Bertoh: Suffering immensely from Effexor attempt and withdrawal. How do I get back to normal?

@Frogie · August 8, 2022

2 hours ago, Altostrata said:

Did you also make a change in lithium around this time? Such as increasing to 750mg?

I made the change to 750 on June 9

2 hours ago, Altostrata said:

Why are you taking lithium?

Depression and suicidal thoughts

——————————————————

2 hours ago, Altostrata said:

Please put ALL your current drugs in this Interactions Checker and post the report or a link to it in this topic.

On 7/23/2022 at 8:44 PM, Bertoh said:

Interactions Checker

https://www.drugs.com/interactions-check.php?drug_list=1477-0,1463-869,703-357

On 7/23/2022 at 9:02 PM, Altostrata said:

You can see potential interaction between Klonopin and lithium.

@Frogie · August 8, 2022

8/7

7:24 woke up took 75mcg levo (thanks son for sleeping in). Woke up once at like 4 last night

7:32 headaches starting early today. Top middle of head. 3-4/10 pain and discomfort. Subsided down to 1/2 after feeding kid

9:00 took 1mg klono at 8:34. Had a brief moment where I felt symptomless but it was fleeting. Headless on left side of head, sometimes burning, plus nausea throughout

10:08 soccer practice was a roller coaster. Headaches sometimes yes, sometimes no. Just rushed home to scarf down quick breakfast before taking the kid to the park, headache mostly no/light right now

11:12 felt pretty good til now that I’m leaving park. Pain top left of head (a bit if burning) nausea there too. 11:33 took 50mg magnesium head started feeling a bit better before that. Ate 11:44…light pain but ok

2:17 went through a period of mostly pain free trying to put the kid down, napping, and cuddling with wife. Starting to get a bit head pain back feels like nerve tickle/burn but not terrible yet

3:20 took kid to swim class. Some head pain, kind of a tingle, in back of head and top right as I sit and watch

3:46 the headache is getting worse and combining with nausea. It’s so hard to be present or think of the future when this happens

10:33 took 600mg Lithium at 10:00. The past 7 hours were a constant battle of headaches and calm with a moment where I broke down and cried not believing I’ll ever get better. Night went ok with some pain

August 8, 2022

You are currently under the care of a psychiatrist, is that correct? This is the same psychiatrist who has switched you from drug to drug since 2019?

This type of situation puts me in a bind. It was the psychiatrist who got you into this state, you pay the psychiatrist for this, and it takes unpaid hours of my life to figure out the trail of medical error that got you here -- when all of this is your psychiatrist's responsibility. (And may have damaged your thyroid.)

In my opinion, you are probably suffering from inconsistent dosing of the benzo and adverse effects of lithium. It's hard to tell what the benzo is doing because you take it on an irregular schedule, but your psychiatrist has gotten you physically dependent on it and now you're probably suffering from rebound effects when it wears off and maybe paradoxical effects when you take it.

If you look at lithium adverse effects -- which you should do here -- nausea and headache are serious adverse effects.

Quote

This medicine may cause pseudotumor cerebri (increased pressure in the brain). Call your doctor right away if you have blurred or double vision, dizziness, eye pain, severe headache, or nausea and vomiting.

Your psychiatrist should know this, but your psychiatrist prescribed the benzo to cover it up. Your psychiatrist has been negligent.

As you are now physically dependent on the benzo, to go off, you will need to taper it, but first, you will need to schedule it in divided doses to distribute its effect throughout the day. If @Frogie or @Shep are available, they will assist you with this.

While you're getting your benzo schedule settled, suggest you read this

Tips for tapering off lithium

and discuss lithium tapering with your prescriber. Cold turkey off lithium can be dangerous.

I strongly urge you to work with a psychotherapist on your psychological problems, we do not treat them here.

@Frogie · August 9, 2022

On 8/8/2022 at 3:25 PM, Altostrata said:

You are currently under the care of a psychiatrist, is that correct? This is the same psychiatrist who has switched you from drug to drug since 2019?

Correct though there is a small window where there was a second psychiatrist involved while I was at an outpatient behavioral health program (CBT focused) for 2 months

2019 - April 2022 Normal psych (prescribed 300mg lithium end of march early April)
May 2022 - July 8 Program psych (alongside prescribing a ton of other things, upped lithium from 300 to 750)
July 13 - present Normal pysch

On 8/8/2022 at 3:25 PM, Altostrata said:

This type of situation puts me in a bind. It was the psychiatrist who got you into this state, you pay the psychiatrist for this, and it takes unpaid hours of my life to figure out the trail of medical error that got you here -- when all of this is your psychiatrist's responsibility. (And may have damaged your thyroid.)

