Superwoman: Effexor taper

[Rhiannon]

14 hours ago, Superwoman said:

@Rosabell, I am so happy for you that your primary care doc is do supportive and agreeable.  This will make things do much easier for you.  Difficult doctors are just an added stress. 
 

@Rhiannon, I am glad that it is going well with you with your doctor also. My psychiatrist already knows that I want completely off the antidepressant.  At least he is not going to try to force me to stay on the Effexor, like the last psyc doc did.

 

 I have an appointment with my psyc doc Monday. I have a peer supporter from a local mental health agency. She may come with me. I am going to request a written summary of the visit with any of his recommendations.  Many major hospitals do this and it is considered good practice. I am also going to say that I would like someone to come with me to future doctor appointments to help prevent miscommunications and as an extra set of ears. I am going to say, “I think that neither of us was happy with the last visit and I would like to start over.  Then I am going to reiterate again that I would like my family doctor to taper the meds and him to do the TMS.  I am going to stick with the taper plan on here. If he continues to treat me poorly I will find another doctor.  The problem is that there are not a lot of TMS doctors and he is the only one close.  I would like to keep the TMS as an option because it did help me a lot. I don’t want to completely burn bridges with him yet until I know that I can find another TMS doctor who would be agreeable to my taper plan. 

 

That sounds like an excellent plan. Let us know how it goes. Great problem-solving. (But you are Superwoman, so of course! 🙂

Edited November 3, 2019 by Rhiannon

[Superwoman]

Rhiannon,

 

Thank you.  I will keep you all posted and  I will put on my cape during the appointment lol.

[Superwoman]

@Altostrata, maybe I could switch to tea instead of coffee?  Tea has way less caffeine then coffee.  I honestly don’t feel like I can function without at least a little caffeine in the morning.  I am like a zombie in the morning, very groggy and trouble getting going and thinking.  I also have chronic fatigue syndrome.  I do understand that caffeine is making the withdrawal and anxiety worse though. So I want to get it down to the lowest dose possible, where I can still function.  How fast would you recommend tapering the coffee?  Most nights I am sleeping well.  How far apart would you suggest that I separate the coffee and Effexor?
 

[Altostrata]

You're going to have to negotiate about caffeine with your own nervous system, not me.

[Superwoman]

@Altostrata, how would you taper the coffee to avoid caffeine withdrawal?

[Superwoman]

Since my doctor increased my Armour Thyroid meditation the depression has lessened a lot and I have a little more daytime energy. However, I notice amplified heartbeat and brain zaps after taking it. I did not notice this before the increase. 

[Superwoman]

@Altostrata, also how far apart do you suggest that I separate the coffee and Effexor?  I take Effexor in the morning so that it does not interfere with my sleep.  I have been tapping coffee by 1/2 scoop every week.  I will negotiate with my nervous system to be a little less sensitive lol. 

[Superwoman]

Well I did it!  I put on my Superwoman cape and stood up for myself. I am so proud of myself!  It is so hard to stand up to a doctor. 

[Superwoman]

I will write more about it later

[Superwoman]

Tested Omega 3 Fish oil 2 softgels at dinner- No reaction

[Superwoman]

I had an appointment with my psychiatrist today. My peer supporter came with me for support. I told him that I think neither of us was happy with the last visit and I would like to start over fresh. He was agreeable to this. I requested a written summary of the visit as my counselor suggested. He did not seem open to this and did not give me one.
 

I then firmly but calmly reiterated that I would like him to do the TMS but my family doctor to prescribe and taper the meds. He said, “I can’t be clear enough, if I do the TMS then I prescribe and taper the meds. He said that medications effect the motor threshold therefore if he does the TMS then he needs to prescribe the meds.  He made the same comment that he made last time (that I could have my family doctor taper the meds and then I can come back to him if I “crash and burn.”)

 

The Psychiatrist said that he spoke with the head pharmacist at a local hospital about taking out the beads of the capsule. The pharmacist said he has never heard of anyone doing this and that you are not supposed to divide up the beads because of something about an enteric coating.  So the psyc doc said he can not do this and that the drug companies get snarky about this.  I said that it is my body and my decision and I would be the one opening the capsules not him. The doctor said that he is treating me so if I do this and am harmed then he is responsible and could lose his license. I printed off an gave him the excerpt from the book of the doctor who developed the 10% method.  He skimmed over it quick, but I doubt he will read it. 
 

