Monty95: Effexor withdrawal

[Monty95]

I tapered from effexor 150 mg over 12 days, 11 weeks ago. I experienced nearly every acute side effect eg. derealisation/depersonalisation, euphoria, vertigo, tremor, intrusive suicidal thoughts, akathisia, blurred vision, crushing pressure in head, pins and needles in forehead etc. 2 weeks ago I started to feel increasing numbness in my forehead and cognitive problems with working memory etc. consistent with chemical lobotomisation. As of 10 days or so ago I am experiencing nausea, extreme intermittent confusion, memory loss, sweating, restless legs, heart arrythmias and tachycardia. I'm very frightened and don't know whether reinstating at a low dose could make things worse although its difficult to see how things could get much worse at this point. I feel as though I'm in late stage dementia and I'm 35. I have no appetite and have lost 10% of my body weight over the last week, from 54 kg to 49 kg at 167 cm. Has anyone reinstated this late from a rapid taper and found it beneficial or did it make things worse? Please help me I'm absolutely desperate.

Edited February 19, 2019 by Shep
added new username to title

[ChessieCat]

Hi and welcome to SA,

 

It's good that you have found us now, and reinstating a small amount might be successful.  What you have done is basically a cold turkey off your drug, and it is not surprising that you are experiencing withdrawal symptoms.

 

SA recommends tapering 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.  Why taper by 10% of my dosage?

 

When the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

The only known way to reduce withdrawal symptoms is to take the same drug that the brain has adapted to.

 

When reinstating a drug, because your nervous system can become sensitised by withdrawal symptoms, we recommend a small dose.  Please read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

Because you have been off the drug for 11 weeks, it is best for you to start with a very small amount of the drug.  It is better to start with a small amount and increase if needed than to risk taking too much.  Taking too much can make things much worse.  The idea of reinstating isn't to get rid of the withdrawal symptoms completely but to bring them to a bearable level.  You will need to stay as calm and patient as possible and try not to panic.  When we panic we can make bad decisions.  Some members have panicked and increased too much and/or increased too soon and made things much worse.

 

Keep daily symptom notes on paper so you can see how the reinstatement is affecting your symptoms. 

 

I will ask the other mods what they think would be an appropriate dose for you to take.

 

This topic explains how to get the dose you need:  Tips for tapering off Effexor (venlafaxine)
 

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

I will provide some more information in the following posts.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[ChessieCat]

Here's some additional information which you might find helpful:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take    Especially this post:  CT and Fast Tapers

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

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

 

On 12/4/2015 at 2:41 AM, apace41 said:

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.  

 

[ChessieCat]

For later - when you are feeling a bit better.

 

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

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

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

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

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.

 

 

[Monty95]

i have a script for 37.5 mg effexor xr. Would it be appropriate to take 10 - 20 beads from the capsule? Or even fewer?

[ChessieCat]

Another member taking Effexor brand capsules says:  "In each capsule of 37.5mg there is an average of 150 pearls (beads)."

 

If your capsules have about 150 beads that means that 4 beads = approximately 1mg

 

I think it would be better to take 4 beads or less to start.  It is better to start with a little bit and then increase if your symptoms don't worsen than to take too much.

 

These drugs are strong and nervous system hypersensitivity causes a little to go a long way.  We've had members here taking a tiny crumb of their drug.

[Altostrata]

Welcome, Monty.

 

Please do try 4 beads from the Effexor capsule and let us know how you're doing.

[Monty95]

Thankyou, even though my original dose was 150 mg? & i’m Just wondering how it would ever be possible to taper from 4 beads & I think some may be filler? Or could they be stopped abruptly if I have an adverse reaction? I’m sorry to bother you with so many questions.

[Altostrata]

Start low to limit adverse reactions. Try 4 beads, swallow them down with water or put them in an empty gelatin capsule. If it looks promising, you might increase. Let us know how you're doing.

[ChessieCat]

If things got immediately much worse you would stop taking them.

 

Try to stay as calm and patient as possible, otherwise you might misinterpret your symptoms.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

 

Keep daily symptom notes on paper so you can see how the reinstatement is affecting your symptoms. 

 

From Post #1 of the tips for tapering Effexor topic:

 

On 5/6/2011 at 1:01 PM, Altostrata said:

Use a liquid solution of regular Effexor (NOT Effexor XR)
(Effexor XR cannot be made into a liquid.)
Titrating using a liquid is very good for very small measured decreases in dosage, allowing more precise measurements.