I truly do apologize for taking up your time like this. I found this forum and was told it was a place to help ppl like me but I didn't intend to take so much of your time...apologies if I upset you in the process. I truly mean this: I'm happy to pay you for your time spent (so far and in the future) (venmo, paypal, however). I realize now thanks to your post you must spend an immense amount of time per person, so thank you. I truly am grateful and am happy to compensate.

Thyroid: Just got some blood results today actually and TSH is 1.55 so pretty good luckily!

On 8/8/2022 at 3:25 PM, Altostrata said:

In my opinion, you are probably suffering from inconsistent dosing of the benzo and adverse effects of lithium. It's hard to tell what the benzo is doing because you take it on an irregular schedule, but your psychiatrist has gotten you physically dependent on it and now you're probably suffering from rebound effects when it wears off and maybe paradoxical effects when you take it.

- The original hypothesis was that my symptoms were an adverse effect to the effexor. Does this change that hypothesis?

- I take klono every day at 7:30 +- 30 mins. Is that not consistent enough? Drs before told me the +_ window for meds was fine but if not I'll be 100% consistent at 7:30 going forward

On 8/8/2022 at 3:25 PM, Altostrata said:

If you look at lithium adverse effects -- which you should do here -- nausea and headache are serious adverse effects.

Quote

This medicine may cause pseudotumor cerebri (increased pressure in the brain). Call your doctor right away if you have blurred or double vision, dizziness, eye pain, severe headache, or nausea and vomiting.

Your psychiatrist should know this, but your psychiatrist prescribed the benzo to cover it up. Your psychiatrist has been negligent

- thanks for sharing the lithium info again. It really is a scary drug the more i read on it. I never really felt any of these symptoms prior to effexor so I'm confused as to why it'd act up now

- some context on the klono. Without klono, my symptoms in July were a looooot more than headaches and nausea. I alos had body burning, shortness of breath, body aches, aches that felt spanned my whole nervous system. This pain was insufferable a 9/10...I have a wife and kid and this pain would not allow me to be present to them or work and had me teetering on hurting myself vs dealing with it. I think with that the klono did become a lesser of the two evils it was untenable to live with that pain. I spoke to Frogie a bit about this and they agreed that klono for now made sense to deal with those symptoms and that I should taper off once we believe they're gone

On 8/8/2022 at 3:25 PM, Altostrata said:

As you are now physically dependent on the benzo, to go off, you will need to taper it, but first, you will need to schedule it in divided doses to distribute its effect throughout the day. If @Frogie or @Shep are available, they will assist you with this.

While you're getting your benzo schedule settled, suggest you read this

Tips for tapering off lithium

and discuss lithium tapering with your prescriber. Cold turkey off lithium can be dangerous.

I strongly urge you to work with a psychotherapist on your psychological problems, we do not treat them here.

- I'm a bit hesitant to get of klono just yet given those horrid symptoms I mentioned above...though maybe @Frogie has some other thoughts on how to go about

- I'll chat with my psych about lithium tapering in my appt tomorrow and next week as well

One thought: when the hypothesis was adverse reaction from effexor (which personally I think is still a legit hypothesis given the other symptoms i brought up and how this all started with taking it) the advise was to keep my medicine regimen the same so my nervous system can chill and recover. Should I change that approach to taper off lithium etc?

--------------

Again, I want to give a big thank you for the work you and everyone here. For everyone. And in my case for me personally. I had not thought of the countless hours y'all must put in hypothesizing, researching, typing out thoughtful responses, and so on...I'd like to acknowledge and see that effort and thank you from the bottom of my heart.

@Frogie · August 9, 2022

On 8/8/2022 at 3:25 PM, Altostrata said:

I strongly urge you to work with a psychotherapist on your psychological problems, we do not treat them here.

Missed this. I do! I work with an RODBT therapist once a week and have been for 6 years. I've worked in CBT modalities, RODB, and also Mindfulness-based stress reduction.

With that, I obviously still have a lot of work to do. My emotional responses to this situation keep leaking out in my writing I think because this is the worst thing I'v ever been through physiologically and I have a real fear of losing my family over it. I think I also prob am looking for empathy, which I'm sure gets tiring. I promise to better lean into my learnings from those modalities/therapy to keep the emotional side frommy texts going forward as I don't mean to make y'all think I'm looking for treatment for that here. Thanks for the call out

August 9, 2022

33 minutes ago, Bertoh said:

My emotional responses to this situation keep leaking out in my writing

You could try journalling which gets your thoughts out of your head:

August 9, 2022

1 hour ago, Bertoh said:

I'm happy to pay you for your time spent (so far and in the future) (venmo, paypal, however). I realize now thanks to your post you must spend an immense amount of time per person, so thank you. I truly am grateful and am happy to compensate.

The staff are all unpaid peers. However, you can make a donation to the site.

Please note that you will not receive any extra assistance or special attention if you choose to make a donation. It is not "fee for service". The site is completely free to everyone and you will be treated the same as every other member on the site.

