mariobros: Withdrawal like I've never felt before from Effexor

[mariobros]

Hello everyone. I'm so thankful to have found this forum. I've been struggling with depression and anxiety for about 12 years now. After being on antidepressants for about 6 years, I'm trying to come off of them and have been in hell for the last month or so. This is going to be long so I'll put a tldr at the end.

 

Here's my medication history:

• Early 2010s primary care physician started me on zoloft for health related anxiety
• Early 2010s upped zoloft dosage multiple times and started xanax 0.25mg 3x daily
• Ultimately stopped zoloft cold turkey iirc b/c I couldn't tell that it was doing anything. Didn't have any withdrawal that I remember but I wasn't on it terribly long
• Around 2013 new primary care physician started tapering me off of xanax - the withdrawal was hell but I made it through eventually
• Oct 2015 - Started Lexapro 10mg
• Feb 2017 - Upped to Lexapro 20mg & started seeing a psychiatrist rather than just my primary care physician
• Mid 2018 - Added very low dose of Wellbutrin (I think it was like 75mg)
• July 2019 - Cross tapered Lexapro to Effexor 75mg
• Aug 2019 - Upped Effexor to 150mg
• Late 2020 - Stopped Wellbutrin - no withdrawal
• Dec 2020 - Started medical marijuana for PTSD & to help with sleep
• Jan 2021 - Worked with my psychiatrist to taper off of Effexor. Reduced Effexor to 75mg for 2 weeks
• Jan 2021 - Reduced Effexor to 37.5mg for 2 weeks. Had a couple of bad days but nothing too out of the ordinary
• Feb 2021 - Stopped Effexor - extreme withdrawal began a couple of days after last does
• Feb 2021 - Started 10mg Fluoxetine for 1 week
• Feb 2021 - Upped Fluoxetine to 20mg

 

I should also add that I've been in therapy through a large portion of this. The therapy is what helped me get well enough to want to try getting off of the meds.

So Effexor withdrawal... this has been hell. I was expecting the physical symptoms which came a day after my last dose - brain zaps, flu like symptoms, nausea, diarrhea, etc... but I was NOT ready for the emotional symptoms. I stopped Effexor on Wed, Feb 3rd. I had 2 really good emotional days after my last dose of Effexor and then everything went to hell on Saturday. Saturday, I had a really bad depressive episode - worse than usual. I wasn't suicidal but I just felt so angry with myself etc... and ultimately ended up sobbing on my bathroom floor for a little bit until I was able to get myself under control. I knew that I wouldn't be able to talk to my psychiatrist's office until Monday so my wife & I decided it probably wouldn't be a bad idea to see if the pharmacy could give me a couple of 37.5mg Effexor pills to get me through the weekend. They gave me 3 pills and I took one. Obviously it didn't help right away but I managed to get through the depressive episode and I thought the worst was over... It wasn't.

 

I use a CPAP machine at night for sleep apnea. Since I started tapering the Effexor, I've had a couple of really high anxiety nights where I have to take my CPAP mask off because it feels like it's suffocating me. Once I've regained my composure, I've been able to just put the mask back on and go to sleep. This happened on Saturday night but as I was in the midst of that high anxiety, an intrusive thought (something I've never experienced before to this degree) popped into my head - "What if I lose control with this withdrawal and hurt or kill my wife & toddler?" Naturally that sent me reeling. Somehow (medical marijuana) I was able to get some sleep that night. The next day (Sunday) was complete hell. I took another 37.5mg Effexor that I had gotten from the pharmacy. The brain zaps were basically gone but I kept having constant uncontrollable intrusive thoughts about hurting my family. As someone who has never dealt with these kinds of thoughts before, they also came with a lot of guilt & grief. It almost felt like I had already hurt them and I was in EXTREME distress. I almost went to a mental hospital - if we weren't in the midst of a global pandemic, I would have. Somehow I made it through the weekend.

