SaltyS- Venlafaxine Withdrawal with Possible Mania - I'm on my own and need help

[SaltyS]

I've been on psychiatric meds for over 8 years, I started when I was 12 and I'm 20 now. Antidepressants, antipsychotics, mood stabilizers, anxiety meds, I've tried nearly all of them. I was on venlafaxine for over 3 years and was on it without an antipsychotic in addition for over a year.

 

The taper I did was 1 month long and it wasn't even the bare minimum because my doctor screwed me over by prescribing instant release tablets to taper with (I was on extended release the entire time). Now I've been off it for 2 weeks and it had been hell. I am so full of anxious, restless, angry, agitated energy. I hurt myself compulsively when I get worked up. I'm pretty sure this is mania/hypomania from withdrawal. In retrospect, I'd go back and take all those brain zaps back if it meant I could avoid whatever this is.

 

I know going to a hospital will make all the psych stuff worse, they have a knack for traumatizing vulnerable individuals. I've been to plenty hospitals, seen my fair share of "psychiatric care" if we can call the pitiful system we have now "care". But I also can't cope with the mania(?) so I'm asking for any and all suggestions. My psychiatrist is dumb as rock and also on vacation. I've tried calling her office and no one calls back. It's also the weekend now so I can't access anyone outside of emergency care.

 

Also, I have an anxiety PRN (hydroxyzine) that I've been taking a lot of lately to keep me sedated from having an episode. But they aren't really strong enough to work and they don't end the misery they just shut off the self-violence part of it all. 

 

Please, if anyone has any suggestions to make the mania(?) more manageable or to decrease my suffering I'd love to know

Edited September 23 by Catwoman73
Name to title

[Catwoman73]

Hi @SaltyS, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications, and their associated withdrawal syndromes. 

 

If you could kindly complete your drug signature, we would greatly appreciate it.  Your drug signature if the little blurb that appears at the bottom of each of our posts, summarizing our drug history.  This helps those of us visiting your thread to know your history at a glance, rather than having to weed through pages of posts to figure out where you've been and where you're going.  In order to do this, please click the following link, fill in the box with your history to the best of your ability, and click save.  That's it!  You can look at mine below for an example of the general format. Signatures should include any supplements you are taking, and be kept up to date as things change. 

 

Your Drug Signature

 

I'm so sorry that you're suffering.  What you are experiencing is quite typical withdrawal symptoms.  I have suffered rom agitation, anxiety and extreme rage in the context of withdrawal previously.  See this list of typical withdrawal symptoms for your reference:

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The reason you are suffering is that a one month taper is absolutely nowhere near long enough to keep withdrawal symptoms to a minimum.  Here at SA, we recommend tapering by no more than 10% of you current dose, no more often that every four weeks (so, an example- 10mg, 9mg, 8.1mg, 7.3mg and so on).  This is known as hyperbolic tapering, and is useful in mitigating withdrawal symptoms because it is designed to release the receptors in the brain from the drug at a more tolerable rate, allowing the body to slowly compensate for the biochemical and genetic changes that have occurred while taking the drug.  Read more here about hyperbolic tapering, and about what is happening in your brain:

 

Why taper by 10% of my dosage?

How Psychiatric Drugs Remodel Your Brain

 

The only way to taper safely/hyperbolically from Venlafaxine is to switch from the XR form once daily to dosing the IR form multiple times per day.  So, as an example, say you were on 120mg of an XR drug- you would first switch to either 60mg twice daily or 40mg three times daily of the IR preparation.  Then start to taper by creating your own liquid suspension.  OR you can open capsules of your XR capsules and count beads.  See here for more advice on tapering venlafaxine:

 

Tips for Tapering Off Effexor and Effexor XR (Venlafaxine)

 

Since you've only been off your meds for two weeks, you are in an ideal situation to reinstate venlafaxine to try to stabilize your nervous system a little bit, before proceeding with a hyperbolic taper.  You will not want to reinstate your original full dose- you will want to start with a very tiny, subtherapeutic dose to see how you fare.  Overshooting a reinstatement dose can be disastrous, causing hypersensitivity, and making you feel significantly worse rather than better.  Slow and steady is always the way!  Start at a low dose and hold for at least a week- if you feel no different or slightly improved, you can make slow increases every 1-2 weeks until your symptoms are more manageable.  If you develop a hypersensitivity reaction, you should either try a lower dose, or abandon reinstatement altogether.  Read more here on reinstatement, and take particular note on the thread regarding hypersensitivity so you know what to watch out for. 

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 How long does it take to stabilize after reinstating or updosing?

 Hypersensitivity and kindling

 

Your other option is to just ride this out.  You will heal- I can assure you of that.  What I can't guarantee is the timeline.  You have a long history with these meds, which can make healing a slower and more gradual process.  

