rmce72a: Effexor withdrawal with Prozac bridge

[Altostrata]

Is it allergy-related itching? 

[rmce72a]

I don't really know, but it may be. Hard to tell. I just thought it might mean allergies since I haven't taken any Clarinex. Since there has been discussion here about histamine tolerance as part of WD stuff, I just didn't know if taking Clarinex is a good thing or a bad thing. If it's going to help WD to take it, I will. Otherwise, I won't.

[Altostrata]

Other than itching, how has your symptom pattern changed since you stopped Clarinex?

[rmce72a]

It has not changed. In fact, this is a second day of feeling better after a horrible Wednesday. I am curious about the  histamine connection. Is having more active histamine a good thing or a bad thing when tapering? If histamine is further disrupting the CNS and the body, wouldn't an antihistamine be helpful? Also, I've taken Clarinex for years and it's non-sedating, but my body hasn't been dealing with the stress of withdrawal either until now. I just want to give any help my body and CNS need to heal. 

[Altostrata]

1 hour ago, rmce72a said:

In fact, this is a second day of feeling better after a horrible Wednesday.

 

Is feeling better not a change?

[rmce72a]

I see your point. Thank you. I guess histamine is a good thing.

[Altostrata]

Histamine itself is one of the many substances that run the body. If you are not suffering from allergies, you don't need an antihistamine.

[rmce72a]

Well, not sure what to do. Still holding at 72.6-73.00 after 15 weeks. I just can't seem to get stable. It seems that I will have 2 or 3 ok days, that Bam! I get hit with a horrible day. Also, even on the better days, my anxiety if so high. I am a nervous wreck all the time. I try to keep myself occupied, but I am so miserable on the inside and memory is terrible. Yesterday was so very bad. In spite of carrying on with positive activities, I cried off and on all day. How can this be happening when I have been holding so long? 

 

Effexor pooped out 3 years ago which was when this all began. It's as if there aren't any brain chemicals anymore helping me cope. I haven't had nausea or dizziness, but the anxiety is so bad.  I have only come down 2 mg from 75mg Effexor since May 28. 

[Altostrata]

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show what your drugs are doing.

[rmce72a]

I am still in a dilemma about how to proceed. I have read (several times) tapering tips and counting beads. I understand the window and waves pattern. I also have read Brassmonkey's info about tapering from poop-out because that is, without a doubt, what is happening with me. I also know that holding and stabilizing are important and have been very faithful about following all the protocols, yet I am still ill.

 

I am in week 15 of holding at approximately 73.05 -72.85 (depending on that day's bead count.) Brassmonkey says that when tapering from poop-out, we should go ahead and gradually reduce slightly. I am so afraid to do that because of ongoing symptoms.

 

Is my CNS  so incredibly sensitized that I will never feel stable or WD normal? After 20+ years on Effexor, how can I ever come off the drug? Since my WD symptoms started about 3 years ago when it seems that I reached tolerance/poop-out, what can I do?

 

I tried magnesium, but that only made me more anxious. I haven't tried fish oil because I am so afraid of how I might react since I seem to react to everything. I barely eat for fear of reacting to something since I am so sensitive. I have lost 20+ pounds in 3 1/2 months, and I don't think my body is getting the nutrition it needs.

 

I do try to keep myself busy to keep my mind off the symptoms, but I'm so tired of things. I will do anything to help myself. I know that I need to get the drug out of my system in order to heal (per Brassmonkey) but I just don't know if I can reach stability to continue reductions.

 

Thank you for any help you can offer.

 

 

 

 

 

Per your instructions, here is a brief journal of last 2 days.

Yesterday

7AM       Up after 6 hrs sleep usual morning nervousness and loud tinnitus

8AM       Decaf - 2 cups still anxious

10AM     Shower, etc

11:30      Bowl of oatmeal 2 hard-boiled eggs anxiety after eating

12:30      2 grocery stores  anxious 

   2:30     increased anxiety, wanting to cry (because of not feeling well) stomach ache

   6:30   Made dinner

   7:00    Took Effexor 72.8 mg

   7:30    ate dinner of  baked chicken, green beans, 1 slice gluten-free toast

   8:00   feeling very cold so I  wrapped in blanket watched tv

   8:30-9:30  on computer having increasing anxiety

   10:00   Washed face, put on pjs feeling very dizzy

   10:30-11:45 watch tv  dizziness lessened

    11:45  bedtime

 

