jr1985: Effexor / venlafaxine taper

[Skyler]

I use my phone to remind me. Usually I just remember anyway, but this time I was working from 6pm-10pm and I take my dose at 7pm. Of course, I remembered as soon as I arrived that I forgot to bring the drug with me. In future I should set a reminder to bring Effexor with me. :-)

 

It sounds like just a matter of time before you forget to take the med with you again? Can you take it at 11PM so you are almost always home, and remembering to take the does is not an issue? We can tell you how to shift the dose to 11PM so you don't get symptomatic in the process. (You could shift an hour later every several days with no ill effects.. Alto may want to chime in. I was SUPER careful because I've had so many issues surrounding this.)

[jr1985]

 

I use my phone to remind me. Usually I just remember anyway, but this time I was working from 6pm-10pm and I take my dose at 7pm. Of course, I remembered as soon as I arrived that I forgot to bring the drug with me. In future I should set a reminder to bring Effexor with me. :-)

 

It sounds like just a matter of time before you forget to take the med with you again? Can you take it at 11PM so you are almost always home, and remembering to take the does is not an issue? We can tell you how to shift the dose to 11PM so you don't get symptomatic in the process. (You could shift an hour later every several days with no ill effects.. Alto may want to chime in. I was SUPER careful because I've had so many issues surrounding this.)

 

I'll let things settle before moving to 11pm. Thanks for the support! :-)

 

I'm now wondering if inconsistent timing has caused problems which I've interpreted as withdrawal. The reason I updosed after my 5% drop was because I thought the numbness and insomnia were due to withdrawal, I assumed the late dosing was just a coincidence, but now it's happened twice I'm not so sure. Perhaps it's a combination of both - instability from dropping dose + instability from late dosing = insomnia.

 

Anyway, I'm going ahead with my plan to sit on the current dose and take note of my symptoms.

[jr1985]

I'm a wee bit concerned about the scales I use to weigh my beads. I keep getting different values for the same amount of beads, so I keep weighing them over and over until it weighs the same twice in a row. The scales I use look like a Chinese knock-off of those American weigh scales everyone recommends. I'm thinking I should try and get the real ones but I don't know if you can buy them in the uk. Maybe I'd be better counting the beads? They're roughly the same size, but not exactly the same.

[jr1985]

I just ordered this one http://www.amazon.co.uk/AWS-Jewelry-GPR-20-Gemini-PRO-Milligram/dp/B003STEJD4/ref=sr_1_1?ie=UTF8&qid=1344874537&sr=8-1

 

It's expensive but if it means getting accurate results then so be it.

[Altostrata]

That's the one we've got in our digital scale topic. (It's less expensive in the US!) There are instructions for calibrating it, too.

[jr1985]

Well holding and taking doses at the same time every day seems to be helping. The akathisia has died down and my insomnia is gone. This is usually the point where I say, "I feel better now, lets go!" and start trying to taper again, but this time I'm going to keep holding on the minus one bead for another month or two to see how my symptoms change.

[Skyler]

Well holding and taking doses at the same time every day seems to be helping. The akathisia has died down and my insomnia is gone. This is usually the point where I say, "I feel better now, lets go!" and start trying to taper again, but this time I'm going to keep holding on the minus one bead for another month or two to see how my symptoms change.

 

Heyyy, good to hear. You do need to hold for awhile.. to stabilize, and let yourself realize you can feel better than you were! Glad you are watching the timing of the dose and have ordered the scale.

[jr1985]

So... my new scale arrived yesterday and I weighed out some new pills. I took the first one yesterday, at the usual time, and I woke up this morning feeling jittery. So I decided to re-weigh the beads on the old scale - they were showing as 85mg on the old one, when they were supposed to be 90mg on the new one...

 

I'm thinking I should just stick with the old scale for now, since I was starting to feel better using it, then suddenly felt worse after using the new one. Or would counting be more accurate?

[Skyler]

So... my new scale arrived yesterday and I weighed out some new pills. I took the first one yesterday, at the usual time, and I woke up this morning feeling jittery. So I decided to re-weigh the beads on the old scale - they were showing as 85mg on the old one, when they were supposed to be 90mg on the new one...

 

I'm thinking I should just stick with the old scale for now, since I was starting to feel better using it, then suddenly felt worse after using the new one. Or would counting be more accurate?

 

jr.. I would offset the amount of the dose with the new scale and use that one. You don't know if different doses will be equivalent as you reduce on the old one.

