rmce72a: Effexor withdrawal with Prozac bridge

[littlebird]

Sometimes when I’m going through it, saying something affirming/encouraging repeatedly can help disrupt rumination. Perhaps you can try telling yourself comforting statements, such as, “I’m healing, my body and brain are balancing things out, I’m getting better all the time, all will be well,” etc. 

 

Being ill is bad enough without spiraling into anxiety about being ill! Try to be the warmest, most comforting self you can be to yourself through this rough time. Proactively balance out the stress your nervous system is under with active self-soothing activities. The more you can help yourself self-soothe and let your nervous system relax, including through sleep, the faster you can recover.

[rmce72a]

I am still passing what Alto described as "ghost pills" and I question whether or not I am getting the dose of Effexor I think I am (and need) during withdrawal steps. This would certainly account for the massive increase in anxiety over the past week, especially since my new Covid test is negative. In desperation, I fished out some beads today from my stool, and they do, indeed, contain white powder. If this is part of my Effexor dose, no wonder my anxiety is so high.

[Vasherr]

This is strange, but not impossible, beads in ER formulations of Effexor are coated in phtalates or Eudragits, which are made to dissolve in specific ph ranges, usually there are 3 distinct kinds of beads, one kind to dissolve in stomach, one at the start of small intestine and last one further down the small intestine, each with higher ph treshold to dissolve.

 

I would think that this warrants GI docs intervention, because it could mean that somewhere in Your GI tract ph is not what it should be. 

 

Sadly there is no way to go around this as all extended release formulations of venlafaxine work like that, this drug shouldn't be on the market, but to be honest, none of these drugs should be.

 

Wishing You a lifelong window!

V.

[rmce72a]

Thank you. Maybe I should increase my dose by a bead to cover what I may not be ingesting. What do you think? Maybe Alto has some insight. Hanging by a thread here.

 

[Vasherr]

Well it depends how many of the beads aren't dissolving, I don't think that manipulating the dose is the answer, as most likely the last part, which is supposed to disolve furthest down Your intestine doesn't disolve, maybe Your intestinal transit is really fast, I don't know, its a question for a GI doc.

[rmce72a]

It's hard to tell exactly how many without sorting through the entire bm. In my desperation earlier, I did sort through some (as disgusting as it was and sounds) and found 5 but I'm there were more. I just refilled my script 9 days ago, and I am just noticing this and never have before. Maybe something is different in the coating in the refill. They looked the same when I counted the beads. Who knows? I take the name-brand Pfizer. I did have a CT abdominal scan 6 weeks ago because I had been having stomach pain. My doc said nothing was irregular. It was done by my PCP tho, not a GI doc.

[Vasherr]

Well as I said earlier, maybe check for H Pylori, it really can have some strange symptoms, stomach pain and indigestion are on the list.

 

Maybe mods will have some other ideas, I hope You will get to the bottom of it, I know that strange symptoms can shake You, for a funny example, I am spitting blood for 1,5 months now, GI says its not from H Pylori and didn't locate any bleeding site in my upper GI tract, ENT also did a scope and found a pretty nothing, no one knows from where I am bleeding and one doctor agreed with me that without organic issue Venlafaxine would be to blame, possibly through drying up the mucus layer of my throat or esophagus, but no one knows for sure, I would rather like that there is some little blood vessel that gets irritated by swallowing or something as if it is Venlafaxine then I am in real trouble...

 

CT scan could show some trauma related damage or cancer or something, but stomach pain would rather be from infection, be it pylori or something else, so there is more diagnostic work to be done.

 

V.

[littlebird]

1 hour ago, Vasherr said:

I would think that this warrants GI docs intervention, because it could mean that somewhere in Your GI tract ph is not what it should be. 

Agreed, this is a sign something is off! Is it possible you have a yeast overgrowth? That can affect PH. Do you have any probiotics, or anything with probiotics like kefir or yogurt? I’m also wondering if acid (like apple cider vinegar or lemon water) might help with digesting meds. Not a doctor! Just recently had some med-related stomach issues.

[rmce72a]

Thank you both so much for your thoughts. Even though I never feel well, I thought I was moving through the WD process as expected. Then this hit. Bleeding? OMG, how scary. I HATE this drug and regret the day I ever took that first pill that was prescribed for me for fibromyalgia. I know, I know. We shouldn't focus on our regrets of ever taking the med because we can't re-write history. But I trusted doctors and didn't personally do anything wrong but accept that my doctors knew what they were doing. Now I must find a way to deal with the damage and move forward.

 

I don't have any apple cider vinegar or lemon. The only thing I have on hand is regular white vinegar. My stomach is isn't feeling normal, so it could be a bug or food poisoning, I guess, buy why would those things cause panic attacks?

[Altostrata]

I have no idea what's going on with these beads in your stool. If your brand is Pfizer, suggest you phone Pfizer.

