goodwill: end of clonazepam taper, beginning desvenlafaxine taper shortly

[ChessieCat]

I was also taking 100mg Pristiq and am now down to 41mg.  I found that once I started reducing my dose (even before I got to 50mg) I wasn't as tired, I wasn't sweating like I had been, my anxiety/agitation reduced to almost nothing and the heart "flips" and night time panicky feeling which I had had on and off now only occur on the very rare occasion.  Up until recently I would get very tight calf muscles when walking.  This seems to have improved since taking 1/2 magnesium morning and night.  My aches and pains at night also don't seem to be as bad as they were which might also have been helped by the magnesium.

 

Magnesium

[goodwill]

Thankyou Chessie. How would you describe your heart flips? Did you have it always?

And who prescribed/suggested magnesium for you? Is it something we can experiment without a prescription, please lemme know.

 

From your signature you seem to have reduced from 100mg Pristiq to 41mg over a period of nearly 3 years now right?

[goodwill]

After much debating and taking help from this forum, in January this year I had started tapering Desvenlafaxine 50-0-50mg by cutting the tablets like Mogfish did.

Before tapering I added Betacap 40mg nightly after consulting with a new doc. The doc was understanding but like others he suggested cutting down from 50mg to 25mg in the night which I did not follow.

My taper schedule was

50mg - 0 - [25mg + 3/4 of 25mg] (4 weeks)

50mg - 0 - [25mg + 1/2 of 25mg] (around 6 weeks)

50mg - 0 - [25mg + 1/4 of 25mg] (4 weeks)

50mg - 0 - 25mg (about 8 weeks now)

Before every taper I waited enough until I felt ready for the next. Not that I felt perfectly fine. That feeling was never there even before I began tapering at all.

 

Now I dont know whether I can say I have stabilized at this dose. During every dose reduction I had some episodes of headaches, dizziness. I have slight fluttering, or pounding heart that causes a lot of discomfort. This problem was there earlier too but seems to have increased more with tapering. Tinnitus is persistant too. I also feel very drowsy and tired on many days and panicky feeling keeps coming now and then.

 

My question is can I go ahead with further tapering now that I am lingering at 75mg for over 8 weeks now?. Plan is to taper by 1/4th of 25mg from the morning dose every 4-6 weeks this time around, so I can reach 25-0-25mg few months from now. Thereafter 10% reduction would mean 5mg so I may go with compounding.

Does this look okay?

 

Is there something in this world that can help me with my palpitations,drowsiness,fatigue?

 

 

 

 

 

[scallywag]

You'd probably be better off waiting until your symptoms have diminished. Starting to decrease your morning dose is likely to worsen your symptoms, not improve them.

[goodwill]

17 hours ago, scallywag said:

You'd probably be better off waiting until your symptoms have diminished. Starting to decrease your morning dose is likely to worsen your symptoms, not improve them.

Thanks Scallywag. What I probably did not mention clearly is that I was never symptom free even before tapering. All these symptoms were there before too. I know if I go back on a high dosage some of my problems like pounding heart may go off for a long time, but I dont want to go back.

 

After 2 months at this dose level I dont expect any further betterment or worsening. Given this, can I proceed to the next taper.

[scallywag]

Ok, gotcha.

[goodwill]

I was last here 2 years ago I guess and I have been greatly helped by some of you in my taper journey. I want to thank Andy, ChessieCat, Apace41, Fresh, ScallyWag and more who've been a great support. My earlier thread:

 

After a long history of medication since 2003 I was on Klopoin .25 mg and Desvenlafaxine 50mg x 2 as of 2016. I tapered Klonopin over a period of 7 months and came off of it. Then I started dry cutting Desvenlafaxine (took help of the 25mg variant) really gradually for 2 years from January 2017 to January 2019 and came down to taking 50mg x 1 of Desvenlafaxine.

