ElleCarolina: My Effexor taper and reinstatement nightmare - Please help!

[ElleCarolina]

Hi everyone, thank you so much for this community you've created. The past three weeks have been some of the scariest of my life and I am so desperate for guidance, help, and support.

 

I am a 31 year old female in the US. My pediatrician put me on Effexor XR at 112.5 mg/day at age 17. About three years ago, I decided to start tapering. I began a very slow, gradual taper and was able to get to 37.5 mg/day with no issues. I held at that dose (and felt great) for a year. I began tapering again earlier this year hoping to get off the drug completely.

 

Unfortunately, I must have tapered too quickly, because about three weeks ago I believe I triggered a severe withdrawal. I was at 12.375 mg remaining for a week, and the next week I tapered down to around 10 mg. At this 10 mg dose I became extremely ill, with debilitating anxiety and GI symptoms. I was non-functional and updosed to around 22 mg in the hopes that the withdrawal symptoms would go away. At the time, I did not know that a large updose was not recommended. I continued to have horrible symptoms and went to a psychiatrist who recommended I reinstate the full 37.5 mg capsule. I took 37.5 mg yesterday and today and have barely been able to sleep. I have little to no appetite and feel completely consumed with anxiety. I feel like I want to crawl out of my own body. Now I am worried that I should not have reinstated and that I am experiencing symptoms due to the rapid updose.

 

The psychiatrist I saw prescribed me a very low dose of Klonopin to help with panic and anxiety from withdrawal, but I am terrified to take it. 

 

What I am desperately looking for advice about is:

- Should I go back down to 12.375 mg (my stable dose before withdrawal symptoms hit), or is it too late to do this and will this trigger withdrawal since I have been taking a larger dose (between 22 and 37.5 mg) for two weeks?

- Or should I stay on the 37.5 mg as recommended by the psychiatrist and hope that my symptoms subside over time? 

- Should I take the Klonopin (I was going to take a quarter of the .25 mg tablet if anything) or avoid it? 

 

Thank you so, SO much to anyone who is willing to comment with any advice. I have been to the doctor/psychiatrist 6 times in the past two weeks and have two more appointments scheduled this week - my symptoms have taken over my life and I just want my life back more badly than I can describe. 

 

 

 

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

This topic is for anything relating to you, and any questions you have. Please do not start another topic.

 

We recommend tapering by no more than 10% of your CURRENT dose each month, to limit withdrawal symptoms. E.g. 10mg --> 9mg --> 8.1mg --> 7.29mg

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

 

 

You tapered too quickly given your time on effexor. It's not the end of the world, though it may seem like it right now.
 

You need to choose a dose and remain on it for a number of months. Things will be turbulent with symptoms for a while, and you have to learn to try and not be reactive by changing your dose as your symptoms change. You likely don't need to go all the way back to 37.5mg, some sort of sensible middle ground will probably be the best option. Anywhere from 15-20mg would be sensible.

 

19 hours ago, ElleCarolina said:

Should I take the Klonopin (I was going to take a quarter of the .25 mg tablet if anything) or avoid it? 

I would avoid benzos at all costs.

 

19 hours ago, ElleCarolina said:

I have been to the doctor/psychiatrist 6 times in the past two weeks and have two more appointments scheduled this week

I wouldn't recommend spending too much time with doctors or psychiatrists. They are only there to prescribe medication, and if you explain all your symptoms to them that is what they will try to do. It would be better to offload to someone who can not prescribe.

[Erimus]

Here are a few of the most useful links:

 

--------Important topics in the Tapering forum and FAQ--------

 

Micro tapering

 

Why taper by 10% of my dosage?

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

 

--------From the Symptoms and Self-Care Forums--------
 
What is withdrawal syndrome?
 
About reinstating and stabilizing to reduce withdrawal symptoms
 
The Windows and Waves Pattern of Stabilization

 

Hypersensitivity and Kindling

 

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

[ElleCarolina]

3 hours ago, Erimus said:

You need to choose a dose and remain on it for a number of months. Things will be turbulent with symptoms for a while, and you have to learn to try and not be reactive by changing your dose as your symptoms change. You likely don't need to go all the way back to 37.5mg, some sort of sensible middle ground will probably be the best option. Anywhere from 15-20mg would be sensible.

 

I would avoid benzos at all costs.

 

I wouldn't recommend spending too much time with doctors or psychiatrists. They are only there to prescribe medication, and if you explain all your symptoms to them that is what they will try to do. It would be better to offload to someone who can not prescribe.