This is what the donation money is used for:

On 4/21/2011 at 12:49 AM, Altostrata said:

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This site's purpose is only to provide support for people withdrawing, reducing suffering, and bringing the problems of withdrawal to the attention of medicine.

Your contribution will go towards expenses such as

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This link goes straight to where you can donate using Paypal or debit or credit card (the option is at the bottom):

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@Frogie · August 10, 2022

Thanks a ton ChessieCat!

thanks for the disclaimer as well on donations. I hope I didn’t imply that I viewed this as something that would give special treatment etc. I’m just hoping to give back given how much y’all have been helping me and have obviously helped others

I’ll make a donation later tonight once I put my kid down. Excited! Thanks and thanks for the journaling rec.

Edited August 10, 2022 by Bertoh
Untagging

August 10, 2022

2 minutes ago, Bertoh said:

I hope I didn’t imply that I viewed this as something that would give special treatment etc.

I wasn't assuming anything of you specifically, but I know that there would be some people who would think this way. As you stated, it was a disclaimer! And also, it needed to be said so that other members don't think that you are receiving more attention because you made a donation. As you can imagine that are many members who probably cannot afford to make even a small donation.

I made a small donation not long after I joined simply because I was so thankful for getting the information that set me on the right path to get off my drug. Background: I arrived here after reducing my dose by 50% and experiencing extreme brain fog which after 2 weeks I couldn't even type (professional typist here) and only 4 HOURS after taken extra Pristiq I was able to type again.

August 10, 2022

3 hours ago, Bertoh said:

Without klono, my symptoms in July were a looooot more than headaches and nausea. I alos had body burning, shortness of breath, body aches, aches that felt spanned my whole nervous system.

As I mentioned before, your psychiatrist has prescribed a benzo to cover up what might be very serious adverse effects of lithium. If I were you, I'd make tapering off lithium your priority. You should have a chat with your psychiatrist immediately, your psychiatrist is clueless, but will be useful in enabling your tapering.

See Tips for tapering off lithium

We will also advise you on redistributing the benzo, which should be tapered last -- that's months away.

August 10, 2022

@Bertoh

You may already know this , but I feel I should tell you, be careful with your words and emotions when talking to your dr. As Alto said you will need him/her to supply your drugs as you taper. below is some helpful information on this.

https://www.survivingantidepressants.org/topic/20161-how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect/

@Frogie · August 10, 2022

2 hours ago, Altostrata said:

If I were you, I'd make tapering off lithium your priority. You should have a chat with your psychiatrist immediately

I have an appt with them tomorrow at 1:30pm. I will bring up wanting to taper/come off lithium.

Should be interesting. They were so nonchalant about me coming off 3 drugs at once in Feb wonder if I’ll face any opposition this time. And if I don’t, wonder what their proposed taper should will be given last time they just kinda left me out in the wild for the apriprazole, Wellbutrin, and trintellix.

Welp, knocking on wood they support me coming off it. I’ll post an update tomorrow and then prob have a million questions about tapering as I’m having a hard time fully grocking the tapering recommendation link (even have a friend helping me figure it by having them read it lol).

thanks a ton y’all and thanks @Heath for the reminders on what language to use with my psych!

August 10, 2022

With regards to the lithium you can tell them that you have research possible long term side effects and are concerned about kidney damage.

Instead of saying that you want to stop the drug completely you could say that you would like to try and be on the lowest effective dose (this is different from therapeutic dose, which is an arbitrary term that the pharmaceutical companies decide on).

Something that I suggest to members before talking to a medical professional is to write down what you want to say and rehearse it. Be calm, gentle but assertive. Saying something like I would like to try this or I'd prefer to do it this way. If they suggest something different (eg adding or changing a drug) you can say something like I would like to think about that before I make a decision.

If a doctor wants you to taper faster you can say something like I realise that many people can probably get off their drug quickly but I'd prefer to be cautious and do it slowly because I don't want to risk getting withdrawal symptoms.

In Post #1 of this topic there is a link to the DSM-5 - Antidepressant Discontinuation Syndrome DSM-5 995.29 (T43.205A) and one to the leaflet - Guidance on stopping antidepressants by Royal College which you could take note of the details and give to the doctor.

We need to advocate for ourselves. We are the customer and it is our body and lives which are being affected, not theirs. Doctors are human and, just like the rest of us, they do not know everything.

August 11, 2022

@Bertoh

Sorry it has taken so long to get back to you, I have been out.

You do need to split the Klonopin into 2 doses and take them 12 hours apart so you don't have many symptoms. You don't want to just split and take it at 6 am and 6 pm. That will throw your body for a loop. So, if you take the 1 mg at 7 pm for instance, take 0.5 mg at 7 pm and 0.50 mg at 6 pm. Then keep moving the earlier dose up an hour 5 pm. 4 pm ect. until you get it to 7 am (this is just an example) as I don't know what time you take it.

