InChristAlone

[Shep]

Because it takes 4 days for your nervous system to register a change and a week or more to adjust, these upticks in anxiety and depression may simply be your nervous system adjusting. Hopefully this will fade out soon. If not, it's okay to hold longer than you've been holding with prior reductions.

[InChristAlone]

Well, I’m feeling a kind of crappy today. Woke up anxious and feeling a little depressed. I have gotten off on taking my meds on time because I’m on Christmas Break and sleeping in later. I have felt mostly good for a few weeks though, so I’m hanging in there. 

[Shep]

In addition to being off schedule with your drugs, are you eating sweets and other foods you normally don't due to the holidays? If so, you may be triggering some symptoms.

 

You may want to go back to your regular drug schedule and diet (if you've made any changes) so you feel better before going back to work. 

 

Glad you've been doing well prior to this wave. 

[InChristAlone]

Yea, I’ve been eating terrible. Actually felt much better yesterday. I’ve been stayin  up late and sleeping late. I’m way off schedule. I will try and get back on schedule. It would probably help a lot. Thank you Shep! 

[InChristAlone]

I’m having the longest stretch of feeling decent I have had since this journey began a couple years ago. I haven’t made a cut since December. I will probably make a cut to Effexor at the end of this week. 
 

it has been nice to feel mostly good. Mid afternoon doesn’t always feel good, but it passes by evening. I hope anybody who reads this knows there is hope. 12-16 months ago I didn’t feel like I wanted to live anymore. My faith has brought me through many storms though. Prayers for anybody struggle. Hang in there. Fight the fight for as long as it takes. 

[Shep]

Thanks for the update, InChrist. Glad to read things are going so well. 

[InChristAlone]

Made my first Effexor cut since December on February 14th. Cut by 10%. I’m now down to 101mg. 

[Shep]

How are you feeling? 

[InChristAlone]

Not too bad. I had a couple of moments where I felt somewhat depressed, but this is better than my last cuts since far. Thank you for asking! 

[Shep]

Excellent update! 

[InChristAlone]

Been doing mostly good. Days aren’t perfect, but a lot of good stretches each day. Other moments are manageable. Cut my Effexor today to 93 mg. Hope everyone is doing well!!

[Shep]

Thanks for the update, InChrist. Glad to read you're doing well. 

[InChristAlone]

Yesterday I cut my Effexor to 75mg daily. It was a larger cut that I’m suppose to make. I’ve been doing really good and just found out my primary care dr is now out of network. I’m not sure I can find another one who will continue to work with me, so I cut a little extra. We’ll see how it goes. 

[Altostrata]

What are you taking now, at what dosages and what times of day?

 

Please let us know how you're doing.

[InChristAlone]

I take 75mg of Effexor in the morning, 0.1mg if Klonopin twice a day, and Nexium 20mg in the morning. 
 

I have been doing really well for a while now. I have moments most days where I feel bad for a bit, but I know it will pass. It doesn’t bother me too much. I feel the best I’ve felt since this mess started a little over 2 years ago. 

[Altostrata]

If I were you, I wouldn't make additional changes for a month, let your nervous system accommodate. Please let us know how you're doing.

[InChristAlone]

Been doing really good until the last few days. Somehow, I forgot my does of Klonopin on Saturday Night. It seems to have brought on a set back. My brain has been foggy this week, some anxiety, and depression. I guess a missed dose can cause some short term issues. I know it will pass. I felt really good leading up to that. 

[ChessieCat]

Hang in there and take care of yourself.  At least you know the probable cause and hopefully things will improve quickly.  It might take one or two weeks so just keep reminding yourself that you know why you feel like you do and that your brain needs a bit of time and extra TLC.

 

And don't beat yourself up over it, we all make mistakes.  I've mixed up my doses a few times during my taper.  I've now got better systems in place to try to reduce the possibility of missed/wrong dosing.

 

And hold off on any tapering for a while.  Give your brain a chance to get stable.  A longer hold now might help prevent the need for an even longer hold or updose down the track.

 

I've just noticed that you made a large reduction in your Effexor in May.  Alto has already commented saying:

 

On 5/25/2020 at 7:48 AM, Altostrata said:

If I were you, I wouldn't make additional changes for a month, let your nervous system accommodate. Please let us know how you're doing.

 

From your drug signature:

 

Effexor: August 2018-150mg. Sept. 2019-139 mg. Oct. 2019-122mg Dec 2019-112mg Feb. 2020-101mg Apr 2020-93mg

May 2020-75mg

 

SA recommends reducing by no more than 10% of the current dose with a hold of about 4 weeks to allow your brain to adapt to not getting as much of the drug.

 

Your reduction from 93mg to 75mg was a 19.3548% decrease.

 

If it was me, I would definitely be doing a long hold now and stabilising instead of risking it catching up and possibly being worse and/or longer down the track.