Today

  5am    woke, very nervous, tinnitus very loud. sat on couch watched tv and dozed. deep breathing to soft music to lessen anxiety

  8AM phone call so I got up

  8:15  took 5mg Clarinex (have not taken for 3 days but have been having allergy symptoms so I thought I see if it helps)

8:30 2 cups decaf  Feeling very anxious and weepy, chest tightness, heavy head, stomach ache

9:00  Water heater repair man  Went well

9:00-10:45  Read paper, had 1 cup decaf, talked with talked with husband, check email and this site

11:15  Got cleaned up for the day, made bed

12:00   Breakfast (same as yesterday)

1:30    Preparing to run to the store

   

 

      

[Altostrata]

Do you feel better or worse after taking Effexor? Do you always have eggs in the morning?

[brassmonkey]

Tapering out of poopout is a special case to which some of the rules don't full apply. One of the primary ones being Stability. Because of the chaos caused by the poopout real stability won't happen until well into the taper. As long as there are no major swing to the good or bad, just a day in, day out feeling the same level of bad, then a person can consider themselves as stable. Even if there are large swings, holding during poopout won't change things much because of the chaos in the body. Tapering out of poopout can be a very frustrating and frequently painful process just because it doesn't act like a normal taper.

 

The taper will take quite a while before any improvement can be seen, but it will happen. WDnromal is the average of how one feels on a day in, day out basis, disregarding the windows and waves. It is taking the long view to seeing improvement. In general, during a taper improvement can be seen about every three months. While tapering out of poopout, the first improvements often are not seen for about a year, sometimes longer. From there the time frame decreases gradually as the taper takes hold.

 

As I have mentioned in other posts there are three options for dealing with poopout; make no change, updose, or taper. With the first two things will stay the same, maybe improve a bit and then will get worse causing you to repeat the process. With the tapering option things will seem to stay the same, possibly get worse at times but will slowly improve and there is an end in sight.

[rmce72a]

39 minutes ago, Altostrata said:

Do you feel better or worse after taking Effexor? Do you always have eggs in the morning?

Yes. Every day for protein since eggs are one of the few things I can eat. Taking Effexor doesn't seem to affect me either way. Last night when I took it, I was feeling overall anxiety which I always do, and it didn't make symptoms better or worse. I did get dizzy for a while before bedtime which is unusual. I haven't experienced the dizziness for several weeks.

[rmce72a]

Brassmonkey, I have read your discussions about poop-out often to re-assurance myself that I am doing things properly. It's just so scary to be doing such tiny tapers and long holds and still having awful symptoms. Did you experience this? I rate my days on my wall calendar with  for tolerable   or  ;/  for not well but functioning or   with tears, high tinnitus, and high anxiety. For August, 14 days were tolerable     13 days were very bad with tears, extreme anxiety, and high tinnitis  and 4 days were not very good, but I could function. 😕   I can go to be one night doing ok and wake the next day miserable for no apparent reason.

 

When I am brave enough to drop, I plan to do 1/2 of one per cent. That is, to go from 72.85ish to 72.82. 

 

[Altostrata]

9 hours ago, rmce72a said:

Every day for protein since eggs are one of the few things I can eat.

 

Are you on a histamine intolerance diet?

 

Egg whites are high in histamine and may cause a reaction like yours. To test this, suggest you have oatmeal for breakfast for a few days.

 

Eventually, you might react less if you ate your eggs scrambled -- whites and yolks mixed.

[rmce72a]

Thank you for the suggestions. I am trying to avoid high histamine foods and thought eggs were ok.

 

[Altostrata]

Egg whites are not okay, unless mixed with yolks, and some people react to yolks as well.

[rmce72a]

Brassmonkey, I appreciate all the info about tapering from poop out and the chaos in our CNS resulting from poop out. Could you please direct me to the info you have read about this situation? I would like to read more about this to help me understand.                                                                          Also, you said "Because of the chaos caused by the poopout real stability won't happen until well into the taper. As long as there are no major swing to the good or bad, just a day in, day out feeling the same level of bad, then a person can consider themselves as stable."  I never have a day in, day out feeling the same level of bad. Some says are better, some days are very bad while others are uncomfortable but not miserable. Thank you

[Altostrata]

@rmce72a I would not assume poop-out, you may be having food intolerance reactions.

