MemberK: Venlafaxine withdrawal & beginning Wellbutrin taper

[MemberK]

Hi all—

 

New here, obviously, and new to forums in general, not so obviously (or maybe so still, idk). Here because I've been unable to (unproblematically) leave bed for the last 48 hours and I can't concentrate on much meaningfully (there goes my work): as a result I've been viewing a lot of content about withdrawal online (against my psychiatrist's pleas—I wonder what he wouldn't want me to know. . .) and found this forum linked in an article. 

 

See my signature for my history, and please feel free to share any information you think might be helpful. An abridged account of my woes:

 

-Since midday Wednesday (first day w/o any poison) I've been experiencing the unique blend of motion sickness/brain zaps/heart palpitations that seem to come in waves (anywhere from every 10-15 seconds to 10-15 minutes) and with increasing intensity have been accompanied by nausea and aural interference (it feels like there are broken subwoofers in my head that, with each heart flutter/kick, respond: like how loud music from within a car driving by sounds from the outside). Hands and feet are also involved in these spasms, with less frequency.

 

-I'm sad. Very sad. Was still feeling OK enough Wednesday night to watch a movie, watched my favourite movie (have seen at least 10 times), and cried (like wept cried) through most of it (for the first time). I don't cry in response to art, news, etc., ever. Highly irregular.

 

-I slept almost all of Thursday. I'm a 6am 7 days a week type of guy, so sleeping in til 11, then sleeping ~1-5, and barely moving for the rest of the day is troubling. Not being able to read more than a page of a book even moreso (since that is what I do, for work and for pleasure). 

 

-My appetite is nowhere and eating is hard. Were it not for the intervention of my partner, with whom I am lucky to live, I don't think I'd have eaten very much yesterday and today. She woke me up to eat breakfast this morning (Friday), and after doing so I felt slightly stronger: I even flirted with the idea of leaving the house for the library. But I crashed about an hour later, just after I'd gotten dressed, and have been in bed or shower or toilet since. 

 

What I'm thinking about/dwelling on: 

 

-I'm feeling really stupid for having done this to myself (by way of trusting this doctor, of overlooking my anxieties about psychmeds) 

-I'm obviously feeling fear about how long these symptoms might last: I'm supposed to board a flight and spend 10 days with her family this Tuesday. . .

-I'm wondering if it would be too hasty to get the few caps I threw out out of the trash and try counting out beads for a much slower taper like I've read about some of you doing, or if I should stay this course

-I'm desperate for suggestions/spells/tricks to minimize the way these feelings feel in the interim, especially the nausea and shocks: I've tried two different raw ginger cocktails thus far to no positive effect and am taking 3x the vitamin D, B12, and omega-3 I usually do

-I'm grateful that the stripe of withdrawal I'm undergoing seems to be primarily embodied and not psychoemotional (my anomalous weepfest the other night notwithstanding): so far I've had no return of suicidal ideation (like what I suffered beginning the drug last summer) and i more or less feel like I recognize myself (knock on all the wood)

-I'm hoping that, given all the information and knowledge collected here, it is possible to not be totally in the dark against this thing: by which I mean, that there might be a way to tell, with some certainty, based off certain signs or makers or clues, that this will be over in a week; might take a month; seems bad and requires a different strategy and soon; etc.. . 

 

In sum: is there anything I should be thinking about that it seems like I've missed? not noticed? should look out for? 

 

Thanks very much for reading and responding.

 

 

[Gridley]

As I think know, you tapered far too fast, which is why you're experiencing the withdrawal symptoms you wrote about.  At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  

 

Why taper by 10% of my dosage?

 

To help you understand the symptoms you are experiencing, here is some information on withdrawal.  The withdrawal time doesn't necessarily correlate with the time you were on the drug.  These drugs alter the architecture of the brain, and the time necessary to heal the brain and return to homeostasis is, unfortunately, impossible to predict.  I know that is not the answer you wanted, but there really is no way to know.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

Please be aware that sometime withdrawal symptoms don't appear immediately after a too-fast taper.

 

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 or longer.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

Reinstatement isn’t a guarantee of diminished symptoms for everyone, but it’s the best tactic available.  You’re still in the time period where reinstatement predictably works.  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when updosing/reinstating it is better to start with a small amount and increase of symptoms remain unbearable.  If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.

 

It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.  Please Keep Notes on Paper so that we can tell updosing is working.