 

This said, I'd make random measurements with both scales and see if they come up with the same level of difference and go with what you think best.

 

Glad you are realizing how much seemingly small dose variations can effect the picture.. these at least these are within our ability to manage.. better than having symptoms change 'out of the blue'.

[jr1985]

So you think I should just stick with the new scale?

[Skyler]

So you think I should just stick with the new scale?

 

I would.. the new one may have been subjected to better quality control, and you can't be sure the weight would not go off again as you lower doses on the old.. that the incremental reductions would be uniformly smaller. With the new, you should be good to go once you adjust for the initial weight difference.

[jr1985]

 

So you think I should just stick with the new scale?

 

I would.. the new one may have been subjected to better quality control, and you can't be sure the weight would not go off again as you lower doses on the old.. that the incremental reductions would be uniformly smaller. With the new, you should be good to go once you adjust for the initial weight difference.

 

You're probably right. The new one comes with a 10 year warranty, so they must be pretty confident about it, and a pharmacologist left a positive amazon review, so it must be pretty accurate. Plus the old one was drifting by up to 12mg, even after calibrating numerous times.

 

I guess I'll wait for my body to adjust to the "new" dose.

 

PS. I ate sugar yesterday, could that make you jittery the next day?

[Skyler]

PS. I ate sugar yesterday, could that make you jittery the next day?

 

I can't speak for the way it effects you, but I don't have any negative response. I do to coffee (same day only) but not to sugar. I'm pretty diet conscious having lost 60 lbs this past year. There are differing opinions on the forum however.

[peggy]

sugar makes me really jittery - but after a few hours, not the next day. However it is conceivable that it could make you jittery the next day if you don't usually eat it

[jr1985]

I think I'm going to go back to the old scale. I was starting to feel better using it, but now I feel all jittery and my mind is racing. It started after I used the new scale, so the dose change must be too much.

 

I'm only using the scale to get 37.5mg, then I will be removing beads from there.

[jr1985]

Well nw I'm not sure I trust those scales at all. I think I might just count them.

 

Does these beads look similar enough that slight variations in size shouldn't cause problems?

 

 

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[Altostrata]

It is indeed a flaw in the bead-removal method that the beads are not all the same size.

 

But -- with Effexor XR, you don't have a choice. It's the only way to go.

 

Don't try to weigh the beads individually, it won't come out right.

[jr1985]

I'm going to trying weighing them using the old scale, just to get close to the number of beads I'm looking for, then count out the actual number of beads to ensure each capsule has the same number.

 

When I tried this earlier there was a variation of up to 10 extra beads for the same apparent weight. I found an average of 145 beads per 90mg (the actual weight of the dose I was on).

 

I'll try taking 145 beads per capsule for a week or so to see how it goes.

[peggy]

i must say jr, those beads look bigger than mine -mine look like 'hundreds and thousands' (the little beads you put on cup cakes. I am on the brand name effexor. I was given a generic version once and it had beads that looked a bit more like yours - they looked to be very uniform in size, where as mine do have significant variations albeit on a much smaller scale.

[jr1985]

The generic brand name I'm on is called Rodomel XL. They beads are fairly similar in size, with some slight variation.

 

One a different note, I found an anecdotal report by a schizophrenia patient, who had akathisia on Abilify. It seems sugar made them feel worse the next day and cutting it out made it go away. It seems to fit my experience.

[Altostrata]

Effexor XR beads will vary in size from manufacturer to manufacturer and from dosage to dosage.

[jr1985]

I was having w/d symptoms from 145 beads, so I added 5 more. Dunno if it's going to help yet.

 

This is starting to scare me. The fact that a few little beads and/or taking a dose late causes insomnia for a few days worries me.

[Rhiannon]

Sugar tends to be very problematic for me. Like with everything listen to your body.

 

I would recommend once you figure out how you're going to weigh and measure, taking another hold. From what you're describing, and from how you felt when you held before, I think you may be pushing your brain's ability to adapt just a bit too hard.

 

Given your history of changes and instability in the fairly recent past, you need to really be gentle with your CNS; it's just not as strong and robust as it would have been before all of that. I recommend a hold now, and intermittent longer holds (a month or two) from time to time as you taper down.

[jr1985]

Thanks Rhi, your advice is much appreciated. I'm going to count 150 beads and try to get stable there.

 

I feel like such a fool for changing scales when I was feeling ok. Yet another lesson learned: if it isn't broke, don't try and fix it.

 

I'm wondering just how many times I can push my brain before it stops being so forgiving.