[rmce72a]

Thank you, Alto. I have cut out the egg whites and am trying to follow the histamine intolerance diet of low histamine foods. Although I don't eat  many of the listed foods, I have been eating some of them. I'm hoping this will help so I can drop from 72.8 to 72.75 next week. 

[rmce72a]

I don't know what I can do to help myself. I feel ill 24/7. Once in a while, I will have a day without distressing symptoms and 5 or 6 hours of sleep, but not very often. I am currently hovering around 72.85-73.05 per day Effexor XR. Here is what I have read here and done so far: 1) Doing a slow taper. Have been holding around 73mg since June 9. 2) I have read Brassmonkey's info about tapering from poop out. Since I have never been stable, he said to taper anyway, so I am now hovering around 72.85-73. taking out 7 or 8 beads a day depending upon bead count in the capsule and per bead dosage. 3) Am following a low histamine diet and eat no sugar, caffeine, gluten and I stopped taking Clarinex 5mg (antihistamine for allergies) I take no other meds or supplements. 4)I see a therapist every 10 days and follow her suggestions for mindfulness, distraction, etc. 5) I keep myself occupied every day even though I don't feel well. (trying to fake it 'til I make it.) 6) I tried magnesium which increased anxiety. Have not tried fish oil for fear of side effects since I am so sensitive to everything. 7) I understand windows and waves and the importance of stability. Buyt no matter how long I hold, I am never stable.

 

I began tapering at 75 mg in May and dropped to only 72.9 or so. More than half the days a month are absolutely miserable. The rest of mostly tolerable symptoms with 4 or 5 when I feel relatively stable.

 

Bear in mind that I have been on Effexor XR for 22 years. I began having all the classic symptoms of AD withdrawal in 2019 although I had no idea what was going on with me at the time. Over the course of the last 3 years, I have been depressed with panic and high anxiety, stomach problems, tinnitus, dizziness, occasional itchiness, poor sleep. Doctor said IBS and return of depression, except I was never depressed or anxious until 3 years ago when all the symptoms started. I was prescribed the med for fibromyalgia associated with allergies and I stupidly kept taking it even though I didn't need it. I refused to take IBS meds and more antidepressants and started doing my own research and found this group and read lots of NIH studies and info about ADs and realized what was happening.

 

I have lost 28 pounds in the last 7 months and shouldn't lose much more. I know I am not taking in adequate nutrition because I am so sensitive to food and am afraid to eat much. The low histamine diet had limited my food even more.

 

I just don't know where to do from here. Should I consult a neurologist about CNS? Should I just keep doing what I am doing and hope for the best? Should I see an allergist? Frankly, sometimes I feel that since I am 75 years old, the medical community has written me off figuring I don't have many years to live anyway instead of looking for valid diagnoses.

 

Thank you for all you do. Any words of advice?

[Altostrata]

You do not need to recount your recent history.

 

To find out if you're reacting to foods, people keep a food diary. Have you done this?

 

We still need to see this:

On 8/28/2022 at 2:01 PM, Altostrata said:

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show what your drugs are doing.

 

[ChessieCat]

Just a thought and I don't know if it has been asked before, but are you taking any other prescription drugs, like a statin, blood pressure medication, thyroid, diabetes drug, hormones?  People sometimes don't think to mention that they are taking these.

[rmce72a]

I don't take any other drugs but Effexor XR 75mg. I take it at 7PM each evening with dinner. Taking Effexor doesn't seem to affect how I feel after taking the daily dose.

[rmce72a]

Monday 9/5

 

9AM     Got up Feeling morning cortisol anxiety

             Had 2 cups decaf coffee (half water per cup) Feeling usual fatigue, nervousness

10AM     Shower, dress for the day Feeling better but tense; less tinnitus

12 noon     1 large bowl oatmeal with soy-free margarine  anxiety after eating; increased    

                   tinnitus

1-4PM     Drove to son's house 80 miles away to drop off car; rode home with husband

                some tinnitus and somewhat tense

7PM         Took Effexor dose ate dinner  plain hamburger patty, baked potato felt ok

8:30         Facetime with grandchildren Feeling down

9:30         on computer   got off because of increased tinnitus

10-11PM   watched tv  fell asleep on couch

11:30  PM   went to bed

1:45AM       woke up; high tension and tinnitus   Got up and went to couch to watch tv

                     fell asleep   

4AM            Back to bed; Slept til  8:30

 

