Sturm: venlafaxine / Effexor withdrawal timeline and length

[Sturm]

Hello, my name is Sturm! I am from Austria and am looking for someone to read over my story about getting off of Effexor, since, quite frankly, I am terrified that it will last a few weeks more, or that I could get addicted to benzos (see more about that later) in the process (as the worst side effect I have atm is very bad insomnia). I hope I am posting this in the correct place.
 

So, this is a bit of a long story. I have been taken Venlafaxine / Effexor for around 7 months (since January 2022). Around two months ago I decided to taper it (I was at 150mg). We tapered to 75mg. I don’t recall any psychological side effects from this, but I did notice muscle pain (especially from my left leg). I stayed on this for around two weeks, when I tapered again to 37,5mg. I stayed at this dosage for two weeks, and didn’t notice any psychological change besides muscle pain. I was then told I could get off Effexor, or I could take it every other day. I took it every day for a week. By this time, I noticed brain fog, but nothing extremely strong. At this point, after a week of this, I asked the psychiatrist about a prozac bridge, knowing the withdrawal effects would undoubtedly be terrible. The next day (Friday 21.07.2022) I was off Effexor and took 10mg prozac. 

 

At this point, I had a decent amount of nausea and akathisia, a reduced appetite, as well as chills, but never experienced brain zaps. The 5th day had the worst nausea. By day 7, the nausea was seemingly gone, and I thought the withdrawal was over, so I stopped taking prozac a few days later (31.07). 

 

The next few days were pretty recent, little to no nausea. By August 5th, (roughly two weeks since being off of the Effexor), I had some mild nausea, chills were back, and worst of all, I started having really bad insomnia. Despite bot having taken any prozac in 8 days, I took it again on August 7th, thinking the insomnia happened due to stopping prozac and being off of it long enough for its half life to expire, therefore allowing more of Effexor’s withdrawal effects to occur (since prozac normally suppresses most of the nasty ones). This, however, doesn’t seem to be the case, as of today, August 10th (day 19), I still am having sleep problems.

 

I am also concerned that I could have become dependent on prozac for taking it for around 14 days. Could dependence on prozac be attained that early, or does it normally take around a month to occur?

 

It has been nearly three weeks since I am off of Effexor. When should I expect the rest of the withdrawal to end? When should my insomnia end (before yesterday and the day before (I was proscribed lorazepam, I hadn’t gotten any sleep in three days due to the insomnia). I was proscribed lorazepam 2,5mg to help me sleep at night. Is this safe to take, or will I get addicted? The psychiatrist and nurses at the hospital where I was given this prescription said it shouldn’t be an issue unless I take this dosage for months. Do I believe them?

 

Edited August 10, 2022 by ChessieCat
Resized font

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry you are dealing with withdrawal and struggling with this.  You have come to the right place.  It sounds to me as though you are dealing with withdrawal from venlafaxine from tapering off of it too quickly and suddenly.  You should not have developed a dependency to Prozac after only being on it for 14 days.  If it were me, I would not take the prozac again.  Even a single dose can further confuse and destabilize your system, and worsen your symptoms.  It's very hard on the brain to take antidepressants on a sporadic basis.  I will give some basic info, and then some suggestions at the end of this post.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.  Use this example:

 

Feb 15 2020 - June 30 2020 - 25mg citalopram, 2mg xanax

July 1 2020 - Sept 7 2020 - 50 mg citalopram, 4 mg xanax

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

I believe you might benefit from a small reinstatement of Effexor.  This would hopefully help to reduce your withdrawal symptoms, especially your insomnia.  Going back on a small dose of your drug, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

Finally, you could become addicted to the lorazepam in 2 weeks.  I would take with a grain of salt what the health care people tell you about it taking months to get addicted to benzos, which lorazepam is.  If the reinstatement works, which it probably will given you've only been off the Effexor for a few weeks, it should help your sleep, and it's better in my opinion than getting addicted to benzos.  Plus, even with the benzo helping your sleep, you might still have other Effexor withdrawal symptoms to deal with.  