 

In either case, you will notice a pattern of days where you feel better, and days where you feel worse as you proceed towards healing/stability.  This pattern is known as the windows and waves pattern of stabilization, and it is an EXCELLENT sign that healing is occurring.  It's easy to be disheartened by the bad days, but keep reminding yourself that just like in nature, all waves eventually recede.  Even tsunamis!  Read more about windows and waves here:

 

The Windows and Waves Pattern of Stabilization

 

You would benefit from starting a symptom journal in order to more clearly identify windows and waves as they come, and to see your improvement over time.  Track each of your symptoms each day, rating them on a scale of 1-10 for severity.  You may also wish to track your food, drug dosages, supplements and activities in your journal as well, in order to identify things that trigger your symptoms (more on that soon).  Not all waves have triggers, but it's nice to know if there's something you can do to avoid worsening of symptoms, and journaling is the only way to figure this out.  You can use the list of typical withdrawal symptoms that I linked above as a template for a journal, if you wish. 

 

There are a few things you can do to help with healing.  Most are fairly intuitive- eat a balanced, whole foods diet, stay adequately hydrated, engage in gentle exercise, and get adequate rest/sleep.  Avoid all neurologically active substances, such as caffeine, nicotine, alcohol and recreational drugs- these substances are highly activating, and worsen symptoms for many here.  And so avoid taking other psychiatric medications to deal with the withdrawal effects of psychiatric medications.  When the nervous system is so unstable, the effects of psych meds are not predictable, and may make thing worse rather than better.  So you should probably reconsider using hydroxyzine, and switch to a low dose reinstatement of venlafaxine if you feel you can't tolerate your current symptoms.  That would be much more safe and predictable. 

 

We only recommend two supplements here at SA: magnesium and omega-3 fatty acids.  Do be mindful though, it is quite common for those in withdrawal to become hypersensitive to all sorts of things, including medications, supplements, and even foods!  So if you start taking any supplements at all, even those we recommend, start with a very low dose, and titrate up slowly if you tolerate it.  Personally, magnesium words paradoxically on me- it gives me brain zaps and insomnia, and I can't tolerate coffee (even decaf), chamomile, refined sugar, and a few other things.  I figured all of this out using my symptom journal, and knowing what makes me worse has been helpful in keeping this journey a bit more tolerable. 

 

Emotional symptoms can be very tough to deal with.  Starting to work really hard on some non-drug coping mechanisms now would be very helpful.  We have many, many threads on this subject here at SA- I'll link some below.  Personally, I have learned to practice mindfulness each and every day, I use guided meditations/yoga nidra/ nature sounds to assist with calming my nervous system/ sleep. I use CBT techniques to deal with emotions- breathing exercises, challenging negative thoughts, etc.  And I love my distractions- engaging in things that bring you joy can help you through the worst days.  I like to swim (I practically feel normal in the water!), cook, and work on artistic projects.  It's important to find what works for you, and mindfully engage in these practices each and every day. 

 

Non-drug techniques to cope with emotional symptoms

 Easing your way into meditation for a stressed-out nervous system

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Ways to cope with daily anxiety

"Change the channel" - dealing with cognitive symptoms

Dealing With Emotional Spirals 

Shame, guilt, regret, and self-criticism

Symptoms and self-care

The importance of recognizing you're feeling good

 

In summary, you have two options- ride this out (though, it doesn't sound like this is a great option for you, given the severity of your symptoms), or reinstate a low dose to try to reduce some of your symptoms.  Take time to find a good dose for you, where your symptoms are manageable, and then hold for a few months to fully stabilize.  Then you could taper hyperbolically, which would be much better tolerated.  Either way, you would benefit from starting a symptom journal to track your windows/waves and progress.  And starting to work really hard on developing your non-drug coping mechanisms would be very beneficial, as this can be a bit of a wild ride, as you've already figured out. 

 

Most of all, please don't lose hope.  We are all healing, all the time, whether it feels like we are or not.  Give your body what it needs to heal, and the journey will be much easier.  ❤️‍🩹

 

This is your introduction topic. Each member gets one intro topic- please post updates and questions here, on this thread.  Don't hesitate to explore the rest of the forum though- there's lots of great information here!  And if you feel up to it, read and comment on the intro threads of other active members.  Having a community of people around you who fully understand what you are facing is very helpful in making this journey a less lonely one.  We can be your community, if you choose to take advantage of the wonderful peer support here!

 

Sending healing vibes, and I look forward to following your journey!  I'm happy to help if you have questions!

 

 

[LostInCanada]

@SaltyS hi and welcome to SA. We really need to see your drug signature to be able to advise. 

Looks like you need to reinstate Venlafaxine but the moderators need to know what your usual dose was and how you tapered to zero including dates.

You would probably need to make your own liquid dose from the pill to be able to taper correctly. But first we want to help you get stable and find a suitable starting dose so you can level out. What you are experiencing is all too common during withdrawal.

Glad you found us. ♥️🙏