Tuesday 9/6

8:30AM        Got up     2 cups decaf (half water per cup) Feeling tense, tired, weepy

11AM            Dressed for the day  very tense, shaky, sad, weepy

Noon            1 large bowl oatmeal with soy-free margarine  feel a bit better

1PM                Grocery stores

3PM             Feeling very sad, achy, weepy, hopeless

6PM             Prepared dinner  High tinnitus  Low back pain

7:30             Took Effexor    ate dinner  baked chicken, spaghetti squash, green beans

8;30             Very high tinnitus, weepy sad, lower back pain

9:00              Watching tv  VERY high tinnitus but feeling better overall than all day

 

 

 

 

 

[Altostrata]

Please include your sleep pattern in your daily notes.

 

Is your tinnitus always worse after you take Effexor in the evening?

[rmce72a]

My sleep pattern is fairly consistent in that I am able to fall asleep most night within 15 minutes of going to bed, usually around midnight. I always wake up at least once to go to bathroom but can fall back to sleep. I often wake up at 5-6 and cannot go back to sleep, so I move to the family room couch, watch tv until I doze off. I often sleep on couch for 2 more hours. I do know that when I cannot fall back to sleep, my symptoms are much worse the next day.

 

Effexor doesn't seem to affect the tinnitus. Tinnitus seems to be directly related to anxiety. The more anxiety I feel, the worse the tinnitus. Today I have not had a stressful morning, yet I have felt shaky with increased tinnitus. I think part of the anxiety is that I am preparing to count beads for doses over the next few days, and I am always worried that I will count out too much or too little.

[rmce72a]

I have had the worst 2 days since I started the taper in May. Yesterday and today my symptoms have been worse than they have ever been with high tinnitus, intense anxiety, weepiness, hopelessness, depression, slight dizziness, and general overall feeling of illness. The only 2 changes have been that 1) I dropped to 72.8 from 72.9 last week and 2) I stopped taking the Clarinex 5 mg for allergies. Hoping to feel better tomorrow. Maybe I should try taking the Clarinex again.

[FindRest]

How long have you been taking Clarinex? I think it would be useful to put your start/end dates of this in your signature. I’ve also noticed that metoprolol isn’t mentioned in your signature. As I’ve stated earlier, I think it could easily be a factor in what you are experiencing. I recommend putting it in your signature as well.

 

On 9/6/2022 at 5:46 PM, rmce72a said:

Bear in mind that I have been on Effexor XR for 22 years. I began having all the classic symptoms of AD withdrawal in 2019 although I had no idea what was going on with me at the time. Over the course of the last 3 years, I have been depressed with panic and high anxiety, stomach problems, tinnitus, dizziness, occasional itchiness, poor sleep.

On August 6th you stated:

 

“I took metoprolol for about 3 years as I recall. Started at 25 mg per day in 2018 or 2019?, but I started taking just a half dose (12.5 per day) in 2020 until I stopped it altogether in May of this year.”

 

By looking at the things I’ve bolded, do you see why I wonder if metoprolol is a factor in all of this?  I don’t think it’s coincidence that your symptoms started around the same time you started metoprolol. Then, you abruptly stopped it after 3 years of use, when it needed to be slowly tapered. 

The symptoms you describe are consistent with withdrawal symptoms of metoprolol, and/or adverse effects of the drug.
 

Regardless, your CNS has obviously been sensitized by something. I’d recommend listening to your body. It’s not liking the fact that you are continuing to taper when it’s so destabilized.  Abruptly stopping Clarinex didn’t help. I don’t know about Clarinex, but many antihistamines need to be tapered, especially after long term use. In fact, adding or stopping any medication or supplement abruptly with a sensitized cns is risky.  
 

Again, I think you may want to re-visit the thought that perhaps Effexor poop out may not be what’s causing your misery. If your symptoms are indeed being caused by your stopping metoprolol abruptly, then I think your best course of action would be to stabilize before changing your Effexor dose again. It could take months for that to happen. 
 

I truly am sorry you are going through all of this. It does get better. 

 

 

 

[rmce72a]

Thank you so very much for all this info which certainly makes sense. I held at 73 for 15 weeks just to be safe. Although I haven't ever been stable as described in the explanation on this site, Brassmonkey indicated that tapering from poop out is different in that I will never be stable by the usual definition and I should taper anyway. That's why I tried a slight drop.

