jr1985: Effexor / venlafaxine taper

[Narcissus]

Does anyone else live in fear that their doctor will one day cut them off of their AD? Ever since my doctor tried to switch me to a different brand, with fewer beads, I've been terrified every time I go to pick up my prescription, that they'll switch me. Then today my dads doctor reluctantly prescribed him more citalopram. It scares and baffles me that he could have just cut him off completely, without realising the danger. In fact it makes me angry - it's ignorance (withdrawal doesn't exist/isn't serious) mixed with arrogance (I'm the doctor, I'm right!)

 

I worry that one day ill have to try and fight for my Effexor prescription and lose because I'm not good with confrontation. I keep all my spare beads just in case...

 

I was thinking the other day that in the event of a Zombie apocalypse we wouldn't fare very well. Everyone would be out looking for food and shelter and we'd be raiding the pharmacies looking for our fix. Our crews would all probably abandon us eventually, "Leave him, he's withdrawing from Effexor, he's worthless to us."

[jr1985]

 

Does anyone else live in fear that their doctor will one day cut them off of their AD? Ever since my doctor tried to switch me to a different brand, with fewer beads, I've been terrified every time I go to pick up my prescription, that they'll switch me. Then today my dads doctor reluctantly prescribed him more citalopram. It scares and baffles me that he could have just cut him off completely, without realising the danger. In fact it makes me angry - it's ignorance (withdrawal doesn't exist/isn't serious) mixed with arrogance (I'm the doctor, I'm right!)

 

I worry that one day ill have to try and fight for my Effexor prescription and lose because I'm not good with confrontation. I keep all my spare beads just in case...

 

I was thinking the other day that in the event of a Zombie apocalypse we wouldn't fare very well. Everyone would be out looking for food and shelter and we'd be raiding the pharmacies looking for our fix. Our crews would all probably abandon us eventually, "Leave him, he's withdrawing from Effexor, he's worthless to us."

 

I've thought the exact same thing while watching "The Walking Dead" lol!

[tezza]

I was hesitant to admit, but me too, LOL!

[Narcissus]

Haha! Great/damaged minds think alike.

[jr1985]

Well my mood has improved today. I suspect the swimming was too much for me and set off the depression.

 

Main symptoms are some mild tingling/prickling in arms and legs, mild overstimulated feeling and pressure in forehead.

 

In the grand scheme of things it's not too bad, but I'd still like relief from all symptoms at some point. Just gotta keep holding on (literally and figuratively).

 

It will be 4 weeks on Friday since I switched back to weighing beads (accurately), so I'm hoping for relief soon.

[Steerpike]

I find that exercise works for me. But I have to be careful about how much I do. I do weights and a small amount of treadmill running. I read somewhere that exercise causes some cell damage in older cells and they are broken down and replaced as a result. The newer cells work better. I can't find the reference but I do tend to think that small burst of light stress are healthy.

[jr1985]

So I'm feeling a lot better - the arm/leg tingling has improved a lot and the head weirdness seems to be going as well. BUT I'm waking up feeling tired every morning and struggle to make it out of bed, however, this is nothing new, I've always been like this to an extent.

 

I take melatonin every night and it definitely helps (3mg knocks me out, but leaves me groggy, so I take ~1mg, lower doesn't do anything). I've tried taking arginine and alpha-GPC (Choline), but they just made me feel strange and/or gave me insomnia. I should note that I rarely take my melatonin at the same time, it can range from 11pm-2am, but after doing my research I see you have to take it at the same time, pref between 9-10pm.

 

The other problem is that I've noticed I start getting mild brain zaps about 2 hours before my next dose. Now they're pretty infrequent, and they don't even happen every day, and I can manage them, they're just noticeable. Is this something I should worry about?

[Lexy]

I've been reading your story and was wondering how you are doing now. It seems you have posted for quite a while.

Please let us know. I am tapering from effexor using a micro taper but currently holding due to wds.

[MrAnxious]

Jr how are you ?!

