Alfred1977: I quit Venlafaxine too fast and by skipping doses and now I feel awful

[Alfred1977]

Hi everybody,

I am new here and I would like to talk about my story. And maybe find help or some comfort. I am from Germany, so please be lenient with my English.

The first time I took a SSRI was in 2001, age 24, Paroxetine for depression. In 2003, I guess, I somehow managed to quit it cold turkey. In 2005 I was prescribed Venlafaxine and took it ever since until lately. So for about 18 years. Most of the time 75mg.

 

I felt very dependent for years and never found the courage to tackle this problem. When missing Venlafaxin for 2-3 days I would get instantly heavy brain zaps, depression, crying spells and dizziness making me feel pretty helpless and desperate.

 

End of last year I thought I gotta try to get rid of this or I will be taking Venla for the rest of my life. I went to a psychiatrist and asked him for help explaining that I feel pretty sensitive to the drug. However he encouraged me to simply go ahead and try quitting by using the commercially available doses of 75 and 37,5mg XR and by skipping doses. So I did. From Dez. 2023 until 03/13/2024 I managed step by step to quit Venla. This was quite strenuous and I experienced again and again brain zaps and so on, but my hope was strong and when I finally managed for the first time in 18 years to endure not taking Venlafaxine for 4 consecutive days I became a little euphoric.

 

Unfortunately after that the situation went badly. I continued to experience mild brain zaps and crying spells but my main problem was and is that I feel like somebody unplugged my power cable. After 2 weeks I started wondering when this would get better and after about 4 weeks I became very desperate and decided to start with Venlafaxine 12,5mg again on 04/07/24. (In the mean time I had read here on SA that you should reinstate low and noticed that my xr capsules contain three 12,5mg tablets.)

 

The last week 04/07/24 til now was terrible. Brain zaps and crying spells were gone and at first I felt more energetic though but on the other hand now I am very nervous, anxious and sleep badly. (Interestingly the 4 weeks I was completely off Venla I had a much deeper sleep.) The anxiousness and tensions are somehow paralyzing and I feel desperate and trapped. Even when the tension is better I have difficulties getting anything done.

 

Now I wonder where to seek help and I dread that nobody will acknowledge that I am most likely experiencing some form of withdrawal. To be honest I wasn't feeling 100% well in the first place when I started quitting and there are a lot of problems in my life, so there is room to argue it is not only withdrawal but a combination of factors. Now it sounds stupid to me trying to quit in that situation. However at that time I thought either now or never and I had no idea that it is possible to taper very slowly and gradually.

[LotusRising]

Hi @Alfred1977

 

Welcome to SA,

 

It sounds like you've already read our recommendations about tapering by no more than 10% of your most recent dose each month. If not, see here  Why taper by 10%.

 

And thank you so much for creating a signature.

 

These two links might be helpful if you haven't seen them already:

 

What is Withdrawal Syndrome?

 

Video on Recovery from Psych Drugs

 

When we take medication, the CNS responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS must then undo all the changes that were made. As the changes are undone, symptoms may occur. You can expect that they will follow 

The Windows and Waves Pattern of Stabilization  and since the CNS likes stability, we suggest to Keep it simple, slow and stable.

 

1 hour ago, Alfred1977 said:

(Interestingly the 4 weeks I was completely off Venla I had a much deeper sleep.)

I feel like this isn't at all uncommon for many people that come to the site. It's almost as though your nervous system is relieved to have the drug out of the system, but then shortly thereafter, there is a realization that there's work to do to bring everything back to balance (WD symptoms).

 

So, you reinstated 12.5mg on April 7 and have noticed improvements, which is a good sign. It may still take some time to stabilize at this dose. 

 

It sounds like you've read the thread on reinstatement, but please let us know if you have other questions.

 

Here is a link for tapering your specific drug.

 

 

1 hour ago, Alfred1977 said:

 

Now I wonder where to seek help and I dread that nobody will acknowledge that I am most likely experiencing some form of withdrawal.

