Jonathan93: tapering Effexor XR, mirtazapine and sertraline

[Jonathan93]

Thanks alot for your help, chessie

 

The only real symptom I had was beeing really tired for no reason, probably because my body needs energy to adjust. But now it is getting better. Im only reducing one medication: Effexor and I surely wont go over 10 % reduction! I learned my lesson.

[Jonathan93]

Hello, little update, I feel pretty good despite the harsch lockdowns in our country. I got infected with corona, but I got over it pretty good so far. Im "supposed" to taper my Effexor again, but since I had the virus for about 2 weeks I give my body more time, so I have more energy for the next time tapering.

 

Wishing everyone the best in these corona times. Stay healthy

 

Jonathan

[ChessieCat]

12 minutes ago, Jonathan93 said:

Im "supposed" to taper my Effexor again, but since I had the virus for about 2 weeks I give my body more time

 

Yes, definitely hold for longer.  You might make a test reduction of 2.5% to make sure that you are okay to start tapering again.

[Jonathan93]

Hello and a happy new year!

 

Im doing ok right now, I tapered my medication 3 weeks ago, close before new year. I went from 56,25 mg to 51 mg Effexor. The first two days I felt kind of sick, but I got over it. Now 3 weeks later I started to having gastrointestinal problems and felt stomach sick. I also feel a bit depressed, but my days are still doable. Just curious if its possible that my gastro problems are related to tapering? My "low" could be related to tapering, but also due to lockdown in germany. The lockdowns are really strict and it ist probably going to last for the next few weeks. Its hard to live with lockdown for me, because I miss meeting people, going to the gym, public life e.g., but I guess I just have to accept the current situation. Everyone has to deal with lockdowns and I think it is a huge impact on the human psyche (and health).

[DataGuy]

@Jonathan93 it's very possible the gastro problems could be the result of the Effexor cut. If you want you could try increasing the dosage to 53 or 54mg and see if that takes care of the symptoms. If you don't want to do that and just hold, I would probably recommend cutting a smaller amount next time and seeing if you handle that better. Ideally you should not feel sick afterwards.

 

I agree the lockdowns are affecting everyone. I saw that Germany had quite a few cases and deaths lately and I was surprised. I always see the Germans as much more organized and under control than us here in Canada. But at this point we have a lower mortality rate than Germany, which I never expected to happen. In any case, there are always many different things that can affect us and it is so hard to know what the culprit is. It's easy to ascribe all problems to the taper, and often that is correct, but we can also test other hypotheses as well. Difficult to know if it is the social isolation and I guess even harder to test (and maybe you don't want to). Perhaps you could skype or zoom with some friends/cousins/family and see if that helps? Group calls can be quite fun and are good for simulating "hangouts". Is there anything else that might be affecting you? My primary suspicion would always be the drug, but that is my bias. 

 

I think I have mentioned this before, but there is very little benefit to "toughing out symptoms" and making larger cuts than you can handle. I don't know if your cut is too large, but it is very possible. In some people 10% is just too much (even 5% can be excessive). It is perfectly ok to cut more slowly, especially since this will be a long process. You want to be comfortable throughout. If you cut too much in the beginning, it can really make it more difficult than it needs to be and may hurt you down the line when you are at the more difficult stage of tapering (the very steep part of the curve I posted on the first page). 

 

I hope you are otherwise doing well, Jonathan, and would love to hear more about how things are going : )

Edited January 19, 2021 by DataGuy

[Jonathan93]

Thank you Data Guy for your help! I dont have any gastro problems anymore, but I still did not know if it was the taper or something else. After tapering Im always super alert and start to be really concious of any symptoms, but I guess thats pretty normal when you experienced tapering symptoms.

 

Right now I'm already at 50 MG Effexor !!! Thats a huge success for me since I started at 150 MG Effexor. My next cut is starting next week which will be about 2,5 to 3 mg. I still have a long way to go since I take 3 medications and it wont be easy, but I feel prepared. Cautious and slowly is probably the best approach.