 

Thank you so, SO much for your comment. Really - I can't tell you how good it is to hear from people with actual experience on these drugs. I really appreciate you taking the time to share with me.

 

This morning before my post was approved I went ahead and went back on my lowest stable dose before withdrawal symptoms hit: 12.375 mg. The past two days on 37.5 mg were intolerable - I was barely able to sleep, felt like my entire body was coursing through with electricity, it felt like I had ice running through my veins. The anxiety was nightmarish. It's hard to know how returning to 12.375 mg will affect me yet, but I was at least able to take a three hour nap in deep sleep this afternoon - something that I have not been able to do in at least a week of broken, low-quality, fitful, anxiety-ridden sleep. 

 

Do you think 12.375 mg is too low for me to be on to stabilize from withdrawal? 

 

I ended up taking about .25 mg Klonopin when I woke up in a panic at 3:30 this morning (also before seeing your comment!) It helped me sleep for a few more hours but didn't seem to do much else because I had waking anxiety again later in the morning. I will definitely avoid using it again. 

 

Thank you SO MUCH to anyone who has any advice!! 

 

 

[Erimus]

18 hours ago, ElleCarolina said:

Do you think 12.375 mg is too low for me to be on to stabilize from withdrawal?

You will stabilise with time. It might take a bit longer on 12.375mg but a lot of people reinstate too high and regret it when they come to tapering again, because they have much more drug to reduce.

 

The symptoms you have now are an accumulation of all the changes catching up at once. We call it a nervous system crash, when you are removing the drug faster than your brain can manage it crashes into a heap. Once you realise this and maintain the same dose it will slowly start to work towards stability.

Edited August 6 by Erimus

[Catina7]

Hi @ElleCarolina, welcome to our wonderful community.  I'm also tapering Effexor (Venlafaxine), so perhaps we can encourage each other!  

 

Catina 💜

[Willy]

Hi @ElleCarolina. I just wanted to stop in here to say lots of us are suffering with you. Good news is you will recover!

 

Please believe Erimus and avoid benzos at all costs. Benzos are the reason I ended up on a drug cocktail 7 years ago. 

[Tuikea]

Hi,

Sending love ❤️ 

I am also in an updose hold situation, but I am 69 yrs and have no time stress to get better like if I was working.

The anxiety is the worst thing to deal with I have had plenty of that in past tapers. I can only suggest stop putting pressure on yourself to stabilise try and understand and accept what has happened and know it will get better.

Putting pressure on yourself to get better will only make it worse.

How are you measuring your dose? are you counting beads or weighing doses.?

 

[SianL]

Hi @ElleCarolina

Just wanted to drop in and say you are not alone 💛
The withdrawals and the psychological effects are debilitating, but as with other addictions, we will recover ☀ Keep going and trust what people say here, it's the best advice I've ever received. I'm still on my journey and 12 years into Venlaflaxine XR, I'm picturing about a year to get off after reading what I've read here. But it will be worth it!

[ElleCarolina]

On 8/6/2024 at 11:16 AM, Erimus said:

You will stabilise with time. It might take a bit longer on 12.375mg but a lot of people reinstate too high and regret it when they come to tapering again, because they have much more drug to reduce.

 

The symptoms you have now are an accumulation of all the changes catching up at once. We call it a nervous system crash, when you are removing the drug faster than your brain can manage it crashes into a heap. Once you realise this and maintain the same dose it will slowly start to work towards stability.

 

Thank you SO much for your feedback... I've been back on 12.375 mg for two days. Yesterday was the best day I've had since withdrawal started, but today has been misery - I have cried for hours and can't stop. I know I need to pick a dose and stick with it, but it's so hard to wonder if I would feel better taking slightly more (Even though I felt AWFUL when I reinstated at a higher dose)... I just don't know what to do, and it's so overwhelming to wake up each day and not be better. I have been barely functional and I feel so bad for my support system for crying to them for hours a day and not improving. I feel so hopeless. I just wish I knew how long it would take for me to heal and be back to my normal self.

[ElleCarolina]

8 hours ago, SianL said:

Hi @ElleCarolina

Just wanted to drop in and say you are not alone 💛
The withdrawals and the psychological effects are debilitating, but as with other addictions, we will recover ☀ Keep going and trust what people say here, it's the best advice I've ever received. I'm still on my journey and 12 years into Venlaflaxine XR, I'm picturing about a year to get off after reading what I've read here. But it will be worth it!