• Have Effexor made into a compounded liquid by a compounding pharmacy
  This may work with regular Effexor.
• Make a solution of Effexor and water yourself
  Technically, venlafaxine is water-soluble (http://chemicalland21.com/lifescience/phar/VENLAFAXINE%20HYDROCHLORIDE.htm ) There are reports that you can make a solution yourself (http://www.drugs.com/forum/featured-drugs/tapering-effexor-how-method-2-a-32338.html ) Also see How to make a liquid from tablets or capsules We don't know how stable a homemade solution would be -- how long it would last at full strength.

 

On 5/6/2011 at 1:01 PM, Altostrata said:

Convert from venlafaxine XL or Effexor XR to regular tablets
Especially in the last leg of your taper, when you might be down to a few beads of Effexor XR, you may wish to switch from an extended-release version to regular Effexor so you can make a liquid from it to make very small reductions.

 

Because of its short half-life, taking regular Effexor as a tablet or liquid necessitates taking the tablets every 12 hours.

 

[Monty95]

I’ll try 4 beads and let you know if there are any improvements, although my symptoms are somewhat variable at the moment so it may be hard to tell. They seem to improve a small amount at night, perhaps because of the drug being at a steady level at that time while I was taking it? I had bad interdose withdrawal symptoms when due for a dose and up to several hours after taking it. I was only functioning relatively well for about 6 hours a day. I’m so incredibly thankful for your help.

[Monty95]

My other worry is that only a certain percentage of beads are coated in order to make them extended release? I suppose there is no way around this other than a script for liquid venlafaxine? I’m sorry to come to you with all of these problems, I’m not at all myself at the moment very anxious and struggling to think clearly or problem solve independently. I’ve even lost the ability to do basic maths in my head, although I did fail first year maths twice at university so maybe it’s not that much of a loss 😕

[ChessieCat]

1 hour ago, Monty95 said:

They seem to improve a small amount at night, perhaps because of the drug being at a steady level at that time while I was taking it? I had bad interdose withdrawal symptoms when due for a dose and up to several hours after taking it.

 

You may be a fast metaboliser.  If this is the case, then you might find taking 2 beads 2x a day might be better.

 

1 hour ago, Monty95 said:

My other worry is that only a certain percentage of beads are coated in order to make them extended release?

 

Unfortunately you are going to have to do the best with what you have or wait until you can get regular Effexor tablets.  My suggestion because you are feeling so bad is to use what you have and get a prescription as soon as possible.  The brain likes consistency, which means taking the same dose at about the same time every day.  I've read that the beads are of slightly different sizes.  I suggest you try and select them as close to the same size as possible, not just for the 1st dose for later doses, so when you pick the beads out, pick out the 1st and 2nd doses at the same time and then before taking the 2nd dose, select beads for dose number 3 so you can compare them.

 

1 hour ago, Monty95 said:

I suppose there is no way around this other than a script for liquid venlafaxine?

 

I can't see any information in the Tips topic about Effexor prescription liquid being available.  But it is possible to make your own liquid from tablets and dose 2x per day (ie half dose am and pm).  The information was provided in my last post.

 

Any doctor can prescribe.  You don't have to see a psychiatrist.  You might find it helpful to write a script and rehearse what you are going to say.  Be calm, gentle but assertive.  You are the customer, it is your body.  Use words like I'd like to try this, or I'd prefer to do it this way.  If a suggestion is made that you don't want to follow, say I'd like to think about it before making a decision.

 

You don't need to tell the doctor that you are taking a very small dose.  Most of them will tell you it is placebo.  Maybe let him think that you are taking more.  But tell them that you want to taper in the future and you will need the regular Effexor so you can get the doses you need.

 

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

What should I expect from my doctor about withdrawal symptoms?

[Monty95]

You are an absolute lifesaver. It is so kind of you to devote your time to this voluntarily and it is very much appreciated.

[ChessieCat]

You are very welcome.

 

1 hour ago, ChessieCat said:

But it is possible to make your own liquid from tablets and dose 2x per day (ie half dose am and pm).

 

Something to keep in mind once you start using liquid.  If you are a fast metaboliser, you may need to dose 3 times a day instead of 2.  You could try doing 2x a day dosing to start with but keep notes to see if there is a pattern.  Three times a day dosing can be inconvenient so I'd only do it if absolutely necessary.

