FindRest: 30+ Years on ADs. Effexor to Pristiq. Now what?

[FindRest]

@Altostrata Immediately after the egd, they told us that from the way it looked they anticipated a Barrett’s diagnosis. When the results came back, it was not Barrett’s but some other pre-cursor to Barrett’s (can’t remember the name right now). I also had benign growths in my stomach, along with a previously diagnosed hiatal hernia. Two siblings have Barrett’s. My youngest brother has it covering 100% of his esophagus and is down to basically a liquid/very soft diet. I know this doesn’t mean mine will turn into this. It’s just something I have to be aware of. I was in severe pain last November when I was prescribed the 40mg omeprozole (the 20mg wasn’t helping much). 
 

17 minutes ago, Altostrata said:

Are your digestion troubles associated with any particular foods? Dairy products are a common culprit, also spicy foods and food additives.

 

I have cut out some things I thought might be contributing.  I agree that dairy and spicy food are not good, nor is anything that is tomato-based. A Few years ago, I got a bed that the head and feet can be raised/lowered. I raise the head every night to help with the reflux. That alone has helped a lot. 
 

All of my symptoms were pretty manageable without PPI’s until the AD merry-go-round that began last spring. Starting/stopping so many in a short time just tore my gut up.

[Altostrata]

7 hours ago, FindRest said:

....

 

Day 5: Feb 5,2020:

• 9:30am  Sinuses clogged, mild tinnitus, mild electrical zapping in left leg, low anxiety, neck ache. Synthroid 125mcg. 
• 10:30a.  Effexor XR (14 large beads).  Mild tinnitus.  BP:118/73  HR:94 
• 12:00p.  Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray.  Tinnitus, bit more anxious, buzzing/zapping from left knee to foot.  BP:132/76. HR:92
• 1:00p.    Arms a bit shaky. Mild anxiety. Tinnitus continues. 
• 3:45p.    Mild tinnitus. Shakiness in arms. Mild brain fog off/on. Sadness, with brief thoughts of wishing God would take me now. Back/neck ache. 1 Tylenol, Omeprozole 20mg. BP:137/82  HR:86
• 5:15p.    Loud tinnitus.
• 6:00p.    Loud tinnitus continues. Brief palpitations, numbing/tingling in left hand (but better since chiropractor!). 
• 7:00p.    Mild, brief buzzing/zapping in left hand. Tinnitus loud. BP:135/82  HR:91
• 9:30p.    Tinnitus, mid-back ache. Neck better. Brief wave of chills.  Cetirizine 10mg and capful Miralax. 
• 10:00p.  Tonight has been lots better than this afternoon and much better than yesterday evening! PTL! Mild tinnitus.
• 11:00p.  Arm tremors in both arms upon exertion. Mild neck and back ache. Mild weakness in left arm. Tinnitus.
• 12:30a.  Loud tinnitus. Mild/brief zapping in left leg.
• 1:30a.    Almost fainted after stretching to touch my toes. Had to go down to floor w head between legs and wait awhile. This is new. Will get up slower next time! Palpitations. Brief zap in left foot. Tinnitus. Also wondering if I have a UTI coming on.  Ambien 10mg, clonazepam .125mg. BP:138/83  HR:75  Bed.

 

 

For the time being, I'd rely on your doctor's advice regarding incipient Barrett's.

 

It may take some time for your symptom pattern to settle down. You may experience The Windows and Waves Pattern of Stabilization

 

Here is your new interactions report, with Effexor substituted for Pristiq. Please read it and print it out for discussion with your doctor:

 

https://www.drugs.com/interactions-check.php?drug_list=2333-1544,1463-869,2360-381,703-0,1750-0,1066-0,1893-1224,2418-0,569-0,646-5790,2296-0

 

Note the interaction of venlafaxine with famotidine. Omeprazole may be better in this regard.

 

Do you need to continue Miralax? Can you reduce the dosage? Are you watching your magnesium and potassium levels? These are very important. Low levels may cause serious symptoms.

[FindRest]

@Altostrata, I didn’t even think of running a new interactions report! Thank you for doing that.

 

Wow, the interaction symptoms between the Effexor and Miralax is remarkable regarding the symptoms I’ve been having! I had the symptoms once I started the Pristiq and find it interesting that it’s not listed as an interaction with it as well. I know they are metabolized differently, but I just find this interesting. 

 

2 hours ago, Altostrata said:

Note the interaction of venlafaxine with famotidine. Omeprazole may be better in this regard.

 

Do you need to continue Miralax? Can you reduce the dosage? Are you watching your magnesium and potassium levels? These are very important. Low levels may cause serious symptoms.

After reading the interactions, I wonder why on earth they aren’t checking all of these levels! They do check potassium, but it’s only once or twice a year. 

I’ll try to reduce the Miralax. I have to stay on it, unfortunately, for the unforeseeable future since my intestines were compromised by the SBO/adhesions/and bowel surgery. Another factor is that Mayo Clinic put me on a low fiber diet as my intestines can’t move things properly. Just writing all of this can bring me down...my body is such a mess! But, there are far worse alternatives. 
 

A month ago, I tried to introduce the smallest mg magnesium glycinate I could find once again, and still couldn’t tolerate it very well (caused increased anxiety). I then opened a capsule and poured 1/4 of it in applesauce. Still got a bit of anxiety so I stopped it. The 1/4th wasn’t too bad but it noticeably increased the anxiety...or it was just coincidence, but I didn’t want to take chances. I have been trying to eat foods that are higher in both magnesium and potassium, but I’m sure I’m probably low in both. I will pay more attention to that. Ironically, tonight I took my very first Epsom salts bath before I even saw your question. I only used about 3/4 cup, so was conservative...I think. I also have Pedialyte Advanced Care in the fridge. 
 

