Caspur: history

[Caspur]

I have been taking Venlafaxine at 75mg per day for about 6 years. The side effects were becoming too annoying to contiune - mainly flat, blunt unemotional mood, drowsineess during the day (i would fall asleep at my desk whilst working (at home)) and frequent urination, especially at night, which interrupted sleep too much.

 

I have successfully tappered off venlafaxine once before after about 10 months treatment. I did it over 9 months without any issues. Buoyed by that success, i thought i could do it again and embarked on a taper using broken pills and liquid preparations prescribed by my doctor on the UK NHS. I only took 4 months this time which wasnt that sensible , as i now know.

 

The taper ended 5 weeks ago today (24/11/17). Since then i have experienced many and varied discontinuation symptoms both physical and emotional:

 

- physical - nausea, diarrhea, flatulence, dizziness and swimmy feeling in the head; mild visual disturbances; mild but constant headache; mild tingling sensation in the face

- emotional - depression, anxiety like i've never experiened before for no aparent reason, irritability, poor concentration; mood swings over a very short time period for no apparent reason etc

The semotional symptoms come and go. I will have one or two good days followed by 2-4  days of feeling depresed, anxious, etc

On the up side i do feel like im experiencing real emotions like i havent felt for year

 

I have mananegd to control some of the symptoms with supplements such as tryptophan. i also take fish oil, B vits, vitamin C and D

 

I exercise a lot - run 5-6 km per day and try very hard to eat well; lots of fruit and vegetables etc

 

Any suggestions for help would be gratefully received!

[Gridley]

Hello, Caspur, and welcome to survivingantidepressants.org.  I'm glad you found your way here.  

 

I'm sorry you're having these symptoms but they are a common result of tapering too fast.   SA recommends tapering by 10% of your current dose with a hold of at least 4 weeks before your next decrease.  The following link gives further information about the 10% per month taper:   

 

Why taper by 10% of my dosage? 

 

May I ask you to fill out your signature so that we have access to a brief version of your drug history whenever you post.  Please put the dates and dosages of all of your reductions, including the speed of both your tapers, especially your most recent taper and the dosage at which you stopped taking Venlafaxine.  Here's how to do a signature:

 

Please put your withdrawal history in your signature

 

If your withdrawal symptoms are difficult to bear, you might want to consider a reinstatement.  Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately, no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months to many years.    

 

Reinstatement is best done immediately upon appearance of withdrawal symptoms. The more time passes, the less likely it is to work. The length of this window of opportunity varies according to the individual.  You are only five weeks out which is to your advantage.  If reinstatement is something you want to consider, after you have completed your signatures and we know more about your dosage, we can suggest a reinstatement dose.  Please do not reinstate until we have suggested a dosage.
 

About reinstating and stabilizing to reduce withdrawal symptoms  

 

Please be aware that B vitamins can be activating (anxiety-causing).  The only two supplements that SA recommends are Omega fish oil and magnesium.  If you decide to try these, try one at a time at a low dosage so you can monitor your reaction.  Some people crush magnesium and dissolve it in water and sip it throughout the day to help with anxiety.

 

Here are some links other which may be helpful to you. 

 

What is withdrawal syndrome?

The Windows and Waves Pattern of Stabilization

Brain Remodelling
 

Please feel free to write whenever you want. This is your thread to journal progress and ask questions.

Edited November 24, 2017 by Gridley

[Caspur]

Hi Gridley,

Thankyou for your reply and for the information in the post.

 

Sorry but i am really struggling today with awful mood swings which strated about 4am the morning and have continued all day so i am having trouble concentrating on writing.. This is by far the worst I have been since stopping venlafaxine.

 

I saw a doctor on Friday who did suggest a reinstatement doeage of 37.5 mg but she was less than helpful otherwise. Wanted me to start another class of AD medicine which I politely declined. I was pleasantly surprised that she did admit I have discontinuation syndrome, and i even have it in writing! Se also told me that she has seen DS in other patients using paroxetine, but not Venlafaxine, which surprised me. The practice no longer prescribes paroxetine....small mercys for some!