 

Indeed, it will likely be difficult to find someone that will acknowledge what you're going through. Withdrawal informed doctors are hard to come by, but they do exist! If you find one, please let us know so we can update our list of providers. But, I hope it's somewhat reassuring that you've now found a very large group of individuals that will support you through the process and DO understand and relate to your experience. 

 

Please post any updates or questions related to your specific situation right here in your thread. It's helpful to keep everything related to your tapering journey in one spot.

[Alfred1977]

Thank you very much for your reply.

 

The most urgent question I have is if I should stay at 12,5mg for now. As far as I understood the related article/post this is the case. But then I have the problem that doctors here probably won't agree and I feel I need more help, some clinic for example. Spending about 80% of the day in bed really wrecks you.

 

I also feel very tempted to take something for better sleep (mirtazapin e.g.), at least once or twice a week. Insomnia is also wrecking me. 

[LotusRising]

@Alfred1977

 

You could hold where you're at and wait to stabilize, or you could try updosing a little more. I can't tell you what might be best for you. You sort of need to go by what your body is telling you to do. If it were me, I wouldn't go up by any more than 0.5mg increments and I would take 7-10 days to wait for an effect between increases.

 

I'm not sure a clinic would offer you more help, but I'm not familiar with clinics in Germany. 

 

5 hours ago, Alfred1977 said:

I also feel very tempted to take something for better sleep (mirtazapin e.g.), at least once or twice a week. Insomnia is also wrecking me

 

I can't tell you what to do about other medications, but I can tell you that mirtazapine is not meant to be taken on an as needed basis. It might also be confusing for your nervous system to take it intermittently. We have many resources on the site for coping with insomnia.

 

If you're interested:

 

 

 

 

[Alfred1977]

Thank you very much again. It is good to have someone to talk. I guess then I hold at 12.5mg for now. At the moment I don't have the means to measure small doses and when I tried about 19mg (1.5 tablets) last Tuesday I felt more tension.

 

At what signs would you consider changing the dose and in what direction?

 

If I understood your link "Tips for tapering Effexor" correctly, I will have to get me the immediate release tablets of my drug. Since I am neither supposed to cut up or crush my xr tablets nor to solve them in water. Is that correct?

 

Do you prefer weighing or solving in water?

 

When I have to take the immediate release Venlafaxin twice a day, how do I split up my daily dose? For example: I want to take 12mg a day. Do I take 6mg in the morning and evening or do I take 9mg in the morning and 3mg in the evening or what is the right way to do it?

 

 

[Alfred1977]

The first 7 days after I reinstated Venlafaxine 12,5 mg on 04/07/2024 I was mostly experiencing tension and anxiety, I guess. Now it's shifting towards fatigue, I think. When I worry about my condition and my problems that I don't know how to handle, I feel anxious of course. But overall I think I became calmer and more fatigued.

 

Do you think this is a good sign? Or is it common to struggle with fatigue in this situation?

[Tweed9674]

Hi,

 

For sleep, you might want to take a look at Melatonin and Magnesium supplements. My understanding is that they're usually well tolerated for people who are in a not 100% stable.

They can help, but they are not a miracle cure. Like everything, start one thing at a time with a low dose. That way, if you have an adverse reaction, it's way easier to know what caused it!

 

 

[Alfred1977]

Thanks to everybody who is taking part and sympathizing. I am feeling really lonely.

 

Yesterday tried again to increase my dose (25mg) and it seemed to have worked this time. I didn't sleep well but tensions and stress were bearable. I feel somewhat better now - more strength, less fatigue. I started around 12/04/2023 with 75mg. Around 03/01/2024 I was the last time at 37,5mg. This was also the last time I felt more or less normal. Those one and a half month have been brutal - especially the last 11 days.

 

The more strength I gain the more I feel shaken about what happened and the situation I am in. As I told you above I knew that it wouldn't be easy. But I never imagined this and it all feels unreal. I had difficulties and a lot of worries in my life before. But now my confidence seems to be completely destroyed. I have no idea how to get going again.

 

What would you do now? Go back to 37,5mg/75mg and try to fix other things in my life? Try to stay and plan another taper? Try to switch the antidepressant?

