Mskb: Problems tapering Venlafaxine, severe anxiety, ruminating, years of antidepressants, please help

[Mskb]

Hello, I think it best to start a history of how I got here. I was also on antidepressants from 1986 to 1989. Was put back on AD’s in 1997. I was functional for years with periods of remission and periods of depression and anxiety. Single mother, worked, raised two girls, etc. I was on sertraline the longest.

 

Over a period of about 4 years I began to slowly lose interest in socializing and doing things and became increasingly anxious and fearful, lost my confidence. Was bumped back and forth from Sert. 100-150mg a few times then stayed at 150. Was able to remain functional.

 

By Fall 2017 my anxiety was constant and severe, panic attacks, increased depression, insomnia, no appetite, and much difficulty functioning, relying on lorazepam to get through the day. In January 2018 the sertraline was increased the max. 200 mg., did nothing. 2 months later was cross tapered over a week to Fluoxetine. Within 3 weeks was non-functional and could not continue working, a huge stressor. Could barely get out of bed or leave the house. Became worse on fluoxetine, horrible symptoms, severe anxiety, panic, irrational fears, depersonalization, racing thoughts, constant jerking, insomnia, panic, speech and word retrieval issues, suicidal ideation, barely able to drive or go out. Constant brain fog, difficulty speaking. 12 weeks later was switched to Paxil, within 2 weeks became even worse, and was switched to venlafaxine.

 

Within 2 days was admitted to a psychiatric hospital for 3 weeks. The venlafaxine, mirtazapine and lorazepam were increased and olanzapine added.  In Aug. 2018 my Psych. increased the Ven to 225 mg, in Oct. 2018 to 300 mg and the olanzapine to risperidone. With the risperidone, became very foggy, out of it, suffered from derealization, anxiety worsened again, had panic attacks. Dec. 2018 Ven was reduced to 225 mg and mirt.to 15. Became worse. Feb. 2019 months back to 300 mg. Stimulants added but made things worse those. Stopped Risperidone over 2 months, July 2018. In Aug. 2019 went to 225mg Ven, Sept. back to 300.

 

I continue to be lethargic, emotionally blunted, disinterested, unmotivated, unable to cry, anxious, periods of heightened anxiety, fearful, uneasy, ruminating and worrying, no anticipation, pleasure, joy, the list goes on. I am bored with no motivation, interest or confidence.  I am now 65 years old and had to retire on disability. Now that I am at 178mg I can think more clearly and word retrieval is better.

 

Last year I began researching online. Found SA., read Robert Whitakers book, joined the Effexor withdrawal group. To put it mildly my eyes were opened. Learned about poop out, withdrawal, PAWS. That these drugs can keep you this way and how dangerous they are.

 

I tapered from 15 mg mirtazapine (too fast) by breaking off pieces (off April 24, 2020). Severe insomnia, but do get broken sleep now. Started tapering from 300 mg Ven on April 1, 2020, by weighing beads. The first 5% taper was okay. Thought it would be easy, 10% here we come. I was so wrong.  Starting with the 5/1 taper, began experiencing greatly increased anxiety and worrying, ruminating over and over, waking with anxiety, dread, unease (the intense morning unease does pass after about an hour) nervous stomach, intermittent heart palpitations. This starts around day 4 of the taper and can go 4 weeks without beginning to lessen its grip. I feel blah most of the day, it’s often a struggle to do even little things.

 

I generally feel better in the evening, then by morning it's all back. I hold, but there has not been a day in over 3 years that I haven’t experienced anxiety and blahness. I’m close to 5 weeks into this taper and am just starting to feel it start to lessen.

 

I know my CNS was destabilized and is oversensitive to drops.  I am afraid that I have been kindled.   Does this sound like kindling? Do people successfully taper when kindled? Could I also still be experiencing PAWS from being taken off sertraline, plus withdrawals from going off mirtazapine too fast, and from tapering venlafaxine? The lack of interest, motivation, anticipation scares me, between that and the fear and anxiety, it’s a terrible way to live. I am home all the time unless I go for a walk or out for necessities. Like others I am sure, I am frightened that I will not recover. I am determined to get off of psychiatric meds. It has been hard to wrap my head around how long this is going to take, and it keeps getting longer. I never again want to go through what I went through when I was in poop out and then taken off sertraline and then paroxetine, it was terrifying.   

 

I’m not sure what to do next once I stabilize from this last drop. It seems even 5% at once is too much. The 4+ weeks of severe (neuro) anxiety and ruminations, morning dread, nervous stomach and heart palpitations are not sustainable. I just can’t tolerate it any more. Being blah and not wanting to do anything and no interest is bad enough. I need to find a taper pace that is tolerable. Maybe at some point in the future I will be able to tolerate larger drops. I was thinking about the Brass Monkey slide method, at 1.25 for 4 weeks plus the hold. Maybe my system would accept that. But maybe not. The thoughts of how may years this could take is so disheartening.

 

I need some help to move forward with a taper rate that I can tolerate. I am trying not to fear that I won’t be able to find a tolerable taper rate. I want to heal from this. Any help, wisdom and encouragement would be very much appreciated. 