 

So if needed:

 

To change to 3x a day dosing it is better to move your doses gradually.  So you would take 2/3 of the morning dose and then take  1/3 of the morning dose 1/2 hour later and take 1/3 of the evening dose 1/2 hour earlier and then take 2/3 of the  and do this each day until they you are talking them morning, middle of the day, and evening.  The 1/3 you have moved from the morning will be added to the 1/3 from the evening to make 2/3.  But you only have to think in those fractions during the transition.  Afterwards it will just be 1/3, 1/3, 1/3.

 

If you ever need help with the maths let us know and we can help you.

[Monty95]

Thanks for your response, it’s a great help. I can’t even remember how to prepare food at the moment which is pretty upsetting/alarming, so i’m unsure of how to work out something complex like a doseage schedule. I just did a quick search to see if the immediate release version were available in Australia and I can’t find them. I think they may have been discontinued, is anybody able to confirm this? Also is anyone aware of someone in a similar position experiencing extreme cognitive effects/ numbness in the forehead that has recovered? It feels very hopeless at the moment.

[ChessieCat]

 

 

52 minutes ago, Monty95 said:

Also is anyone aware of someone in a similar position experiencing extreme cognitive effects/ numbness in the forehead that has recovered?

 

There are many existing topics on the site.  I like to use google and add survivingantidepressants.org to my search term.

 

brain-fog-blank-mind-comprehension-cognitive-and-memory-problems

 

 

[ChessieCat]

59 minutes ago, Monty95 said:

I just did a quick search to see if the immediate release version were available in Australia and I can’t find them. I think they may have been discontinued, is anybody able to confirm this?

 

http://www.pbs.gov.au/medicine/item/8301X-8302Y-8868R

 

I've just done a search and unfortunately you might be right.  I suggest you check with the pharmacist first, maybe even ask a few different ones.  The pharmacists seem to be more knowledgeable about drugs than some/most of the doctors.

 

Darn, they don't make this stuff easy to get off do they?  Pristiq is made in 25mg, 50mg and 100mg tablets, but the TCA (Therapeutic Goods Administration) in Australia haven't allowed the 25mg.  I have to get my Pristiq compounded.  My compounding pharmacist is reasonable cost wise, but it's still costing me $15 per 100 capsules.

 

Maybe post in the tips for Effexor topic and also in the Australian members topic.

 

 

[Monty95]

No, that’s pretty disappointing. How are you managing with tapering from pristiq, I understand its very similar to Effexor? Can a standard pharmacist compound medications, or is it specialised? Don’t feel the need to respond unless it’s convenient, I shouldn’t really be bombarding you with all of these questions, you’ve been very generous with your time.

[ChessieCat]

Professionals Compounding Chemists of Australia Pty Ltd:   http://www.pccarx.com.au/Resources/FindACompounder

 

I'll email my compounder and ask him and see if he responds.

 

Yes they are related drugs.  Pristiq was created to take the place of Effexor when it was about to go off patent.  Pristiq is desvenlafaxine and Effexor is venlafaxine.  Pristiq is now off patent but I've stuck with the brand.

 

From:  https://natashatracy.com/medicationtype/antidepressant-comparison-pristiq-effexor/

 

Pristiq and Effexor Are Almost the Same Drug. ... Pristiq, O-desmethylvenlafaxine, is actually the main metabolite of Effexor, venlafaxine hydrochloride. This means that if you take Effexor, your body breaks it down into Pristiq and other chemicals. Yes, Pristiq and Effexor are almost the same drug.

[Monty95]

12 hours ago, Altostrata said:

Start low to limit adverse reactions. Try 4 beads, swallow them down with water or put them in an empty gelatin capsule. If it looks promising, you might increase. Let us know how you're doing.

Thanks so much,  both of your support has been lifesaving. I've been keeping track of any symptom changes & just wanted to update and let you know that I was still experiencing extreme cognitive difficulties this morning eg. with concentration, awareness, memory and planning/ spontaneity. I took 5 grains in a gel cap at 4:30 pm and about two hours later experienced a slight but noticeable increase in cognitive sharpness/ awareness, which I wouldn't have believed was possible from such a small dose. I think its extremely unlikely to be a placebo effect, I was able to do a few small tasks I have been unable to do over the last few weeks and remembered where some household items were kept which I had previously been struggling with. I felt some increased electrical activity in my forehead also, I'm not sure whether this might be a positive indicator? My pupils are also more dilated and the numbness in my lower face has improved somewhat so I take that to be a sign that the dose had some effect. On the negative side I did notice a slight deterioration in my blurred vision that hasn't resolved, and some slight irritability/ agitation, sweatiness and fatigue standing around five hours later. Not much of a change in anhedonia, anxiety and inability to engage, maybe a very slight improvement? Perhaps a slight improvement in derealisation also. Overall I think it has been very positive result and I haven't experienced any really debilitating symptoms other than the blurred vision which isn't ideal but I'm willing to put up with it as my main concern by far is the cognitive decline. Are you able to let me know whether you would recommend a dose increase tomorrow, I was considering possibly taking a half capsule ie. 19 mg, if nothing deteriorates overnight or would that be too much of a jump do you think? Is continually changing the dose problematic or would it be best to be cautious and increase slowly rather than jump to 37.5 mg and stabilise? Sorry, I realise this is a bit of an essay, I'm uncharacteristically anxious/ocd at the moment, not really myself at all  

