sammy: Effexor taper after 7 weeks use with complex medication history

[sammy]

During a disastrous attempted benzo taper, I developed severe depression and anhedonia, different and more intense than ever before in life. I have history of anxiety and depression, but nothing ever of this scale. I also developed severe insomnia during benzo taper, which persists even after I've paused benzo tapering (currently on 20mg Valium). I rely on Clonidine to get a few hours of sleep every night.

 

My timeline:

2006 Effexor for anxiety and mild depression

2010 change to Lexapro

2012 change to Pristiq 100mg

Multiple unsuccessful attempts to taper (psychological symptoms only). These were all quick tapers, as advised by doctors, which I only now in hindsight realise were too fast.

 

Psychiatrist diagnosed ADD in November 2017 started Modafanil 400mg. Functioned well on Modafanil, was also still on Pristiq.

Modafanil expensive and wanted a cheaper alternative.

Feb 2018 Psychiatrist started me on Ritalin LA 40mg. I reacted badly with this stimulant, too agitated and couldn't function so Psychiatrist added Temazepam 10mg.

March 2018 ceased Modafanil.

March 2018 switched from Temazepam to 20mg Diazepam. Diazepam increased up to 90mg over next few months.

June 2018 switched from Ritalin to 70mg Vyvance.

August 2018 switch from Diazepam to Clonazepam, kept needing increased dose, progressively went to 6mg Clonazepam, and also prescribed short acting Dexampthetamine.
My life was spiralling out of control and I realised I needed to get off all the meds and not see this Psychiatrist again. I naively asked the Psychiatrist for tapering advice. Was advised to taper Pristiq first, then Vyvance and Dexamphetamine, and lastly Clonazepam. All the suggested tapers were, ofcourse, extremely fast.

 

Tapers:

Sept - November 2018 tapered off 100mg Pristiq (compounding) while still on Vyvance, Dexamphetamine and 6mg(!!!) Clonazepam. I don't really remember this taper. My family tell me I was bed bound during last few weeks. All psychological symptoms.

Jan 2019 fast taper Vyvance and Dexamphetamine. Got very agitated towards the end and cold turkeyed the last bit of the dose as couldn't handle it anymore and wanted it out my system.

Feb to March 2019: fast taper 6mg clonazepam to 1 mg, ended up in Psych hospital due to acute anxiety and insomnia, and had developed severe intensity depression and anhedonia, different and more intense than ever before in life.

March 2019 hospital admission: Stopped tapering benzo. Commenced Seroquel for sleep but didn't help . commenced Chlorpromazine, slept well.  Commenced Mirtazapine.  Self discharged. 

 

Found Ashton Manual and converted to 20mg Valium, and planned to hold benzo taper to try to stabilise. The 'holding' did not ease depression.

April 2019 GP converted me from Mirtazapine to Effexor XR (took Mirtazapine for 9 days, wasn't helping depression and was causing increased appetite). Started Effexor XR at 37.5mg for one week, 75mg for 2 weeks, and then 150mg for 4 weeks (total 7 weeks).

May 2019: ceased Chlorpromazine, even though it helped with sleep, as didn't want to be on it.

 

Effexor had not eased depression at all after 7 weeks so started tapering. Again, a fast doctor-led taper:
6th June 2019 reduced Effexor from 150mg to 75mg, held for one week.

13th June reduced from 75mg to 37.5mg, still holding this dose.

Have not had any noticeable withdrawal from these reductions.

 

I reluctantly agreed to try antidepressants as the depression is unbearable and I have no quality of life. But it hasn't helped so I want to get off the Effexor before I get more dependent on it, but I'm scared as I've since realised that doctor-advised tapers are too fast, compounded by the problem of my nervous system being so vulnerable during a recent too fast benzo reduction from an extremely high dose. 

 

Reluctantly started Trans Magnetic Stimulation (TMS) therapy 27th June. I've had 7 treatments so far without adverse effect. I hope the depression eases, even if only a minor improvement, I would be grateful.

My GP is advising to continue Effexor taper during TMS but I'm scared, so I'm holding 37.5 dose. I'm using generic Effexor (6 mini tablets inside each 75mg capsule). I want to taper Effexor more gradually, but don't know how. Generic don't have the small beads which I've read about on this site. Can I change to brand name Effexor?

 

I know now that gradual slow taper is best, but I don't have this luxury as I need to get off Effexor before I can re-start my benzo taper (taking 20mg valium currently). I am desperate to be benzo free to reclaim my life. I haven't been able to work for nearly 1 year, feel like I have no future. 

 

 

2006 Commenced Effexor
2010 Converted to Lexapro
2012 Converted to Pristiq
2017 Commenced Modafanil
2018 Commenced Ritalin and Vyvance, with benzos added due to reaction to Ritalin

September-November 2018 taper off 100mg Pristiq

January 2019 Dexamphetamine and Vyvance taper

February-March 2019 tapered from 6mg to 1mg Clonazepam
April 2019 Commenced Effexor XR
6th June 2019 started tapering Effexor, from 150mg to 37.5mg currently.