 

I will complete my signature as requested.

 

Yes, please i would be interested in your input regarding reinstatement and a possible dose to try. I have access to a liquid preparation at 37.mg in 5ml on a repeat prescription. The wonders of the UK NHS! Otherwise it would be £120 per 150ml bottle!

 

Yes, i have stopped the b vits as these may have been contributing to my anxiety, but its difficult to tell. I do try to eat as well as i can, but today i have been feeling so nauseous, its been difficult.

 

Thanks again.

[Gridley]

Caspur,

 

Until you post your signature, we won't know the dose to recommend.. 37.5 is very likely too high.  During the five weeks you've been off, your brain has adapted to not having the drug and a reinstatement that is too high will throw your system farther into imbalance.  It is better to start low and if it's not enough, you can titrate higher.  It's good you have the liquid so that you can easily customize your reinstatement dose.

 

What was the dosage you were on when you jumped to zero and how long had you been on that dose?

 

Gridley

[Caspur]

Hi Gridley,

I was on 4mg when i stopped but i was getting withdrawal symptoms at that point and before such as dizziness and visual disturbacnes, mild depression, nausea. I had no idea about the risk of protracted withdrawal at that point unfortunately. I only held on that dose for a few days at the most.I do accept that i tapered far too quickly for the length of time i was on the medication.

 

I have completed my signature now. I hope this helps

 

Cheers

 

Caspur

[Gridley]

Caspur,

 

Thanks very much for posting your signature.  I'm sorry you're having such difficult symptoms.

 

I'm going to consult with the other moderators about a recommended reinstatement dosage and will get back to you as soon as I've heard from them.

[Caspur]

Hi Gridley

Thank you for your help

Cheers

Caspur

PS I keep wanting to sing off with my real name. Not used to aliases :-)

[ChessieCat]

Taper information:

 

(75mg venlafaxine)

 

2017 - started taper from June 15th - 5% dose reduction on each step (does divided into two 12 hourly doses).

2017 - October 20th - took last does of Venlafaxine - 4 mg

 

 

Generally we suggest a dose lower than the last dose you took.  However because you have  reduced so quickly from 75mg my personal opinion is that reinstating 4mg would be okay in this particular case.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  It is helpful to keep notes on paper so you can see improvement which you may not feel.  If after a week you find that you have had no improvement or only a very small improvement, please let us know and we can suggest an updose amount.  It is important not to panic and start increasing your dose too soon after reinstating/updosing.  The idea of reinstating is not to get rid of withdrawal symptoms completely but to take the lowest dose which will bring your symptoms to a bearable level.  We need to be very patient during this stage especially and it is very helpful to learn and use Non-drug techniques to cope during this stage and throughout your taper.

 

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

[Caspur]

Thanks Chessiecat for your advice. When I stopped the medication at 4 mg I was already getting withdrawal symptoms and stupidly I stopped without realising the consequences. I was also taking 2 mg in two doses. Do you advise this approach. Also, if this low dose helps what would the next step be? Tapering at 5 or 10% per step from such a low amount may be hard due the need to measure such small amounts?

 

In your experience or that of the forum,  how successful is this approach compared  to simply waiting for the symptoms to resolve with time.

Thank you

Caspur

[Caspur]

Hi,

Things got bad today. I've started to reinstate. AM had anxiety which faded and disappeared by mid afternoon, at which time i felt ok. Went for a run; i try to do this every day.. Then had massive wave of depression at about 5.30pm. Symptoms alleviated by 5htp , 200mg, but have decided to start reinstatement as recommended by ChessieCat.

Thanks

Caspur

 

[Caspur]

SYmptoms just too much. I have seen adoctor and decied to try Mirtrazipine to alleviate withrawal. Have been given a mild beta blocker to help alleviate anxiety.