[jr1985]

Hello everyone, I haven't posted here in a long time! Tbh, I was obsessing over the withdrawal thing and I wanted to get away from it for a while. I also hoped to return with mostly good news, but unfortunately it's rather mixed.

 

The good news:

 

The last time I posted I was experiencing some weird symptoms, like a heavy feeling in my head. I figured out it was actually withdrawal from omega-3, which was caused by me experimenting with a higher dose for a while and returning to the lower one. I decided to take a more potent liquid omega-3, which worked wonders and I hadn't felt better in years. It pretty much cured my depression and anxiety, so much so that I was actually able to sit my first exam in years, without having to drop out due to anxiety.

 

The bad news:

 

Unfortunately, the anxiety didn't stay away for good. The higher dose omega-3 was starting to make me feel exhausted after taking it for a few weeks, and gave me rage attacks. I tried lowering it, which caused withdrawal symptoms (horrible stingy feeling in arms and legs, chills, etc), so I bumped it back up again, which made me exhausted, and so on... Eventually, I tried changing the timing, which resulted in massive anxiety, which was actually triggered by a situation in work. I changed it back to the original time, kept chopping and changing the dose, which made things worse and worse.

 

I kept thinking the symptoms were withdrawal or side effects, but it finally dawned on me that they were probably due to me chopping and changing the omega-3 so much. It never occurred to me before because a) I had no idea fish oil could have that effect (almost like chopping and changing an antidepressant) and the symptoms would sometimes not appear until a couple of weeks after adjusting the dose. Also, the dose changes were literally tiny, yet they could trigger symptoms that were pretty substantial. I've been keeping the dose the same for 4 weeks now, except Friday I panicked and increased it and lowered it again after I felt awful.

 

As for Effexor, I've barely made any progress on tapering it. I dropped it a little by removing a couple of beads and didn't really notice any symptoms. I decided to hold on it while I figured out the omega-3 thing, which has taken a lot longer than I thought, mostly because I've been stupid.

 

I have an exam in a few weeks and I've been panicking again. I feel like it's too much for me when the anxiety hits, I become completely non-functional, but I'm going to wait and see of things improve before giving up. If I did I could always do something less stressful while tapering.

 

What now?:

 

My plan for now is to hold on both the Effexor and omega-3, now I know it's as potent as a drug for me. It might take a while for me to stabilise again because of all the chopping and changing I've been doing over the past year. Once stable, I'll continue with the Effexor taper.

[Altostrata]

Very good to hear from you again, jr.

 

That is a remarkable story regarding omega-3 fatty acids. I have never heard it having such a strong effect.

 

Ordinarily, I wouldn't suggest this, but flaxseed oil is a way to get omega-3 fatty acids, but in a more roundabout way than fish oil. Conceivably, if you took part of your omega-3 dosage as flaxseed oil, it would not get into your system as fast, it might buffer the effects of the fish oil omega-3s.

http://www.health.harvard.edu/fhg/updates/Why-not-flaxseed-oil.shtml

 

This is just a guess. It seems that if somehow you found a golden mean, you might get the benefits of omega-3s without the hyperstimulation.

[Altostrata]

jr, how are you doing?

[jr1985]

Hi alto,

 

I'm not doing so well at the minute.

 

I told myself that I was going to start tapering properly in the new year, because I'd already wasted so much time faffing about with omega 3, etc. In January, I made cut Effexor by a small amount, but I later discovered I'd accidentally messed up my dose of both omega-3 and phosphatidylserine at the same time. Making a small change in one was enough to trigger symptoms, so as I'm sure you can imagine, cutting all 3 was a bad idea.

 

I tried "fixing" it by bumping the dose back up but that just made things worse. I've had quite bad depression and anxiety for a month or so now. But don't worry, I have hope that if I keep holding eventually I'll feel better again.

 

Thanks for asking!

[Skyler]

Just 'stopping by' to say hello jr.  I'm very sorry you have continued to have so much difficulty.  I had very much hoped things were improving. 