Alto, thank you for pointing all of this out to me. I value your help and take it seriously. I’m learning so much. The best feeling, however, is knowing I’m not going through this alone and I have you and the rest of the community to help me. What you all do here is invaluable. Thank you so very much.

[FindRest]

Today begins day 7! Although I’ve had some annoying symptoms since switching to Effexor, I cannot complain at all. They are not nearly as bad as I expected and, frankly, I went through far worse last summer/fall during the drug merry-go-round. I also know this can change at a moment’s notice. I think this is what’s so hard about coming off these drugs...worrying that the worst is right around the corner and will bite you just when you start to get hopeful. Writing down a symptom timeline on paper, as recommended here at SA, has helped a lot. When a tough hour comes along, I can look back to just hours before and prove to myself that this wave did not define my day. 
 

Day 6 was pretty good, but this tinnitus has got to go! I’m hoping that it getting louder is an indication that my cns is working hard to heal. 

 

Day 6: Feb 6, 2020:

• 10:30am  Mild tinnitus, low anxiety, neck ache. Synthroid 125mcg. Effexor XR (14 large beads).  BP:108/75  HR:105
• 11:15a.   Zap down right foot. Tinnitus continues.
• 11:45a.   Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray.  Tinnitus, pelvic pain. 
• 1:00p.    Arms a bit shaky. Mild anxiety. Tinnitus continues. 
• 3:00p.    Mild tinnitus. Brief zap/buzzing right hand. Omeprozole 20mg. 
• 4:00p.    Low backache, reflux, sinus pressure, tinnitus increasing. BP:131/76 HR:78
• 6:00p.    Zap/buzzing in left foot, itchy scalp, itchy right eye, runny nose, right leg falling asleep, mild tinnitus. 
• 7:00p.    Jaw clenching + tooth pain. Tinnitus loud. BP:128/79 HR:90
• 8:00p.     Lots of buzzing/zapping in left foot (almost pulsating), loud tinnitus.
• 9:00p.     Loud tinnitus. Cetirizine 10mg and capful Miralax.
• 9:30p.     Epsom Salt bath, lightheaded upon standing from bending over, brief palpitations in chest, ears hurt and stuffy, tinnitus continues. Netipot. 
• 11:00p.   Arms a bit shaky, especially on exertion. 
• 11:45p.   Palpitations at base of throat then ear ringing begins immediately. Tinnitus loud.
• 2:00a.     Stayed up too late!  Note to self: Left arm weakness has been MUCH better today! Also, focused on drinking more water today. Tinnitus continues. Ambien 10mg, clonazepam .125mg. BP:139/82. HR:89  Bed.

[Andie]

4 hours ago, FindRest said:

Day 6 was pretty good, but this tinnitus has got to go! I’m hoping that it getting louder is an indication that my cns is working hard to heal. 

 

I feel pretty good too, and I’ve also got tinnitus that is getting louder. It sounds like a high pitched vacuum cleaner and it’s worse in my left ear than my right.

 

I feel you! Aargh it’s so annoying!  

[FindRest]

@Andie I’m glad things are going better for you! Sorry you still have the tinnitus. Did you have it at all when you were taking just the Pristiq? That’s when mine started...when I started Pristiq. But, the “tone” has changed since I’m off the Pristiq. On, it sounded like a constant hiss/buzz, sometimes loud but mostly mild to medium. Now, the pitch is high like yours, and more like a constant ringing. I hope that since we’re both experiencing this that it’s a good sign. I just try to tell myself that it’s proof my cns is working to repair itself (that’s what I choose to believe anyway). Mine started in my right ear, then both started up.

 

I’ve been telling Alexa, “Alexa, play white noise.”  It helps.

[Altostrata]

4 hours ago, FindRest said:

• 3:00p.    Mild tinnitus. Brief zap/buzzing right hand. Omeprozole 20mg. 
• 4:00p.    Low backache, reflux, sinus pressure, tinnitus increasing. BP:131/76 HR:78

 

It appears something happens after you take omeprazole. Can you take it with the batch of drugs at 9 p.m.? I would move it later in the day by a couple of hours at a time.

 

What other annoying symptoms have started with Effexor?

 

Why is it you're taking fluticasone and cetirizine?

[Andie]

4 minutes ago, FindRest said:

@Andie I’m glad things are going better for you! Sorry you still have the tinnitus. Did you have it at all when you were taking just the Pristiq? That’s when mine started...when I started Pristiq. But, the “tone” has changed since I’m off the Pristiq. On, it sounded like a constant hiss/buzz, sometimes loud but mostly mild to medium. Now, the pitch is high like yours, and more like a constant ringing. I hope that since we’re both experiencing this that it’s a good sign. I just try to tell myself that it’s proof my cns is working to repair itself (that’s what I choose to believe anyway). Mine started in my right ear, then both started up.

 

I’ve been telling Alexa, “Alexa, play white noise.”  It helps.

It’s only come on since the switching, so I’m thinking it’s the removal of the Pristiq. 

 

Thanks for the white noise tip. It’s so jarring in the morning in the morning, I might try leaving the white noise on before I go to bed. 

[FindRest]

@Altostrata, I will do that tomorrow. We’ll see! 
 

I take fluticasone and cetirizine (per ent’s order) due to rhinitis, chronic ear infections, deviated septum, and Eustachian tube disorder. The combo has decreased the number of ear infections dramatically. I did think about reducing them, however, I didn’t want to change up anything that might destabilize my system more. I also didn’t want to risk an ear infection and need antibiotics in the middle of tapering.  
 

If I were to reduce one of them, does one stick out to you more than the other of where I should start? I could start with spraying the fluticasone in one nostril rather than both (one side is always worse than the other). The other thing I could try is going back to loratidine instead of the cetirizine.  I used to take that but they switched it to cetirizine to try and get the ear infections under control. I see in the interactions checker that it would have far less interactions than cetirizine.