 

I will report back

 

Thanks

Caspur

 

[Survivor1]

Hello Caspur,

 

I have been reading you story and feel compelled to respond since I did the same thing you are thinking of doing, with very negative results.

 

Last year, I cold-turkeyed seroquel.  Things got terrible, especially sleep-wise.  I added mirtazepine which helped a little with the sleep, but nothing else.  In fact, there was a reaction (serotonin syndrome) with another drug I was taking, and I had to discontinue the mirtazepine cold.  I am still not stable despite 6 months having elapsed since stopping it.

 

My point is that mirtazepine may not help the WD from venlafexine as they are from two different classes of drugs; you would then have to discontinue the mirtazepine, which is a real bear to get off. (There are many on this forum trying to discontinue it and are not finding it easy - do a search to get more info.)  Further, if you reinstate venlafexine (which in my opinion is the best way to alleviate your discomfort), there may be an negative interaction with the mirtazepine like I had, and you would have to discontinue one of the drugs very fast leaving you back at square one.

 

In my case above, I reinstated a small dose of seroquel (0.5 mg), and I stabilized.  When WD hit from the cold turkey of Seroquel, I wanted to do anything to get relief FAST.  Unfortunately I am now stuck with having WD from the mirtazepine ...

 

If you decide to reinstate venlafexine, it may be a while before you get relief, but it will happen.  Hope you get some relief soon.

[Altostrata]

Hello, Caspur. I would stick with reinstating 4mg Effexor rather than experimenting with mirtazapine.

 

How are you doing now?

[Caspur]

Hello Survivor1 and AltoStrata,

Remarkably, all my symptoms have disappeared. I have taken only once dose of Mitrazapine and 1 beta blocker yesterday. None today. I had a full and complete nights sleep. Time will tell if this has allevaited all the issues for me. At present, I am not in a position to bear any more WD symptoms. There is too much going on in my life - good things - that i am missing out on. I have two young kids, a wife who has been supportive, my house is being extended and work is full on. The time of year is also difficult. I accept i may have a problem when it comes to getting off Mirtrazapine, but when i am ready to do so, I know this group of very helpful people are here and this time i will not rush. I have already checked i can get a liquid preparation of this drug - its available via order on the NHS. I am on the lowset dose of Mirtrazapine and unless I have to I will not increase it. I see it as a short term fix only. The most bizarre thing of all this WD was that underneath the hideous anxiety and other symptoms, I had started to feel genuine emotions that Venlafaxine had robbed me of for years. On the good days all was good. On the bad ones...... I do believe some of my anxiety was situational. Now the stressors have been removed, things have definitely improved.

 

It took four doctors before I could find one that had genuine exeperience of Venlafaxine withrawal, but he did say it can be hideous. He's not wrong there.

 

I intend to have a ceremonial burning of that drug in my garden at some point.

Thank you for your support. I will be back.

Cheers

Caspur

[Caspur]

Hi Alostrata, Survivor1,

Please ignore my previous post. I was wrong and should have listened to your experience.

The last three days or so, look like this:

Sunday (26th Nov) PM - really suffering and panicing - reinstated Venlafaxine - 0.26ml (about 2mg)

Monday AM - in a state of complete anxiety, took another dose - 0.26ml (about 2mg); by 11am in the morning most if not all withdrawal symptoms had gone; went to doctor to explain situation but didnt realise the relief was due to reinstatement of venlafaxine (when I left the surgery, felt fine). Prescribed Mirtrazapine and beta blocker to alleviate anxiety

Monday PM - OK. Took first dose of Mirtrazapine at about 9.30pm and had a full nights sleep 8.5 hours; DID NOT TAKE ANOTHER DOSE OF VENLAFAXINE

Tuesday AM- DID NOT TAKE ANOTHER DOES OF VENLAFAXINE. Feelin pretty good; no withdrawal

TuesdayPM - 3pm had a 'brain zap/bump' and drop in mood; still didn't make the connection.