 

Give yourself a hug from me, K?

[Altostrata]

A hug from me, too. Hang in there, jr.

[jr1985]

Hi All, 

 

I'm sorry I haven't posted here in such a long time.  I pretty much pressed pause on my taper for years since I last updated due to some very stressful life events.  It's not all bad though, in the interim I managed to complete my degree and get a job in IT (yay!).  However, I have hit a bit of a snag recently in terms of Effexor and was hoping someone might be able to offer some advice.

 

I've been taking the brand "Rodomel XL" for years, which contains hundreds of beads inside a capsule.  I've been weighing them out using a jewelers scale, as I ended up on just below half of my original 75mg, and that worked ok for some time.  However, I moved to a new area and had to change my GP, who prescribed me Vensir, which contains mini tablets inside rather than beads.  I asked to be switched back, but the GP was horrified when I told her I opened the capsule and weighed the beads, and flat out refused to swap me.  Then I recently discovered my original brand, Rodomel, has been discontinued.

 

I ended up buying Venlor XL from an online pharmacy (they don't sell Rodomel) and began taking it around 1.5 months ago.  

 

There are more beads inside this one, so I worked out the percentage I was taking of Rodomel and took the equivalent in Venlor.

 

However, ever since the switch I've noticed my anxiety creeping up.  I feel a bit weird - head feels fuzzy, I feel very jumpy and shakey and my anxiety feels worse.  I was on a flight to London a couple of days ago and my palms were sweating the whole time. Usually I hate the taking off, but I'm mostly ok with the actual flying part.  It feels like it's maybe getting worse.

 

Anyway, I'm wondering what my best option here would be:

 

1) Carry on with Venlor at the current dose and see if things subside?

 

2) Swap back to Rodomel (I still have some beads saved up, which should last me 2 months or so), and then cross-taper with the Venlor over a month or so (3/4 Rodomel 1/4 Venlor for 1 week, 1/2 Rodomel 1/2 Venlor for 1 week, 3/4 Venlor 1/4 Rodomel for 1 week)?

 

3) Try brand name Effexor XR to see if it's any better?  There's a study showing some generics are less bioavailable than the brand name (https://www.ncbi.nlm.nih.gov/pubmed/19653973)

 

Any advice would be much appreciated!

 

[jr1985]

From what I can tell I seem to feel gradually worse throughout the day, until I take my next dose in the evening, then feel slightly better.  That makes me think it’s maybe being released too quickly, so there’s not enough left to sustain me until the next dose, but not 100% sure.

[jr1985]

Well looks like Effexor XR  brand may not be an option after all.

[ChessieCat]

Q:  How long does it take after taking your dose before you feel improvement?

 

If you think that it is interdose withdrawal you could try splitting your dose.  If you are taking it in the evening you could move 1/2 of the dose earlier each day.  You will need to keep daily notes on paper to see how it is affecting you.

 

If you notice that the improvement starts happening earlier as you move your 1/2 dose earlier then that might be an indication that you have been getting interdose withdrawal.

[jr1985]

16 hours ago, ChessieCat said:

Q:  How long does it take after taking your dose before you feel improvement?

 

If you think that it is interdose withdrawal you could try splitting your dose.  If you are taking it in the evening you could move 1/2 of the dose earlier each day.  You will need to keep daily notes on paper to see how it is affecting you.

 

If you notice that the improvement starts happening earlier as you move your 1/2 dose earlier then that might be an indication that you have been getting interdose withdrawal.

 

Maybe an hour or so afterwards?  It’s hard to say because I don’t feel great most of the time, though it does seem to get worse by late afternoon until evening and then improves by bedtime.  However I should stress that since switching generic brand I don’t really feel normal at all.

 

I switched back to my old generic brand Rodomel last night and, while definitely not stable, I do seem to feel better than I did on the new brand already.