 

As of January 2019 I have been taking 50mg of the tablet along with Betacap 40mg because I have been having pounding in my heart, (some times fluttering) that would aggravate during my afternoon naps.

 

In a few months after this reduction  I started having this pounding even during my night sleep which  wasn't there earlier. Now my major problem at the moment is that my tinnitus (Caused in 2008 due to a cold turkey withdrawal by a doc) has spiked to an extremely loud level since December 2019 and now in both ears vs right-only earlier. I must mention that I often used earphones to sing and record music as a hobby for the past few years. I don't know which of these have caused the spike.

 

I consulted a new psychiatrist yesterday and he has advised me to increase Desvenlafaxine to 75mg plus take up Cognitive Behavior Therapy sessions.

 

My worry is

 

1. having to increase the dose after all the hard work done to taper. What if it does not make a difference to my tinnitus. Then I'll be stuck at 75mg. Please advise on this with your experience and thoughts

 

2. Does CBT help. I've not tried it before. I have no depression or severe anxiety per se. I got into this medication and mess by chance. Now I am only struggling to combat the side effects of ounding heart and tinnitus.

 

3. Any other advise for thr tinnitus spike. I have stopped using earphones. ENT tests and visits of no help.

 

Appreciate any thoughts as I have benefitted greatly earlier on from all your advices.

 

 

[Altostrata]

Hello, @goodwill. I moved your post here to update your Introductions topic.

 

5 hours ago, goodwill said:

As of January 2019 I have been taking 50mg of the tablet along with Betacap 40mg because I have been having pounding in my heart, (some times fluttering) that would aggravate during my afternoon naps.

 

When did this pounding start?

 

What times of day do you take your drugs, and their dosages? How long have you been taking Betacap (propranolol)?

 

Did you experience any withdrawal symptoms as you were reducing desvenlafaxine?

 

5 hours ago, goodwill said:

I consulted a new psychiatrist yesterday and he has advised me to increase Desvenlafaxine to 75mg plus take up Cognitive Behavior Therapy sessions.

 

Why did this doctor think this would help?

 

5 hours ago, goodwill said:

Does CBT help.

 

CBT can help with intrusive thoughts or worries.

[FindRest]

When I started taking Desvenlafaxine (25mg), I started having intense tinnitus. My dosage was upped to 50mg. Tinnitus got even worse and my blood pressure spiked. Have you taken your BP during the worst times of your tinnitus? For me, there was a strong correlation.  When my tinnitus spiked, so did my BP.

 

Since I have stopped the desvenlafaxine (switched back to Effexor ... only 9 mg), the tinnitus has improved GREATLY. So has my blood pressure. 
 

If it were me, there is no way I would increase the desven. I think this will only worsen the tinnitus and BP.  Also, I know several studies have questioned the effectiveness of any desven dose above 50mg. If you search SA, I think you’ll be able to find a link to these studies. 
 

Just my two-cents. 
 

Sorry you are struggling. Tinnitus is ugly. White noise helped me get through the worst of it. Also, the strong heart beats ... the back of my head especially.  So strong. These also diminished greatly once I got off desven and stabilized.

 

Of course, it may be wise to talk to your primary care doctor about your palpations. It sounds like withdrawal, but it might make you feel better knowing that there’s nothing else going on.
 

 

[goodwill]

6 hours ago, Altostrata said:

Hello, @goodwill. I moved your post here to update your Introductions topic.

 

 

When did this pounding start?

 

What times of day do you take your drugs, and their dosages? How long have you been taking Betacap (propranolol)?

 

Did you experience any withdrawal symptoms as you were reducing desvenlafaxine?

 

 

Why did this doctor think this would help?

 

 

CBT can help with intrusive thoughts or worries.

 

Thanks @Altostrata for your reply

 

1. My pounding started in 2008 (5 years into medication) when I did my first quick taper and withdrawal under doctor's advice. Back then I was on Escitalopram 10mg and within a short span of 2-3 weeks I reduced to 5 mg and quit.