Tuesday PM - early evening WD symptoms started to return quite badly; short tempered; anxious, nausea etc Took second does of Mirtazapine 10pm

Wednesday AM - feeling mildly depressed, anxious etc. Definite withdrawal. Took 0.26ml (about 2mg)venlafaxine

Wednesday - day WD symptoms gradually declined. By 4-5pm feeling pretty good

Wednesday - PM about 5.30pm took another dose of Venlafaxine - 0.26ml (about 2mg)

 

From this I can almost certainly conclude that reinstatement at this level works for me and probably would have worked at a slightly lower dose.

 

I would be grateful to receive further instructions from you all. Main questions are:

1. how long should i hold at this dose

2. When I take a step down/resume taper I assume it should be no more than 10% of this reinstated dose. Is this correct? I was doing 5% reductions in my previous taper without too much trouble (some minor withdrawal only).

 

Thank you for your help

Cheers

Caspur

 

 

hence my post at 2.57pm yesterday being so

[Altostrata]

Yes, we often see reinstatement of a low dose works to reduce withdrawal symptoms.

 

Please take the same amount each day at the same time. Keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. This will help us see if the drug is causing problems, or if you might increase or decrease venlafaxine.

 

Your symptom pattern will tell when you are stable enough to taper even this low dose. Yes, it will be 10% of your current dose.

 

How are you measuring out 0.26mL? Are you making a liquid of the regular, immediate-release venlafaxine?

[Survivor1]

Hello Caspur,

 

I'm glad that you are getting some relief from the reinstatement.

 

When I reinstated, three months had elapsed, and it took another three to get stable.  I had intense symptoms every day of the three months it took to stabilize.  Don't be alarmed if you continue to have symptoms for a while, they will eventually fade and you can resume a slow taper.

 

All the best.

[Caspur]

I feel compelled to write about the last 4-5 months of my life, just to get it off my chest and also in the hope that it may help others on this forum in some way. Unfortunately, this is not a success story as I am now back on venlafaxine at 75mg, but I am well, although I have been to hell and back to get here.

Sorry about the long post, but if you stick it ou to the end you may realise why 🙂

I last posted on this forum on the 29th November last year (please see my previous posts for the history), just after reinstating a very low dose of venlafaxine (which did kill off the withdrawal symptoms) but also having just started mirtazapine as offered by my doctor. I could not tolerate the mirtazapine, even at a low dose of 7.5mg. All it did really was sedate me sufficiently to enable a full nights sleep. I had to stop taking it after about two weeks. Unfortunately taking and stopping it also messed up the benefits of the venlafaxine reinstatement, as per the advice of the forum admins.

I went back to the same doctor that prescribed the mirtazapine not long after stopping it and asked if I could go back onto venlafaxine because the withdrawal symptoms were becoming intolerable. By this time, I was signed off work completely as I could not deal with it.

To his credit he said yes but that I should be very careful about how I did it and to do it in small increments. I went away and increased the dose from 4mg per day to 11mg per day. This sent me into a complete tailspin. Within 24 hours I became completely hyped up, totally unable to eat or sleep and having very strong suicidal thoughts. It was very frightening. I assume this was a reaction to the reintroduction of too much of the drug and due to the state of the withdrawal I was in.

As I was in such a bad way, my wife phoned the doctor and I was referred on to a mental health team in the NHS. At this point I was still taking the 11mg of venlafaxine each day in two divided doses to stave off further withdrawal symptoms. Then I was prescribed 30mg of duloxetine per day. A psychiatrist I never met told my doctor that this would enable me to taper off the venlafaxine…..some hope! I tried to reduce the venlafaxine (by 5%) and the reaction was terrible.

My primary point of contact in the mental health team was a prescribing nurse. I only had phone contact at this point (mid-December). From the description of my symptoms she accepted I was in withdrawal and prescribed diazepam to get me through the Christmas holidays with some comfort. This worked quite well but I was taking about 8mg of diazepam a day for about a month, which I later had to taper off over 2 months or so.