[FindRest]

15 minutes ago, Andie said:

Thanks for the white noise tip. It’s so jarring in the morning in the morning, I might try leaving the white noise on before I go to bed. 

You can also try “brown noise” and “pink noise” with Alexa. There are also several different apps, and YouTube, that have a variety of continuous play sounds for tinnitus. 

[Altostrata]

In terms of drug interactions,  cetirizine might cause more problems than fluticasone. You would need to taper it or you could get rebound itching.

 

You need to be more consistent in your drug schedule. Variations of an hour or two here and there may be causing some of your symptoms, such as faintness and palpitations prior to your nightly benzo and Ambien.

 

Please take your drugs on a more consistent schedule and gradually move omeprazole to later in the evening so we can see what it's doing.

[FindRest]

1 hour ago, Altostrata said:

You need to be more consistent in your drug schedule. Variations of an hour or two here and there may be causing some of your symptoms, such as faintness and palpitations prior to your nightly benzo and Ambien.

and here I thought I was doing so good with that.     I’ll have to go back and review.

[FindRest]

Today is day 8!  This morning started out a bit rocky but improved quickly and I am feeling good now. I woke up about 6:30am with the soles of my feet burning and itching, along with some anxiety. By 8am, the itching had gone away but the anxiety was still there. However...get ready...the tinnitus was gone!!! It returned later this morning (mild), but surely this has to be a good sign!

 

Yesterday went pretty well. The tinnitus was better than the day before and I didn’t notice any numbness/tingling in my arms at all! During the evening, I began to have more itching than I’ve had before (which only began after the switch to Effexor). I’m assuming this is WDs from the Pristiq along with the small dose of Effexor.

 

Today, I will move the omeprozole from 3pm to 5pm per alto’s suggestion. I have also read up on tapering the cetirizine but probably will wait to do that until I’m sure things are stable with the Effexor dose. That way, it would be easier to distinguish the cause of any symptoms.  Unless, of course, my current itchiness is being caused by the cetirizine. 
 

Yesterday,  Day 7: Feb 7, 2020:

• 9:30am.  Synthroid 125mcg. No tinnitus!!
• 10:30a.  Bit of ruminating, Mild tinnitus. Effexor XR (14 large beads).  
• 11:00a.  BP:124/77  HR:90
• 11:45a.  Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray.  Used SAD light, mild tinnitus.
• 12:45p.  Tinnitus better.
• 2:00p.    Tinnitus/ringing mild. 
• 3:30p.    No tinnitus!  Omeprozole 20mg.  BP:129/76  HR:74
• 3:45p.    Tinnitus/ringing is back.
• 4:15p.    Low backache, Buzzing/zap in left foot, tinnitus increasing. BP:131/76 HR:78
• 5:00p.    Sprinkled a small amount of magnesium glycinate (~17mg) into applesauce, tinnitus (medium)
• 6:00p.    Palpitations at base of throat. Tinnitus continues. 
• 7:30p.    Brief wave of anxiety. Tinnitus better. 
• 8:30p.    Loud tinnitus.
• 9:00p.    Mild tinnitus . Cetirizine 10mg and 4 tsp. Miralax.  BP:141/76  HR:75
• 9:40p.    Jittery arms and head.
• 10:30p.   Scalp and face itching. Tinnitus better.
• 11:00p.   Right ear hot and burning, tinnitus.
• 1:00a.     Mild itching on scalp, face, and back. Mild tinnitus. Note to self: Tinnitus better today and no pins/needles in arms today. Ambien 10mg, clonazepam .125mg. BP:143/80  HR:80  Bed.

[Altostrata]

Seems like you're stabilizing. Please take notes of the itching in your daily notes.

 

Have you accidentally skipped any doses of cetirizine lately? Reduced the dosage? Changed your soap or shampoo?

[FindRest]

1 hour ago, Altostrata said:

Seems like you're stabilizing. Please take notes of the itching in your daily notes.

 

Have you accidentally skipped any doses of cetirizine lately? Reduced the dosage? Changed your soap or shampoo?

No skipped doses of certirizine and the same dosage every day.  You know, I was going to say I used the same soap, shampoo, and laundry detergent for years now, all of them being the “sensitive skin” versions. But, two nights ago,  I 1) took my first Epsom Salt bath (using 3/4 cup), and 2) I used a travel-sized “sensitive skin” bath wash for the first time (haven’t used it since).  Neither one caused itching the night of. Would the itching start 24 hours afterwards? Looking at my symptom notes, I was having some mild itching before the bath, and days before that. My guess is that my body is just adjusting to the change up of ADs??

[Altostrata]

Did the Epsom salts get on your scalp and face?

 

Did you get itching when you took Effexor 1996-2019?

 

Please keep posting your daily notes.

[FindRest]

2 hours ago, Altostrata said:

Did the Epsom salts get on your scalp and face?

 

Did you get itching when you took Effexor 1996-2019?

 

Please keep posting your daily notes.

 

The itching/burning has started tonight again, on my face and scalp.
 

No Epsom salts on my scalp. They would have gotten on my washcloth, however, when I wet it prior to washing my face. But, I started having itching before the Epsom salts bath. 
 

I didn’t get itching those other years, but, I used the generic most of those years. I believe the initial years I probably did the name-brand but am not sure.

 

Will keep posting my notes.

[FindRest]

Yesterday, day 8, was a good day. The itching got a bit worse than the day before, but isn’t super bad. Seems to get worse in the evenings. Today, I’ve been having mild itching on my scalp and face, but it mostly feels like a burn/inflammation. Weird. Hard to describe. 
 

