MamaCat: want to taper Effexor right this time, help appreciated

[MamaCat]

Hi everyone!

 

Don't know where to begin... I've been on and off (mostly on) antidepressants since the birth of my son in 2013. My history is so similar to many here, jumping from one drug to another. I've tried to withdraw from SSRI's/SSNRI's four times and have ultimately always ended up back on them because what I thought was a return and worsening of my depression was most likely pretty significant and scary withdrawal symptoms. To summarize, I usually last about 6 weeks and then all of a sudden am unbearably irritable with increasing suicidality, which is the one symptom I cannot handle and have always returned to drugs at that point. Or some life stressor sends me over the edge. It breaks my heart because, like many here, my withdrawal symptoms are worse than the (postpartum) depression that landed me in this mess of drugs. I was never suicidal before, I was having an adjustment disorder and some PTSD following the difficult and traumatic birth of my son. I needed support and counseling, not drugs thrown at me to make me functional in the mess of my pain. 

 

What compounds this is the fact that I have PCOS, which in itself can contribute to anxiety and depression. It's hard for me to tease the two apart- I wonder, is this a PCOS thing or is this my depression? The last time I tried to taper effexor was when I had been off birth control for about 5 months and had been feeling really good. BUT, I know the pattern now for that too- every single time I quit ocp things are awesome for about 4-6 months and then the walls come crashing in (periods disappear, moods worse, skin breaking out, hair loss). The hormonal derangement compounds any issues I am having with mood or anxiety and I am back on oral contraceptives now and will be for awhile, I'm not even thinking of stopping those at the moment. Although I'd very much like too...xsighx

 

Right now, I have stupidly followed my primary card md's advice of the two week every other day taper and am two weeks post my last effexor 37.5mg. Prior to tapering, I had been feeling really good and truly want off these drugs. I did not do this under my md's supervision or suggestion because at this point I feel like I know more about this subject than he does as his only suggestions are basically to taper off or go back on them at full dose. I have definitely been experiencing withdrawal symptoms during this time- hypomania, insomnia, increasing irritability, and headache are my biggest complaints. The headaches have basically stopped and I'm trying to reign in my spending and obsessive behaviors (no one needs to be on amazon.com until 4am!). However, I feel like my irritability is remaining the same if not getting worse and unfortunately my children get the brunt of that. Work is fine, relationship with my husband is fine, but I am having a difficult time dealing with my 3 1/2 and 4 1/2 year old. (Although tbh, I imagine anyone with kids this close in age and at this age in particular would struggle) I find myself yelling at them more than I would like and becoming frustrated with innocuous behavior; that I am not handling my feelings and emotions well. 😢   This is heartbreaking and worth considering going back on the effexor but I don't want to.

 

I have no doubt that I tapered too fast as I did not properly educate myself on the best way to get off this drug. After spending considerable amounts of time on this site, I reinstated at half the granules in my 37.5mg capsules. I just did this tonight and I will continue to take this dose and slowly work back the time I take this drug to be back in the morning. My symptoms are kind of subtle, more mental than physical sensations, and I was wondering how will I know if this dose I've reinstated at is good? I know I need to go back on the effexor and stabilize for awhile before thinking of tapering again. Any advice/suggestions/insight into reinstating at half 37.5mg? How do I know if that's a good dose to reinstate at? I'm not sure where to go from here, although the next couple days will hopefully give me some clues.

 

Thank you to everyone here, although I am new to this community it has helped me so much already to see other people sharing the same struggles and helping each other to get better together. ❤️ 

 

[Songbird]

Hi Mamacat, welcome to SA.  My journey with ADs also began with PPD, and the same for some others here.  I agree with you, the withdrawal experiences have been far worse than the original condition.  I'm also convinced that ADs mess with hormones, and withdrawal seems to make any hormonal issues much worse.

 

Thanks for creating a signature with your med history, that's very helpful.  It sounds like you've already read around the site and absorbed a fair amount of information.

 

If you've only been off for two weeks then taking half of your previous dose of 37.5mg sounds like a reasonable reinstatement plan to me.  If you need to move the time of day you take your dose, it will be easier on your system if you move it by only an hour per day.

 

Here are some topics you may have already read, but just in case:

about reinstating and stabilizing to reduce withdrawal symptoms

the rule of 3KIS - keep it simple keep it slow keep it stable

why taper by 10% of my dosage?

