JamieZ44: Didn't even realize this was a thing

[JamieZ44]

I took on a career change about 10 years ago. I think I always had some underlying anxiety and don't think I really understood regulated baseline then. During my career change, I had a stressful internship and attended grad school (all unpaid, well, I paid tutition:). I probably had panic attacks before and just didn't realize they were since they didn't always have symptoms of shortness of breath which I thought was what a panic attack was. But they started to increase and I was having trouble functioning professionally/socially and therapist encouraged me strongly to go on anti-anxiety medications, which I did in short order initially be prescribed by GP who say me just once.

Over the course of the next few years, I increased from 75mg of Venafaxine (Effexor) to 225mg. I think I went up to 150mg in my first couple years. It was huge for me. I was a lot calmer. In those first two years the only side effect I noticed and acknowledged was very small sexual impact that didn't negatively impact my life. 

After about 2 years of being on, I started having angry outbursts at work. I would mostly have trouble with patients at that time not coworkers. The conclusion from a therapist is that life stress and anxiety was too much and I should increase from 150mg to 225mg. I think it was around that time I almost had a panic attack and was able to recognize it and get support. I haven't had any since even with troubles with withdrawals. 

Starting to find out what I've realized with support from the internet and forums like this is perhaps after those first two years on the medication I and my professional advice perhaps conflated anxiety symptoms for side effects and later withdrawal as I did not remain at 225mg for only 3-5 years.  I started experiencing extreme fatigue like hardly having any energy particularly during times off of work or vacation needing to sleep and rest nearly all the time. I was experiencing weight gain after going up to 225mg. I started having other health issues with my weight. I can't recall when and if about flatness or blunted mood because I was stressed. I had suicidal as well as violent homicidal thoughts, which I never experienced before going on the medication. Sometimes when I look back I struggle to remember things, particularly movies. There will be movies I watched during that time period, and I have little memory of them when I go to watch them. This is not normal for me. 

In the last few years I took a less stressful job and relocated from my home country. I thought my weight loss and fatigue would disappear with a job change. It helped a lot, and I started to taper down. I've now successfully tapered down to 37.5mg. I went much slower than my phycologist recommended. I actually started moving my doses around when I still working at my stressful job and didn't realize some of the rage. While I went super slow. I think I went down from 187.5 or 150 mg I can't remember to the 37.5 mg I am on now over the course of a year and a half. I would usually taper over a month. Until I got down to 75mg and lower I didn't have the most severe issues. I've had really intense outbursts and angry irritability. So I stopped at 37.5mg and started to find news reports and articles about withdrawal issues and realized my physicians perhaps didn't have all the context to help and told me to taper way faster when I was tapering way slower than they suggested.  

So now I am struggling with function particularly with work. My fatigue is pretty overwhelming. I've seen something about windows and waves. Its been that because I've had windows and waves. At times the waves are really disappointing because I am making progress and overwhelmed or fatigued comes what feels like out of nowhere. 

Where I live now I can only appear to get access to 37.5mg. I also am struggling to find psychologists who really know much. I know this is a problem where SSRI and antidepressants are prescribed more, but like they are easy to get here, but they are very rarely used. I'm kind of at a cliff I feel like. I want more of a plan and support. Its effecting my quality of life, relationships, and work. But I felt maybe not my relationships but everything else is also try being on 225mg of these things. I don't know what to do. 

 

[Jane318]

Greetings @JamieZ44 and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications and their associated withdrawal syndromes. 

 

Please put the above information in a drug signature - drugs, dosages, and dates to the best of your recollection.   Summarizing your drug history in this way helps us be informed and efficient in addressing your concerns.  To create a signature, click the following link, fill in the box, and click save. Your Drug Signature. 

