Holly26: tapering venlafaxine with a compound

[ChessieCat]

If a diagnosis of bipolar has been made after a person has taken psychiatric drugs then the diagnosis is not valid.

 

Please note, you have posted this as a new topic in the Introduction forum.  Only one (1) Introduction topic per member.  Please do not create any new Introduction topics.  Thank you.

[Holly26]

Thank you so much for your reply. 

I wasnt on anything when i got the diagnosis.

I wonder how to treat it if not with meds. 

 

Kind Regards 

Rella

[ChessieCat]

Had you ever taken a psychiatric drug AT ALL prior to the diagnosis?

 

SA is a site for tapering and withdrawal of psychiatric drugs.  If your diagnosis was made before you ever took a psychiatric drug then I suggest that you do an internet search to find forums and groups specific to bipolar.

[Holly26]

Hi i get a compound for a year now and i just checked the compounded 6mg from my pharmacy and this is the result. Supposingly all 6mg . Im freaking out . Im not doing well anyway. 

[Holly26]

Hi Everyone,  is it normal that my 6mg Venlafaxin compound weight all differently?? 

Thank you!!

[getofflex]

Previous 6 posts (starting with Feb 11 2021) moved from 2 additional threads to your intro topic to keep your history all in one place.  

 

Please use just this one thread to ask questions and give information about your situation.  This way the moderators have all your information in one place, and can get the best context for how to advise you.  Thank you.  

Edited April 17, 2021 by getofflex

[getofflex]

Hello.  In your drug signature, can you please type the date in this format:  October 31 2020, Dec 28 2020, Jan 15 2021, etc.  These are just examples, I'm not sure if they are your actual dates.  That will help us better understand your tapering and give you the best help.  Thank you.  

 

The fact that you are not doing well could be because your doctor tried to bridge you with prozac, and perhaps went too fast.  I would need to be more clear on the specific dates for each time you made a drug/dosage change.  

 

Please refer back to the link in the first post by Shep on Tips for Tapering Effexor (Venlafaxine). 

 

Here is some information on how to use the digital scale to measure your dose:  Using a Digital Scale to Measure Doses Weighing

 

Please let us know if you still have questions. 

 

 

[Holly26]

Ok, ill ask again not sure why no one answers 😔 

Is it normal that 6mg Venlafaxin has a different weight in every capsule,  done by a compound pharmacy? 

[brassmonkey]

It all depends on how different they are. It is normal for there to be a few milligrams difference, like three or four, between the various capsules. In manufacturing them there is an "allowable tolerance" in the weight. For compounded drugs I believe it is 3% but it varies from country to country.

 

The total weight of a full compounded dose is going to be a lot more than the strength weight by which the pills are referred. So your 6mg capsules will probably weigh more like 50mg or more.

[Holly26]

Thank you so much for answering! 

Very interesting . I cant upload all files 🤔 but they differ from 0.85 up to 1.15 with the capsule and only beads 0.020 up to 0.043. And they are all from the 6mg compound pharmacy. 

Thank you!!

[brassmonkey]

It sounds to me like their quality control is very poor. Would it be possible to find a different compounding pharmacy?

[Holly26]

Thank you for your answer. 

No i called a few and the other pharmacys would all crush the beads so that it would be immediate release. I guess I have to weigh them myself from now on or i bridge with brozac.  I received my Venlafaxin from the pharmacy for about 2 years and just double checked recently because im not doing well at all.  

Thank you for your help!!

[ChessieCat]

You might be experiencing interdose withdrawal:

 

The easiest way to work out if you are experiencing interdose withdrawal is to keep daily symptoms notes for yourself.  There will be a daily pattern of worsening and improving at certain times of the day, corresponding to 'x' number of hours before and after you take the dose.

 

If this turns out to be the case, then dosing twice a day might help.

[Holly26]

Hi Cat,

 

Thank you for your answer. My assumption was that im not feeling well because my pharmacy didnt weight the beads right 🤔.. but you are right this could also cause interdose withdrawl . 

[ChessieCat]

In most cases If an extended release tablet form of a drug is crushed it loses its extended release properties and becomes immediate release.

 

So even if your capsules were of a consistent dose, you might still be experiencing interdose withdrawal.

[Holly26]

Hi ChessieCat,

 

i think this is what im experiencing,  interdose withdrawl.  Sometimes my symptoms improve in the middle of the day for no reason whatswhoever but most days , even if acute withdrawl is over after a couple of days, i always feel the withdrawl dizziness for most of the time ( 90%) at least. I discused weighing the beads ( extended release)with another member and even if they all weight the same i guess the extended release mechanism wont be equal over the day because the tiny beads are all different sizes.  