You want to taper off of this last. Concentrate on the Lithium now because the Klonopin will help with the wd symptoms.

@Frogie · August 11, 2022

Hey @Frogie no worries on the delay. Life be busy, I have a 2 year old and I barely find tie to post in this thread nvm do anything besides tend to him and help my partner lol.

Scheduling

So I take my klono at 7:30am to start the day (an hour after levo..I can move this as I know you said it may be best to wait 2 hours) as I fear the intense side effects w/o it so much that I wanna get ahead of them before they start. Given your guidance above does the split schedule look like:

Proposed Split Schedule

7:30am .5mg. 4:30pm .5mg
7:30am .5mg. 5:30pm .5mg
7:30am .5mg. 6:30pm .5mg
7:30am .5mg. 7:30pm .5mg

- Is that right? Or am I completely off?

- How long do I wait in between each time move? 1 day, 1 week, etc? e.g. wait 1 day after moving to 4:30 before moving to 5:30 (or longer)

Questions

Out of curiosity, what side effects am I likely experiencing right now from taking 1mg at 7:30am vs splitting. Just wondering what I've been doing to myself
What does splitting as such ultimately do for your body/symptoms? I fully trust you and am gonna do this but am excited to learn how this'll help me feel better
Any side effects I should keep an eye out for as I do this split? If I experience them, anything I should do to relive them (e.g. go back an hour)

Thanks a ton, @Frogie for your time and pro tips. Hope your time out was a positive vacay or just chill time vs something else. Take care and thank you =]

August 11, 2022

@Bertoh

A two year old. My you are busy. I'm a grandma to a sweetheart that will be 15 in 2 weeks!

I guess I didn't explain myself as well as I'd hoped. But, to reduce wd symptoms it's always best to take multiple doses of a benzo. Since you are on Klonopin, you can take it 12 hours apart. But to get there you need to space it out one hour everyday until you get to the correct time. Since I know have a time you take it, I can tell you how to do it.

Yes, you want to take it at least 2 hours after your Levothyroxine and anything else you are taking.

7:30 am 0.50 mg - 8:30 am 0.50 mg

7:30 am 0.50 mg - 9:30 am 0.50 mg

7:30 am 0.50 mg - 10:30 am 0.50 mg

Then you just keep moving the later dose one hour each day until you get to where you are taking it at 7:30 am and 7:30 pm.

Does that make sense?

Once you start doing this you may feel some wd symptoms:

Stabilising After a Reduction - What Does That Mean?

Withdrawal Normal Description

Let me know how you are doing.

@Frogie · August 11, 2022

OMG so busy (with a second maybe on the way). He, alongside my wife, are the reason I'm taking this so seriously though. I want to get back to a stable state without headaches and nausea so I may be present for them. They deserve that from me. I want to give them that.

Grandma to an almost 15 year old, wow! That sounds amazing. I'm glad to hear they're a sweetheart..I hope their bday goes well an is filled with happiness =]

-----------

Thank you for the adjusted schedule! I'll use that starting the next few days and will post updates on how things are going then. Knock on wood I don't experience any wd that are too crazy as I do this...I could use some things going my way right about now (this nausea and headache things really has me down in the dumps). Thanks a ton again for the pro advice, I'm so very grateful ❤️

@Frogie · August 11, 2022

One more question for ya, @Frogie, sorry to bother you so much!

I'm considering changing my klono time to 8:30am since waking up at 5:30am to take levo for a 7:30am klono sounds terrible. How should I go about that?

Should I just change it to 8:30am starting tomorrow (when I plan to start the split schedule), should I get through the split schedule first and then try to move to 8:30am, or should I try something else? TY again for being so insanely helpful. Hopefully that's the last from me on for a while aside from update on how the split is going!

August 11, 2022

@Bertoh

I would make the 8:30 am change and then give it a day until you start to split doses. That gives your body time to regulate.

Let me know how it goes! You are not a bother at all.

@Frogie · August 30, 2022

Hello everyone!

I hope you’ve all been safe and loved since we last spoke. I missed all your help and kind words greatly.

I’m writing with a few updates!
————————-—

- I’m now consistently in klonopin at 8:30am and 8:30pm (as of 8/25). Ty so much @Frogie for the guidance. I’m eternally grateful to you for it.

- It took them a while to come around but I semi-convinced my psych to start a lithium taper! They started it as an “experiment” to see what impact it has on me (they hypothesize the lithium actually has been been playing a big part in my improving depression despite all this bs the last few months).
— Taper started Monday 8/22 600 > 450 (150 cut)

— Observations:

—— I def appear to be way more depressed than before the taper. Im crying a lot, more low energy mood wise, and want to sleep all the time

—— More unsure but it does seems like the headaches and nausea are down some with the cut tho harder to say definitively than the obvious increase in depression

The depression is really rough and has me wondering if I should power through it another week, really try to get out the house to see if I can over come it or if I should updose back to 600 and convince my psych to try again but at a cut of 60 monthly vs this 150 every few months. Something for me to ponder as I’m really impacting loved ones with this mood.