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

Edited August 13, 2022 by getofflex

[Sturm]

On 8/13/2022 at 11:05 PM, getofflex said:

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry you are dealing with withdrawal and struggling with this.  You have come to the right place.  It sounds to me as though you are dealing with withdrawal from venlafaxine from tapering off of it too quickly and suddenly.  You should not have developed a dependency to Prozac after only being on it for 14 days.  If it were me, I would not take the prozac again.  Even a single dose can further confuse and destabilize your system, and worsen your symptoms.  It's very hard on the brain to take antidepressants on a sporadic basis.  I will give some basic info, and then some suggestions at the end of this post.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.  Use this example:

 

Feb 15 2020 - June 30 2020 - 25mg citalopram, 2mg xanax

July 1 2020 - Sept 7 2020 - 50 mg citalopram, 4 mg xanax

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

I believe you might benefit from a small reinstatement of Effexor.  This would hopefully help to reduce your withdrawal symptoms, especially your insomnia.  Going back on a small dose of your drug, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

Finally, you could become addicted to the lorazepam in 2 weeks.  I would take with a grain of salt what the health care people tell you about it taking months to get addicted to benzos, which lorazepam is.  If the reinstatement works, which it probably will given you've only been off the Effexor for a few weeks, it should help your sleep, and it's better in my opinion than getting addicted to benzos.  Plus, even with the benzo helping your sleep, you might still have other Effexor withdrawal symptoms to deal with.  

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

I hope I am allowed to quote this. I very much appreciate the response. In the meantime, I believe my insomnia has come to an end. For the past three or so days I have been able to sleep at night with just my usual sleep aid, which is catapresan / clonidine, which is a big improvement!

 

i also added some medications to my signature, and the years I was on them. I did not do a very good job, though, nor is that even remotely close to the full amount of medications I have ever been proscribed. 
 

i do not think I have mentioned it, but I have been on the antipsychotic Abilify for close to a month now. For the past five days I have been off of it cold turkey, however. I have not yet noticed any withdrawal effects  (I am hoping I am spared them). I do not think an antipsychotic is a good fit for me really.

 

I am still getting a bit of nausea, especially evenings. I hope the withdrawal is coming to an end. As of today, it has been I believe 24 days since I have quit Effexor.

[getofflex]

20 hours ago, Sturm said:

I hope I am allowed to quote this

Sure, no problem at all.  

 

20 hours ago, Sturm said:

I believe my insomnia has come to an end. For the past three or so days I have been able to sleep at night with just my usual sleep aid, which is catapresan / clonidine, which is a big improvement!

That's really good.  I'm glad to hear this. 

 

20 hours ago, Sturm said:

i also added some medications to my signature, and the years I was on them. I did not do a very good job, though, nor is that even remotely close to the full amount of medications I have ever been proscribed. 

We mainly need to see a complete and accurate list of the drugs in the past 18-24 months.  Don't worry too much about the time before that.  

 

I see you were recently on haloperidol and Abilify.  How many weeks were you on the haloperidol?  

 

20 hours ago, Sturm said:

i do not think I have mentioned it, but I have been on the antipsychotic Abilify for close to a month now. For the past five days I have been off of it cold turkey, however.

As long as you were on it less than a month, you should be OK with a cold turkey.  It's good you went off of sooner rather than later.  

 

20 hours ago, Sturm said:

I am still getting a bit of nausea, especially evenings. I hope the withdrawal is coming to an end. As of today, it has been I believe 24 days since I have quit Effexor.

It sounds like your withdrawal symptoms are pretty minimal at this point.  Consider yourself very fortunate.  However, remember about windows and waves.  If you have a wave (worse symptoms) try not to be too alarmed, and don't jump back on any drugs impulsively.  

 

So, just to clarify, are you still on these drugs: lorazepam 2.5 mg, and clonidine/catapres?  If so, please add these to your signature box.  What dose of clonidine are you on? 

Edited August 15, 2022 by getofflex

[Sturm]

48 minutes ago, getofflex said:

Sure, no problem at all.  

 

That's really good.  I'm glad to hear this. 

 

We mainly need to see a complete and accurate list of the drugs in the past 18-24 months.  Don't worry too much about the time before that.  

 

I see you were recently on haloperidol and Abilify.  How many weeks were you on the haloperidol?  

 

As long as you were on it less than a month, you should be OK with a cold turkey.  It's good you went off of sooner rather than later.  

 

It sounds like your withdrawal symptoms are pretty minimal at this point.  Consider yourself very fortunate.  However, remember about windows and waves.  If you have a wave (worse symptoms) try not to be too alarmed, and don't jump back on any drugs impulsively.  

 

So, just to clarify, are you still on these drugs: lorazepam 2.5 mg, and clonidine/catapres?  If so, please add these to your signature box.  What dose of clonidine are you on? 

