Casbear98: tapering off venlafaxine

[casbear98]

Hello! I am very lucky to have found this site right at the start of my weaning off process. 

 

For context, I started taking Venlafaxine XR 75mg in August 2020 after a traumatic event left me unable to function due to constant severe anxiety. I have since done psycho-therapy and generally feel "fine" except for persistent suicidal thoughts and ideation. At first, we thought these were related to the traumatic event, but as time progressed, I began to feel that the drug was the cause.

 

I have asked to come off the drug before but all my providers were against it because of the thoughts. One tried to switch me to Zoloft but it made me feel worse so I hopped back. I'm tired of feeling this way. Psychotherapy hasn't helped with this particular problem. I have always had GAD and was managing fine pre-trauma and, honestly, the Effexor doesn't help the anxiety That much. I still have to use pre-med techniques to get through most stuff, even the little things. 

 

Monday, I told my doctor that I'm coming off. I want to get a baseline of my new normal, and go from there. My doctor had me do a 50% reduction 5 days ago (June 25, 2023) to 37.5mg. I had some nausea, headaches, irritability, and restlessness the first day. But since then I have had no withdrawal symptoms AND I've seen significant reduction in suicidal ideation (from frequent throughout the day to less than once a day). I also no longer have periods of listlessness (you know, laying on the couch miserable with no motivation to do anything). 

 

I will wait out the next week as told, but I'm not skipping doses like prescribed. Because I haven't had significant withdrawal symptoms, I was wondering if I could/should do another 50% reduction (I know about counting beads and all that). I understand that 10% is safer, but with such a serious side effect, I think it may be worth the risk to come off fast. 

 

Please share your thoughts, opinions, and experiences! Thank you in advance! 

[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 glad to hear you had only minimal withdrawal from the 50% reduction.  I will give you some basic information about how these drugs affect us, and and about withdrawal, then some specific suggestions.  

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months? Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Your Drug History in Your 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

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Effexor and Effexor XR/Venlafaxine

 

 

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

 

Keep It Simple, Slow, and Stable

 

 

Even though you are not having any withdrawal symptoms at this time that you are aware of, there is a strong possibility that your nervous system is still trying to adjust to this major reduction in your venlafaxine XR dosage.  There is also a good chance that you may be hit with some withdrawal symptoms in the future, as your system works to achieve equilibrium after this as well.  Some people don't get hit with withdrawal until several months after they reduce or jump off their drugs.  I strongly suggest that you do not make any more changes to any of your drugs for at least several months.  If it were me, I would wait 3-6 months, and see how things go.  If you rush things, and go into major destabilization, it can take many months to years to recover.  (this happened to me). If you do OK during this hold period, then I would carefully do a reduction of 10% of the current dose.  That would be 37.5 mg x 0.9 = 33.75, round up to 33.8 mg.  The link above on Tapering Effexor will explain how to measure the nonstandard doses.  And, I'm glad you are not going to skip doses as prescribed.  I don't know why doctors recommend this - it is like playing ping pong with our brains.  Consistency is very important when tapering off psych meds.  Same dose at same time of day every day.  Please keep us posted, and let us know how you are doing. 

Edited July 1, 2023 by getofflex

[getofflex]

There are ways to cope with thoughts of SI (suicidal ideation) in the meantime: 

 

For Those Who are Feeling Desperate and as if They Can't Go On.

 

Here is an excellent quote by Altostrata, the founder of this forum: 

 

 

On 7/30/2015 at 12:56 PM, Altostrata said:

Please note, folks -- Thinking of suicide is not unusual and, by itself, is not a mental disorder, nor is it "suicidality." Many people think of suicide as one of their options when confronting a difficult life problem.

 

Please do not add to your distress by considering yourself mentally damaged because you consider suicide, and therefore make yourself more desperate.
 
The thought of suicide is a great consolation: by means of it one gets successfully through many a bad night.
—Friedrich Nietzsche, Beyond Good and Evil

 

Not everyone is happy all the time. Some people have gloomy dispositions. Having negative thoughts might be something you need to accept in yourself. With self-acceptance will come a greater peace.

 

 

 

Emotional Spirals

 

Acknowledge Accept Float

 

 

APPLE Technique

 

I just came across a very nice technique that really helps me.  It's called APPLE. I have printed it and have it where I can see it every day and be reminded of it so I internalize this technique. 

 

A - Acknowledge Notice and acknowledge the thought or uncertainty as it comes to mind. 

 

P - Pause Don't react as you normally do.  Don't react at all.  Just pause and breathe.   

 

P - Pull Back Tell yourself this is just the thought or worry talking, and this apparent need for worry or analysis or certainty is not helpful and not necessary.  It is only a thought or feeling.  Don't believe everything you think.  Thoughts are not statements or facts.   

 

L - Let Go Let go of the thought or feeling.  It will pass.  You don't have to respond to it.  You might imagine the thought floating away in a bubble or cloud.   

 

E - Explore Explore the present moment, because right now, in this moment, you are OK.  Notice your breathing and the sensations of your breathing.  Notice the ground beneath you.  Look around and notice what you see, what you hear, what you can touch, what you can smell.  Right now.  Then shift your focus of attention to something else - on what you need to do, on what you were doing before you noticed the thought or worry, or do something else - mindfully - with your full attention.  

Edited July 1, 2023 by getofflex