member21: tapering venlafaxine

[FindRest]

Not sure I understand what you are asking. If you’re asking how to calculate the amount of active ingredient, the files will be able to answer that. If you are wondering if your scale that has an accuracy down to 6mg (.006g) will be useful at the lower dosages, the answer is yes. I’m down to around 4mgai which weighs about 15mg on the scale. Please note that your weights will be different than mine as we are not using the same brand, nor the same manufacturing facility, nor the same lot number. So, you will need to calculate this on your own.

[member21]

It has been apporx. 8 weeks since I last increased my venlafaxine dose. Also I have stopped taking the ayurvedic medicine (for Hernia) which I suppose had caused the need for updose. Now I feel pretty much free of WD symptoms...only minor mood fluctuations are experienced.

I practice OEFT (emotional freedom technique) in the evening...for about 20 minutes. And after that mantra or chakra meditation for another 20-30 minutes.

For last 3-4 days after the evening OEFT practice and meditation I feel that my head, face have gone cold. As if inside the head the brain also feels cold. Can anyone suggest what this indicates.

[member21]

18 hours ago, member21 said:

It has been apporx. 8 weeks since I last increased my venlafaxine dose. Also I have stopped taking the ayurvedic medicine (for Hernia) which I suppose had caused the need for updose. Now I feel pretty much free of WD symptoms...only minor mood fluctuations are experienced.

I practice OEFT (emotional freedom technique) in the evening...for about 20 minutes. And after that mantra or chakra meditation for another 20-30 minutes.

For last 3-4 days after the evening OEFT practice and meditation I feel that my head, face have gone cold. As if inside the head the brain also feels cold. Can anyone suggest what this indicates.

I have noticed that even after morning walk I have this feeling of cool sensation inside my head. Perhaps it becomes more noticeable after any kind of relaxation. Does this indicate lower than normal brain blood circulation (meaning that I need to withhold my tapering for some more time).

 

Also I am now experiencing significant PSSD. Should it also improve if I stop further tapering for sometime. Or can someone suggest some remedies.

[Altostrata]

What exactly are you taking now, at what times o'clock and dosages?

 

What drug changes have you made in the last 3 months?

[member21]

I take Venlafaxine XR 27.2mg (counting beads from 37.5mg Venlor XR and putting them in a gelatin capsule) - 8am.

Encorate chrono 200mg - 8:30pm.

 

In the last 3 months I have updosed my venlafax twice. 31st oct to 25.3mg, 25th Nov to 27.2mg. (approx. 2 months ago)

I took ayurvedic medicine for hernia pain from 20th oct to 10 jan. Now I have stopped it. I think starting that ayurvedic medicine had caused the need for an updose.

 

Currently I off-and-on feel restlessness, and some overwhelm (not willing to do anything) (In addition significant brain fog and PSSD persist). As  I mentioned earlier...I feel that my face, head, hands feel cold after some physical activity, meditation. Even today, to relieve my restlessness - at about 2 in afternoon I did alternate nostril breathing for about 30 min. Felt the same cooling sensations.

 

I have not noticed any time pattern in the symptoms. I was once told by a psychiatrist friend that when you increase your antidepressant dose then the feeling in your head are due to the increased blood circulation in the brain. So  I was wondering what do my current symptoms indicate. Do they indicate withdrawal, or they indicate that its time to further reduce the antidep.

[Altostrata]

14 hours ago, member21 said:

In the last 3 months I have updosed my venlafax twice. 31st oct to 25.3mg, 25th Nov to 27.2mg. (approx. 2 months ago)

 

If these symptoms occurred after an increase to 27.2mg, you may be feeling an exaggerated effect from the increase in venlafaxine. Or you may be feeling after-effects from the Ayurvedic medication.

 

A "cooling sensation" does not sound like a severe withdrawal symptom.

 

14 hours ago, member21 said:

I was once told by a psychiatrist friend that when you increase your antidepressant dose then the feeling in your head are due to the increased blood circulation in the brain.

 

This is nonsense.

[FindRest]

Do you by chance take Venlafaxine and Encorate Chrono at the same time of day? They both use some of the same liver enzymes to metabolize the drugs, causing an interaction. 

 

Also, they both can mess with your sodium levels, causing low sodium and additional symptoms. You might want to research the symptoms of low sodium and see if they correlate to what you’re experiencing. 

[member21]

I take the two medicines with a gap of 12 hours.

 I have been taking them for decades.

Yesterday I noticed that my hands and feet were very cold.

 Earlier I forgot to mention...for last 10 days for a couple of days I feel good, then for a couple of days more of restlessness etc.

[member21]

People may experience:

Whole body: dizziness, fatigue, lethargy, malaise, or thirst

Also common: headache, insufficient urine production, mental confusion, or nausea
 

above is the google result for low sodium symptoms.

