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HonestAbe: Pins and Needles


HonestAbe

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Hello All:

I’m a new member and don’t have a long story to tell, but, I presume like those who are reading this, it’s still a difficult one.

My own issues began about 18 months ago, when I began experiencing paresthesia after having restarted escitalopram about six months after having come off the medication.

In a nutshell, I had been on 10 mg of escitalopram between 2010 and 2022 with no issues. It was prescribed for anxiety and depression. In February of 2022, I decided to taper off the drug, which I did over about a month or so (10 mgs to 5 mgs to 2.5 mgs to zero).

I felt fine for the first four months and then, in late June I began to suffer from significant waves of anxiety, which I and my doctor took to be a recurrence of my earlier condition. In September, the escitalopram was resinstated at 10 mgs and, within a couple of days, I began to feel pins and needles in my forearms and legs. As the escitalopram didn’t help the anxiety, my GP upped the dose to 20 mgs. The tingles got worse and the condition did not improve. We tried Wellbutrin in December and January, 2003,  and, again little improvement in my moods and the paresthesia remained. Between February and May we tried Trintelex. Same result. Finally, in the summer of 2023, my GP put me on venlafaxine. We tried different dosages and, in February of this year, we upped to the dosage to 187.5 and added Pregabalin to deal with the pain of what I would now call nerve pain. My mood improved fairly significantly and the tingles were reduced in number, but the severity of the pain increased quite a bit.

Last month, my GP suggested I taper down on the venlafaxine to make way for a neurological test (an EMG), which I have scheduled for the near future. I have tapered from 187.5 to 150 in week one; from 150 to 112.5 in week two; from 112.5 to 75 in week three and from 75 to 37.5 in week three. The first two tapers were relatively uneventful. The second taper down to 75 began a period of increased paresthesia and the taper to 37.5 has been quite difficult. My last taper was to take place today, but I’m concerned about this because the recent two tapers have been harmful. So…..I’m asking if any other folks have had experience with what I’m going through, if this sounds like withdrawal to the experienced folks out there and, finally, why did the paresthesia start after I began taking escitalopram the second time ( didn’t experience any tingles during my first time on the drug.) I’m baffled as to whether this is another depression or a delayed withdrawal of some sort.

By the way, I also take trazadone to sleep and have been doing so since 2010.

Cheers,

 

Edited by Emonda
Name added to title

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe

Welcome to Surviving Antidepressants. 

 

I'm sorry you're suffering with side effects from your drug cocktail. Surviving antidepressants is a site that helps people get off of their medicines in the safest way possible. 

 

We do not advise people on how to manage drug cocktails or their side effects. If you'd like to traper off of your  drugs we'd be glad to provide information. Until that time you'd be best to work with your prescribing doctor. 

 

FYI it is quite common for people to have hypersensitivity to psychoactive drugs after they've withdrawn from a psychoactive drug before. Look up "kindling" in the symptoms forum on this site. Taking more drugs usually makes this worse. Seems like venlafaxine masked some symptoms but caused others - I'm not sure how that worked.

 

Please do let us know when you want to come off of your drugs so we can help you with our expertise. 

Omw

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • Emonda changed the title to HonestAbe: Pins and Needles

Thank you for your clarification Omy. I have a short follow up for you or others on the site. 

As mentioned in my previous post, my GP is having me taper down on my venlafaxine in time for a neurological test to rule out other possibilities with respect to why I’m feeling this way. Alas, as I’ve tapered, I have begun to feel worse….more anxiety and depression and more pins and needles, although different in character. Hard to know, I guess, whether this is withdrawal or relapse, but I was feeling somewhat better before this taper.

I am certain my GP will ask me whether I want to reinstitute venlafaxine after I see him ten days from now. Do you have a view on whether going back on the drug at higher levels will make things worse? And second, why, would the pins and needles get worse while I’m tapering downward on the venlafaxine. Is it simply because any movement in dosage (up or down) will create side effects like paresthesia (I have some tinnitus too). 

Many thanks.