 

Please post your updates here in your introduction topic.

 

 

 

 

 

 

[MamaCat]

Songbird, thank you for your reply and insight! The links are really helpful as well!

 

I didn't think it was necessary to go so slow with moving the time of day back but I have been. I had a mishap on friday and didn't take until later than planned so that threw a wrench into my plans but today I took the half-dose effexor around 4:15 and will continue to aim for moving back an hour a day.

 

Last week for a couple days after reinstating, I had a very mild headache but that only lasted a few days. I had moderate forgetfulness, really noticable the first few days but it seems better now. That was a really strange and unfamiliar symptom for me! Irritability and temper were much better the first 4-5 days as well but I had a tough time over the weekend and yesterday. That being said, I was starting to get sick and today feel completely awful so I don't know if it's the effexor dose or just irritability because I'm not feeling well. I am also adapting to a new schedule, my two toddlers went from 5 1/2 days at daycare down to 3 1/2 days now that its summer, so I have even less down time which I'm sure doesn't help. For whatever reason, I am usually more irritable (with my kids) on the weekend- I don't know if that's because my husband is around more and they know they can get away with more when he's around or if it's something else. It's actually easier for me during the week when I am the primary care-giver and my husband is working long days. Sorry for the tangent on that...

 

Anyways, reinstatement has been mostly good so far. I was outside in the sun a lot and every day I was outside was a good day so I will continue to try to optimize my sun exposure! I am a little concerned about the irritability the past couple days but I am not sure if it's because I'm getting sick, changes in family dynamics when hubby is home, or if it's because the half dose isn't cutting it. I've been doing my best to track my symptoms so hopefully that will yield some more insight. At what point would it be necessary to consider up-dosing? I do not think I am there but genuinely want to know what I should be looking out for. 

 

I don't know if it's because my nervous system is all haywire from my rapid taper but taking dayquil/nyquil makes me feel nauseous and generally worse :(. I might try taking just one (vs two) of the tablets of those but maybe just at night.

 

Worth noting, in the past four months I've switched to a whole-foods, plant based diet (essentially a vegan diet, no animals or animal products, avoiding processed food). I've felt much better since the transition, enough so that I've wanted to get off the effexor for good. But, it makes my eating much more difficult as most of my meals are prepared from scratch. It is definitely not an easy way to eat. I'm trying to be patient with myself and allowing myself some more wiggle room with that while I focus on my recovery, but still abstaining from animals/animal products. (ie, bagel with vegan cream cheese for a snack which I would have avoided a few weeks ago) That being said, I know I feel my best when I optimize my nutrition by eating lots of fresh whole foods, fruits and veggies.

 

Hopefully I'll be feeling better soon and will update then!

 

 

Edited June 26, 2018 by MamaCat
forgot to mention being forgetful, diet

[Songbird]

13 hours ago, MamaCat said:

I am a little concerned about the irritability the past couple days but I am not sure if it's because I'm getting sick, changes in family dynamics when hubby is home, or if it's because the half dose isn't cutting it.

 

Getting sick can definitely make withdrawal symptoms worse.

 

14 hours ago, MamaCat said:

I've been doing my best to track my symptoms so hopefully that will yield some more insight. At what point would it be necessary to consider up-dosing? I do not think I am there but genuinely want to know what I should be looking out for. 

 

Tracking your symptoms is a very good idea.  You could journal them with date and time, and rating out of 10 (1 being hardly there, 10 being extreme) and post them here.  What we are looking for is the pattern over time.  We need to see what happens over the next few weeks and gauge if your reinstatement dose could use any tweaking.

 

14 hours ago, MamaCat said:

Worth noting, in the past four months I've switched to a whole-foods, plant based diet (essentially a vegan diet, no animals or animal products, avoiding processed food). I've felt much better since the transition, enough so that I've wanted to get off the effexor for good. But, it makes my eating much more difficult as most of my meals are prepared from scratch. It is definitely not an easy way to eat. I'm trying to be patient with myself and allowing myself some more wiggle room with that while I focus on my recovery, but still abstaining from animals/animal products. (ie, bagel with vegan cream cheese for a snack which I would have avoided a few weeks ago) That being said, I know I feel my best when I optimize my nutrition by eating lots of fresh whole foods, fruits and veggies.

 

Vegan diets are missing some nutrients - you might need to supplement to get all the nutrients you need, particularly vitamin B12.