 

 

[InChristAlone]

Just noting that I have had a nice window. Felt good for 2-3 weeks. I’ve hit a little bit of wave, but it may be caused more by situational issues than the withdrawal. I’m assuming withdrawal can make the normal stress of life seem worse also. Tomorrow I start a new teaching and coaching job. On top of that I’m returning to school with this whole Covid issue making every part of my job unknown and a little stressful. I’m sure I’ll feel better once I get into the swing of things. It always brings a little seasonal depression to return back after having the summer off. This is quite a bit different. We’ve been out since March because of Covid, and we are returning to a school day that will look much different.

 

I have faith things will be fine (school-wise, Covid-wise, and with withdrawal). I’m just hanging in and trying to be patient with the process of tapering. Some days I just want to cold turkey the remaining Effexor and Klonopin. I’m sure that would be disastrous. 

[InChristAlone]

I’m sure it has been discussed on here thoroughly, but it is hard to understand why the last cuts are so hard. I made cuts based of of a study suggesting the cuts would be  a hyperbolic reduction of 10% occupancy of serotonin receptors. The cuts were significantly higher than suggested on here. I’m feeling somewhat crappy. Functioning, but not even close to myself. It hard to fathom how such small doses can effect a person so much. 
 

 

[ChessieCat]

1 hour ago, InChristAlone said:

The cuts were significantly higher than suggested on here.

 

SA's recommended taper rate is no more than 10% of current dose with a 4 week hold.  There is a good reason for this.

 

Why taper paper: dose-occupancy curves

 

The reductions you are making are a lot more than "significant".

 

Going from the information in your drug signature:

 

Sept 2020-53mg

Nov 2020-37.5mg      29.2453% decrease

Dec 2020-20mg         46.6667% decrease

Jan 2021-12mg          40% decrease.

Feb 2021-7mg            41.6667% decrease

 

You have not just made one large reduction but have continued to do so over several months.  What we have seen with other members who go too fast is that at some point the wheels end up falling off and it can take a long time for them to stabilise.  From what you have written it seems that yours are getting very wobbly.

 

1 hour ago, InChristAlone said:

It hard to fathom how such small doses can effect a person so much. 

 

It is not the small dose of 7mg that is causing the issues, it is the large reductions you have made, so it is the lack of drug not the amount you are taking.

 

You have a few options:

• Make a small updose and hold until you reach WDnormal
• Hold on 7mg until you reach WDnormal
• Continue making reductions of any size before you have stabilised and possibly end up suffering more than you are now

 

Holding until you reach WDnormal will probably take at least 3 months or even much longer.

 

Stability

 

WDnormal

[InChristAlone]

Don’t get me wrong. I don’t feel completely horrible. I do understand and appreciate your concern. 
 

I was experimenting with a tapering chart that I found researching on the internet by Dr. Anthony Horowitz. I would never suggest for anyone else to do that. 
 

I do plan a long hold now since I am feeling the effects of cuts that may have been too much for me. 
 

My question about the small dosage was more of that it’s crazy that cutting a relatively small percentage of the original, “therapeutic” dose can effect a person. Makes you wonder why the therapeutic doses are so high. I guess they are that high in part to prolong how long it takes to reach tolerance. Also, I’m sure there is so much at play that will never be completely understood.

[Shep]

Effexor works on various neurotransmitters, depending on the dose. You can google and learn more. Here is an article that states that "Venlafaxine is essentially a selective serotonin reuptake inhibitor at 75 mg, and with higher doses such as 225 mg/day, it has significant effects on the norepinephrine transporter in addition to serotonin." 

 

Venlafaxine

 

So you may have varying withdrawal symptoms according to your individual sensitivities to the various neurotransmitters.

 

Also, please see:

 

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

Even when you get to these lower doses, it doesn't mean you have less of the drug. 

 

Also, please note from the tips for tapering off Effexor thread: "Withdrawal from Effexor is thought to be brutal because it has a very short half-life (at most, about 15 hours for regular Effexor)."

 

So you may be getting some interdose withdrawal. 

 

As ChessieCat wrote, we recommend a harm-reduction approach of no faster than 10% because it helps mitigate as much of the withdrawal as possible. A lot of what's going on is a combination of a lot of these factors, so going slow allows you to set yourself up for as least harm as possible. 

 

[InChristAlone]

Thanks Shep and ChessieCat for pointing me in the direction of that info. Patience is definitely something I battle, especially with tapering. I appreciate the support! 

[InChristAlone]

Well, I am in a pretty nasty wave that started this weekend. Got stressed over a somewhat tough decision I needed to make for my son, and it got me really down. I have had a couple days since early Feb where I felt something coming on, but I guess it hit a little harder than I’ve felt in a while this weekend. 
 

I know I cut my meds too fast, but I also know I’ll be ok. It is not fun, but will make me stronger in the long run. 
 

Has anyone else noticed simple stressors such as tough decisions start them into a wave? I know waves and windows are inevitable, but is this a normal part of the recovery process? 

