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LarryS

LarryS: tapering off venlafaxine / Effexor 225mg

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LarryS

Hello, I'm new to this forum and I'm working toward tapering off of 225 mg of venlafaxine. I am a 70 year old male, that has been very active and health conscious. My weakness has been depression. I previously had two periods of feeling depressed that involved obtaining an antidepressant from my general practice doctor.  I would get to the point of feeling spacey and or lethargic, then do talk therapy to get back off of the drug.  These where phase one antidepressants, and I would taper off slow over say 4 to 6 months without noticeable side effects.  These events occurred between 2005 to 2008 per notes I still have.

 

I retired from Highway Engineering March 1, 2014.  Many emotional events piled upon me during the next five months.  The stressors where; retiring and adjustment period, daughter coming home to live with us and get a divorce, a vicious son in law (being divorced), one or two other more minor stressors that I do not recall, and a huge spiritual crisis in which I felt I had not lived as graciously as God would have wanted me to.

 

In July 2014 I became fixated on thinking about all these things.  I sat in a stupor for days, lost 15 pounds, thought the devil was speaking and accusing me of my wrongs and tempted me to deny God and just die.  My wife asked me If I had thought of suicide and I admitted that I had.  She called 911 and got help.  They took me to a hospital and put me on suicide watch till they could transfer me to a psych ward for treatment.  I was confined for a week and given many medications.  I also had a physical problem that they dealt with.  I was released to an out-patient psychiatrist.  The psychiatrist told me he would take me off all the previous medications except for increasing my dose of venlafaxine to 225 mg.  I have been on venlafaxine for four (4) years.

 

In May 2018 I stopped drinking all alcohol and also stopped experimenting with legalized cannabis.  I quickly felt a bit more energy.  I put this energy toward searching the internet for information about venlafaxine and antidepressants. I have learned much, but still want to keep learning.

My Psychiatris agreed to allow me to get off Venlafaxine October 4, 2017, after telling him repeatedly about my desire to and why.  He reduced my venlafaxine from 225 mg to 150 mg.  The short of it is that I did not make it, and went back to the full dose.

 

After learning more about how to decrease slowly, I am ready to try again.  I have sought the help of my general practice doctor, who is supportive and has reduced me to 187.5 mg.  Since I know that a 10% reduction is better, I cut open a 37.5 mg capsule, counted the beads, and took 40% of those beads, 15, and added them to the 187.5 mg, for a new total of 202.5 mg.  I'm also taking daily notes of my physical and mental state, and dosage.  I will see my general practice doctor monthly.  I will be also talking to my Psychiatrist about my plans. I plan to start talk therapy also.

 

Does anyone have any advise or comments?

 

Edited by ChessieCat
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Petunia

Welcome LarryS,

 

Thank you for joining and sharing your story. I'm glad you found us, it sounds like you have looked around the site and now have a good understanding of tapering and the possibility of withdrawal. It's great that you have a cooperative, supportive doctor, that will be a big help.

 

At this point I don't have any advice, but just want to say well done for doing your own research about these drugs and congratulations for giving up alcohol and cannabis. I think you will do fine if you take things slowly.

 

I will post some links here in your thread, you may have already seen them on other parts of the site, but they will be here for easy reference if you need them:

 

Tips for tapering off Effexor (venlafaxine)

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Rate symptoms daily to track patterns and progress

 

Here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top. 

 

You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want. Its a good idea to bookmark it or follow it, so its easy to find again.

 

Please stay in touch and let us know how you are doing.

 

Petunia

 

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LarryS

I've counted the number of beads in 37.5 mg and 75 mg capsules of Venlafaxine.  It appears that one bead is worth about 1 mg of drug.  Am I correct?

 

Is it better to take Venlafaxine (antidepresant) in the morning or evening?

 

I like to have one to two cups of coffee in the morning.  Since it is a stimulant, is there anything about this practice that would hinder my progress towards recovery from an antidepressant drug?

 

Edited by ChessieCat
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ChessieCat
15 hours ago, LarryS said:

I like to have one to two cups of coffee in the morning.  Since it is a stimulant, is there anything about this practice that would hinder my progress towards recovery from an antidepressant drug?

