Lexy: tapering off Effexor

[Lexy]

The constant depression came in from one day to the next.  It began coming in the afternoon and now its upon awakening.  When I wake up its usually a 4 and escalates through out the day.  A good day is when it stops at a 6.5, ten being the worst.

 

Before last month these low moods would only last an hour or less, maybe 3-4 times a week.  

[Altostrata]

What does this depression feel like?

[Lexy]

 doom, despair, hopelessness, 

[Altostrata]

Do you also have any particular thoughts when you wake up, Lexy?

[Lexy]

My first thoughts upon wakening are.....Again? I have to deal with this again? ANother day of the same,,,

I'm also having brain zaps that had diminished by a third but are coming back in flurries.

[Altostrata]

Do you think your attitude could be contributing to your emotional state?

 

Are you also seeing a therapist?

[Lexy]

I havent found a therapist that believes in withdrawals.  Can you recommend someone?

 

What is the difference between depression and antidepressant induced withdrawal?  

[Lexy]

excuse me

 

that should be depression induced from withdrawal....

[trouper]

lexy,

i'm not sure about you but many of my withdrawal symptoms don't really follow a pattern. i think that its just the way i am healing. things change so much for no reason at all that part of me gave up trying to find a pattern. sometimes i will wake up in the middle of the night with the withdrawal induced depression, sometimes evenings, sometimes mornings. sometimes it lasts several hours and sometimes it lasts 10 minutes. one thing that kind of happens in a pattern for me is that my symptoms ramp up and get worse or more constant before it "breaks" and relieves itself for a bit, including zaps. knowing this helps me deal when things start to ramp up. have you noticed anything like this?

 

my therapist has worked with people who've had withdrawals from antidepressants but she's never been exposed to a case as severe as mine. i've had to school her and a lot of other providers and i continue to see the ones i can trust and who believe and support me. most of the time you can talk to someone for a few minutes and get a feel for them and you can decide if you want to give them a try. you can explain what you are going through and tell them its important they believe this is real. my acupuncturist (who i trust) recommended my therapist to me. do you have any provider you see that you trust who can give you a recommendation?

[Lexy]

Thanks trouper 

I am trying to find a therapists that believes in withdrawals that can be helpful in dealing with these depressive feelings.

[Lexy]

I just spoke to Dr. Stuart Shipko

 

I had contacted him while i was waiting for my new doctor to call.  I hadn't heard from him until now, which completely took me by surprise.  

We talked for about fifteen minutes and told him my story, I hope i was making sense because i was so afraid he'd had to cut it short and leave me hanging on.

I'd like to write it down in here in case i forget….

He obviously agreed that I have been sensitive to these type of drugs.  I let him know about using both the effexor extended release and immediate release, lamictal and that my new doctor wanted me to start on the Brintellix, which he hadn't heard of. 

 

He feels that I should not try any other drug because of horrible side effects that affect me so quickly.  He said If I were him he would stay at this dose until I completely feel better. Then taper off 10% per month, which i think that's way too fast.  

He also said he would just take the 37.5mg for as long as it took to feel better and forget the tapering and immediate release.  Then use the bead method to taper.

 

I am so in need of advice, don't know if I should try the 2.5mg  Brintellix or go on effexor 37.5mg once a day.

[trouper]

thats nice he got back to you.

i can't offer any advice on tapering. does the l-theanine do anything for you?

i sent you a private message, btw.

[Lexy]

I have an appointment with my doctor and he will want me to try Brintellix at 2.5mg,  I've tried looking up others who have been on this new med and there is not much out there.  

 

After talking to Dr. Shipko he said to switch to 37.5mg on Effexor xr and stay at that dose until i feel better.

 

 I don't know whether to try the Brintellix or take the 37.5mg.  

 

 

I have't changed anything since the last week of May:

 

8:00am Effexor XR-15mg

1:00pm Effexor immediate - 7.5mg

6:00pm immediate release 7.5mg

10:00pm XR        10.5mg 

 

Total Effexor 40.5mg

 

My mood (depression) is worse in the evening, should i trying changing the 6pm dose to the XR? Many have said that there is not a difference between the XR and immediate release however when i changed to the XR the vertigo, dizziness and headaches went away.  Now its the emotional problems: depression and irritability. Or is this the pattern of withdrawals?

