Onwardmarcher: Prolonged SNRI withdrawal

[Onwardmarcher]

10yrs in public mental health system, treatment resistant, MDD.

 

Maintained on

1200mg lithium,

200mg Quetiapine,

225mg Venlafaxine Pd.

 

Today I am on

800mg Lithium,

0mg Quetiapine since Xmas 2016.

 

I went excessively quickly on the SNRI, 1/2 the dose over 1mth. A real "Horrorshow". On the 23.2.17, I recommenced my revised reduction program. Of 525mg pw, I made one reduction of 37.5mg on a Thurs three weeks later on the 16.3.17 I made a second reduction of 37.5mg on a Sunday and started to record symptoms four times a day in Excel.

 

Today I am still physically unwell from withdrawal, psychology I am utterly isolated and emotionally unstable but even though I can cure my ills by re-up of the very drugs I have to take every day, my goal is still in place and my plan is flexible. I am under pressures beyond the perception of people without experience. "Nothing to be done".

 

A Question. Could Lithium be extending some of the properties of the SNRI extending the efficacy and so the withdrawal?

Edited July 20, 2017 by scallywag
add extra lines after paragraphs; isolate doses + meds one/per line for clarity

[scallywag]

Onwardmarcher -- Welcome to Surviving Antidepressants (SA)

 

Great username!  The symptoms you are experiencing now are almost certainly the result of large reductions in lithium (50%) and quetiapine (100%) followed by rapid reductions to discontinue venlafaxine.

 

We suggest that people come off these drugs one at a time by a gentle taper: decreasing dose by no more than 10% and making the decreases no more often than once per month. For more information, please read:

Tapering -- what you need to know.

Why taper by 10% of my dosage?.

 

Here's information relevant to your current and recent medications:

Tips for tapering off Effexor (venlafaxine)

Tips for tapering off Seroquel (quetiapine)

Tips for tapering off lithium

 

Thank you for taking time to post a signature.  It's easier for us to help you if you limit it to "just the facts" summarizing your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly:

• Any drugs prior to 24 months ago can just be listed with start and stop years.
  
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
  
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
  
• Please leave out symptoms and diagnoses.
  
• A list is easier to understand than one or multiple paragraphs.
  
• Link to Account Settings – Create or Edit a signature.
  
  

It would be helpful for us to know the dates (actual or approximate) on which you

• started decreasing dose of lithium, when you reached your current dose, and the dates and doses of any interim steps
• started decreasing dose of quetiapine, when you reached your current dose, and the dates and doses of any interim steps
• started decreasing dose of venlafaxine, decreased dose as a step down (already posted, but please include them) and when you reached your current dose

Once we have that information we may be able to suggest a next step for you.  Other information that is often helpful is your log of symptoms. You've been keeping a log in a spreadsheet. Have you been recording only your symptoms or have you included the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

 

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

[nz11]

I'm told that some people post on sa then get off their meds and do so well they don't bother to come and post again.

Would that be true for you. 

Love to hear from you onwardmarcher