 

Some members have that they have had to stop drinking caffeine and alcohol and are unable to tolerate some foods and supplements.

 

There are many existing topics on this site.  Either use the search function or a search engine and add survivingantidepressants.org to the search string.

 

caffeine-in-coffee-or-tea-tolerance-issues

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peng

Hi, Larry,

You sound like a good man that has been through the mill.

 

I have a couple of cups of coffee (instant) per day with no adverse effects, that I can notice.

I can also have a beer - maybe 2 (with food), now and again.

I am 72 and have a lot of fatigue on most days.  It has to be due to the Effexor - it is widely reported and mostly no one is able to offer a dramatic remedy.

I bought a rowing machine about 4 years ago but arm pain from a cervical disc means I have to do other gentler stuff.

I have been on effexor since 2002, but have tapered down from 225mg to 62.5mg in 2 years with the advice on this site.  My GP is supervising.

I take my dose with a meal c1800hours.

 

Best wishes from Scotland/UK

PS - In my former profession, we worked quite a bit with highway meteorology.  I prepared a couple of climate profiles for two small highway projects here.

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LarryS

Thanks (peng) for sharing your experience with coffee and beer.  Two beers around 5:00 PM usually just caused me to want to close my eyes and nap.  After stopping beer and wine May 2018, I have noticed an uptick in available energy.  This gives me good reason to stop all together.  I have not noticed any adverse effects from 1 to 2 cups of coffee for me in the early morning.  I'm currently taking my medications about 9:30 pm, before bed around 10:00 pm.  I guess the next thing to do is learn about the half life of effexor (venlafaxine (generic)).

 

Currently on 202 mg of venlafaxine, a 10% reduction from my initial 225 mg.  

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LarryS

I've been reading on this website every day since I started taper June 5, 2018.  My primary symptoms that I'm hoping will dissipate over time are lethargy, anhedonia, insomnia, spacy, and light head pressure.  I have mild sleep apnea, and have dealt with fatigue for many years, but not lethargy and anhedonia.  I'm age 70. I mention lethargy in my daily notes 17 out of 21 days.

I will see my primary care doctor July 2.  I'm considering my next decrease (start July 5) will be less than 10% from 202 mg to 187.5 mg.  187.5 mg will be convenient because it is one 150 mg and one 37.5 mg capsule.  I will be on a two week vacation during the following four week period.  The vacation is all booked, and my wife and I are looking forward to starting it July 10.

My lethargy is not bad first thing in the morning, usually, but progresses throughout the day.  By 5:00 pm I often can do nothing but nap.  I know that naps can throw off my sleep cycle, and that they should be avoided if possible.  But my lethargy takes over.  Fortunately, I do not have to work at a job.  My hope is that I will be able to decrease my symptoms and live a fuller life with feeling, and maybe some laughter.

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LarryS

My quality of sleep seems to cycle every other day.  This is the 25th day since I started my first 10% drop.  Going on two week vacation starting July 10.

With 10 equal to worst feeling:  Lethargy 8, Anhedonia 8, Insomnia 7, spacy 4, light head pressure 5

I read about being patient and holding until some symptom relief.  Also about allowing the body to adjust.  Also read of the desire to move forward.

My dilemma:

Drop 8% to 187.5 mg venlefaxine on July 5 (4 week 2 day hold).

Or, wait until after vacation, and then consider 10% drop.

 

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Gridley

Why don't you hold and enjoy your vacation and allow your system more time to stabilize?

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Madeleine

Wait until after the vacation.  I think all travel, even if it is pleasurable and relaxing, also does add a bit of stress -- due to changes in routine, location, etc. especially in the lead up to it -- even if it's a good kind of happy stress.  And, if you drop now, you might be watching for withdrawal symptoms, and even if the cut doesn't affect you physically, you might feel even more anticipatory stress worrying about the cut.

When you get back, do a 10% drop.  

I recently travelled overseas and held at the rate I was on, and then made the cut the day after I got back.  

By the way: it was the best holiday of my life.  Everything went perfectly smooth and it was so nice to get away.