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe

It seems like you're having withdrawal symptoms and they will likely get worse. Withdrawal has more to do with dysregulation of the nervous system than a simple lack of serotonin or other neurotransmitters. And because there is huge interdependence between the various neurotransmitters it's hard to pinpoint what is happening in your body right now. 

 

If you withdraw from the V for the test,  we'd recommend that you reinstate to as close of your previous dosage as possible. Then, if you decide to come off of the drug you would do that very slowly and gently. V is one of the hardest drugs to withdraw from. Similar to paxil. 

 

I had pins and needles at times in withdrawal but quite mild. It is a common withdrawal symptom.

 

Hope you feel better soon. Do check out the venlafaxine thread in the Tapering forum. It should be page 1 or 2 there. It may help you get ready to withdraw when you decide to. 

 

Hope the test goes well and do let us know if we can help. 

Omw

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Howdy:

I had my EMG test Friday and all went well. I have no nerve damage, which is something my GP has now ruled out with respect to my parasthesia.

Onmyway, thank you for the recommendation of titration back up to my previous level of venlafaxine (which was 187.5)

My GP has suggested going up from the current 37.5 to 75 and to see him in three weeks to see how I am feeling. I wonder if you and others might comment. Is this too slow?

(BTW, are others seeing my posts or is it just yourself).

Many thanks,

HonestAbe

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe

I'll need detailed doses by dates to give an opinion on what dose you should go back to. Have a look at my signature for an example of the level of detail needed. 

 

Once you put that in I can reply. Please tag me so I don't miss this. 

 

Your thread is open to everyone. The symptoms forum is much more lively. 

 

Omw

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Hi and thanks. Here’s a detailed accounting of my meds from 2010

August 2010 to February 2022 — 10 mg of lexapro daily for anxiety/depression

February 2022 — tapered off of lexapro over a month. No side effects or symptoms.

August 2010 to July 2023 - 50 mgs of trazodone nightly for sleep

July 2023 to current - 75 mgs of trazodone.

September 2022 to November 2022 restart 10 Mgs of lexapro … paresthesia begins in forearms and thighs

November 2022 to late December 2022 - 20 mgs of lexapro…paresthesia intensifies

December 2022 begin tapering Lexapro…paresthesia remains

January 2023 - bupropion for one month (don’t recall dosage)…no help..paresthesia remains tapered off

February 2023 to May 2023 - Trintellex (don’t recall dosage)…parasthesia moves to feet..tapered off.

May to early July 2023…only taking Traodone…paresthesia remains

July 2023…75 mgs of venlafaxine.

August 2023…titration up to 150 mgs venlafaxine…relatively significant relief of depression and decent relief of paresthesia in feet, arms and legs. Some pain in chest. Feeling cold in feet.

February 2024 to March 18th 187.5 mgs of venlafaxine.

February 2024 add 150 mgs of Pregabalin for paresthesia/leg pain.

Late February 2024, reduction of Pregabalin to 100 mgs daily due to some constipation. Depression reducing. 

IN PREPARATION FOR ELECTROMYAGRAPHY EXAM.

Start reduction of Velnaflaxine by 37.5 per week,

March 18th to 25th — reduction to 150 per week (few side effects)

March 25 to April 1st — reduction to 112.5 mgs per week. (Few side effects).

April 1 to April 8th — reduction to 75 mgs. Some increase in paresthesia in toes.

April 8th reduction to 37.5 mgs —- significant increase in paresthesia/burning which remains to this day. Anxiety and depressive episodes up. 

April 20th — New General Practitioner due to loss of imminent retirement of previous MD. Prescribes 37.5 increase in Venlafaxine to 75 mgs. Make appointment for May 10th to discuss issues.

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe, I need to know at each date of change what medicines and what doses you were taking rather than by medicine. Have a look at my signature. The way you have posted is not helpful to understand what your medicine burden is at any point in time and what changes have happened. I can't go and track each change at each date. 

 

Example: 

 

Jan 2002 - Jan 2020 20mg prozac, 0.5mg abilify

Feb 13, 2020: 28mg prozac, 0.5mg abilify

March 15, 2020: 26mg, prozac, 0.5mg abilify, 200mg pregabalin

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Okay. Thanks. I’ll give it another go.