On the positive end, the psych is now open to lithium maybe playing a role in this and it not just fully being the Effexor (which I def think was the starter) and that’s progress! They also get that I just want off psych meds period and I’m glad they know I’m done with it.

Bonus: getting an MRI Thursday! Let’s see what it says. Mentioned @Altostrata’s theory of

On 8/9/2022 at 3:24 PM, Bertoh said:

This medicine may cause pseudotumor cerebri (increased pressure in the brain). Call your doctor right away if you have blurred or double vision, dizziness, eye pain, severe headache, or nausea and vomiting.

so they can keep an extra eye out for that.

As always, thank you all for the help. This has been such a trying 3 months (really year). Ty for doing what you do for people like me, it means the world me (us).

August 30, 2022

What does this "depression" feel like?

1 hour ago, Bertoh said:

— Taper started Monday 8/22 600 > 450 (150 cut)

Good to hear your psychiatrist is helping. This is a large cut. Your feeling of "depression" may be a withdrawal symptom.

If I were you, I'd "power through" this decrease for at least a week. Withdrawal symptoms tend to diminish over time. I would insist that the next decrease be much smaller. Did you read Tips for tapering off lithium? Please do not let your psychiatrist set you up for failure.

1 hour ago, Bertoh said:

More unsure but it does seems like the headaches and nausea are down some with the cut

You cannot tell if the headaches and nausea have decreased? The reason I mentioned pseudotumor cerebri is because these are symptoms that should raise a red flag. You may have a low-grade version of a much more serious adverse effect.

@Frogie · August 30, 2022

Altostrata! Ty so much for the quick reply. Just getting back from putting my kid down to bed so gonna steal these few mins to reply myself!

54 minutes ago, Altostrata said:

What does this "depression" feel like?

It feels like: constantly tired, wanting to sleep, lot's of spells of crying over ruminative or worry thoughts, lot's of lamenting and ruminative thoughts that I'm unable to hold in thus burdening people (my partner) with them. Low energy, don't want to leave the house. All very similar to how bad I was before I started lithium, I admittedly got better during the period I was on it, but I'm not sold that my improvements were because of lithium (my psychs theory)

54 minutes ago, Altostrata said:

If I were you, I'd "power through" this decrease for at least a week. Withdrawal symptoms tend to diminish over time. I would insist that the next decrease be much smaller. Did you read Tips for tapering off lithium? Please do not let your psychiatrist set you up for failure.

I'm at week 1, I'll def "power through" for another with a more positive approach!

That was def a large cut. I should've pushed back but I think I was so eager to get off this crap that I was willing to give it a try. Figured I'd give it a try per the below post from Meimeiquest a few years ago (in the tapering of lithium thread). My plan after a few months hold (1-3 hold, I'm debating given how big this cut was) is to push for 60mg cuts a month (10% of the original 600mg). I was referred multiple specialty pharmacies in SF that can likely compound the lithium doses I need, so excited about that!

54 minutes ago, Altostrata said:

You cannot tell if the headaches and nausea have decreased? The reason I mentioned pseudotumor cerebri is because these are symptoms that should raise a red flag. You may have a low-grade version of a much more serious adverse effect.

Yea, I'm not 100% sure if in the past week the headache and nausea I've been experience have decreased in a meaningful way. Right now I'm leaning towards they have just very subtly. Since the change the way my head hurts has def changes, to be less sharp pain and burning to be more "tingly" which is interesting.

Either way, I plan to continue with tapering off of this and hopefully the MRI helps give a bit of insight into what you've flagged. If all clear, I'm sure there's still a decent chance this pain is related to the lithium side effects. (and Effexor given they apparently always had major interaction effects to being with https://www.drugs.com/interactions-check.php?drug_list=2296-1523,1477-16548. It prob snowballed from there (conjecture))

Anyway, sorry for the long post. It's always a pleasure hearing from you Altostrata and receiving your guidance and care. I'm so darn grateful to you, frogie, chessie, heath. Here's to a week of pushing through this cut with a smile on my face for myself, my family, an honestly for y'all! I wanna bring positive news every once and a while too since I'm sure that's nice to hear; hopefully soon! =] ❤️ y'all!

August 30, 2022

16 hours ago, Bertoh said:

It feels like: constantly tired, wanting to sleep, lot's of spells of crying over ruminative or worry thoughts, lot's of lamenting and ruminative thoughts that I'm unable to hold in thus burdening people (my partner) with them. Low energy, don't want to leave the house. All very similar to how bad I was before I started lithium, I admittedly got better during the period I was on it, but I'm not sold that my improvements were because of lithium (my psychs theory)

Constantly tired and wanting to sleep can been adverse effects from the benzo. "Depression" can also be an adverse benzo effect.