[rmce72a]

Thank you

 

[FindRest]

The link Alto posted above explains why there are beads in your stool. Both the link and Pfizer’s patient information pamphlet that should come with your prescription state:

 

“Do not be concerned if you see small white balls or granules in your stool after taking this medicine … as they travel through your stomach and intestines, venlafaxine is slowly released. The spheroid ‘shell’ does not dissolve and is passed out in your stools. So even though you may see spheroids in your stools, your dose of medicine has been absorbed.” Pfizer

 

Edited January 17, 2023 by FindRest

[rmce72a]

Many thanks for this info. My extreme symptoms must be caused by something else. 

[Vasherr]

Google "H Pylori anxiety reddit" and see for Yourself normal people reporting heightened anxiety with this infection. I suppose in our state any infection can cause some extreme mental symptoms.

[rmce72a]

I did and it is certainly possible as I have some symptoms. So were you ever treated for H Pylori?

[Vasherr]

Due to the fact that I can't use either metronidazole or levofloxacin the doctor who was doing my endoscopy basically told me to go away, and find someone who will treat me, looks like he has forgotten what he swore to do when taking on the mantle of a doctor, but as we all know it's a rather standard case everywhere.

 

I've scoured the internet and have found many natural remedies with some clinically proven efficacy like: ginger, black seed, mastic gum, vinegar, roiboos, probiotics and I am trying for a month to get rid of the bug using these, but with very limited success (my antigen count went down from 5,84 to 4,84, so it seems that it is doing something, just not enough...)

 

I have another GI queued up on 25.01, maybe they will help some more, I am really scared to try antibiotics, but if it would mean being free of this bacteria, than maybe it is worth the risk.

 

Apart from antibiotics PPI are also included in treatment and I am also reluctant about it as it is clinically proven that they inhibit liver metabolism and raise antidepressant serum levels, and I have adverse reactions on 0,2mg more than I am currently taking...

 

But You seem to be able to tolerate standard venlafaxine doses so it won't be a concern, so get tested and I'm sure You will get rid of the bug if it comes back positive

 

V.

[rmce72a]

Thank you for your response. I struggle with most antibiotics too.

 

[rmce72a]

I need some gut health guidance. I read an old post by Alto about probiotics, careful diet, etc. I eat very few things and am not taking any supplements, unfortunately. I know I need something to add nutrition, but supplements of any kind seem activating. I am thinking of trying probiotics, but I have cut out all dairy and don't really want to take a capsule. Any have any suggestions for me. I am hoping that if I can improve my gut health some of my symptoms will improve.

[rmce72a]

I am currently back at 73 trying to stabilize. I am still very sick. Yesterday was the worst day I have ever had with extreme anxiety, shaking, pacing, nausea. I see the doctor tomorrow and will beg for some help. I know he will again suggest the Prozac bridge, but I fear that will only make it worse. I must do something. Maybe I am one of the few who cannot get off Effexor. I have to do something. I continue to drop weight because I cannot eat much. Have lost now 34 pounds in 9 months. I fear I am dying. Stomach has settled today and I have less anxiety, but I am still so ill. I have tapered from 75 XR Effexor to 72.9 in 8 months and am still ill. Please help me.

 

[Vasherr]

Did You check for h pylori?

[rmce72a]

I see the dr tomorrow and will ask him to order the test for me. 

 

[FindRest]

To me, it sounds like something else is causing your symptoms other than Venlafaxine WD/AR. I would stay at your current dose until your medical doctor figures out what is going on. 
 

Is your signature up to date, including all medications and supplements you might be taking?

[rmce72a]

I updated my profile info today. Maybe I didn't do it right. I take only the Effexor and 5 mg Clarinex daily. I can't tolerate supplements of any kind. I also do not eat gluten, dairy, soy, sugar, caffeine.

[rmce72a]

Just updated signature.

[Vasherr]

Remember that blood test for h pylori is not a recommended diagnostic tool, stool antigen is better.

[rmce72a]

I saw doc yesterday and asked for the H pylori stool test. He said he would order it. I have another question. Is it every okay to add a low dose tranquilizer for the terrible panic days of Effexor withdrawal?

[Catina7]

On 1/29/2023 at 1:28 PM, rmce72a said:

I am currently back at 73 trying to stabilize. I am still very sick. Yesterday was the worst day I have ever had with extreme anxiety, shaking, pacing, nausea. I see the doctor tomorrow and will beg for some help. I know he will again suggest the Prozac bridge, but I fear that will only make it worse. I must do something. Maybe I am one of the few who cannot get off Effexor. I have to do something. I continue to drop weight because I cannot eat much. Have lost now 34 pounds in 9 months. I fear I am dying. Stomach has settled today and I have less anxiety, but I am still so ill. I have tapered from 75 XR Effexor to 72.9 in 8 months and am still ill. Please help me.