 

I’m not really sure what the best way forward is.  I can beg my GP to prescribe Rodomel, but it looks like it’s been discontinued (https://www.tevauk.com/p/venlafaxine-332) and I’m not sure how long stocks will last.

 

I was thinking I could stay on Rodomel

for a month or so until stable, then cross-taper over the course of a month to the generic brand I bought online (Venlor)? 

 

 

[ChessieCat]

It would be best to try and stay on the Rodomel until you are stable before transitioning to the generic.  Are you able to get a pharmacy to hold Rodomel for you for a few months to be able to do this?

 

You will need to leave enough Rodomel to do the cross over to the generic.

 

We generally suggest each combination of 3/4 old + 1/4 new, 1/2 + 1/2, 1/4 old + 3/4 new for 3-7 days.  In your case, because it seems that you did notice a difference changing directly over I think 7 days at each combo would be better.

[jr1985]

I have approx 70 days worth of rodomel left over.  Would that be enough for me to cross-taper? I can stay on it for a month to stabilise then cross-taper over to the generic?  I can try and ask my GP to prescribe Rodomel again, but they refused the last time because I made the mistake of telling them I was opening the beads.  I can lie and say I stopped doing that and started taking the new one they prescribed but it didn’t work for me.

[ChessieCat]

Unfortunately after what has happened we don't know how long it will take to stabilise.  It might take longer than 1 month.  You will need to listen to your body.

 

The best way to work out how many days you can stay on the Rodomel you have is to work backwards.  So work out how much you will need to do the combination cross over for 7 days at each combination and then the remainder you can take leading up to the cross over.  If you find that you haven't stabilised enough to do the cross over then you may need to do as you said in order to get some more Rodomel.

 

This is my calculation of what you will need:

 

The first and last combinations add up to 1 so you will need 7 of each Rodomel and generic for those weeks.

 

3/4 + 1/4

1/4 + 3/4

 1   +   1     (each x  7)

 

and for the middle week of 1/2 + 1/2 you will need 4 of each Rodomel and generic (divided the week, 7 days, by 2, 3.5, then rounded up to whole number).

 

So in total, you will need 11 of each Rodomel and generic.

 

EDIT to add:  And as a double check on the calculations, 11 x 2 = 22, and you need 21 days' worth of drug.

 

I hope that helps.

 

Edited April 13, 2019 by ChessieCat

[jr1985]

So it looks like I’m screwed.  Rodomel XL has been discontinued as we thought and so far my usual pharmacies have none in stock.

 

The only one we seem to have in the U.K. now is Vensir, which contains mini-tabs, rather than beads.

 

I can buy Venlor, which has beads inside, online, but it’s a bit dodgey in the sense no prescription is required and I can’t really tell my GP about it.  I’m sure it’s the legit drug because it is labelled as such and wasn’t causing any major withdrawal, other than some anxiety breaking through.

 

I’ve been thinking about doing the Prozac bridge.  I’m aware it carries risks but it means I’d be able to get it easily enough from the pharmacist and seems like it would be easier (though not EASY) to taper than Effexor.  I’d also be able to keep my doctor in the loop.

 

What do you think is the best course of action here?

 

 

[jr1985]

Well I managed to get brand name Efexor.

[jr1985]

So ever since my hellish Effexor withdrawal I sometimes get these symptoms when I rock the boat too much.

 

It feels like a tingling, nerve pinching feeling in my legs and feet.  I can also sometimes feel it in my head and mouth.  If it’s bad enough it can keep me awake all night.  I actually haven’t had it in a long time, but I, er, “rocked the boat” a little too much recently and I’d had a flare up.  I couldn’t sleep at all last night.

 

It’s different from RLS, because that’s a feeling like the muscles in your leg need to contact.

 

Walking around and generally being distracted helps.

 

Is it Akathisia or something else?

[ChessieCat]

paresthesia-pins-needles-numbness-tingling-burning-sensations-aka-neuropathy

 

[jr1985]

I’ve managed to set off Akathisia again.  I haven’t experienced it in years.  I think it was a combination of the fact I switched over fully to Efexor (I cross-tapered over 3 weeks from the generic that has been discontinued) AND cut my Vyvanse dose by half.