Yesterday,  Day 8, Feb 8, 2020:

• 6:30am. Soles of feet red, hot, burning and itching. Mild anxiety. No tinnitus!
• 8:00a.    Anxiety still there. No itching. No tinnitus.
• 10:30a.  Mild tinnitus, anxiety better. Synthroid 125mcg. Effexor XR (14 large beads).  
• 11:45a.  Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray.  Mild tinnitus.
• 2:30p.    Mild tinnitus, but has been much better.  BP:115/71 HR:81
• 3:30p.    Mild itching on scalp and face. Mild tinnitus. 
• 5:00p.    Arms a bit shaky. No tinnitus. Omeprozole 20mg
• 5:45p.    Mild tinnitus, increasing 
• 7:30p.    Face and scalp itching (very mild), Mild tinnitus 
• 9:00p.    Face and scalp still itching with some burning sensation (mild). Burning feet. Buzz/zap down left leg. Mild anxiety.  Mild tinnitus . Cetirizine 10mg and 4 tsp. Miralax. 
• 9:45p.    Jittery arms. Itching of scalp/face continues. 
• 10:30p.  Scalp and face itching. Used hydrocortisone 1% cream on forehead and chin. Also wondering if I’m getting a yeast infection...or perhaps it’s the same thing causing the face/scalp itching/burning.
• 12:30a   Itching better. Mild burning sensation on face/scalp. Med tinnitus.
• 1:00a.    Mild itching on scalp, face, and eyes. Med tinnitus. Ambien 10mg, clonazepam .125mg.  BP:145/87 HR:76 Bed.

[FindRest]

Yesterday was another good day. The itching lasted from the night before until about mid afternoon yesterday. Then, it disappeared. This morning, I woke up without itching and haven’t had any today so far. One thing I did differently yesterday was I only used 1 spray of the fluticasone instead of two (sprayed in one nostril instead of both). I doubt this had anything to do with it, but used  one spray again today to see if it makes a difference today.

 

I also got a rapid, intense onset of burning feet about midnight. I wonder if it could be that it was getting nearer the time to take my ambien/clonazepam. I’ve had burning feet off and on for many years, always in the evening. Didn’t happen real often; usually days after a surgical procedure, when I wasn’t feeling well,...but mostly out of the blue. I could never figure out what it was. Dr’s wondered if it was gout flare ups. Sometimes, the bloodwork would indicate an increase in uric acid, but not all the time. Now, I’m wondering if this round could somehow be influenced by my splitting the .5mg clonazepam into fourths unevenly. I just eye it. I had taken a smaller half the night before. I noticed the burning feet got better once I took my evening meds (Ambien/clonazepam). I had also put hydrocortisone 1% crime on my feet to relieve the burning and itching, so maybe it was just that. Been reading up on this and still am in progress...

 

Yesterday,  Day 9, Feb 9, 2020:

• 9:00am. Mild itchy scalp.Synthroid 125mcg. 
• 10:30a.  No tinnitus! Effexor XR (14 large beads).  
• 11:45a.  Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray (left side only). Still no tinnitus. 
• 12:30p.  Mild itching begins again (scalp, face). Mild tinnitus. BP:123/72. HR:92
• 1:30p.    Scalp tingling (not itching). Mild tinnitus. 
• 2:30p.    Mild tinnitus. Eyebrows/eyelids itching and burning (like raw skin). 
• 4:00p.    Tinnitus/ringing. Itching gone.
• 5:00p.    Very mild tinnitus, pulsating buzz in left foot, no itching. Omeprozole 20mg
• 7:30p.    Actually enjoying watching TV (been months since I’ve even been interested)!  Mild tinnitus, no itching but rt ear is hot and burning, pulsating buzz in left foot continues.
• 9:00p.    Tinnitus increasing. No itching. Cetirizine 10mg and 4 tsp. Miralax. BP:133/74. HR:74
• 11:00p.  Hot poker type pains in right shoulder (came and went rapidly). Mild tinnitus, no itching.
• 12:00a.   Both feet w pulsating buzz and burning/itching (feet only). Used hydrocortisone 1% cream on feet.
• 1:00a.    Mild itching on eyelids. Pulsating buzz continues in feet. Both feet still hot/burning/itching. Slight anxiety. Mild tinnitus. Ambien 10mg, clonazepam .125mg. Bed.

[FindRest]

Today’s day 11 and going very well. Started out a tiny bit rough upon wakening: mild body tremors/buzzing, mild anxiety, some muscle jerks. That all cleared once I got up...it’s like having an internal alarm clock and mother all built into one (buzzer goes off, mom comes in and shakes you saying, “Time to get up!”).  No itching when I got up but now, at 3:30pm, my face is beginning to itch/tingle/burn mildly.

 

Yesterday was pretty good as well. Some itching, burning, mild anxiety, and a bit more sad than I’ve been recently. 
 

Yesterday,  Day 10, Feb 10, 2020:

• 10:00am. Synthroid 125mcg., no tinnitus, no itching.
• 10:30a.  Effexor XR (14 large beads).  BP:109/71. HR:90
• 12:00a.  Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray (left side only). Very mild tinnitus. 
• 1:15p.    Scalp tingling (not itching). Tinnitus increasing. 
• 2:30p.    Mild itching of scalp and face. BP:128/77. HR:72 
• 3:30p.    Tinnitus/ringing.
• 5:00p.    Mild. Omeprozole 20mg
• 7:00p.    Tingling in face and forehead.
• 8:00p.    Tinnitus increasing. Had lemongrass tea. 
• 9:00p.    Tinnitus still pretty loud. Slight itching on face/scalp, right ear is hot/burning. Cetirizine 10mg and 4 tsp. Miralax.
• 9:30p.    Itching and tinnitus increase.
• 10:00p.  Getting nervous (maybe from the lemongrass tea?) Mild itching on face/scalp.
• 10:30p.  Mild anxiety. 
• 11:00p.  Doing better, anxiety gone. Mild muscle tightness/weakness in left biceps (first time in several days).
• 12:00a.  Tinnitus/ringing
• 1:00a.    Medium tinnitus. No itching. Note: Bit more sad/numb today than previous days. Have yeast infection. Decided to use the 7 day Monistat in case my CNS is sensitive to it (as opposed to the 1-day or 3-day Monistat). Monistat 7, Ambien 10mg, clonazepam .125mg. Bed.