In my amateur opinion, you are seriously overdosed with lithium and maybe the benzo, too, and they are causing many of your symptoms.

You may also have a more pessimistic disposition, not a mental disorder. Have you ever pursued psychotherapy or other coaching to manage your negative thoughts?

At any rate, are you getting at least 1/2 hour of gentle exercise, such as walking, per day?

@Frogie · August 30, 2022

2 hours ago, Altostrata said:

Constantly tired and wanting to sleep can been adverse effects from the benzo. "Depression" can also be an adverse benzo effect.

In my amateur opinion, you are seriously overdosed with lithium and maybe the benzo, too, and they are causing many of your symptoms.

These symptoms got much worse though after the recent lithium cut. Doing better today though so yay! In general yea I can see how these drugs I'm on are likely making things worse, thus the push to get off em once and for all!

I take your "amateur" opinion very seriously and thus am actively working on getting rid of the lithium. The timeline for when I'll be off that is definitely daunting, nvm the fact that the benzo will come after that but I'm heading in the right direction and I know things will turn out well. I will be stronger than ever before once this is all over.

2 hours ago, Altostrata said:

You may also have a more pessimistic disposition, not a mental disorder. Have you ever pursued psychotherapy or other coaching to manage your negative thoughts?

Oh yea, I def a negative ned. I've been working with my therapist (specialized in CBT modality and now RODBT) for 6 years. It's been rough and negative thoughts are the stickiest of my issues by far but believe it or not I've come a long way from before. I actually used to be even more negative! haha. Think this particular run of headaches, nausea, etc plus some at home problems are just the straw that broke my back recently thus the increased negativity.

I'm actually considering adding somatic therapy to my rotation to see if that'll help bolster my defense here

2 hours ago, Altostrata said:

At any rate, are you getting at least 1/2 hour of gentle exercise, such as walking, per day?

I haven't been great about this but have been getting better. Taking my kid to and brining him back from daycare gives me 30 mins walks during the week though I should likely add some more walk given my state and while I'm on leave from work (on leave from 8/15 - 10/15). Exercise is one of those things I've always been told to do to help with my depression/anxiety (which are why I started this whole pysch med journey) but I can't seem to find the one I like. Why can't I just like running or something dammit? lol

@Frogie · August 31, 2022

Hi all,

Just sharing that I came to the realization that the 10% cut recommendation is for the most recent dose not of the does you started at. Putting that into the calculator for just lithium it looks like a 5-6 year taper just for that. NVM the klonopin to follow. Due to my misunderstanding I was hoping (tho still hurting at the idea) of a year but wow.

F these pharma companies to give this stuff away like candy and leave us to painfully pick up the pieces. Anyway just posting cuz I feel really daunted and down (as warned by Brassmonkey's post on tapering lol). Mostly venting, I know I'll get through this journey and live a peaceful good life with my family either way!

@Frogie · September 2, 2022

Hello friends!

I was wondering if anyone had any good tips for now to reduce/get rid of/cope with the headache and nausea I'm experience as an adverse effect. I read the headache thread and didn't really come away with much that worked for folks (aside from maybe botox?) and I tried magnesium over the past month at 50mg cuts 1x a day then 2x a day but I feel like it made my head hurt.

I think these headaches and nausea are the the single biggest blocker to me living a decent life and being willing to take on the long tapering journey of lithium and klonopin the 10% way. As long as these headaches and nausea continue the way they do I just fear I'll really struggle to be present and happy in life (I'm workin with my therapist to address this but it is HARD), but also feel like I'll opt/lean toward faster-ish taper options (like my psych's proposed 150 every 203 months) if presented as my focus will be "get rid of these headaches ASAP". If they were less of a problem I'd be more comfy with taking many years to taper.

Anyway, putting this out there in hopes of some tips/help and to out a concern/risk of mine in following the SA tapering method (I wanna be open with my friends!).

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Complete aside: @Altostrata in your (inspiring) intro/history post, you wrote that you eventually found a psych that "got it" when it came to antidepressant wd/tapering. I was wondering if you'd mind sharing their name/info with me (hopefully they're still in practice) as I also live in SF and would love to get second opinions/switch over to someone Alto themselves trusts! Thanks in advance for the help ❤️

September 2, 2022

See What to do for dizziness , queasiness, nausea and other topics listed in

@Frogie · September 12, 2022

Hi @Altostrata. Really sorry to randomly bother you but wanted to poke you on these lines from your about post

On 3/16/2011 at 7:50 AM, Altostrata said:

In late 2007, I finally found a doctor, a psychiatrist and sleep specialist, who understands and treats withdrawal syndrome, coincidentally in San Francisco.

