CharlieBrown13: Reducing venlafaxine and escitalopram

[CharlieBrown13]

Hello everyone, a quick update.  

Three days ago I was hospitalized with a serotonin syndrome, I was literally poisoned  by my psychiatrist (thanks again, Altostrata, for your great help over many thousands of kilometers).  
Without exception, all the doctors here in the ward shook their heads about both the dosage and the drug combination, they really couldn’t believe it. 

I think this was malpractice and if at some point I am well enough and have the strength to do so, I will consider suing her.

 

The medication was discontinued immediately (escitalopram 25 mg / venlafaxine 50 mg).  

Maybe or probably I was too naive not to question that at the start of therapy, but that's why I started reducing it already 4 weeks afterwards, because I felt so badly with and about it.  

Now I'm on the third day without anything.  Yesterday and the day before yesterday were good days, my body literally breathed a sigh of relief. Today is not like yesterday , but ok.  
 

I have strong brain zaps when it comes to symptoms, but these began at the same time as the overdose symptoms two weeks ago, so I do not consider this a withdrawal symptom but a toxicity symptom.
I have DP mainly in the mornings, it fades in the afternoon. This also started two weeks ago and is sometimes more, sometimes less, more today.  
Today also slight nausea, abdominal cramps, feeling of anxiety, like a much smaller wave of the symptoms of the last two weeks.  
And unfortunately my brain is not working well at the moment, more complex thought processes are hardly possible.  Not at all nice, but I think many of you know that. It was much better yesterday afternoon, that is reassuring, the mind is still there, just blocked. 

I still have a lot of that dreadful stuff in my body, of course. 

Of course, I am very afraid of what happens when my body and brain register that the medication intake has gone from 300 to 0.  Like a Formula 1 crash.  

But I don't see any alternative at all right now. The doctors are extremely nice, everything is being observed now,  nobody pushes me to do anything. 

But still, I’m very very afraid.

The chief doctor said whether we should perhaps re-dose a low (very low!) amount of escitalopram or fluoxetine in order to alleviate any withdrawal symptoms, in the further course, not now.  

I don't have any withdrawal symptoms at the moment, although it is certainly difficult to distinguish where toxicity symptoms end and when do withdrawal symptoms begin.

 
I'm really very, very insecure about re-dosing, I have the feeling that every new manipulation makes the stormy sea in my brain even more stormy.

I am happy to hear your opinions on this, otherwise I will keep you up to date.

And stay strong , everybody, I think of all of you and your daily struggles- your great!!

[MirandaN]

Dear Charlie, I am glad you are now in good hands at the hospital. Acknowledging fear is to be brave. You are very brave! 

[CharlieBrown13]

Thank you very much for your kind words, MirandaN, that really means a lot to me !!

[ChessieCat]

9 hours ago, CharlieBrown13 said:

I have strong brain zaps when it comes to symptoms, but these began at the same time as the overdose symptoms two weeks ago, so I do not consider this a withdrawal symptom but a toxicity symptom.

 

Serotonin toxicity is dose-related.  Having been on the doses of the drugs for the length of time you were on them it is highly likely that you are/will experience withdrawal symptoms, and I think what you are experiencing now, after stopping the drugs, is WD and not due to the serotonin.  Because of the relation to dose, the serotonin toxicity should be reducing after stopping the drugs.

 

9 hours ago, CharlieBrown13 said:

The chief doctor said whether we should perhaps re-dose a low (very low!) amount of escitalopram or fluoxetine in order to alleviate any withdrawal symptoms, in the further course, not now.

 

Starting Prozac / fluoxetine might not be a good idea because it has a very long half life and can be difficult and long process trying to work out a suitable dose, which can involve having to endure discomfort for a week or more if you take too much and then having to endure more whilst you wait for the dose to diminish in your system.

 

I have asked Alto if starting a small dose of citalopram, a gentler sibling of escitalopram and easier to get non standard doses.

 

My suggestion would be to NOT start another drug until you hear from Alto.

[Altostrata]

Good to hear from you, @CharlieBrown13

 

You did the best you could. At last, the hospital took your symptoms seriously. Your adverse drug reaction was bad and getting worse, quitting the drugs was justified.