So, into the new year. At this point I was a wreck. Deeply depressed and very anxious and spending long periods of time at home in bed, not wanting to get up or go out at all. As I tapered off the diazepam the anxiety just got worse and worse. I have never felt so depressed and debilitated in my life before and I never want to go there again. I was very suicidal and its only the support of a few very good friends and having my wife and children around me that kept me alive.

One thing that was very noticeable was the diurnal nature of the symptoms I was experiencing. I would wake in the morning with that very strong spike of anxiety which I now know is caused by cortisol, as per the many descriptions other people have described on here. By the evening (5-7pm) the symptoms would have calmed considerably and some days I would go to be feeling like there was nothing wrong, only to wake the next morning and start the cycle all over again. I was a hideously torturous existence. This went on for 2-3 months, during which the duloxetine was increased to 60mg per day and then 90mg. I could not tolerate the latter and it was reduced back to 60mg. I never worked for me and I only got off it last week after tapering down by opening capsules and weighing the contents to enable a reasonably slow reduction. I’ve had minor withdrawal from stopping, but thankfully only physical symptoms.

I was also prescribed quetiapine (25mg, about mid-February I think) by the prescribing nurse in the hope it would augment the duloxetine and make it work. It didn’t and I still have to taper off this drug too.

As I was in such a terrible state of anxiety and depression and having constant suicidal thoughts I was referred on to what is called an Intensive Team – read ‘crisis’ team here – which meant I was receiving home visits from field nurses every other day. I was also introduced to another psychiatrist. I met with her and described what had happened to me when trying to stop the venlafaxine and how I had gone into withdrawal, etc. Her diagnosis was a relapse. She paid no heed to the withdrawal explanation. No real surprise I guess.

At this point I should say that the previous depressive episodes I have experienced in my life are not even on the same scale as the way I was feeling at this point. I have never had the deep depression or debilitating anxiety I was suffering at this point, before.  I had no interest in anything.  Motivation was at rock bottom.

The psychiatrist increased the dose of the quetiapine to try to kill off some of the anxiety. It went up to 50mg, taken at night, so at least I was able to sleep as it is so sedating. I’m not sure if it helped, but at this point I didn’t care, literally. I was convinced my life was over and that I would never recover.

I was also advised to restart the venlafaxine (increase from the 11mg I was still taking) by 3 mg every 5 days (yes you read that right!), using the liquid preparation I had access to. I was very frightened of doing this due to the hideous reaction I had previously when I tried to increase the dose. However, I complied as I was in no fit state to fight it. Each does increase was unpleasant and caused side effects and suicidal thoughts, but I progressed, although it seemed so slow and a therapeutic dose seemed so far away. In the mean time I was discharged from the crisis team to a community mental health team sometime in late March.

This meant a new psychiatrist (who was also not interested in the withdrawal explanation). When I met with her I was taking about 30mg of venlafaxine per day and still reducing the duloxetine. She suggested I should increase the venlafaxine dose more quickly, by 10 mg per week. So even though I was very anxious about it, I did and I got to 37mg and was able to take a slow release version. I also switched from the liquid preparation to tablets which could be broken up and didn’t caused the spike of drug absorption (and hence side effects) that the liquid did, presumably because it is taken up so quickly by the body. I was able to increase the dose more quickly than planned. By the time I was at about 65mg, things had improved considerably. The depression lifted and the anxiety went away. No more suicidal thoughts. This happened in a 2-3 week period and I’ve ended up back on 75mg XL per day. The relief was immense. Motivation returned. I was able to go back to work.

The psychiatrist seemed very surprised by this miraculous recovery when I met with her again this week. I don’t know if the dose I have returned to has merely killed off the withdrawal or if it has just worked as AD medication can and made me feel better? It seemed to happen quite quickly.