[Tweed9674]

5 hours ago, Alfred1977 said:

The more strength I gain the more I feel shaken about what happened and the situation I am in. As I told you above I knew that it wouldn't be easy. But I never imagined this and it all feels unreal. I had difficulties and a lot of worries in my life before. But now my confidence seems to be completely destroyed. I have no idea how to get going again.

 

I'm exactly in the same situation. I somewhat knew it was going to be hard, but I never imagined that it could destroy me overnight.

 

Now you have to focus on stabilizing. Give it some times at 25mg. When I started reinstating, I was told to give it 1 or 2 weeks minimum before making another move. I think you should do the same!

 

Stay strong and keep us updated!

[Alfred1977]

Thanks Tweed. Did your crash happen end of march? Your signature looks like you are also looking for the right dose at the moment. Have you somewhat recovered?

 

Did your switch to Escitalopram went smoothly? Why did you switch? I am actually considering this as well.

[Tweed9674]

Yes, I crashed around March 25. I didn't know, at that time, that it was protracted withdrawal from escitalopram. It took at least a week before I found survivingantidepressants.org and understood what was happening to me.

 

I have yet to stabilize. I'm in the process of writing an update in my introduction thread. Things are a little better, I think.

 

I switched from venlafaxine to escitalopram because I had too many symptoms. It was almost impossible for me to reach orgasm, I had a lot of night sweat, night terrors and vivid dreams, etc. My doctor switched me to Escitalopram over a week. Over the next few years, I had to consult for many weird symptoms: jelly legs, dizziness, weird pain on the left side of my body, snowy vision, etc. I now believe that this was all from quiting effexor/venlafaxine. No way to be sure.

[Alfred1977]

Yes, I have also those unpleasant side effects. And I feel totally dependent.

 

So your switch was a little bumpy but all in all ok? Did escitalopram then do better or was it the same?

Is dosing with it easy?

 

I made a couple of bad decisions in life. Taking ADs probably has been the worst or number 2.

[Tweed9674]

1 minute ago, Alfred1977 said:

Yes, I have also those unpleasant side effects. And I feel totally dependent.

 

So your switch was a little bumpy but all in all ok? Did escitalopram then do better or was it the same?

Is dosing with it easy?

 

I made a couple of bad decisions in life. Taking ADs probably has been the worst or number 2.

Meh. To be honest, I think that all the switching, stopping and starting again led me straight to kindling and drugs sensitivity. If I had the change to redo it all, I'd ultra slow taper venlafaxine and live with the consequences.

 

Dosing escitalopram is fairly easy. I crush half a pill then I mix it in water, take my dose using a syringe and get rid of the leftover immediatly.

But escitalopram is VERY potent and, from what I saw here and my own experience, just as hard to get rid of as all the other ones.

 

Don't blame yourself for taking ADs. This is not your fault. At some point in life, they are offered as a solution to us and any issues with them is downplayed or ignored.

It suck, but it is not your mistake. The doctors who prescribe them and the pharmacists who give them to you are the one who should know better and not give them like candies.

[Alfred1977]

18 hours ago, Tweed9674 said:

If I had the change to redo it all, I'd ultra slow taper venlafaxine and live with the consequences.

Maybe you are right. I just saw an interview with Dr. Horowitz where he also said that switching can be difficult. On the other hand everybody here seems to say Paroxetin and Venlafaxin are the hard ones when it comes to tapering. And I probably also hope for feeling better than now with Venlafaxin (side effects and extremely fast onset of problems when missing doses).

 

18 hours ago, Tweed9674 said:

Don't blame yourself for taking ADs. This is not your fault. At some point in life, they are offered as a solution to us and any issues with them is downplayed or ignored.

It suck, but it is not your mistake. The doctors who prescribe them and the pharmacists who give them to you are the one who should know better and not give them like candies.

Thank you. This is a better way to see it.