 

Monday was finally here and I could call my psychiatrist for help... but the scheduling person told me that the soonest they could see me was Friday. I explained to her that this was an emergency situation and I was dealing with extreme anxiety after discontinuation of the Effexor. After lots of back & forth with her talking to my psychiatrist via chat etc... she finally said that they could get me in on Wednesday afternoon and that he was going to call in Hydroxyzine 10mg 3x a day to help with the anxiety. I was upset and didn't know how I was going to manage until Wednesday. I didn't fill the Hydroxyzine prescription because I already had a prescription for 25mg 3x a day (I used to use it to help me sleep). I started taking the Hydroxyzine 25mg on Monday and it provided some marginal help. I also stocked up on some 1:1 THC:CBD gummies that helped to level me out a little. I was still having the intrusive thoughts but I tried to just spend a lot of time sleeping and started trying to just observe the thoughts, label them as intrusive, and let them go. It's really hard.

 

Wednesday finally came and I was still in hell. I connected to the video chat for my psychiatrist appointment and immediately got kicked out of the waiting room. I called their office only for them to tell me that my appointment was THE FOLLOWING WEDNESDAY - A WEEK AWAY. I completely broke down and lost it on the phone with the receptionist. I explained to her that I can't wait that long and that this has been the worst week of my entire life. I can't stop the intrusive thoughts, I can't eat, and I'm terrified. Finally, she says that she can put me in an emergency slot on Friday. My psychiatrist also called in 10mg of Fluoxetine to take for a week before upping it to 20mg. He said that should help with the withdrawal but I knew it takes a little while for a new medicine to get into your system.

 

The rest of the week went by and I continued having the intrusive thoughts, constant anxiety, couldn't eat, etc... Thankfully I was able to talk to my therapist several times throughout the week and he was able to at least provide a little bit of a respite from the hell that I was living. Medical Marijuana was proving to be pretty hit or miss with helping as well. Sometimes it helps stop the thoughts (or at the very least helps me control my response to them) but sometimes it ramps my anxiety which makes them worse.

 

Friday came and I finally got to talk to my psychiatrist. He was also under the impression that I was supposed to have seen him on Wednesday so that was a total scheduling miss. He called in 10mg propranolol 3x a day and said that it should help alleviate some of the body anxiety and just generally turn my body down a notch. He also scheduled a follow-up on Monday. I started taking the propranolol on Saturday along with the hydroxyzine. The intrusive thoughts were still coming but I felt like I was better able to control my emotional response to them with the propranolol & hydroxyzine. I made it through the weekend thanks to the propranolol, hydroxyzine, and some high CBD medical marijuana. Also, after the scheduling snafu earlier in the week, my psychiatrist has been really good about seeing me more frequently so that has been helpful.

 

Through the next week (last week), I was really feeling the waves & windows of the withdrawal. Some days were good and some days were bad. On Tuesday, my psychiatrist upped my fluoxetine to 20mg and switched the propranolol from 3x 10mg pills per day to 1x 60mg extended release pill per day. I don't really feel like it's helping much. This past Saturday was a particularly bad day. Lots of intrusive thoughts, high anxiety, etc... but then Sunday was great (until the evening when things went a little side-ways but it was manageable).

 

Yesterday I talked to my psychiatrist again and he called in a prescription for Gabapentin 100mg 3x a day to replace the Hydroxyzine 25mg 4x a day. He said that it should help chill me out more. Last night I did my usual medical marijuana but for some reason, I ended up going into a thought spiral and having a really rough night. I'm still feeling a lot of that today as I type this. I filled the Gabapentin this morning and took one. I can't really tell if it has helped much.

 

TLDR for all of that: I tapered off of 150mg effexor too quickly (with the help of my psychiatrist) and have gone into some terrible Harm OCD intrusive thought withdrawal spiral for the past month. I'm finally starting to get out of the waves and into some of the windows but I'm still struggling.

 

These intrusive thoughts have been absolutely terrifying. I would NEVER in a million years want to hurt my family. It's like my brain has just latched onto the most terrifying thing that it could find and is showing it to me on loop. Some days there aren't as many thoughts, some days I can label them and let them go more easily, and some days I'm just completely at their mercy as they terrify me. All I can do is tell myself that these are involuntary thoughts that I would never act on and try to just let them pass. I'm absolutely miserable. This is my personal hell.

[Erell]

Hello

 

And welcome on SA. 