 I only feel mental confusion.

All other are much improved.

[Altostrata]

I still have no idea what you're talking about. Maybe you have a circulation problem.

 

We're only a peer support forum on the Internet, we cannot diagnose you long-distance and we can't help you with reactions from other drugs you might take, such as Encorate chrono 500,sodium Valproate (200mg) and valproic Acid (87mg), and Ayurvedic medicine. 

 

I think your problems may be beyond what we can do as peer support here.

[member21]

I have been holding my dose since 25 Nov 22 (3.5 months). I now feel fairly stable. Many a time feel such a mood that think of big plans for family life, career etc. But many times feel low...overwhelm, mild anxiety,  mild restlessness (sometimes they are more than mild). Also am easily exerted.

Mainly its overwhelm (loosing mental strength/hope, giving up easily, feeling that everything is too complicated). Plus feeling brain fog, sort of partial mental dysfunction, some PSSD.

I used to practice EFT (emotional freedom technique) with some success (relief). It used to be my favorite tool. But now feel totally blank while trying it...think that it is a form of withdrawal.

My eyesight is a big problem. Pain, burning, prickling in eyes disturbs the whole physiology. Also unclear vision. Watching television/ computer for a couple of hours triggers the eye problems. Doctors say it is dry eye syndrome.

Daily do around 30 min walk and meditate twice a day. But for last 15 days feel that do not get proper rest after medtn/sleep. Perhaps was taking more stress at work.

Hope that would be able to start my micro taper in a month or so.

Some advise/pointers please

 

[Altostrata]

Why taper by 10% of my dosage?

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide Method of Micro-tapering 

[member21]

During February and March I felt quite good and thought that I may be able to do a few 5 or 10% tapers.

Then at March end tries some naturopathy, which I expected to be harmless. But I think it fluctuated my blood levels (of venlafaxine). So had to stop it (though it had many benefits and wanted to continue. perhaps would be able to start it again...after completely coming off the psycho-actives.)

Since then...small problems like cough-cold/ stomach infection have been stopping me from further tapering.

Feel significant brain fog, easy overwhelm (giving up all hope and effort), lack of strength in limbs, sadness over such difficulties/struggles in life, and thus having to live in mediocrity.

Other challenges being: extremely dry eyes-making day to day working difficult and painful; blurred vision, aggravating symptoms of sciatica, hernia of the groin.

About 2 weeks ago, my doctor advised that I seem to have reached my limit for tapering venlafax...So tapering encorate chrono instead.

 

I was keen on reducing the venlafax first (as reducing the encorate may cause mood swings and/or sleep difficulties).

Still waiting and weighing my options.

 

The tapering process is turning out to be much difficult and slower than expected...and I feel that the worst is yet to come. Wish there was a way that I could taper all my remaining medicines within 2 years from now, with a constant improving functionality due to diminishing side effects of lower doses.

[member21]

My body zaps are now more than 90% improved.

anxiety, restlessness, overwhelm are almost healed, but sometimes strangely they appear without a trigger…and scare me.

This leaves me wondering- when would be the right time to begin further tapering.

[member21]

To sum up my recent experience:

I had to updose venlafax in Oct 22 and Nov 22. Since then I have been taking the same dose.

Feb and Mar 23 were very good for me. Then at March end I tried some naturopathy treatment which I think disturbed my blood levels for the medicines. Thus I had some disturbing anxiety, restlessness in April. Again I had cold, then after a few days had loose motions. So my symptoms continued.

Also due to overwork at office and annoyances at home, I was having some anxiety, overwhelm (unable to properly do my duty at work) till recently. Also since April I have been feeling lack of energy in my hands, feet (sort of numbness, powerless grip); sometimes get up early in the morning...and feel that sleep hours and quality are low; and sort of mental dysfunction (understandability, thinking, remembering).

About one month ago my doctor had suggested to me that as further venlafax tapering is giving me withdrawal, I can taper the encorate chrono from 200mg to 160....120....80mg over six months.

 

Now when I am having the above symptoms on and off, would it be wise to taper sodium encorate?

My April symptoms were different from those from earlier venlafax tapering but they were perhaps only just short of making me unfit from going to work.

As discussed with the doctor, withdrawal from this stabilizer can (i) cause mood fluctuations (ii) sleep disturbance/disorder.

Also the moderators advise to keep the "brakes" for tapering at the end.

next week I am taking my family for a vacation.

So please advise (do I taper sodium encorate slowly?).

 

[Altostrata]

Please list the changes you've made in your drugs since January, in chronological order with the date on the left and action on the right, in this format:

 

Quote

 

January x, 2023 - drug name and dose

February x, 2023 - drug name and dose

March x 2023 - drug name and dose

April x, 2023 - drug name and dose

May x, 2023 - drug name and dose

June x, 2023 - drug name and dose

 

 

[member21]

I have not made any changes to my drugs this year.