The main remaining symptoms I have been left with are gastrointestinal upset, tiredness, tinnitus and that morning cortisol spike was still there, albeit not as strong as before. Running and vitamin C really helped with the latter. I started taking about 2000mg of vitamin C before bed and I am also trying phosphatidylserine for a month. The morning spike seems to have abated for now. For people still suffering out there, vitamin C does seem to have some efficacy. I am assuming the tiredness is a result of being hyped up on adrenaline for the past 3-4months and I hope it will improve. The gastro effects are improving and the tinnitus is still there.

So, I am left back where I started…..on 75 mg of venlafaxine per day. I am feeling so much better. I now have to get off the 50mg of quetiapine I am still taking without messing things up. I will start slowly with a 10% decrease and see how it goes.

I hope this story is of use to someone. I’m not sure what the lessons are, but it does show that reinstatement may work quite a while after stopping the offending drug. I stopped taking venlafaxine on the 15^th October last year. I reinstated 4mg about 5-6 weeks later and to 11mg about 2 weeks after that. I increased again from the beginning of March and reached 75mg by late April. The interim period was hell.

Thanks

Caspur

[Caspur]

Hi All,

 

This is probably not the right location for this post, so admins please feel free to move.

 

There has been quite a bit about antidepressants and their over use, especially in adolescents in the UK news and television coverage recently. There seems to be quite a lot of traction with the issues they cause getting good publicity. This lead me to find the Risk database run by Professor David Healy, a psychiatrist, who is a very outspoken individual on drug safety and the cavalier attitude of some doctors, psychiatrists and especially the pharmaceutical companies. I have seen some of his articles referred to on this site.

 

The Risk database encourages individuals to report any issues they have experienced with prescription medications and you recive a Risk score and report according to the likelihood the drug caused the issues - this includes withdrawal and drug cessation issues that are so widely reported on this site. As an example I entered the issues  I experienced with venlafaxine - my Risk score came out at 14, with highest score being 15. The questionairre is very easy to complete and there are opportunites to fully describe any issues in detail.

 

I know many people on this site are suffering very badly and may not be inclined to undertake such an activity but I do believe the Professor Healy is building the database to enable a better understanding and greater insight into the issues we have all faced. This kind of information is criritical to the advancement of understanding and education of the terrible consequences of pschiatric medication withdrawal.

 

The database can be found here: https://rxisk.org/

 

The site also contains other resources and I noticed Professor Healy has used many of the principles advocated by this site in his current advice to people who want to stop taking psychiatric medications.

 

Professor Healys Blog is here: https://davidhealy.org/

 

Another interesting site is http://www.rjmoore.co.uk which has some good podcasts on the topic of medication withdrawal. Richard Moore is an individual who had his life severely disprupted when trying to stop Mirtazapine.

 

Thanks

 

Capsur

[Caspur]

Hi All,

 

Please can I ask for some advice - although I had to resort to going back onto venlafaxine to be able to recover from the hideous withdrawal I experienced, I still have a few enduring problems.

 

I find exercise very difficult now, and I tend to lack energy, but the most prominent issue is tinnitus. I first experience this when I tried Citilopram about 9 years ago. I only took it for a couple of weeks, but it gave me mild, but tolerable tinnitus which never went away. I remember my now decased father in law having the same issue when he was prescribed citilopram (for what turned out to be parkinsons disease).

 

When I tried to reinstate and updose venlafaxine late last year (from 4mg to 11 mg/day), I reacted severely to it and the tinnitus intensified considerably and never subsided. Now I have a constant ringing in both ears, which I am beginning to find intrusive. I never experience complete silence any more. Has anyone else experienced this and if so, is there anything that can be done to help resolve it? I have read that tinnitus can be incurable, but I dont know what the prognosis for drug induced tinnitus is? Can anyone help?

 

Many thanks

[peng]

Caspur, I have just read your thread because you are in a similar position to myself in that we appear to have arrived at our "minimum therapeutic dose" of Venlafaxine.