There is more to the conversation but it is late so I will finish the story tomorrow. 

 

 

[Passionlifetime]

12 hours ago, Superwoman said:

I will write more about it later

May god help you ...........

[Superwoman]

Doctor appointment continued...
 

I told the doctor that it is the beads that are time release not the capsule itself. 
 

The psychiatrist said that he can switch me to immediate release Effexor because those are a tablet that can be cut up.  I said that at some point the tablets would need to be made into a liquid in order to reduce by very small amounts.  I asked about a compounding pharmacy making a liquid. He did not seem real comfortable or open to this.
 

I then said that I would not feel comfortable abruptly switching over to immediate release. I would want to make the switch slowly by combining immediate release and extended release. The doc said “Immediate release and extended release can not be combined. We're done here.” 
 

The psyc doctor said, “You are going to do what you want to do so you should just have your family doctor do the meds because he is comfortable with it.”  He said that if I, “crash and burn” then I can come back to him and get TMS from him but then he will take over the meds while I am getting the treatment.  
 

I mostly stayed calm. But I at one point I got really mad and upset and I told him that “he should go on this - - - - and try to go off of it and then tell me how easy it is to get off of!”  I pointed out how when I told him that I was having brain zaps and it had been 6 weeks since a reduction, he said, “that is something else discontinuation syndrome only lasts 1 week.”  I said, “Why don’t you call it what it is?  It’s a drug withdrawal.”  I also said that I am p’d off because no one informed me of all the side effects and that this stuff is this hard to get off of.  
 

So I am going to have my family doctor taper me off the antidepressant. It sucks because TMS is off the table for now because I just don’t feel comfortable with this doctor managing my meds. I wanted to keep the TMS as an option because it helped me a lot. There is another TMS doctor that I am going to try. Location is an issue and I don’t know if he will be more agreeable.  Lets hope so.  
 

 

[Superwoman]

My peer supporter had the impression that he was not open to questions. She picked up on this also.  He didn’t want me to question him and he wants to be the voice of authority.  She felt that he was threatened by it.  As my peer supporter said “everyone is not going to agree with you so you need to deal with it.”  She had the impression that most patients just go along with him and don’t question him. 
 

I tend not to get along with authoritarian type doctors. I want a doctor who will partner with me. My family doctor does this and we work well together. I am not the type to blindly follow orders. I have my own mind and am used to being in control of my own health and body. 

 

My peer supporter also felt like he was not welcoming and like he didn’t want her there.  She felt that he was edgy and somewhat rude. 

 

[Superwoman]

My psychiatrist said that antidepressants do not cause withdrawal. He said that it is not a true drug withdrawal like heroine and alcohol.  It can’t kill you but you might feel like you want to die. This is a lie. People do die from withdrawal.  They sometimes commit suicide because of it. The doctor said that antidepressants do not cause withdrawal because they effect serotonin and alcohol effects GABA receptors. 
 

I asked the doctor if had heard of the recent review of drug withdrawal and dependency in Britain. He did not reply. I replied that the Royal College of Psychiatrists declared that the withdrawal from antidepressants can be severe and long lasting and they are recommending a slower taper.  I also told him that they recently also mandated in Britain that drug companies mention on the drug pamphlets that antidepressants can cause long lasting sexual dysfunction after stopping the drugs. He also said nothing to this. What can he say?  I think he knows he is lying.  He does at least acknowledge that Effexor is a hard drug to get off of. 

[Superwoman]

My peer supporter also mentioned that I like working and I don’t want to get so ill from a too fast taper that I can’t work. I mentioned how there are a lot of people on this site that are disabled and practically bed ridden from a too fast taper and that I don’t want that to happen to me. 
 

The doctor said that he has never seen anyone become disabled from going off these meds. He said that most people come off Effexor easily, but there are a small amount of people who are sensitive and have a hard time and I am one of those people. I find it hard to believe that most people have an easy time getting off this drug.  The doctor said that he has never had anyone who has had to taper by only 10% a month. He used the drug companies exact words (I forget the exact wording but something like “Discontinuation Syndrome is usually mild and transitory.”