 

I am sorry you are suffering so much right now.  This is the right place to get information, support, and help with a plan for getting off Effexor.   I too am tapering off Effexor and can relate to the extreme fatigue and other symptoms you describe.  I've learned Effexor is a "high risk" AD for withdrawal symptoms.  That symptoms worsened as you got to lower doses is typical.  Even though you tapered down over 18 months, which fortunately much more slowly than most of us did before we were better informed, it is still faster than we would recommend for such a high starting dose.  Withdrawal symptoms were likely piling up in the background and have caught up with you (as they did with me). 

 

You were wise to stop tapering at your current dose of 37.5 mg. Depending on your history, you might consider a slight updose in order to ease withdrawal symptoms or you can continue to hold at current dose until you stabilize.  The good news is that you WILL heal.  But it may take several months for you to stabilize.  You can read about reinstatement/updosing here: 

Reinstatement: About reinstating and stabilizing to reduce withdrawal symptoms

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

 Hypersensitivity and kindling

 

Alternatively, you can choose to hold at current dose until you stabilize.  Let us know if you have questions on this after reading the above topics.

 

Once you are ready to resume tapering, we recommend a hyperbolic tapering method: Why taper by 10% of my dosage?  This gradual taper gives the nervous system the time it needs to slowly undo all those biochemical and genetic changes made due to the presence of the drug, and therefore, minimizes the severity of acute withdrawal symptoms.  It also reduces the risk of protracted withdrawal.  

 

As you stabilize and then resume tapering, you will notice that you have periods where you are feeling better, interspersed with periods where you feel worse.  This is absolutely normal.  Experiencing windows and waves is a sign that the nervous system is doing the work it needs to in order to find homeostasis again: Windows and waves pattern of stabilization.

 

I recommend you keep a daily symptom journal - This will help you identify your windows and waves, and may help you identify medications, foods, or activities that trigger symptoms for you.  If you can avoid your triggers, the journey definitely goes a bit more smoothly.  You can use this list of typical withdrawal symptoms as a template for a journal, if you wish:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

As you hold, I encourage you to eat a healthy, whole foods, balanced diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep to support your body's healing.  Avoid all neurologically active substances, including caffeine, nicotine, alcohol and recreational drugs. These things can be like pouring gasoline on a fire for your symptoms.  And avoid adding any further psychiatric medications to deal with the withdrawal effects of psych meds.  When the nervous system is destabilized, the effects of these meds are not predictable, and can make you worse rather than better.  

 

It is very common for those in withdrawal to develop sensitivities to other medications, supplements, and even some foods.  We recommend only two supplements - magnesium and omega-3 fatty acids.  So if you start any supplement, even those we recommend, start with a low dose, and see how you fare.  If you tolerate them, you can increase the dose slowly over time.  

 

It is important to learn how to cope with symptoms – I encourage you to check out the various forums / links on the SA.org home page.  

 

Do explore the rest of the forum – there is a lot of great information here.  Be sure to read “About SurvivingAntidepressants.org,” which has good information about how to use / search the site: https://www.survivingantidepressants.org/forums/topic/54-about-survivingantidepressantsorg  

 

Also, feel free to read and comment on the intro threads of other members.  This is how you build a community of people who understand what you are dealing with.   It is so helpful to connect with others who are experiencing the same things.

 

This is your introduction topic.  I look forward to following your journey, and helping out in any way I can.  Please keep us updated and ask any questions here, in this thread.  Best wishes.

 

 

Edited October 31, 2024 by Jane318

[JamieZ44]

4 hours ago, Jane318 said:

Greetings @JamieZ44 and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications and their associated withdrawal syndromes. 

 

Please put the above information in a drug signature - drugs, dosages, and dates to the best of your recollection.   Summarizing your drug history in this way helps us be informed and efficient in addressing your concerns.  To create a signature, click the following link, fill in the box, and click save. Your Drug Signature. 

