peggy: 13 years of Effexor

[Altostrata]

Yes, try the 37.5mg.

 

You had gotten down to 24mg with minimal problems. Theoretically, if you go back to 24mg, you should be okay.

 

What we call neuro-anxiety is a withdrawal symptom. It's an exaggeration of normal anxiety and can last for a very long time after too-fast tapering. It does not necessarily mean a return of your original anxiety condition.

 

Doctors often mistake withdrawal symptoms for relapse or emergence of a psychiatric disorder. This is why they think these conditions are chronic. The studies are probably wrong in this regard.

[peggy]

Thank you so much Alto, i was worried that the surge of Effexor from the 75mg and the 50 that i took might come back to bite me in the bum!!!

[Altostrata]

Try gradually lowering over a few days to 24mg. You should be okay (cross fingers).

[peggy]

HI again - well i woke up yesterday ok, but quickly deteriorated again and now back to the ruminating worry about the way i am feeling, needing to be OK in 4 weeks for a big event and then going overseas in 10 weeks

I can't get my head past everytime i do this i have to go back up - not only to 75, but 150. I know that's probably over the top..i keep worrying then that reinstatement won't work this time - even though it worked the previous 10 times - that should be good enough to have trust that i should feel better on 75 isn't it? I did take 75 this morning and will probably settle on this (hoepfully no more)

 

I feel defeated, yet again - i really don't think i am cut out to go through nuero anxiety - it's not JUST the feeling it's the wearing down of the thoughts - even though it's only been a few days it feels just like it did when i endured it for 3 months - and that time it took much longer to settle because I guess i was in that state for such a long time. It almost seems that as soon as i start to have those thoughts it'a all over red rover.

 

For those that updosed because of anxiety and depression issues, how long before you felt some relief? was it sudden or gradual?

 

Thanks for your thoughts

 

P

[Karma]

Hi Peggy,

 

For me when I up-dosed it was gradual.

 

Karma

[peggy]

Hi Peggy,

 

For me when I up-dosed it was gradual.

 

Karma

 

thanks Karma,

do you mean over a week or two? was it pretty intense at times?

TIA

[Karma]

It was over a week or two and there were times when it was pretty intense, but there were moments when I could tell I was making progress.

Karma

[peggy]

Thanks Karma, that gives me some hope

[Altostrata]

Peggy, you may be one of those people who need very, very gradual tapering. Don't worry, you can do this.

[peggy]

Thanks Alto, i am sooooo glad i found this board - once stablised, next time i will go very, very slow..

 

btw, what influence, if any do you think change of diet might have? 2 weeks ago i started a 'cleanse' with a group of friends - basically a raw vegan type diet. It meant no dairy, meat and no gluten. But i was getting juicing (or really vitamising to keep the pulp) lots of greens every day - i probably ate much more veges than usual. Protein came from nuts, brown rice, lentils and chick peas - so i was eating cooked food at dinner. However, i was waking in the middle of the night hungry, but then by morning i was ok - not hungry at all during the day - maybe no effect but you always wonder don't you?

[Altostrata]

I don't know about the effect of that particular diet, Peggy. If it made you feel better, I guess it was good for you.

 

Generally, we recommend lots of protein, not veggies. The amino acids in protein help your nervous system to repair itself. Withdrawal is not a time when you want to starve your body of animal protein.

 

Some of our folks are getting good results from a low-starch "paleo" diet with meat and veggies.

[peggy]

yes, in retrospect I think it was foolish to change my diet so dramatically at this time - feeling a little better today - my thoughts are a little less intense, but at these times i always think - will i be ok to do xy or z (what ever i might have planned in a couple of weeks)

[peggy]

*big sigh*

still feeling quite shaky, anxious and somewhat depressed. Has been 5 days since updosing back up to 75 - i thought by going back up this far i should be good by now

I have my next doc appoint in 4 days - I really wanted to be feeling significantly better - my doc has been supportive and she acknowledges some people have more trouble than others getting off - and even though she knows i want to get off and will support me in trying, i don't know if she believes that my symptoms are withdrawal or depression. Every other time this has happened he has had me go back to 150mg

 

thoughts?

is it typical for the anxious/depressed withdrawal symptoms to take longer to resolve? How do i know they are resolving? - i do have windows of not feeling too bad, but not like before this happened - the awareness is still there IYKWIM

[Altostrata]

peggy, after 13 years, withdrawal is much more likely than relapse. What are you relapsing to? Do you really think you get a return of PPD when you go off Effexor?

 

Doctors all over the world are mistaking withdrawal symptoms for relapse. Your doctor may believe this or your doctor may believe that. It's your nervous system and you get to decide what you want to do with it.

 

According to the APA's own guidelines, antidepressants are supposed to be used for only 6 months. You're 12.5 years overdue to go off Effexor.