 

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And I'm really sorry fr what you've been through. Yes it seems that you're going through withdrawal symptoms from a too fast taper off Effexor.
Unfortunately, doctors don't realise how powerful these drugs can be, and don't recognise withdrawal syndrome.
We usually advise our members to do very slow tapers and to not drop more than 10% every four weeks.
This might help you what is going on : 

how-psychiatric-drugs-remodel-your-brain

 

On 2/23/2021 at 8:50 PM, mariobros said:

have gone into some terrible Harm OCD intrusive thought withdrawal spiral for the past month.

This is a common symptoms of withdrawal : it can be very distressing but we can learn how to deal with it.
You might find this thread interesting : 
 

obsessive-compulsive-disorder-or-ocd-repetitive-intrusive-thoughts-compulsive-behaviors

 

A lot of folks have been through these weird thoughts : you might find comfort in reading this member's thread as he describes it very well : 

☼-ten0275-im-dave-and-im-almost-there

 

As every other withdrawal symptoms, it tends to get better and fade in a windows and waves pattern : 

 

the-windows-and-waves-pattern-of-stabilization

 

-> Please can you specify the day /date you jumped off Effexor - introduced Fluoxetine - updosed Fluoxetine ?

-> Can you also specify the day/dates of your Propanolol-Gabapentin changes ?

Again, welcome  
 

 

 

 

[mariobros]

Thanks so much!

 

• My last regular dose of 37.5mg effexor was on Feb 3rd. CVS gave me a couple of extra pills on the following weekend and I took one on Feb 6th and 7th. I haven't had any Effexor since Feb 7.
• I took my first does of Fluoxetine on Feb 10th. It was upped to 20mg on Feb 16th.
• Propranolol 10mg 3x daily was prescribed on Feb 5th
• Propranolol was changed to 60mg extended release 1x daily on Feb 19th
• Gabapentin was added (to replace hydroxyzine) on Feb 22nd. I only took 2 doses of it on the 22nd and switched back to Hydroxyzine b/c the anxiety & intrusive thoughts spiked on the evening of the 22nd

This week has been rough. Monday night, the anxiety & intrusive thoughts spiked so hard that it almost felt like it did at the very beginning when the intrusive thoughts started. It took my a couple of days of spiraling to get back into a good headspace to be able to deal with the thoughts. Wednesday night, I managed to pull myself back out of it. Thursday & Friday were great. Yesterday (Friday) especially I was starting to really feel back to normal.

 

Most of the time, medical marijuana seems to help but sometimes it makes things worse. Last night, it made things worse and I felt a lot of anxiety & stress from some intrusive thoughts but I was still able to recognize the thoughts as intrusive and let them go - it was just uncomfortable. I didn't sleep particularly well. I woke up multiple times worried about my toddler. I'm tired and feeling a lot of anxiety today but I'm managing.

[Altostrata]

Welcome, @mariobros

 

A change in in Prozac dosing is takes 7-10 days to reach full effect. This is why the effect of 20mg Prozac increased   since February 16.

 

It may be that 20mg Prozac is too much for you, and you may wish to take 10mg instead. Please let us know how you're doing.

 

Substitution of Prozac does not always work to go off Effexor. It may be that you will want to reinstate 37.5mg Effexor XR and taper it by counting out the beads inside the capsule.

 

Any doctor can prescribe these drugs. If you do not find your psychiatrist to be adequately attentive, your GP may be able to issue prescriptions to enable your tapering.

[mariobros]

Thanks for the comment @Altostrata!

 

I'm firmly still in the waves & windows of the withdrawal but I'm starting to manage it better now I think. I've been working on trying to adjust my mental state to be more mindful and try to think "above" my thoughts/ego if that makes sense. Thankfully I have access to medical marijuana and that has helped tremendously (specifically products very high in CBD). I don't know how I could've gotten this far through the withdrawal without it.

 

I ended up not taking the gabapentin after the first day. I haven't made any other medical changes:

• 20mg fluoxetine
• 60mg propranolol ER
• 25mg hydroxyzine 4x a day (sometimes I only take 3)

The waves & windows seem to be trending upward. I'll get a couple of good days & then have 2-3 not so good days. The jump to 20mg fluoxetine might have been too much too fast but it seems to have leveled off for now. I'm just going to leave things where they are for a while and let my brain stabilize. Once I'm back in a good state, I'll start working toward losing the propranolol & hydroxyzine then the fluoxetine. After the effexor debacle, I'm certainly not in a hurry and will be taking it EXTREMELY slow.

