code: Introduction of me: "code"

[code]

So I've been on 150mg Venlafaxine daily for ~10 years. Originally started taking it for depression/anxiety, which I think helped.

 

Started tapering down as follows:

 

Jul 8 - 135 mg per day
Aug 4 - 121.5 mg per day
Sep 22 - 109.36 mg per day
Nov 10 - 98.4 mg per day
Nov 17 - 103.88 mg per day (current)

 

The tapering process started off okay, the first 2 10% reductions were easy enough. Started getting a few side effects after that, and you can see I actually went back up 5% a week after Nov 10th's drop in dose.

Since around November I've been struggling with anxiety and focus.

 

Bit of background, I work as a software engineer and require strong focus and concentration to perform my work.

 

Loss of focus has been quite disruptive the past month-ish (probably since early November). It started out with small things, like noticing I was skimming over sentences more often while reading, or giving up reading internet comments whenever a particular comment was too long. I'm considerably more distracted in meetings, finding my mind frequently drifting away. Reading code and holding the requisite multiple abstract concepts in my mind while reasoning about a problem has become increasingly difficult.

I have been wondering if this is partly caused by a change in Venlafaxine's mechanism of action as the dose reduces. Acting as both a serotonin (SNRI) and norepinephrine reuptake inhibitor at doses at or above 150 mg daily, I wonder if since reducing my dose I am more strongly feeling the loss of norepinephrine reuptake inhibition.

 

The key question I have is will this begin to improve as my brian learns to regulate norepinephrine itself? What I am afraid of is that I am dependent on this medication to perform my job to an acceptable level. When the withdrawal symptoms fade and I am completely free of the medication, will I still be capable of this mentally demanding job? Or did some element of Venlafaxine provide me with the capability to focus so well. This thought scares me. I hope it's just withdrawal symptoms...

 

Hopefully that paints a clear enough picture of the focus related issues.

 

I am also acutely aware I am judging my performance more harshly, which may contribute to an overly un-generous perception of my performance. I also find an increased tendency to assume others "dont like me" or "think I'm not good enough". Part of this must be a normal return of emotions long since hidden from me by Venlafaxine, or manifestations of withdrawal symptoms which are to be expected. In other words, I'm aware I should be cautious in how much I trust my own thoughts right now.

 

Side note, I eat very well and exercise regularly.

 

I am trying to resist giving up and going back to my full dose. It helps to keep in mind the reasons I wanted to stop. My current plan is to stop tapering until the symptoms have stabilised completely.

[Jane318]

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

 

Thank you for completing your drug signature.

 

I commend you for your decision to get off venlafaxine and the research you obviously did beforehand to follow the slow, hyperbolic taper method that we recommend.   You were wise to put a pause on things when symptoms became noticeable.  This is not unusual.  Venlafaxine is considered high risk for withdrawal symptoms and so can be a difficult drug to get off of, as I have learned for myself.  

 

On 12/9/2024 at 4:50 AM, code said:

Loss of focus has been quite disruptive the past month-ish (probably since early November). It started out with small things, like noticing I was skimming over sentences more often while reading, or giving up reading internet comments whenever a particular comment was too long. I'm considerably more distracted in meetings, finding my mind frequently drifting away. Reading code and holding the requisite multiple abstract concepts in my mind while reasoning about a problem has become increasingly difficult.

I have been wondering if this is partly caused by a change in Venlafaxine's mechanism of action as the dose reduces. Acting as both a serotonin (SNRI) and norepinephrine reuptake inhibitor at doses at or above 150 mg daily, I wonder if since reducing my dose I am more strongly feeling the loss of norepinephrine reuptake inhibition

Trouble concentrating is a common withdrawal symptom.  Compare with this WD symptom checklist:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF).  It is one I have experienced, and my original dose was less than 150 mg.  The chemical imbalance theory that so many of us were told was at the root of our problems ... turns out that this was just a made-up story.  (Again, chemical imbalance is a myth. Stop the lies, please.)  We experience withdrawal symptoms when our brain / central nervous system is working hard to re-establish homeostasis in the absence of the drug.  You may want to read/view:

 

What is withdrawal syndrome.

Brain Remodelling 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 12/9/2024 at 4:50 AM, code said:

The key question I have is will this begin to improve as my brian learns to regulate norepinephrine itself? What I am afraid of is that I am dependent on this medication to perform my job to an acceptable level. When the withdrawal symptoms fade and I am completely free of the medication, will I still be capable of this mentally demanding job? Or did some element of Venlafaxine provide me with the capability to focus so well. This thought scares me. I hope it's just withdrawal symptoms...

 Please do not fear - Withdrawal symptoms are not permanent, you will recover your focus once your brain / central nervous system has stabilized / healed. 

 

On 12/9/2024 at 4:50 AM, code said:

I am also acutely aware I am judging my performance more harshly, which may contribute to an overly un-generous perception of my performance. I also find an increased tendency to assume others "dont like me" or "think I'm not good enough". Part of this must be a normal return of emotions long since hidden from me by Venlafaxine, or manifestations of withdrawal symptoms which are to be expected. In other words, I'm aware I should be cautious in how much I trust my own thoughts right now.