[Altostrata]

It sounds like you're allergic to something. Is there anything in your environment that might make you itch? New soap? New laundry detergent? Hair product?

 

Have you changed Premarin brands recently?

 

Please stop taking the probiotic.

[FindRest]

28 minutes ago, Altostrata said:

It sounds like you're allergic to something. Is there anything in your environment that might make you itch? New soap? New laundry detergent? Hair product?

 

Have you changed Premarin brands recently?

 

Please stop taking the probiotic.

Alto, I’ve wracked my brain and I can’t think of anything new. Same soap, same shampoo, same deodorant, same everything...not even a new bottle of anything. One exception was the hypoallergenic bodywash sample I used several days ago. Haven’t used it since that one time.

 

Even my probiotic, Premarin, etc., are all even from the same bottle for months now. I’ve been taking the same probiotic for years.  Do you think it’s possible I’ve become allergic to it since stopping Pristiq? Could all of this just be a histamine hypersensitivity I’ve been reading about here? 
 

Also, I go to my psychiatrist on Thursday. Should I have him prescribe the generic Effexor and try that? I’m currently using the name brand. Would that totally screw me up? I had been using the generic for the past few years prior to ct, but thought the name brand would be more “clean”. Is it worth a try or am I messing with fire?

[FindRest]

This has been by far my hardest day yet. Lots of anxiety, dizziness/vertigo, depression, and fear. Will post yesterday’s diary a bit later. 

[Andie]

2 hours ago, FindRest said:

This has been by far my hardest day yet. Lots of anxiety, dizziness/vertigo, depression, and fear. Will post yesterday’s diary a bit later. 

Thinking of You.

[FindRest]

Today has been rough. Woke up with anxiety, mild tremors, and ruminating. The anxiety escalated mid-afternoon to a near panic. Fear, depression, and dread followed. I guess there was one blessing from the hell of last summer/fall...I now know that I will be able to make it through, even when my body and emotions are telling me otherwise. 
 

Itching is a bit better today, but now starting up again, mildly. I didn’t take a probiotic today. I may skip the omeprozole tomorrow and take famotidine instead to see if it’s the omeprozole. Or, maybe it’s the D3. Who knows. I’ve been taking these for a long time without problems (all of them are even the same bottle from months ago except the omeprozole). I don’t think it’s the Effexor as I read through my diary notes from the beginning of January and see several places where I had itchy eyelids listed. I don’t wear makeup real often, and haven’t changed any of my moisturizers, etc. Maybe what I’m calling “itching” others are calling “burning and tingling,” a common side effect of WD. For me, however, there is a difference between the burning and tingling vs itching. I try not to scratch the itch because it makes things worse. 

 

Yesterday, the itching was mild but lasted a good portion of the day. 
 

Yesterday, Day 11, Feb 11, 2020:

• 8:00am.  Woke up with mild anxiety, body tremors (mild), couple of jerks, ruminating.
• 9:30a.    Synthroid 125mcg., ruminating
• 10:30a.  Effexor XR (14 large beads)
• 11:45a.  Premarin .625mg, Probiotic, D3 25mcg, fluticasone nasal spray (left side only)
• 12:00p.  No tinnitus yet today. Sadness. BP:128/74. HR:93
• 2:00P.    Magnesium glycinate ~12mg
• 3:30p.   Top of head tingling w light itch, very mild tinnitus 
• 4:00p.   Ear ringing. Face and scalp itching increasing. Feel stressed and on edge. Teary. 
• 5:00p.    Lips tingling. Itchy face and scalp better but still there. Teary and sad. Omeprozole 20mg
• 6:30p.    Left arm jittery and weak/unstable.
• 7:00p.    Pins/needles both arms. Tinnitus. Itching eyebrows, but face/scalp itching is better but there.
• 9:00p.    Tinnitus mild. Cetirizine 10mg and 4 tsp. Miralax.
• 10:00p.  No itching! Tinnitus.
• 11:00p.  No itching, mild tinnitus 
• 12:00a.  Mild itching on face, right ear burning, mild tinnitus 
• 1:00a.    Mild itching on face, lower lip tingling, stuffy nose. Monistat 7, Ambien 10mg, clonazepam .125mg. Bed.

[manymoretodays]

On 2/11/2020 at 6:44 PM, FindRest said:

lso, I go to my psychiatrist on Thursday. Should I have him prescribe the generic Effexor and try that? I’m currently using the name brand. Would that totally screw me up? I had been using the generic for the past few years prior to ct, but thought the name brand would be more “clean”. Is it worth a try or am I messing with fire?

 

Hi FindRest,

On the above, I think if it was me, I'd stay with the same Effexor.  Sounds like you had to go through a lot to get it to begin with.  Why change now?

 

 

On 2/6/2020 at 8:07 PM, Altostrata said:

Here is your new interactions report, with Effexor substituted for Pristiq. Please read it and print it out for discussion with your doctor:

 

https://www.drugs.com/interactions-check.php?drug_list=2333-1544,1463-869,2360-381,703-0,1750-0,1066-0,1893-1224,2418-0,569-0,646-5790,2296-0

 

Note the interaction of venlafaxine with famotidine. Omeprazole may be better in this regard.

 

And I just thought I would quote this one ^ too.  So you can possibly go over some of this with your Doctor.  And then I saw that you were experimenting a bit between using the famotidine and omeprazole.

 

.......And then am, just stopping by to lend support for your stick with it- ness now.  In general terms how is it all going?  Are you getting out once in awhile and maybe doing anything funnish or enjoyable?  Or even at home?

 

(((((FindRest))))))

L, P, H, and G,

mmt

[FindRest]

Thanks, mmt. 