 

I've started trying to keep a brief journal as well as tracking my "windows" in a calendar. I'm not really trying to track trends or anything. It's just helpful to see that I've had good days and honestly, reading about the bad days helps too. It's a helpful reminder that I made it through that day.

[Altostrata]

Please let us know how you're doing.

[mariobros]

I told my psychiatrist that it felt like I was having more anxiety in the evenings so he switched me from 1x propranolol 60mg extended release per day (in the morning) to 3x propranolol 20mg normal release per day on Mar 3rd. Right now my current medications are:

• 20mg fluoxetine
• 20mg propranolol 3x daily
• 25mg hydroxyzine 4x daily

March has been mostly tolerable until this weekend - I made a surprise trip back to hell this weekend. Friday was a good day overall until the evening. After work, I had my toddler and she was in a tantrum mood. She had multiple LONG screaming tantrums. I was able to deal with her effectively & managed to get through the rest of the evening until she went to bed. After she went to bed, I realized how emotionally exhausted I felt after dealing with the tantrums and then the intrusive thoughts started again. The intrusive thoughts and rumination over the thoughts has just completely steamrolled me this entire weekend. This might be the worst that it has been. I'm absolutely miserable.

 

I have an appointment with my psychiatrist on Tuesday. I'm going to ask his thoughts on reinstating effexor and trying to do an extremely slow taper. Do you all think this is a bad idea? It has been about a month and a half since my last dose of effexor and this weekend has proven that the waves can still be extremely powerful and debilitating. I just wanted to get off of the medicine because I felt like it wasn't really helping that much anymore. The only real negative side effect I've had on the meds is weight gain. If going back on effexor and slowly tapering will get me out of this hell, I think that's preferable to this.

 

I'm just feeling so desperate for this to be over. This is so much worse than the depression that got me on these damn pills to begin with.

[JesusSavemefromWD]

Hi,

I just wanted to say that the first week I started Zoloft and upon quitting Zoloft (I only took it for few weeks at low dose) one of the symptoms I had was the exact same thoughts as urs. That I would loose control and hurt my kids with a knife. I didn’t dare to hold a knife while cooking or eating due to these thoughts. I assure u they will subside. I still have many symptoms after quitting Zoloft and I am in pure hell but the fear of hurting my kids has left. I adore my kids and would give my life for them, but Zoloft made me think for the first time in my life that I am dangerous for them. So u are not alone, these are just drug induced thoughts, nothing more. May God help u through ur WD journey 

[mariobros]

On 3/15/2021 at 12:49 AM, JesusSavemefromWD said:

Hi,

I just wanted to say that the first week I started Zoloft and upon quitting Zoloft (I only took it for few weeks at low dose) one of the symptoms I had was the exact same thoughts as urs. That I would loose control and hurt my kids with a knife. I didn’t dare to hold a knife while cooking or eating due to these thoughts. I assure u they will subside. I still have many symptoms after quitting Zoloft and I am in pure hell but the fear of hurting my kids has left. I adore my kids and would give my life for them, but Zoloft made me think for the first time in my life that I am dangerous for them. So u are not alone, these are just drug induced thoughts, nothing more. May God help u through ur WD journey 

 

Thank you so much for your reply! It helps to know that I'm not alone and others have made it through this. I'm still struggling through this wave - Day 4. This has absolutely been the most intense wave since the very beginning. I feel like it's finally starting to ease up this afternoon. Hopefully this wave is almost over.

[mariobros]

On Tuesday, I met with my psychiatrist again. We're gonna try upping the fluoxetine to 40mg (started taking 40mg yesterday) and he said I could take an extra hydroxyzine daily. He said if upping the fluoxetine to 40mg doesn't help stabilize me, we're gonna try going back to effexor and do a much slower taper with that. My current medications are now:

• 40mg fluoxetine
• 20mg propranolol 3x daily
• 25mg hydroxyzine 5x daily

Yesterday evening I was finally able to stop chasing down the thoughts and get back into the swing of just observing them, labeling them as intrusive thoughts, and then let them go. A mantra I've been using that seems to help is "I don't need to think about that".

