nanette: venlafaxine reintroduction at 14 days after discontinuation

[nanette]

All of my symptoms in bolded, for ease of quick scanning for relevance by anyone interested.

I have ended up on this website after lots and lots of google research to pin down the cause of my incessant symptoms of a low-grade migraine headache and constant nausea that I have been experiencing for 10 days straight now. 

 

My Migraine History:

I have been getting migraines fairly regularly (about 2 or 3 each month) since middle school. but they are pretty mild, as migraines go. About 25% of the time, one will be preceded by an aura that is a lightening-shaped blind spot or blurry vision and then the headache will be very severe. And occasionally, one will be accompanied by severe nausea. But normally, my migraines are  just quite painful headaches accompanied by heightened sensitivity to light, sounds, and smells. With ibuprofen and extra sleep, they are usually completely gone within 30 hours. During puberty and especially pregnancy, my migraines were more severe in all aspects: nausea, sensory sensitivity, and pain.

 

My Venlafaxine Withdrawal/Discontinuation Symptoms:

I did not connect these symptoms to the cessation of Venlafaxine until recently because

1. I did not know that physical symptoms could be related to the cessation of antidepressants.

2. The onset of symptoms did not occur until 5 days after my last half dose of Venlafaxine.

3. I was only on Venlafaxine for 27 days (including a half-dose for the last 7 days).

I only made this correlation after several days of googling possible causes, and after including symptoms that I had previously dismissed as insignificant and inconsequential in my internet searches

I started experiencing a persistent nausea that did not seem like food poisoning or stomach flu (no stomach cramping, etc.) 14 days ago. There were/are waves when the nausea is worse throughout the day, and a constant malaise otherwise. Unlike the stomach "flu" or food poisoning, there is/was no stomach cramping or urge to vomit. On the 4th day of no relief, I realized that it was just like the nausea I get that sometimes accompanies my migraines. I hadn't equated it with a migraine previously, because there was no headache. I started taking ibuprofen periodically, treating it as if it were a migraine. On about the 5th day, I could feel a headache "trying to set in", which is my usual precursor to an impending migraine (although historically the nausea, if it develops, does not come on until after the headache presents). Since then, I have had no improvement in symptoms. On about day 6, I started googling possible migraine prescriptions and was considering seeing my M.D. the following day, if there was no improvement. I also started googling the combination of all my other mild/querky symptoms to see what else it could possibly be, if not a migraine. These other sporadic symptoms had each seemed inconsequential as they had come and gone here and there, and were easily dismissed. But I was starting to realize they might be related.

Muscle Weakness in my biceps that I had noticed when using a steering wheel or when filing through clothing racks while shopping.

Crying and/or the feeling that I needed a good cry, without provocation, that felt very similar to PMS (although this was about 10 days after my last menses).

Brain Fog in the middle of conversation. I will have to concentrate really hard to remember what the conversation is about, and what I was going to say next. I will forget what my husband told me just minutes ago.

Word Recall Difficulty both while texting/typing (spelling) and in conversation (vocabulary). 

High Pulse Rate of 88pm, which was noted at the medical appointment that I had on the fourth day after my last dose of Venlafaxine, when I felt great.

Chills

Hot Flashes/Feeling Flushed

Sinus Congestion which was present before, but is now much worse, especially at night.

Nausea that feels like "Morning" Sickness when there is 0% that I am pregnant. Yes, 0%. At times, I can tell that I will feel better if I eat, and at other times I can tell that eating will make me feel worse. My best time of day is the first 3-4 hours after waking up.

Shivers not related to body temperature this one I just experienced last night, and suspect (hope!) is more likely related to my inadverdently taking 2 different antihistamines (diphenhydramine and cetrizine) at the same time! 

Very pronounced and fast onset of "prune skin" on the soles of my feet, followed by Extreme itchiness on the soles of my feet Another really bizarre symptom that I think might have another cause. ??? I had sprayed the soles of my feet at bedtime with magnesium oil two nights in a row, as I have done in the past when experiencing a severe migraine. I did not bathe or shower until a third night. 5 minutes into my bath, my feet (and only my feet) were EXTREMELY pruny, as if I had been soaking for more than an hour! I have found nothing online indicating that this wierd fluke may be related to the magnesium oil, nor to antidepressant withdrawal/discontinuation. After the bath, my feet were excruciatingly itchy (just the skin, not the nerves) for at least 30 minutes!

 

After much reading on this and other similar forums, I contacted my P.A. that has been assisting in my medication management for the last 3 months. I am going to reintroduce 5 beads of Venlfaxine tonight and see if it makes a difference by the time my afternoon appointment rolls around tomorrow. She is doubtful that any of these symptoms are related to the antidepressant, so I hope this works. I really hope that my experience, along with the litany of literature I will be leaving with her tomorrow, convinces her of this very real and very under-reported issue!

 

 

 

[manymoretodays]

Hi nanette and welcome aboard,

So sorry for the delay in getting your initial post approved and getting you started.

Did you reinstate 5 beads then on the 10th?

And then, how are the migraines and other symptoms today?

 

Any thoughts about what you might do with your bupropion going forward?

 

And thank you for getting your signature going too.