 

You are at 75mg and I am at 62.5mg after a 2-year taper down from 225mg and a slight relapse at c56mg, making an updose to 62.5mg necessary.

 

I am sorry I cannot help with the tinnitus, but if you want to compare notes at times, have a look at my thread first.

 

Regards & Best wishes.

[Caspur]

Hi All,

I have been tapering off a 50mg dose of quetiapine and started by using the 10% rule which caused me no issues until I got down to about 4mg.

 

I have been cutting pills and weighing the small pieces to work out the dosage each time. However, with the small pill cuts, getting an accurate weight is difficult as the scales cannot cope. I have tried to stop at about 2.5 mg and have experienced disturbed sleep (I can get to sleep and sleep for about 4 hours, but am then awake for the rest of the night), anxiety, dips in mood, some derealisation, diarrhoea and nausea. I stopped two days ago.

 

I am thinking of trying to make a liquid preparation from the pills which are immediate release and then reinstating at about 4mg (the last stable dose) and trying to stabilise again, then slowing the taper down to get off the remainder, probably starting with a 5% reduction. I have 1ml and 5ml syringes to measure the volumes and the dose.

 

Please can you advise as the symptoms are becoming quite difficult.

 

Many thanks

[ChessieCat]

I've merged your new Intro topic with your original Intro topic.  Each member has only 1 Intro topic where they can ask questions about their own situation and journal their progress.  Please do not create any more Intro topics.  Thank you.

 

tips-for-tapering-off-seroquel-quetiapine

 

how-to-make-a-liquid-from-tablets-or-capsules

 

[Caspur]

Hi ChessieCat,

Thanks for the quick response. Understood 🙂

Caspur

[Caspur]

Do you have any comment on the actual plan to reinstate?

Thank you

[Caspur]

On 6/30/2018 at 2:04 PM, peng said:

Caspur, I have just read your thread because you are in a similar position to myself in that we appear to have arrived at our "minimum therapeutic dose" of Venlafaxine.

 

You are at 75mg and I am at 62.5mg after a 2-year taper down from 225mg and a slight relapse at c56mg, making an updose to 62.5mg necessary.

 

I am sorry I cannot help with the tinnitus, but if you want to compare notes at times, have a look at my thread first.

 

Regards & Best wishes.

Hello Peng,

Thanks for your comment and interest. I have now given in to staying on 75mg of Venlafaxine for the time being. I had such horrendous withdrawal when I tried to stop taking it, although I am fully aware that i tapered too quickly. I dont have the support of my wife to try another taper, and to be fair it was hell for her as well as me. I need to work to support the family etc so I must face that repsonsibility before my own desire to be drug free.

I've just had another problem trying to taper of 50mg of quetiapine (see further posts below). It has really scared me as i dont want to go backwards again at the moment!

 

Are going to continue with your taper? I will check in to see how you are getting on.

Good luck and best wishes

[Caspur]

Hi,

So I reinstated 4mg of quetiapine last night which resulted in better sleep. But now during the day I am feeling very restless and feel like I cannot sit still. I want to get up an pace around all the time. It feels like akasthisia but I dont have any involutary movements, just restlessness. Its like there is pressure in my chest as well. Does anyone have any advice or thoughts on this? Its strating to get quite unbearable.

Thanks

Caspur

[TheWayBack]

Hi Caspur

 

That is akathisia! Involutary movements is typical dyskinesia, they are not the same thing. Stop the Quetiapine. Akathisia can get very dangerous very fast. I don't want you to get in the same boat as me. You are probably lucky because you got it right away, which means it is acute instead of tardive (late onset), and that means that it almost always goes away on discontinuing. Quetiapine is a anti-psychotic with a low EPS profile, so I wouldn't recommend trying other meds in this drug class, like Seroquel, which docs seem to love. They are much more dangerous if you are prone to akathisia.