I was on haldol / haloperidol for around a month before dropping it, same as Abilify. It was pretty terrible. I had insomnia and akathisia during the entire time I was on it (which is pretty typical). It was a low dose, however. I’ll have to ask my mother. I think it was only around 1 or 2mg.

 

I was actually unable to sleep with my regular clonidine last night, so I used 1mg lorazepam (I have a prescription for 1mg and 2,3mg). It eventually put me to sleep. It is possible the insomnia actually isn’t completely over yet, and I misjudged it to be prematurely.

 

it is also a possibility that the insomnia I had last night was due to Abilify withdrawal, and to be honest, I feel like a zombie today. It doesn’t even feel like the Effexor withdrawal. I feel like a zombie and was thinking it might be from the Abilify. It has been almost a week since I last took it. At the same time though, I was only on it for around 4 weeks and was only taking 5mg. What are the chances that I actually would experience a withdrawal from that? Maybe I am just overthinking things.

 

i’ll also update my signature. I’m no longer taking the 2,5mg lorazepam, especially since I only had a few tablets from that (I never filled the prescription I had from it). It is also worth noting that I have two psychiatrists, one in the US, and one in Austria, since I spend some time in the US (I am a dual citizen). The psychiatrist in the US is the one who put me on both Haloperidol and Abilify (and she even wanted me to stay on the former!!!). The reason I was put on both to begin with was due to these antipsychotics’ ability to apparently suppress disturbing thoughts (which I would say is accurate) I often have.

 

If the Insomnia actually isn’t over as I thought it was, and I am also dealing with withdrawal from Abilify, do you think it would be worthwhile to try to get admitted into a hospital?

[getofflex]

On 8/15/2022 at 4:55 PM, Sturm said:

it is also a possibility that the insomnia I had last night was due to Abilify withdrawal, and to be honest, I feel like a zombie today. It doesn’t even feel like the Effexor withdrawal. I feel like a zombie and was thinking it might be from the Abilify

The insomnia itself can make one feel like a zombie.  I feel that way when I've had insomnia.  

 

On 8/15/2022 at 4:55 PM, Sturm said:

What are the chances that I actually would experience a withdrawal from that? Maybe I am just overthinking things.

You might be having some WD from the Abilify, but this should resolve itself as time goes by. Since you've made a lot of drug changes recently, it's hard to know what is causing what.  That is why we suggest only going off one drug at a time.  

 

On 8/15/2022 at 4:55 PM, Sturm said:

I’m no longer taking the 2,5mg lorazepam, especially since I only had a few tablets from that

OK, were you taking this regularly, and if so, please indicate the start and stop dates of this.  You've been making quite a few drug changes all at once.  We discourage doing that, because it tends to exacerbate and complicate withdrawal.  So, the only drug you are on now is the clonidine?  Please do clarify your drug history, and what drugs you are currently on, as well as all drugs you've been on the last 1.5 to 2 years.  We can't give you the help you need if we don't have accurate and complete information about your drugs. 

 

On 8/15/2022 at 4:55 PM, Sturm said:

If the Insomnia actually isn’t over as I thought it was, and I am also dealing with withdrawal from Abilify, do you think it would be worthwhile to try to get admitted into a hospital?

 

I personally would not do this.  They will just add more psychoactive drugs to you, to deal with your insomnia.  This puts you at risk or worsening your nervous system destabilization, and keeps you on the drug merry go round.  Please realize that insomnia will not kill you.  I know it is really miserable when you cannot sleep, but eventually, with proper self care, your insomnia will resolve.  This was my worst WD symptom.  And, there are non drug ways to help with insomnia.  Have you tried melatonin? Here is some information that may help: 

 

Melatonin for Sleep

 

Withdrawal Insomnia

 

My Insomnia Tips

 

Insomnia has been the worst part of WD for me.  Here is what I do to help.  

 

1) don't get overly anxious about it.  Realize that eventually, your sleep will improve.  Insomnia won't kill you, although it can make you pretty dang miserable.  Anxiety about sleep just makes the problem worse.  I know, easier said than done. I don't always do this, but I try.  Practice acceptance.

 

2)listen to very soft relaxing music at a very low volume.  

 

3)don't worry about what time it is.  Don't look at the clock.  

 

4) I try to stay active during the first half of the day.  I take a walk (mine is one hour) after breakfast every day.  Then, as the day goes on, gradually slow down.  Several hours before bed, I only do very relaxing things, like read, or just sit and relax.  This helps to set our circadian rhythm.  Try to get outside and get some light exposure during the day, too. 

