MarieF: Protracted withdrawal from Effexor

[MarieF]

Hi all,

I am seeking your advice on my persistent symptoms after coming off of Effexor 150 mg three years ago and would be immensely grateful to hear your opinions on the alternatives I have.

Here is my story: I was on antidepressants over a period of 20 years, with some breaks in between, on different SSRIs/SNRIs and dosages. In the beginning, the tablets seemed to help, but this effect wore off over time and I was more and more reluctant to swallow tablets while still being chronically depressed.

In 2019 I felt stable enough and discontinued the medication twice. Unfortunately, I had no clue about the risks and how to taper off safely. I had no adverse effects until 3-4 months after the discontinuation. I believed my doctor that this was a relapse, went back on and was quickly ok again. In 2020, after having learned about delayed withdrawal symptoms I started a new taper using tapering strips over a 6 months period. Unfortunately, still far too quick. Again, I had no problems during the taper, but hell started once I was on zero in August 2020. I have not recovered since then.

The physical symptoms in the acute phase included insomnia, weight loss, diarrhea, vertigo, night sweats, tinnitus. The mental symptoms were far worse – I couldn’t be alone, suffered from immense anxiety, inner restlessness, anhedonia, suicidal ideation, felt very much impaired with regard to planning, deciding, executing.

What has improved: I have regained 6 kg, gastrointestinal issue are rare, no vertigo or night sweats anymore. But these were minor things.

What tortures me most today is the persistent insomnia (can go to sleep, but wake up 3-5 hours later), anxiety, severe cccdepression, anhedonia, unability to feel well and have positive emotions, suicidal ideation.

Over the 3 years in protracted withdrawal I tried the usual things: naturopathic treatment, homeopathy, yoga, nutritional supplements, Gupta program, hormone replacement therapy, psychotherapy, spent 5 weeks in clinic. I use intermittently sleep teas, melatonine, valerian, lavender oil and occassionally sleeping pills and lorazepam as an emergency medication.   

I am 58 years old, female, and live with my husband and daughter in Germany. I am currently employed, working mostly from home and fear I can’t keep this up due to my deteriorating state. 

My symptoms are permanent, i.e. no windows and waves, but I get better in the evening. I feel I have reached a point where I can’t go on. I am too exhausted fighting this level of anxiety and depression in a sleep-deprived mode. I have not seen any real improvements to sleep or the mental stuff in these three years.

I consider going back on medication. I know I need to consult a doctor, but as you know they have no knowledge about withdrawal. Can I have your opinon please? Going back on Effexor, if so what dosage? Taking a sedating AD like mirtazapine to help with sleep? Other sleep medication? Tricyclics? I wonder if it is the lack of sleep that prevents me from recovering.

Thank you so much for taking the time to respond! I greatly appreciate the work you do here, I really do!

All the best

Marie

 

 

 

 

 

 

 

[Catina7]

Hello @MarieF and welcome to the site!  We're so glad you found us.  😊

 

I'm so sorry to hear of your immense struggles with your protracted withdrawal symptoms.  Sometimes these symptoms can last for a long time, but the good news is that most people do eventually recover.  We have an entire section here about people that have gone through similar things and they did recover:  https://www.survivingantidepressants.org/forum/28-success-stories-recovery-from-psychiatric-drug-withdrawal/

 

Many people here have struggled with insomnia.  Here's a link that talks about that:  Tips to help sleep: so many of us have that awful withdrawal insomnia .  What type of "sleeping pills" do you take?

 

Here are some other helpful links for you:

 

The Windows and Waves Pattern of Stabilization

Are We There Yet? How Long is Withdrawal Going to Take?

"Is it always going to be like this?"

Protracted Withdrawal or PAWS (post-acute withdrawal syndrome)

Withdrawal dialogues & encouragement

Non-drug techniques to cope with emotional symptoms

 

We don't offer advice on going back on drugs; you'd have to discuss that with your doctor.  We only help people who are wanting to taper off of them.  What we can do is help you to make your situation more manageable, give you hope and encouragement, and offer emotional support.  Two supplements that have shown to help many is taking a high-quality fish oil and magnesium glycinate.  You can try them to see if they help with any of your symptoms.

 

One thing we do require of new members is that they summarize their drug history in their profile so we can offer you the best help possible:  summarizing your drug and withdrawal history in your signature

 

We look forward to helping you and working with you to get you feeling better and keeping hope alive that you will recover!

 

With Kind Regards,

Catina ❤️

Edited August 25, 2023 by Catina7

[getofflex]

Hello Marie, welcome to SA.  I'm very sorry to hear you have been feeling so poorly in the past 3 years.  

 

On 8/23/2023 at 8:22 AM, MarieF said:

Over the 3 years in protracted withdrawal I tried the usual things: naturopathic treatment, homeopathy, yoga, nutritional supplements, Gupta program, hormone replacement therapy, psychotherapy, spent 5 weeks in clinic. I use intermittently sleep teas, melatonine, valerian, lavender oil and occassionally sleeping pills and lorazepam as an emergency medication.   

