taking these 4 drugs at the same time:

Quote

 

6:30 am Klonopin 

7:30am 30mg Duloxetine, 10mg Lexapro, .50mg Estradiol

 

 

First, suggest you gradually move 30mg duloxetine by an hour each day to noon.

 

Your schedule would then be

6:30 am .25mg Klonopin 

7:30am 10mg Lexapro, .50mg Estradiol

12 noon 30mg Duloxetine

6:30pm .25mg Klonopin

 

What effect does the evening Klonopin have on you?

[Ninabird]

1 hour ago, Altostrata said:

What effect does the evening Klonopin have on you?

Helps w/ relieving wd symptoms and anxiety.

 

Altostrata, In your experience has changing the timing of medication provided relief from these awful symptoms? Oh goodness, I hope that it does! Then I can get on with tapering the Lexapro then onto Klonopin. I know, one step at a time. 😍

I made a donation to SA yesterday. I just want you to know I appreciate your time and knowledge. 

 

😊

Chrissy