[MamaCat]

Good to know that illness can exacerbate wd symptoms. Will continue to keep track of how I'm feeling.

 

I supplement B12, B-complex, and D3; I've done this since becoming vegetarian (and then transitioning to the way I eat currently). The next time I go to the dr's I will ask for blood work to see if I have any deficiencies though.

 

Will update again in a couple days. While I find this site tremendously useful and supportive, it is also somewhat triggering and overwhelming for me (especially when I calculated how long a 10% taper would take) so I'm trying to limit my time here to like 15min at a time. I've deleted basically all of the time-suck app's from my phone too because I found myself staying up wayyy too late.

 

 

[MamaCat]

Little update... still feeling sick so I went to my primary care md for that but to also discuss the withdrawal symptoms I'm having. He agrees they're withdrawal symptoms but is surprised that I am having such trouble following my every other day taper (bad sign) and questions why I would want to discontinue a drug that mostly keeps me stable (worse sign lol). We talked for a little bit about dosing and the conclusion of that was I would talk to the pharmacist to ask the best way to get 18.75mg although he offered to write me a script for 25mg tablets I could split to lower my dose to 12.5. To which I told him I am not ready to drop that low yet. Kind of a frustrating conversation because I felt like he didn't *get it* but at least he was supportive of my intentions to stay at 18.75 and do a slower taper, which might involve changing my script in some capacity. He told me he's never had anyone having trouble getting off effexor before (it was hard for me not to literally LOL at that). 

 

Also went to the therapist I was seeing when in the midst of my ppd, primarily to talk to her about my symptoms and come up with a plan. She's wonderful and agrees it can take some people a long time to taper, especially those who are sensitive to changes in dose or having severe symptoms (ie me). It was nice to talk to her and get her blessing on stabilizing for a couple months before trying to decrease my dose again. Also talked about ways to help deal with not getting so frustrated with the kids. I know there are a lot of life style and personal changes I am going to have to make on this journey and I'm trying to get my ducks in a row. A huge one is going to be learning to not be so reactive. (not that I'm tremendously reactive, I am just so hard on myself when I know I'm capable of handling a situation better- Mommy guilt is the worst and is a huge component of the ppd that got me here)

 

Lessons learned this week: taking Unisom Monday night completely messed me up and I don't think I recovered from that until maybe yesterday? idk. I've also dropped my B-complex as I've read that can be stimulating. 

 

Tuesday- difficulty getting OOB, irritability/hair trigger, "bad day"; 4/5 (5 as worst); effexor@ 4:15p

Wednesday- less irritability but depressed mood in afternoon and evening, felt lonely; 3/5 effexor@ 3p

Thursday- poor sleep (sick), irritability/frustration; 3/5 effexor @ 2p

Friday- still sick but no noticeable wd symptoms!  (by noticeable, I mean nothing different than before I started to taper, still have frustrations but felt I could handle it and that it wasn't anything above and beyond normal day to day stuff); 1/5 effexor @ 1p

 

I will continue taking the 18.75mg, I plan to stay there until at least September (for the purely selfish reason that I've had absolutely awful birthdays the last two years and I want to not feel suicidal on this upcoming one). 

 

Any feedback, from anyone is greatly appreciated. I'm trying to update appropriately so please let me know if there is anything I've forgotten. I enjoy this site very much but struggle with not getting sucked into spending too much time here because I get SOOO upset knowing myself and so many others are suffering so immensely. As a nurse, so much of what I see on this site in regards to dr's advice, how people got into this situation, how I got into my own situation is frustrating beyond words. It's unfair. My brain has been effed with and I'm upset because I worry I'll never be the same. BUT maybe I can be okay or even better, or maybe I can help someone else one day which would be a light at the end of the tunnel.

 

 

Edited June 30, 2018 by MamaCat
spacing

[ChessieCat]

49 minutes ago, MamaCat said:

surprised that I am having such trouble following my every other day taper

 

Are you still taking your drug every other day?  SA recommends taking the same dose at about the same time every day.  You can experience interdose withdrawal when skipping days.  This is a good example of why:  Skipping Days vs Every Day Dosing Graph

[MamaCat]

I'm taking the 18.75mg every day, I'm trying to get the time of day that I take it slowly back to around 9am. 