Edited January 29, 2021 by manymoretodays
spacing for readability, tags

[brassmonkey]

Hi Mskb-- welcome to SA. I'm so glad you found us. With all those ups and downs and big reductions I can see why you are having the symptoms you describe. These drugs are very powerful and need to be reduced in a slow and careful manner.  Before we can do that though you need to be in a fairly stable condition. Meaning that the symptoms are at a consistent level day to day and not jumping all over the place. The best way to achieve this is to hold on the the dose you are at and let your body sort things out. Even though it feels pretty bleak at the moment things will get better.

 

We are experiencing a huge influx of new members right now, which is why we have been slow getting back to you. Please bear with us if we seem a bit slow in answering.

[Mskb]

 

HI brassmonkey,

 

Thank you for the reply and all you do. I have read many of your helpful posts. Congratulations on successfully tapering off. I try to hang on to the hope that things will get better. The hard part is figuring out what constitutes feeling “better”, a good enough lesser state of not good.  I consistently wake up in the am with anxiety and dread, that awful feeling in the pit of my stomach, toss and turn try to doze back off, to no avail, and then lie there and don’t want to get up. My mind us off and running. The ruminating exhausts me.  I pretty much stay home unless I go to the therapist, have an appointment or need groceries. I find it hard to be alone. I am fatigued most of the time. I do go for a walk most days. I mainly sit on the couch, find it hard to motivate myself to do much of anything. I have been like this for 3+ years. I did get manage to get out a bit more before the pandemic.

The excessive rumination, anxiety and fears are what really ramp up when I taper. For example, my biggest fears since this all happened (with my income becoming not only fixed but quite reduced) I fear running out of money, not being able to pay bills in the future and having to move. I have become fearful of spending any money except on necessities. I doubt my capacity to handle problems. I fear someday being unable to take care of myself. My mind will loop around and around over scenarios of what ifs and what to do.  Or I go back and regret past mistakes and try to imagine outcomes if I had done things doing things differently. I know rationally you can’t change the past or know the future and I know that these thoughts are unreasonable but it doesn’t help when this happens. I realize the exacerbation has to do with neuro emotions, neuro anxiety, neuro regret. It doesn’t take much to get triggered and set off. I also feel more sadness in the morning, with this physical feeling that I get when I know if would cry if I could. I do get sparks of feeling better here and there sometimes, even in the morning. I get most anxious it seems later in the morning through the afternoon. My nervous system goes on high alert, my heart pounds on and off and my stomach gets that nervous feeling, for hours on end. Then later in the evening my CNS calms down, once in a while I might even feel okay.

 

In terms of holding, I has been 5 weeks since I last tapered. The previous taper, I held 7 weeks, 5.5%. My criteria for tapering has been feeling less intrusive rumination, less anxiety, less activation and stomach issues for about a week. Not long enough it seems. It always returns, this time it came returned with a vengeance. I did however experience a big trigger, which has worsened my fears. So what you are saying is that I should wait until I feel less symptomatic for a longer time? Does that mean that possibly if I hold longer and feel more stable for longer then the tapers will be less difficult? I have pushed on tapering because I have been impatient for progress and healing. It feels good to see that milligram number go down, that I was putting less in my body.  I was originally thinking about trying 1.25% starting next Sunday. Based on your post I am going to continue to hold.  I’m not sure what more stable will feel like or how long it will take. I am so scared by all that has happened and where I’m at. The neuro emotions are so difficult to cope with and so hard to stop in their tracks. I am so scared by that has happened in the last few years. I am frustrated by not being able to taper even 5% without feeling worse for 3 or 4 weeks at minimum. Thank you for the reassurance that it will get better, even for someone who has my history. I need the reassurance.

[Altostrata]

Welcome, @Mskb

 

What drugs are you taking now, in milligrams, at what times of day?

[Mskb]

 

Hi Altostrata,

 

Thank you, I am very appreciative of all of you.

 

The Venlafaxine time is always the same, within 5 minutes, the other times may vary some.

 

8:45 am – 178.2 mg Venlafaxine, 1000 mg Omega 3 Fish oil, 1000 mg Vit. D

11:00 am – 300 mg calcium with 400 mg, vitamin D, 125 mg magnesium malate

1:00 pm – 20 mg Atorvastatin (prescription to lower cholesterol), 1000 mg Vitamin D, sometimes 1200 fish oil

(sometimes I take the 1200 mg of fish oil with dinner instead)

4:00 pm – multivitamin for women over 50

6:30 – 7:00 probiotic 10 blend of 25 million – 130 mg, every other night, 1 Acidophilus probiotic 100 million every other night (until I use them up then will go with the probiotic 10 blend every night) 1200 mg fish oil if not taken at lunch.

9:00 – 9:30 pm – magnesium glycinate 100 mg

Sundays, once per week 8:30 am 70 mg alendronate sodium (prescription medicine for osteoporosis

Sometimes I take 500 mg inositol for anxiety, a few times a week, sometimes not at all. Not sure if it really helps.

[Mskb]

Greetings, I have held my last taper of 6% (Venlafaxine) for 8 weeks and would like to start the Brass Monkey Slide Method on Sunday at 1.25% per week, which is about a 2.23 mg reduction.  The severe anxiety and obsessive worrying have lessened in the past few weeks. I have actually some decent days – decent meaning not much anxiety and being able to let the catastrophic worrying/thoughts go more quickly. Less neuro emotions, less neuro regret. Only one 6 am with the severe sick feeling morning anxiety – dread – doom feeling in the last 2 weeks. Some early mornings not at all, others much less, just slight. Unfortunately, I always feel blah, emotionally blunted, unmotivated, lethargic, some level of anxiety, no interest etc., then better later in the evening, my usual side effects of this medication. Do you think the 1.25% amount is a good place to start since 5% all at once has been too much? Am trying not to go down the catastrophic thinking road – the what if’s – what if I can’t do it, what if I can only do a few mg per month? It’s frightening and difficult, feel awful on the med and awful trying to get off. 