I can identify with these self-condemning / negative thoughts, which for me also intensified as my dose got lower.  The ADs do mask / numb our feelings, which can be a relief in the short term but in the long term, interfere with normal maturing processes of working through our problems.  And I sure withdrawal plays a large part.  I am glad you have the insight to not put too much stock in these thoughts.  Here is some information that may help you cope with these and other withdrawal symptoms:

Apathy, anhedonia, emotional numbness, emotional anesthesia 

Non-drug techniques to cope with emotional symptoms

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

"Change the channel" - dealing with cognitive symptoms

Dealing With Emotional Spirals

Symptoms and self-care

 

Getting Started With Mindfulness

Cognitive Behavior Therapy (CBT) for anxiety, depression, withdrawal symptoms, insomnia

 

On 12/9/2024 at 4:50 AM, code said:

Side note, I eat very well and exercise regularly.

This is so important!  Among other things, the brain is re-building receptors - we want to provide the best building blocks we can through good nutrition.  Exercise is important although we caution against over-exertion and that can aggravate symptoms.

We do encourage people who are tapering to avoid caffeine, alcohol, and recreational drugs.  Many prescription and OTC drugs can cause problems too and should be avoided as much as possible. 

 

We recommend only two supplements here - magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

On 12/9/2024 at 4:50 AM, code said:

I am trying to resist giving up and going back to my full dose. It helps to keep in mind the reasons I wanted to stop. My current plan is to stop tapering until the symptoms have stabilised completely.

I would strongly urge you to not go back to your full dose.  If your symptoms are not manageable right now, you might consider another small increase.  But a sudden increase back up to 150 mg could trigger a kindling reaction, which can be difficult to recover from and may make it harder the next time you try to taper.

Recommend reading:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

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

Hypersensitivity and kindling

 

If I were you, I would stay at current dose for at least another month or two until you feel you have stabilized.  When you are ready to resume tapering, you may find that tapering by smaller weekly amounts more tolerable. You can read more about this approach here: The Brassmonkey Slide Method of Micro-tapering.

 

 

As you hold and later as you continue to taper, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization.  This is actually a good sign of healing!  Read more about windows and waves here:   The Windows and Waves Pattern of Stabilization

 

 

It’s important to keep tabs on your symptoms.  This will help you identify your windows and waves and reveal your progress, which is encouragement we need!  And as you resume your taper, it will help guide you in adjusting amount and schedule as needed.

You can use the following list of typical withdrawal symptoms to track the severity of your symptoms over time:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF).

You may choose to also track your foods and activities to identify things that trigger symptoms as well. 

 

Again, I encourage you that these symptoms are temporary.  Given the nature of this drug and your demanding job, you may need to taper much more slowly than you first expected, however.  This is not important - the time will go by regardless.  What is important is that you continue to move forward in your journey towards a drug-free life!

 

This is your introduction topic.  Each member gets one intro topic.  Let us know if you have any other questions and please keep us posted here, in this thread.

 

Best wishes.

 

[Jane318]

How are you doing @code?  Wishing you the best for the holidays.

[code]

Hey, apologies for the slow reply.

 

I did read your message shortly after you posted it, and I can't quite find the words to say how much it helped in the moment. I really needed to read it. It was very grounding and let me externalise my worries. I managed to hold on at my current dose thanks in part to your reply.

 

So, thank you for taking the time to respond with such useful information, I am still working my way through.

 

As for progress, you mentioned "waves pattern of stabilization"; a few days after posting this message I started to feel a lot more normal, happy even. My mood changes in ebbs and flows over the course of days/weeks but overall I'm noticing a return to some stability. There really is a lot of truth in that waves of stabilisation concept.

 

Right now I feel pretty fine, tired after all the holiday food and later nights, but pretty good otherwise.

 

I expect I will stay on this current dose for a total of ~2 months, making another 5% drop when I have felt "normal" for "long enough".

 

Thanks again, have a good rest of your holiday season, I will update here some time soon.

[Jane318]

8 hours ago, code said:

thank you for taking the time to respond with such useful information, I am still working my way through.

It is a lot of information - I have to take it a bit at a time.  But the more I learn, it helps me see what I am dealing with. That this is withdrawal, not the real me, and it will get better. 

 

8 hours ago, code said:

ou mentioned "waves pattern of stabilization"; a few days after posting this message I started to feel a lot more normal, happy even. My mood changes in ebbs and flows over the course of days/weeks but overall I'm noticing a return to some stability. There really is a lot of truth in that waves of stabilisation concept.

It is amazing isn't it?!  SA has built up this wisdom through the experiences of tens of thousands of people like you and me.  I recently felt that I had stabilized after several months of holding - it DOES happen and you will know when you have reached that point.

 

8 hours ago, code said:

Right now I feel pretty fine, tired after all the holiday food and later nights, but pretty good otherwise.

 

Great news!

 

8 hours ago, code said:

expect I will stay on this current dose for a total of ~2 months, making another 5% drop when I have felt "normal" for "long enough".

This is wise - you will know when you are ready to resume tapering.

 

8 hours ago, code said:

I will update here some time soon.

No pressure, but when you feel up to it.  Your experience helps benefit the entire SA community.

 

Thanks for the update and Happy New Year!