 

You’re right about not changing things now. The only reason I had thought about getting the generic was my concern that the name brand might be responsible for this itch. However, once I went through my notes from the beginning of January, I saw where I was already beginning to have some itching...before Effexor. That made me more comfortable ruling that possibility out.

 

50 minutes ago, manymoretodays said:

 

.......And then am, just stopping by to lend support for your stick with it- ness now.  In general terms how is it all going?  Are you getting out once in awhile and maybe doing anything funnish or enjoyable?  Or even at home?

It’s been going pretty well for the most part. Yesterday afternoon was difficult, however, but got better in the evening. Mornings are generally getting rougher as well. Still, it’s going ok. The scariest part is not knowing how long the bad will last, or wondering if I need to increase the dose, etc.. 

 

Honestly, I haven’t been doing anything enjoyable for some time. I need to just force myself to do some of those things, don’t I? 

 

Hope you are doing well, mmt. 

[FindRest]

Today’s going ok, better than this time yesterday. Increased anxiety and weepiness/depression creep in at times. The itchiness appears to be better, but still there. 
 

Had an appointment with my psychiatrist today (only my second one with him). It was pre-scheduled back in December. I told him I am getting older and wanted to get off these meds and asked him how he would recommend coming off the Effexor XR “when the time comes”. I was wanting to get a feel for where he stood. He said “we’d” begin by skipping a dose every other day, then skipping two days, etc.. I told him I had heard about people taking beads out of the capsule. He acted like he didn’t hear me. Then, I told him my experiences with skipping days. He acknowledged the withdrawals of Effexor XR and said I must be “one of those” who had difficulty with skipping days and that “we” probably would need to do the “bead method” or use the IR Effexor.  He said to give myself 3 months to stabilize on 37.5 then at our next appointment we’ll discuss reducing it. I didn’t tell him I was already counting beads. Got my 3 month prescription. At least I’ve opened the door to discussing beads. Not holding my breath, however. 
 

Yesterday, Day 12, Feb 12, 2020:

• 9:00am.  Woke up with mild anxiety, body tremors (mild), mild tinnitus, ruminating.
• 9:30a.    Synthroid 125mcg., ruminating, anxiety. 
• 10:30a.  Effexor XR (14 large beads), very mild itching eyes
• 11:45a.  Chin itching mildly. Premarin .625mg, No Probiotic, D3 25mcg, fluticasone nasal spray. 
• 1:00p.    Anxiety increasing, breathlessness, mild face itching. No tinnitus since 9am. Therapy appointment.  
• 2:30p.   Grocery shopping. Shortly after arrival, I began having a near-panic attack. Got dizzy, nauseous. Lots of anxiety and fear, doom/gloom.
• 4:00p.   Anxiety better but still there. BP:139/88. HR:84
• 5:00p.   Chin and rt eye starting to itch/tingle. Low-level anxiety. Omeprozole 20mg
• 7:00p.   Tinnitus. Itching between eyes. Top of right ear burning.
• 8:00p.   Mild burning/itching between eyes. Ear better. Mild tinnitus. Nasal rinse.
• 9:00p.   Calmer. Face is burning slightly. Tinnitus mild. Cetirizine 10mg and 4 tsp. Miralax.
• 11:00p.  Left arm pins/needles. No tinnitus 
• 12:00a.  Left leg involuntarily jerked once. Mild tinnitus 
• 1:00a.    Red, hot, burning and itching feet. No itching on face or scalp. Very mild tinnitus. Monistat 7, Ambien 10mg, clonazepam .125mg. BP: 138/75. HR:83. Bed.

[Altostrata]

Well, your psychiatrist is a dinosaur. There's no reason to keep him on your payroll. Can your GP prescribe all your drugs?

 

Is the Monistat oral tablets?

 

Good idea to swap out the omeprazole. You had been alternating it with famotidine before, correct? That is one drug change you've made recently since you developed itching. Maybe you're allergic to omeprazole and taking it every day made this obvious.

 

Some people are allergic to fillers in drugs like Synthroid and need to have their thyroid hormone compounded without fillers.

 

On 2/6/2020 at 7:07 PM, Altostrata said:

....

Here is your new interactions report, with Effexor substituted for Pristiq. Please read it and print it out for discussion with your doctor:

 

https://www.drugs.com/interactions-check.php?drug_list=2333-1544,1463-869,2360-381,703-0,1750-0,1066-0,1893-1224,2418-0,569-0,646-5790,2296-0

 

Note the interaction of venlafaxine with famotidine. Omeprazole may be better in this regard.

 

Do you need to continue Miralax? Can you reduce the dosage? Are you watching your magnesium and potassium levels? These are very important. Low levels may cause serious symptoms.

 

It's possible you were starting to be allergic to desvenlafaxine (Pristiq) and now you're allergic to venlafaxine (Effexor), which is too bad because you seemed to be doing better with the reinstatement. As a last resort, you may need to replace Effexor with Prozac liquid (fluoxetine).

 

Another potential problem may be that some of your batch of drugs are causing a traffic jam in your liver, which can increase the blood level of one drug or another and you are allergic to that drug at a higher level. We can't tell which one.

 

On the other hand, when people go off cetirizine, they can get something called rebound itching. It's possible something you're taking is causing fast metabolization of cetirizine and you're getting rebound itching every day, before you take cetirizine. You've been taking it and fluticasone since late 2018, did you get itching in 2019? Why are you taking cetirizine?

 

This is the danger of polypharmacy. Please note that I've discussed interactions among your non-psychiatric drugs. Your GP should be the person to deal with this. You might ask him or her or your pharmacist to map out all the potential P450 liver enzyme conflicts.

 

[FindRest]

2 hours ago, Altostrata said:

 

On the other hand, when people go off cetirizine, they can get something called rebound itching. It's possible something you're taking is causing fast metabolization of cetirizine and you're getting rebound itching every day, before you take cetirizine. You've been taking it and fluticasone since late 2018, did you get itching in 2019? Why are you taking cetirizine

 

@Altostrata, let me first say that the itching has been better today (I did take the omeprazole). 