Also I don't know if I am doing these posts correctly, I'm using reply, so it's like I'm replying to myself.  AM I doing this correctly?

Thank you.

 

[brassmonkey]

Hi Mskb-- yes you are doing your posts correctly. This is your personal thread for asking questions, keeping journals and making friends. Each time you want to post something here just use the reply field just like you have been. If you want to talk with other members go to their intro thread and do the same thing and it will enter your post on their thread. Once you make a post you have one hour to make any edits.

 

Starting a Brassmonkey Slide using 1.25% for each reduction is a very good idea. We have a large number of members who are doing it this way. The whole purpose of the Brassmonkey Slide is to reduce the symptom load while maintaining a reasonable rate of reduction. As your taper progresses all the various symptoms you are feeling should start to become less noticeable in general, it is not all suffering the entire way down, but rather gets better the further you go. The symptoms you describe make it sound like you are pretty stable so starting a taper should not be a problem.

[Mskb]

Hi brass monkey - It’s rather sad that stable is feeling a little less awful more consistently. It would be wonderful to feel better the further I go, I keep waiting and hoping that less medication translates to less suffering. My stomach is in knots over tapering again, I so want to be able to tolerate this. I will check in again later this week. Thank you.

 

[brassmonkey]

Unfortunately, that is the definition of stability "feeling a constant level of blah with no big swings in either direction". The one to pay attention to is WDnormal "feeling a constant level of blah, but not feeling as bad as you did several months ago". That is the measure that shows things are improving, albeit slowly. I think you will be pleasantly surprised once the Brassmonkey Slide has a chance to settle in.

[HopeD]

Hi @Mskb,

 I read your post and noticed that we have been on similar drugs, that the doctors put us on and off. I can see that we have some similar symptoms.

You can read my posts to see the similarities.

 I’m so sorry that you are suffering so much. 

I push myself really hard to get better, but sometimes it’s almost impossible, because of constant anxiety, rumination and OCD on top of it.

I’m tapering Mirtazapine now and I’m determined  to get off all the psych drugs. It’s not easy, and I can understand you completely, because my suffering has also been very long.

We have to keep pushing though, believing that things will get better.

I’m so happy that I have found SA, as I don’t feel so alone in this. I come here when things get really hard to convince myself that I’m not going crazy and that there is a light at the end. I have read all of the success stories and I have hope that one day I will be able to write mine and to help others surviving. For now I’m trying to take one day at the time and sometimes one hour at the time. 
I can see some improvements already and I’m getting some short windows every now and then, when my symptoms lessen and that gives me hope.

Please stay strong.

[Mskb]

Hi HopeD,  Thank you so much for reaching out to me and for your kind words.  I’m sorry you are suffering so much also. I read your story and you have been through a lot. We feel similarly also. Like you I have been up and down and on and off several medications, never knowing how detrimental it was and trusting that it was the right thing. I was convinced that I would need medication for life. Also like you I have much anxiety and rumination, such a hard time letting the thoughts and the “what if’s” go. Whenever I taper, it gets worse and takes several weeks to lessen I feel like I am a shell of the person I used to be, fearful and without confidence in myself. Plus then you add in the lethargy, lack of motivation and lack of interest in anything. Sadness at what my life has become. Most days I sit on the couch and except for a daily walk, weather permitting, don’t do much of anything. I try and keep up with some housework but even that is a struggle. Some days I am better than others at pushing myself. The Covid pandemic doesn’t help either. I have had some decent days in the past few weeks, which gives me hope.  I am determined to get off psychiatric medication no matter how long it takes, I have not been helped by medication for several years and the only way I see to get better is to get off.  I am hoping the microtaper that I have just started helps lessen the withdrawal effect. We do need to keep pushing through and staying strong. Taking one day at a time and as you wrote sometimes one hour at a time. Keeping going, having that faith that we will get better, we will recover. I am also glad that I reached out on this forum. I read it for quite a while before I posted. I didn’t have what it took to even do the post and describe what I was going through for a long time. It helps to know one is not alone in this and to be reminded that it does get better. Thank you again for taking the time to reach out to me.

[HopeD]

Hi @Mskb, 

thank you for your response. Keep in touch and keep fighting. We can do this, even if sometimes it feel like we can’t. Keep pushing 

[Mskb]

Hi HopeD,

 

You as well.