 

Just reading this post of yours.  I am SO sorry you are going through so much suffering.  I do know there are dangers with trying to bridge onto Prozac.  Sometimes it works, sometimes it doesn't.  Did all your symptoms appear after you started titrating down the Effexor?  Were you fine before that?

[rmce72a]

My symptoms actually started in 2019 when I was reaching tolerance. Began having massive panic and depression which I had never had. Tried 2 1/2 years of just counseling before I found this website and realized what was happening. I began my taper late May 2022 and am down to 73 from 75. My symptoms are only getting worse and worse with tinnitus and anxiety the worst.

[rmce72a]

I am so sick. I just don't know what to do. Still finding white beads in bowel movements and wondering if I am getting the correct dosage. Things got so much worse after my last prescription refill. I take Pfizer brand name. Alto suggested I contact Pfizer, but I don't know how to do that or what they would do about it. I'm just too sick and weak. Have lost 2 more pounds. Am wasting away. Can't eat anything.

[Vasherr]

You have said that Your doc will order Pylori test. When? I don't know how it works in Your country, I would opt to do it ASAP.

 

Someone said earlier that it doesn't look like withdrawal, and this newly onset indigestion (beads in stool), is pointing to GI infection or something like that in my opinion. Maybe I'm wrong but if it is then no amount of psych meds will help it. Also if Pylori test comes back negative then endoscopy might give some answers.

 

This is hardly advisable, but even before I've gotten my positive results I have assumed that I have Pylori and started natural treatment, it didn't clear the infection for me and I am taking antibiotics now but it helped with symptoms so if You would like to try it I can send You links to the clinical trials with some herbs and things like that.

[rmce72a]

Thank you for your info. Yes, I would like to know what I can eat that would fight H pylori. 

[rmce72a]

I see a psychiatrist tomorrow. I have been treated all along by PCP and am getting much worse instead of better. I am going to the appt armed with Alto's info, the advice from this forum, and my Genesight test results. I hope and pray that he can help me figure out a way to taper since even one bead causes a huge increase in WD. I don't know what he might suggest. I am anticipating a "bridge" drug of some kind. I am still around 73 mg. Any suggestions about what I can say if he offers a drug switch or bridge? 

 

I am hoping that he has knowledge about what we are learning about AD withdrawal, PAWS, etc.

[rmce72a]

I have read all Brass Monkey's info, particularly since I am also trying to taper from poop-out which produced WD symptoms even on full dose. A question I have for him is Will a "bridge" not work since I am in poop-out. Alto says since in the info about the bridge that often it doesn't work if symptoms have started. Does this mean that a bridge is out of the question? I am only considering a bridge because I cannot seem to taper slowly enough. Even a decrease from 72.9 to 72.7 cause severe symptoms.

[brassmonkey]

I would not try to do a bridge. Experience is showing that bridging does not work for more than half the people who try them, and frequently causes even more problems.

 

Effexor is tied with Paxil for being the hardest drugs to taper off of. A bridge would involve CTing the Effexor and trying to cover the WD symptoms with a different drug. CTing Effexor is an extremely rough way to go. As you are finding even a very slow taper is going to be rough. One of my taper buddies, Aberdeen, bridged from Effexor to Paxil. She suffered for many years but has finally recovered, but it was very bad the entire time. 

 

Tapering out of poopout is a whole other ballgame. WD symptoms can be overpowering for the first several years, until the body finally gets control, and the progress starts to show.  There will be plenty of healing going on during those first few years, it just won't be too noticeable. In the end, tapering out of poopout is a matter of "blind trust" that one's body is doing the right thing. The only way out is down and accepting and dealing with everything that it throws at you. I wouldn't expect any medical professional to be knowledgeable about the process.

[FindRest]

Taking even a small amount of Prozac (5, then 10mg) after my Effexor CT gave me akathisia-like symptoms within a week. I trusted my dr’s wisdom for about a month longer, as aka symptoms only got worse. Long story short, I ended up back on a low dose of Effexor. Have only been able to drop 1 tiny bead every 3-4 months, some of which is due to other health complications. Am now down to 4.5mg. It might take me another 3-4 years to get off those last beads, but I will get there. I feel much better than I did when this mess all started in 2019.
 

As  Brass Monkey has stated, a prozac bridge often doesn’t work for Effexor and tends to make things worse.

Edited February 3, 2023 by FindRest

[littlebird]

11 minutes ago, FindRest said:

Taking even a small amount of Prozac (5, then 10mg) after my Effexor CT gave me akathisia-like symptoms within a week.

 

I didn't realize it at the time, but same! I was so tense too. Could not sit still, I was pacing and twitched when I lay down. So glad I stopped trying to prozac bridge.