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birken

birken: venlafaxine problems

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birken

I have had a time using sertraline before, but right now I'm only using venlafaxine so I will focus on this here.

 

In the winter/spring 2017 I was put on venlafaxine/effexor, mainly for anxiety .So, with hope that this would help I went back to work and gradually increased the dosage up to 225 mg.

 

I can’t really say that it helped though. My anxiety was still very bad and I had a really hard time coping with just about anything. Every day was a struggle and the slightest deviation from the normal pattern would induce severe anxiety. Unlike when I first started on sertraline I never felt any significant relief this time around. After a couple of months, it all became too much too handle and I had to stop working.

 

After some time my dosage was increased to 300 mg. I now had some time to rest and recover but the anxiety would still haunt me whenever stressors increased a little and most activities were still hard to do.

 

Fast forward six months and I had improved somewhat, with a little more energy and slightly less anxiety. Since the venlafaxine hadn’t really made a significant difference all this time, I decided to try and reduce the dosage a little. So, I cut back to half, had some minor physical withdrawal reactions, but otherwise nothing noteworthy to me.

 

I continued on this pattern for a couple of months, gradually reducing the dose until reaching 37.5 mg (i.e. taking half of the previous dose). And although I still had some problems, I felt that my thinking became clearer and I had more ability to focus the more I cut back. This can, of course, have been a coincidence and be due to me overall taking it much slower and resting, but is worth mentioning. Withdrawal symptoms were not too bad during all of this process and I actually felt better than in a very long time during a couple of weeks earlier this fall (i.e. after reducing the dosage to 37.5 mg). I also tried CBD oil at this time with some good results, which can have contributed to me feeling better than in a very long time.

 

The withdrawal reactions came into full effect, however, during the past weeks when trying to go even lower and stop completely. This time it was not so much physical symptoms but mental ones that bothered me most. First it was irritability and occasional depressive states or sadness. So much so, that I didn’t go more than a few days without any intake of the venlafaxine because of feeling bad. I thought that reintroducing a bit of it, and go a bit slower, would be enough. It wasn’t. Even though I started taking a bit again I still felt more and more depressed and anxiety-ridden. Many days I was unable to do anything at all. Even got some suicidal thoughts. I gradually worked up to 37.5 mg again, thinking this should be enough to stabilize again. Now I’m at this level, and still not stable. It has improved since the worst days, but my feelings and general outlook varies a lot from day to day, also during a day.

 

My idea now is to remain on this dosage until things stabilize. I initially thought that gradually reinstating until symptoms went away would work, but it didn’t really work like that. Now I know, from reading on the forums, that this is possible and sometimes you can actually feel worse when reinstating too much. I realize I changed things too much and too quickly up until now. But now I just aim to not change anything for some time and hopefully things stabilize soon. Is this a good idea for now?

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Altostrata

Welcome, birken.

 

Many apologies for the delay in reviewing your topic.

 

When was the last time you reduced venlafaxine? Are you still taking 37.5mg?  Are you taking any other drugs?

 

Remaining on your current dosage for a while is a good idea. If you are getting withdrawal symptoms, please do not continue to taper until we sort out your situation.

 

To prepare to taper again, please read Tips for tapering off Effexor (venlafaxine)

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature

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birken

Thank you for your reply and for welcoming me here.

 

I am still taking 37.5 mg right now. I have been on this level for almost three weeks now, increased from a very low level maybe a month ago. So I would say the last time I reduced the dose was over a month ago or even a little longer. Since then it's been going up gradually to 37.5 mg again. Still not feeling well though. 

 

I'm not taking any other drugs. One benzo at one time, but nothing regularly. I do take some CBD oil as it seems to help a little at least. Also magnesium and omega 3 most days. 

 

Unfortunately there have been additional stressors in my life lately, which of course is very bad timing. So it's hard to know sometimes what is what, but given the very strong feelings of depression and anxiety I've experienced lately I tend to think it's the drug reaction that's magnifying everything as well, because I've never felt this utterly hopeless before. 

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birken

I've now been back on 37.5 mg again for over a month. Things seem to have stabilized to a large extent. I still have problems but it's not on the insane level things were on a few weeks back. 

 

I have tried to practice mindfulness and acceptance a lot more lately and at least for a few days last week I was able to access a sort of inner peace. This week it's been harder to do it in that way, but I feel this is important to practice. 