 

5) Avoid toxic, negative people.  Avoid stress when possible, although I know a lot of stressors are unavoidable.   For me, this can really help me to relax better.  

 

6) I stay away from MSG and aspartame.  These are exitotoxins which overstimulate the nervous system.  They are in a lot of our modern processed foods.  I try to eat more whole and natural, and not as many processed foods.  Also avoid processed meats with sodium nitrate, etc , such as hotdogs, ham, bacon, and sausage.  These can keep you up at night too.

 

7) avoid eating large amounts of sugar and processed carbohydrates.  This causes your blood glucose to spike up, which causes your pancreas to create insulin to control your blood sugar, which then causes your blood sugar to drop too low, and then your to create adrenaline to try to regulate your blood sugar.  Adrenaline keeps you awake because it is an activating hormone.

 

9) too much sodium (salt) can cause your blood pressure and heart rate to rise, and make it hard to sleep.

 

 

Edited August 17, 2022 by getofflex

[Sturm]

4 hours ago, getofflex said:

The insomnia itself can make one feel like a zombie.  I feel that way when I've had insomnia.  

 

You might be having some WD from the Abilify, but this should resolve itself as time goes by. Since you've made a lot of drug changes recently, it's hard to know what is causing what.  That is why we suggest only going off one drug at a time.  

 

OK, were you taking this regularly, and if so, please indicate the start and stop dates of this.  You've been making quite a few drug changes all at once.  We discourage doing that, because it tends to exacerbate and complicate withdrawal.  So, the only drug you are on now is the clonidine?  Please do clarify your drug history, and what drugs you are currently on, as well as all drugs you've been on the last 1.5 to 2 years.  We can't give you the help you need if we don't have accurate and complete information about your drugs. 

 

 

I personally would not do this.  They will just add more psychoactive drugs to you, to deal with your insomnia.  This puts you at risk or worsening your nervous system destabilization, and keeps you on the drug merry go round.  Please realize that insomnia will not kill you.  I know it is really miserable when you cannot sleep, but eventually, with proper self care, your insomnia will resolve.  This was my worst WD symptom.  And, there are non drug ways to help with insomnia.  Have you tried melatonin? Here is some information that may help: 

 

Melatonin for Sleep

 

Withdrawal Insomnia

 

My Insomnia Tips

 

Insomnia has been the worst part of WD for me.  Here is what I do to help.  

 

1) don't get overly anxious about it.  Realize that eventually, your sleep will improve.  Insomnia won't kill you, although it can make you pretty dang miserable.  Anxiety about sleep just makes the problem worse.  I know, easier said than done. I don't always do this, but I try.  Practice acceptance.

 

2)listen to very soft relaxing music at a very low volume.  

 

3)don't worry about what time it is.  Don't look at the clock.  

 

4) I try to stay active during the first half of the day.  I take a walk (mine is one hour) after breakfast every day.  Then, as the day goes on, gradually slow down.  Several hours before bed, I only do very relaxing things, like read, or just sit and relax.  This helps to set our circadian rhythm.  Try to get outside and get some light exposure during the day, too. 

 

5) Avoid toxic, negative people.  Avoid stress when possible, although I know a lot of stressors are unavoidable.   For me, this can really help me to relax better.  

 

6) I stay away from MSG and aspartame.  These are exitotoxins which overstimulate the nervous system.  They are in a lot of our modern processed foods.  I try to eat more whole and natural, and not as many processed foods.  Also avoid processed meats with sodium nitrate, etc , such as hotdogs, ham, bacon, and sausage.  These can keep you up at night too.

 

7) avoid eating large amounts of sugar and processed carbohydrates.  This causes your blood glucose to spike up, which causes your pancreas to create insulin to control your blood sugar, which then causes your blood sugar to drop too low, and then your to create adrenaline to try to regulate your blood sugar.  Adrenaline keeps you awake because it is an activating hormone.

 

9) too much sodium (salt) can cause your blood pressure and heart rate to rise, and make it hard to sleep.

 

 

At the moment I am also getting Akathisia again. I confuse it often for RLS, but I don’t think it is actually RLS since it appears to be related to medications (in this case, probably Abilify), and lasts the entire day, whereas RLS apparently only occurs at night for the majority of people. So it probably is more accurately described as Akathisia. And yeah, it really sucks. It is worse than regular insomnia.