I would need immediate release and split them in two right? 12 Hours apart? 

Thank you!!

[Holly26]

Hi Everyone, 

 

im try the prozac bridge a second time. At 5mg Venlafaxin i was in the er, i couldnt deal with the anxiety anymore i was drenched in sweat. 

So 5mg Fluoxetin and 5mg Venlafaxin simoultaniously for a week and than i stop Effexor and than i keep taking Prozac for another week, right? 

Yes i will update my signature .

 

Thank you for confirming that this is the way to do it.

 

Warm regards

Holly

[Holly26]

No one 😥. 

I just need clarification on the method please ! 

How long should it take them simoultaniously?Im currently taking 5mg Fluoxetin ( 5 days)  and 5mg Venlafaxin. 

Thanks

[brassmonkey]

A typical crossover between drugs is done in four steps: 75%old/25% new, 50/50, 25% old/75% new then 100% new. Each step is usually held for a week or two.

[Holly26]

Thank you so much!! 

Over two weeks? Just wondering if i hold this for a week or two than i take Prozac for about a month?

 

Somehow i thought no longer than 2 weeks 

[Nomansland]

Hello @Holly26,

 

here you can find a lot of information about the so called "Prozac Bridge".

 

 

Greetings

 

Nomansland

[Holly26]

Thank you so much !!! 

[Holly26]

I get interdose withdrawl from 5mg Effexor er. I doubt that this method is healthy ( weighing or bead counting doesnt give me a consistent dose during the day). How do i dose immediately release? 12 hours apart? Thank you

[Altostrata]

@Holly26 I see you were asking about the bead-weighing technique here.

 

If the compounding pharmacy is filling capsules by weight to a specified number of milligrams of active ingredient (MGAI), variation in the size of the beads doesn't matter. Some will be smaller and some larger, that will average out.

 

Is your prescription written so the compounding pharmacy is putting 5mg Effexor (active ingredient) in a capsule, or is it putting 5mg weight of beads (milligrams of pill weight, or MGPW) in a capsule? 5mg MGPW will contain less active ingredient than 5mg MGAI, because some of the weight will be filler.

 

What do you mean by interdose withdrawal? What time of day do you take 5mg Effexor, what time of day do you get the symptoms you attribute to interdose withdrawal? Are you taking any other drugs?

[Holly26]

Thank you for your answer!

 

Yes  they do weigh the active ingredient but im not doing well lately and i was thinking about what you said about interdose withdrawl and i think that is the case for me. 

 

5mg have aprox 16 beads , some variation because the go by weight. So if i have 70% larger beads and 30% by chance im not getting an equal distribution of active ingredient in my blood and because of Effexors short half life this seems to cause issues for me. 

 

I think KT is right that dividing them into different bead sizes to ensure that i get as much as extended release as possible lasting 24 hours . Or even take immediate release 3 times a day. 

 

Im not taking anything else. 

I think the unequal extended release due to the fact that they go by weight and not bead sizes causes instability. I take effexor at 9am . I get random dizzines which is pretty severe along with fatigue and because i cant tell when which bead is released in my body i get pretty random interdose withdrawl.  Thats what it feels like. All of a suddan im fine and than i get dizzy and feel faint. 

 

Warm regards 

Holly

 

[Holly26]

Update.

 

stopped Effexor 4 weeks ago at 5mg. 

The first couple of weeks i was in the er about 4 times.

 

Its getting better!! 

[Holly26]

Hi Everyone,

 

i need some help please.

 

I took Effexor for 15 years (225mg).  About 4 years ago i didnt know anything about tapering so i dropped from 225 to 150mg. At this time i visited my au pair family in Ireland and thought i need to go to the psych ward. Anxiety on end. i never contributed it to the drug. Sice than i suffer from dizziness i mean severe dizziness i cant work ( i am a sociologist). From 150 i tapered 10% but the dizziness never left me until today. MRI blood work all ok. Am i damaged permanently???? What do i do???? Go back to 225mg?? I have no life and i am soooo depressed from it. The dizziness is left sided my left eye is numb/pressured.

 

I need some advice on this.

 

Thank you!!

[Holly26]

Hi,

 

i was on Effexor for 15years and and tapered for 3 years. The first step was pretty large , from 225 to 150 and i didnt contribute the withdrawls to the drug at that time. Everything subsided apart from dizziness. I am on disability because of it. The taper was 4 years ago so i guess i have long term damage which makes me severely depressed. Would reinstating to 225 help? Im at 0 now for a month. I am dizzy now for 4 years 😢.

 

Thanks for reading

[Shep]

@Holly26I moved your last post and placed it here in your intro thread. Please don't start anymore intro threads. We need all of your information to be in one place.