Have fun and enjoy!

Best wishes, 
M.

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LarryS

Gridley, Madeleine

Thanks for your advise, I'll take it and wait till after vacation.

Also downloaded the taper spreadsheet which is great.

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LarryS

Returned home yesterday,  July 24, 2018 from 15 day sight seeing trip to Prince Edward Island, Canada; and three New England States, USA.  This trip was a first of it's kind for my wife and I in many ways.  I learned a few things about travel that I will change next time, due to  our current physical abilities and stamina.  Over all, it was a wonderful experience.

Per advise of two members on this site, I waited till today to begin my next step down taper, at level 187 mg, which is 15 mg or 8% drop.    This avoids counting beads, by using a 150 mg and 37 mg capsule for this next duration.

Since I'm at a fairly high dose, and a curve that I saw on this site shows a slowly decreasing flat curve till one gets to about 75 mg dose, I would like to try decreasing by half a 37 mg capsule over a 4 to 6 week period next time.  This would get me down to a 150 mg dose in 8 to 12 weeks.  This will be about an 18 mg drop each time, which is less than the 22 mg drop I did initially.  My initial taper has been OK without major withdrawal symptoms.  Venlafaxine is toxic to my body, this is why I'm tapering, to eventually eliminate this toxic drug.  

I like to experiment, and I'm only hurting myself if this does not work.  When I get to the 4th step down, I will be at 150 mg, which is 2.4 mg above the recommended 147.6 mg, per the "Standard Gab Taper" excel spreadsheet.  This will eliminate two (2) periods of having to count capsule beads.

A little bit different way of looking at how to taper, but somewhat inventive, if I do say so myself.  I'm not proposing this method be used below 75 mg.

Your feedback welcomed.

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peng

Read your post with interest, Larry.

Glad you both had a most reasonable holiday experience!

Last 2 year period, my taper from 225mg went mostly smoothly, too.

I was able to report good or not bad  colours on my daily excel spread sheet until I got to about 56mg when bads came in.

Even the apparently cautious 5-10% taper caused me to overshoot what, in my opinion, was my minimum effective therapeutic dose for the time.

Looking further back (pre-SA website era) I did go down to 0.0mg once in 2006 and was still feeling great, doing lots of projects, legal reports, expert witness attendances in court, etc.  However, typically for the beast, it came back to bite me within a few months.

So please be wary when you start passing the 75mg(?) mark, and do not take chances by thinking you are "good enough to go" faster.  Euphoria and deceptive self-confidence are other tricks in venlafaxine's armoury.

Not trying to rain on anyone's parade here - just spreading the word about the sneaky dangers this, at times effective, drug is liable to hammer us with when we are feeling "free".  

 

Best wishes & success

peng.

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LarryS

In my previous statement I was thinking back to the curves in the following link.

 

http://www.mediafire.com/view/f3h1ao5ijfj93/papers#0yp2c8pbjrziaab

 

These curves are examples and are not directly related to Effexor.  We all seem to be looking for a better way, but each must find how there own body responds to each decrease in drug dose.  I'm not a doctor of medicine.

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LarryS

Last night I came home late from playing music with friends and was tired and went right to bed, missing my normal 8:00 PM dose of 150 mg Venlafaxine.

When I woke up at 5:30 AM, and got out of bed, I felt strange and dizzy.  Realized what I had missed.

Took a 75 mg cap at 5:30 AM and my regular 37 mg cap at 7:00 AM with breakfast.

I felt unstable for about 3 hours.  It is now 1:30 PM as I write this note, and the dizziness has subsided, but I'm feeling out of sorts still and tired.  Retired, so I can take it easy today and see how it goes.

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peng

Yes, Larry, puts you out of your stride, that.  I think many of us do that from time to time.

 

I used to be restless in the early hours after such an omission and wondered why I had been having such weird dreams all night and was still feeling strange.

One usually twigs what has happened.