 

It takes around 15-16 days for Abilify to leave the body completely, I think (75 hour half live x 5 half life cycles = 15 or 16 days)?

 

And yes, I’ll update my signature (edit: finished). I’m sort of not good at keeping a detailed list of medications, but I understand it is really important now.

 

To deal with the recurrent Akathisia, do you think Propranolol would be worth trying? At least for a little bit?

[Altostrata]

Welcome, @Sturm

 

As I understand it, since June you have been on and off lamotrigine, venlafaxine, Prozac, Haloperidol, and Abilify?

 

For what reason have you been taking all these drugs since 2015? You started with sertraline only, is that correct? Why the trials of all the other drugs?

 

When did you get this symptom you call akathisia before?

[Sturm]

2 hours ago, Altostrata said:

Welcome, @Sturm

 

As I understand it, since June you have been on and off lamotrigine, venlafaxine, Prozac, Haloperidol, and Abilify?

 

For what reason have you been taking all these drugs since 2015? You started with sertraline only, is that correct? Why the trials of all the other drugs?

 

When did you get this symptom you call akathisia before?

Yes, that’s correct. I had a really bad depression and tried killing myself around 30 times. I believe the Effexor / Venlafaxine played a big role in my suicide ideation / behaviour. I was extremely suicidal whilst on it, and I haven’t been nearly as much since getting off, despite the ensuing withdrawal and problems with other meds since then. I got a psychiatrist who put me on Haloperidol (I was already on Venlafaxine, and Lamictal at the time) which is when I experienced the Akathisia symptoms for the first time. I was on Haloperidol for around a month. I got off that and was put on Abilify shortly after, which I now believe also causes Akathisia (a common occurrence with antipsychotics). I decided I didn’t want to be on Abilify within the last two weeks. It has been around 10 days since I last took any Abilify. I’m really hoping the new wave of insomnia and akathisia ends as the Abilify fully leaves my body (which happens around the 16 day mark), or hopefully even before.

 

The Prozac / Fluoxetine just acted as a ‘bridge’ to minimise the withdrawal from getting off Effexor. I only took it for around 13-14 days max. I originally only took it for the first 8 days of being off of Effexor (I mistakenly thought the withdrawal was over due to lack of symptoms at the time), but went back on when I realised the withdrawal actually wasn’t over, for a few more days.

 

One of the main reason I decided to get off of so many medications around the same time is due to my interest in pursuing psychedelics (due to many reasons, especially the ability of DMT and LSD in treating depression). SSRIs / SNRIs block and/or diminish the effects of many psychedelics, and I was unable to use them properly when I was on many of these medications. I later found out that Abilify also conflicted with many classical psychedelics. I wish I did proper research and found out about that before getting on it! I hope I don’t get in trouble for mentioning psychedelics.

[Sturm]

The akathisia was horrible last night. It still is terrible. Apparently it does sometimes manifest within two weeks of abruptly stopping an antipsychotic. The timing, around 9-10 days after having my last Abilify dose, does seem to fit. My anxiety has also skyrocketed around this issue.
 

I was wondering, should I reinstate Abilify 5mg, and taper off of it? These side effects from the presumed withdrawal are *really* bad and uncomfortable (mainly speaking about Akathisia). I can deal with a lot of things, I dealt with the Effexor withdrawal, but this…I really cannot take having to move around 24/7. It’s beyond awful. Does a reinstatement to taper sound alright in this case?

[Altostrata]

How do you feel the akathisia? Please give more detail.

 

How did you feel when you were taking Prozac as compared to after you went off?

 

Since you took Prozac on August 7, how has your symptom pattern changed?

 

What times o'clock do you take your current drugs, with their dosages?

[Sturm]

1 hour ago, Altostrata said:

How do you feel the akathisia? Please give more detail.

 

How did you feel when you were taking Prozac as compared to after you went off?

 

Since you took Prozac on August 7, how has your symptom pattern changed?

 

What times o'clock do you take your current drugs, with their dosages?

The akathisia feels like it does for most people. Inner restlessness, inability to sit still, and all that. It was pretty severe, but seems to have died down a lot in the past few hours. I’m not nearly as restless right now, and can even lay in bed without having to get up in 5 seconds. I think reinstating Abilify 5mg probably had something to do with that (since the extreme Akathisia first came about a week and a few days off of Abilify). I also took around 60mg of Propranolol and 1mg of Benzatropine (Cogentin) around midday, which didn’t seem to do anything but I’m not sure now. I believe Propranolol is a pretty safe medication. Cogentin I’m not so sure.