 

Mskb

[Mskb]

Hi brassmonkey,

 

I tapered 1.25% starting last Sunday and the anxiety/restlessness/agitation has returned full force.  I think what I have been experiencing is a form of akathisisa, starting later in the morning and peaking during the afternoon hours. I feel anxious, tense, restless, agitation and my stomach is in a knot for several hours – regardless of whether or not I am obsessively worrying or ruminating about something. It’s just there, like my flight or fight response is activated. I have a hard time sitting still, wringing my hands or rubbing my fingers, moving my feet, feeling like I need to get up. Sometimes my heart will pound. As I’ve mentioned before, I generally feel better in the evening, after 7 or so, usually by 8. So I have about 2 decent hours. That is something that’s gotten later, I used to feel better around 5. I have been suspecting this but would tell myself I didn’t have it because I don’t pace or move from one foot to the other. I paced about 2 years ago but I didn’t know what it was then and it eventually passed.  I have been reading that one can have it without those symptoms. I have had this for a while and I do believe it is related to tapering. (Although my doctor keeps saying it’s the part of the original “illness” coming back.  I am upset, not that it does any good, and also discouraged. Did you ever have this? I not sure what to do.  I had my phone appointment with my psychiatrist today who said it was psychomotor agitation not akathisia, that akathisia was only caused by antipsychotics. It was not worth arguing with him. He knows I am tapering and reluctantly supports me in his own way, but at least he does. He called in a prescription for propranolol (10 mg twice a day) but I do not want to take another medication to deal with side effects from taking and tapering from this medication. I can see taking one pill occasionally to help with a bad afternoon, but not on a regular basis. I tried 5 mg today just to see what it would do. It took the edge off for about 2 hours. Not very helpful or worth it, especially with my aversion to adding more meds.

Which brings me to my question of where to go from here.  I doubt that the next 3 days are going to be any much better, although that would be a wonderful miracle. So my 2 thoughts are either wait another week and see, or accept that probably I was not stable enough after holding 8 weeks, that 3 or 4 decent afternoons in a two week period were not enough.  It depresses me to go back to holding, especially not knowing how long it will take, but maybe what I need is to hold until I feel better for a longer period of time and then start again. It makes me feel defeated and scared that I will never get off this stuff.  I have so much further to go, 177.5 mg. On the other side, I am afraid that if I continue to taper right now, slide taper and all, it’s just going to snowball, which is what has probably been happening over the past months. I held the taper that I did prior to the 8 week hold taper for 7 weeks. That is what is so discouraging, the thought of having to hold for months on this awful medication.  But I just can’t take feeling so agitated just about every day and having it snowball more. I can’t function like this. I am determined to be successful and get off this medication.  What are your thoughts?

 

Thank you,

Mskb

 

PS One plus is that with the 1.25% taper this week so far I have not seen an the usual increase in obsessive worrying or a worsening in the morning dread/doom/knotted stomach. It’s only been 4 days but hopefully symptoms won’t ramp up. 

[Mskb]

Some days it is difficult to hold on to hope. Three years ago when I crashed from what I now know is sertraline poopout and still believed meds were the answer, as I was being switched and poly drugged and barely functional, I kept waiting to get better, which didn’t happen. As I learned more about the toxicity and damage caused by these drugs and after (too fast) tapers of risperidone in 2019 and mirtazapine (stopped April 2020) I then began to slowly taper venlafaxine (April 2020) I have kept waiting for tapers to get a little easier and they haven’t. The anxiety, fears, worrying and ruminations and nervous stomach have not gotten better and they worsen every time I taper. I wait and now 3+ years has gone by. Can this go on for years? How does one tolerate years of this? Does it get easier? I guess on the positive side there are some things that are better than a year ago. Some of the side effects have lessened, especially the brain fog and derealization.  Not much improvement in motivation or interest, but I think there has been a little. Really little.

On the tapering front I tried 1.25% hoping that I could do the brassmonkey taper, after 8 weeks of holding my previous 6% taper which was very difficult, with close to 7 weeks of increased anxiety, fears, ruminations, neuro emotions, tense stomach, etc.  I had to hold held the 1.25% taper 3 weeks, so no 1.25% each week.  It took about 12 days in for the anxiety etc, to lessen. More waves here and there than constant. I then decided to try and see what % I could try that would allow me to taper again after a month, to try to at least establish that. I am also trying to establish whether or not the feeling less crappy that eventually happens is actually withdrawal normal. It is now 10 days since I tapered 3%, 5 mg. (172.2 mg)  Usually I start to really feel it on day 4. This time the first week was not quite as bad. It has hit in the last few days. I realize it’s only been 10 days and I could feel better in a few days but it so frustrating to feel worse 2-3 weeks out of 4 and then have it start again. Or worse 6 -7 weeks out of 8. I know it’s not a great idea to focus on length of time but at 3% I’m looking at 10 more years and so far it has been almost a year of difficult tapers.  I’m trying hard to hold on to hope that it gets easier and that I can weather this for as long as it takes but I am having a hard time not going down the negative rabbit hole. Could withdrawal from the other drugs still be affecting how I am feeling through these tapers? Or is it hard to know? Should I be doing something differently? I need to know this gets easier, I am trying to hold onto hope that the symptoms eventually don't last as long and lessen with time. Wishing for for some quality of life. Thank you. 

[inextinguishableconfidence]

I can tell you are very motivated to remove these harmful drugs from your system. I can also tell that you are very smart to be trying all these different things, researching and posting new ideas for the style of taper that will work for you the most. Keep this up, I know it’s not easy but for me I know I feel and think a lot better than I did one year ago. 