[Altostrata]

jr, go back to the method that worked well for you.

[jr1985]

Righto, back to weighing beads with the old scale. It makes sense as I was actually starting to feel "normal".

[jr1985]

Well if anything this experience has showed that switching to Prozac is probably a bad idea. If my brain freaks out over slight variations in dose and/or timing, then what would happen if I shoved a new drug in there. Probably nothing good. The main reason I wanted to switch anyway was because I thought it would let me get off faster, but I'm coming round to the fact that this process will take as long as it takes. Based on the experience of myself and others, trying to rush this and push through w/d symptoms only causes problems.

 

I was thinking I could start my taper, once I've been stable for a while, by removing a bead per week for a month, then hold to see how it goes. If I'm ok, then try taperingf or two months and holding, and so on. If things go well, I can try two beads per week and so on, but let's not get ahead of myself.

 

The good news is I'm officially registered with the BSc(Hons) Psychology degree at The Open University (UK-based distance learning institution). I decided to drop the life science course because a) I wasn't really enjoying it and I was freaking out over withdrawal. I'm hoping the psychology will be better because it interests me more and I plan to go much more slowly with the w/d.

[Altostrata]

Taking something of more interest is much better for your brain!

 

Switching to Prozac might still be a last resort, if decreasing bead by bead doesn't work. Let's cross fingers it will all go fine.

[jr1985]

Well that feeling in my legs has flared up. It feels similar to the RLS I had while on mirtazapine, only more persistent and isn't just happening while I'm in bed. It seemed to fade in the afternoon, but flared up again after I took my next dose. Sometimes it's painful, like a sharp stinging sensation. Its very annoying. I guess it's from switching scales, then to counting beads, then back to the old scales.

 

Btw, is it possible I could be having withdrawal from Mirtazapine? I was only on it for a month, but I quit cold turkey.

[Altostrata]

I wouldn't worry about mirtazapine withdrawal.

[jr1985]

This RLS/akathisia is driving me mad, although I did manage to sleep last night with a 1/4 capsule of arginine. The usual dose of vitamin B6 isn't helping, so I'm trying half a tablet more.

 

Does this sound like a side effect?

 

Before reinstating Effexor I had bad anxiety, where I was actually shaking/trembling. The same evening I took citalopram and woke up with akathisia the next morning. I continued taking it for a week beforeI switching back to Effexor. The sensation became more like a burning feeling and I got a jaw tremor, but the symptoms seemed to improve to the point where I could tolerate it after two weeks. I then updosed to 75mg and the horrible sensation came back after two weeks. I dropped back down to 37.5mg. The next day I had a wave of calm come over me and the akathisia improved a lot.

 

When I dropped 5%, the feeling flared up slightly, but then it gradually got better before returning. I've read that tapering too quickly can make akathisia worse, even if it's a side effect.

 

It seemed to get worse after I updosed back to 37.5mg. Although it did subside for a while after a few days of holding, but then it came back.

[Skyler]

Hi jr.. I'm really sorry to hear you are having such a difficult time. For me, before the withdrawal stuff started, the first sign I had that RLS was when the antihistamine I took for sleep gave me the 'creepy crawlies." Now, because I'm prone to RLS it's associated with withdrawal from many meds. Lyrica, requip, and diazepam. Too fast (or inconsistent dosing) on any and the RLS dragon raises it's head. (Tinnitus is same.. it's associated with all of them. There is cross over, and many of the psychotropics will cause these symptoms.)

 

The RLS got dramatically worse when I was jerking the Lyrica dose around. STAY AT ONE DOSE jr, don't keep moving it. I would have taken an uptick in symptoms to go with the better scale but otherwise would go by the book. I absolutely loathe RLS..

[jr1985]

Thanks schuyler, it's actually eased up this afternoon.

[jr1985]

Schuyler, how long did it take for your RLS to go away after you stopped jerking your lyrica dose around?

[jr1985]

Well the RLS seems to be easing up, still here but not as bad. I did some yoga leg stretches last night, so I dunno if it's that or if it would have eased up anyway.

[Skyler]

Schuyler, how long did it take for your RLS to go away after you stopped jerking your lyrica dose around?

 

Just saw this.. and glad the RLS eased up last night. Hope that holds, though you may find they ease up over a few days.

 

I mostly had tinnitus from Lyrica withdrawal.. that was the one that seemed to go on and on. RLS went away over a couple of weeks for that go round. They come back whenever the taper starts to go too fast, and last for a few nights each time they are tweaked.