 

August 2010 - 10 mgs Lexapro; 50 mgs Trazadone

February 20th, 2022 - 5 mgs Lexapro; 50 mgs Trazadone

February 27, 2022 - 2.5 mgs Lexapro; 50 mgs Trazadone

March 6, 2022 - 50 mgs Trazadone

Sept. 7, 2022 - 10 mgs Lexapro; 50 mgs Trazadone (parasthesia starts)

Oct. 9th, 2022 - 20 mgs Lexapro; 50 mgs Trazadone

Dec. 12, 2022 - 15 mgs. Lexapro; 50 mgs Trazadone; 150 mgs Bupropion

Dec. 20, 2022 - 10 mgs Lexapro; 50 mgs Trazadone; 150 mgs Bupropion

Dec. 27, 2022 - 5 mgs Lexapro; 50 mgs Trazadone; 300 mgs Bupropion

Jan 3, 2023 - 50 mgs Trazadone; 300 mgs. Bupropion.

Jan 24, 2023 - 50 mgs Trazadone; 150 mgs Bupropion

Jan. 31,  2023 - 50 mgs Trazadone; 150 mgs Bupriopion

Feb.7,  2023 -  50 mgs Trazadone

Feb. 10,  2023 - 50 mgs Trazadone; 10 mgs Trintellix

Feb. 17th, 2023 - 50 mgs Trazadone; 20 mgs Trintellix

May 7, 2023 - 50 mgs Trazadone; 10 mgs Trintellix.

May 14, 2023 - 50 mgs Trazadone.

July 7, 2023 - 75 mgs Trazadone; 37.5 mgs Venlavaxine

July 14, 2023 - 75 mgs Trazadone; 75 mgs Venlafaxine

August 8, 2023 - 75 mgs Trazadone; 112.5 mgs Venlafaxine

August 15th 2023 - 75 mgs Trazadone; 150 mgs Venlafaxine

Jan. 16th, 2024 - 75 mgs Trazadone; 187.5 mgs Venlafaxine; 50 mgs Pregabalin

Feb. 5th, 2024 - 75s mgs Trazadone; 187.5 mgs Venlafaxine; 100 mgs Pregabalin 

March 5th, 2024 - 75 mgs Trazadone; 187.5 mgs Venlafaxine; 50 mgs Pregabalin (optimal emotional well-being, reduced paresthesia and reduced constipation)

March 18th, 2024 - 75 mgs Trazadone; 150 mgs Venlafaxine; 50 mgs Pregabalin

March 25th, 2024 - 75 mgs Trazadone; 112.5 mgs Venlafaxine; 50 mgs Pregabalin

April 1st, 2024 -  75 mgs Trazadone; 75 mgs Venlafaxine; 50 mgs Pregabalin

April 8, 2024 - 75 mgs Trazadone; 37.5 mgs Venlafaxine; 50 mgs Pregabalin

April 20th - 75 mgs trazadone; 70 mgs Venlafaxine; 50 mgs Pregabalin

 

I hope this helps.

Honest Abe

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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3 hours ago, HonestAbe said:

Okay. Thanks. I’ll give it another go.

 

August 2010 - 10 mgs Lexapro; 50 mgs Trazadone

February 20th, 2022 - 5 mgs Lexapro; 50 mgs Trazadone

February 27, 2022 - 2.5 mgs Lexapro; 50 mgs Trazadone

March 6, 2022 - 50 mgs Trazadone

Sept. 7, 2022 - 10 mgs Lexapro; 50 mgs Trazadone (parasthesia starts)

Oct. 9th, 2022 - 20 mgs Lexapro; 50 mgs Trazadone

Dec. 12, 2022 - 15 mgs. Lexapro; 50 mgs Trazadone; 150 mgs Bupropion

Dec. 20, 2022 - 10 mgs Lexapro; 50 mgs Trazadone; 150 mgs Bupropion

Dec. 27, 2022 - 5 mgs Lexapro; 50 mgs Trazadone; 300 mgs Bupropion

Jan 3, 2023 - 50 mgs Trazadone; 300 mgs. Bupropion.

