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Lb11

Lb11: Effexor and Prozac

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Lynnardgirl
2 hours ago, Altostrata said:

Nobody said anything about serotonin syndrome.

 

 

 

The sensation you call "depression" and then enlarge upon it by worrying about it is likely a normal effect of taking antidepressants. Your occasional drinking probably exacerbates the adverse drug effects.

 

This is a site for going off drugs. We do not treat "depression". If you think you need drugs for depression, continue to see that psychiatrist. If you want help reducing or minimizing your drugs, we can answer your questions.

 

It could possibly be (I personally think that it is highly likely) serotonin syndrome from taking both Effexor and Prozac.  The only way to treat this is to reduce the drugs.  It is best to only reduce one drug at a time
From one of the Moderators! Above 

She is just sacred and  wants to know if she does do the bridge if that would be better ! 
she never had depression before the drugs ! 
She stop doing the bridge because everyone told her to wait until she stabilized 

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Lb11

yes someone did mention serotonin syndrome in the previous comments. I was never depressed before I began effexor and since I cut back I’ve been really depressed. I bridged and added Prozac and was going to taper the effexor after I stabilized but since I have not stabilized I’m wondering if I need to go up on the Prozac and then maybe I’ll stabilize and taper? I know no one knows exact answers. I am just very unsure and ultimately I would love to be off all of this medication. I’m not happy about bumping the dosage but I’m just trying to figure out the best and safest way I can stabilize and finally get off of this stuff 

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Altostrata

I believe I already covered this:

 

On 10/27/2019 at 10:00 AM, Altostrata said:

I agree with Erell, even a small, very normal amount of alcohol will trigger an upset in a person whose nervous system has been sensitized by withdrawal.

 

If you don't drink alcohol -- not even a little bit -- my guess is you'll stabilize from the Effexor reduction without complications. It could be that adding the Prozac was unnecessary.

 

That leaves you on this Effexor-Prozac combination. Here are your choices:

 

- Effexor can be difficult to taper, doctors often substitute Prozac because it's somewhat easier to taper. (But your doctor forgot to get you off Effexor.)

 

- Generally, doctors should never prescribe an SNRI, such as Effexor, with an SSRI, such as Prozac, the combination can be too stimulating. So taking the two drugs together is probably not a good long-term plan. Besides, you're not seeing any benefit from the combination.

 

- You've been taking Prozac for less than a month, your risk of withdrawal from that is theoretically lower. Theoretically, you could gradually go off Prozac over a few weeks, then taper Effexor more slowly using bead-counting Tips for tapering off Effexor (venlafaxine)

 

BUT, you might find backing out of Prozac is not that easy, your nervous system has become accustomed to it.

 

- However, you might want to complete the switch to Prozac to go off Effexor, then taper Prozac. Tips for tapering off Prozac (fluoxetine) This means a fast taper off Effexor. Again, you may find this difficult even if you're taking Prozac.

 

I cannot predict the best route for you. What you need to do for now is not drink at all or do anything else that will rock the boat for a week, let your nervous system settle down. Keep daily notes of when you take your drugs, their dosages, and your symptom pattern in this format Keep daily notes of drug schedule and symptoms to track patterns and progress

 

Please let us know how you're doing.

 

You may notice that the option of increasing Prozac was not included. This is because if you are having an adverse reaction (short of serotonin syndrome) from the Prozac-Effexor combination, increasing Prozac could make it worse. That would be the opposite of stabilizing.

 

If your "depression" occurred after you started Effexor, it is a reasonable assumption it was caused by Effexor (possibly in combination with alcohol). If it's gotten worse as you've gone up and down with your drugs, you can assume going up and down with your drugs (and possibly alcohol) has upset your nervous system further.

 

I asked for your daily symptom pattern 7 months ago to see if your symptoms were caused by the drugs. Still have not seen your daily symptom pattern. I can't tell if Effexor is causing problems or Prozac is causing problems. I have nothing to add until I see that daily symptom pattern.

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Lb11

@Altostrata @ChessieCat

Night before tossed and turned. Slept from 11pm -8:30 am

6/16

8:30 am woke up anxious 

Felt some anxiety before meds. Not too bad

9-10:30 felt ok, ate breakfast 

10:40 took Prozac 10mg effexor 37.5 mg

12-3 little anxiety 

3:30-5:30 bad anxiety

6-8 pm felt depressed 

8:30 -10:30 Some anxiety but not as bad- seem to calm down more at night and feel better

 

11:30 pm  slept good 11:30- 9am

6/17 woke anxious and depressed 9 am

10 am calming down some eating breakfast 
10:35 took both meds 

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Altostrata

In my opinion, one or both of those drugs is causing anxiety in the afternoon. Which do you want to taper?

 

As I said before, Effexor tends to be activating, but Prozac can be too. If I were you, I would go off Effexor first, completing your switch to Prozac, which would probably be easier to taper off later.

 

We don't treat "depression" here, you'll have to cope with that as you get your drugs straightened out. My guess is it's caused by some life circumstance you might work with a psychotherapist to change.

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Lb11

So you don’t think the “depression” is due to withdrawals? Like I said I never have had depression until as soon as I changed my dosage. I am currently on 20 mg of Prozac since June 17 and 37.5 of effexor still. So do you think it would be good to taper effexor?  

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ChessieCat

You've been taking both Effexor and Prozac since September last year.

 

Q:  Did the "depression" start after starting the Prozac at 10mg or after you increased the dose to 20mg?

 

It may be related to taking 2 antidepressants.

 

Please update your drug signature with the date and dose for 20mg Prozac.