 

The curve on effexor is actually really helpful! On this Data I can make better decicion. (Listening to your body should always come first, of course)

[Jonathan93]

Yesterday, I reduced from 50 mg to 46 mg Effexor XR. I feel ok, just a bit increase in anxiety and feeling a little down. Should subside pretty soon.

[DataGuy]

Great work @Jonathan93. Best to keep symptoms as smooth as possible. You're doing very well with your cuts. Glad to hear the gastro symptoms went away. Hope you have a smooth ride down : )

[Jonathan93]

Thanks Dataguys for the kind words. My symptoms actually increased a bit. I have anxiety and feel depressed, but its still manageable. Actually Im not sure if its withdrawal or my life circumstances because I was a little bit down before the taper... Its been just over a week, so I guess I have to be a little bit more patient. 

 

Happy easter to everyone reading 🙂

[Jonathan93]

So its been 15 days since my last cut and the cut might've been to big, even though it was "only" 7-9 %. I felt pretty down for 14-15, but now im slowly improving. I have a light headache and just dont feel that fit. Eye movement hurts a little bit.

Since I had Corona it could also be Long-covid so it kind of annoys me not knowing if its AD-withdrawal or long-covid or both? Next cut will be just 2,5 mg to 3 mg. Id wish I could make bigger cuts, but I just know my body cant handle it that good.

 

Question: The next taper should always be done when there are no withdrawal symptoms left , right?

 

[DataGuy]

Yes @Jonathan93, that's correct. You want to wait until symptoms are minimal. For some people it's not really possible to wait until there are no symptoms, or they would be waiting a very long time. Although we're not exactly sure what is happening in your nervous system, it seems like allowing symptoms to get too intense to the point where they become intolerable is counterproductive, since they may take a very long time to go away and thus both lower your quality of life and slow down your taper and your return to normal functioning. For example, people who cold turkey seem to experience both more intense and more protracted symptoms than people who taper very slowly, so it seems reasonable to hypothesize that some sort of injury to the nervous system is happening, on top of the adjustment to the absence of the drug. 

[Jonathan93]

Thanks for the advice, yes I think you're right in long term it probably takes even longer ... So far I've been feeling a bit better. I don't have so much anxiety anymore and phases of windows and waves are about 50/50 right now, so it seems like Im getting a bit better after three weeks of reducing.

[Matheus]

Your story seens like mine. I am taking two ADs togheter..

 Effexor and paxil. 😐

[Jonathan93]

10 hours ago, Matheus said:

Your story seens like mine. I am taking two ADs togheter..

 Effexor and paxil. 😐

Im so sorry to hear that Well at least we are on the same journey and have the same goal :). You have a new follower 🙂

 

Its been three weeks now since last time tapering and right now in a wave :(. Feeling depressed and really tired the last few days. 

I have a question to everyone reading: Are goosebumps a symptom of WD? I have always these really short bursts of freezing, like I suddenly feel cold. I dont know if thats normal :0.

 

[DataGuy]

Yes @Jonathan93, goosebumps seem like a normal withdrawal symptom. Plenty of people reporting it on this site and others. Seems like body temperature regulation issues are fairly standard https://www.survivingantidepressants.org/search/?q=goosebumps&quick=1

 

Hope things smooth out for you with slower reductions.

[Jonathan93]

Im still feeling really down ☹️ In the evening its always a bit better, but especially in the morning I feel anhedonic and depressed..😕

Withdrawal symptoms like hurting eyes and sensitivity to bright light is pretty much gone.. but I still have little Goosebumps/ shivers.. I really hope my depressed state is linked to withdrawal..

Its been about 4 weeks since tapering and I really hope I have some better days soon.. 😮

[Jonathan93]

Little update: 5 weeks since my last taper. RN I am in this anhedonic state, not necessarily depressed. Everything feels pretty gray right now, but I do not have a problem doing my daily tasks. Other symptoms: My eyeballs hurt and and I feel really aggressive from time to time 😕 

 

So I've been wondering why a reduction from 50 to 46 mg Effexor XR has such a big impact.. I mean its just 8 %..  There is a big drug Interaction between Mirtazapin and Effexor XR (Psychatrist call it California Rocket Fuel). Is tapering tougher, when there are drug interactions? 