 

I've brought your question to the attention of the other staff who are more familiar with Effexor. 

 

Questions while we're waiting - are your symptoms more severe since you stopped Effexor at 5 mg? What doses were you on the past few months and what was your taper rate? 

 

Answering these questions will help the staff guide you in your next steps. 

[Holly26]

Thank you Shep,

 

no my symptoms are not more severe since im off completely.  The same dizziness/ drunk like feeling i have for 4 years now. I had a compound and i tapered in 1mg reductions from the last dose ( 2 and a half years in total). But 4 years ago i dropped from 225mg to 150mg and this is where the dizziness started until today. So i guess since im off completely im permanently brain damaged. I had to quitmy master 4 years ago and live with my mom getting disability becauseof it. Is there a chance that my symptoms would get better going back up to 225mg???? Im at a total loss here. 

[Altostrata]

On 6/25/2021 at 6:16 AM, Holly26 said:

Update.

 

stopped Effexor 4 weeks ago at 5mg. 

The first couple of weeks i was in the er about 4 times.

 

Its getting better!! 

 

@Holly what symptoms sent you to the ER? How has your symptom pattern changed, how are you getting better?

 

How long did you take 5mg Effexor, and how did you go off?

[Holly26]

Hi Altrostata,

 

i had panic attacks and vertico that send me to the er. But those withdrawl symptoms have subsided. What didnt subside is the dizzines which i have for 4 years now since i went from 225 to 150 not knowing anything about tapering. 

I was 5 month on 5 mg and got down to 0, 5 weeks ago. Everything is gone except the dizziness. So i strongly assume im brain damaged at this point because 4 years is simply to much to have hope still. Im so depressed from the dizziness my life is simply over . I live with my mom getting disability.  I have a new psychiatrist who confirmed i could be damaged for life .....

[Altostrata]

Not brain damage but something happened to upset your nervous system.

 

How do you feel on 0.5mg? How are you measuring this? How's your sleep?

[Holly26]

Hi Altostrata, thank you very much for your answer. Im at 0 for 5 weeks. My sleep is good. All withdrawl symptoms are gone apart from the dizziness which i have since i dropped from 225 to 150mg ( 4 years ago). My lifestyle is very healthy but i dont walk much because of the constant dizziness. 

 

I really assume that im permanently damaged. I was on a high dose for 10 years 225mg

 

[Shep]

On 6/29/2021 at 3:20 AM, Holly26 said:

I was 5 month on 5 mg and got down to 0, 5 weeks ago. Everything is gone except the dizziness. So i strongly assume im brain damaged at this point because 4 years is simply to much to have hope still. Im so depressed from the dizziness my life is simply over . 

 

I've often referred to people's worst symptoms as a "signature symptom," meaning it's the worst and most defining symptom of your withdrawal journey. My signature symptom is dp/dr. I wrote a success story even though I haven't fully recovered from this symptom. It's gotten so much better and my healing OVERALL is so much better, that I consider my recovery a success-in-process and I'm out living my life now. 

 

It looks like dizziness is your signature symptom. I wouldn't script your life narrative at only 5 weeks off this drug. It's going to take time, but please give gratitude for the symptoms that have resolved. Perhaps look over any notes, website posts, or correspondence you had over the years you reduced to put your healing into perspective. 

 

Constantly telling yourself that you're permanently damaged is a weight you don't need to carry. Travel lightly, Holly. And that includes the lightness of your thought-load. It's really the small things that we can do over the healing process that translate into the bigger things. You can sleep all night now, and that's major, and it will become more and more restorative over time. Your mind/body will benefit from the growth factors that comes from this restorative, non-medicated sleep.  

 

While I'm no fan of Pollyanna positive thinking, I am a huge fan of acknowledging the healing that has already happened and having expectations of future healing, knowing that our brains are very neuroplastic. 

 

Neuroplasticity video (2 minutes)

 

Healing from antidepressants. How to speed up the recovery process video (5 minutes)

 

And just like there are positives to neuroplasticity, be careful of going into spirals of catastrophic thinking, as that can also re-wire the brain. 

 

Norman Doidge - The Dark Side of Neuroplasticity video (2 minutes)

 

Some ways of not going down the dark side of neuroplasticity:

 

Dealing With Emotional Spirals

 

"Change the channel" -- dealing with cognitive symptoms

 

Better days are ahead. It's painfully slow, but we do get better over time. 

 

Success Stories

[Holly26]

Hi Everyone, 

 

i am off of Effexor for aprox 5 month. 

I am considering TMS and i wonder if its safe because im still in withdrawl i guess. I was on Effexor for 15years, 225mg. Or what your general take on rTMS is. Thank you .