Under his care, I very slowly recovered

I live in San Francisco (Noe Valley!) and would love to see this miracle psych/doctor if they're still in practice. If they're not in practice I'd love to talk to them about who they'd recommend that thinks like them!

Would you feel comfortable sharing their name(s)/practice/contact info with me in this thread or via DM? Thank you Alto, I hope things have been well for you ❤️

Best regards,

Alberto

September 13, 2022

I believe he's on the verge of retirement. Sent you a dm.

September 21, 2022

Hey Bertoh -

I just wanted to check in and see how you're going. The p-doc gave you a huge cut - but you are in his/her care, so that is what I would call a "supervised cut." (we never recommend such large cuts here because we cannot "supervise" over the internet). Supervised, the first cuts can be a little bigger.

How are you doing now?

Upon reading your thread, my first thought is that - yes, you have been suffering withdrawal from Effexor. Alto has a good point that you may be suffering an extreme side effect from the lithium, too.

But - if your blood tests are okay, you don't want to go too fast on the lithium, you want to trick your body into thinking everything is just fine, so that it doesn't notice your taper from here on out. This is why we go slowly. Don't think about the finish line years from now - think about how much better you feel as your doses go down and you are less encumbered.

The big cut was in June (which is also when you were removed from Effexor) - that's 3 months ago now, how are you going?

If you'd been tapering, this big cut would have taken 6 months to achieve. So my first thought is - you probably have both.

Side effects from Lithium (450 is a much more manageable dose) and withdrawal from Effexor.

If it were me, I would hold at these doses for another month, up to 3 months before tapering further. Just to make sure you give your system a chance to settle from all the changes in June.

Lithium is actually one of the easier tapers - except for big drops (which you experienced), it is a metal, an element, and is more of a nerve/neurotransmitter deadener than it is a neurotransmitter fiddler. So as you reduce you should start to lift and feel lighter (It always angers me that they give this for "depression," sure, when you are numbed out on lithium, the depression doesn't hurt as much, but the anhedonia & "zombie affect" can be depressing!).

When tapering lithium, it is important to know whether or not it is time released (XR/SR). If so, when you break the tablets you will need to dose 2x a day. When lithium is IR (immediate release), it will hold for about 12 hours, so you will need to dose twice a day. A broken XR/SR tablet = IR.

Let us know what you decide to do re: tapering lithium. Please do not accept another huge drop from your p-doc. S/he obviously does not understand the dangers of these drugs.

Here is a link to my post to you in my thread:

I hope you see the Sun today!

@Frogie · September 23, 2022

Thank you so much for checking in, JanCarol. It's so kind of you. I really do love this community.

I'm feeling hot and cold this past month mostly as a result of the headaches and nausea, which I believe are a result of a strong adverse effect the effexor. I keep track of the pain every day in a spreadsheet with my therapist and the numbers on average are going down, which is nice, but glacially slow it feels (7.5/10 on average 8/2, 7.2/10 on average this week)

I still haven't found a great way to reduce or combat the nausea or headaches regularly but I'm trying things I've read on the forum to mixed results. That plus some good ol' fashion just do it when feeling in pain/down have gotten me through the days though it's not a great life, it still has great moments with my wife and son.

Lithium-wise: I actually think I've been handling the 150 cuts quite well, and my body is telling me it can handle them ok so I'm going to try the 150mg a month cut suggested to me by a few psychs. I know this is faaaaar from SA standard but I think my body so far has been handling it ok and I'm doing my best to listen to it. If at any point things go sideways tho I plan to updose back to stable and re-evaluate.

Klonopin-wise: What i'm really freaking out about for some reason this week is what's to come after lithium with klonopin. I've read nothing but horror stories and i'm scared out of my mind. For that, I def plan to take it slowly and carefully, much more in line with SA recs, especially if my headaches and nausea have lowered or subsided by the time that journey comes. I think one thing worrying me is the longer I take to start the longer I am on a benzo meaning the harder it'll be to get off? I'm not sure that's true but it's been weighing on me

Anyway. In general I'm moving along ok. Not great, not loving it, but I know I'm still early in the journey and this part hurts the most. On a happier front my little family will be going to Japan next week, which I'm really excited about! My wife an I love it there and my 2 year old has never been. I'm hoping this is a nice distraction from my non-stop med thinking and for my beautiful wife who has been so work stressed.

Additionally, we have a baby girl on the way! As if I needed any more motivation in life to get better, knowing I have another bundle of my and my wife's love coming fills me with equal determination and fear of this all. Scared to get it wrong and not be there or her (and the family) if I'm in constant pain etc, but more importantly determination to do it right and keep on fighting for them. I love them with all my heart and can't wait to look back at this whole post one day with a phew...that was crazy, now to share my success story and focus fully on my 3 loves.