[DataGuy]

Hi @Jonathan93,

 

I think with your extensive history of medications, switching, trying to come off and then going back on, polypharmacy etc your nervous system may just be a bit unstable and sensitive to changes. It's always hard to say exactly what is going on, but you have been taking 3 drugs together that all have significant effects on serotonin. It also sounds like you may have had some difficult withdrawals in the past. All of these things could be contributing factors for sensitivity to reductions. I know in medical textbooks they note that past difficult withdrawals from alcohol are a strong predictor of having medically serious problems coming off again. The same may be true of psychiatric meds. But this is mostly speculation. 

 

I agree that the next cut should be lower, maybe 2mg rather than 2.5-3mg, but I do think you should wait until you feel stable. You have already had very significant reductions in the venlafaxine and sertraline in the not too distant past, so that could also be a factor. Always best to go slower than necessary. I think you should be thankful you are getting a small taste of what it is like when you go too fast. Best to stabilize and take it on board as a lesson for future reductions. Still a long way to go, but you are doing great @Jonathan93.

[Jonathan93]

Ok thanks for your help! Yes Im gonna level it out even slower.. I once reduced from 51 to 50 mg and I did not feel any difference! I agree with you on the taper, but its just really hard to have that much patience! I feel like this is going to take forever, till I will be at 0 mg for all the three meds. Im really thankful having a therapist and an understanding family, this are and will be important resources for me in my tapering journey. Im 27 years old, still young and besides my mental health I am pretty healthy. I just thought I would have less tapering symptoms since I am pretty young, but I guess withdrawal does not care about age 😬😬

[Jonathan93]

Status update right now, slight stomach problems, barely any appetite, feeling depressed. Waking up earlier then usual, tomorrow its the 5 week mark since my last taper. Just hoping for better days right now.. 

 

I'm having doubts about my tapering rn. I just wish for at least one good day (or wave) 😮 Despite this I can "live" pretty normaly, but Im just in this anhedonic, lethargic emotional state.

[DataGuy]

How are you doing now, @Jonathan93? You may want to think about doing a slight updose. Sometimes we can also have delayed reactions to previous reductions that were too big. May be that your nervous system is telling you it's had enough.

 

Of course it is all up to you. Very uncertain how much of a difference it will make, but it is an option. 

Edited May 6, 2021 by DataGuy
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[Jonathan93]

Hey thanks for asking! Things are actually going good! After 6 weeks my symptoms are finally starting to fade...and Im actually feeling good 🙂It was a really tough time, but I pushed through finally.. even tough it might be a window Im just glad that my body showed me first signs of healing from tapering. I will hold now for probably like two weeks (or 3 weeks) and next taper will be "just" 2 mg. One of the reason is time and the other reason for feeling better is that I started a part-time job as a geriatric nurse (I dont work full time since im at college) ... helping other people really distracted me from my symptoms and  doing "good" in the world helps me handling symptoms much better.

[Jonathan93]

So I had some really good 2 weeks and I feel stable enough to taper again.. my withdrawal symptoms from last tapering are pretty much gone. My taper this time is only 1,8 mg. I choose this small reduction so I can taper in 4 weeks again, if everything goes smoothly.

So my current Med status:

 

Effexor XR 44,2 Mg 

Mirtazapin 15 mg 

Sertraline 25 mg 

 

I still have a long way to go.. but I'am already with all the medications under the "therapeutic" doses for depression which is a nice success!

 

 

Have a nice week to everyone reading. 

 

 

 

[Matheus]

Congratulations, @Jonathan93!!! You're on the right track!!!

[DataGuy]

Thanks for the update @Jonathan93, glad you are feeling a bit better. Very generous of you to help out in the care of the elderly at this time, I hope it goes well. Let us know how you feel after the current taper. Hopefully a big improvement over last time : )

[Jonathan93]

Update: 6 days since tapering, no withdrawal symptons at all so far. The small reduction seems to work much better with my body.