 

So…right now.

Cogentin 1mg (taken around 2:00 PM)

Propranolol 10mg x 6 (60mg), taken the same time as Cogentin.

Abilify 5mg (taken around 10:00-12:00)

Clonidine 0,3mg x2 (bedtime, around 10:00-12:00). Ofc I still could not sleep.

 

[Sturm]

As for the Prozac (I didn’t edit the last post in time, sorry), I only used it for no more than two weeks. Originally I thought my withdrawal from Effexor ended around the 8 day mark, so I stopped taking Prozac for around that time. Around a week after discontinuing it. i took it again for three more days, hoping it would help with the Effexor withdrawal again. I’m not sure it did anything at that point. By the 10th of August or so, I was off Prozac again. I haven’t taken it since (it was 10mg). I don’t think it really changed my symptom pattern. Do you think it could have caused some sort of issue?

 

i’m not sure it did anything at that point tbh. The Prozac was mainly probably most useful during the first week of Effexor discontinuation.

 

As for Cogentin, do you know anything about it? I was reading and apparently it can cause lots of eye problems. I was previously using it for around a month when I was on Haloperidol. I was inconsistent with taking it, however.

[Altostrata]

17 hours ago, Sturm said:

I think reinstating Abilify 5mg probably had something to do with that (since the extreme Akathisia first came about a week and a few days off of Abilify). I also took around 60mg of Propranolol and 1mg of Benzatropine (Cogentin) around midday, which didn’t seem to do anything but I’m not sure now. I believe Propranolol is a pretty safe medication.

 

Sorry, we can't help you while you're changing your drugs. We cannot advise you on creating a drug cocktail.

 

Please let us know when you want to taper your drugs.

[Sturm]

1 hour ago, Altostrata said:

 

Sorry, we can't help you while you're changing your drugs. We cannot advise you on creating a drug cocktail.

 

Please let us know when you want to taper your drugs.

I’m not wanting to create a drug cocktail. I haven’t slept in three days. All I wanted was some temporary relief from the Akathisia (it is literal hell to deal with), and I heard both Propranolol and Cogentin could do that. It turns out that actually Vitamin B6 was probably the reason why the Akathisia stopped last night for a few hours. I used it today too, and the same effect happened within a few hours. Vitamin B6, at least for me, appears to temporarily get rid of Akathisia.
 

How exactly do I taper Abilify, considering I have the lowest dose for it (which is 5mg) in many countries? Do I get the liquid Abilify and taper it from there? I should have tapered it from the beginning, instead of going cold turkey on it, but the past is the past.

[Sturm]

Can I have some help with the Akathisia? It’s torture. What can I do? 

[Sturm]

7 hours ago, Sturm said:

Can I have some help with the Akathisia? It’s torture. What can I do? 

It went away for a bit laat night, but came back and now seems worse. The wave seems worse.
 

can it going away briefly be classified as a window? Do windows mean I am healing?

[Altostrata]

Have you been taking vitamin B6 regularly?

 

What date did you reinstate 5mg Abilify?

[Sturm]

22 minutes ago, Altostrata said:

Have you been taking vitamin B6 regularly?

 

What date did you reinstate 5mg Abilify?

I haven’t really been taking Vitamin B6 regularly. The past few days, and I might not take it anymore due to concerns about toxicity. Also it is possible that it didn’t get rid of the Akathisia during those days, but rather was a complete coincidence. I wasn’t taking insane amounts of it. I took between 100-150mg of it for two days. 

 

I reinstated the 5mg Abilify on the 17th iirc. Reinstating it didn’t get rid of the Akathisia though, as I thought it might have. Does it take a few days for Abilify to enter my system? If this was an SSRI withdrawal, taking it again would clear the withdrawal within a day. Not sure how that works for Abilify though.

 

Unless the Akathisia is actually not a result of withdrawal from Abilify. I assumed it was due to the time it first appeared (a week to 10 days after stopping it CT, which apparently is when withdrawal from Abilify would normally occur initially). Withdrawal from Abilify definitely can cause Akathisia. 

 

As for the Akathisia going away for a brief time during the last three days, is that a good sign? I think that would be considered a window, correct? 
 

I’m really hoping the Akathisia isn’t long-term or permanent, because it is the hardest thing to tolerate ever.