Jan 24, 2023 - 50 mgs Trazadone; 150 mgs Bupropion

Jan. 31,  2023 - 50 mgs Trazadone; 150 mgs Bupriopion

Feb.7,  2023 -  50 mgs Trazadone

Feb. 10,  2023 - 50 mgs Trazadone; 10 mgs Trintellix

Feb. 17th, 2023 - 50 mgs Trazadone; 20 mgs Trintellix

May 7, 2023 - 50 mgs Trazadone; 10 mgs Trintellix.

May 14, 2023 - 50 mgs Trazadone.

July 7, 2023 - 75 mgs Trazadone; 37.5 mgs Venlavaxine

July 14, 2023 - 75 mgs Trazadone; 75 mgs Venlafaxine

August 8, 2023 - 75 mgs Trazadone; 112.5 mgs Venlafaxine

August 15th 2023 - 75 mgs Trazadone; 150 mgs Venlafaxine

Jan. 16th, 2024 - 75 mgs Trazadone; 187.5 mgs Venlafaxine; 100 mgs Pregabalin

Feb. 5th, 2024 - 75s mgs Trazadone; 187.5 mgs Venlafaxine; 150 mgs Pregabalin 

March 5th, 2024 - 75 mgs Trazadone; 187.5 mgs Venlafaxine; 100 mgs Pregabalin (optimal emotional well-being, reduced paresthesia and reduced constipation)

March 18th, 2024 - 75 mgs Trazadone; 150 mgs Venlafaxine; 100 mgs Pregabalin

March 25th, 2024 - 75 mgs Trazadone; 112.5 mgs Venlafaxine; 100 mgs Pregabalin

April 1st, 2024 -  75 mgs Trazadone; 75 mgs Venlafaxine; 100 mgs Pregabalin

April 8, 2024 - 75 mgs Trazadone; 37.5 mgs Venlafaxine; 100 mgs Pregabalin

April 20th - 75 mgs trazadone; 75 mgs Venlafaxine; 50 mgs Pregabalin

 

I hope this helps.

Honest Abe

Dear Onmyway:

So sorry. Made an error in my dosage number with respect to Pregabalin. The correct numbers are in this new post. I had underreported by 50 mgs the amount of Pregabalin I have been taking. I also made a small error on my Venlafaxine intake on April 20th, which has been corrected. I am taking 75 mgs, nor 70, as earlier written.

Cheers,

Honest Abe.

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe

thank you for the information. It is exactly what I needed. I can see from it that you have made multiple changes in the last couple of years in multiple pills. I can count at least 9 changes - (attempt to quit escitalopram, addition of trazodone, addition of wellbutrin, CT of wellbutrin, addition of trintellix, CT of trintellix, addition of venlafaxine, taper of venlafaxine, addition of pregabalin, cut of pregabalin). Your poor nervous system doesn't know what hit it or what to do with all of this. 

 

To recover from this - you need stability - no adding or subtracting new drugs. However, I would suggest that you should go back close to your previous dose of Venlafaxine. I would suggest trying back to 150 rather than 187 as your body may have made some adaptations by now. You could even try lower and see how you react. 

 

What happens when you make so many changes with psychiatric drugs is that your nervous system becomes hypersensitive so the addition of new drugs or changes results in activation and more agitation. It may also  make subsequent withdrawals much worse (this is well documented in alcohol withdrawal where multiple withdrawals make subsequent ones much worse in proper alcoholism). Here is a thread on hypersensitivity and kindling from SA. 

 

If I were you, I would titrate up the Venlafaxine and stop titrating up if it makes you more agitated. I would then stay at that dose for a good many months not changing any of the other drugs. I would then slowly taper venlafaxine (10% or less of previous dose every 4 weeks). After that I would taper trazodone or pregabalin. These recommendations may change depending on how you react to the tapering and updosing of venlafaxine or the other drugs. You may update us if you need help in that. This may be a painful process and may last a long time. However, it is a temporary process (years, I would say) and we see that people do get better. 

 

I am not sure what to do with pregabalin. It is generally easier to come off of (based on my observations here) but I don't have as much experience and my observations aren't that significant. Could you come off of it faster if it is not helping? I don't know. I will ask other moderators what they think. 