 

I am sorry you are suffering so much right now.  This is the right place to get information, support, and help with a plan for getting off Effexor.   I too am tapering off Effexor and can relate to the extreme fatigue and other symptoms you describe.  I've learned Effexor is a "high risk" AD for withdrawal symptoms.  That symptoms worsened as you got to lower doses is typical.  Even though you tapered down over 18 months, which fortunately much more slowly than most of us did before we were better informed, it is still faster than we would recommend for such a high starting dose.  Withdrawal symptoms were likely piling up in the background and have caught up with you (as they did with me). 

 

You were wise to stop tapering at your current dose of 37.5 mg. Depending on your history, you might consider a slight updose in order to ease withdrawal symptoms or you can continue to hold at current dose until you stabilize.  The good news is that you WILL heal.  But it may take several months for you to stabilize.  You can read about reinstatement/updosing here: 

Reinstatement: About reinstating and stabilizing to reduce withdrawal symptoms

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

 Hypersensitivity and kindling

 

Alternatively, you can choose to hold at current dose until you stabilize.  Let us know if you have questions on this after reading the above topics.

 

Once you are ready to resume tapering, we recommend a hyperbolic tapering method: Why taper by 10% of my dosage?  This gradual taper gives the nervous system the time it needs to slowly undo all those biochemical and genetic changes made due to the presence of the drug, and therefore, minimizes the severity of acute withdrawal symptoms.  It also reduces the risk of protracted withdrawal.  

 

As you stabilize and then resume tapering, you will notice that you have periods where you are feeling better, interspersed with periods where you feel worse.  This is absolutely normal.  Experiencing windows and waves is a sign that the nervous system is doing the work it needs to in order to find homeostasis again: Windows and waves pattern of stabilization.

 

I recommend you keep a daily symptom journal - This will help you identify your windows and waves, and may help you identify medications, foods, or activities that trigger symptoms for you.  If you can avoid your triggers, the journey definitely goes a bit more smoothly.  You can use this list of typical withdrawal symptoms as a template for a journal, if you wish:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

As you hold, I encourage you to eat a healthy, whole foods, balanced diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep to support your body's healing.  Avoid all neurologically active substances, including caffeine, nicotine, alcohol and recreational drugs. These things can be like pouring gasoline on a fire for your symptoms.  And avoid adding any further psychiatric medications to deal with the withdrawal effects of psych meds.  When the nervous system is destabilized, the effects of these meds are not predictable, and can make you worse rather than better.  

 

It is very common for those in withdrawal to develop sensitivities to other medications, supplements, and even some foods.  We recommend only two supplements - magnesium and omega-3 fatty acids.  So if you start any supplement, even those we recommend, start with a low dose, and see how you fare.  If you tolerate them, you can increase the dose slowly over time.  

 

It is important to learn how to cope with symptoms – I encourage you to check out the various forums / links on the SA.org home page.  

 

Do explore the rest of the forum – there is a lot of great information here.  Be sure to read “About SurvivingAntidepressants.org,” which has good information about how to use / search the site: https://www.survivingantidepressants.org/forums/topic/54-about-survivingantidepressantsorg  

 

Also, feel free to read and comment on the intro threads of other members.  This is how you build a community of people who understand what you are dealing with.   It is so helpful to connect with others who are experiencing the same things.

 

This is your introduction topic.  I look forward to following your journey, and helping out in any way I can.  Please keep us updated and ask any questions here, in this thread.  Best wishes.

 

 

Jane thanks so much your response and empathy. A quick question if the pills I can find the smallest is 37.5 mg. How would I take less than that?

[Jane318]

@JamieZ44 -

 

Please complete Your Drug Signature. 

 

To your question - This depends on which form you use.  If XR, you can open the capsules and count beads to taper.  I take the venlafaxine HCl tablets - I crush, weigh, and dissolve in water.   The topics linked below provide the details:

Important topics in the Tapering forum and FAQ

Tips for tapering off Effexor and Effexor XR (venlafaxine)

 

I describe how I prepare my own solutions in my Introduction, July 15 post.

 

Let us know if you have more questions after reading through these posts.

 

Edited November 1, 2024 by Jane318
added second request for signature