 

If you are afraid to face your doctor, you need a new doctor. See Medical compliance? Adherence? Screw that. My MDs are my PARTNERS by Gianna Kali.

 

The hard truth is, updosing doesn't always work. If you want to live drug-free, you may need to learn how to manage withdrawal symptoms or, when you recover from that, garden-variety anxiety. Another article from Gianna Kali: Become aware of your anxiety/panic/fear and heal yourself

 

Besides, you've given it only 5 days. Did increasing the dosage not make any difference at all? Could it be worrying about talking to your doctor (a very traumatic experience for many of us) and worrying about your upcoming trip are adding to your perception of your symptoms?

[peggy]

thank you Alto, i am sure worrying does play a part.

 

I am not worried about the PPD - i had 3 episodes of depression that were after the PPD - each one about 3 years apart and each one about 6 - 8 months in duration. In between episodes i had no anxiety or depression symptoms - i was probably a little more cautious that some people and may have got anxiety before going to the dentist or speaking in public, but not the all day anxiety i had in my depressive episodes or now. That is why it has been hard for me to discern as i have experienced these feelings prior to effexor. To be honest i am WANTING it to be withdrawal. I don't want to change docs as i have done a lot of therapy with her as well - she is not gung ho at prescribing meds and treats many people without - her assessment of me when i first went to her was i was quite ill and she recommended meds - she doesn't do that with everyone and i think from that perspective she is quite conservative

[Altostrata]

Why don't you think of your symptoms as withdrawal, as something you can manage and will go away in time? That's true of depression, too.

 

When you feel low, try changing the channel. This works whether you have depression or withdrawal.

 

One of the things that depending on psychiatric drugs does is that it makes you feel helpless, that you can't cope without the drugs. For the vast majority of people taking them, this is absolutely untrue. "Depression" is not the big scary monster psychiatry and drug company ads make it out to be. Episodes of sadness are part of life. They come and go like bad weather.

[peggy]

Thank you Alto, for the main that is what i am trying to do. I guess i was trying to get a handle on how long the updose might take to be effective. Its hard to tell if i am feeling a little better - maybe I am, certainly no worse.

 

I have long thought that my thoughts have played a big part in my previous depressions. In my 3 PPD and 2 of the other I didn't take medication, but i did try a lot of other things - acupuncture, hypnosis, chinese medicine, homeopathy, and other things. I exercised like a maniac and that was probably the most effective thing, but it was hard, hard work - esp with 3 young kids and a husband and everything that that entails - sleepovers, weekend sports, concerts - apart from the daily grind of squabbles and homework, holidays and housework.

 

I tried to go off 2 years ago with my doctor (but i still did a much too fast reduction) and we did the mindful way through depression workbook in my sessions - but i hit the wall at the 6 week mark - i had been floundering from week 2. I KNOW that i have put my self efficacy in effexor, and I hate that. I am also terrified of the way i felt in the past - but I AM learning more strategies and cope with each set back a little better than the previous time - i also think that if i had had treatment (not drugs, but CBT or even supportive counselling) during my first episodes they may not have got so bad, once i start that downward spiral i seem to follow that engrained pattern that i am trying to break. I know it might seem like i am not trying hard, but i really am

[Altostrata]

I know you're trying hard, Peggy. Join the club! None of us are finding this easy.

[peggy]

I know you're trying hard, Peggy. Join the club! None of us are finding this easy.

 

where is the like button!

[alexjuice]

Hey Peggy,

 

I've been pleased with CBT. I don't think it can overcome acute w/d anxiety but it helps and then the strategies can be implemented forever after.

 

Keep in there, Peggy. It won't last forever. (It may be something else tomorrow, though. Sometimes life just beats ya up. This is why one day your smile will shine brighter than most others. Only if you've been inn the deepest valley can you ever appreciate what it feels like to reach the highest mountaintop*)

 

Alex

 

ps - *37

[peggy]

Thought i would update you on my doctor appointment today

I was a little anxious about talking about what had happened 10 days ago, thinking that my doc would say...see, you need the meds... Well, i was totally wrong. She has been very upfront with me always saying that she can't guarantee no more episodes if i stay on the med (which would be the only reason i would stay on - the thought of another depressive episode DOES frighten me, as mine last one was quite severe - i was terrified of the suicidal ideation that i had at times - before i went on meds)

 

She said, that's ok, stay where you are and next time reduce much more slowly especially as you get lower - you went the wrong way around - you spent longer on the higher doses where the cuts were significantly less proportion wise to your total dose. DUH!, I know that now...So, I feel a lot more relieved. I expressed concern that staying 'forever' on a drug was pushing the boundaries for what the drugs were originally designed for- and yes, she agreed, but the alternative?