 

Prior to reinstating, I had tapered every other day dosing over two weeks on my dr's advice and it was an absolute disaster. When I talked to him today about the issues I had tapering this way and afterwards, he was surprised.  Yikes! He is an excellent primary care md but dare I say this skipping days advice is almost negligence? Bad practice at a minimum. 

[peng]

From my own experience, MamaCat, I would say you have come down too quickly from the 75mg of July 2017 - mostly or totally due to the ignorance of your doctor.

I have been on Effexor since about 1999 and have tapered from 225mg to 62.6mg in the last 2 years.  Refer to my thread if you wish more details.

 

You have only been on it since 2016, so, in theory you should do better.  Here's hoping!

 

Best wishes.

[MamaCat]

Absolutely Peng. It's unfortunate that I've found this forum a little too late but this is the situation I find myself in. It's crazy how significant the withdrawal from effexor is, at least the symptoms I've experienced (compared to going off zoloft/celexa). I've been feeling much better on the lowered dose I've reinstated at though. The thought of it taking so long to taper is daunting but I'm looking to do my time with minimal WD SE, vs the hell I might go through for years following too fast of a taper. 

 

I will definitely check out your thread! 

[ChessieCat]

37 minutes ago, MamaCat said:

The thought of it taking so long to taper is daunting but I'm looking to do my time with minimal WD SE, vs the hell I might go through for years following too fast of a taper. 

 

When I realised how long it was going to take I felt the same way.  I had hoped to be off by November last year when I turned 60 and it got me down for a while.

 

You've got the right attitude.  Just a word of caution.  I have found that when things have been going well that it can be tempting to try to go a bit faster.  What is helpful is to remember how far you have come, whether mg or time, instead of how much further you have to go.  I've been tapering for 2y 8m and I'm amazed at how quickly it has passed.  I've still got at least 18m to go but, like you, my goal is to get off as comfortably as possible, not as quickly as possible.

[peng]

Strangely, as ChessieCat has said, I have found the 2 years has passed quickly, too.

Absolutely not what one would expect at all, but there it is.

[MamaCat]

10 hours ago, peng said:

Strangely, as ChessieCat has said, I have found the 2 years has passed quickly, too.

Absolutely not what one would expect at all, but there it is.

 

18 hours ago, ChessieCat said:

 

I've still got at least 18m to go but, like you, my goal is to get off as comfortably as possible, not as quickly as possible.

 

Thank you, ChessieCat and Peng for your responses, they help make the thought of this easier and I am happy the time has passed quickly for both of you. As comfortably as possible is a great way to put it and I will keep that in mind! When I think of how I want to feel for the next couple years, feeling well is more of a goal than getting off the effexor. 

[MamaCat]

So the last two weeks have been rough for me, lots of ups and downs. I’ve really struggled with symptoms of irritability and agitation. Unfortunately I’ve had a lot going on with my family, which doesn’t help. I have this lingering cold (allergies now, I suspect) and the two times I’ve taken medication for it, the unisom and Zyrtec made my wd symptoms much worse. I still don’t know if I’m back to where I was before I took the Zyrtec last Wednesday. 

 

Both my kids had gi bugs last week and were in and out of the bathroom all night for most the week, my husband was mostly unable to help. The interrupted sleep definitely did not help. 

 

Yesterday and last night we’re my worst. I’d say a solid 4-5/5 (5 being worst). Insomnia, thoughts of suicide, mood swings, irritability/agitation. I wasn’t able to fall asleep until after 3am 😥. The majority of my days since my last update were 2-3/5. I don’t know if this is just because of all the physical stressors (still not feeling well, taking otc cold meds, interrupted sleep/routine) or if it’s indicative of wd symptoms reemerging after my reinstating.

 

I’m not sure what to do and am feeling rather lost and discouraged. I feel awful about being cranky with my kids. I’m going to make an appt with my therapist to talk about some better ways to help manage my reactions. 

 

Any advice, suggestions, or support would be greatly appreciated. I’m struggling to stay in the sunshine...

[Songbird]

8 hours ago, MamaCat said:

I have this lingering cold (allergies now, I suspect) and the two times I’ve taken medication for it, the unisom and Zyrtec made my wd symptoms much worse. I still don’t know if I’m back to where I was before I took the Zyrtec last Wednesday. 

 

They are both antihistamines.  It's possible your system is more sensitive to them in withdrawal.  Decongestants can also cause problems.  I would try just paracetamol and saline nasal wash.