[Superwoman]

@Altostrata,

 

What do you think about the doctors plan to abruptly switch me to immediate release Effexor tablets and cut them?  Just curious. Do you think that is a good plan or not?  Why does he say that Effexor tablets and capsules can not be combined?

 

I do see on here that people switch to immediate release at the very end. But I believe that the whole reason for doing that is because it can be made into a liquid allowing for smaller reductions (something the doctor did not seem to want me to do).  I have not seen where people switch to tablets at a high dose.  I also was concerned about taking pills twice a day.  I would have to take it at work and I would be worried about forgetting to bring the pills.  

 

[Rosabell]

I am so sorry that you had to deal with all of this at your appointment, but glad that you at least had a support worker there with you.

it is so hard to convince doctors sometimes, they think we are all full of it and are just being hysterical.

When we are in a state of hyper awareness of everything already, a non-sympathetic doctor can make things so much worse, it is just a shame that he cannot see past his own “always right” mentality to do what is right for his patient.

[Superwoman]

Thank you Rosabell. I feel much more comfortable having my family doctor taper me and I am proud of myself for standing up for myself. The psyc doc was causing me a lot of anxiety.  You should post the contact information of your withdrawal friendly family doctor. There is a place to do that on here. It is so hard to find a good doctor. My family doctor is retiring in a few years and not taking new patients. 

[Superwoman]

I tried taking a probiotic capsule and had anxiety immediately following.  Today I got a bottle of a liquid probiotic from the Health Food Store so I can slowly work up to a higher dose.  I took 1/4 tsp. I did not have any problem with it.  1 hour later I did  have some heartburn. I don’t know if this was related or not because I have heartburn every day. 

[Passionlifetime]

10 hours ago, Superwoman said:

My psychiatrist said that antidepressants do not cause withdrawal. He said that it is not a true drug withdrawal like heroine and alcohol.  It can’t kill you but you might feel like you want to die. This is a lie. People do die from withdrawal.  They sometimes commit suicide because of it. The doctor said that antidepressants do not cause withdrawal because they effect serotonin and alcohol effects GABA receptors. 
 

I asked the doctor if had heard of the recent review of drug withdrawal and dependency in Britain. He did not reply. I replied that the Royal College of Psychiatrists declared that the withdrawal from antidepressants can be severe and long lasting and they are recommending a slower taper.  I also told him that they recently also mandated in Britain that drug companies mention on the drug pamphlets that antidepressants can cause long lasting sexual dysfunction after stopping the drugs. He also said nothing to this. What can he say?  I think he knows he is lying.  He does at least acknowledge that Effexor is a hard drug to get off of. 

 

My psychiatrist said the same things, I asked him

Why all this shivering of anxiety when I dont have any tension in mind and I am relaxed?

he said that its relapse

 

I asked about high fatigue?

relapse

 

about all sysmptoms?

relapse

 

I said but I dont have this shivering 8 yrs back when I first come to you and also I dont have this much fatigue?

he said that you had and he remember.

 

I asked reuptake is a natural process and these medications stopping it , does this not cause any adverse effects?

He asked me "what is the effect?"

I said you are the doc you should know.

he replied that risk harm dose of effexor is 225mg a day and more than that will may  have side effects.

 

I asked him about pooped out concept and show him evidence with my med history that with all the stressors my doses increased and had not worked.what will you do when this 225mg effexor max out?

he replied its a myth and it will not happen.

 

I asked him what are my limitations if I ll be on this med foreever, specifically to choose my career path, does this med have any effect on my intelligence?

He said not at all.

 

I asked him XR is once a day dosing why you giving me twice a day?

He said you can take once a day and but some people have gastro issues so we divided meds.

 

I asked him I cant stop ever ?

he said we will try after you sort out your things totally and then we will see to stop it over 3 months.

I said its impossible in 3 months I know now.

he said than we will take 6.

I told him about 10% taper.

he said its a myth.

 

 

I asked him about sexual issues and informed him that I dont have any desires left like previous just 5% remains may be,How will you handle this issue?

He did not reply this.

 

I just went to him to clear some doubts and gain more clarity but I find that docs also know very limited and they go by research.

my fatigue is very low now and I am still in my room just trying to go out.I dont have will to live remains, its just for my mother I have little remains.

 

I had a dream to get married. I am a religious guy, never had gf even. Now 3 things required for marriage I think, love sex and daily support.  I have lost first two and only for third I dont want to get married at all.