I’m definitely planning a long hold as I work back towards withdrawal normal. I don’t think this is a major setback, but probably is a little discomfort I could have avoided with a little more patience. 
 

it’s funny how waves make you think that you always feel terrible when in reality I’ve had more good days than bad over the past months. It’s such an emotional rollercoaster. I guess that’s why so many get misdiagnosed with bipolar. 
 

I know I’ll recover. The only way not to is to give up. 

[InChristAlone]

I was up almost all night last night because of acid reflux and anxiety. I had a bad case of reflux start a week or so ago, and it’s starting to cause me to get anxious. Closest I’ve felt a panic attack in a really long time. I hope I can get the reflux settled soon, and I’m sure the anxiety will pass if so.

 

I’m sure I’ve done a lot of this to myself by tapering too fast. I’ll continue to ride it out. Definitely hate the way the anxiety waves feel. I’ve always had a little health anxiety, but it’s been pretty bad the last couple of days. 

[InChristAlone]

I feel like the stress I’m feeling over a little setback with my GERD is probably worse because of the large cuts I’ve made over the past several months. Would y’all agree with this? 

[Mia1]

1 hour ago, InChristAlone said:

was up almost all night last night because of acid reflux and anxiety

I’m sorry to hear you had a difficult night. I find that just focusing on relaxing and not sleeping helps me to actually sleep. I don’t allow myself to focus on the anxious thought, accept that it is just a thought and focus back on relaxing. I just focus on my breathing, the sensations of the breath will keep you grounded in the present moment and away from anxious thoughts.

1 hour ago, InChristAlone said:

I had a bad case of reflux start a week or so ago, and it’s starting to cause me to get anxious. Closest I’ve felt a panic attack in a really long time. I hope I can get the reflux settled soon, and I’m sure the anxiety will pass if so.

So what I’m reading here is you have a thought related to your acid reflux that is causing the anxiety. Again, it is just a thought. You have a thought, it produces a feeling, which in turn releases a chemical in your body. If you don’t react to that chemical, the body sensation, over time it will stop happening. In the meantime if you can just not react (stay calm inside) it simply won’t matter what sensations your body is producing. The key here is acceptance, both of thoughts and body sensations. Remember, whatever you resist persists!

[Mia1]

I too have made large cuts that have left me feeling vulnerable.  It’s like a feeling on steroids. However, everything I wrote still applies. The deeper you go into true acceptance, that no matter what happens you will be okay, the easier it becomes. Counter intuitive to what a person may want to do when feeling anxious but will bring tremendous peace. 

[InChristAlone]

Thank you, Mia! I know you are right. I kept telling myself last night, that it is going to be ok. I knew when I was going to bed that I was worked up and agitated. Every time I would almost dose off I would wake up in a moment of panic. Then, I would calm myself down.

 

I think a big problem I had yesterday was that I couldn’t accept that I had acid reflux and that I was going to be ok. Kept having thoughts of esophageal cancer. I have had GERD all my life, so I’ve always known in the back of my mind that I’m at a little higher risk. Yesterday, I let my thoughts spiral out of control. 
 

I believe that if I was not in withdrawal I would have managed my thoughts better yesterday. I can feel that the large cuts have put me a ways below withdrawal normal. I’m sure that didn’t help. 
 

I have developed mental toughness in the past few years, as I’ve withdrawn. There was a time not long ago that not sleeping last night would have been really bad for me, but I’m hanging in there today. 
 

While I do hope this is the low point of this wave, I also understand that accepting that it might not be is super important. Am I right in calling this a wave even though it was brought on by other health issues?

[Mia1]

You are doing amazing and it sounds like you have really put the work in! I personally think you were feeling a little extra sensitive because of the accelerated detox and momentarily forgot to accept what was happening and stay in the moment. It sounds like you’re already getting back. Keep the faith, it’s what gets us through 🙏

[InChristAlone]

Thank you! I really appreciate the support and encouragement! 

[InChristAlone]

Any suggestion on how long I should hold at 7mg of Effexor? I know it needs to be a rather long hold. My body is telling me that. Just curious what has been a good hold for people who got carried away and cut too much too fast.

 

Thanks to any advice! 

[Gridley]

2 hours ago, InChristAlone said:

Just curious what has been a good hold for people who got carried away and cut too much too fast.

It is all individual but a six months hold would be a good starting point.

 

 You might want to consider a small updose to 8mg to see if that helps.  It takes 4 days for an updose to reach full strength in the blood steam and several more days to register in the brain.  Be patient and allow to updose a chance to work. 

 

If you decide to updose, please help us updated on how it's going.  If you decide to stay at 7mg, then settle in for a lengthy hold.

[InChristAlone]

Thanks Girdley! I figured it would be 5 or 6 months before I’d be ready to make a cut. I don’t think I’ll updose. I’d like to go for a long hold if I can. 

Edited March 19, 2021 by InChristAlone

[InChristAlone]

I’m still hanging in there today. Feeling quite a bit more anxiety and depression than I have had in a while. Small windows everyday, but still in a wave. Hoping to get back closer to withdrawal normal soon.