 

You may be tempted to try to optimize a cocktail that will give you some relief and I totally understand that but it is likely to exacerbate the current problem so I would advise caution there. And trust me things can get much much worse (you can have a look at some of the symptoms here). Psychiatrists keep adding and subtracting drugs in these cases. You will probably be offered some non-traditional psych drugs or low doses of atypical antipsychotics or likely some tricyclics for nerve pain. If that doesn't work, often other more drastic measures are suggested like ECT and you would be labeled treatment resistant. But the real culprit here seems to be iatrogenic. 

 

If you decided to work with a psychiatrist on optimizing cocktails we wouldn't really be part of that. If you want to come off of the drugs we can provide help. 

 

I hope you start feeling better soon. 


OMW

 

 

 

I am also going to add a thread on withdrawal symptoms and the brain. 

 

 

 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Howdy Onmyway;

Thanks for the response. Super helpful and hopeful.

As I mentioned I increased Venlafaxine from 37.5 mgs to 75 mgs this past Saturday April 20th. I have an appointment with my MD on May 10th when I will suggest titrating up to 150 (depending on how I am tolerating this current titration).

In your view, is that soon enough?

Second, can I be so bold as to ask how you have found your own situation? Has it improved since you began your journey with Surviving Antidepressants?

Thanks Again,

HonestAbe

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator
Posted (edited)

Hi @HonestAbe

it might be helpful to keep a daily symptom log so that you know how these changes are impacting you. When we are in the middle of a crisis it may seem like things are really bad and those bad days may color our view of the whole journey. On the other hand, if a drug makes our mood bad, we may ignore physical symptoms. Many people here rate symptoms on some scale daily esp. when making changes. With V you would know fairly quickly if things are getting bad/good but we want to allow 1-2 weeks for symptoms to appear/resolve. 

 

I just noticed in your signature that you are taking omeprazole. That may impact absorption and may result in unstable dosages as well, worsening hypersensitivity. I would try to understand the reason behind GERD (H-Pylori? Diet?) and deal with those first. 

 

I will describe the principles under which I am operating and the tradeoffs that you need to make without opining on your current cocktail. 

Lots of simplifications here but in general psych drugs are downers and uppers. For most people V is an upper (not as in it improves mood necessarily but as in it makes you agitated, energetic etc.) Then trazodone is a downer - I took it briefly and it knocked me out so much that I would take it in the bathroom, walk 10m and fall in bed and asleep. Pregabalin is also a downer (similar to benzos) but supposed to have an effect on neuropathic pain. Doctors believe that they work individually but each drug impacts many neurotransmitters and even just impacting serotonin itself may have downstream effects on other neurotransmitters and hormones. So in effect they are more like mixing colors than like sound dials. The final result can be very different from the individual contributions. 


What we have learned here is that over time humans adapt to these drugs - the receptors that have too much serotonin end up getting less sensitive to serotonin. Other downstream hormones and neurotransmitters change, hormone secretion changes etc. The body finds a new balance. When you withdraw the drug it is not just about taking away serotonin and the drug getting out of your body. You now need to restore that balance again and a new re-adaptation is necessary which sometimes takes years.  One of the things that happens when you are in withdrawal and your nervous system is dysregulated and vulnerable is that new changes make things more difficult - new symptoms, hypersensitivity, lack of effect etc. Not only that but the drugs were probably working as a placebo to begin with so now that you are in real trouble that may not cut it. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

 

So you are trading off a few things here: 

1) If you stay on the lower dose of V, your body may think you CT'ed and go into withdrawal dysregulation. Restoring the drug fairly quickly may avoid that. 

2) Some adaptation to the lower dose of V has happened already

3) You are already hypersensitive and have symptoms while on the drug - it is unclear if those symptoms are drug side effects of if they are withdrawal symptoms and hypersensitivity from previous changes

 

If I were you I'd read as much as I can on the site and see how we think to make these decisions for yourself. In the end you bear the consequences of these decisions and my advice lacks the depth of knowledge that you have from your symptoms.  