 

Do life have any enjoy left after 30 yr of age or is it just because of meds or is it just me thinking like this?

 

 

 

[Superwoman]

@Passionlifetime, Great questions. Your mind is still sharp despite withdrawal.  Was he receptive to your questions or was he annoyed?  Often doctors have a “You don’t question me type attitude.”  They don’t like when people ask intelligent questions because they don’t have the answers. Their big egos just can’t handle that. Well, I don’t need to be a doctor to diagnose my prior psychiatrist with Superiority Complex. 

[Superwoman]

6 hours ago, Passionlifetime said:

My psychiatrist said the same things, I asked him

Why all this shivering of anxiety when I dont have any tension in mind and I am relaxed?

he said that its relapse

 

I asked about high fatigue?

relapse

 

about all sysmptoms?

relapse

Of course......According to doctors EVERYTHING under the sun is a relapse. 

[Superwoman]

8 hours ago, Passionlifetime said:

 

I asked him about pooped out concept and show him evidence with my med history that with all the stressors my doses increased and had not worked.what will you do when this 225mg effexor max out?

he replied its a myth and it will not happen.

A myth?  Whhaaatt?  According to your doctor everything is a myth it sounds like. One of my previous doctors admitted that the drugs pooped out after 5 to 8 years. Then you have to increase the dose or switch. Of course he said it’s not a tolerance. Yeah right.  Okay doctors you can just call it “poop out” if you want.  Such a scientific term (sarcasm).  If you were to stay on the drug you would max out eventually and then have to switch to another drug at an equivalent dose.  Then after another 5 to 8 years that drug poops out. Now another drug with the same or different side effects.  It is a continuing downward spiral of more drugs, and more side effects for life.  Sorry to sound pessimistic. But this is the truth of staying on drugs for life and your doctor should be upfront about this.  I saw this as my own future if I stay on drugs for life. I decided that I don’t want this future for myself and that is why I decided to get off of these drugs. 

[Altostrata]

17 hours ago, Superwoman said:

@Altostrata,

 

What do you think about the doctors plan to abruptly switch me to immediate release Effexor tablets and cut them?  Just curious. Do you think that is a good plan or not?  Why does he say that Effexor tablets and capsules can not be combined?

 

I do see on here that people switch to immediate release at the very end. But I believe that the whole reason for doing that is because it can be made into a liquid allowing for smaller reductions (something the doctor did not seem to want me to do).  I have not seen where people switch to tablets at a high dose.  I also was concerned about taking pills twice a day.  I would have to take it at work and I would be worried about forgetting to bring the pills.  

 

 

Superwoman, that psychiatrist knows nothing about tapering and withdrawal syndrome and is punting regarding switching to immediate-release Effexor. There is no need to do that if bead-counting is working for you.

 

He doesn't want to give you TMS without having control of your drugs. You'll have to give up that expectation and move on. You don't need him on your payroll. Maybe go back for TMS later.

[Rhiannon]

14 hours ago, Superwoman said:

I tried taking a probiotic capsule and had anxiety immediately following.  Today I got a bottle of a liquid probiotic from the Health Food Store so I can slowly work up to a higher dose.  I took 1/4 tsp. I did not have any problem with it.  1 hour later I did  have some heartburn. I don’t know if this was related or not because I have heartburn every day. 

SW I have heard that taking probiotics can aggravate SIBO if that's an issue for you. (Heartburn is a symptom of SIBO.)  I cut mine back from daily to once a week, I think it's helped.

[Superwoman]

@Rhiannon, I don’t have SIBO as far as I know. It might have been one of the things I was tested for. I’m not sure. I have a hiatal hernia that causes me acid reflux in addition to multiple food allergies.  I used to have candida and had to be on a horrible extremely low carb diet plus an antifungal.  It was a struggle to get my gut bacteria back in balance.  I want to take a probiotic because I don’t want the candida to come back again. I got a liquid probiotic so that I can slowly increase it.  I am reacting to everything.

[Superwoman]

9 hours ago, Altostrata said:

 

Superwoman, that psychiatrist knows nothing about tapering and withdrawal syndrome and is punting regarding switching to immediate-release Effexor. There is no need to do that if bead-counting is working for you.