 

8 hours ago, MamaCat said:

I don’t know if this is just because of all the physical stressors (still not feeling well, taking otc cold meds, interrupted sleep/routine) or if it’s indicative of wd symptoms reemerging after my reinstating.

 

All of those stressors can make withdrawal worse.  Also remember it can be up and down for a while after reinstating.  Restabilising takes time.

 

Here's an example of the drugs/symptoms daily journal that we find helpful (note this is a made up example):

 

23 June

7 a.m. woke up, anxiety 3/10

8 a.m. ate breakfast, took 20mg Prozac tablet

10 a.m. anxiety 7/10, nausea 3/10

12 p.m. ate lunch, anxiety 5/10, nausea 1/10

2 p.m. anxiety 4/10, nausea 2/10

6 p.m. ate dinner, took magnesium tablet 200mg, anxiety 2/10, no nausea

8 p.m. anxiety 1/10

11 p.m. went to bed, anxiety 2/10, difficulty falling asleep for 2 hours

4 a.m. woke up, no anxiety, went back to sleep for 3 hours

 

Keep notes during the day and post here each day so that we can look for patterns over time.

[MamaCat]

Songbird, Thank you for your reply over the summer. I realize that the mods on this site ask for daily logs so as to make the best recommendations possible but that degree of detail/information is just not possible for me to capture. I can give ratings and a description of symptoms on a daily basis but as basically a part time working mom with minimal support from my significant other with the kids or any aspect of housework (cooking, cleaning, laundry- unfortunately I handle everything with both the house and the kids), it’s just not possible because I have neither time nor the recollection of those details. I know it’s hard to interpret tone and intention over the internet, but I’m not feeling much support from any of your responses.

 

I realize I haven’t updated in awhile so thought it was a good time to do so... have stayed constant on the reduced 18.75mg Effexor dose which has been mostly good. I can’t remember exactly when it was but sometime in august or September I switched to the brand name Effexor because my pharmacy kept switching generics on me. I had no problems with this transition in terms of symptoms and felt the brand name was actually easier to work with in making the half dose pills (did via weight). 

 

I don’t know exactly when my symptoms started to improve but by the middle of August, I was no longer feeling as irritable and had less anxiety and no SI. Tbh I wish I kept better records but it was beyond me to do so during that time as I struggled so much; it was bad. I did my best to keep busy, eat well, exercise, get good sleep but in general it was not an easy summer for me. By September, I was feeling much better, very minimal wd symptoms. Things would’ve been great if life didn’t get in the way! Lol some family drama in October reinforced that it would be best to stay at 18.75 until the holidays were over at least.

 

From the beginning of December until basically now, I’ve struggled more with my mood and general irritability. But, this is typical for me as I have always struggled around the holidays (kids bdays are beginning of December and beginning of January, which just adds to my stress). I’ve tried to focus on self care and there were some good days but it hasn’t been the easiest road. I know that I feel my best when I’m making good food choices, exercising regularly, and getting good sleep but those things weren’t always possible over the last month, which certainly hasn’t helped. There were several days that I wasn’t able to take my medication until much later (like 10pm vs usually around 8am), which also doesn’t help. 

 

Then the icing on the cake, my new insurance will not cover the brand Effexor in any capacity so a months worth of pills would be like $400. 🤬😫☹️ I am now on the generic and wasn’t able to do a gradual transition as I had waited too long to fill my script. I’ve been on the generic for roughly a week and it has been awful. I’m very unhappy and irritable, it feels like I have such a short fuse/hair trigger (especially with my kids which makes me feel awful). I don’t even want to be around myself! No headaches, SI, insomnia, or hypomania which I experienced over the summer after quitting the Effexor too quickly but still unpleasant enough. I had a small breakdown today when I was trying to follow a recipe to cook lunch and realized I completely and irreparably messed it up because I couldn’t concentrate (as my kids were non-stop bothering me while I was trying to cook). Thankfully my husband stepped in and finished cooking our meal and everything was fine but it’s almost too much for me to handle right now. 

 

He has taken the kids out and I’m going to go see a movie in a bit but my reaction really highlighted how tough it’s been for me. I feel like I’m barely getting through. I will continue to reach out and ask for help from him and our family during this time, especially with stuff for the kids because I feel so inadequate as a parent right now. I’m doing my best at not yelling at them but I’m not necessarily being nice either which I feel awful about.