 

[manymoretodays]

Hi sammy and welcome,

 

And woah, you have had quite a year or more of alot of medications, and changes.

Your depression may be due to Valium and WD.  I just know that benzo's can be notorious for making one feel depressed.

It sounds like you have been really miserable and compromised greatly.  So sorry sammy.

Thankyou for getting your signature done too.  Nice job.  Could you go ahead and add the Valium, noting start date, and dose.  If you need to you could go across, instead of down, and add it after the Clonazepam, on the same line.  Add the Clonodine, as well.  Go to Accounts Settings to update or edit your signature.

Also I'll add the main link to signatures for you:  Please put your withdrawal history in your signature to help the moderators.

 

We generally 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.  Or even less of a percentage, sometimes.  Even with the benzo's.

Why taper by 10% of my dosage?

 

You may be going a bit fast with the Effexor now too.

    

Tips for tapering off Effexor and EffexorER(venlafaxine)

How have you been tapering your Effexor XR so far?  Have you been counting beads, or getting decreasing capsule dosages from the pharmacy?

And editing:  found this information in your initial post: 

On 7/5/2019 at 7:09 PM, sammy said:

My GP is advising to continue Effexor taper during TMS but I'm scared, so I'm holding 37.5 dose. I'm using generic Effexor (6 mini tablets inside each 75mg capsule). I want to taper Effexor more gradually, but don't know how. Generic don't have the small beads which I've read about on this site. Can I change to brand name Effexor?

 

Some general WD information, important:

What is withdrawal syndrome.

Brain Remodelling

 

The windows and waves pattern of 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.

You've had a lot of medication/drug changes and tapers in last year and one half, and no doubt that your nervous system is in an uproar.  Hence symptoms.  What kind of symptoms are you having other than the depression that you mention?

 

I think that you are wise to be holding your Effexor dose now, during TMS.

We've got a little bit collected, on site, on TMS, including some members experiences:

TMS(Transcranial Magnetic Stimulation)

 

Welcome aboard again sammy.  And apologies....for the time lag in getting you approved and started.

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.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

* have asked for additional moderator input, and as to your question on switching to brand name Effexor?

 

 

 

Edited July 12, 2019 by manymoretodays
added quote, that answered my ?

[Shep]

Welcome to SA, Sammy.

 

Manymoretodays has give you some great information. 

 

It will help us to know how your symptoms are manifesting in context with when you take them each day. In order to sort this out, please start a daily drug and symptoms journal in the below manner.

 

Please also include the number of hours you sleep and any supplements you are taking. Also include when you are getting the TMS treatment. 

 

After a few days of your journal, we'll know more about how to guide you in setting up a taper. 

 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 
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

 

 

[sammy]

anhedonia severe case poly drugged

 

Trigger Warning

 

I have come off several medications including Pristiq, stimulants, Klonipin and an anti psychotic. Anhedonia is basically my only symptom but it is so severe im barely clinging onto life. Its been like this for 17 months with zero improvement. Infact I just dont believe it will ever improve. Can anyone out there say I have any hope? please be honest. Ive read every horror story out there and its safe to say I am one of them. At this point im looking into treatment because its a better alternative to death. Im at loss with what to do. 

 

I have reverted back to being child like needing my mother to look after me all day and im 34 years old. I cant feel a single positive emotion. The chemical feeling you get when you feel happiness has been wiped out. No Dopamine, no serotonin nothing. 

 

Ive spoken to Baylissa countless times and she seems to think everyone heals but thats not what I have been reading. I dont have 5-10 years to wait around wondering. 

 

If I reinstated Pristiq would it help? I really wish I had just stayed on all the drugs and never committed to withdrawal. My life has gone down the drain completely 

 

Edited August 16, 2020 by ChessieCat
added topic title

[ChessieCat]

I moved your post here to your Introduction topic which keeps your history in one place.

 

Instead of reading the horror stories it would be better to read the success stories.  success-stories-recovery-from-withdrawal

 

Both of these members are now drug free:

 

Shep     Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

GiaK     withdrawn from a cocktail of 6 psychiatric drugs that included every class of psych drug.

 

57 minutes ago, sammy said:

I have come off several medications including Pristiq, stimulants, Klonipin and an anti psychotic.

 

So that we can see your drug history at a glance please create your drug history for ALL drugs.  We need details for the last 2 years and a summary for anything older than 2 years.  We also need to know how you stopped the drug/s, ie cold turkey or fast taper, as well as the last dose you took before stopping the drug.

 

Instructions:  Withdrawal History Signature

Account Settings – Create or Edit a signature

 

Once we have your drug signature we will be better able to offer suggestions.

 

[ChessieCat]

Once you have created your drug signature, please tell us in a post so that we will be notified.  Thank you.

[ChessieCat]

44 minutes ago, ChessieCat said:

 

Instructions:  Withdrawal History Signature

Account Settings – Create or Edit a signature

 

 

The second link goes straight to your own signature.  Remember to Save after you have created it.