[Altostrata]

Please take 5 beads at the same time each day over the next 4 days. It will take at least 4 days for a dose change in Effexor to take full effect. Let us know how you're doing.

[ChessieCat]

7 hours ago, Monty95 said:

I was considering possibly taking a half capsule ie. 19 mg, if nothing deteriorates overnight or would that be too much of a jump do you think? Is continually changing the dose problematic or would it be best to be cautious and increase slowly rather than jump to 37.5 mg and stabilise?

 

It looks like you may be thinking in the terms the doctors use, ie "therapeutic dose".  This is an arbitrary term which the pharmaceutical companies use and where doctors get their information about the drugs from.  Arbitrary:  based on random choice or personal whim, rather than any reason or system.

 

At SA we prefer to use the term "lowest effective dose".  And that is an individual thing, it is the lowest dose that you need to bring the withdrawal symptoms to a bearable level.

 

Please continue to keep daily symptom notes.  Providing these can help us to determine if you might need to increase a small amount.

 

Edited February 20, 2019 by ChessieCat

[Monty95]

3 hours ago, ChessieCat said:

 

It looks like you may be thinking in the terms the doctors use, ie "therapeutic dose".  This is an arbitrary term which the pharmaceutical companies use and where doctors get their information about the drugs from.  Arbitrary:  based on random choice or personal whim, rather than any reason or system.

 

At SA we prefer to use the term "lowest effective dose".  And that is an individual thing, it is the lowest dose that you need to bring the withdrawal symptoms to a bearable level.

 

Please continue to keep daily symptom notes.  Providing these can help us to determine if you might need to increase a small amount.

 

Yes, I just want my self and my life back and I would give anything to undo the decision to stop taking it now and go back to my old normal. I associate the lobotomisation effect with downregulated dopamine to my frontal lobe and understand this effect can become permanent in users of antipsychotic drugs so I’m now panicking in a desperate attempt to minimise the damage. I’m just thinking if the symptoms are so severe then a significant fraction of my previous dose would be required to mitigate the effects of the drop, though I understand this hasn’t necessarily been your experience. Unfortunately I didn’t see much improvement overnight, possibly more sensations of my heart beating irregularly,  though this has been happening a bit lately so it’s hard to tell. The tremor and mild nausea are also back this morning, i’m not sure whether this means the dose is ineffective or has possibly exacerbated an existing problem. I’m very confused, so will try to stick with the dose as you suggest.

 

[ChessieCat]

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.

 

I understand that it can be frustrating but please try and stay as calm as possible and be patient.

[Monty95]

I'm in a bit of a mess, I should have listened to your good advice, which is well informed and I should have taken more seriously, unfortunately I panicked somewhat and decided to increase the dose to 10 mg today as I find the symptoms of lobotomisation unbearable and thought I had a good effect from the 1 mg yesterday. I felt significantly better in terms of cognitive functioning around two hours after taking the dose, around four hours later I noticed I felt a bit agitated and an increased sensation of adrenaline in my lower legs, at the moment, 9 hours later I'm feeling very anxious and agitated, mild nausea, my heart arrhythmias have been noticeable and I'm apprehensive about being able to sleep. I'm feeling very lost and wondering whether I should stick with this dose for the next three days and see whether the symptoms become more bearable? 

[ChessieCat]

It sounds like 10mg is too high a dose.  I suggest returning to the previous dose.