 

When I first cut 150 to 75mg I had flu like symptoms, and vomiting almost every day.  That went on for three months,  next three months came the vertigo.

After that were the headaches then the joint pain and worsening of the fatigue.  

I appreciate any feedback from anyone.

[trouper]

when is your appt with your doctor? maybe you can ask him what he wants you to do about effexor then.

did you make a major change when you changed things up last may?

 

i wish there was a pattern to the way we heal. it would make things so much easier. it seems everyone heals differently.

[ladybug]

I'm sorry you have to go through this, Lexy. Paxil and Effexor are so terribly hard to taper off of. I have been tapering for many years and despite a micro taper and long holds I still have many symptoms. I wonder if your daily dosing schedule is the problem. It seems very strange to take two different types of Effexor 4 times a day. If it were me I would opt for trying the once daily dosing of 37.5mg Effexor XR and a long hold. That's just my personal opinion.

[Lexy]

Thanks for your reply ladybug,. Maybe I should try to find a better dosing schedule before trying another med.

 

Has anyone heard of brintellix?

New doctor would like me to try this out.

 

How long does a wave of depression last?

[Newbeginning]

Gosh Lexy...I hate to see you suffering like this!

 

It seems to me that the depression arised when you did not do any major changes in the dosage of effexor. Is this correct? Depression is a real illness and it's not always the result of withdrawal. We need to figure out if your depressive symptoms are due to withdrawal. I think that's an important consideration in your case.

 

I agree with ladybug. Why are you on this "odd" dosage of effexor? How did you decide on this combined xr and non-xr 4 times a day dosaging? What is the rationale?

 

If you're on summer break or can take a prolonged break from school and other stressors (which I highly recommend in your case because you're dealing with enough as it is), I'd think it would be best to go back to the dosage you were at before all hell broke lose and stay there as long as necessary to regain stability.

 

I understand you're in agony now, but all the changes you're trying to get relief might be making it worse.

 

Let's start by trying to understand exactly when and why your situation worsened. Maybe we can figure something out in retrospect that you missed because you were so distraught by the onslaught of new symptoms.

 

Also, you need to find a therapist. Someone that you feel listens and understands. She does not need to be specialized in withdrawal, as long as she is open to the reality that some people are more sensitive to meds and can experience all kinds of symptoms for long periods of time as a result of med use.

 

You need help for the symptoms of depression youre having--regardless of their cause. The only help I can think of right now is psychotherapy. I urge you to seek a therapist and consider it as important as seeing the psychiatrist. Forget about looking for one specialized in withdrawal. Look for someone with a lot of expertise treating depression. You can call them on the phone and get a feel for them. Tell them the situation and see how they would address it. Then make an appointment with whoever feels like he/she might be a good choice.

 

Where do you live exactly? Could you PM it to me if you don't want to post it in the forum?

 

[Lexy]

Thanks for your kind words.

I know I did not have depression before I started the effexor. I was doing great in my senior year of high school regardless of the panic attacks I was having from the PTSD.

I believe if I had gone to a therapist instead of a psyche doc I would not be like this.

 

How can I tell if this is depression or wd depression?

[trouper]

for me, if the depression is independent of my thoughts i know its withdrawals. its just this sunken feeling that happens out of the blue.

[Lexy]

Yesterday that's exactly how I feel.

 

I have another appointment with my new doctor yesterday he'd like me to try the new medicine Brintellix. He will be starting me at 2.5 mg the lowest dose it comes in is 5 mg. I know someone else who tried brinteliix ecept at 5 mg and she did worse on the depression wd.

I know I have to work with my doctor, he does seem a lot more knowledgeable than my previous doctor, however I am afraid to get on so many different meds that will make me worse off.

He did mention going up higher on Effexor to relieve some symptoms. The last dose that I was on before this wave of depression was about 41.75mg. Should I have to go up higher than this or should I just creep up the dose until I feel better?

 

I did increase by .25mg two weeks ago however it did not change anything.

I'm currently at 40.5 mg.

 

He told me not to start the brintellix now and wait until after an event that I am obligated to go to. Can anyone advise me if I should go up on the Effexor now before I start the brintellix?