[Tweed9674]

48 minutes ago, Alfred1977 said:

Maybe you are right. I just saw an interview with Dr. Horowitz where he also said that switching can be difficult. On the other hand everybody here seems to say Paroxetin and Venlafaxin are the hard ones when it comes to tapering. And I probably also hope for feeling better than now with Venlafaxin (side effects and extremely fast onset of problems when missing doses).

 

I feel you. I had many unpleasants side effects using Venlafaxin and just like you, missing a single 75mg dose would leave me in a very bad state with dizziness, nausea, crippling anxiety, etc.

Another odd thing with Venlafaxin for me: since the day i started taking it, getting a fever meant getting intense brain zap. I'm still this way as of today. 🤷‍♂️

I feel like switching AD is kind of like a coin toss. It can go smoothly... or it can go very wrong. Is it worth it? I don't have an answer to that 😕 

 

Do you have a link for the interview with Dr Horowitz?

[Alfred1977]

 

[Alfred1977]

A little update. It's been about 2 weeks since I reinstated and about 8 weeks since I experienced relatively severe withdrawal.

 

My main symptoms are fatigue, weakness, anxiety, tension and sleep problems. Crying spells and brain zaps didn't return after reinstatement, but my brain often feels tense and as if somethings working up there. Memories are getting unclearer I but still think that reinstatement also brought relief with respect to weakness and energy (besides removing brain zaps and crying spells). Right now I seem to feel as down as before reinstatement, but I sleeping badly and spending too much time in bed for 2 weeks now. It's difficult to find the strength for activity. I seem to be hungry but I am eating not much (lost about 7 kg in the last couple of weeks).

 

I wonder if I should keep on getting rest or try to be more active??!!

[Alfred1977]

Hi everybody,

 

my reinstatement is now about 2.5 weeks ago, in which I spend a lot of time in bed. I struggle mainly with anxiety, depression and insomnia.

I feel I need to get going again...at least slowly, but have huge troubles with that.

I read and watched a lot of stuff in the last two weeks and several times came across the advise to focus on each single day (step by step) and to find faith (in God for example). This resonated strongly with me. I guess I had a deficit in this regard for all my life. I strongly tend to overthink and think of how the future might be instead of focusing on the present day. And I have no strong faith either.

 

Now experiencing withdrawal and crisis this was like an epiphany. I desperately need to fix this...to survive this crisis, but maybe also to have a better life in general.

I guess my problem is that my anxiety and fears get easily triggered...especially now. It's hard to do the necessary and unpleasant stuff without getting confronted somehow with problems that  you cannot solve right now (and don't know how to solve them in the future). I lack the strength to put those problems aside and concentrate on what I can and should do NOW. And my thinking and feeling then easily gets out of control. I think this makes me avoid the things that I could reasonably do ("fear of fear") at the moment and thus makes me more miserable.

Maybe this inability to put problems aside is caused by my lack of faith. I wish I could somehow feel that life or God are going to carry me even when things go badly. Or have more hope that life will be good or think that the world/everything is just fine as it is.

 

Can you help with that?

Do you know any good books or channels on that subject?

 

 

[Alfred1977]

Yesterday I was confronted with external stress and tried to start getting some things done. The result was insomnia and anxiety and worrying throughout the night.

 

How do you handle days after a sleepless night??

And how do you keep stress away from you (when life somehow needs to go on)??

[Tweed9674]

Hi @Alfred1977

 

I'm very sorry you've been feeling this way.

 

The way I cope with daily stress right now is mostly by using a daily routine and setting small objective to "achieve".

I avoid trying to distract myself from anxiety or stress. I might feel a bit better while I scroll endlessly on internet, but when I'm done, I have less energy to do.... everything that needs to be done... and I feel worse.

 

So instead, I go for small things to do. Do (part of) the dishes, take a shower, take a walk, etc.

 

For days after a sleepless night, I wish I had an answer. Those days are absolutely brutal and they bring a lot of struggle.

 

Did you try magnesium supplement to help with the anxiety?

