Mandrake: protracted Effexor withdrawal

[Mandrake]

I took Effexor for 22 years with a maximum dosage of 56.25 mg. I tapered off way too fast (3 months) getting off in June 2018 and immediately plunged off a cliff with severe depression,  terrible insomnia, and crying jags. The crying jags are the only symptom that went away quickly.  Because of my severe insomnia my then psychiatrist recommended I take a benzo (15 mg Temazepam) which I did for a while before realizing that it was not a good drug to be using. I switched over to 7.5 mg Valium tapered over 4.5 months, getting off the benzo in February 2019.  
 

From February 2019 until January 2021, I remained drug-free.  During that time, I continued to suffer a tremendous amount with deep despair, very bad insomnia and burning nerve pain which began when I started tapering off the benzo. I have lost all interest in the things I used to care about.  I have no motivation and I feel very hopeless about the future.  My cognitive function has also declined significantly — perhaps from lack of sleep.  My concentration and memory have suffered.
 

Nonetheless, I strive to maintain self-care rituals such as eating well — no junk food, dairy, gluten, added sugar or seed oils.  I’m on a keto diet and exercise regularly. I take an infrared sauna every morning and I meditate.

 

In January of this year I became so desperate for the lack of sleep and my inability to focus or concentrate do at least in part to my insomnia that I started taking Trazodone. I started at 25 mg and went up to 100 mg and maybe got a slight sleep benefit from it.   But after a while I recognized that I didn’t think that more medication was a good idea so I started to taper off the trazodone.  I’m now down to 62.5 mg but I’ve held for almost a month because the last cut was very difficult for me.

 

I would love to know if people have suggestions for the best way to get off the trazodone and also whether people have had positive or negative experience with supplementation. I spoke with an integrative psychiatrist recently who recommended a comprehensive supplement — Hardy’s Daily Essential Nutrients — because he said the brain really needs nutritional support to help with healing.  I haven’t tried the product and I’m nervous about doing so but I’m also becoming more and more desperate because I just don’t seem to be getting any better. I’ve tried a variety of therapies including transcranial magnetic stimulation and CBT, which have not hurt me but they haven’t help me either.  
 

I look forward to learning from the people on this group.

 

 

 

 

 

Edited July 29, 2021 by Karma
To fix typos and to add some additional detail; name update

[Gridley]

Welcome to SA, Mandrake,

 

To start:

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Please be sure to include the dates and rate of your taper from Trazodone and also your original Trazodone dose.

 

Account Settings – Create or Edit a signature.

 

You are experiencing antidepressant withdrawal and benzodiazepine withdrawal.  The damage is not permanent and you will heal, but we can't predict how long it will take.  So that you have a better idea of what you're experiencing, here is some information on withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Regarding tapering off the Trazodone, we recommend tapering no faster than 10% of your current dose every four weeks.  Since you've had a difficult time with the last reduction (and since very likely you've been tapering too fast) I would hold where you are at 62.5mg for at least two more months to allow your system to stabilize.  If the symptoms prove too difficult, you could try a very small updose back up to 65mg to see if that helps.  I wouldn't updose any more than that because too much can overwhelm your system and make things worse. If you do updose, you will need to wait to stabilize before continuing your taper.  This can take several months.   Please read the following:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

Once you're ready to taper the Trazodone, here is a link explaining why we recommend tapering no more than 10%of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

The following link is specifically about tapering Trazodone, including how to get the non-standard doses you'll need for a 10% taper.

 

Tips for tapering off trazodone (Desyrel)

 

You asked about supplementation.  We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).  We don't recommend mixed ingredient supplements, such as the Hardy's supplement suggested by your integrative psychiatrist, because if problems arise you won't know the cause.  Multiple supplements generally contain B-vitamins, which can be too activating for people in withdrawal.

 

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

[MrAnxious]

As for nutritional healing I would recommend eating a diet rich in fruits and vegetables. You want to steer away from antibiotic/hormone filled meat/dairy, which exacerbate the problem . I found all supplements have been a waste of money. The gut/brain has a true connection. The nutrients found in fruit/veg are deeply needed for true healing long term. It's what worked for me. After wasting tons of money, mother nature supplies  🌱😊

 

*Not doctor advice* You do what you feel is best for you. This is what has helped me down my road.

[Mandrake]

Gridley, thanks for your very helpful  reply.  I will hold my Trazodone dosage for two months before trying to taper further.   I have reviewed a lot of the materials on tapering by only 10% of the current dosage, and the approach makes sense to me.  However, my cognitive function is so impaired because of the insomnia that I’ve been dealing with for three years that I’m struggling to understand how to put into it effect the liquid micro taper.  Is there any possibility that I could consult with somebody on the phone to discuss the actual approach. I don’t want to do it wrong and I’ve tried to review the materials and I just can’t understand them particularly figuring out how to use a spreadsheet, which had never been one of my strong suits even when I was mentally much sharper than I am now.

[Altostrata]

Welcome, @Mandrake

 

This indicates that you have withdrawal syndrome dating from going off benzodiazepines -- unless your sleep problems started when you went off Effexor.

On 6/26/2021 at 8:29 AM, Mandrake said:

From February 2019 until January 2021, I remained drug-free.  During that time, I continued to suffer a tremendous amount with deep despair, very bad insomnia and burning nerve pain which began when I started tapering off the benzo.

 

How do you feel before and after taking trazodone every night? Has your symptom pattern changed as you've reduced it?

 

I agree with MrAnxious, it's better to eat the whole foods, supplements are not as effective and often a waste of money. The only supplements we widely suggest are fish oil and magnesium supplements; many people find them helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

How do you feel after your sauna every day?

Edited July 29, 2021 by Karma
Name update

[Mandrake]

My insomnia started when I got off Effexor. Getting on and off the Benzo may have exacerbated it a little bit but it was very bad as soon as I took my last dose of Effexor in June 2018.  
 

While taking Trazodone up to 100 mg did not really help my sleep very much getting off it is definitely having a negative affect on my sleep.  Tapering the Trazodone has also caused me to have much worse head pressure than I was previously having and low level nausea,  which I was not having before tapering.  I just think my system is incredibly sensitive to psych meds and tapering is extremely difficult for me even though I’m going quite slowly. I just did a 10% cut about a week ago and my sleep has gotten worse and my head pressure has also I don’t intend to cut again for another three weeks.

[Altostrata]

I am sorry you're having this difficulty with trazodone. What time o'clock do you take it? Do you feel any effects afterward?

 

What methods have you used to reduce trazodone?

[Mandrake]

I take it at 10:30 pm right before I go to bed.  I fall asleep within about two minutes of turning out the lights, but that was true before I started taking Traz in January 2021. My problem is that I wake up 3-4 hours later and cannot fall back asleep even though I am exhausted. When I wake up I feel deep, deep despair, have terrible burning nerve pain and head pressure.  I had the despair since I tapered off Effexor in 2018 and the nerve pain since I started tapering Valium in late 2018 (I have been off Valium since Feb 2019). But the head pressure started once I started taking the Traz in January 2021 and has gotten worse since I started tapering it a few months ago after I concluded it wasn't helping me sleep any better.

 

I starting tapering from 100 mg nightly by making 12.5 mg cuts every 2-3 weeks. The first two weren't bad, but the third one (from 75 to 62.5 mg) knocked me for a bit of a loop reducing the amount of sleep I was getting by a bit and increasing my head pressure. So, I held at 62.5 mg for two months.  I then made a 10% cut about 8 days ago. My instinct is that I am sleeping a bit less and having a bit more head pressure as a result of this, which I intend to hold for at least a month.