 

One thing I've been frustrated by this last week is an increased feeling of brain fog or slow thinking, as well as tiredness. This is something I've more or less experienced over my whole period of being on this drug, with varying intensity. Always a feeling of not being myself fully and as sharp as I used to be. Of course it's always hard to know whether something is caused by the drug or not -- is it caused by fatigue, depression or actually a side effect from the drug? 

 

I am now contemplating whether to try a ~10% taper again or to wait further. Things are more stable again internally, but I still have some things in life that probably will be stressful. On the other hand I don't like this feeling of a dulled mind,  which in some ways also causes stress and/or apathy. 

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ChessieCat

Please edit the information for Effexor in your drug signature so we can see the dates and doses.  If you don't know exact dates, please use early, mid, late MONTH.  Thank you.

 

Account Settings – Create or Edit a signature

 

 

Having your drug signature in the following format will make it much easier for the mods to see your drug history at a glance and means we will not have to read back through your posts to get the information.

 

Example:

 

Sertraline/Zoloft:  2014 - 2016
Venlafaxine/Effexor:  300mg, ? MONTH 2017, DOSE, DATE; DOSE, DATE, DOSE, DATE; 37.5 mg DATE
 

Please delete this.  It is not needed.  Tried to stop completely but feeling awful caused me to go back up.

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ChessieCat
birken

Hey Chessiecat,

Thanks for your reply. I updated my signature with doses and dates to the best I can remember. I will take a look at the links you provided as well.

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ChessieCat

Dose                Date                % Reduction

             

300 mg           Aug 2017

150mg             June 2018        50%

75mg               July                  50%

37.5mg            Sept                 50%

19mg               Oct early         ~50%

10mg               Oct late           ~50%

5mg                 Nov early        50%

Gradual increase?  Q:  Did you go straight from 5mg to 37.5mg?  If no, please add the dates and doses to your drug signature.

37.5mg            Nov late

 

You have been making 50% reductions about every month.  SA recommends reducing by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

On 12/31/2018 at 11:58 PM, birken said:

I've now been back on 37.5 mg again for over a month. Things seem to have stabilized to a large extent. I still have problems but it's not on the insane level things were on a few weeks back. 

 

It is good that you are feeling improvement.  Because you have made such large reductions over a short period of time, it would be a very good idea to hold on 37.5mg for at least 3 months.  Holding for 6 months or possibly more would be better.  I know that this might sound like a long time but you have reduced very quickly and if you don't give your brain the time it needs to adapt to the new dose you could end up having difficulties if you start trying to taper again too soon.

 

The good thing is that you have reduced your drug load.  However, once you have held on 37.5mg as mentioned about, it would be best to follow SA's tapering protocol.  You will probably be able to reduce by 10% after a long hold.  However, when you make your first reduction after your hold it might be a good idea to make a smaller (test) reduction, eg 5% to ensure that you have stabilised.  This topic is interesting and can help to explain the reasoning behind the 10% with 4 week hold:   Why taper paper: dose-occupancy curves

 

You have reduced from 300mg to 37.5mg in a period of 6 months compared to 20 months.  To give you some perspective on why a long hold is suggested below is the calculations for getting from 300mg to 37.5mg at 10% reduction every 4 weeks.  Tapering Calculator - Online

cycle dose start date
start 300.00 7/1/2018
1 270.00 7/29/2018
2 243.00 8/26/2018
3 218.70 9/23/2018
4 196.83 10/21/2018
5 177.15 11/18/2018
6 159.43 12/16/2018
7 143.49 1/13/2019
8 129.14 2/10/2019
9 116.23 3/10/2019
10 104.60 4/7/2019
11 94.14 5/5/2019
12 84.73 6/2/2019
13 76.26 6/30/2019
14 68.63 7/28/2019
15 61.77 8/25/2019
16 55.59 9/22/2019
17 50.03 10/20/2019
18 45.03 11/17/2019
19 40.53 12/15/2019
20 36.47 1/12/2020

 

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birken

I will update with a rough estimate of that gradual increase (don't remember exactly, but it was fairly quick). 

 

In hindsight I realise it was way too quick of a reduction. At the time 50% reductions was what I thought was normal. Was also eager to get off the drug. And it seemed fine at first. This turned out to be wrong, evidently, when I got to very low doses. At least I have found the info on this site now, among other things, so hopefully things go smoother next time with a more gradual taper.