 

I don’t know if this has been brought on by the switch to generic or because I messed up the time of day I take it a few times (those days were all close together though unfortunately) or likely both. Either way, I struggle with knowing how to proceed. My current plan is to stay on the generic for a month (maybe 6 weeks? Idk) and then reevaluate. I may have to cough up the extra money for brand if I’m still this miserable in a month. I’m thinking if I do switch back to brand, I’ll ask for a higher dose so that the pills last me longer (would keep my dose at 18.75 but would have more beads to work with to make the pills). 

 

Would love any any feedback or support from you, Songbird, or any of the other mods or users on here. I’m trying so hard to keep it together for my family but it’s at a steep cost to my own psyche and I feel like I’m not doing a good job at it anyways. 😥

[Altostrata]

2 hours ago, MamaCat said:

I don’t know if this has been brought on by the switch to generic or because I messed up the time of day I take it a few times (those days were all close together though unfortunately) or likely both. Either way, I struggle with knowing how to proceed. My current plan is to stay on the generic for a month (maybe 6 weeks? Idk) and then reevaluate. I may have to cough up the extra money for brand if I’m still this miserable in a month.

 

Sometimes people find the change to a generic is bumpy. A few find they can't tolerate the generic and must take the brand drug.

 

Yes, taking the drug inconsistently can cause additional symptoms some time later, so you have a confounding factor there. Your plan to observe for a month or so is a good one. It could be your system will gradually settle down.

 

We ask for daily drug and symptom notes to determine if the drug is causing adverse effects. We need to know your symptoms before and after you take the drug. Times of day are also important; sometimes taking the drug earlier or later can reduce symptoms.

 

We can't help you without knowing details about how the drug is affecting you. I'm sorry if you find this approach lacking in supportiveness, but it takes a lot of work for us to respond to each individual circumstance. Please take it as a sign of concern.

 

I understand how busy you are, but you must take some time for self-care in this regard. We need to know your drug schedule and symptom pattern to address your dosage level. Without that information, we cannot say whether 18.75mg Effexor is too high or low, or if the generic is causing additional symptoms.

 

You'll also have to be sure to take the drug at the same time each day, to avoid throwing that upset into the mix.

[MamaCat]

Altorstrata, thank you for your response and explanation. I greatly appreciate the work of all the mods on this forum and I understand what you all do is not easy. Sorry for the delay in my response; while this site is the most helpful source of info on tapering and AD’s, it can be largely triggering for me, especially if I’m not doing as well.

 

I will work on a better log to help the mods answer questions, make suggestions, and best reply to me.

 

The past week has been tough, I inadvertently skipped a dose two saturdays ago and didn’t realize it until a few days later. My biggest symptom when this happens is irritability, feeling in general cranky and easily annoyed by people. I’m yelling at my kids for such stupid things, my daughter avoided me last night at bedtime and while I don’t blame her, it still hurts to see how I’m affecting the people I love most. I don’t feel like I had such a dramatic reaction to accidentally skipping a dose or messing up times when I was taking the brand, but without logs I realize that’s not something you can confirm or make recommendations about.

 

I bought a new pill case last night and have been brainstorming ideas to make it easier for me to take my Effexor more consistently. I will stay on the generic for another month to see if things improve but I do sometimes have thoughts of going back on the brand and eating the cost.

 

heres what yesterday looked like:

 

6am- up, getting ready for work and getting kids ready for school, frustrated but ok (no yelling, kids were sleepy and easy)

7am- take kids to school and drive to work

8am- work, typical day (don’t usually notice symptoms at work but in general I don’t enjoy being there)

10- breakfast, forgot to take pill

115- lunch, took Effexor

4- drove home

445- made kids dinner and got them ready for karate, minimal irritability

6- kids martial arts, minimal irritability

715- back home, irritability wayyy up (yelling, frustrated) kids want to eat again while I try to cook and eat my own dinner and get them ready for bed

8- kids in bed, still feeling irritable but am able to not be a complete lunatic to my husband

8-845- finish eating dinner, phone insurance to see if there is anything  can do about trying to get brand name for less than $400/month

9- relaxing watching tv, irritability coming down

10- shower, then reading in bed

 

[ChessieCat]

5 hours ago, MamaCat said:

I bought a new pill case last night and have been brainstorming ideas to make it easier for me to take my Effexor more consistently.