[Alfred1977]

Hey @Tweed9674 ,

 

thanks. I tried magnesium but only once or twice. I also have a sleeping mask, ear plugs and did an online course on CBT-I (cognitive behavorial therapy insomnia). But I don’t think I am able to implement those methods at the moment. With CBT-I I should only spend 5.5-6 hours in bed per 24h and get up immediately if I lie 20 minutes awake. I tried CBT-I yesterday. I stayed active during the day, got to bed late and was standing half an hour beside my bed during the night because I lay awake before and then thought „f*** I cannot do this“. The little sleep that I got was very shallow and with the cortisol coming around 4 and 5 am my night was as usual over.

 

When I am able to rest a lot during the day and then go sleeping around 10 pm I had a couple of „ok nights“ last week. But I cannot keep on resting that much since there are problems and work waiting around me. I really don’t know what to do. And worrying about this also does not help sleeping. I also have a family (1 daughter) and old parents.

 

I am thinking about a combination of CBT I and sleep drugs, maybe taking a pill every second or third night. Switching the AD is also on the table again since I read that Venlafaxine is supposed to be one of the ADs causing the most problems in this respect. Escitalopram is supposed to cause the least sleeping problems amoung SSRIs. My brother is taking Escitalopram for 1 or 2 years and said he had no side effects. So I am really thinking about this.

 

https://link.springer.com/article/10.1007/s11920-017-0816-4

https://pubmed.ncbi.nlm.nih.gov/22057726/

https://psychopharmacologyinstitute.com/publication/citalopram-and-escitalopram-a-summary-of-key-differences-and-similarities-2179

 

Mirtazapine is even supposed to be good for sleep. But it’s not an SSRI and so I am afraid the switch might be more difficult.

 

Going to a clinic might also be an option. I still have no physician/psychiatrist that I trust and this is a huge issue too. I might have f***ed this up by raising my dose too high after reinstating. About 3 weeks ago when I was completely off Venla I slept like a baby compared to now – even though I had withdrawal symptoms at that time (brainzaps, weakness, depression). Now brainzaps and weakness is gone but insomnia and anxiety are wrecking me instead. After 1 week on 12.5 mg I felt fatigue and decided to raise my dose which might have been a mistake.

 

For any help I would be very thankful. Do you have any ideas, @LotusRising?

 

 

[Tweed9674]

Hi @Alfred1977

 

I can relate to your pain. It is hard to push trought stress and anxiety. Doing it while in withdrawal is even more insane.

 

I don't know much about CBT-I but I feel like it's the kind of tool that can help in the long term.

 

Switching to escitalopram might be worth a try. I'd advise you to talk to a doctor about it.

I'd also advise to treat it like a reinstatement. A doc might want you to start at 5 or 10mg from the start. I'd not go higher than 1mg from the start to avoid kindling or a very bad reaction.

 

You are not alone in this, keep fighting

 

Tweed

[Kaylaq]

Hi, not giving much advice but reading through the thread, I can only say that you have to be so patient with this WD process, keep it simple and don’t get caught up in mixing up or trying different meds for a quick fix.  That just adds more stress to your brain…. Your brain needs time to heal, and it takes longer than expected.  
magnesium helps a lot but you have to let it build up in your body. I use “YouTube”, meditation music for sleep, keep to a routine as much as possible. 
this is a scary journey we are on, but there is a lot of support and compassion here for you!  
💪💪😊😊 

[Alfred1977]

Thank you @Tweed9674. I am glad to have you here.

 

Thank you too, @Kaylaq.

[LotusRising]

@Alfred1977

 

If it were me, I wouldn't switch around to other medications. I know the concern is lack of sleep, but there's no guarantee that a new medication will help. It can take your nervous system quite some time to stabilize and switching medication would be confusing for your body. 

[Alfred1977]

Thx @LotusRising. Would you then try to reduce the dose again? For example 22mg instead of 25mg and then maybe 20mg. I know anxiety and insomnia can be caused by post acute withdrawal and also simply by the emotional stress this whole experience has put me through. But I also think Venlafaxin itself might be the problem or at least part of the problem, since it is known for it and this corresponds to my observations in the beginning when I tried to raise my dose. When I can't get rid of it by switching and I won't be able to quit it completely for a long time, then reduction might be the only option for now...what do you think? 