[Monty95]

Hi ChessieCat,

Thankyou for your reply. Although I was anxious I was able to sleep last night for about 6-7 hours, (I usually sleep around 10-12 hours), although my heart was pounding and I felt somewhat wired. Waking up I feel lucid and more aware of my surroundings which is a significant improvement, not my old normal, however very much improved, even from yesterday . I do still feel uncomfortably wired though. When I first started taking venlafaxine I was so sedated after the first dose I could hardly stand. When I was taking it regularly I felt slightly sedated and a lack of focus and awareness of time passing after the dose, which would wear off over the day and by the end of the day I was almost slightly manic, nothing too extreme , but in a good mood and talkative. It seems as though I have become hypersensitised to the drug as you said and it has the effect of being much more stimulating overall, though following the same pattern. If I am a fast metaboliser as this suggests, would your recommendation be to take half the dose in the morning, then half again 12 hours later, or would this be a potentially detrimental abrupt change to my brain chemistry which has become accustomed to one dose over years of use? If so should I take 5 mg each time in the hope that some of the agitation gradually subsides and I am able to retain some of the cognitive improvements? Or just take 5 mg? I'm worried about not being consistent with dosages and this being damaging. Have you ever seen people adjust to overstimulation in reinstatement or is it more likely these effects will be permanent, as it is quite uncomfortable at the moment. I'm sorry about the constant questions, I know you probably can't answer most of them and I'm asking the impossible, just feeling very anxious at the moment. 

[ChessieCat]

To start with I suggest that you go back the lower dose you were taking (? 5 beads).  Only make one change at a time.  Keep notes on paper.  We can than look at the daily symptom pattern to see if the dose needs to be split and/or increased by a tiny bit more.

 

This is what Alto , this site's founder, said:

 

On 2/21/2019 at 6:52 AM, Altostrata said:

Please take 5 beads at the same time each day over the next 4 days. It will take at least 4 days for a dose change in Effexor to take full effect. Let us know how you're doing.

[Monty95]

Hi Chessie, 

Thanks for your advice; I made some notes about how I have been feeling over the past two days - 

 

Friday: Very agitated on waking at 1:45 pm after falling back to sleep, tremor, very low mood, however cognition was improved and didn't feel as drugged and confused as I do usually. Anhedonia and ability to engage was slightly improved. My appetite was poor, I was nauseous and unable to eat as much as usual. I took five grains in a gel cap at 3pm, around 6:30 I felt relaxed with no irregular or fast heart rate or agitation. I would say my cognition was similar to the first day I took the 1mg and impaired compared to the 10 mg day. At 7 I felt sedated and fatigued with minimal awareness of time passing. Around 7:30 to 8 I was slightly agitated and fatigued at the same time. I had a slight window around 9 to 11:30 where I was relaxed with no anxiety and anhedonia was not extreme.11:30 to 12:30 I was feeling sedated with minimal awareness of time passing, very slight abnormal heart rhythm as went to sleep, improved from yesterday. Was able to fall asleep easily. 

Saturday: Woke at 10:30 with some anxiety about cognitive impairments and numbness in forehead, very worried about brain damage being permanent. Was not as confused as before reinstatement at 1 mg but perhaps feeling more drugged than yesterday on waking. My heart rate was slightly elevated. Took 1 mg in a gel cap at 3pm. Very confused and cognition very poor in the afternoon ie. struggled to work out how to wash my hair/ remember how I would usually do this, had very limited awareness of time passing. Distressed due to this. 5pm felt extremely fatigued and dizzy on standing, extreme vertigo, faint, felt almost catatonic with slow thinking and feeling frozen. Wondered whether feeling faint and breathless was due to low iron/haemoglobin as apparently this was slightly low in hospital. 7pm still feeling very fatigued and spaced out with vertigo. Memory loss is significant. No heart arrhythmia or tachycardia. Tried to sleep at 8 pm as was so fatigued, woken by feeling of adrenaline in my chest and awareness of my heart beating. Tremor returned.  10:30 pm agitation somewhat improved, tremor calmed. 11:30 - 12:30 am agitated, shaking, drinking water helps to calm tremor temporarily, akathisia moderate to severe unable to stop shaking and moving my legs. Mood very poor. 

 

I'm wondering if the increased agitation is due to abruptly stopping the 10 mg and whether I should stick with another day of 1 mg and monitor the effects. I've noticed there seems to be a trend towards increasing agitation later in the day/ mid way through the half life of the venlafaxine and wondered whether you thought I should take twice daily. I'm not in a good place right now and my family want to have me admitted to a psych ward, which I don't think is a good idea, but I'm feeling a bit desperate at the moment. I'm very uncomfortable and anxious, just hoping this is an effect of the dose change which won't be permanent. Could you let me know what you think if you get the chance? I understand you're probably busy so don't feel any pressure to respond quickly. Thanks so much for your help.