[Mskb]

Hi @inextinguishableconfidence

 

Thank you for your post and encouragement.  As we know, it is such a difficult struggle. I have been tapering for close to a year now and still feel the almost relentless anxiety and all that goes with it, little motivation, nothing interests me, the list goes on. I felt that way before tapering too, although the anxiety was more numbed out. I have been trying to find a taper rate that doesn’t increase the anxiety and irrational worrying so much or that it lessens to less than a few weeks so I can at least taper again after 4 weeks and is not a tiny percentage decrease. Even trying to do 3% this month I am struggling. But I am more clear headed and like you can think better. I just hope and pray this gets better. I try to hold on to the hope that it will eventually get easier.  I am glad you are better than a year ago.  

[Mskb]

Looking for help plus update,  question about kindling, continue to have trouble tapering, scared

 

The last 3 months I have slowed my taper to 3-3.75% per month and continue to have problems, anxiety, stomach in knots and feeling anxiety in my body, rumination, fearful, worsening insomnia and early morning bad anxiety. Plus I remain the usual blah, with little to no motivation or interest or enjoyment and emotionally blunted, which I have had since even before crashing in early 2018. Maybe 3 weeks after tapering I might have a few days (not in a row) that I feel a little better. It usually lessens most evenings, only to come back during the many night time wake ups. it’s really bad the first few weeks. I feel terrible every time I taper, and I don’t feel well on the medication. I need to keep tapering.  I tried the brass monkey method twice but was not able to taper again the second week, even trying 1.25%.

 

I don’t know what else to do, besides holding longer. I’ve been at this 14 months and can’t seem to get away from 3+ weeks of worse symptoms. I keep going in circles about what to do and I am scared that the tapers continue being difficult with small drops and sometimes 6-8 week holds. The quality of life is not good.  Can this tapering be a result of kindling? My signature shows the med changes and also then the dose drops and reinstatements back to the higher dose. Is it possible that was kindled, does it affect tapering too? Does kindling eventually start to heal?

 

Thank you

 

Mskb

[Mskb]

Since my last update, I have continued to having difficulty tapering. I feel lousy on medication and I feel lousy tapering, which has been ongoing since the nightmare with another drug pooping out and then being poly drugged and many dose changes.  Details are in my introduction. I started tapering 300 Mg. Venalfaxine in April 2020, all my tapers have been difficult with several longer holds, which didn’t help much. I am now at 151.5 mg. I don’t know I ever really stabilized, it seems my withdrawal normal is a slightly lesser version of how awful I feel most of the time. Recently I had dropped my taper rate to the 3- 3.5 range. I held my last 2 tapers 13 weeks and 6 weeks, with little change. Every time I taper, I have increased anxiety and tenseness all day, like an inner akathisia, and I ruminate, worry and imagine doom and gloom scenarios over and over about the future.  My system usually calms down somewhat for a few hours in the evening and then it comes back full force early in the morning. I literally feel sick with anxiety when I wake up in the morning. I also feel it when I wake up during the night, which is usually 2-3 times. Somehow I usually get back to sleep. After about 5 weeks it lessens a little and I might get a decent day or two every so often. I continue to struggle with anhedonia and emotional blunting along with anxiety, lack of motivation and interest, fearfulness, some derealization, inability to cry and many other symptoms,  ongoing for the past almost 4 years.

 

A few weeks ago I switched to the Brass Monkey method of micro tapering.  I am trying 1.33 Mg or .008%, to try to taper 5 mg over 4 weeks. I just did the third drop this past Sunday. The first 2 weeks the symptoms were less intense than when I taper all at one. The last 3 days though have been tough, more intense again. I am not sure how to tell if I should do the 4^th week taper, although it’s 4 days away? How do you know if you should taper the next week, that it’s not going to make withdrawal symptoms snowball? So far I have dropped each week as I haven’t felt as awful as when I tapered all at once.

Is stabilization possible if I try to keep this small taper, if I can? Should symptoms eventually improve?  After the extra 2 week hold, does one go by “withdrawal normal” even though in the past mine hasn’t been much better than my usual not much better? I am hoping the micro taper helps with this. I don’t have much quality of life, but I do function a little better than a year ago.  I thought that having tapered from 300 mg to almost 150 mg would have made a decent difference in the symptoms I have but there has been little improvement. Any little progress has been ever so slow and not consistent.  Along with tapering continually becoming more difficult I am at a pace where I’m afraid it may be a long time before I feel any consistent relief or have some quality of life, especially if I can only manage a such a small taper. I try to remember that it is still moving forward, no matter how small the taper is.

[Faure]

@Mskb I’m so sorry to read that tapering is proving so difficult for you, not to mention the number of drugs you’ve been put on. I’m doing the BM slide and do find the first two weeks of the drop are easier than the 2nd 2 weeks. I think this is because all the drops catch up with the body. My experience is that there are three good weeks: the last week of the hold and first two of the drops and three trickier weeks. I am fortunate in that I’m only on one drug for a short ish period of time so it is easier for me. Really I was popping in to say if you want help from a mod you need to type the @ sign followed by their name - otherwise they are not likely see it ☺️

[Mskb]

@Altostrata@brassmonkeyI posted an update on Tuesday with some questions and have not yet received a reply from a moderator and could really use some help. I know you are all very busy with so many people needing help and that you are volunteers and I am so grateful for this site. (The previous time I posted (May) I didn’t get a replay from a moderator also.) I have been having so much trouble tapering, for so long.  I am still having trouble, now trying the Brass Monkey slide. I have divided a 3% taper into 4 weekly very small drops. So far I have done 3 of them but this week has been very difficult, anxiety and tense feelings through the roof, lots of ruminating and I don’t know what to do next. If someone could please respond I would be so appreciative.  