 

remembering-to-take-your-dose-reminder-ideas

 

[MamaCat]

Thank you Chessiecat! Will def check it out. For the most part, I’m pretty good but maybe once a month I slip up or forget (weekends are hectic with two kids!). It is so frustrating that if I do forget a dose, I’m not myself for weeks. Is this normal or would you consider that a very sensitive reaction? My primary symptom afterwards is irritability, reactivity.

 

also, if these symptoms stay constant with maybe slight improvement, how long would you hold to stabilize? (Assuming no new symptoms or life stressors, etc) I realize that the irritability and reactivity may never go away as long as I’m still taking the Effexor but may be more pronounced if I mess up my dosing. My plan is to wait a few weeks and see how it goes, if my irritability lessens or at least stays constant, I’m considering a low reduction in about a month. Thoughts??

 

As a positive, the last few days have been pretty good. It’s  hard to say if I’m less irritable or just coping better as I recognize patterns. It seems the worst time for me is evening aka the kids dinner and bedtime, and it’s compounded if there’s some sort of time crunch. I’m generally cranky in the morning too and I wonder if this is symptomatic of a cortisol spike or just the Effexor leaving my system as I usually take it in the morning. 🤔🤔🤔

[ChessieCat]

It is really important to be consistent with taking your dose every day at about the same time.  The brain likes consistency.  Think of it this way.  If you don't look after yourself, not only you, but the rest of the family suffer the consequences.  You need to find a way to make sure that you do this.  It's not being selfish, it's being sensible.

 

WDnormal (withdrawal normal)

 

Something to consider, being female, is timing your reductions around your monthly cycle.  I haven't had to do this so I can't offer any suggestions about when might be the best time of the month but it is something to keep in mind.

 

It's generally better to hold for long than to risk reducing too soon.  You will need to listen to your body and symptoms.  If you aren't sure if you are ready to reduce, but think that you might be, it may be better to make a smaller reduction to test to see if you are stable enough, rather than making a full 10% reduction.

[MamaCat]

Quick update! I started to taper in April, spreading roughly a 7.5% drop over 4 weeks with an additional two week hold. So far I've gone from 18.75mg to 15.2mg with minimal symptoms. My first month of dropping I remember some headaches but those have gone away. I'm happy its been relatively smooth. 

 

While tapering, Ive focused on self-care as best as I can. I try to walk for 45 minutes most days of the week, eat as best as I can, and get good sleep. I've been going to a meditation center and classes that have been tremendously helpful as well in terms of having more inner peace/calm. Unfortunately, the past few weeks have been hectic w travel and life stressors and I've fallen out of my routine but will be doing my best to get back to it. Have also completely stopped drinking (minus occasionally tasting someone elses fun mixed drink); I very infrequently drank before so it's not been hard for me to cut it out completely in order to give myself the best possible chance to get off the effexor.

 

Will think about doing 10% over my next drop and see how it goes. Am basically reducing 1mgpw each week (18.75mg effexor was 56.7mgpw zydus generic, am down to 46mgpw). One looming thought I have as I inch closer to this point is at which point do people switch to liquid? It won't be long before I'm at 12.5mg effexor, half of a 25mg IR tablet (which I know would have to be further split and taken 2x/day- quartering the 25mg tablet essentially, which is not the most precise way to get an exact dose).

 

Also, I realize that switching to the IR tablet will be a transition requiring a hold (which may or may not be a successful switch, only time will tell). As I know I'm ultimately going to have to make a liquid of it, would I transition from my current XR capsule directly to making a liquid suspension of the IR tablet or do I break that up into two transitions (from XR capsule to IR tablet and then from IR tablet to IR suspension)?

 

Thoughts/advice/comments are welcome!

[ChessieCat]

5 hours ago, MamaCat said:

Unfortunately, the past few weeks have been hectic w travel and life stressors and I've fallen out of my routine but will be doing my best to get back to it.

 

5 hours ago, MamaCat said:

Will think about doing 10% over my next drop and see how it goes.

 

My suggestion would be to stick to your current rate for the next reduction, and wait for a few weeks before you do to get over the added recent added stress.  It is better to go as slow as you need to and not be gung ho about it.  You will get there eventually, probably not as soon as you would like to, but it is better to get there as comfortably as possible.

[MamaCat]

ChessieCat, thank you for the reminder! It's easy to get ahead of yourself! Currently planning to drop 8.4% this month (just how it works out with dropping 1mgpw/week for 4 weeks with an additional 2 week hold), will see how I feel and consider an additional 1-2 week longer hold. 