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LarryS

Thanks peng for your observations.  I'm trying to read as much as my eyes can handle here daily to get a bigger picture of what I'm up against.  It's not comforting to find out how long it may take to taper off Venlafaxine (Effexor).  Nasty drug!  My eyes have been opened.  I've decided to follow you, since you have been at it for a few years.  Years of experience, I may utilize.  It's nice to be able to have others who are actively pursuing the same goal, and have gone before, ( where no man or woman want to go).  

Slow and cautious is the way to be.  Looking, assessing, learning, before one leaps.  

At 70, I'm not that much older than you, if I interpret correctly.

Four years of retirement have at least taught me to take each day as it unfolds.

 

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peng

Hi, Larry,

I was 73 about 5 weeks ago.

I want to do more physical stuff, (have rower in garage) but I have pain due to a pinched nerve at C6 neck vertebrae.

Had MRI scan last week, hope diagnosis doesn't mean adding NSAIDs, etc!

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LarryS

Hi, peng;                    I also have constant low grade neck and low back pain.  The neck pain I contribute to a hit I took in high school football.  The back pain is a bulged disk.  Pain is my friend, it tells me to be careful, think before lifting or moving.  Right now it is tolerable, and I avoid pain pills most of the time.  I have had two excruciating past events due to the bulged disk, which I hope to avoid happening again.  I do physical therapy exercised in the morning to loosen up before starting the day.  I believe in moving, and also like to get down to a local gym for a light work out.

I'm in the middle of my second drop, which is an 8% drop, so that I can take whole venlafaxine capsuls, a 150 mg and a 37 mg.  I plan to do this for 4 weeks.  So far, the recommended process of going not more than a 10% drop is going well.  I believe most of the symptoms in my head are from the high dose I'm coming off of.  Looking forward to the day my head starts to clear up.

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LarryS

Third day since dropping another 10%.  The previous two 4 week 10% drops felt overall successful.  I've read on this site, per Alto, that one may consider using a 3 week period for the duration of a drop, IF first two drops where successful.  Considering my previous experience with weaning off antidepressants, with minimal side effects, I think careful evaluation should be made.  Therefore, I intend to evaluate dropping again, 10%, at the end of 3 week hold.  I'll know more about how I'm progressing in 3 weeks.

 

One unfortunate thing that happen August 12 to me, was the straining of my low back, due to work involved in hitching up my trailer.  Fortunately, it is not as severe as I have twice previously experienced.  The additional constant low back pain could potentially skew my self assessments.  Slow, careful and steady is at the top of my mind.

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LarryS

My loving wife asked me to see the General Practice Doctor who is helping me wean off Venlafaxine.  I appreciate her caring support, it is not easy I'm sure.  I saw the doctor for about 15 minutes, September 10.  He agreed that I could drop to 150 mg amount.  So I did the drop Sept. 12, after doing a 21 day hold at 168 mg.  Doctor wants me to hold at 150 mg till my wife feels comfortable that my mood is stable.  I have asked wife to record daily how she perceives I'm doing.  I have been recording for myself daily.  The doctor actually stated that he thought I may have been at too high a dose, at 225 mg, and he thinks I will do better at 150 mg.  The drop from 168 to 150 is a 12% drop.  The doctor believes a 12% drop will be fine.  Well, it is watch and wait.

 

My low back pain has subsided, but I must be very careful.

 

I took my wife to the Hospital Emergency Room Monday, Sept. 10.  They have identified additional heart problems and we will see her Cardiologist Friday Sept. 14.  More stress for both of us.

 

Slow and careful are the keys that I continue to remember.

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LarryS

Since taking my wife to Emergency at Hospital, things have been stressful, not knowing.  Wife had an Angiogram (CATH) procedure yesterday, September 21.  We got good news that her main heart arteries are looking good, and no stint is needed.  She is now at home recovering, with a board wrapped around her wrist area to prevent movement and potential bleeding.  I'm taking care of her due to her immobile hand.  Some stress has released, but she still is having dizziness issues.  The search for a cure is continuing.

Today is my 11th day since drop to 150 mg venlafaxine.  I'm experiencing some low mood today, but no serious side effects from drop.  Maybe it's just cause I'm sitting around all day, being available to help with every need.  It is raining hard now, and night has come.  Tomorrow is a new day.