[Mskb]

@Faure Hi and thank you for your post. I thought there was notification when someone posted so I hadn't logged in. Your comment is helpful, I am finding the 3rd week much more difficult, like I feel when I do the drop all at the same time.  In 18 months of tapering I have yet to ever have a good week but I am hoping this method will help me be able to continue. So you do the 4th taper anyway after a bad third week and then it eases after a while? I am so tired of feeling awful.

Thank you for letting me know I should address the comment.

Mskb

 

[Altostrata]

@Mskb, with the Brassmonkey Slide, the second decrease can compound the withdrawal from the first.

 

You tried decreasing every 2 weeks? Since you found the first decrease was tolerable, perhaps you should extend the interval to 3 weeks and see if that's better.

 

Venlafaxine can be very difficult to go off. Some doctors give up on tapering it and simply substitute fluoxetine (Prozac). This has its own risks, but you might consider a gradual cross-over.

[Mskb]

@Altostrata Thank you for your reply. I have tapered 3 weeks in a row using the brass monkey slide. I'm sorry I was unclear. I have been trying for months to find a tolerable taper schedule, the first 2 weeks of the slide has been the closest I have come, albeit also difficult. I am trying to get through the 4 weeks and see how I feel during the hold to determine if would be better to extend the interval as you mention. It is hard to accept that at 151.5 Mg I am affected by a 1.33 mg taper but I am. Not sure about the 4th taper. 

In March of 2018 I was cross tapered from sertraline to prozac, crashed and could no longer work. I took it for 12 weeks and just kept getting worse, although I now know it was withdrawal. I felt worse on prozac than venlafaxine and I feel pretty awful on venlafaxine. I couldn't really function on prozac. At least I am more functional on venlafaxine. 

[Altostrata]

25 minutes ago, Mskb said:

In March of 2018 I was cross tapered from sertraline to prozac, crashed and could no longer work.

 

How much Prozac did you take, how was the switch accomplished, what were the symptoms you got after the switch to Prozac?

[Faure]

9 hours ago, Mskb said:

So you do the 4th taper anyway after a bad third week and then it eases after a while?

None of my withdrawals cause anywhere near anything intolerable. If I do feel wobbly which has happened a couple of times I have held for longer till I felt ready to do the next drop. The first time I only had to wait a few days, the second time I waited 2 weeks. The advice I always get is to wait if I’m not feeling ready for it. But remember things are much easier for me as it’s only one drug, lowest dose and I’ve only been on it a few years (although on and off another SSRI for several years). 

[92sharks]

@MskbI have nothing really to add to help other than support, understanding, and my experience. I understand exactly how you are feeling. I have been tapering Effexor XR since 2018. Started at 188mg. I am now at 10 beads. 12 years ago I tried to get off of Effexor dropping CT at 37.5mg since there were no lower manufacture doses. I was physically and psychologically ill the entire 7 months. I remember crying every morning when I woke up because it was another day of suffering. I lived on the couch. I bought a treadmill and cried every time I got on it. I cried when I took a bath. Everything hurt. Everything was a mountain to climb. I was in wd for 7 months, felt so bad, and was told my depression had returned so I went back on it for another 9 years. I couldn't take it and going back on medication worked to alleviate the wd. My psychiatrist supported my attempt to get off, but never admitted the symptoms could be wd or could last that long. Idk if she knew. As others have said, I NEVER felt so bad before taking and stopping ADs. There was no SA at the time, only a few anecdotal stories on line. I felt absolutely alone in what I was trying to do. I remember the symptoms as if they were yesterday because they were so traumatic.The symptom I remember most was the incessant voice in my head telling me how worthless I was and how I had ruined my life, my husband's, and my children's. This is still a symptom, but thankfully milder now and I try to not believe it. But I feel it. I am also 65. I have taken 3 years to taper from 188mg. I have just kept it in the background, decreasing a bead at a time every 3-4 days, then every week, often holding for weeks or months at a time when I thought I "should". I only watched for physical symptoms to tell me there was a problem. I have never worked out % drops or holding. That isn't to say it isn't beneficial, but I can't figure it out and it puts too much focus on tapering for me. Last August I was at 60 beads and started tapering 1 bead a week every week, and not paying any attention. There were several major family events that happened (starting in 2019 and continuing today). But I just kept tapering, thinking that tapering and those events did not overlap emotionally. I believed they were separate and my brain was keeping those issues in two separate "departments", working on each independently of one another. I didn't read much on SA because I thought I was fine. The life events that were going on could explain why I was such a mess emotionally and unable to function very well in my daily life. I didn't realize until I got to 10 beads August 2021 and began having wd vertigo that I had been having emotional wd symptoms for months and months, and I continued to taper. I returned to SA and have learned so much. I almost feel as if I am at square 1 because I am fearful I will never get off, have lots of wd symptoms, and live a good bit of my life on the couch or in bed. I am at 10 beads, but I went too fast! There are days I don't have hope. Most days I don't have joy. The desire or ability to do anything is incredibly rare. And it feels horrible. But I do have some days where I have all of those wonderful feelings and I can do lots of things. And I want to do things!  And now I am remembering that those days are real and I don't forget them. I am fully aware that I am in a wave, even at 10 beads. Today, I know and feel I will not be in this wave forever. It is a good day! My advice is listen to the moderators, know you are not alone in what you are feeling physically and emotionally, know it is wd and a troubled CNS that needs healing. Your CNS has been to hell and it is not back, yet. The most important thing is to stabilize your CNS and be gentle with yourself. I know you want to know when you will feel better. That's the mystery. It is torture, but there is no speeding this along. You can figure out one or two self-care things to try: 5-10 minutes of silent meditation, a weighted blanket, vagal stimulation breathing, whatever you can do daily. Start slowly, but they will work. You already take a short walk daily. You're already doing one! The fatigue and anhedonia is all consuming. You don't have to wait to want to do something, you just try to do it. It doesn't need to be pretty and definitely it doesn't need to be perfect. Make a plan to slow your taper way down. Listen to the moderators suggestion on holding if that is what they suggest. Put the taper in the background. I know you say you feel horrible on the med and want to get off. I believe for now the best option is being on the med at a dose where you feel alright. I believe that is possible. Then stay on it for a few months before you even think about tapering. You first must get to feeling better, then you can think about getting off. Sending much support! ❤️