 

Most of the venlafaxine and escitalopram has been metabolized by now. All in all, it doesn't sound like you're doing too badly. But in these situations, the lowest effective dose of a long-acting benzodiazpine, taken as sparingly as possible, may be helpful.

 

If you take it daily, it's likely you would have to taper off, but we can help you with that.

 

How's your sleep?

 

10 hours ago, CharlieBrown13 said:

The chief doctor said whether we should perhaps re-dose a low (very low!) amount of escitalopram or fluoxetine in order to alleviate any withdrawal symptoms, in the further course, not now.  

 

That is a very interesting remark, because the only source for recommending very low dose reinstatement is this site and the paper I wrote, 

Framer, A. (2021). What I have learnt from helping thousands of people to taper off antidepressants and other psychotropic medications. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125321991274

 

However, I would not anticipate any kind of antidepressant reinstatement. It may be your nervous system is so relieved, you will feel a lot better now.

 

Fish oil and magnesium supplements can be 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/

 

Fish oil in particular seems to reduce brain zaps. You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[Heath]

Charliebrown13 wow I’m so glad you are ok!  The actions taken were amazing!  You and Altos brainstorming - You new you needed to go to hospital and you got yourself there - the drs recognized the medication toxicity-  the dr stated low dose for withdrawals WOW! WOW!
 

Having the hospital regonize toxicity and withdrawals I thought that was only in dreams ! 
Thanks to Alto and everyone involved ! Prayers for healing Charliebrown13! 

[CharlieBrown13]

@Altostrata

7 hours ago, Altostrata said:

 

Most of the venlafaxine and escitalopram has been metabolized by now. All in all, it doesn't sound like you're doing too badly. But in these situations, the lowest effective dose of a long-acting benzodiazpine, taken as sparingly as possible, may be helpful.

I think there is still a lot of escitalopram in particular in me, as it has a significantly longer half-life than venlafaxine.  
This morning, I had the same symptoms as yesterday, fear, sweating, abdominal cramps, DP, Diarrhea, skin burning, but not very severe, just quite uncomfortable. And my mind is still not working very good, that is the greatest burden for me right now..😟

If it comes to severe wd, I will ask for for a benzo, maybe diazepam. 

 

7 hours ago, Altostrata said:

That is a very interesting remark, because the only source for recommending very low dose reinstatement is this site and the paper I wrote.

 

Maybe he read your paper. It would be nice if it caught on in a few minds. Or a few more.

If not, I will recommend it to him. This hospital (TUM in Munich) has a very good reputation. Maybe he could talk to some of his colleagues about it.

 

7 hours ago, Altostrata said:

How's your sleep?

I sleep much better now, 6-7 hours again.  Waking up (probably also because of the high cortisol levels in the morning) and the hours afterwards are the main problem.
 

7 hours ago, Altostrata said:

Fish oil in particular seems to reduce brain zaps. You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

The brain zaps are still very violent.  I have been taking high doses of fish oil for 8 weeks now, as well as magnesium glycinate.   

 

7 hours ago, Altostrata said:

However, I would not anticipate any kind of antidepressant reinstatement. It may be your nervous system is so relieved, you will feel a lot better now.

Yes, I am not currently taking any new medication either.  I'll just wait and see now.  And hope. What a year.

[CharlieBrown13]

3 hours ago, Heath said:

Charliebrown13 wow I’m so glad you are ok!  The actions taken were amazing!  You and Altos brainstorming - You new you needed to go to hospital and you got yourself there - the drs recognized the medication toxicity-  the dr stated low dose for withdrawals WOW! WOW!
 

Having the hospital regonize toxicity and withdrawals I thought that was only in dreams ! 
Thanks to Alto and everyone involved ! Prayers for healing Charliebrown13! 

Dear Heath,

thank you for your words, that touches me very much.  On Sunday I just had my back to the wall and was so desperate that I was so happy to have a contact person in Altostrata.  

And that I came across an extremely nice admission doctor who listened to everything for a long time and in detail and took the right measures, I am also very happy about that.  I hope so much that some of the symptoms will now subside again, especially the impaired cognition and brain zaps and those stupid feelings of fear.  I guess I'll just have to wait and see now.  Thank you very much again !!  