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ChessieCat
On 9/14/2018 at 10:25 AM, LarryS said:

I appreciate her caring support, it is not easy I'm sure.

 

4 hours ago, LarryS said:

I'm taking care of her due to her immobile hand. 

 

And the caring is a two-way thing.

 

It sounds like you are doing okay consider everything.

 

This might help to put your mind at ease regarding the 12% reduction.  My first reduction was 25% because I was experiencing mild serotonin toxicity.  Many members find that the lower their dose gets the slower they need to go.

 

Why taper paper: dose-occupancy curves

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peng

Best wishes to you both, Larry.

Low mood?  Personally I would not worry too much about that at the moment.

"It's a normal reaction to a stressful event" as the cliche goes.  It would be odd if you were bouncing!

 

I know everyone is different, but I was fit for years on 150mg.

 

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LarryS

QUESTIONS        QUESTIONS        QUESTIONS

I have now held steady at 150 mg venlafaxine for 7 weeks.  I will be going to see my general practice doctor at the end of 8 weeks to discuss next drop.

At end of six weeks, my wife said she did not think I was ready for the next drop.

I have been experiencing more fatigue and general slowness of thought than in the past drops since starting this taper.  

Prior drops where done every 4 weeks, except for one 3 week drop.

This is the same level that my previous psychiatrist had dropped me suddenly to, from 225 mg to 150 mg.  That previous experience threw me into some depression and fatigue.  I up dosed back to 225 mg.

QUESTION:  Is it common to have more difficulty at some levels, than others?

QUESTION:  Should I wait longer than 8 weeks before trying to continuing on, at 4 week interval drops?

QUESTION:  If fatigue is my only primary issue, should I let this slow down my taper progress?

 

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Gridley

Larry,

 

Yes, it is common to have more difficulty at some levels than others.  This is especially so at the lower doses.  However,  difficulty at a level can sometimes be attributed to outside factors, such as stress.

 

Regarding waiting longer than eight weeks, it depends on whether you are stable.  By stable, I mean not totally free of WD symptoms but rather without wild swings in symptoms and severity.
Stabilizing after a reduction -- what does that mean?

 

If you are able to function with the fatigue, I don't think this should slow down your taper.

 

Please stay with the four-week schedule.  It is safer.

 
I notice you are on a B-complex.  While it is often a first response to stress to take a B-Complex, in withdrawal it can be overstimulating.
 
 

 

 

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LarryS

Thanks Gridley,                   I have stopped the B-complex vitamins, will see what happens.  Will likely just take B-12, since this was recommended by the doctor.

Read the information on what "stable" means to us who are tapering off a drug.

 

The primary care doctor was agreeable to my continuing to decrease venlafaxine.  Will start 135 mg tomorrow, November 7, 2018.

The doctor has started me on a cholesterol lowering drug named Atorvastatin Calcium 10 mg ( Brand Name: Lipitor)

I evaluated my tracking of fatigue and find it between 5 to 10 on the scale, cycling up and down, dependent upon what is going on and amount of rest and sleep I obtain.  Just will live with it.

I have been getting down to the gym for a good work out, about 3 times a week.  Now with long winter nights, I use my Happy Light in the morning to help me wake up and maintain circadian rithem.

I have not been drinking alcohol, because of its interference with tracking my body feelings.  But not sure I can swear I will not ever have a drink.

I'm going fishing with a friend for two days in central Washington state.  It should be a good little break.

 

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ChessieCat
54 minutes ago, LarryS said:

The doctor has started me on a cholesterol lowering drug named Atorvastatin Calcium 10 mg ( Brand Name: Lipitor)

 

It's a good idea to research:

 

are-statin-drugs-for-reducing-cholesterol-really-a-good-idea

 

statins-lipitor-and-others

 

https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statin-side-effects/art-20046013

 

https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statins/art-20045772

 

 

 

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LarryS

ChessieCat                Thanks for the tip.  Since your post I have been reading a lot on statin drugs.  I have decided NOT to start Atorvastatine Calcium because I have enough side effects already.