[Mskb]

@Altostrata

I was cross tapered over week from 200 mg sertraline to 20 mg of Prozac, then to 40 and after about a month to 60 mg. At that time 15 mg of mirtazapine was added for sleep. (At that time I had been on antidepressants for 21 years) Within 3 weeks I could no longer work. I was curled in a fetal position all day, taking Ativan every 4 hours. I was extremely depressed, with severe terror and anxiety, panic, irrational fears, compulsive worrying/ruminating, derealization, racing thoughts, constant jerking, insomnia, pacing, speech and word retrieval issues, suicidal, terrified to drive or leave the house.  Constant brain fog, lethargic, anhedonia, shaking, emotional blunting, disinterested, unmotivated, unable to cry, uneasy, no appetite, lost 25 lbs (from 130), stomach felt sick, always in a knot, noise intolerance. I’m sure I’m forgetting some of them. After 12 weeks I was switched to Paxil, 2 weeks later Venlafaxine. Four days later I ended up suicidal and in a psychiatric hospital. The nightmare went on from there. Slowly reduced the Ativan. More drugs and changes, up and down in doses. No significant improvement. I then reduced and stopped risperidone and mirtazapine, too fast, and started tapering venlafaxine. I even had TMS, which really didn’t help. I’ve continued to feel awful. My goal is to be free of psychiatric drugs.  Although I do not have all those symptoms now, I still have several and of course much difficulty with even tiny tapers. I have been in that place of feeling awful on the drugs and feeling awful tapering for so long now. I’m trying to find a way to taper that’s tolerable and instead it just keeps getting more difficult. 

Also I have not done the 4^th micro taper drop, today is the 8^th day and the anxiety, ruminations and sadness aren’t any better.

[Mskb]

@Faure

I appreciate your input, I did not do the 4th decrease. After 8 days I don't feel any better and to force a 4th drop would only make it worse.

[Mskb]

@92sharks

 

I am so sorry you are going through this and I so appreciate you taking the time to offer your support. Congratulations for getting to 10 beads, it has taken me 18 months to get from 300 mg to almost 150 which is probably about 270 beads. I don't count them, I weigh them.  Yes, the anhedonia and fatigue are all consuming. I am so disheartened by not having any interest in anything, or motivation, forcing myself to do what I have to do, blunted emotions, well, it seems like blunted positive emotions because I certainly feel anxiety, fear, dread, doom, pessimism etc. The anxiety is all consuming as well. I have never felt alright on this medication, even holding 3 months has not helped much. I sometimes wonder if I should try a longer hold. I am afraid to be at a standstill and I keep hoping the tapers will get better. I just don't know what to do to feel better and have tolerable tapers - and have some quality of life. I feel better in the evening but it's all back again the next day. You are so right, our nervous systems are very damaged and we don't know how long it is going to take. It is torture and its very hard. There is no easy way for us. I am sorry you spend a lot of time in bed. Please reach out any time and thank you for reaching out to me. Your kind words and empathy really helped. It helps to know one is not alone.

[Altostrata]

@Mskb, why did you go off sertraline in June 2018?

 

Your problems date from initiation of sertraline withdrawal syndrome then.

[Mskb]

@Altostrata

 

The problems started with poop out and then yes, worse problems starting with going off sertraline and all the subsequent drugs dose changes.  What happened was over the previous 4 years I began to slowly lose interest in socializing and doing things and became increasingly anxious and fearful, worrying constantly, periods or worsening depression, lost my confidence. Was bumped back and forth from. 100-150mg a few times then stayed at 150. I t came on slowly and I was able to remain functional for a few years.. By Fall 2017 my anxiety was constant and severe, panic attacks, increased depression, insomnia, no appetite, much difficulty functioning, very depressed and relying on lorazepam to get through the day at work. I was in bad shape. Was bumped up to 200 mg, more side effects but no change otherwise. Eight weeks later my psychiatrist switched the medication because it was no longer “working”. I have not recovered much and I don't really know how to proceed.

[Altostrata]

You are describing your travail in the language of psychiatric disorder. It can more clearly be described as antidepressant withdrawal syndrome with subsequent adverse reaction to drugs. We have thousands of cases like yours here.