Warm greetings

 

Charlie

[CharlieBrown13]

11 hours ago, ChessieCat said:

nd I think what you are experiencing now, after stopping the drugs, is WD and not due to the serotonin.  Because of the relation to dose, the serotonin toxicity should be reducing after stopping the drugs.

Hi, @ChessieCat, 

the symptoms i have now are the same as before the discontinuation, only in a much weaker intensity.  Only the brain zaps and the tinnitus are still very pronounced, but I think it is slowly getting a little better.
And I hope that this continues to subside.  In this respect, I believe that these symptoms can actually still be traced back to the serotonin toxicity, as they started with the acute events 14 days ago.  Unfortunately, I have relatively few doubts that I will get withdrawal symptoms ...

 

11 hours ago, ChessieCat said:

 

Starting Prozac / fluoxetine might not be a good idea because it has a very long half life and can be difficult and long process trying to work out a suitable dose, which can involve having to endure discomfort for a week or more if you take too much and then having to endure more whilst you wait for the dose to diminish in your system.

I think you are absolutely right, at the moment I don't want to take any new / different drugs at all.  And before I even consider doing that, I'm going to do a genetic test to see if I'm a poor metabolizer.  That would perhaps explain why I do not tolerate so many drugs well or why I often only need very small doses (e.g. Metoprolol)

 

Thank you very much for your input and your effort, I really appreciate that!

[CharlieBrown13]

renewed update

I’m now the 6th day without antidepressants after they were suddenly discontinued last sunday due to a serotonin syndrome.  
Unfortunately, I struggle a lot.  

Apart from a slight headache, I don't (yet) have any physical withdrawal symptoms, but psychological ones.  After I was almost euphoric for the first three days (I wrote a very strange email to my boss 😬), every day something changes in my brain (that was expected), unfortunately not for the better.

I wake up every morning with massive anxiety (in my stomach, I can't describe it better) that continues longer and longer, yesterday until late afternoon.  This morning my brain didn't work at all, everything went haywire, I thought I was going out of my mind.
In addition, the anhedonia (which was the original reason for the AD therapy) is significantly more severe, as is the depersonalization.  Things that were important to me yesterday (like the anger about my psychiatrist) are almost indifferent to me today, I am becoming more indifferent, including to friends and family.  That really really frightens me.

 

Nothing is being done medically at the moment, just observed in order to possibly see a bit more clearly whats maybe a result of the serotonintoxicity, what withdrawal symptoms, and what possibly also depression.  
I do art therapy, occupational therapy, psychotherapy, sports.  

Thank you for every kind word you sent me!!

[ChessieCat]

On 10/27/2021 at 9:06 PM, CharlieBrown13 said:

And before I even consider doing that, I'm going to do a genetic test to see if I'm a poor metabolizer.

 

This post might be helpful.  To see the whole topic click on the arrow at the top right of the quote and go to Page 1 of the topic:

 

  

On 4/23/2012 at 5:11 AM, Altostrata said:

Some people lack specific liver enzymes needed to metabolize specific drugs. For example, many antidepressants require the liver enzyme designated at P450 CYP2D6 to be safely metabolized.

 

People who are low in CYPD6 (an otherwise normal genetic variation that causes no problems other than with drug metabolism) would be called "poor metabolizers" for CYP2D6.

 

Most likely what this test does is test liver enzyme genetics.

 

If your test result shows you are a "poor metabolizer" via this or that liver enzyme, the doctor may be able to select a drug for you that does not use that metabolic pathway.

 

This doesn't mean the drug will work, or that it will not have adverse effects. It means that the doctor may be able to avoid adverse effects because of poor metabolization -- which are pretty common among poor metabolizers, and not just for psychiatric drugs.

 

Many doctors mistakenly attribute ANY adverse effect, including withdrawal syndrome, to a lack of liver enzymes. This is yet another way they misunderstand the adverse effects of psychiatric drugs.

 

So the test is probably not total B*******, but it is of limited value and pretty much useless to anyone with withdrawal syndrome.

 

[Altostrata]

Those "psychological" symptoms are very typical of post-drug effects. Please hang in there, don't diagnose yourself as "relapsed" yet.