 

Please don’t judge me for taking Vyvanse. I really felt like I needed something for my ADD to help me cope with life and was getting desperate.  I’d only been on it for about 2 months, so I thought I could get away with dropping by half, but apparently not.

 

I have this horrible restless feeling in my legs and chest and have been unable to sleep because of it since Monday.  I did take a Benadryl last night, which helped me sleep.  It helped the last time too.

 

I have this fear it will get worse and never go away.  I had the same fear the last time too and it did diminish eventually, so maybe this will be the same but there’s always the fear that it will be different this time.

[ChessieCat]

Please add the Vyvanse information to your drug signature.

 

Are you aware that there is a major interaction between Effexor and Vyvanse?

 

Are you taking any other drugs or supplements?

 

Interactions between your drugs

Major

venlafaxine lisdexamfetamine

Applies to: Effexor (venlafaxine), Vyvanse (lisdexamfetamine)

Talk to your doctor before using venlafaxine together with lisdexamfetamine. Venlafaxine may increase the effects of lisdexamfetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

[ChessieCat]

Please add the year to these:

 

Aug/Sept 11: Fast tapered Effexor to Mirtazapine

Oct: C/T Mirtazapine after bad reaction and back on Effexor

Nov/Dec: Fast Tapered Effexor - w/d hell

 

Please correct the dates:

 

5/2/12: Reinstated Effexor 37.5mg

30/6/12: Dropped to 35.6mg

[Altostrata]

Hello, jr. What was the timing of your drug changes? As you know, we advise against changing more than one drug at a time.

[jr1985]

On 7/18/2019 at 8:44 AM, ChessieCat said:

Please add the year to these:

 

Aug/Sept 11: Fast tapered Effexor to Mirtazapine

Oct: C/T Mirtazapine after bad reaction and back on Effexor

Nov/Dec: Fast Tapered Effexor - w/d hell

 

Please correct the dates:

 

5/2/12: Reinstated Effexor 37.5mg

30/6/12: Dropped to 35.6mg

Hi, I fixed it but had to squish everything together a bit for it to fit. The dates were in the U.K. format (day, month, year), but I changed them to avoid confusion.

[jr1985]

On 7/18/2019 at 7:21 PM, Altostrata said:

Hello, jr. What was the timing of your drug changes? As you know, we advise against changing more than one drug at a time.

Well I cross-tapered from Rodomel to Efexor over 3 weeks by taking 3/4 and 1/4, 1/2 and 1/2, then 1/4 and 3/4.  I ditched Rodomel entirely on 12th July and cut Vyvanse in half on 13th.  So I guess I rocked the boat too much... I know I should’ve known better but there’s a part of me that wants to prove to myself I’m “healed”, when that’s obviously not true.

[jr1985]

In terms of dealing with the Akathisia, I have Benadryl (actually Nytol in the U.K. but it’s the same thing - diphenhydramine) and propranolol.  5mg Propranolol seemed to be enough to help, so I might increase to that from 2.5mg for a while until it dampens down.  The problem is it gives me insomnia, so might just take that in the morning and small amount of Benadryl at night for sleep.

 

im not sure what the consensus is around here these days, but I think before I tried to fight through it would adding any other drugs, but the fact I’m working full time and it’s affecting my sleep makes me more willing to try something to fix it.

[jr1985]

Sorry for all the spam but I thought of another question.  Let’s say propranolol for instance takes away the akathisia and I feel fine.  Does that mean the withdrawal is under control and I could start tapering Vyvanse? Or not because maybe the propranolol is just masking the withdrawal?

[Altostrata]

If I were you, I'd let my nervous system settle down for some months before making any more drug changes, and then MAKE ONLY ONE VERY CAUTIOUS DRUG CHANGE AT A TIME.

 

What exactly are you taking now, at what times of day and dosages?