 

Have your prescribers been associated with Harvard, by any chance? Harvard is the epicenter of biological psychiatry, where any adverse effect of the drug must be caused by a psychiatric defect in the patient.

 

It looks to me like your psychiatrist switched you from sertraline to an excessive dosage of Prozac in 2018. Your "crash" was probably combined sertraline withdrawal and serotonin toxicity from too much Prozac. 

 

Unfortunately, the last antidepressant you landed on, venlafaxine, is itself a very difficult drug to go off. 

 

What has been the effect of venlafaxine as long as you've been taking it since summer 2018?

 

You are still taking a substantial amount of venlafaxine. You may find adding perhaps 1mg fluoxetine or citalopram reduces your venlafaxine withdrawal symptoms. If so, gradually substituting fluoxetine or citalopram up to 5mg or 10mg of an SSRI may help you go off venlafaxine. Then you'd taper the SSRI.

[Mskb]

@Altostrata

 

Thank you for taking the time and being so quick to reply. On Venlafaxine I was able to somewhat stabilize from the debilitating symptoms I was having. The hospital added a low dose of Olanzapine, an awful med, which I went off of within 5 months, when my psych, introduced risperidone. I only took a small amount and went off of that within a few months also. By stabilize I mean I wasn’t curled up in bed all day. I had brain fog, anxiety, rumination, fears, derealization, emotionally blunted, like numb, lethargic, anhedonia, cognitive difficulties, insomnia, jerking when I would lie down, sadness, etc., I was on 300 mg, a very high dose. In the 21 prior years of taking antidepressants, before poop out and all that happened, I was never numb like that, or disinterested, unmotivated, with no anticipation, laughter or happiness. Or had the crazy anxiety and worrying. At this dose my cognition much better, words come to me more, much less brain fog and I don’t feel as numb, rarely jerk at night. I get spurts of motivation occasionally, as long as it’s been a while since I tapered and feel an occasional fleeting spark of positive emotion. As I have mentioned before, a lot of the anxiety and tenseness leaves my body in the evening. I still don’t look forward to anything and have to force myself out.

I agree that the crash was probably caused by the withdrawal of sertraline and the excessive dose of fluoxetine, plus he added 15 mg mirtazapine. (The hospital brought me up to 30) Also, the hospital I spend three weeks in is a Harvard teaching psychiatric hospital, a well known name. So much for the gold standard.

Do you think it’s possible to stabilize keeping the tapering low and slow? I am going to see how I feel over the next 2 weeks. If I feel I can, I’ll try 2 or 3 microtapers again and then hold a few weeks and see, etc. If that is still difficult I can try holding 3 or 4 months, even though I find it disheartening. The microtapers, at least the first few, were a little easier on the system. I appreciate the suggestion and it could be a possibility but at this point I don’t want to add in any more drugs. I have worked so hard to get down to 1 drug and I am very scared to add more in and take a chance that I could feel worse. I really would like to find a tolerable taper rate, at this point I will take low and slow even though like everyone else I want off yesterday. I hold on to the hope that it does get better. 

Thousands on SA in this kind of misery and worse, psychiatry has a lot to answer for. So many ruined lives.

 

[Altostrata]

How have you felt with the reductions you've done over the last 6 months?

[Mskb]

@AltostrataI haven’t been able to taper much in the past 6 months, about 20 mg from around 172 mg.  After I realized I couldn’t do 10%, I dropped to 5% but I don't believe I had stabilized enough yet. I was hell bent on making progress down. It was still hard but I kept trying to bump it up which was a mistake. Last October I tried 5.5%, held though the holidays and then 6% (12mg) which was really difficult, I was frightened I had some akathisia.  I now realize I was pushing myself and should have taken more time to stabilize. (I also was very stressed due to the effect of a large real estate tax increase on my fixed income, stress which continues with the potential harm that more large increases will do to my financial situation. Much of my anxiety and rumination is around difficulties I am having with living on a reduced income and fears about the future, on top of the fear that I will never recover and heal from all the drug damage.)  I held about 10 weeks and in March tried 3 tapers, one month apart, 3%, 3.5%. 3.75%. They were difficult, and I kept going, continued tapering even though after 4 weeks I didn’t feel up to it. It was too much and my CNS couldn't handle every 4 weeks  I was anxious, tense and my stomach was in a tense knot all day. Plus so blah and unmotivated, mornings especially.  I held about 7 weeks, had a few better days here and there, tried 1 mg to see if I could microtaper, symptoms got worse again, held another 6 weeks. Had a few better days again and in August I tapered 5 mg, which was 3%, held that 6 weeks and then tried the brasssmonkey taper, which brings me here.  Three mini tapers and the last one was really difficult. I think I may have pushed too hard for my sensitized CNS I wanted so badly to reach 150 mg, which for me is a big milestone, although I have a very long way to go. It has been difficult to accept that I can’t have a timetable. I would feel that enough time went by and that I “should” be able to taper again. I am learning it doesn’t work that way. I will say that overall I am slightly better than I was 6 months ago. I don’t feel as blah as much as I did then. But my tapers have not been any easier, until the first 2 microtapers were a little easier. Also, the last 2 mornings I have felt less early morning anxiety. Not a lot less, but less, and not such a sick feeling. It’s the afternoon and my stomach isn’t in a knot. A little window.