[cymbaltawithdrawal5600]

Well, I did a little reading on it and brintellix is just another drug (according to rxlist) that purports to manipulate serotonin. If you believe in that sort of thing (many here don't) as a way to 'cure' depression then that is up to you. Others may weigh in on this matter but it surely seems as though your doc is throwing meds at your 'depression'.

 

Lexy, do you think that another med will fix this? The way you feel? And do you think that increasing the med you are tapering will take the depression away? I, for one, know that no medication will ever be able to relieve my 'depression' without ultimately making me feel worse and very ill to boot. Right now I am severely depressed and know I will just have to live with it till it turns around. Walking every day, eating well and maintaining sleep are bound to have an effect eventually, even if slowly, and at a lot less risk to my overall health.

[Newbeginning]

It can be hard to distinguish them Lexy. If you get the depression right when you decrease/stop the med or within a few weeks and accompanied by other withdrawal symptoms like brain zaps, sensory disturbances, etc, then you know it's probably withdrawal.

 

While it is true you had no depression before effexor, you were very young and depression usually starts in the early 20s. PTSD and anxiety disorders increase your risk too, so your problem might have been anxiety but the stress from those problems and the stress you've been through because of withdrawal could have certainly triggered depression too.

 

Other than the timing and whether the beginning of depression happened at the same time as other withdrawal symptoms, it can be very hard to tell.

 

It would be helpful to understand your symptoms better. Could you point out which of these symptoms you have?

 

1-Depressed mood: feeling sad, irritable, or apathetic?

2-Increased or decreased appetite

3-Sleeping a lot more than usual, insomnia, waking up at night unable to go back to sleep.

4-Fatigue or loss of energy

5-Feelings of worthlessness or inappropriate guilt.

6-Crying spells

7-Hopelessness

8-Loss of pleasure in activities that used to be pleasurable.

9-Diminished concentration or difficulty making decisions

10-Recurrent thoughts of death or suicide

11-Intrusive thoughts/rumination

12-Psychomotor retardation or agitation (moving much slower than usual or being agitated, pacing around, unable to stay still)

 

Another thing to consider is any other meds you have taken even if they are not psych meds. Some meds that can cause depressive symptoms as a side effect or from withdrawal are:

Reserpine, steroids, alpha-methyldopa, propranolol and hormonal therapy; as well as active use or withdrawal from alcohol, cocaine, sedatives,

opiates, cannabis,anxiolytics, hypnotics and amphetamines.

 

Even other meds not listed here might cause it so it's important to consider other meds you're taking.

 

Another important thing that I don't think you ever answered: when was the last time you checked your thyroid, sex hormones, B12, Vit D, glucose, anemia & general blood check? All these things can cause depression that feels exactly like clinical depression.

[Newbeginning]

I respect all opinions, but I believe depression does exist. I experienced it before I took antidepressants and have several family members who've had it who have never even tried antidepressants. It is a very real illness. It's also a serious illness that can be fatal and is often fatal, regardless of whether the person treated it with antidepressants.

 

Depression existed and was documented for centuries, way before antidepressants even existed. To say depression is not real or is always the result of withdrawal is just inaccurate.

 

That is not to say that antidepressants are the right treatment for everyone or for every depression. I completely agree that they are overprescribed and that in many cases they not only don't help, but make things worse.  But to go to the other extreme and say depression is exclusively the result of antidepressant use or withdrawal is a generalization that does not apply to every person.

[Lexy]

I feel sad, irritable, guilt, difficulty making decisions, thoughts of death,  brain zaps, hot flashes, sometimes nausea, memory is not good.

I feel I need to constantly move my hands (fidgety).  

I do not take any other meds except birth control to regulate cyclle and medical cannabis, which is the only thing that helps to subside these symptoms.  I told my new doctor (actually my asked him if this was bringing the depression) about the cannabis and he asked if I had ever felt paranoid on it.  That would be a negative.   He replied that with pot its what you see is what you get for  the moment.  That its trying to modulate my serotonin levels which only lasts as long as the high.

 

I just read an article Which Antidepressant to Choose From.  For children and adolescents, therapy is what is recommended before any antidepressants are used.  If not successful then Prozac should be prescribed (i got suicidal ideations in three days on Prozac)  for my previous doctor to put me on Effexor is so hard to understand after what I've gone through with this crap.