 

3-6+ months sounds like a very long time just holding. At the same time I can understand why. Just so much frustration in this! You want to get rid of side effects, but if you stop you get worse withdrawal effects. And then life to handle in between everything...

 

Anyway, thanks a lot for your help! I will hold on 37.5 mg for some time longer.

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birken
20 hours ago, ChessieCat said:

 This topic is interesting and can help to explain the reasoning behind the 10% with 4 week hold:   Why taper paper: dose-occupancy curves

 

This was interesting to see, thanks. Those graphs of dose/SERT occupancy make a lot of sense given the tapering experience so far.

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ChessieCat
1 hour ago, birken said:

This was interesting to see, thanks. Those graphs of dose/SERT occupancy make a lot of sense given the tapering experience so far.

 

Yes, it helps to see the pictures.  I was able to reduce from 100mg to 75mg without too much problem.  Just as you seem to have been okay going from 300mg to 150mg.  That is because at the higher doses there is not a lot of "gain" from the extra drug.  Many members find that the lower their dose gets the slower they need to go.  And at the very end of a taper it can be hard to know when to jump off because that last jump is a 100% reduction.  When to end the taper and jump to zero?

 

Also, some members find that particular doses for them seem to be harder to get past than others.

 

1 hour ago, birken said:

3-6+ months sounds like a very long time just holding. At the same time I can understand why. Just so much frustration in this! You want to get rid of side effects, but if you stop you get worse withdrawal effects. And then life to handle in between everything...

 

Anyway, thanks a lot for your help! I will hold on 37.5 mg for some time longer.

 

There are some things that are helpful to understand about this tapering journey.  Although doing nothing (holding) seems like we are doing nothing, and in fact we are doing nothing,  the brain is doing something.  What we are doing is giving the brain the time it needs to adapt to getting less of the drug.  It's also helpful to understand that men can find it more difficult to do nothing.  Men have a natural tendency to want to fix things, which means doing things.  Some members have become impatient and started trying supplements and have made things worse.  The only supplements which SA recommends are Magnesium and  Omega-3 Fish Oil.  Only make one change at a time.  Try a small amount, one at a time, to see how you respond.  Keep it Simple, Slow and Stable

 

Also it seems that part and parcel of tapering is impatience.  Just before Christmas I was thinking about whether it would be okay to stop taking my 5mg of Pristiq.  And being a moderator I have seen many members get into difficulties by trying to get off too soon.  It would be much easier if we were able to see inside our brain or if there was a test so that we have evidence of what is happening.  All we can do is use the experiences of others to make our own journey off the drugs as careful as possible.

 

Remember, it is better to hold for longer than to risk reducing too soon.  If it was me, I would be holding for at least 6 months.  However, and this is a suggestion, not a recommendation, if you really feel that you have to reduce after 3 months and you feel like you can't wait any more it would be best to try a very small reduction.  Maybe even 0.5% or 1%.  If your symptoms worsen then it means that the brain hasn't adapted to previous large reductions.  It would then be best to hold at that dose.

 

Something to understand, how fast we get off the drugs has nothing to do with how strong and disciplined we are as a person.  The drug has changed our brain and it takes time for the brain to adapt to not getting as much drug.  Other than giving the brain the time it needs to make those adaptations, and us providing a calm and reduced stress environment, there is very little that we can do to speed up the process.

 

And the side effects reduce the lower the dose we take.

 

And, yes, we have to remember that we have to live our life whilst getting off the drug which is another reason not to try and get off too quickly.  Some members have ended up having to leave their job, move in with relatives and/or become bedridden because they have made bad decisions about getting off their drug.  I'm not writing this to frighten you, but to help you to take holding and careful tapering very seriously.

 

To get through the discomfort which we experience during tapering SA strongly recommends that members learn and use Non-drug techniques to cope

 

And healing isn't linear.  There is a Windows and Waves Pattern of Stabilization

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ChessieCat

I have found that understanding what is happening helps me to stay patient.  These are also good:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

I really like the Rubik's Cube analogy in the video.

 

and:

 

"When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. "

 

and:

 

"Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  
And just like the Twin Towers- it's possible - but the buiding is a major effort -and it takes a good year or more sometimes."

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birken

Thank you very much for your detailed reply! It is kind of scary to realize how much these drugs actually change stuff in our brains. I think I will constantly need to remind myself that a lot of what I am feeling is due to these changes and the repair that is going on (those were some good analogies, btw). When stress or difficult situations arise it is so easy to get into negative thoughts and blaming yourself. 