[Altostrata]

Hello, sammy. How do you feel this anhedonia?

 

You've been on and off many drugs for years.  It's very common that people experience emotional anesthesia after a history of rough withdrawals. Your nervous system is regrouping. Are you still taking Effexor? If not, when did you come off and why?

 

We must have that summary of your drug history in your signature, as requested by ChessieCat. Thank you.

[sammy]

Yes I am off the Effexor. I came off more than a year ago after 3 months use because it literally made no difference to my symptoms. Just have 2mg left of Valium to taper. I literally cannot locate where to update my signature 

 

I feel SO utterly hopeless because ive done so much research and a large portion of people with anhedonia live with it for so many years and noone knows how to treat it or when or if it will ever go away. ive never heard that it has anything to do with the nervous system. its more to do with a dysfunctional dopamine system. does anyone here know anything about it? has anyone over come it naturally??

 

i have been living like this for almost 2 years now and i cannot take this torture anymore!!!!!

[ChessieCat]

2 hours ago, sammy said:

I literally cannot locate where to update my signature 

 

Are you using a phone to access the site?  You might need to use a computer to update your drug signature.

 

This link will go straight to your own signature.  Remember to click on Save when you have finished. 

Account Settings – Create or Edit a signature

[sammy]

I dont have a computer. dont worry about it ill try and get help elsewhere

[ChessieCat]

That's okay.  We assume that members do have access to a computer, but of course not everybody does these days.

 

If you provide your drug history in a post one of the admin staff can create your drug signature for you.

[sammy]

Here it is

 

2006 commenced Effexor

2010 converted to Lexapro

2012 converted to Pristiq

2017 commenced Modafanil 

2018 taper Modafanil commenced Ritalin then Vyvanse, added Benzo

Sep - Nov 2018 tapered off Pristiq 

Jan 2019 - Dexamphetamine and Vyvanse taper

Feb 2019 - present tapering Valium current dose is 2mg 

March 2019 - present - Chlorpromazine 25mg

April 2019 3 month stint with Effexor tapered off July 2019

 

 

 

[ChessieCat]

 

Thank you.  Once we get a bit more information I will organise to get it done for you.

 

13 minutes ago, sammy said:

2018 taper Modafanil commenced Ritalin then Vyvanse, added Benzo

Sep - Nov 2018 tapered off Pristiq 

Jan 2019 - Dexamphetamine and Vyvanse taper

Feb 2019 - present tapering Valium current dose is 2mg 

March 2019 - present - Chlorpromazine 25mg

April 2019 3 month stint with Effexor tapered off July 2019

 

We need more information on how you tapered the above please.   We need to get an overall picture of what has happened in the past with your drug taking/stopping because going on and off different drugs and changing the doses and quick tapers can destabilise your nervous system.

 

Please provide more information on the dates and doses for the drugs in the quote.  If you don't know exact dates please state early, mid, late and the month if possible please.

 

Thank you.

[sammy]

They were all rapid tapers. The only taper that has been done at a reasonable rate is the end of my Valium. All tapers finished in 1-2 months. 

Doses - Modafanil 400mg

Ritalin LA - 60mg

Dexamphetamine - 15mg

Vyvanse - 70mg

Valium - 240mg

Effexor - 150mg

[Shep]

@sammy I've added a signature and included the dosage information you just provided. Thank you for this information.

 

Questions:

 

• What drugs are you currently taking and what are the doses? You have "March 2019 - present - Chlorpromazine 25mg" in your signature but in the first post in this thread, you mentioned coming off this drug May 2019. 
• How fast are you tapering Valium?  In the post above this one, you wrote - Valium - 240mg. And now you are down to 2 mg, per your signature. 

[sammy]

Im currently taking 25mg Chlorpromazine and 2mg of Valium. I didnt come off the Chlorpromazine in May 2019 thats when I started it. I rapid tapered the valium to begin with as per my doctor’s instructions until i got down to 20mg. ever since then only reducing by 0.5mg per

month. I dont really have any extra symptoms since tapering slowly just the extreme anhedonia and some mental akathisia.  I havent started reducing the Chlorpromazine yet not sure when I will. I know it has to be done eventually but I think I will actually lose my mind dealing with this with chronic insomnia on top of it

[Shep]

Thanks for the additional info, Sammy.

 

15 hours ago, sammy said:

I rapid tapered the valium to begin with as per my doctor’s instructions until i got down to 20mg. ever since then only reducing by 0.5mg per

month.

 

What time(s) of the day do your take the Chlorpromazine and Valium? 

 

Please note that at your current dose of 2 mg Valium, reducing by .5 mg per month is way too fast. 

 

When was your last Valium reduction? You may benefit from an updose to help with the insomnia, so please tell us more about your taper over the few months. 

[sammy]

The taper speed is just fine. I dont feel any different to the way I felt a year ago. Ive tried updosing in the past it does absolutely nothing to help with my symptoms! 

i take the valium and chlorpromazine at night time before bed around 10pm