[alexjuice]

I am glad to hear that your doctor seems open and willing to hear you. (I've found it anxiety provoking to discuss this stuff with my doctor too.)

 

That's a good thing. A pushy doc or a poor relationship with one can undermine the cause.

 

It took me a long time to realize that my doctor was just another human, that he didn't necessarily know the answers to my questions, that the answers he did give to questions without definitive answers were his educated guesses, that guesses that turned out to be wrong affected me negatively but didn't affect his billable hrs.

 

I have changed my views as a result of experience and today I take the responsibility for the final say on my health decisions. So I accept that I will have heath problems at times, this is true of all people, but I will do my best to make a choice based on the options presented by a health professional. Since lousy consequences may occur no matter who chooses I'd rather it be me since I care the most about avoiding these consequences.

 

Anyway, I'm really glad that your doctor seems like a reasonable individual. I'm sorry you're going through all this mess.

 

best,

Alex

[peggy]

just thought i would update. two weeks after updosing i have stabilised again - i ended up settling on 75mg - 20 beads..totally more than i would have needed to,but i still feel good that i didn't go back up to 150mg. So, it's back to the withdrawal drawing board, on a much slower schedule. I think i will start a journal so i can document doses and be mindful about how I am feeling - rather than just noticing once i dip down into the unbearable - i must have some predictors as i go along - i must be so cut off that i don't notice the subtleties along the way.

 

BTW, what is the consensus about alcohol during w/d? I never drink much, but do like a glass of wine a couple of times a week.

[Karma]

Peggy,

 

The journal is a great idea. I rate my symptoms on a daily basis so that I can see when I'm starting to see a decline. Identify your most challenging symptoms so that you can consider and rate them every day. I include things like anxiety, depression, fatigue, pain, drowsiness, sleep (getting to sleep, how satisfying and how refreshed upon waking). If you have any questions about how I rate my symptoms, let me know, happy to share.

 

Very happy for you that you have stabilized on your dose. I know that is a relief.

 

Karma

[Altostrata]

No alcohol, it will confuse your nervous system.

[peggy]

Karma, I would LOVE to know how you rate your symptoms - I am notoriously bad for recognising patterns or bodily symptoms. It's not until they completely disable me that i sit up and take notice.

[Karma]

I rate my symptoms on a scale of 1 to 10, 1 being "awful, I'm dying, I can't take it any more", 10 being "great, flipping fantastic!", a 7 is when I feel the symptom, but I can tolerate it and get through the day - so for me a 7 is acceptable.

 

I rate my sleep the next morning and I rate anxiety, depression, ringing in my ears, pain, etc. at night. In the morning I go through the list and rate my sleep from the night before - I make a note next to some of the other symptoms, e.g. Aches & Body Pains - slight pain in right wrist AM, Anxiety - none AM, Ringing in the ears - mild AM, moderate by noon - that way I have reminders of how I've felt throughout the day to accurately rate my symptoms in the evening.

 

It doesn't matter if my 7 and your 7 are different - this rating system is for you. Once you start thinking about how the specific symptom felt during the day compared to the day before, you will begin to see when a specific symptom is improving or deteriorating. I find it really helpful when I am trying to tweak thyroid treatment or determine when I'm through initial withdrawal symptoms associated with decrementing my dosage.

 

Below are all of the things I rate daily - note that some of these symptoms are no longer a problem for me and generally get a rating of a 10. But I started this in 2008 when I was healing from celiac disease and getting my thyroid treatment optimal from hashimoto's thyroiditis. I had bone and muscle pain, fatigue and energy challenges, so should any of those problems come back I want to be able to detect it.

 

Aches & Body Pains, Anxiety, Appetite, Energy, Ringing in the Ears, Fatigue, Mood (flat, upside or downside of flat, joyful, irritable), Drowsiness or Sleepiness in AM or during the day, Night sweats/day sweats, and Bowels/Digestion.

 

Hope this helps.

 

Karma

[peggy]

thanks Karma, I think this will be very helpful to me - I think it will especially help me to see how i change - both from day to day and within each day. I have often said to my therapist that i feel the same everyday. Once she said to me, I know you say that, but i want you to try and feel how you feel, because sometimes i (as in the therapist) feel how you are feeling. That kind of blew me away - we would be talking about something and she would say stop and take a deep breath, close your eyes and just breath - and then ask me what i feel - i would usually say 'nothing' - when she would say she gets a feeling of deep sadness. *shrug* - i think i was conditioned as a child to block out how i felt - as children we were only allowed to feel what our mother felt - headaches, hot, tired - and these are probably the 3 physical feelings that i would have the most...

 

thanks again!!!

[Altostrata]

I rate my symptoms on a scale of 1 to 10, 1 being "awful, I'm dying, I can't take it any more", 10 being "great, flipping fantastic!", a 7 is when I feel the symptom, but I can tolerate it and get through the day - so for me a 7 is acceptable.