 

I can definitely relate to what you wrote on wanting to fix things. I have been trying a lot of things in order to feel better over the past years, not just when in withdrawal. Some things better and some things without notable benefit. It is such a hard struggle to get better and it is even harder when it seems nothing works and people around you can't understand. I think I now have begun to understand that some of my problems may have been caused or prolonged by the drugs themselves, after years of use. I sure need to work on how I view myself and the anxiety I've had for long, but from what I have been reading lately it is quite sad to realize the effect these drugs can have long-term (and how little attention is given to this by doctors etc.).  I guess these realizations, plus lack of benefits, caused me to eagerly want to get off. I know we all desperately want to feel better and get back to our true selves. But as you said, patience is required here. So much patience. I thank you and the others on this site for providing information and support. 

 

 

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ChessieCat

You are very welcome.  I'm pleased that SA has been able to assist you.

 

I've had two completely different experiences.  I CTed citalopram and felt great for a few months then got hit with the withdrawal flu and was bedridden for 2.5 weeks and lost 8kgs.  It wasn't until I joined SA that I made the connection that it was withdrawal.  I ended up on Pristiq.

 

I reduced my Pristiq from 100mg to 50mg and for 2 weeks I experienced severe cog fog, and even walking took my whole concentration.  I joined SA but didn't updose as suggested because I was trying, through the brain fog, to learn about what was happening.  A couple of days after joining I got to the stage that I was unable to type.  Having been a typist for 40+ years I knew that something was really wrong.  I was very thankful for SA's suggestion.  I went and took extra Pristiq.  Astoundingly after only about 4 hours I was able to type again and the brain fog was lifting.  Because I had a benchmark I knew that it was because of the drug. 

 

Not many members of the medical profession understand tapering and withdrawal from psychiatric drugs.  That is why this site exists.

 

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


What should I expect from my doctor about withdrawal symptoms?

 

These are truly eye opening.  Gwen Olsen was a pharmaceutical representative for 15 years:

 

Gwen Olsen YouTube videos:

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes)

 

Manipulating Doctors (10 minutes)

 

We are trained to misinform (6 minutes)

 

 

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

 
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)
 
On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

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birken

Thanks again for your detailed reply.

 

Tapering and withdrawal effects sure can be confusing, especially when things show up long afterwards. I'm starting to wonder if some of what I was experiencing when I stopped sertraline was actually prolonged withdrawal, making things worse for longer than expected. This was nothing I considered at the time and I eventually ended up on venlafaxine. It doesn't matter now of course, but things make you wonder sometimes. 

 

I think acceptance is key when dealing with problems like anxiety and tough situations, not just WD related. The more I study these things the more this seems the case. I got familiar with Dr Weekes a couple of years ago but back then I had trouble achieving good results from it. I think the method makes perfect sense, but I think I hade a very hard time to actually accept and not resist the anxiety. Perhaps it was all too much at the time.

 

I want to give acceptance another go. I see it kind of as a red thread in several teachings, from Dr Weekes and ACT to spiritual teachings and mindfulness. The hard part is, I suppose, when things seem to get too much to still accept. I have had some moments recently when it really made sense on a deeper level. Then other days it feels very hard and it seems everything is going bad. 

 

I will try to check out some of the other things you linked as well. Watched some of the Gwen Olsen vids, interesting. Definitely in line with what I've heard from some others as well. 

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eymen23

Birken,

 

What you said about acceptance makes sense ‘things seem to get too much to still accept’.

 

My old mindfulness teacher used to say this - ‘You wouldn’t walk into a gym for the first time and start bench pressing 300lbs’.  His point was, learning to be mindful and accepting of life’s struggles is skill, and you become more accepting the more you practice. Severe emotional turmoil like withdrawal, can often overwhelm people’s ability to accept. 

 

Sadly, people going through ‘unnatural’ symptoms created by psychiatrist drugs don’t necessarily have the chance to build this ability to accept over time and work up to it, they have to start right in the deep end. It’s not impossible, but it’s tough. After all, the flight or flight response was designed to help you evade danger at all costs; it’s not easy working with something so potent.  

 

Keep working at accepting the emotions and symptoms, but if you can’t accept them at times... tell yourself that’s ok too. It’s a more indirect form of acceptance ‘I’m not able to accept this right now, and that’s ok’.