Result was pounding/fluttering and majorly Tinnitus. Reinstating medication didn't help.

Pounding used to be more when I lied down for a nap in the afternoon and otherwise it was intermittent with fluttering or plain discomfort. ECG has been normal and so is my BP.

 

8 months or so after my last taper (100mg to 50mg from Jan 2017- Jan 2019) the pounding has started to interfere with my night sleep as well. Plus extremely loud spike in the tinnitus again much later after taper and to reiterate I don't know if this is due to use of earphones.

 

2. I take Desvenlafaxine 50mg around 11.30 am after a light meal and Betacap 40 mg in the night around 9pm after dinner. I started Betacap in 2018 (suggested by a GP) midway during my taper to see if it helped with the preexisting pounding. It made very little difference but I notice if I skip the dose it causes more palpitation/pounding 

 

3. I noticed a pattern while tapering Desvenlafaxine by 1/10th (every 6 weeks or more until I stabilized). Roughly 2 weeks into each taper I would have Mild muscle cramps around the neck/shoulder. Even now I often have cramps or pain in the neck but I don't know if it is related. No other noticeable taper effects other than those mentioned in Point 1 which happened much later after I was done with the taper .

 

4. Doctor says that CBT would impact the brain chemicals/wiring in the same way medicines would do. He says it would help with my issues and when ai asked him if the medications would be a lifetime thing he said I could even come off medication later on with the help of CBT. When I asked him if I could take CBT directly without the suggested increase in the dosage (to 75mg) he told me in my case medicine would aid better as there are no real anxiety issues. I felt both were contradicting.

 

 

 

[FindRest]

2 minutes ago, goodwill said:

I would have Mild muscle cramps around the neck/shoulder. Even now I often have cramps or pain in the neck but I don't know if it is related.

Yes!! One of my worst symptoms, but that is also getting much better the more I am stabilizing.

[goodwill]

1 minute ago, FindRest said:

Yes!! One of my worst symptoms, but that is also getting much better the more I am stabilizing.

 

Goodness..I think we have the same symptoms. Thanks a bunch for your replies. I'll respond in a while.

[goodwill]

9 hours ago, FindRest said:

Have you taken your BP during the worst times of your tinnitus? For me, there was a strong correlation.  When my tinnitus spiked, so did my BP

My BP has always been 110/70

 

9 hours ago, FindRest said:

 

Since I have stopped the desvenlafaxine (switched back to Effexor ... only 9 mg), the tinnitus has improved GREATLY. So has my blood pressure. 

 

Good for you. Do you think  it is to do with Effexor or its because you were better off going back to something you were used to.

 

My new doc did mention he might have preferred Venlafaxine if it were him. But since I was already on Desvenlafaxine and I was telling him how I was apprehensive about changing medications (after I ve seen an aunt of mine suffering Parkinson and we suspect it's because of frequently changing her meds over a course of 30 years) I think he just suggested an increase in dose.

 

Is there something about Effexor I should check with my doc.

 

Iam worried too about going over 50mg. What if it does not work?

[Altostrata]

11 hours ago, goodwill said:

Pounding used to be more when I lied down for a nap in the afternoon and otherwise it was intermittent with fluttering or plain discomfort. ECG has been normal and so is my BP.

 

Have you had an ECG while having one of these bouts? Perhaps you should ask your doctor for a Holter monitor to wear for a few days for a more complete cardiology examination.

 

11 hours ago, goodwill said:

It made very little difference but I notice if I skip the dose it causes more palpitation/pounding 

 

That is because you need to taper beta blockers to go off them.

 

When was the last time you skipped a dose?

 

11 hours ago, goodwill said:

4. Doctor says that CBT would impact the brain chemicals/wiring in the same way medicines would do. He says it would help with my issues and when ai asked him if the medications would be a lifetime thing he said I could even come off medication later on with the help of CBT. When I asked him if I could take CBT directly without the suggested increase in the dosage (to 75mg) he told me in my case medicine would aid better as there are no real anxiety issues. I felt both were contradicting.