 

I don't know what else to do, I can either go up higher on Effexor or try the new med, or do nothing and wait.  

When I had the vertigo, it lasted for months, also the headaches took months, will the depression last months also?? 

[Newbeginning]

I feel sad, irritable, guilt, difficulty making decisions, thoughts of death,  brain zaps, hot flashes, sometimes nausea, memory is not good.

I feel I need to constantly move my hands (fidgety).  

I do not take any other meds except birth control to regulate cyclle and medical cannabis, which is the only thing that helps to subside these symptoms.  I told my new doctor (actually my asked him if this was bringing the depression) about the cannabis and he asked if I had ever felt paranoid on it.  That would be a negative.   He replied that with pot its what you see is what you get for  the moment.  That its trying to modulate my serotonin levels which only lasts as long as the high.

 

I just read an article Which Antidepressant to Choose From.  For children and adolescents, therapy is what is recommended before any antidepressants are used.  If not successful then Prozac should be prescribed (i got suicidal ideations in three days on Prozac)  for my previous doctor to put me on Effexor is so hard to understand after what I've gone through with this crap.

 

I don't know what else to do, I can either go up higher on Effexor or try the new med, or do nothing and wait.  

When I had the vertigo, it lasted for months, also the headaches took months, will the depression last months also?? 

 

Ok, that new information changes a lot though. Namely,

 

1-You're not just taking effexor. You're taking 2 other drugs that can affect mood.

 

2-Keep in mind that, even if you did not have certain side effects from them before effexor withdrawal, it is not uncommon for people to react differently to medication once they have been through withdrawal.

 

3-Hormonal disbalances and hormonal therapy can cause depression in some people. Have you checked your hormones recently?

 

4-Think back 2 months ago. Where there any changes in dose or frequency of use in the Marijuana or Hormone?

 

I don't know if you misunderstood the dr, but his statement that "with cannabis, what you see is what you get" sounds naive coming from a psychopharmacologist. Cannabis is a psych drug and no one can predict what it can do to the brain, especially long term and especially in someone very young whose brain is still developing, and especially in someone sensitive to drugs and who has gone through withdrawal like you!

 

I'm not saying the cannabis is bad for you, but to just assume it plays no role in your symptoms without much evidence is not wise either.

 

Let's start looking closer at these things and see if we can figure something out. I also sent you a PM. Hang in there! This WILL pass. Promise.

[Lexy]

New beginning

I didn't receive your PM.

[Petunia]

Hi Lexy,

I'm also wondering if perhaps something else may be adding to your symptoms.  How long have you been on birth control pills and what kind?  As newbeginning mentioned, some of them are notorious for increasing anxiety and depression in some women, I could never take them. When my daughter first started trying to take them, she had bad reactions to any which contained estrogen, she had a sudden, complete personality change to one kind and said she spent 2 weeks crying almost every day at school and she rarely cries.  She is ok on the progesterone only kind and actually has an implant now.

 

The cannabis may be temporarily relieving symptoms, but be causing more long term destabilization please read through this thread which discusses the pros and cons of its use in withdrawal:

 

http://survivingantidepressants.org/index.php?/topic/5030-cannabis-thc-or-marijuana-to-ease-withdrawal-symptoms/

 

Please would you add those other meds to your signature.

 

You have been struggling for a long time Lexy, I hope that what you decide to do helps.

 

Petu.

[Newbeginning]

I agree 100% with Petu. Thanks for sharing the cannabis thread. I'll check it too. Have never tried cannabis myself for depression or anything else & I'm interested in hearing people's experiences. My intuition tells me it might alleviate anxiety temporarily, but it has withdrawals of its own and, depending on the person's sensitivity, and the dose & chronicity of use, the symptoms of cannabis withdrawal could very well mimic and/or aggravate both anxiety & depression. This is especially true in withdrawal.

 

I tried birth control pills many years ago when my period stopped due to stress. I could not handle them more than a week. The headaches and stress they caused were something I never experienced before. If you have a hormonal issue still, try bioidentical hormones. But only take them if you have to. What exactly is wrong with your hormones & when did it start? Maybe you don't even need them at this point.