 

 

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birken

Thanks for your input and encouragement, eymen23.

 

It makes sense that acceptance, surrender to what is, should become easier the more you practice. Even though it often feels like such a constant battle. One moment it feels like you accept, then something unwanted happens and you're back to not accepting. I will try to remember the thing with also accepting that I'm having a hard time accepting right now.

 

It really goes against all conditioning to move towards what we don't like; opening up to anxiety and other unwanted emotions. I think I have had a tendency to suppress a lot of feelings, so this is very 'unnatural' for me. Yet I believe it can be a key thing to feeling better overall.

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ChessieCat
3 hours ago, birken said:

Watched some of the Gwen Olsen vids, interesting. Definitely in line with what I've heard from some others as well. 

 

We have a topic here:  the-worst-of-doctors-threadstatements-that-defy-belief

 

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birken

Has been quite an awful wave over the past days. Some small windows a few occasions but otherwise very anxious and tired. 

 

I've upped my dose a little, at the moment at 50 mg. If I could just relax and basically do nothing I could maybe get through this wave, but unfortunately there is a lot of other stress now, that makes things hard to handle. Bad timing with very much right now. So with bad WD anxiety and low energy, difficulty doing stuff, I think I have to up a little and hopefully feel a little better and more stable. Let's see how it goes.  

 

(I took one more of the mini tablets of 12.5 mg in the capsules I know have). 

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ChessieCat
1 hour ago, birken said:

I've upped my dose a little, at the moment at 50 mg.

 

37.5 mg, November 27 2018

50 mg, January 8 2019

 

Q:  Have you increased from 37.5mg to 50mg?  If yes, that is not a little increase.  That is a 33.33% increase.

 

 

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birken

When you put it like that, quite true. I guess from what was the procedure when I started taking it in the first place, it was a small increase (then it was more in increments of 100%). But I guess you recommend even smaller steps then. 

 

I did not react badly to the increase now at least. It's just been so hard to deal with WD with other things going on right now, plus some pressuring me to just go back to what I used to take. I know such a big leap would be a mistake, so I thought this would be more reasonable. 

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ChessieCat

"Therapeutic dose" is an arbitrary term used by the pharmaceutical companies.  SA prefers "lowest effective dose".

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Altostrata
On 12/31/2018 at 4:58 AM, birken said:

I've now been back on 37.5 mg again for over a month. Things seem to have stabilized to a large extent. I still have problems but it's not on the insane level things were on a few weeks back. 

 

On 1/9/2019 at 11:29 AM, birken said:

Has been quite an awful wave over the past days. Some small windows a few occasions but otherwise very anxious and tired. 

 

I've upped my dose a little, at the moment at 50 mg. If I could just relax and basically do nothing I could maybe get through this wave, but unfortunately there is a lot of other stress now, that makes things hard to handle. Bad timing with very much right now. So with bad WD anxiety and low energy, difficulty doing stuff, I think I have to up a little and hopefully feel a little better and more stable. Let's see how it goes.  

 

(I took one more of the mini tablets of 12.5 mg in the capsules I know have). 

 

What happened that might have triggered this wave? What were the symptoms?

 

Generally, it's not a good idea to increase dosage because of waves. They will pass if you let them, but if you increase dosage, you may find it difficult to decrease again.

 

Since you had this feeling of tension and anxiety before you went on drugs, there might be something in your life that is causing these feelings. You may need to look at lifestyle changes to lower your stress.

 

Or, it could be something like hyperthyroidism, which can come in waves. Have you had your thyroid function checked recently?

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birken

I'll try to take it easier with any increase. I was feeling desperate and confused, with people close to me also saying I need to go back up. 

 

I think external stress was the main trigger. I feel quite incapable in general right now and at the same time there are more problems and worries on my mind that have sort of added up lately (need to move out from the place I live, not sure where to go, worried about finding some new job in the not too distant future, tension with my parents, to name a few). My symptoms have mainly been anxiety, intense knot in my stomach, feeling a bit sick at times, fatigued and difficulty thinking clearly. Fearful thoughts just about everything and feelings of hopelessness. I try to take a step back and not get caught in the anxiety loop, but it's very hard when it gets so intense. 

 

It usually is a bit better in the evening, feeling a little calmer. Worse in the morning slightly after waking up then sometimes quite bad the rest of the day.

 

I don't know about any thyroid issue. 

 

Thanks for your concern

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