 

This didn't make any sense to you because he doesn't know what he's talking about and is just guessing.

 

I don't know where the tinnitus is coming from. Reducing an antidepressant can cause tinnitus, but it could have been caused by your experiments in skipping your beta blocker. It can also be affected by bruxism or neck tension.

 

Many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. They may alleviate the muscle tension.

 

I doubt if increasing desvenlafaxine to 75mg will help. If you want to go up in dosage to see, you might add a few beads of venlafaxine, a sibling drug. Have you ever taken venlafaxine (Effexor)?

[goodwill]

On 8/8/2020 at 10:30 PM, Altostrata said:

 

Have you had an ECG while having one of these bouts? Perhaps you should ask your doctor for a Holter monitor to wear for a few days for a more complete cardiology examination.

 

 

That is because you need to taper beta blockers to go off them.

 

When was the last time you skipped a dose?

 

 

This didn't make any sense to you because he doesn't know what he's talking about and is just guessing.

 

I don't know where the tinnitus is coming from. Reducing an antidepressant can cause tinnitus, but it could have been caused by your experiments in skipping your beta blocker. It can also be affected by bruxism or neck tension.

 

Many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. They may alleviate the muscle tension.

 

I doubt if increasing desvenlafaxine to 75mg will help. If you want to go up in dosage to see, you might add a few beads of venlafaxine, a sibling drug. Have you ever taken venlafaxine (Effexor)?

I have taken ECG a couple of times but not done the holster monitor. Since my BP has always been 110/70 (even when I have the pounding) and I know my pounding started only after a near cold turkey withdrawal 5 yrs into ADs I guess I may not need to take this route.

My tinnitus also started after the withdrawal. These problems are since 2008 but worsened last year after I tapered desvenlafaxine by half.
 

Thanks for the link on supplements. I am dropping the idea of increasing my dosage and planning to try magnesium. Do you have any idea on this Calcium magnesium zinc combination supplement that Iam considering to try. I searched a lot on the internet before I got here.

https://www.amazon.in/Nature-Made-Calcium-Magnesium-Tablets/dp/B000OD1F7U

 

Or if you have a specific brand or combination to suggest please share the link. Of course I’ll do some research to see if it suits me so pl do share.

 

I am 43 female by the way.

 

No point asking my doc about this as he wasn’t sure about it the last time I asked him about magnesium. He dismissed saying there aren’t enough researches done. So I need to take a chance and experiment. I’ll be taking it along side Desvenlafaxine 50 mg and Propanalol 40mg

 

Thanks for your inputs and assistance.

[Altostrata]

If you read https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/ , you will see taking calcium with magnesium cancels out the calming effect of magnesium.

 

Blood pressure is independent of heart rate. If I were you, I'd request a Holter monitor.

[goodwill]

On 8/14/2020 at 9:45 PM, Altostrata said:

If you read https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/ , you will see taking calcium with magnesium cancels out the calming effect of magnesium.

 

Blood pressure is independent of heart rate. If I were you, I'd request a Holter monitor.

Insightful link that was. Iam zeroing in on Doctor's Best chelated Magnesium Glycinate tablets on Amazon. Hopefully I can find an authentic seller. I'll track my progress here when I do start using it.

 

Will consider Holter Monitor too.

 

Thanks a bunch for your advices

[ChessieCat]

4 hours ago, goodwill said:

Will consider Holter Monitor too.

 

It might be better to do this before starting the magnesium.  I've just done a search online and apparently magnesium affects BP.

 

Edited August 15, 2020 by ChessieCat

[goodwill]

On 8/16/2020 at 4:29 AM, ChessieCat said:

 

It might be better to do this before starting the magnesium.  I've just done a search online and apparently magnesium affects BP.