It is quite possible that the trials you describe above may have exacerbated an already sensitized nervous system.  It is quite natural to want to fix something that is broken, but the best way to heal from this is natural self care and time, time, and more time.  Please read this post by one of our senior staff: 

 

On 9/18/2021 at 1:42 PM, brassmonkey said:

Trusting that your body knows what needs to be done to heal and will do it naturally is one of the hardest parts of doing this. The amount of trust that we have to have is amazing and the ability to accept what happens and move through it, even if it isn't what we had planned, is equally so. We have all been taught to think things  through and do what we think is best, but sometimes our logic gets the best of us. We can think too much and see too many sides of the coin.

 

To me ADWD is proof that nature is in control despite what we think. In most cases we have to get out of the way and let it happen. We may want a specific outcome by next weekend, but the choice isn't ours. If our body wants to heal in that direction by them it may happen, but usually it needs to do something else, which it knows is more important for the healing process. It doesn't really care what our weekend plans are, but rather knows what it needs to do to heal.

 

Giving up that control is very hard because we think about the problem too much.

If it were me, I would discontinue the valerian, sleeping pills, and lorazepam.  These may also be interfering with your healing.  Instead try working on your sleep hygiene, and natural things that aid sleep. 

 

Tips to Help Sleep for Withdrawal Insomnia

 

 

On 5/25/2021 at 4:51 PM, Gridley said:

here is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

 

Also, are your currently drinking alcohol, or using any other mind altering drugs or substances?  If so, this can cause problems, and it is suggested you stop these things.  

 

Unfortunately, the nervous system is very complex, and takes a long time to heal, but the good news is, that eventually, given proper self care, it will.  

[alex01]

Hi MarieF,

 

 Unfortunately, I've been going through something very similar to your case. I used paroxetine for 8 years, I stopped in a very short time (less than 3 months) due to erroneous advice from my psychiatrist. I went through one of the worst hells of my life in the first two years of withdrawal.  I have now 3.5 years of withdrawal, several symptoms have improved (extreme irritation, extreme insomnia, panic, suicide ideation) but I still have several debilitating symptoms that are blocking my life too much (fatigue throughout the day, a lot of hypersensitivity to sound, a lot of brain fog, still easily angered, depressive mood, intolerance to physical exercises, etc)

 

 A watershed for me in terms of sleep was magnesium. Have you tried it already ?  I use magnesium threonate. Our nervous system is out of balance and out of control, it seems that magnesium calms the nervous system. I'm able to sleep reasonably again, I don't wake up at 3 a.m. every day anymore. Try magnesium before going back to any psychiatric drug (which I wouldn't do)! I take one pill before bed time. Search the site for magnesium articles. 

 

 Hope you get better!

[MarieF]

Catina and Getofflex,

Thank you for your responses and the links. I have been a silent member for quite some and I have read some of the pages and stories over and over again. But I’ll check them out again!

I use over the counter sleeping pills, Hoggar Night (Doxylamine). But, as I said, very rarely. And I do not drink alcohol.

As requested, I have created my signature – I hope this is alright.

Thank you

Marie

[MarieF]

Hi Alex,

Thank you for sharing your experience! I did try Magnesium Glycinate before and I am back to it now. Yes, it does help. In good nights, it helps me go back to sleep or at least slumber after waking up too early. I am happy if I get 5 hours of sleep. I just wish there was some stability in getting enough sleep. This is not my worst symptom though. What I find most unbearable is this inner state of restlessness, anxiety, depressed mood and hopelessness. Every day, with no abatement in 3 years. Some people wrote that their symptoms improved once sleep was back to normal. This is why I am so much hoping to see a constant improvement in sleep at last.

All the best to you! Hope your improvements will continue.

Marie

[getofflex]

Thank you for your signature - it is very good.  How often do you take the lorazepam on average?  Please add this info to your drug signature - it is very important.  

 

When you say "very rarely" for the use of sleeping pills, is this once a week?  Once a month?  Please be more specific, and just give us an average.  

 

It is quite possible that even though you take these things rarely, if your nervous system is very sensitive, they could still be impeding your full recovery.  They could cause a reaction with your nervous system that could prevent your symptoms from improving.  If it were me, I would stop these things completely, along with the valerian.  

 

I'm glad to hear that the magnesium helps.  

On 8/23/2023 at 8:22 AM, MarieF said:

I am too exhausted fighting this level of anxiety and depression in a sleep-deprived mode.

Have you tried any of the non drug coping techniques?  Here is a link with a list of topics about depression.

 

Search Results for Depression

 

 

Here are some that can help with anxiety.  

 

video: Claire Weekes on Anxiety and Panic

 

Emotional Spirals

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

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
 

[getofflex]

It is also possible the valerian, doxylamine, and/or lorazepam could be having a paradoxical effect.  This means it does the opposite of what it normally does, and instead of sedating us, it causes restlessness and sleeplessness, etc.  Here is our topic on valerian: 

 

Valerian