 

I rate my sleep the next morning and I rate anxiety, depression, ringing in my ears, pain, etc. at night. In the morning I go through the list and rate my sleep from the night before - I make a note next to some of the other symptoms, e.g. Aches & Body Pains - slight pain in right wrist AM, Anxiety - none AM, Ringing in the ears - mild AM, moderate by noon - that way I have reminders of how I've felt throughout the day to accurately rate my symptoms in the evening.

 

It doesn't matter if my 7 and your 7 are different - this rating system is for you. Once you start thinking about how the specific symptom felt during the day compared to the day before, you will begin to see when a specific symptom is improving or deteriorating. I find it really helpful when I am trying to tweak thyroid treatment or determine when I'm through initial withdrawal symptoms associated with decrementing my dosage.

 

Below are all of the things I rate daily - note that some of these symptoms are no longer a problem for me and generally get a rating of a 10. But I started this in 2008 when I was healing from celiac disease and getting my thyroid treatment optimal from hashimoto's thyroiditis. I had bone and muscle pain, fatigue and energy challenges, so should any of those problems come back I want to be able to detect it.

 

Aches & Body Pains, Anxiety, Appetite, Energy, Ringing in the Ears, Fatigue, Mood (flat, upside or downside of flat, joyful, irritable), Drowsiness or Sleepiness in AM or during the day, Night sweats/day sweats, and Bowels/Digestion.

 

Hope this helps.

 

Karma

 

Great idea, Karma. Feel free to start a topic in Symptoms about this, it can help people to find out what works for them in a lot of ways.

[peggy]

I am now nearly 5 weeks after updosing from about 24mg effexor. I ended up going to 75 initially, then after a few days to 65mg. I stayed there for 2 weeks and then came down to 55mg. I plan to do 2 weeks here and then go to 45mg then to 37.5 where i will stay for a month - I am going away then and wanted to be just on an easy to manage dose. When i get back from my trip i plan to do 10% drops every 4 - 6 weeks.

 

My primary withdrawal symptoms are overwhelming anxiety and obsessive, unrelenting negative thoughts and fear. Even though the up dose did reduce the symptoms it was 28 days when i felt 'better'. It sort of feels like a curtain opens and the clouds clear away completely. Up until then the weather of my mind is fast moving clouds, some stormy, some hazy, some thin, some thick, but always cloudy. Is this a typical time to recover from the emotional symptoms of withdrawal? I guess it is so individual that it is hard to make a judgement about 'typical'.

 

My doctor is very open to journey with me and he is keen to be educated.

[Altostrata]

peggy, since you are already suffering from signs of stress on your nervous system, my sense is your reduction plan is too aggressive.

 

Protecting your nervous system is much more important than having a convenient dosage.

 

If I were you, I would not make any more cuts until those withdrawal symptoms abate, and then make only a 10% reduction. You're entering the danger zone for your nervous system -- that's what the withdrawal symptoms indicate.

 

You can get large empty gelatin capsules; measure out your daily dosage for your trip ahead of time and put each one in a gelatin capsule.

[peggy]

maybe i wasn't clear Alto, i feel great now - it took 28 days to feel better after updosing - i have felt very good for over a week now - but i do take note of your advice.

[Altostrata]

Oh, sorry! I misunderstood. Very good to hear you're feeling well.

 

Still, I'd be careful here, see how the reduction to 45mg goes before taking a bigger jump to 37.5mg.

 

When you updose, it can take a while for your nervous system to stabilize again. When you went back to 75mg, did you feel any relief within a day or so?

[peggy]

no, not really. It was a very gradual change.

I will certainly take it very carefully. I have a much better understanding of the process now - not that understanding really helps...

 

I was reading a mindful meditation book and something in there really resonated with me: somehow i have learned to think that not feeling good is wrong, bad and i try to hard to rectify this - whereas the MM perspective is that it's OK - this how i am at the moment (when i am bad that is) They encourage you not to chase the bad feelings away and not to try to hold on to the good feelings - that is all new to me.

[Altostrata]

That's a great insight, Peggy.

 

It's all an ebb and flow -- sometimes good, sometimes bad; the clouds come in and then they blow away.

[Karma]

Hey Peggy,

 

My symptoms are very much like yours. I did my first decrement of Effexor after something like 9 weeks and it has been about 33 days and I am just beginning to feel normal again. I get those irrational negative fears, too. I got a diagnosis I wasn't expecting this week and it sent me into near panic ... it all seemed like the end of the world. After I took positive action to get help the fear lifted.

 

But that whole pattern doesn't feel normal. I'm glad to feel better, but I think it will be a while before I decrement my Effexor any further.

 

Best wishes on your upcoming travels.

 

Karma