 

I've found Karma's post where she is tapering using  compounded liquid effexor and read how mammaP tapered by dropping beads, do you know of any other users who switched from XR to a liquid IR that I could read about their experiences? Just curious!

 

I'm leaning more towards switching to a liquid sooner vs later but am honestly scared. I'll be able to get down to 11.9mg easily with my current method but then it gets tricky for me using the beads (dropping 1mgpw is too big a drop), so I'm thinking that is when it'll be time to switch. Going to be proactive and start looking into compounding pharmacies near me, and will speak to my pharmacist if unsuccessful in the former endeavor. Luckily, my husband does IT support for our pharmacist so she's generally amenable to being helpful. 

[Altostrata]

MamaCat, how are you doing? Yes, when the beads aren't suitable for your tapering schedule any more, you'd switch to liquid.

[MamaCat]

Altostrata, I apologize for the delay in my response! Life got crazy! We moved, my son started and then switched schools, husband has been having health issues; there has been a lot going on! Moving was generally awful for my stress but that has leveled out now. 
 

Because of all the change, I slowed my taper considerably (dropping less that 2%/month). I’m currently at 13.2mg and have been stable in regards to symptoms since september. The only time I had issues over the past month were holidays and my kids bdays, but my issue was mainly irritability with my family, which I don’t view as abnormal 😂. (Read: in-laws drive needs nuts and I hate having clutter and toys everywhere) I realize I need to update my signature.

 

This month I’m going to start going back to tapering 10%/month brassmonkey style. Just doing the math earlier today, I will likely have to switch to liquid in the next 6months or so. I’m thinking when I get to <10mg, for the sole reason of 10gm/5ml is a nice concentration to work with. I’ve read the threads about compounding and I’m hoping to find somewhere to do that, called a few pharmacies and it looks like it will work out. 
 

Even though there have been plenty of bumps in the road lately, life has been good. I’m happy, I feel joy. Sure I have my moments, but the past two years have taught me that they’re just moments and it’s not forever. 

[MamaCat]

Currently at 10.9mg! Tapering in the time of quarantine! (Part of me is laughing, part crying, part shaking my head; what a time to live through!)

 

Have been continuing to drop roughly 10%/6 weeks and will continue to do so as I, shockingly, have been doing absolutely fine despite the massive change in routine and significant stressors we are all facing right now. I’ve basically been furloughed from work, which is fine to be honest. My husband is working from home and I am solely responsible for homeschooling my 5 and 6 year old. We haven’t left the house in 4 weeks until this weekend (live in NJ, anything we need is being delivered at this point). 
 

The beginning of the corona virus crisis was very stressful for me but once our state shut down the schools and I was furloughed, my stress has been much better. I was watching the news a lot but I had to stop. Having to navigate home schooling leaves me with less time to even think about the news anyways. The yoga studio I go to has been streaming classes which is a huge benefit. I’ve been reading much more too 🤷‍♀️. 
 

Anyways, I was thinking once I got to about where I am now in terms of dose I’d be thinking of switching to a liquid BUT I’m going to wait on that and will continue as I’ve been doing. Instead of dropping 1mgpw/week x4 weeks, eventually I’ll have to increase that to maybe 1mgpw/10 days but that is an easy enough switch to make. I can wait a bit for things to start to go back towards whatever the new normal looks like. Plus, I don’t want to make the switch to a new form of drug delivery right now anyways. 
 

When I think about everything happening in the world, it’s tremendously overwhelming. In order to manage, I have to chose to be selfish and focus and worry only about the most important things right now and that is the health and well-being of me and my family.
 

I hope anyone reading this is doing as well as possible! ❤️

Edited April 13, 2020 by MamaCat
Too wordy!

[MamaCat]

Am currently at 7.9mg. Because of the way I make my doses, I’ve been dropping about 12% each time (over 4 weeks and then a two week hold) and it’s going well. 
 

Will continue this way. Am thinking I will likely have to switch to a compounded liquid IR version around 3mg because of the limits of my scale. 
 

I hope everyone else is doing as well as possible right now!

[ChessieCat]

8 hours ago, MamaCat said:

Am thinking I will likely have to switch to a compounded liquid IR version

 

You will probably need to split your dose so that you don't get interdose withdrawal because of the immediate release.