 

Managing drug cocktails is beyond my pay grade and to be honest your doctor doesn't have a clue either because these drugs have not been studied in randomized trials together. He/she is trying to tinker with neurotransmitters as if they are not interrelated but in reality they are and he/she has only a very vague idea how interrelated. You are an experiment of one for them. 

 

You can have a look at my thread to see my journey if you wish. I was in a horrible spot when I found SA but I was lucky that I found an article by Mark Horowitz and reinstated within a month at half my dose. It took me 4-5 months to get to some level of normalcy with windows and waves since then. I am still at 0.3mg of my drug but taking long holds when symptoms resurface. My last cut was in August last year as life has been difficult. 

OMW

 

 

Edited by Onmyway

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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That is all very sobering.

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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Hey omy: Titrated up to 112.5 this morning April 28th.

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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On 4/24/2024 at 10:06 AM, HonestAbe said:

That is all very sobering.

Hi @HonestAbe- I was just reading your story, and wanted to say hello.  Yes, it is sobering.  I think I'm still in a state of disbelief that we are given these drugs with so little thought, after a 10 minute appointment with a doctor.  It's crazy, isn't it?

 

I just wanted to lend my support- OMW has given you some awesome advice.  The mods here are amazing.  I really hope you manage to stabilize fairly quickly. ❤️‍🩹

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell.

2009- Daughter born 🥰

2016- Back on escitalopram

2022- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN

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  • Moderator
6 hours ago, HonestAbe said:

Hey omy: Titrated up to 112.5 this morning April 28th.

How are you feeling? Are you keeping track of the symptoms? 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Onmyway and Catwoman:

Thanks Catwoman for the kind words. I’m not what to say about being prescribed the drugs. I think my GP was a good-hearted person who perhaps hadn’t kept up with the literature. He first prescribed me lexapro in 2010 and I felt well for 12 years. But coming off and then going back on again was a real blow that I’m still struggling with. I hope my posts get more hopefull.

Dear Onmyway. Yes. I’m keeping track of my symptoms. Since moving back up to 112.5 yesterday I have noticed my tinnitus has increased, that I have some chillls and some tingling in my scalp. This is what happened last time I started titrating upwards with venlafaxine so, while it’s disconcerting, I’m not panicking. I hope, after meeting with my new GP next week, that I will be able to find a baseline at 150 (or even 187.5), as you suggested. I feel certain that my MD had me come down far too quickly in time for the nerve test. Now I hope that by going back up that I will stabilize. 

The good news is that there’s no nerve damage, so the tingling absolutely must have something to do with meds. There’s really no other viable reason.  

Thank you both,

HonestAbe 

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator
Posted (edited)

@HonestAbe

If your symptoms are getting worse it may be worth considering staying at this dose. You're trading off side effects to withdrawal effects. 

 

You know best what's more bearable to you, of course. 

 

Omw

Edited by Onmyway

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Hi Again. Thanks for the advice.

It is pretty rough right now. Loads of burning in all parts of my body. Night sweats last night and tinnitus.

Anyhow, life goes on, I guess and I have a couple of quick queries.

When I came off Lexapro in February of 2022, I was feeling fine after I  tapered down over about four weeks. (10 mgs, then five mgs. Then 2.5 mgs than half of that again). I began to experience waves of anxiety in July of that year which my doctor and I took to be a recurrence of anxiety/depression. Is it possible that it wasn’t a depression at all and that the waves of anxiety were, in fact, withdrawal effects emerging after three months after the taper?  And then the pins and needles hit after I re-instituted Lexapro in September (six months after the taper.) Does that follow known patterns.

Would it possibly follow  that every anti-depressant I’ve taken since then  have not been dealing with a depression at all but, rather, creating new spikes of medication, followed by withdrawal symptoms from different drugs I’ve taken since then?

Finally, I was finally feeling significantly better on 187.5 mgs of venlafaxine six weeks after having been on the drug for nine months (February and March on  months on the 187.5 dosage and 150 mgs since last summer). Is it possible that I was hitting stability from withdrawal and all that good work is down the tubes thanks to tapering off for that test. Yeeesh if true.

Thanks again. You’ve been most helpful.