2 hours ago, Altostrata said:

You might ask him or her or your pharmacist to map out all the potential P450 liver enzyme conflicts.

I will do that.
Is there a reason you think it’s an allergic reaction versus the wd symptom others here report involving histamine?

 

I actually have gotten itching over the years, just not as often in a row as now. I have also been getting the burning feet off and on for years. I take cetirizine because:

On 2/7/2020 at 5:42 PM, FindRest said:

I take fluticasone and cetirizine (per ent’s order) due to rhinitis, chronic ear infections, deviated septum, and Eustachian tube disorder. The combo has decreased the number of ear infections dramatically. I did think about reducing them, however, I didn’t want to change up anything that might destabilize my system more. I also didn’t want to risk an ear infection and need antibiotics in the middle of tapering.  

 

On 2/7/2020 at 5:42 PM, FindRest said:

The other thing I could try is going back to loratidine instead of the cetirizine.  I used to take that but they switched it to cetirizine to try and get the ear infections under control. I see in the interactions checker that it would have far less interactions than cetirizine.

 

The Monistat is the vaginal cream.  The itching on my scalp/face has ironically gotten better since I’ve started on the Monistat. Don’t know if it’s coincidence or not.

 

2 hours ago, Altostrata said:

This is the danger of polypharmacy. Please note that I've discussed interactions among your non-psychiatric drugs. Your GP should be the person to deal with this. You might ask him or her or your pharmacist to map out all the potential P450 liver enzyme conflicts.

Thank you for giving me your thoughts on all of this. I will contact my pharmacist and/or dr about the P450. Please know that I am willing to stop any of the drugs. I just don’t know how or where to start or if/how it would affect the adwd symptoms.

 

I feel so hopeless over all of this, plus just having a hard night with internal jerking of my body and neck (others can’t see), anxiety, doom/gloom, etc. I actually thought about asking if you thought it would be safe to increase a few beads tomorrow. I pray I’m not allergic to Effexor. I am at a loss right now. 
 

 

 

[FindRest]

Mods or @Altostrata, I am thinking I need to add a few beads and would like your opinion. I’m on day 14 of starting the Effexor XR...took 10 beads for 2 days then increased them to 14 beads on Feb 3rd. Before that, I was on Pristiq 25mg.

 

The muscle jerking, internal shakiness, muscle pain returning, along with the high anxiety, hopelessness, and doom/gloom all have me concerned. 
 

What do you think? Here’s my diary from yesterday:
 

Yesterday, Day 13, Feb 13, 2020:

• 9:30a.    Synthroid 125mcg., ruminating, anxiety, was harder to get to sleep last night. 
• 10:30a.  Effexor XR (14 large beads), no tinnitus, no itching
• 11:45a.  Anxiety increasing, mild tinnitus, no itching. Premarin .625mg, No Probiotic, D3 25mcg, fluticasone nasal spray.
• 12:30p.  Chin itching lightly, anxiety continues, weeping  BP:130/78. HR:106
• 2:30p.   Anxiety bit better for past hour, chin tingling but no itch, mild tinnitus 
• 4:00p.   Mild itch on scalp. Mild tinnitus . 
• 4:30p.   Left shoulder pain, left arm shaking on exertion and weak
• 5:00p.   Tinnitus increasing. Shoulders aching even more. Omeprozole 20mg
• 6:30p.    No itching for couple of hours now.
• 7:00p.   Left arm pins/needles/unsteady/aches. Mild tinnitus. Heartburn/reflux.
• 8:30p.   Neck wobbly like it can’t support head. Shoulders feel like they want to come out of my skin, they also ache. Arms trembling within, lots of anxiety and fear.
• 9:00p.   Very hopeless, weeping, high anxiety near panic. Shoulders and neck jerking and are tense. Left arm weak and tremor on inside. Lip tingling, scalp beginning to itch, ears burn. Smell smoking wood for some reason. Cetirizine 10mg and 4 tsp. Miralax.
• 10:30p.  Hopeless and scared.
• 11:30p.  Muscle spasm up spine, left arm weak and unstable.
• 1:00a.    Post-nasal drip, dry nose, left foot burning, pain in bottom left jaw, left earache, mild tinnitus. Monistat 7, Ambien 10mg, clonazepam .125mg. BP: 138/83 HR:90  Bed.

[Altostrata]

19 hours ago, FindRest said:

Is there a reason you think it’s an allergic reaction versus the wd symptom others here report involving histamine?

 

I don't understand this question. If you think you're histamine-intolerant, I would go on an exclusion diet.

 

Perhaps it was the probiotic causing the itching.

 

The symptoms you get in the early part of the day may be rebound or interdose withdrawal from Ambien and clonazepam.

 

Yes, you can add a few beads to the Effexor. I am concerned Effexor is causing the itching. If you increase it and itching increases, it may be the culprit. Please continue to take notes.

[FindRest]

Thanks, alto.

 

Today I added 2 medium-sized beads to my dose for a total of 16 beads (14 large + 2 medium). 
 

Yesterday was a better day overall compared to the previous two days. I think the itching was even better. It’s turning from an “itch” sensation to one of burning/tingling. 
 