Sorry for the long post, guess just a lot to share today. Love you all...thanks so much for the help! I'll keep y'all posted on how things go!

September 24, 2022

Why do you think nausea and headaches are an adverse effect of Effexor specifically? They could even be from levothyroxine.

It appears you are taking advice from at least one psychiatrist. Not sure how we can help, according the principle of "too many cooks".

FYI, people can often get down to about half their dose with fairly large cuts, but run into trouble after that. You would be well advised not to get too aggressive at the half-way mark.

@Frogie · October 19, 2022

Hey Alto and everyone! Sorry for the late reply. I went to Japan end of September/early October as prepping for the trip and the trip itself was hectic!

2 year olds, they really don’t care what your plans are or what you’re experiencing…they’re gonna live it up their way 🥲 haha

On 9/24/2022 at 1:29 PM, Altostrata said:

Why do you think nausea and headaches are an adverse effect of Effexor specifically? They could even be from levothyroxine.

My hypothesis is it’s the straw that broke the camel’s back after kindling. Before Effexor I didn’t experience headaches/migraines or nausea in my day to day nor as a result of other drug side effects at all. Not when starting levo or trintellix, adding or removing lithium, stimulants, or rexulti. I have a distinct memory of day 2 of Effexor being like “this is not right. These headaches and nausea are immediate, new and really really bad”. Unfortunately the partial hospitalization place i was at (Rogers Behavioral Health) kept downplaying my pain. Think I touch a bit on it in my intro. After a week and a half on Effexor headaches/migraines have been a daily part of my life with only a small improvement in average pain since August (I’ll take it). That experience is what leads me to believe this ultimately happened because of the Effexor. I believe had i just stopped taking new drugs after they took me off the rexulti id be fine right now with those symptoms

Alas it’s impossible to fully know I suppose but I’m hoping getting off lithium and eventually klonopin will help. Really I’m kinda sold on this is ADR of Effexor and fortunately these symptoms will go away but unfortunately the only solution is time. The question for me is can I hold on for as long as it takes without falling back into the help of a medicine (in this case migraine specific medicine like nurtec) cuz life is too unbearable with the pain. Right now I’m planning and betting that I’ll hold out and win. I hope I’m able to given the birth if my second child coming next April.

I’ll def keep this thread posted on how things go throughout the days/weeks/months. SA has empowered me so much to navigate this terrible situation with info that makes me feel better prepared. I don’t know the right answers for sure but I know better thanks to y’all. I hope to keep learning from and getting advice from y’all as things progress.

My best wishes to all of you. Especially you, Alto. You’re a real hero… ty

@Frogie · January 3, 2023

Hi all. Super quick question. (Sig updated to capture most recent tapering and addition of vitamins for migraines)

After 5 months of holding off I finally started taking fish oil (yay) I’m December.

i started 12/15 with Trader Joe’s fish oil, two pills or 1200mg of DHA+EPA and then immediately went up to 1800 the next day. I but the bullet finally per my neuros rec as he said it’ll help with my migraines. (I take one with every meal, bfast > lunch > dinner)

I felt fine at first but have noticed since after Xmas that my stomach has been more uncomfortable than before. At first I attributed to eating too much too badly in xmas but it has persisted. Additionally I’ve noticed pain in my private areas from this discomfort now for a week or so now (discomfort when going bathroom, burning throughout the day).

Wondering if this can be attributed to pushing myself to 1800 too fast or if it’s something else to chase. If so, should I try moving down to one pill for x week then gradually move up or should I power through and I’ll normalize?

Any advice would helpful if anyone has any experience with this. Thank you!

Note: I also upped my magnesium to to 400mg 12/15/22, a month after starting at 100mg. Felt fine but throwing in there in case could be impacting

Hope you all have had a great holiday season. I love you all. I truly believe this year I will heal, and in time for my daughter si sending good vibes to you all as well so we can all share in the goodness to come. ❤️ cheers!

January 3, 2023

Everyone has a different tolerance with supplements, and more isn’t necessarily better. Perhaps scale down to just one per day with breakfast and see how you fare for 2-4 weeks. Are you eating oily fish regularly as well?

January 3, 2023

Perhaps you have a urinary tract infection.

Taking too much magnesium at once can cause gut upset or diarrhea. Magnesium is best taken in small doses throughout the day. This is explained in Magnesium, nature's calcium channel blocker

Fish oil can upset the stomach. It's best taken with meals. Our recommendations are 3000mg-4000mg EPA+DHA per day. This is often 2 capsules 3 times a day. See

Please post questions about your particular situation only once, in your Introductions topic. If you have questions about a specific supplement, please use search in the Symptoms and Self-Care forum.

Bertoh: Suffering immensely from Effexor attempt and withdrawal. How do I get back to normal?

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