 

Thanks ChessieCat. I checked with my GP online and she suggested it's very unlikely I'll need it.  In any case at the moment that's what I wanted to hear since it's tough to visit a doc in this present Covid situation.

 

I have ordered the chelated Magnesium 200mg tablets and will try it very soon. 

Thanks for dropping by.

 

[goodwill]

@Altostrata@ChessieCat @FindRest

 

I had last updated in August 2020

Quick Recap: On ADs since 2003. After a cold turkey withdrawal from Escitalopram in 2008 I got palpitations and tinnitus.

No help with reinstating meds. Switched to Desvenlafaxine 100mg in 2015. Between 2017-2019 reduced to Desvenlafaxine 50mg using dry cut tapering method on this website. My complaints worsened in 2020 (a year after the 100 to 50mg taper) : 1. Much much worsened palpitations (pounding in heart) during sleeps/lying down/waking up from sleep and 2. Tinnitus that was earlier manageable peaked multifolds and is unbearable at times. Present medication Desvenlafaxine 50mg-0-0 and Betacap 40mg.

 

After some of your advices last August I began taking Magnesium. But that again worsened my Palps so I stopped after a month or so.

 

My heart parameters/BP/pulse rate are always normal.

 

I still don't know whether to increase Desven dose (to 75mg as my doc advised last year) or add another new medicine or try new supplements. Problem with increasing meds is if I dont see an improvement at higher dosage there is no coming back. So I am very scared to do this.

 

My struggle continues everyday because I dont trust doctors anymore. Please can someone guide me.

[Altostrata]

When do you notice the heartbeat issue? Is it constant?

 

How's your sleep?

 

At what point in your desvenlafaxine taper did your withdrawal symptoms start?

 

While some people can tolerate dry-cutting desvenlafaxine, it's too rough on others. Also, when you break a tablet, you may have to take half a dose twice a day. Are you taking a whole 50mg tablet or half a 100mg tablet?

[goodwill]

17 hours ago, Altostrata said:

When do you notice the heartbeat issue? Is it constant?

 

 

Predominantly when I lie down. It starts hitting hard either the moment I lie down or midway when asleep or just awake and trying to go back to sleep.  It subsides when I get up and start walking.

Also I make sure never to lie down right after a meal which is one of the things they say as a reason. So this is ruled out.

 

17 hours ago, Altostrata said:

How's your sleep?

 

Sleep is fairly good but if the palpitation overpowers (usually the case during my midday naps ) it becomes a disturbed sleep and it increases my tinnitus much more and sometimes also causes a mild headache. Its like forced anxiety though I am mentally not anxious but the symptom is there. At night usually it is not bothersome when I hit the bed but sometimes I wake up in the morning with pounding heart.

 

17 hours ago, Altostrata said:

At what point in your desvenlafaxine taper did your withdrawal symptoms start?

 

Actually my first withdrawal was cold-turkey in 2008 (after 5 years of ADs) when I was on Escitalopram 10mg. The withdrawal symptoms of pounding heart and tinnitus started then. Both have been there ever since but were manageable. Desvenlafaxine taper from 100 to 50mg took me 2 years (Jan 2017-Jan 2019). There was no prominent worsening of my symptoms during the taper except I had neck cramps during every taper. I think pounding heart worsened incrementally over time. But tinnitus clearly spiked (November 2020) 10 months after the taper to 50mg. Most of the time this is  accompanied with ear pain. (I no longer can hold the phone close to my ear during calls and need to keep it a little away).

17 hours ago, Altostrata said:

Also, when you break a tablet, you may have to take half a dose twice a day.

 

Since I was on 50-0-50, I always had a whole 50mg once a day and tapered the other dose (with help of 25mg variant)

 

17 hours ago, Altostrata said:

Are you taking a whole 50mg tablet or half a 100mg tablet?

 

I am taking a whole 50mg. Along with it Betacap 40mg

 

 

[goodwill]

Any help greatly appreciated.