 

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe

the first time I quit citalopram CT (after 3 years of taking it) I had severe brain zaps and a few other symptoms for a few weeks and though the issues went away. However, about 3-4 months later I had severe anger issues (very unusual) and was constantly frustrated and often crying out of anger. I went back on the drugs thinking I needed them. However, seeing the same anger issues now with withdrawal - and now I know it is withdrawal because of the other symptoms - makes me think that those were delayed withdrawal effects. Before the citalopram CT I had been briefly on Wellbutrin and trazodone which caused no effects when CT'ed

 

I think lots of people (not all) get away with one or two withdrawals and the next one hits quite hard. Did you see the hypersensitivity and kindling thread in the Symptoms forum? Kindling is the idea that every subsequent withdrawal is worse. It comes from alcohol withdrawal. 

 

Once you have withdrawal effects which are mistaken for relapse, and you reinstate you can end up getting yourself sicker which then ends up with more symptoms, which then ends up getting more drugs - usually new classes. You often get labeled bipolar if you get activation from the drugs then you start lithium, antipsychotics etc. - we call it the drug merry go round here. And of course none of them work and then you end up getting ECT for treatment resistant depression. Then you get more diagnosis. Check out the book - Anatomy of an Epidemic by Robert Whitaker. 

 

Likely you had withdrawal effects and hypersensitivity and side effects from the reinstatement all along. The brief respite you got was likely just a window as you were staying stable and not changing things. [Have you read about waves and windows?] 

 

The thing to decide now is how far up you want to go. If your symptoms are amplifying, then you should probably not increase much more. You weren't  at that high dose for that long and have come down since. 

 

It will be very helpful if you put more detail in your signature of the ups and downs of medication and the ways in which you tapered. Have a look at mine for an example. 

 

Here is a story of just such a case similar to yours. There are many more. 

 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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I think it's withdrawal symptoms I hope you feel better soon I also had pins and needles sometimes in withdrawal it's a common withdrawal symptom

June 2019- June 2022 Amitriptyline for migraines, came off June 15, 2022 CT. Withdrawal symptoms.

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19 hours ago, HonestAbe said:

Would it possibly follow  that every anti-depressant I’ve taken since then  have not been dealing with a depression at all but, rather, creating new spikes of medication, followed by withdrawal symptoms from different drugs I’ve taken since then?

 

I've been struggling with this very question, too.  I had a long break from antidepressants before and after my daughter was born, but that was me being stubborn, refusing the drugs so I could have a healthy pregnancy and be able to breastfeed.  My psych wanted me to go back on during that time for 'recurrence' that I now recognize as protracted withdrawal, and poor coping skills during a challenging time in my life.  

 

Aside from those few years, I've been on a revolving door of psych drugs for my whole adult life.  It's mind-boggling to think now that my whole adult life has been shaped by these drugs.  I'm definitely mourning what might have been, but looking forward to forging a new path.

 

I'm grateful to be here, and to know that I'm not the only one dealing with these questions!  Hang in there @HonestAbe!  We're all here for you!

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell.

2009- Daughter born 🥰

2016- Back on escitalopram

2022- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN

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Howdy all:

Trying to change my signature, but can’t quite figure out how. Any advice?

Please and thanks.

Honest Abe

 

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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On 5/5/2024 at 3:04 PM, HonestAbe said:

Howdy all:

Trying to change my signature, but can’t quite figure out how. Any advice?

Please and thanks.

Honest Abe

 

Hello OMY and other supporters. I’ve changed my signature to include more information about somatic and mental changes as dosages increase and drop off over the last two years. After six days on an increased dosage of venlafaxine. (From 75 to 112.5), my neuropathic pain spiked and was quite painful by Sunday. I’ve noticed some reduction in pain over the past two days and am hoping the spike is due to side effects that will dissipate. I see my GP Friday and am still wondering whether to suggest an increased dosage to 187.5 V, given that I felt mentally best at that level. Advise if you think it wise.

Best to all.