(had to updose in Nov 2022).

 

due to off and on significant symptoms like dizziness, lack of energy ( especially in limbs), mental overwhelm (finding routine office work challenging): I feel unfit for further venlafax withdrawal.

 

so wondering if it would be wise to taper my other medicine- sodium valproate ( a stabiliser)

(my doctor has advised so)

[Altostrata]

Is this what you're taking?

 

8 a.m. Venlafaxine XR 27.2mg (counting beads from 37.5mg Venlor XR and putting them in a gelatin capsule)

8:30pm Encorate chrono 200mg

 

You are under the care of a psychiatrist, why are you seeking peer support here?

[member21]

Yes Alto,  I am taking the medicine as you have written above. I am sorry I thought of typing this summary for easy reference but then it slipped off my mind.

 

I am under the care of a psychiatrist, but that is only for prescription, broad opinion, and to help in case the situation goes out of control.

Also as we discuss in the forum...medical doctors do not have similar opinions for withdrawal, tapering, switching etc.

 

 

[Altostrata]

Very possible the drug combination you're taking is causing you to feel dizziness, physical weakness, and mental overwhelm.

 

Are any of these symptoms better or worse after you take each dose of your drugs?

 

 

[member21]

I have not been able to notice how the symptoms change after taking the tablets.

 

 I only have a vague idea that the physical weakness in the limbs is more noticeable during night hours (after sodium valproate)

 

[Altostrata]

You might consider Tips for tapering off sodium valproate and valproic acid (divalproex sodium, Depakote, Depakene)

 

[member21]

There isn’t much guidance (on symptoms) in the topics that the above links point to. They only tell about the importance of slow tapering and various alternate preparations available.

 

 

 I have a question:

I used to take encorate chrono cr 200mg which is a controlled release tablet (8:30pm).

now for the purpose of tapering I am switching to syrup encorate ip.

It has approximately the same chemical composition.

so can I take the syrup only once at night or do I split it into 2 equal doses - 8:30pm night and 7:30am morning.

 

Tablet Encorate chrono cr 200mg: 

Sodium Valproate (133.5mg)+ Valproic Acid (58mg)

 

syrup Encorate: 

Sodium Valproate (200mg/5ml)

[Altostrata]

Ask your pharmacist how often to take syrup Encorate, or read the package insert yourself.

[member21]

Around my place pharmacists do not give so much advise. No package insert came with the syrup. I googled a lot but could not find the desired advise.

Finally from the above link (pointing to sodium valproate)...I have deduced that as for the ER variant it is advised that the dosage is supposed to be taken twice a day....so for IP liquid variant it would be twice a day. (only CR may be appropriate for once a day administration). 

 

I was lately experiencing some insomnia, so I have deferred any tapering in sodium valproate.

 

Also, I have been holding my Venlafaxine at the current dose for more than 6 months. During March, April I felt quite good. And overall I have a lot of relief/stability in my withd. symptoms, but still the difficulty I experience during brief fluctuations (anxiety, dis-orientation/cognitive dysfunction - work appearing too overwhelming) stops me from tapering it at this time.

[member21]

For a few months I had been feeling that my breathing is restricted/constricted. Sometimes used to feel restless while lying for sleep.

But in the past one month or so the breathing has deteriorated a lot more. Feel lack of breathing while talking. In general feel shortness of breath during some activities.

Sometimes (perhaps once a day) gasp for air with an oral noise.

Makes me wonder if it is withdrawal which would resolve with time, or something like asthma which shall get worse.

Am overwhelmed with my own health care (hernia and urethral strictures, dry eyes in addition to bipolar) plus chronic illnesses of most members of the family…so am unable to think of going for any further investigations, Dr visits.

 

Other members, moderators please guide.

[member21]

In addition, as detailed in my signatures, I have only tapered 10% many months ago. And after that have had many spells of feel good days where I think of tapering further. So why breathing not improving.

 

Also so many people express their concern over my weight loss that it is causing me fear.

When I look at myself in the mirror I too sometimes feel that now I look too skinny.

In addition to withdrawal, I had switched to Vegan diet with intermittent fasting (July 2023). Both of which result in fat loss.

But sometimes I associate my weight loss with glandular malfunction, or even cancer.

[member21]

On 1/26/2024 at 11:16 AM, member21 said:

For a few months I had been feeling that my breathing is restricted/constricted. Sometimes used to feel restless while lying for sleep.

But in the past one month or so the breathing has deteriorated a lot more. Feel lack of breathing while talking. In general feel shortness of breath during some activities.

Sometimes (perhaps once a day) gasp for air with an oral noise.

Makes me wonder if it is withdrawal which would resolve with time, or something like asthma which shall get worse.

I have noticed that my breathing is better…and that the gasping is not happening now.