[Jonathan93]

Little Update: I had a pretty good tapering experience last time. It was just 1,8 mg and I did not had any symptoms.  Next reduction is tomorrow from 44,2 mg Effexor XR to 42,37 mg. Lets see how I will do, I should be good hopefully.

[getofflex]

It sounds like your taper is going very well.  Keep up the good work!  These careful gradual tapers really work.  

Edited June 6, 2021 by getofflex

[Jonathan93]

Update 14.06.2021:

I am in a depressed state again :( . My sleep is bad. I wake up early and feel pretty tired over the day. I really hope its because of the reduction and not because of my mental condition. Seperating these two is always tricky and confusing.

[getofflex]

It could very well be from your reduction, which you just made a week ago.  

 

Even if it is your mental condition, there are many non drug ways to deal with depression, and other mental health issues.  Here is a link: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

[DataGuy]

Agree with @getofflex, it could be the taper. I believe there was only 3 weeks between your last two cuts? It could be the second one amplified the withdrawal from the first. You can try to hold on until you feel better, or you can do a small updose of 1mg to your dose. 

 

Hard to separate out what is making you feel worse. If you feel better with a small updose, then we will know what the cause was, and you can slow things down a bit until your system stabilizes. But if you don't want to do that it is ok. In any case, it may be better to do smaller cuts from now on. Much preferred to cut not enough than too much. It isn't a race after all, and it's also likely the quickest way for you to get back to feeling your best, @Jonathan93. 

[Venlafckcine]

On 4/27/2021 at 10:44 AM, Jonathan93 said:

Little update: 5 weeks since my last taper. RN I am in this anhedonic state, not necessarily depressed. Everything feels pretty gray right now, but I do not have a problem doing my daily tasks. Other symptoms: My eyeballs hurt and and I feel really aggressive from time to time 😕 

 

So I've been wondering why a reduction from 50 to 46 mg Effexor XR has such a big impact.. I mean its just 8 %..  There is a big drug Interaction between Mirtazapin and Effexor XR (Psychatrist call it California Rocket Fuel). Is tapering tougher, when there are drug interactions? 

Hey Jonathan93,

How are you doing? 

Here is an existing Thread about going off mirtazapine plus venlafaxine (Effexor) aka "Russian Roulette" forgivness... I meant "California rocket fuel".

Ven

[Jonathan93]

Thanks for all the helpful replys! I appreciate it.

Hello Community, I had a stressful time with university so thats why I did not post anything! About a week later, about the 21. th June my condition got much better and I could enjoy life pretty much since then. Im glad that I got passed the withdawal symptoms. University stress is getting less and I have a feeling that I can reduce my dosage agains. I decided to taper again on the 9th July, so upcoming thursday. Im reducing my Effexor XR from 42,37 mg to 40,8 mg. Lets hope my symptoms will be ok.

 

What really helped me during the last few weeks is doing WIM HOF breathing exercise, Im doing it every morning for about 10-15 minutes and I feel it improves my overall well being. I can recommmend it to anyone who has not tried it yet.

 

[Gridley]

13 minutes ago, Jonathan93 said:

About a week later, about the 21. th June my condition got much better and I could enjoy life pretty much since then.

It's very good to hear that you're doing well. You're doing a great job with the slow taper.

[DataGuy]

On 7/4/2021 at 7:04 PM, Jonathan93 said:

What really helped me during the last few weeks is doing WIM HOF breathing exercise, Im doing it every morning for about 10-15 minutes and I feel it improves my overall well being. I can recommmend it to anyone who has not tried it yet.

 

 

Thanks for the update @Jonathan93, hopefully the cut goes well. I have had a couple people recommend Wim Hof breathing to me now, so I guess I will have to try it : )

[Jonathan93]

Its been 5 days since last tapering, so far Im feeling ok, just a little down shift in the mood, but nothing out of controll so far. @ Dataguy (how can I tag you?)  there are a lot of introduction videos and guided sessions for wim hof on youtube! For beginners this is a good way to start.