jen33: Could this be withdrawal?

[jen33]

Hi, 

I'm brand new to this site and ran across is on psychology today. I have a few concerns around what could possibly be withdrawal from SSRIs that I've been taking for a number of years. First being that I'm not on any anti-depressants right now and it has almost happened by accident and I don't believe in a very responsible way by my doctor, but I suppose I'll let others weigh in on that, too. 

 

Essentially, here's the bit: I've been on antidepressants for approximately 10 years now. For the vast majority of that time I have been on sertraline but last fall felt it wasn't really helping my OCD as well as it could anymore and started seeing a psychiatrist rather than just my GP. We've tried several medications that gave me bad side effects, most recently, viibryd. I started viibryd only 2 weeks ago on a Sunday. Two nights later I wasn't sleeping at all, and at first she urged me to keep taking it. However, I woke up the next Saturday not feeling well so I asked if I could come off of it and for the time being until the next time I could see her I asked if I should go back on the Sertraline (quite honestly, it's been a long road of nasty side effects and I didn't want to try yet another new medication with another bad side effect). She just told me to go off the viibryd. 

 

I already felt ill on Saturday, but the rest of the week I got worse. I stayed home from work all week. I've been sleeping up to 18 hours a day. Flu and mono tests were negative, I have been extremely nausea with no appetite, unable to keep my eyes focused - the computer screen is a real challenge -, I've felt generally sick, I've cried several times which is pretty unlike me... I continue to feel very ill, and my cloud of nausea tonight sitting on the couch I thought "my doctor didn't wean me off 10 years of SSRIs, could that be a problem?". I did start feeling ill before I stopped the medication, which is why I'm not sure - but more generally, I guess, I'm looking for others thoughts on whether this could be what's causing my symptoms? 

 

Apologies if my thoughts aren't clear - the computer screen really is very difficult for me right now. 

[ChessieCat]

Hi jen and welcome to SA,

 

We are going to need some additional information about your drug history before we can make any suggestions.

 

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• 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.
• Link to Account Settings – Create or Edit a signature.

 

I'll give you some links to get you started:

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Windows and Waves Pattern of Stabilization

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Intro topic where you can ask questions and journal your progress.

 

Edited March 10, 2018 by ChessieCat

[ChessieCat]

Thank you for completing your signature.  It is very clear.  Exactly what we need 

 

It sounds like you are experiencing withdrawal symptoms.  The only known way to reduce withdrawal symptoms is to make a small reinstatement.  Please answer the following questions so we can try and work out which drug you could try:

 

Q:  How did you feel whilst taking duloxetine?  Please provide as much information as possible.  Q:  Why did you stop it?

 

Q:  How did you feel whilst taking venlafaxine?  Please provided as much information as possible:  Q:  Why did you stop it?

 

Q:  Do you have any sertraline, duloxetine or venlafaxine left?

 

 

Please read Post#1 of this topic so you can understand what is involved with reinstatement:  About reinstating and stabilizing to reduce withdrawal symptoms

[jen33]

Hi, ChessieCat, sure - here's a quick recap of how I felt on the medications:

 

1. Sertraline: I felt stable and had little panic symptoms while taking this medication, but still had a fair amount of OCD thoughts and anxiety, which is why I sought out a psychatrist and ultimately changed to duloxetine. 

 

2. Duloxetine: I felt quite flat/apathetic while taking this medication. I took it for about 3 weeks feeling like this and my prescribing doctor assured me that it would probably go away and get better, but after giving it another week and not feeling any better, she switched me to venlafaxine. 

 

3. Venlafaxine: I felt good on this medication in terms of depression and anxiety symptoms but it made me extremely constipated so I discontinued it and tried viibryd. 

 

As far as what I have left, I have sertraline and venlafaxine left. 

 

 

 

[ChessieCat]

It sounds like the venlafaxine (SNRI) helped with any withdrawal you may have been experiencing from sertaline (SSRI).

 

I had a similar thing happen when I cold turkeyed citalopram (SSRI) and was then put on to desvenlafaxine (SNRI).

 

You might find that taking a small dose of venlafaxine will help reduce the withdrawal symptoms.  There are several reasons for starting with a small dose.  Please ensure that you read Post #1 of About reinstating and stabilizing to reduce withdrawal symptoms  This explains why a small dose is suggested and other things regarding reinstatement.

 

The idea of reinstating isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.  Reinstating a small dose might also mean that you don't suffer the side effect/s which you did when taking 75mg.

 

Q:  When did you stop taking venlafaxine?  Please add the dates or early/mid/late to your signature where I have inserted question marks.  Thank you.

 

Venlafaxine, 75 mg: ?  December 2017-  ? February 2018

Duloxetine, 30 mg : ? October- ? December 2017

Sertraline, 200 mg: January 2008- ? October 2017

Before we can suggest a dose we need to know what type of venlafaxine you are taking.

 

Q:  What type of venlafaxine do you have?  Brand name Effexor or generic?

 

Post #1 of this topic mentions various types:  Tips for tapering off Effexor (venlafaxine)  

 

Please provide as much information as you can about the type you have.  Thank you.

[Altostrata]

Welcome, jen.

 

On 3/9/2018 at 7:49 PM, jen33 said:

I continue to feel very ill, and my cloud of nausea tonight sitting on the couch I thought "my doctor didn't wean me off 10 years of SSRIs, could that be a problem?". I did start feeling ill before I stopped the medication, which is why I'm not sure - but more generally, I guess, I'm looking for others thoughts on whether this could be what's causing my symptoms? 

 

As ChessieCat observed, you have classic withdrawal symptoms. The withdrawal probably dates back to one of your drug switches, probably from sertraline to duloxetine. Yes, your doctor should have been more careful of making this change after 10 years of sertraline.

 

Chessie's suggestion of an Effexor reinstatement is a good idea. It may have made you constipated before because you were taking too high a dosage.

 

HOWEVER, since you've developed withdrawal syndrome, you may now be hypersensitive to any psychiatric drug. If you wish to try a reinstatement, if I were you, I would open an Effexor capsule and take perhaps 5 beads to start. Or, perhaps 1mg Prozac, like sertraline, it's an SSRI and is somewhat easier to come off than Effexor. 

 

Please let us know how you're doing with the reinstatement.

 

Once you find the right level of reinstatement, you'd stay on that for some months, then very slowly taper off. If you want to live drug-free, you will need to manage any tendencies to depression or troublesome thoughts with non-drug methods. Have you ever tried psychotherapy or other coping strategies?