 

I'll include here, on your introduction, some of the general information that I often give to new members:

It does sound like you already have a collection of literature for your provider to present to her as well, and thank you for doing that education bit.  Appreciated very much.

 

 

Here at Surviving Antidepressants, we recommend that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

"I was only on Venlafaxine for 27 days (including a half-dose for the last 7 days)."

And wow.  I did see this ^, in your initial post.  Often these medications/drugs do create dependencies in as little as 2-4 weeks usage.  So sorry you've had to go through all this.  The withdrawal(WD) symptoms.

    

Tips for tapering off Effexor and EffexorXR(venlafaxine)

About reinstating and stabilizing to reduce withdrawal symptoms

 

Brain Remodelling

What is withdrawal syndrome.

The windows and waves pattern of withdrawal stabilization

 

Dr.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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal. 

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

Again, welcome.

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

 

Edited June 13, 2019 by manymoretodays
additional comment added

[DMV64]

Hi Nanette!

Glad you are here. It is an amazing supportive and informative place! I also have a lot of brain fog and word recall difficulty so I relate. I seem to be in a window today so I can think. Which is very nice. Sometimes I am too muddled to even really read much here. So when I have a more clear day I try to catch up.

xo

DMV

[RichT]

Hi Nanette,

 

If I read your signature right, you have gone through many changes to your drugs in the last few months.

 

My experience is that it can sometimes take quite a while (a number of months) for the full impact of a change to be felt, so you may have a number of effects going on at once here.

 

I can certainly relate to the nausea you describe as a withdrawal effect!

 

Warmest wishes,

 

Rich

[nanette]

Thank you for the warm welcomes!

And thank you for the links, ManyMore. I will definitely be perusing all of them thoroughly! To answer your question about the Wellbutrin- honestly, I think I will stay on it for quite some time. I feel better now, mentally and mood-wise, than I have since high school.

Another thing I realized while reading some of the medical literature: If Prozac has about a 28 day period before symptom withdrawals might surface (as one article suggested), then that would have coincided with the same week I stopped the Effexor. So that undoubtably contributed to my WD reaction, despite the very short time I was on the venlafaxine. That same article mentioned that sometimes temporarily introducing Prozac works as well as reintroducing Effexor, specifically. And then stopping prozac creates a naturally induced slower taper, due to it's loong half life.

Has any one had experience trying prozac for venlafaxine  withdrawal symptoms?

 

Here's the latest:

I had forgotten that my Vanlafaxine RX was in tablet form (not capsules). So I took 1/4 of a 37.5 tablet the night before my appointment. Sure enough, the nausea was gone within 12 hours! I still had the headache at my afternoon appointment, but it disappeared by the 2nd day without an increase in dosage.😌

 

My P.A. was somewhat open-minded, at least more than I thought she would be. And, although I did take literature with me, I thought it best not to go in seeming like I was telling her how to do her job, so I decided I will leave it with her another time. Maybe even just drop it off for her at the front desk in the next day or two.

She was extremely skeptical that WD could cause any physical symptoms. I deliberately expressed incedulity along with her. I said, "I know, right!? That's what I thought! That's why I didn't even consider it as a possibility until googling all of my symptoms together brought it up." I pointed out that there are LOTS of forums, etc. with lots of people reporting and sharing their WD experiences.

And at the end of the visit when she kindly encouraged me not to wait so long (14 days) before calling next time I have an issue, I reiterated that I just could not believe it might be WD, and that each day I had just been sure I would feel better tomorrow. But WD really did seem to be the only explanation. Hopefully the "isn't this the wierdest thing? I just can't believe it!" angle will help keep her a little more open minded. 

She also balked at me quartering my tablets, since it's impossible to be precise, although she was okay with me halving them. I told her I would much rather take an inacurrate lowest-dose possible every day than take a larger dose just for the sake of accuracy. I think we kind of agreed to disagree on that one, as she reiterated at the end that she was okay with me taking Half a pill until my next appointment, and I did not respond. 😶

She also said if it did not help the headache go away, we would need to look at other causes. She kept saying that having an WD reaction was pretty rare, but possible. And having a physical reaction was basically unheard of.

She said if this Did seem to help, we could leave me at this dose for 2 weeks and then try going off it again. I told her that from reading everyone else's experiences, I would really like to stay at a stable dose for at least a month before trying to taper more. She thought that was very extreme.

Sooo, we'll see how it goes. I have a follow-up in 2 weeks, and another 2 weeks after that.

 

She is pretty young- I would say in her low 20's. It's disheartening that a mental-health-focused student that recently out of medical school is still so unfamiliar with WD.

Hopefully my experience, at the very least, will make her lean towards prescribing the longer half-life antidepressants First, for new patients, rather than those with the shortest half life. And hopefully she'll be a little more likely to attribute another patient's physical symptoms to WD. And who knows- in ten years the medical profession may start to believe us, just like they've finally started believing people with gluten sensitivities.

 

 

 

 

[nanette]

Is there a way to update my signature? I tried using "edit profile" but I don't see anything about my signature there. I also tried searching for an existing thread that might answer this question, to no avail.

[ChessieCat]

Click on this link, which will take you straight to your own signature:  Account Settings – Create or Edit a signature

 

Remember to click save.

 

 

It's under Account Settings, on the left.

[nanette]

Thanks, ChessieCat!