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Lb11

Ok, I just updated it. And no the depression was before Prozac at all. The depression began 3 days after I cut my effexor dose in half and I’ve had the depression ever since. I only added Prozac hoping it would give some relief but it hasn’t much. The depression comes and goes randomly. And seems to without reason 

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Altostrata
17 hours ago, Lb11 said:

Ok, I just updated it. And no the depression was before Prozac at all. The depression began 3 days after I cut my effexor dose in half and I’ve had the depression ever since. I only added Prozac hoping it would give some relief but it hasn’t much. The depression comes and goes randomly. And seems to without reason 

 

Yes, this sounds like a withdrawal symptom. Can you describe this "depression" in more detail?

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Lb11

The “depression” feels like I will be fine then out of nowhere I’ll just start to feel really really upset and unhappy- kind of emotional too and sometimes I can pull myself out of it sometimes I can’t. It’ll happen randomly during the day even at times when there’s nothing to be upset about. I’ll start to feel worked up and I just feel really miserable. Then it’ll go away and I feel fine again. Sometimes it’s kinda like a mood swing almost. But then I’ll have days where it doesn’t happen at all. It’s very random and only started when I changed my dosage 

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Altostrata

That sounds like a drug-related symptom. Does it feel like a surge? Does it happen at any particular times of day? How did your symptom pattern change after you increased Prozac to 20mg in June?

 

You are still taking a combination of antidepressants that is not recommended.

 

Do you take any other drugs? Drink caffeine? What is your drug schedule, with times and dosages?

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Lb11

No I don’t not take any other drugs. Yes I drink coffee every morning. I take my meds at different times depending on if I’m working that day or not.  I work 3 days a week so those days I take both meds (Prozac 20mg and Effexor 37.5mg) at 6:40 a.m.  the four days a week I’m off I take both meds around 9-10 after I’ve woken up and ate breakfast. And I guess it can slowly feel it start happening then it’s like a surge. Just hits me and I feel miserable. Usually it takes a couple hours after I wake up to start feeling bad. Most mornings I wake up feeling fine. Maybe 5 Hours after I take meds I feel bad. But like I said, it varies. Sometimes I have a good day and don’t feel bad at all. Sometimes I feel bad most of the day. But it usually does hit like a surge I guess out of nowhere. Feels overwhelming. And I know I am taking two meds not recommended together but honestly I am very afraid what to do next to get off of one. I am afraid it will get even worse if I try to taper again. But I know I need to get off. I just don’t know the safest way. I swear I know I was never anything like this even a year ago. Never even slightly struggled with depression and was a happy person now I feel crazy honestly 

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Artistic1

@Lb11 Hi. I've been reading your thread. I know the fear about tapering and the fear of not knowing how you will feel when you do. That fear is stopping you from taking the first step. You cannot possibly predict what will happen. What if you feel a whole lot better? That could happen, too. I was scared, too, but I just decided I wanted off the Zoloft and back to my normal life. You want that, too, and the only way to get there is to take the first step.

 

If you are prepared with the knowledge that yes, you may have some side effects, but also the knowledge that they don't last forever, then you can do it. Coping skills with therapy can really help, and your psychiatrist should be able to help you find the right therapy. I couldn't be doing my taper without Cognitive Behavioral Therapy. 

 

Stop thinking about the depression coming and going. Now that you know you have a cycle of those, you can get through them when they happen. I know my cycles, and after months of dealing with them, I know how to ride them out. I don't like them, but I've stopped fearing them.

 

Your psychiatrist has already recommended you start a taper with Effexor. GO FOR IT! But do it slowly until you know your reactions to the reductions. All the information you need to do it is on this group. FYI:  I do a 10% taper as recommended on this site. I don't do it all at once....I lower my dose slowly over 2 weeks. Then I hold that dose for 7-8 weeks. This allows my body plenty of time to adjust and heal. If you start really slowly, your body will tell you what you can handle. Then you can make adjustments.

 

Best of luck.

 

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Lb11

Thank you. I needed that encouragement. I do think I should go ahead and start tapering effexor. I want to do it very very slowly at first like you said and make sure I’m taking enough time. I do think I’ll feel much better one day off this drug 

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Altostrata
58 minutes ago, Lb11 said:

I take my meds at different times depending on if I’m working that day or not.

 

This is not a good idea! It may very well be what's causing your symptoms, particularly the variation in Effexor schedule. Why did you increase Prozac in June?

 

Please take your drugs at the same times each day. If I were you, I'd take the Effexor first, to see what it does, and take Prozac several hours later. Taking them together also confounds your symptom pattern. Separating them will allow you to understand what's happening as you reduce Effexor.

 

Please stay on schedule for a week before starting to reduce Effexor. Please let us know how you're doing in that week.

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Lb11

Okay I will start taking meds at the same time every day. And I will try to start separating when i take them too

Do you think it’s okay if I still have caffeine?

also I was thinking you were asking about antidepressants if I was taking any more drugs but I also take Prilosec- for heart burn and also take birth control

dont know if that matters but i was gonna add if it does 

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Lb11

Also do you think I am not stabilizing since I’m on both Prozac and Effexor? Or just still withdrawals 

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Lb11

I added more Prozac to see if it would relieve the depression.

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Altostrata

I cannot answer questions without context. I need to know your drug schedule for the last week. When did you make changes? List each day on a line.

 

Also, if I were you, I'd stop fiddling with the drugs. When I said keep to the same drug schedule and dosage each day, that's what I meant. It can take at least a week for any drug change to take full effect. With Prozac, it's several weeks. You might have increased Prozac unnecessarily.

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Lb11

Since last Saturday 8/1 I have taken both medicines (Prozac and effexor) at 10 am everyday. I have had a slight window for 2-3 days this week but started feeling some depression again yesterday and today. I would take one med later than the other but at work I am very busy and don’t think I could find time to effectively do this. Im running around all day at work and doing different things at different times. But I make sure to find time to take at 10 each day 

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