 

Yes, get the pills you threw away and keep them.  Let us know if reinstating is something you're interested in.  Wait before reinstating until we can give you a suggested dosage/number of beads.   Later, once you have stabilized (which can take several months) you can taper the reinstated dosage down at a 10% per month rate.

I understand your desire to be off the drug.  Ultimately the choice whether to reinstate is yours, but thought I should bring this possibility to your attention so that you can make the best decision regarding your health and well-being.  

 

 

 

 

[MemberK]

First: thank you very much for responding so quickly, and with so much information. I'm actually overwhelmed by how helpful it's felt to read through.

 

Second: I would like to reinstate. I couldn't find the caps I'd thrown out but managed the walk to the pharmacy and got 14 37.5mg XR doses. I would like to give this a shot in the AM, so, how low should I go? 

 

Third: Thank you, again, for all of this work. The pharmacist with whom I had to deal (and dared ask some questions) was so unhelpful and clearly uninformed I felt like, one degree away from suspecting this all to be a very sick, sick troll at work. Unfortunately it's all very, very real.

 

Will be waiting for more direction. 

 

 

Edited June 30, 2018 by ChessieCat
removed quote

[Gridley]

The other moderators have been notified and we will be back with you shortly with a suggestion.

[mammaP]

Hi MemberK,  It would help us to suggest a dose if you can tell us how you tapered and the lenght of time you were at 37.5.  If you can put that in your signature that would be great.  We need to know when you dropped the doses and the doses you dropped down to. Did you feel any withdrawal during the taper?  

[MemberK]

1 hour ago, mammaP said:

Hi MemberK,  It would help us to suggest a dose if you can tell us how you tapered and the lenght of time you were at 37.5.  If you can put that in your signature that would be great.  We need to know when you dropped the doses and the doses you dropped down to. Did you feel any withdrawal during the taper?  

 

Hi mammaP, I've updated my signature—hope it's helpful. I tried to be brief about what tapering was like. If more info would help, let me know. 

[mammaP]

Thank you, that is helpful. How were you since starting venlafaxine? There were a few drugs added in a short time, do you feel that ven helped or were you having side effects? 

[MemberK]

50 minutes ago, mammaP said:

Thank you, that is helpful. How were you since starting venlafaxine? There were a few drugs added in a short time, do you feel that ven helped or were you having side effects? 

 

I would say that overall Venlafaxine had a positive effect on my life. That is, of course, relative to how things were going prior to starting, and, very hard to differentiate from other drugs and/or changes made independent of drugs. 

 

An important detail is that before exceeding the 150mg threshold (which I've read is when the drug begins working on dopamine as well) I was feeling almost no positive effects and severe negative effects. Like, to the point where everything in my life stalled and going to the ER or checking myself into somewhere shortlong term was a daily consideration. Once at 225mg things began to level out, and with the addition of Bupropion I achieved a regularity of mood, energy, and clarity that allowed me to complete the schoolyear problemfree and elevate other areas of my life. 

 

Side effects

-escalated nightmares (the type wherefrom you wake up screaming)

-de-escalated libido

-gastrointestinal confusion and pain

-tremors (tho this is also the Lithium and Bupropion, as I understand it)

-body spasms within 5 minutes of laying prone and closing eyes

 

Since these are relatively normal I didn't feel too concerned about them: I (thought I) knew what I was getting myself into, what sort of give/take there would be. The way I've felt since Wednesday is so awful that I've had thoughts like being on Effexor forever wouldn't be that bad, would it? Any advice w/r/t that line of thinking? Which is to say, staying motivated about getting off the drug, or questioning that motivation?

[mammaP]

Thank you. I would consider reinstating effexor (venlafaxine) at 37.5 mg as it's only 4 days since quitting and you tapered very quickly. People often become sensitive to the drug after tapering quickly and then can't tolerate the previous higher doses. If 37.5 does not alleviate the symptoms you could then go up in dose.  It is important to log your symptoms daily on paper and here after reinstating in case the dose is too high. Often people feel worse then go UP in dose when in reality they have reacted to the starting dose and it needs lowered. This why we ask a zillion questions, so we can get a picture of what is going in in the body. Reactions and withdrawal can be very similar. 

 

It will take arounnd 4 days to get to a steady leven in your blood, so don't go higher for at least a week to give it a chance. If you can stabilise on the lower dose it is less to taper later should you decide that is what you want to do.  We recommend tapering very very slowly to avoid withdrawal. Effexor is one of the most difficult to taper but it can be done if it is done slow, turtle slow!  