[Altostrata]

26 minutes ago, Sturm said:

I reinstated the 5mg Abilify on the 17th iirc.

....

As for the Akathisia going away for a brief time during the last three days, is that a good sign? I think that would be considered a window, correct? 

 

It may well be that the Abilify you started on August 17 relieved your withdrawal akathisia at a low dose as it was getting into your system, but since then, it's ramped up to a higher drug plasma level and is now paradoxically causing akathisia. Suggest you lower the dosage to 2.5mg and let us know how you're doing.

[Sturm]

7 minutes ago, Altostrata said:

 

It may well be that the Abilify you started on August 17 relieved your withdrawal akathisia at a low dose as it was getting into your system, but since then, it's ramped up to a higher drug plasma level and is now paradoxically causing akathisia. Suggest you lower the dosage to 2.5mg and let us know how you're doing.

Okay, I’ll do that.

 

So you seem to think the Abilify is causing the Akathisia?

[Sturm]

I haven’t noticed any real changes since reducing to 2,5mg. Akathisia still present. Hadn’t had a window yet either.

 

Would it probably take a few days?

[Altostrata]

16 hours ago, Sturm said:

Would it probably take a few days?

 

Yes.

 

Please read up on the adverse effects of all your drugs.

[Sturm]

2 hours ago, Altostrata said:

 

Yes.

 

Please read up on the adverse effects of all your drugs.

The Akathisia does sort of seem reduced. I had a five hour flight today and barely even got up during it. I wouldn’t have been able to do that a few days ago. So yes…I think cutting to 2,5mg probably does have an effect. I still have a tingling sensation in my legs, but I am not getting up as much as before or pacing as much.

 

How long would you consider it to take after cutting the dosage to 2,5mg?

[Sturm]

I felt a lot better earlier. Now I feel a lot more jittery and am all over the place again. I also feel like my arms are getting a similar prickly feeling like my legs.

 

What does that mean exactly? Should I reinstate the 5mg Abilify since maybe the 2,5mg was too fast of a taper again?

[getofflex]

On 8/21/2022 at 1:28 PM, Altostrata said:

It may well be that the Abilify you started on August 17 relieved your withdrawal akathisia at a low dose as it was getting into your system, but since then, it's ramped up to a higher drug plasma level and is now paradoxically causing akathisia. Suggest you lower the dosage to 2.5mg and let us know how you're doing.

 

On 8/21/2022 at 1:37 PM, Sturm said:

Okay, I’ll do that.

 

On 8/22/2022 at 1:05 AM, Sturm said:

I haven’t noticed any real changes since reducing to 2,5mg. Akathisia still present. Hadn’t had a window yet either.

 

Would it probably take a few days?

 

13 hours ago, Altostrata said:

Yes.

 

 

10 hours ago, Sturm said:

The Akathisia does sort of seem reduced. I had a five hour flight today and barely even got up during it. I wouldn’t have been able to do that a few days ago. So yes…I think cutting to 2,5mg probably does have an effect. I still have a tingling sensation in my legs, but I am not getting up as much as before or pacing as much.

 

How long would you consider it to take after cutting the dosage to 2,5mg?

 

6 hours ago, Sturm said:

I felt a lot better earlier. Now I feel a lot more jittery and am all over the place again. I also feel like my arms are getting a similar prickly feeling like my legs.

 

What does that mean exactly? Should I reinstate the 5mg Abilify since maybe the 2,5mg was too fast of a taper again?

 

Considerations About Stability - Stop Jumping Around!

 

 

Windows and Waves Pattern of Stabilization

[Sturm]

Do windows and waves generally mean I am recovering? I agree that what I was experiencing earlier was a window (also the times a few days ago when the feelings of akathisia stopped), and what I am experiencing now is a wave of increased symptoms. 
 

i’m just terrified that this thing may last a very long time. I can't afford to waste my life waiting for it go away. 
 

I should just stay on the 2.5mg Abilify and wait for things to stabilise? How long does it take for it to stabilise? Weeks, months, years? I cannot put my life on hold waiting for it, which is another part of the problem. 
 

could part of the problem be anxiety?

[getofflex]

6 hours ago, Sturm said:

Do windows and waves generally mean I am recovering?

Yes, this is a very normal part of the nervous system stabilizing.  

 

6 hours ago, Sturm said:

I should just stay on the 2.5mg Abilify and wait for things to stabilise? How long does it take for it to stabilise? Weeks, months, years?