[Altostrata]

8 hours ago, Monty95 said:

Hi Chessie, 

Thanks for your advice; I made some notes about how I have been feeling over the past two days - 

 

Friday: Very agitated on waking at 1:45 pm after falling back to sleep, tremor, very low mood, however cognition was improved and didn't feel as drugged and confused as I do usually. Anhedonia and ability to engage was slightly improved. My appetite was poor, I was nauseous and unable to eat as much as usual. I took five grains in a gel cap at 3pm, around 6:30 I felt relaxed with no irregular or fast heart rate or agitation. I would say my cognition was similar to the first day I took the 1mg and impaired compared to the 10 mg day. At 7 I felt sedated and fatigued with minimal awareness of time passing. Around 7:30 to 8 I was slightly agitated and fatigued at the same time. I had a slight window around 9 to 11:30 where I was relaxed with no anxiety and anhedonia was not extreme.11:30 to 12:30 I was feeling sedated with minimal awareness of time passing, very slight abnormal heart rhythm as went to sleep, improved from yesterday. Was able to fall asleep easily. 

Saturday: Woke at 10:30 with some anxiety about cognitive impairments and numbness in forehead, very worried about brain damage being permanent. Was not as confused as before reinstatement at 1 mg but perhaps feeling more drugged than yesterday on waking. My heart rate was slightly elevated. Took 1 mg in a gel cap at 3pm. Very confused and cognition very poor in the afternoon ie. struggled to work out how to wash my hair/ remember how I would usually do this, had very limited awareness of time passing. Distressed due to this. 5pm felt extremely fatigued and dizzy on standing, extreme vertigo, faint, felt almost catatonic with slow thinking and feeling frozen. Wondered whether feeling faint and breathless was due to low iron/haemoglobin as apparently this was slightly low in hospital. 7pm still feeling very fatigued and spaced out with vertigo. Memory loss is significant. No heart arrhythmia or tachycardia. Tried to sleep at 8 pm as was so fatigued, woken by feeling of adrenaline in my chest and awareness of my heart beating. Tremor returned.  10:30 pm agitation somewhat improved, tremor calmed. 11:30 - 12:30 am agitated, shaking, drinking water helps to calm tremor temporarily, akathisia moderate to severe unable to stop shaking and moving my legs. Mood very poor. 

 

I'm wondering if the increased agitation is due to abruptly stopping the 10 mg and whether I should stick with another day of 1 mg and monitor the effects. I've noticed there seems to be a trend towards increasing agitation later in the day/ mid way through the half life of the venlafaxine and wondered whether you thought I should take twice daily. I'm not in a good place right now and my family want to have me admitted to a psych ward, which I don't think is a good idea, but I'm feeling a bit desperate at the moment. I'm very uncomfortable and anxious, just hoping this is an effect of the dose change which won't be permanent. Could you let me know what you think if you get the chance? I understand you're probably busy so don't feel any pressure to respond quickly. Thanks so much for your help.

 

Exactly how much Effexor have you taken every day since Wednesday, when you took 5 beads? What times of day did you take each dose?

 

When we say 5 beads, we mean 5 beads. What we see is that when a person's nervous system is sensitized by withdrawal, too much of the drug can be activating. This is what happened to you.

 

It may take a while for your nervous system to settle down from your having taken 10mg. You will need to be patient. Please continue to take 5 beads each day at the same time of day.

 

Please keep daily notes on paper with times of day for when you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. Post your notes here in your Intro topic.

[ChessieCat]

2 hours ago, Altostrata said:

Please keep daily notes on paper with times of day for when you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. Post your notes here in your Intro topic.

 

Example:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

[Carmie]

Hi Monty, 

 

I wanted to welcome to you to SA too. I’m really sorry that you are struggling so much. 

 

Can you please answer Alto’s questions and do a daily log. Thank you. No, you haven’t got permanent brain damage, our brains have an amazing capacity to heal. Even people who have cold turkeyed or tapered too quickly have eventually healed. It can take a long time though.

 

I’ve been tapering for many years and I’ve got many more to go.

 

I hope that your reinstatement works, but chopping and changing that can make your symptoms worse. I know you panicked and updosed a higher amount, but we can’t change the past. Continue with a low dose, as Alto and ChessieCat suggested. Because you updosed quite high and then went back down again it can take a little while to stabilise from that too. 