 

 

[Caspur]

Hi TheWayBack,

Thanks for your advice. I have been taking it for quite a short period - since Feb at 25mg and then increased to 50 mg sometime after that. I started tapering at the beginning of May. I am obviously worried about cold turkeying off even this low dose, but fully appreciate what you are saying. Broken and disturbed sleep became a problem straight away after I stoped a few days ago. The reslessness started then as well.

 

Do you suggest I should just stop and weather the storm? Any thoughts on how the symtoms may subside? I appreciate you cannot give absolute recommendations, but based on your exeperience?.

 

Thanks

Caspur

[TheWayBack]

Did the restlessness start when quitting  or starting up? If it started when quitting, you can slowly go back on the dose and taper slower. If it started when reinstating, stop the drug or taper reasonably quickly.

 

But this is not absolute advice. There isn't unfortunately. Akathisia is no joke. And I can't say do this or do that with certainty.

[Caspur]

The restlessness started when quitting. Today has been the worst of three days of it. The first two days were relatively mild (after stopping at 2.5mg), and some of it may have been anxiety; i certainly didnt have the desire to pace like today. But i wanted to reinstate to 4mg because of the sleep issues. The updose seems to have made it worse. I atke it at night btw.

 

Thanks

 

[Caspur]

Sorry, should have asked - what do you mean by taper reasonably quickly in terms of time?

[Caspur]

Hi The WayBack,

 

I spoke to a psychiatrist yesterday afternoon. I thought I had better, as I am still under her care. She wanted me to carry on with the 4mg. I persuadeed her that i should reduce the dose having seen what you had written and she accepted this, although denied the issues I described could be anything to do with the drug "at such a low dose". I discussed withdrawal with her but she wasn't convinced sayings its a return of previous/underlying symptoms, as i expected her to say I suppose.

 

Anyway the upshot is I have halved the does to 2mg and I feel less restless today. I still have similar symptoms, but the desire to pace has diminished and concentration has improved, as has my mood. I still feel quite irritable and uncomfortable, but its bearable. I am also using niacin to try to control the symptoms which has brought some relief. I am running first thing in the morning to kill of the early morning spike, which helps, but takes a lot of motivation to do!

 

Please comment on my previous points if you can. I agreed with the psych that I would take 2mg for a week then stop.

 

Thanks

 

Caspur

 

 

[Caspur]

21 hours ago, Caspur said:

The restlessness started when quitting. Today has been the worst of three days of it. The first two days were relatively mild (after stopping at 2.5mg), and some of it may have been anxiety; i certainly didnt have the desire to pace like today. But i wanted to reinstate to 4mg because of the sleep issues. The updose seems to have made it worse. I atke it at night btw.

 

Thanks

 

Sorry, I've just reread my post above. I dont think i was clear. I stopped for two days (from 2.5mg), during which i got some anxiety symptoms, brocken sleep etc etc. I then reinstated at 4mg, and the next day was when the restlessness really kicked in. So i intend to follow the advice of tapering quite fast as you stated.

[Caspur]

Update to taper - stopped drug at 2mg on 13th July. Since them I've had mild but bearable symptoms - broken sleep and lowered mood being the worst. My tinnitus has also intensified since the restlessness and agitation I experienced (and hence the fast taper). I have continued with a 5km run at 6am most mornings, which seems to help kill the mild morning (cortisol??) spike i am still getting. I have not experienced any further reslessness/agitation/anxiety. Thankfully those symptoms seem to have gone.

 

Today has been the best day so far. Mood has lifted and i feel generally better.

[Caspur]

This is what happened to my resting heart rate during the period when I experienced the agitation/restlessness etc from the quetiapine taper/dose change. I am quite a fit person with a resting heart rate in the low 50s. To see it race up to 64 in a few days was quite alarming. I guess this is the impact on the autonomic nervous system. During the same period I experienced brethlessness whilst exercising. I do accept i have experienced quite mild symptoms, but what is it like for those poor souls experiencing severe symptoms? I worry about the impact it must be having on the bodys critical organs.