HonestAbe

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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On 5/1/2024 at 12:52 PM, Catwoman73 said:

I've been struggling with this very question, too.  I had a long break from antidepressants before and after my daughter was born, but that was me being stubborn, refusing the drugs so I could have a healthy pregnancy and be able to breastfeed.  My psych wanted me to go back on during that time for 'recurrence' that I now recognize as protracted withdrawal, and poor coping skills during a challenging time in my life.  

 

Aside from those few years, I've been on a revolving door of psych drugs for my whole adult life.  It's mind-boggling to think now that my whole adult life has been shaped by these drugs.  I'm definitely mourning what might have been, but looking forward to forging a new path.

 

I'm grateful to be here, and to know that I'm not the only one dealing with these questions!  Hang in there @HonestAbe!  We're all here for you!

I guess if my therapist has taught me one thing is that the past is the past. I know that sounds trite, but, at least in my case, there’s not a lot to do about it. Just trying to keep walking forward.

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

Hi @HonestAbe,

Can't advise on the right dosage as no one knows but given that you've had bad side effects from the increase, you might  want to wait a bit more before making changes. Why do you think the side effects will go away? 

 

I'd personally put the 187mg dose away in the past. It worked for a bit in that context but things have changed since then. It may also have been a window. I understand how amazing it must have felt given the struggles you faced until then. And I understand how you'd like to replicate that but going back to that dosage now may not bring the same relief. It's not like there's a key in your brain that  that specific dose will unlock. I'd opt for dynamic optimisation. Balance the withdrawal symptoms and the side effects carefully now and remember that stability is good for the brain. 

 

Omw 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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14 minutes ago, Onmyway said:

Hi @HonestAbe,

Can't advise on the right dosage as no one knows but given that you've had bad side effects from the increase, you might  want to wait a bit more before making changes. Why do you think the side effects will go away? 

 

I'd personally put the 187mg dose away in the past. It worked for a bit in that context but things have changed since then. It may also have been a window. I understand how amazing it must have felt given the struggles you faced until then. And I understand how you'd like to replicate that but going back to that dosage now may not bring the same relief. It's not like there's a key in your brain that  that specific dose will unlock. I'd opt for dynamic optimisation. Balance the withdrawal symptoms and the side effects carefully now and remember that stability is good for the brain. 

 

Omw 

I guess my thinking is that, in some cases, side effects do go away as a matter of course. Eg. You put up with constipation for a while and, when the body gets used to it, it goes away. But I guess my bigger reason is that, at the higher dose, my anxiety attacks dissipated, even if there was some parasthesia. 

 

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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  • Moderator

That makes the tradeoff clear in your case then, @HonestAbe.

Ultimately this is your decision and you and  your doctor can choose the dose. 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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I am mindful of what you say with respect to dynamic optimization. I’m leaning to staying at 112.5 mgs in spite of the increased tinnitus and neuropathy.  Is a 10-day period long enough to ascertain whether you’re kindling on the higher dosage?

If yes,  do you have any thoughts on whether going to back to 75 mgs would be useful in terms of reducing symptoms? You’re trade-off arguments seem to mirror my experience. Lower dosage = more anxiety but fewer symptoms. Higher dosage =  less anxiety but more symptoms. Hobson’s choice.

 

ESCITALOPRAM - 2010-2022 for anxiety/depression. Taper from 10 mg to zero over four weeks in Feb. 2022. No problems. Anxiety recurs and E reinstated in Sept. Parasthesia starts. Four-week taper late 2022. Paresthesia remains.

TRAZADONE - 2010-present. Increased from 50 to 75 mgs in July/23 for sleep.

WELLBUTRIN - 300 mg in Dec/2022. No help. Tapered off over 3 weeks in Jan.

TRINTELLIX - Feb to May 2023. Tapered down in May. Parasthesia remains.

VENLAFAXINE - July 2023-Current; 150 mgs in August/2023. Increased to 187.5 in Jan 2024. 100 mg Pregabalin at same time. Parasthesia reduced. Mental health improved. VENLAFAXINE reduced to 37.5 over four weeks in March/April of 24.  Parasthesia and tinnitus worse. V upped by 37.5 and another 37.5 to 112.5 late April. Tinnitus, parasthesia remain. Esomeprazole on and off.

 

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