 

I accidently double dosed a couple of times and that affected me too.

 

We will all heal eventually, there will be lots of ups and downs though in this process. I know you’re scared and everything is overwhelming at the moment, but focusing on the fact that we do all eventually heal gives us hope. 

 

In the meantime do you have any distractions that can help you to take the focus of your symptoms? In the midst of the severest waves I’ve been through I’ve always done things to distract myself, whether arts and crafts, cranking up the music, photography, watching DVDs and Netflix, going out in nature etc etc. Anything that would help me focus on something else. I may not have felt like doing these things at the time but I did them anyway, it really helped me get through the day. 

 

Wishing you all all the best in your healing journey.💚

 

[Monty95]

14 hours ago, Altostrata said:

 

Exactly how much Effexor have you taken every day since Wednesday, when you took 5 beads? What times of day did you take each dose?

 

When we say 5 beads, we mean 5 beads. What we see is that when a person's nervous system is sensitized by withdrawal, too much of the drug can be activating. This is what happened to you.

 

It may take a while for your nervous system to settle down from your having taken 10mg. You will need to be patient. Please continue to take 5 beads each day at the same time of day.

 

Please keep daily notes on paper with times of day for when you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. Post your notes here in your Intro topic.

 

Hello Alto,

Thanks for your response, I very much appreciate the support. I have taken five beads in the afternoon on every day since Wednesday with the exception of Tuesday when I took 10 mg. Wednesday I took the dose at 4:30pm, Friday and Saturday at 3 PM and Sunday (today) at 4:30 pm. 

Here are my notes from today -

Sunday:

12PM: Was able to settle to sleep eventually and slept well with no disturbances, unaware of any cardiac instability or adrenaline surges or high temperature/sweating. Relatively lucid/not confused on waking (less so than following the 10 mg dose, more so than prior to reinstatement)

12:30: Prepared food - Struggling with cognition, ie. working memory, holding multiple concepts in my head, problem solving, only able to perform tasks by rote.

1 PM: Appetite very much improved, was able to finish eating 

2PM: Slight window, dysphoric mood somewhat diminished, cognition perhaps 50-60% of normal function prior to discontinuation.

4:30PM: Took 5 grains effexor in gel cap (1.5 hours later than previous day)

5PM: Somewhat dizzy and agitated. Aware of slight deterioration in cognition. (Due to late administration of dose?)

5:30: Very dizzy, focus/ situational awareness/reactivity and planning very poor.

6:30: Relaxed, not anxious. Mood improved. Cognition seems consistent with initial improvement after reinstating 1mg dose.

7 PM: Took 1000 IU Vitamin D. Anhedonia somewhat improved, short term memory still poor, concentration/ awareness of time poor. Feeling relaxed without agitation or autonomic instability. 

7:30 Dizzy on standing. noticeable hair loss. 

8PM: Significant window. Cognitive functioning the most improved since the onset of confusion and autonomic instability over 2 weeks ago. Able to speak to my sister on the phone, and make and follow jokes, remember what she was talking about, no confusion. Working memory and spontaneity, ability to problem solve improved. Perhaps 60-70% of my original functioning before discontinuing effexor.

9 PM: ate dinner, feeling relaxed, mood not dysphoric, not anxious.

10:45 Some fatigue and dizziness when standing. Heart rate noticeably a bit faster. 

11 PM: Sweating, slightly anhedonic, slightly nauseous. 

11:30 Slightly agitated and anxious, very sweaty (checked temperature which was normal at 37 degrees) Dental pain when brushing teeth seems unchanged since reinstatement. 

12 AM: Slightly dysphoric with some racing thoughts and anxiety. 

1AM: Mood not too bad, only very slightly aware of abnormal heart activity - (no tachycardia or arrhythmia, just uncomfortably aware of my heart beating which never occurred prior to discontinuing effexor) No adrenaline surges/tremor/restless legs. Aware of a slight sensation of adrenaline in my legs, but not too uncomfortable. Urinary frequency at night seems improved today. Depersonalisation is still significant, but I think derealisation has improved since reinstatement. Facial numbness may have improved a bit, numbness in my forehead is still severe. Blurry vision is unchanged.

 

Forgive me if the notes are a bit unclear, I feel kind of in a dream state at the moment. Since I have taken 5 beads for 3 days, I will take the same dose at the same time tomorrow and post notes then. I think effexor has quite a short half life of 15 hours plus or minus six hrs - if a steady state is achieved in the blood after five half lives, would you recommend I evaluate again tomorrow as to whether to updose or split the dose? Or do you recommend I wait a bit longer given the destabilising effects of the 10 mg dose?