 

He doesn't want to give you TMS without having control of your drugs. You'll have to give up that expectation and move on. You don't need him on your payroll. Maybe go back for TMS later.

I don’t need to get TMS at the moment anyway.  I am stable as far as the depression goes.  I feel much more comfortable with my family doctor handling the meds anyway. I am going to set up an appointment with another TMS doctor. It is not ideal location wise. But I would rather take off work and have good care. 
 

I am not currently counting beads because I have not started to taper yet. I plan to use the bead counting method when I do start to taper. When do you think I might be ready to start tapering?  I would think that counting beads would actually be more precise and better than cutting tablets. 

[Superwoman]

My sister told me that I am bad *** and may be her hero for walking into a factory that makes Effexor and asking them questions about withdrawal and my medication. She said that is the most amazing thing she has heard in a long time.  My sister is a counselor. She said that the drug companies are so corrupt and the drug companies are doing the same thing with the antidepressants like they did with the opioids. 

[Passionlifetime]

I am living dead. I just want to die. Extremely sad.

[Passionlifetime]

15 hours ago, Superwoman said:

don’t like when people ask intelligent questions because they don’t have the answers. T

I find this exactly that they don't have all the answers and this makes me more hopeless. 

[Passionlifetime]

53 minutes ago, Superwoman said:

walking into a factory that makes Effexor and asking them questions about withdrawal and my medication. She

You really did this. What u find there? 

 

[Altostrata]

What factory is this?

 

Please post your daily drug and symptom notes.

[Superwoman]

@Altostrata,

 

The factory was Teva in Cincinnati, Ohio.  My psychiatrist was not down with me opening the capsules and tapering by removing beads myself. So I suggested to him having a compounding pharmacist prepare the medication for me.  I called my local compounding pharmacy and spoke with the pharmacist.  The pharmacist called the Effexor drug manufacture to find out some basic information about the drug that he needed to know in order to compound my drug.  Unfortunately the drug manufacturer either could not or would not answer his questions. The woman he spoke with simply read from the medication leaflet. The pharmacist said that he runs into this all of the time.  He said that occasionally he gets someone who will tell him something, but they usually are very limited in what they will say.  The pharmacist said that he could not compound the prescription without this information. 
 

Anyway, I was on vacation worrying and obsessively researching about this instead of enjoying my vacation. It just so turned out that the Teva factory happened to be located in Cincinnati, right by where I was driving through. So we stopped by the factory. I put on my Superwoman cape. Then I walked in and asked to speak with a pharmacologist or chemist so I could get answers to the pharmacist’s questions. I figured maybe I would have more luck getting some answers if I talked to someone like this versus a customer service person that just reads from a script. 

Oh my God!  You would think I was asking for the nuclear launch codes. I thought they might arrest us!  What was my crime you might ask?  Asking intelligent questions and looking for answers. One woman said, “You don’t come in here and ask questions. You call the customer service number.”  I explained that my pharmacist already tried that and they were extremely unhelpful.  I said that they were very unhelpful here as well.  I then pointed out that they had a sign on the door that read “visitors.”  I asked why do you have this sign if you don’t want visitors?  Then she said, “You can leave now!”  
 

I told my sister I would post this experience here and maybe I can start a movement. We can all walk into the drug companies and ask intelligent questions and demand answers!  Expect to be dragged out in handcuffs though.  Big Pharm is just like a lot of doctors. They don’t like to be questioned. 

@Passionlifetime,

 

Can you find a withdrawal friendly psychiatrist?

[Passionlifetime]

20 minutes ago, Superwoman said:

Can you find a withdrawal friendly psychiatrist?

No. 

 

How old are you?whats ur profession?

[Altostrata]

Very amusing story.

 

You're making this more complicated than it needs to be. Since few psychiatrists know anything about tapering drugs, few are going to approve opening the capsules and removing beads.

 

If I were you, I'd continue to get my Effexor XR prescription refills from the doctor and customize my own dose at home. You do not have to discuss tapering with a psychiatrist who doesn't get it. Why are you even paying this doctor? Any doctor, including GPs, can write the prescription.

 

Just about everyone here tapering Effexor XR is tapering by the bead-counting method. Here's a psychiatrist tapering off a similar drug, Cymbalta, himself: https://journals.sagepub.com/doi/10.1177/2045125319884834