That is what I would do, if I were you.  I don't know how long it will take to stabilize, it is different for each person.  Please read 

 

Stability

 

How Long is Withdrawal Going to Take, Factors Affecting Withdrawal

 

What is Happening in Your Brain? (Explains why recovery takes so long)

 

6 hours ago, Sturm said:

could part of the problem be anxiety?

Yes, it very much could be.  It probably is. Please try to distract yourself with other things, and not think about and worry about your symptoms.  As the links have suggested, this will eventually improve, with proper self care and time; stop jumping around on the drugs, and eventually taper yourself off the drugs. I strongly suggest you learn to rely on non drug coping techniques, see the link in my first post above.  Also, these links about anxiety.  

 

Emotional Spirals

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

 

15 hours ago, ChessieCat said:

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk

 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

 

 

Meditation

 

 

[Sturm]

Are windows only when the symptoms temporarily go away completely, or are windows also any positive improvement in symptoms (not just when they go away temporarily)? I’m wondering because the akathisia symptoms haven’t completely gone away in a while, but I do experience times where the symptoms aren’t as severe (before spiking)? Is this also considered a window?

 

Basically I’m asking if a window is only 100% relief from symptoms to be considered a window. If the akathisia was less severe and more manageable for a few days, is that likewise considered a window? I believe I am going through a wave atm.

 

When the akathisia first appeared (around 18 days ago), I couldn’t sit still for 5 seconds. I was pacing around 20.000 steps some days. I couldn’t lay down either. I couldn’t sit down long enough to even eat. Now I can lay down fairly well (although am a bit fidgety) and was even able to survive a 5 hour plane ride around a week and a half ago. Should I view this as a sign that I am healing?

[Altostrata]

If you feel better, it's a window.

[Sturm]

4 hours ago, Altostrata said:

If you feel better, it's a window.

So windows do not necessarily have to be 100% relief? They can be partial improvement of symptoms?

 

I had a rough evening yesterday and I view that as a wave. But I’m doing better again today it seems. Another window? The fact that I’m having a lot of windows (never 100% relief though really) I view as a positive thing.

 

I’m concerned that when I taper the Abilify it will just make it worse. Is this a legit concern or unlikely to occur if I taper slowly? The problem is, I cannot spend a year trying to slow taper Abilify. I want to get off of it as soon as possible (especially considering that the longer one is on Abilify, the greater the risk of TD occurring is). There is also the concern that the akathisia won’t go away completely until I am fully off of Abilify again.

 

Can withdrawal akathisia persist after reinstating the medication? That’s another weird thing with my case. As explained, the akathisia appeared within 10 days of CT on Abilify 5 mg. It, however, hasn’t gone away (although it has gotten better) since I reinstated the Abilify. I really pray that it does not last months or years, otherwise I definitely will become suicidal again.

 

i apologise for the rumination. However, rumination is another symptom of akathisia.

[Altostrata]

In stabilizing, we expect the waves to get shorter, less frequent, and less intense and the windows to get longer, more frequent, and more like "normal". This appears to be happening for you.

 

If you want windows to increase, you should be careful not to overdo activity in any way. High stress could set you back.

 

Is rumination perhaps a longstanding habit of mind for you?

[Sturm]

1 hour ago, Altostrata said:

In stabilizing, we expect the waves to get shorter, less frequent, and less intense and the windows to get longer, more frequent, and more like "normal". This appears to be happening for you.

 

If you want windows to increase, you should be careful not to overdo activity in any way. High stress could set you back.

 

Is rumination perhaps a longstanding habit of mind for you?

I also tested positive for Coronavirus yesterday. The fever has already seemingly broken, however. Could this cause any issues or unlikely to?

 

And yes, rumination is something I’ve had a lot of in the past. The akathisia has made it worse though.

[Altostrata]

If I were you, I would not make any changes in your psychiatric drugs until you are fully recovered from covid.

[Sturm]

4 hours ago, Altostrata said:

If I were you, I would not make any changes in your psychiatric drugs until you are fully recovered from covid.

Understandable.

 

Since the akathisia improved once I reinstated Abilify 5mg, does this mean that it isn’t tardive akathisia?

[Altostrata]

2 hours ago, Sturm said:

Since the akathisia improved once I reinstated Abilify 5mg, does this mean that it isn’t tardive akathisia?

 

Correct, it was a withdrawal symptom.