 

Hormones are very powerful chemicals that affect many systems in your body.

[Lexy]

Its been 7 weeks since this depression wave set after the .50mg decrease I made in May.  Brain zaps are still coming in flurries…is this a sign that .50mg was too much of a cut? Are the brain zaps the tell tale sign that the depression wd induced?   Also anxiety is a constant now.

It seems that anxiety and depression try to battle each other out and comes out as a draw.  

 

I am still debating whether I should take the new drug Brintellix, I told doctor that I would take after an event that I was obligated to go to.  Now its time to decide.

 

I dont want to introduce any new drug to my system as sensitive as it is.  I understand my new doctor is trying to find ways of helping but this is a a shot in the dark as this med barely came out last year.  There is another person in this forum who took Brintellix  and made her depression worse.  Should I just try to stay on Effexor and not taper for months?  

 

Should I try going back on the generic immediate release to see if that helps instead of introducing a new drug?  Shouldn't I try that first? 

I know I'm throwing a lot questions and that I should be talking to my doctor about all this except I need to hear from people who are dealing with all this since I value your opinion on top of the doctors. 

If I would have come here in the first place I would NOT be suffering as I am now. 

[Lexy]

Doctor's Stuart Shipko's advice as per his phone call was to get on Effexor 37.5mg and stay there…do not add, change, or taper until I feel a lot better then decrease by 10% and hold there again as long as it takes to feel better again.  

What I'm afraid is that when I partially switched from immediate to Xr that's when I noticed my mood swings coming more frequently.

 

SHould i try making switch to immediate release before I try taking  a 37.5mg Xr?  That would be almost all my dose(40.5mg) and make up the rest in immediate? Or just take the 37.5mg?

[trouper]

its my understanding brain zaps happen when the brain is unhappy that the drug it expects to be there isn't. thats the case for me. here is a thread on brain zaps that may be helpful to you:

http://survivingantidepressants.org/index.php?/topic/288-brain-zaps/

 

another option is the try the brintellix at a very low dosage for a few days to see how your body responds to it. if you feel things are worse, you can stop taking it and if its better, you can raise it a bit. in my experience my setbacks from meds and supplements are in relation to the amount i take. i had a big setback when i took a larger dose and i have minor setbacks when i take a little. everyone is different though. 

how long did it take you to feel better from the lamo setback?

 

did you tell your doctor you talked to dr. shipko and what he suggested?

[DrugSlave]

Lexy said: "Doctor's Stuart Shipko's advice as per his phone call was to get on Effexor 37.5mg and stay there…do not add, change, or taper until I feel a lot better"

 

That's exactly what I am doing. Patiently waiting to start feeling better.

 

Sending out positive vibes to you Lexy....

[Lexy]

Trouper - took about 2 whole weeks to feel better. I just felt on edge, everything bothered me.

Depression got worse on it, anxiety started with the lamo, not sure if I can blame it all on the lamo.

However I think doctor should have realized how sensitized I am and started me with 5mg instead of 12.5mg.

 

Drug slave - I will check your thread...I hope you are doing well.

[Newbeginning]

Lexy,

 

I'm confused. If you experienced withdrawal when you decreased in May, why did you keep decreasing in the following months  (as per your signature)???

 

If the brain zaps started/reapperead or got worse at ther same time as the depression emerged, that is evidence the depression might be withdrawal related.

 

You're trying to decide what to do, but it seems to me it's more important to understand why you got worse first. Otherwise, you're making decisions in the dark.

[trouper]

lexy,

yeah i'm not sure why he started so high either. the only reason i can think of is maybe it needs to be high enough to see if it has a positive effect or not, and to test your tolerance. when i was on 12.5mg i felt agitated, anxious, sensitive to sounds, and had bad tinnitus, but i felt improvement in my withdrawals. i'm not sure if i would have started lower that i would have noticed an effect. truthfully i barely notice much on 1.25mg. i wish i could tolerate more.

[Lexy]

Thank you all for your support.

 

I feel culprit is the tapering I did in May as that was when increase of zaps came and depression.

 

Now that I look back I should have stopped micro tapering until ALL wds had subsided. I've had brains since Oct 2012 when I first cut med in half.