 

Last night I took a sleep drug. I slept 8 hours and woke up with anxiety. By skipping days and rotating drugs I can maybe hold out like this for 2 or 3 weeks? But I should be careful not to incur the next drug dependency and so I would have to find some kind of solution during this time. 

[LotusRising]

@Alfred1977

 

Did you notice any improvements at all from reinstating? If you did, you may want to hold and wait for your body to stabilize before making any reductions. 

[Alfred1977]

@LotusRising

 

6 hours ago, LotusRising said:

Did you notice any improvements at all from reinstating? If you did, you may want to hold and wait for your body to stabilize before making any reductions. 

 

As far as I can tell, reinstating has been a two edged sword for me. Before reinstating I experienced brain zaps, crying spells, loss of appetite and a pretty severe lack of drive/weakness/depression, but I was relatively calm and slept well. I started somewhat to panic when I realized that this wasn't getting better after 4 weeks off Venla. One of my big problems - also right now - is that I feel a lot of pressure from my working/living situation/family. I don't really have anybody to back me up should I stay seriously sick for a longer period of time. Reinstating removed the brain zaps and crying spells completely and improved the lack of drive/depression strongly. Appetite returned, maybe even more than normal. But ever since reinstating I suffer a lot of tension, anxiety and insomnia - disabling me basically to the same extent as the depression before reinstating. I am not sure about the cause of this tension/anxiety/insomnia. For me at the moment there are three plausible explanations (that don't necessarily exclude each other):

1) side effect of simply taking venlafaxine

2) destabilisation of the nervous system by the recent drug changes

3) psychological/emotional trauma by the extreme experiences of the last weeks, especially the extreme feelings of helplessness and the fear of having not enough time to recover

[Tweed9674]

Hi @Alfred1977

 

Stabilizing can take some time. I understand your need to feel better, to sleep and to feel relief from all of this. I really do.

 

Sleep pills can be a double edged sword. I believe they can further destabilize you or mask any improvements / worsening of your reinstatement.

 

For anxiety, and tension, magnesium can definitely help. I'd give it another try.

If you can find the energy and motivation, walking every day can help too.

You could try breathing exercices, and focusing on relaxing your muscles. Breathing exercises are surprisingly effective when I'm about to have or having a panic attack.

 

Staying busy also help.

Just, keeping yourself distracted can also work. It usually doesn't work for me though since my mind quickly start to drift back to weird toughts and... anxiety.

It's easier said than done 😕

 

For sleep, melatonin is a fairly safe bet. You already have a sleep mask and ear plug, this is good.

 

Personally, instead of earplug I use wired in hear monitors and set an ocean waves track on repeat using spotify.

It's not perfect: I sleep on my side so I can only wear one monitor at a time and I have to switch ear as I change position during the night.

I use wired monitors instead of blutooth earbuds mostly because blutooth monitors battery life is just not good enough.

They start complaining in the middle of the night because of their battery level and it gets very annoying very quickly.

 

Another thing to try for sleep is camomile tea. It's not super strong and won't do any miracle to stay asleep but I find it helpful to calm my nerves.

 

I really hope that you can find a way to cope with all this

[Kaylaq]

Once your nervous system is des-regulated, it will take an awhile for it to settle down again.  Lots of deep breathing exercises, everything @Tweed9674 said. Work on not letting the anxiety get to you!  Keep your focus on other positive areas of your life! 
 

Venlafaxine Is a nasty drug to come off, take it super slow! Stay in a stable place for as long as you can before trying to taper again!!  

[LotusRising]

@Alfred1977

 

As mentioned above, your system is dysregulated right now and it can take quite some time to settle. Since you've had resolution of some of your symptoms, there is reason to hope that more will ease with time. I understand and can relate to how difficult insomnia can be. The only thing I can suggest is to stick to sleep hygiene principles to reinforce the routine to your nervous system. 

 

And keep checking in here and exploring our resources. There's lots of support here.