 

Gridley has left links to some good topics for you to read, you should first read the one on reinstating, and here is the one for tapering effexor. 

 

https://www.survivingantidepressants.org/index.php?/topic/272-tapering-off-effexor-venlafaxine/

 

 

 

 

 

 

 

[MemberK]

On 7/1/2018 at 12:56 AM, mammaP said:

Thank you. I would consider reinstating effexor (venlafaxine) at 37.5 mg as it's only 4 days since quitting and you tapered very quickly. People often become sensitive to the drug after tapering quickly and then can't tolerate the previous higher doses. If 37.5 does not alleviate the symptoms you could then go up in dose.  It is important to log your symptoms daily on paper and here after reinstating in case the dose is too high. Often people feel worse then go UP in dose when in reality they have reacted to the starting dose and it needs lowered. This why we ask a zillion questions, so we can get a picture of what is going in in the body. Reactions and withdrawal can be very similar.

 

 

Sorry mammaP(&co.) for my delay in reporting back. On the 30th I decided, after waiting as long as I felt I could, to dose at 1/3 37.5mg (~33 beads). I recorded that within 4-5 hours I felt slight improvement in the motion sickness and heart/body spasms and nausea. Today will be day 7 at this dose: over this past week I have felt only brief waves, usually by the end of the day and when standing after sitting for long periods of time or turning around quickly, of the fullbody sensations that were permanent during those 3.5 days without the drug. I'm very relieved, and grateful for the contribution of this community to my stabilization.

 

I'm committed to holding at this dose for the recommended month minimum, whereafter I will follow the community's guidelines for tapering safely the rest of the way. I feel compelled to share, furthermore, that this experience has felt eyeopening and reaffirming: insofar as I want to appreciate what these drugs have helped me accomplish over the past year but feel very determined to get off of them and seek out other ways of maintaining my health thereafter.

 

Please feel free to contact me about anything, or to ask any questions, and please accept my (perhaps superfluous) apology for acting before receiving the advice you were in the process of preparing; with my flight approaching I felt pressure to do something, and after reading other accounts on the site and elsewhere felt that trying the 1/3 dose was a good starting point. I apologize because, were I on the other side of this interaction, it might bother me if I were busy thinking about the safest ways for people to restabilize only to learn that they're just going to do what they want after all.

 

Anyways, hopefully this course of action goes well for the foreseeable future and you don't hear too much from me (unless you want otherwise!).

[mammaP]

No need to apologise, I am so glad that it helped and hope that you can stabilise at that dose, it is much better if a lower dose works because it is less to taper later! Let us know how you progress, you can log your progress here for your own record to go back to.  

[MemberK]

Hi all,

 

I haven't been on this site since August, when I had my first encounter with Effexor withdrawal. This resource was incredibly helpful, and I have shared it with several people since then. I am happy to say that since I re-instated and stabilized, I have had no problems with my bead-by-bead taper. I'm posting today because I have decided to begin tapering off Wellbutrin. 

 

As you'll find in my signature, I have, until recently, been taking Wellbutrin XL 150mg once daily in the AM. Late October, however, XL became unavailable in my city and I had to switch to SR. This already presents dosing problems, since I'm still only taking one 150mg daily in the AM, but metabolizing it differently. Fortunately, the only noticeably consistent changes have been how frequently I have to pee (I can't get through one class comfortably without feeling the need, and find myself doing this hilarious and frustrating dance while trying to study: sit down, think for a few minutes, have a sip of water, have an idea, need to pee, repeat) and slightly increased irritability and animation. 

 

Anyways, I'm confident that with what I've learned from this site I can approach this taper with complete disregard for my doctor's advice (he would, predictably, have me begin staggering doses one day on one day off etc and then just stop). One upside to having switched to SR, I suppose, is that (from what I've read in the Wellbutrin threads) it responds better to being cut than the generic brands. So, my plan is to start dosing the 150mg SR as two 75mg SR doses (one in the AM, one six hours later) and see how I feel after two weeks. If all's well then, I'm not sure if the better move would be to drop to just one 75mg SR dose daily, or to go about cutting into quarter doses. My hesitation for the latter option is a result of reading some warnings that beyond 24hrs a cut pill begins deteriorating. Any input on this front? 

 

Thanks for reading and responding, and I hope you're all doing OK and staying hopeful. 

[Altostrata]

Hi, MemberK, this is what you want Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

 

Dividing the dose is a good idea. I would wait until the peeing settles down before reducing the dosage.