 

This morning & early afternoon I was actually feeling pretty good aside from some digestive issues (which have been ongoing intermittently through this whole ordeal). I'm hoping that's a good sign after upping to 40mg fluoxetine yesterday. After lunch, I went out to run some errands. Nothing noteworthy happened but I started dipping back down into "not great" feeling territory. The best way that I can describe it is that it just feels like something bad is going to happen. Like, I feel on edge like I'm just waiting for some terrible thing to happen. Combine that with the intrusive thoughts and it turns into a terrifying situation that's hard to dig out of. Hopefully this hell wave is almost over. It was a bad one.

[mariobros]

After a couple of days on 40mg fluoxetine, I really didn't like how I was feeling. It didn't feel like it was helping with the withdrawal but also I just felt kind of "distant" and had trouble accessing any of my emotions except for the fear/anxiety from withdrawal. I messaged my psychiatrist a few times and we decided that it's probably best to just reinstate the effexor, get back to stability, and then try to taper the effexor much slower. I reinstated 37.5mg of Effexor on Sat, Mar 20.

 

My psychiatrist's cross taper plan is:

• Drop back down to 20mg fluoxetine for 7 days while starting Effexor
• Effexor 37.5mg for 4 days
• Effexor 75mg for 4 days
• Effexor 112.5mg for 4 days
• Effexor 150mg

It feels to me like the Effexor dosage increases may be a bit too fast but I guess I don't know that for sure. I'm on day 3 of 37.5mg now and I'm starting to feel better already. How long would you typically stay at a particular dosage when reinstating? Is this going up too fast?

 

This past weekend was pretty rough. I spent most of Friday, Saturday, and a large portion of Sunday in bed. The only way I've been able to eat for the past week or so is after using cannabis. I don't like using cannabis much during the day. I usually use it in the evening to relax & sleep so I've really only been able to eat about 1 meal a day in the evenings. My stomach actually doesn't feel terrible today so I might be able to eat. I feel like I'm finally starting to see the other side of this wave. I don't know if it's just letting up or if the reinstatement of Effexor is already working but at this point, I don't really care. My primary goal right now is to get back to stability.

[mariobros]

It has been a little over a week since I reinstated Effexor. Today was my first day at 112.5mg Effexor. My last dose of Fluoxetine was on Friday. On Thurs, I'm supposed to go up to 150mg of Effexor. I'm not sure if I really need to go up to 150mg or not. I'm just gonna play it by ear and see how I'm feeling later this week I guess. I won't be going higher than 150mg. I've seen several other stories on here where people tried to reinstate and ended up on a higher dose than they started on. I definitely do NOT want to do that.

 

This week, things finally started getting better and I'm feeling more like myself. I'm trying to do 20-30 mins of exercise everyday and I think it's helping. I've been able to cut out most of the hydroxyzine & propranolol that I was taking to manage the anxiety. I'm kind of afraid that I might be starting to go back into a wave (starting last night). Last night and today my appetite has been pretty low and I'm feeling kind of mentally drained/uneasy.

[Holly26]

Hi Mariobos, 

 

i was reading through your story and i really feel for you. Im was on Effexor for 15years and i am currently at 6mg . Sometimes i think my brain cant live without Effexor anymore.  

[mariobros]

On 4/2/2021 at 3:57 AM, Holly26 said:

Hi Mariobos, 

 

i was reading through your story and i really feel for you. Im was on Effexor for 15years and i am currently at 6mg . Sometimes i think my brain cant live without Effexor anymore.  

Thank you! I hope the rest of your taper goes well.

 

I've been holding steady at 112.5mg of effexor. Last week was amazing. For most of the week, I felt almost entirely back to normal. Unfortunately, I started going back into another wave on Fri evening. So far, this wave is way weaker than the others but it's still unpleasant - lots of anxiety & worrying, feeling extremely exhausted all the time, feeling hopeless etc... For the past 3ish days, I just haven't really felt like doing anything. I just want to sleep. I've been trying to use the hydroxyzine & propranolol very sparingly since I'm already feeling exhausted without them.

 

I'm wondering if this is prozac withdrawal or if I need to go back up to 150mg of effexor. I was hoping these waves were over.