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

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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.

 

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manymoretodays
Posted (edited)

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

 

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:
 
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 by manymoretodays
added quote, that answered my ?

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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

 

 

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