I used to feel very sedated and unable to focus/limited awareness of time passing after taking effexor on the full dose, which I usually attempted to counteract with a lot of caffeine. As the day went on I would have a window of normal functioning, followed by being very talkative/good mood & almost a bit manic. The following morning I would be dizzy and get brain zaps and sensation of my brain lagging behind me when I moved when I was due for my next dose, then extreme dizziness, nausea and fainting or vomiting if I was more than 3 or 4 hours late with taking it. It seems as though I have become hypersensitive in withdrawal as you say and it has become more activating overall, although there is a similar pattern over the course of the day with agitation, anxiety and akathisia replacing the good mood and mania. I'm wondering whether this means I am a fast metaboliser and might be better off splitting the dose over the course of the day?

I also just wanted to express my thanks for all the work that is put into this website from everybody that contributes. 

 

 

[Alanmane]

Hello friend, I am also struggling with the horrible affections of effexor abstinence, the worst, more than the animic state is mental dysfunction, very difficult to think clearly and use my head efficiently in this state, I feel with creativity, memory , concentration etc in low form. I have 10 months reducing from 150mg to 40mg, you can write in this forum and you are not entered is already a great achievement, to what seems ridiculous all this? I'm so furious.

[Altostrata]

This is what you reported:

 

On 2/20/2019 at 5:07 AM, Monty95 said:

Thanks so much,  both of your support has been lifesaving. I've been keeping track of any symptom changes & just wanted to update and let you know that I was still experiencing extreme cognitive difficulties this morning eg. with concentration, awareness, memory and planning/ spontaneity. I took 5 grains in a gel cap at 4:30 pm and about two hours later experienced a slight but noticeable increase in cognitive sharpness/ awareness, which I wouldn't have believed was possible from such a small dose. I think its extremely unlikely to be a placebo effect, I was able to do a few small tasks I have been unable to do over the last few weeks and remembered where some household items were kept which I had previously been struggling with. I felt some increased electrical activity in my forehead also, I'm not sure whether this might be a positive indicator? My pupils are also more dilated and the numbness in my lower face has improved somewhat so I take that to be a sign that the dose had some effect. On the negative side I did notice a slight deterioration in my blurred vision that hasn't resolved, and some slight irritability/ agitation, sweatiness and fatigue standing around five hours later. Not much of a change in anhedonia, anxiety and inability to engage, maybe a very slight improvement? Perhaps a slight improvement in derealisation also. Overall I think it has been very positive result and I haven't experienced any really debilitating symptoms other than the blurred vision which isn't ideal but I'm willing to put up with it as my main concern by far is the cognitive decline. Are you able to let me know whether you would recommend a dose increase tomorrow, I was considering possibly taking a half capsule ie. 19 mg, if nothing deteriorates overnight or would that be too much of a jump do you think? Is continually changing the dose problematic or would it be best to be cautious and increase slowly rather than jump to 37.5 mg and stabilise? Sorry, I realise this is a bit of an essay, I'm uncharacteristically anxious/ocd at the moment, not really myself at all  

 

On 2/21/2019 at 6:24 AM, Monty95 said:

I'm in a bit of a mess, I should have listened to your good advice, which is well informed and I should have taken more seriously, unfortunately I panicked somewhat and decided to increase the dose to 10 mg today as I find the symptoms of lobotomisation unbearable and thought I had a good effect from the 1 mg yesterday. I felt significantly better in terms of cognitive functioning around two hours after taking the dose, around four hours later I noticed I felt a bit agitated and an increased sensation of adrenaline in my lower legs, at the moment, 9 hours later I'm feeling very anxious and agitated, mild nausea, my heart arrhythmias have been noticeable and I'm apprehensive about being able to sleep. I'm feeling very lost and wondering whether I should stick with this dose for the next three days and see whether the symptoms become more bearable? 

 

Is this what you've taken:

 

Feb. 20 Wednesday 4:30 p.m. 5 beads Effexor XR

Feb. 21 Thursday 4:30 p.m. 10mg Effexor XR

Feb. 22 Friday 3:00 p.m. 5 beads Effexor XR

Feb. 23 Saturday 3:00 p.m. 5 beads Effexor XR

Feb. 24 Sunday 4:30 p.m. 5 beads Effexor XR

 

Why are you taking Effexor at different times of day? Please take the same dose at the same time each day.