Also,  a recent Echocardiogram  and discussion  with cardiology doctor leads me to believe it is to soon to start a statin.  Cardiology doctor states that my heart is so healthy that I have less than 1% chance of heart attack.  Also, my "total cholesterol to HDL ratio" is excellent at 3.18.

 

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ChessieCat

My girlfriend's husband was recently prescribed a statin and also told to change his diet.  I looked at my girlfriend and said if there is an improvement how is he going to know what brought it about.

 

Yes, it is about the ratio.  I'm pleased that you looked into it further and even better still is that you are at low risk.

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LarryS

Lately I have been experiencing pain flair ups in lower back, most likely due to a previous bulged disc problem.  I recall reading somewhere that some SNRI's have been prescribed for pain relief.

QUESTION:  Could there be any connection with decreasing my venlafaxine and the increase in number of pain flair ups I'm experiencing?

 

I'm planning on going down another 10% on Thursday Dec. 6, 2018.  I plan on making that decision based upon other factors I'm tracking, rather than this hopefully temporary pain I have been experiencing.  The factors I track are lethargy, anhedonia, insomnia, spacy, dizzy, headache and fatigue.  Of these, fatigue is the only factor that I rank consistently above a 5 out of 10.  But this has always also been an issue for me, even prior to tapering venlafaxine (Effexor).

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ChessieCat

I'm sure that I've read a comment by Alto, this site's owner, somewhere on the site (I'm not even going to try and find it because it could be anywhere) that withdrawal can "trigger" existing weaknesses (my words, not hers).

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LarryS

Below was previously in my signature.  Moving it here to preserve it.

 

Have previously weaned myself off Bupropion (Wellbutrin), Citalopram (Celexa) and Trazodone antidepressants.

First two episodes of depression where minor compared to third episode.  Third depression episode involved trance like state, hearing voices, losing 15 pounds of weight in days, and thinking of suicide.  Spent one week in mental hospital due to third depression episode.

 

Have been on Venlafaxine 225 mg for 4 years, since August 2014.

 

I have recognized acute spacy lethargy since 9/2017.  I don't want to live the rest of my life like this.  I'm 70 years of age, and other people my age don't seem to exhibit as much fatigue as I do.

 

It is becoming difficult to enjoy my last remaining recreational hobby, playing the violin with a group of similarly accomplished musicians.

 

I must push myself to do three gym workouts a week.  I feel better after a workout, but it does not last long.

I have become aware of the psychotic drug epidemic being pushed by the political, pharmaceutical drug companies and medical fields.

 

Edited by ChessieCat
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LarryS

Today I'm dropping venlafaxine by 10% to 109 mg after a previous 3 week hold.  Lethargy, anhedonia and fatigue have been significant these past weeks, but not enough to prevent me from continuing downward in dose.

 

I have been able to get down to the gym for light workouts, which include bicycle,  treadmill, elliptical machines and swimming 12 laps.

 

I intend to drink only one 16 ounce cup of coffee in the morning.  Two has been a bit to energizing.

 

Edited by ChessieCat
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LarryS

I'm planning on dropping another 10% in about 5 days. Lethargy, anhedonia and fatigue have been significant.  I initially thought I would drop in 3 weeks, but my wife and doctor want me to maintain a slower pace during the winter time.  I live in an area with much cloud cover and rain during the winter which is difficult on my mood.  I believe I have Seasonal Effective Disorder (SAD).   I sit in front of a 10,000 lumen light box each morning to stimulate wakefulness.  

My wife and I look forward to a two week trip to Mexico beginning mid February.  It will be sunny and warm there.

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LarryS

I proceeded with my next 10% drop on January 24, 2019, after a 4 week wait.  Lethargy, anhedonia and fatigue seem to be stable and not difficult to deal with.  I'm feeling more upbeat now that the Mexico vacation is booked and only 20 days away.  We are also in a four day sunny break here in the northwest USA, which helps my mood.  I'm reading information about our 10 day tour.   I'm also re-reading my scuba diving manual in preparation for going under water several times around the island of Cozumel, Mexico.  It is wonderful to have this vacation to look forward to.

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