 

Thank you SO much for your encouragement... I appreciate it more than I can say. It is so good to know that I am not alone and that there are people who understand how serious withdrawal is and who know what it is like. It is so hard to keep going everyday and I honestly don't know how I am going to do it. 

[ElleCarolina]

On 8/6/2024 at 4:49 PM, Tuikea said:

Hi,

Sending love ❤️ 

I am also in an updose hold situation, but I am 69 yrs and have no time stress to get better like if I was working.

The anxiety is the worst thing to deal with I have had plenty of that in past tapers. I can only suggest stop putting pressure on yourself to stabilise try and understand and accept what has happened and know it will get better.

Putting pressure on yourself to get better will only make it worse.

How are you measuring your dose? are you counting beads or weighing doses.?

 

Thank you so much for your comment - I can't say how grateful I am for your support. Have you had anxiety with updosing or just with tapering/withdrawal? My anxiety from updosing was intolerable, but a lower dose also feels terrible ... It's like I feel terrible now no matter how much Effexor I take 😥. 

 

I've been counting beads so far. Each of the XR capsules I take has about 125 beads. Currently I'm taking out 80 beads a day. I cried for about three hours today on and off, but the constant panic I had when I updosed seems to have abated a lot. It's like picking a poison 😥

[ElleCarolina]

On 8/6/2024 at 1:08 PM, Willy said:

Hi @ElleCarolina. I just wanted to stop in here to say lots of us are suffering with you. Good news is you will recover!

 

Please believe Erimus and avoid benzos at all costs. Benzos are the reason I ended up on a drug cocktail 7 years ago. 

 

I have taken your advice very seriously - I haven't taken any more Klonopin (I took it one day only). The last thing I need is another drug messing me up. 

[ElleCarolina]

On 8/6/2024 at 11:47 AM, Catina7 said:

Hi @ElleCarolina, welcome to our wonderful community.  I'm also tapering Effexor (Venlafaxine), so perhaps we can encourage each other!  

 

Catina 💜

 

Hi Catina, thank you so much for your encouraging comment ❤️ I am so sorry that you are experiencing an Effexor taper as well. I hope that your taper has been going well and that you are doing okay! I see in your signature that you experienced kindling when you updosed to 37.5 mg. I took 37.5 mg for two days and then quickly realized I could no longer tolerate that dose. I'm hoping that taking that dose for two days didn't set me back too far.

[Tuikea]

40 minutes ago, ElleCarolina said:

 

Thank you so much for your comment - I can't say how grateful I am for your support. Have you had anxiety with updosing or just with tapering/withdrawal? My anxiety from updosing was intolerable, but a lower dose also feels terrible ... It's like I feel terrible now no matter how much Effexor I take 😥. 

 

I've been counting beads so far. Each of the XR capsules I take has about 125 beads. Currently I'm taking out 80 beads a day. I cried for about three hours today on and off, but the constant panic I had when I updosed seems to have abated a lot. It's like picking a poison 😥

It was past tapers I had bad anxiety, this time I got a small amount of anxiety that went as quick as it came. It was a warning to slow down!!! 

Unfortunately it seems to have hit you bad and only time and keeping stable on your dose will bring you right.

From past experience I have learnt not to put pressure on myself or it will make it worse. Yesterday I tried to do to much to soon and I ended up throwing a wobbly at my husband and putting myself to bed. Today I am pacing myself and off for a lay down and a relax now.

The most important thing right now is getting through each day and hope tomorrow is a bit better.

❤️

[Walleebug]

@ElleCarolina. 

[Erimus]

12 hours ago, ElleCarolina said:

Currently I'm taking out 80 beads a day.

You need to count the number of beads you are taking rather than the number you remove, as some capsules will have wildly different amounts of beads in.

 

There's a bit in Joseph Glenmullen's book "Coming Off Antidepressants" about this:

 

"In late winter, Andy solved the mystery of why the apparently same-sized dosage reductions were producing varying degrees of withdrawal symptoms. 'Not all Effexor capsules have the same number of beads,' Andy reported. 'I've been counting the beads I removed, not realising that left a variable number of beads.'

 

'So, while overall your dose has been going down for months, on a day-to-day basis it's been going up and down?'

'That's what I have now realised.'

Which explains your roller coaster symptoms.'

'Now I'm counting the number of beads that I actually take. It's even more of a pain, but that way I know for sure my dose is decreasing.'"

Edited August 8 by Erimus