 

I had no idea that metoprolol needed to be tapered or I certainly would have done so. Is there any way to know if the effects of abruptly stopping metoprolol are gone so I know I am safe to continue tapering? I know we must listen to our bodies, but mine is sending me mixed messages!

 

I will add the info you mentioned to my signature. I appreciate your help so much. I don't know how I could manage without the guidance here. Bless you.

[Altostrata]

As I noted earlier, it appears your tinnitus might be related to your taking metoprolol and not to Effexor.

 

It's easy enough to test whether Clarinex is an important element in the mix: Take it again for a few days on the same consistent schedule on which you took it before.

[FindRest]

48 minutes ago, rmce72a said:

Is there any way to know if the effects of abruptly stopping metoprolol are gone so I know I am safe to continue tapering?

When I was going through terrible WDs from my Effexor CT, I began using the following spreadsheet to keep track of my symptoms.  Each night before bed, I would rate my symptoms and add them up for a total score. This was an easy way to 1) keep track and know what things were improving (or getting worse) over time, and 2) remind myself that things do improve, as is evident from a week/month before.

 

Once I saw (and felt) that my symptoms were much improved for a couple of months without any setbacks, then I felt comfortable dropping one tiny bead. For me, I waited 6 months to try and stabilize before I dropped a bead. That one bead set me back a bit, so I waited another 3 months before trying again. Your stabilization time may be shorter or longer.  

 

The keys for me were: tracking symptoms, patience, not suddenly adding/stopping any new meds, and constantly reminding myself that my symptoms will improve (as was evident by looking back on my tracking sheet). 
 

There are several links listed here in this post. I used the one labeled “PDF Monthly List BLANK to Print”. 

 

 

[rmce72a]

Thank you Alto and FindRest.

 

[rmce72a]

I have been so much worse the past week. I have extreme anxiety, high tinnitus, slight nausea, hot and sweaty then chilled, hopelessness, heart pals yesterday. I am so unsure about how to continue my taper. I was having a decent day with mild symptoms every now and then, but now the bad days with high symptoms just go on and on.

 

I am trying to eat low histamine foods, but there are so few I can eat. Fresh fruits and vegs are problems for me because they upset my stomach. I have been eating baked chicken and green beans, but green beans are not low histamine. I tried baked squash and it made me nauseous. I was eating eggs with morning oatmeal, but now eggs are out because they are not low histamine. I have been eating gluten-free bread and crackers, but I cut that out because they contain sugar, yeast, high histamine oils.  Now my diet consists of oatmeal, soy-free margarine, baked chicken or beef, head lettuce, and baked or mashed potatoes. That's it.  Every day. Still losing weight I shouldn't lose and feel sick 24/7.

 

I tried taking the Clarinex today and feel no better.

 

I just don't know what to do. I am taking 72.8 mg down from 75 in May. I have dropped only that much in 3 months and am so sick. I really am beginning to think that at my age after so many years on Effexor, I may not survive. 

[Altostrata]

Do you feel better having eliminated eggs?

 

You seem to have a lot of digestive problems. Have you had a test for h. pylori? Is it possible you have a medical condition? Long covid?

[rmce72a]

No, I do not feel better after eliminating eggs. I have not been tested for h.pylori. I have not had Covid. I have always had a touchy stomach although no major problems. After I began having anxiety/depression and other problems (stomach, difficulty with sleep, etc)  problems 2 years ago (which I have since concluded resulted from Effexor poop out after 20+years)  and started seeing a new dr, he felt I possibly had IBS and prescribed meds, which I did not take. Instead, I started a no caffeine, gluten and dairy-free diet which has helped. My food sensitivity has been ongoing for many years, supposedly related to my allergies.

 

As for another medical condition, I just don't know anymore. I wish I had a doctor who would test everything to make sure all body systems are healthy. My present dr did a CBC once to check for thyroid problems and said all looked okay. My dr is a nice guy, but not a diagnostician and I don't know how to find one. He concluded from the beginning that I had GAD and depression and needed antidepressants. 

 

I feel that my CNS is very sensitized (as described on this site) but I don't know what to do about it. Thank you for your help. I have all but given up.

 

By the way, I don't know why my amended drug signature isn't showing up in my current posts. I changed it in my profile.