Yesterday, Day 14, Feb 14, 2020:

• 9:00a.    Synthroid 125mcg., ruminating. No anxiety.
• 10:30a.  Effexor XR (14 large beads), mild tinnitus 
• 11:45a.  Premarin .625mg, No Probiotic, No D3 25mcg, fluticasone nasal spray.
• 1:00p.  Chin tingling but not itching. A little internal anxiety.
• 2:00p.  Right eye twitching, mild tinnitus, nervously wringing hands around knees. Face started tingling then turned into mild itch.
• 2:30p.   Arms trembling upon exertion, mild tinnitus 
• 4:00p.   Right eye twitching. 
• 4:30p.   Left shoulder pain, left arm shaking on exertion and weak
• 5:00p.   Headache. Right knee and right torso itching lightly. Famotidine 20mg instead of omeprozole. BP:125/84 HR:90
• 6:30p.   Mild tinnitus. Forehead and right ear tingling/burning.
• 7:00p.   Under chin burning/tingling, right ear burning, scratchy eyes. Mild tinnitus.
• 8:30p.   Lips/chin tingle. Right ear still burning but not red. Mild tinnitus.
• 9:00p.   Left leg buzzing. Nasal rinse. Cetirizine 10mg and 4 tsp. Miralax.
• 10:00p.  Throat a bit sore. Reflux.
• 11:00p.  Heavy/wobbly head as if neck couldn’t support it.
• 12:00a.  Ears ringing.
• 1:00a.    Lower jaw/tooth pain, dry nose, ears popping, itching torso, mild tinnitus. Monistat 7, Ambien 10mg, clonazepam .125mg. BP: 130/80 HR:76 Bed.

[FindRest]

Yesterday was the first day of adding two medium-sized beads to my Effexor XR. In retrospect, I was probably too conservative and should have upped it a few more. I plan to wait another day or two to see if I need to add a few more. Yesterday afternoon was difficult, with wd symptoms creeping in ...nausea, dizziness, anxiety, doom/gloom, etc. 

 

BUT...the itchiness is a ton better!! Either the updose or not taking the probiotic is helping greatly regarding the itchiness. My gut feeling is that the itching was caused by withdrawal (have also read of others going through Effexor or Pristiq wd’s with the same symptom). I do have a different probiotic here that I was waiting to try when my usual bottle ran out. I might try that one in a few days. Since my intestines do not function normally (bowel surgery), probiotics make a huge difference in motility. If I start getting itching again, then I’ll know the culprit.  
 

Yesterday, Day 15, Feb 15, 2020:

• 9:30a.    Synthroid 125mcg. No anxiety or ruminating! No tinnitus!
• 10:30a.  Effexor XR (16 beads: 14L +2M) neckache
• 11:00a.  Right palm and forehead itch, mild tinnitus 
• 11:45a.  On edge/short temper. Premarin .625mg, No Probiotic, D3 25mcg, fluticasone nasal spray.
• 12:15p.  Mild anxiety, worrying about future. BP:112/75 HR:90
• 2:00p.   Tingling/burning on chin, scalp, forehead. Head heavy/wobbly. On edge.
• 3:00p.   Above symptoms continue with increasing anxiety/fear.
• 4:00p.   Sad, anxious, tired, feels like neck can’t support head.
• 4:30p.   Sadness/doom/gloom. Above symptoms continue. Crying. Omeprazole 20mg.
• 5:00p.   Dizzy and nauseous, especially upon standing. Inner shakiness. Feel like body is craving some kind of drug. Tense. On alert.
• 7:00p.   Nauseous, dizzy, trembling arms. Head beginning to itch.
• 7:30p.   Tinnitus, on edge, can’t stand noise (husband talking, lol)
• 9:00p.   Sad/depressed. Fear. Cetirizine 10mg and 4 tsp. Miralax.
• 9:45p.   Arm tremors/shaky
• 10:15p  Heavy head/neck, right arm jerking, pins/needles in left arm/hand.
• 11:00p. Left arm/shoulder tight and achy/weak. Mild tinnitus. Right eye twitching.
• 12:30a.  Eyes dry.Feeling better. No itching since around 7pm! Monistat 7, Ambien 10mg, clonazepam .125mg. Bed.

[Andie]

1 hour ago, FindRest said:

BUT...the itchiness is a ton better!!

Awesome 👏 ! 

[FindRest]

Today I increased my dose to 15 large beads + 5 medium-sized beads. I hope this isn’t too much of a leap...was wanting to even increase it more but thought this was conservative. Please let me know if you think it’s too much. What symptoms do I watch out for that would indicate it was too much of an increase?

 

Yesterday, the weakness and trembling of my arm, head, and neck were the most bothersome symptom. It’s as if my neck can’t support my head and my shoulder can’t support my arm. Still some itching going on.

 

Yesterday, Day 16, Feb 16, 2020:

• 9:30a.    No anxiety or ruminating!
• 9:30a.    Synthroid 125mcg
• 10:30a.  Effexor XR (16 beads: 14L + 3M)
• 11:45a.  Mild itching on left foot and forehead. Premarin .625mg, No Probiotic, D3 25mcg, fluticasone nasal spray.
• 1:45p.   Arm/neck tremors, twitching right eye, tingling lip
• 2:15p.   Dizzy. Shaking like I’m very cold (but not). Tingling face and soles of feet.
• 4:00p.   Reflux. No tinnitus yet today!
• 4:30p.   Left arm shaking on exertion. Tinnitus. Omeprazole 20mg.
• 5:30p.   Tingling/itching chin and around mouth. Tinnitus.
• 6:30p.   Wobbly head, inner shakiness in left arm, stiff/achy/weak/shaky left shoulder, arm, and neck. Mild tinnitus. 
• 7:15p.   ~12mg magnesium glycinate, juice glass of pedialyte
• 7:45p.   Increased anxiety, left arm still weak and shaky. Nasal Rinse. 
• 9:00p.   Anxiety better. Left arm still weak and shaky. Heavy head/neck. Tinnitus. Cetirizine 10mg and 5 tsp. Miralax.
• 10:00p. Small wave of anxiety/fear.
• 11:30p. Left shoulder/arm and neck ache, tremor on exertion, bottom of right foot and forehead beginning to tingle and itch.
• 12:30a.  Mild burning/itching in feet and scalp. Tinnitus.  Monistat 7, Ambien 10mg, clonazepam .125mg. Bed.