[CharlieBrown13]

34 minutes ago, Altostrata said:

Those "psychological" symptoms are very typical of post-drug effects. Please hang in there, don't diagnose yourself as "relapsed" yet.

Thank you, Altostrata!!

No, I don't think I’m relapsed, I really think it’s still a drug-hangover. 
But while you lie there in the morning and fight your fear down, you really have to tell yourself that over and over again ...
This afternoon the symptoms (anhedony, DP, anxiety) were also completely gone, the ability to think is still limited, however. 
I have a theory - maybe the medication accumulates a bit in the body during the night, you don't drink anything for 7-8 hours and then stronger symptoms such as anxiety and drowsiness appear in the morning.  

Maybe a small increase in the plasma level at night is enough and zap-anxiety appears.
(That are of course always only guesses, i try to deduce some things from my work as an oncologist- less drinking over the day, chemotherapy with for example Cisplatin- much higher toxicity.  
A little late though to think about such things, but better than not at all)

I've had this lightheadedness, almost confused, in a lighter form every morning since I took AD.  

 

And now I could imagine that there are still residues, especially of the escitalopram, in the body (with a half-life of 30 hours, it takes 14 days until it is almost completely gone) and that this is still bothering me in the mornings with anxiety and DP (which I didn’t have in the months before the acute toxicity). 
What do you think about that?  Could that be true?

[Altostrata]

1 hour ago, CharlieBrown13 said:

But while you lie there in the morning and fight your fear down, you really have to tell yourself that over and over again ...

 

This is exactly what you need to do. Reassure yourself often.

 

No, it's not because there's residue of the drug. With the morning light, there's a natural peak in the daytime hormone cortisol, it's what wakes us up. Because of your adverse drug experience, your nervous system is unusually sensitive to this. It takes some hours for your system to settle down from this stimulus. 

 

How's your sleep?

 

See What is the sleep cycle?

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

This paper may help you understand how antidepressants and other psychiatric drugs leave a footprint on the nervous system https://markhorowitz.org/wp-content/uploads/2021/04/18TLP1004_Horowitz-1-11.pdf

 

It takes time for the target receptors to re-adapt, meanwhile other body systems dependent on stable signaling struggle to stabilize themselves. This process is usually fitful, uneven, and very gradual.

 

With luck, your body will be so relieved it's not overstimulated any more, it will not generate withdrawal symptoms. It may take some time for you to get back to normal, though.

 

Did you say you were taking omega-3 fish oil and magnesium?

[CharlieBrown13]

8 hours ago, Altostrata said:

How's your sleep?

It’s relatively good, I sleep about 6-7 hours 

 

8 hours ago, Altostrata said:

With luck, your body will be so relieved it's not overstimulated any more, it will not generate withdrawal symptoms. It may take some time for you to get back to normal, though.

I hope so so much, I just have to wait and see ...

 

8 hours ago, Altostrata said:

Did you say you were taking omega-3 fish oil and magnesium?

Yes, I take high dose fish oil and 400 mg magnesium

[CharlieBrown13]

@Altostrata

Forgive me for asking, I know everyone wants to know exactly that:

do you think the morning anxiety attacks and dp will go away and my cognitive skills will come back? 

 

Thank you and your team again for all the time and effort you put into this forum to help people who are desperate!

[MirandaN]

Dear Charlie, are you still at the hospital? It is good that you can sleep 6-7 hours. I hope the doctors and nurses are taking good care of you. 

 

I, too, have fears for dp, physical symptoms not going away and fears for my cognitive skills not returning etc. Both you and me have jobs where cognitive skills are fundamental. I don't know if it is helpful for you (or you have perhaps already thought about this since long), but I have recently started trying to visualize my body and brain doing what they can in every moment to heal. I have realized that my body and brain need encouragement to do their job. They need my mind to cheer them on and tell them they are doing a great job in order to keep healing well. Some people call this practising "self love". I am not at all very good at this myself, but I think it makes sense somehow. The body and mind are connected. If I let my mind run off with negative thoughts, it may affect my healing negatively. If I encourage my body to heal and cheers it on, it may easier find ways to heal. You have probably already thought much about these things, but I thought I would write it down anyway. 

 

You may find this article from a doctor in the UK interesting with regard to whether the mind can affect healing of physical ailments: https://blogs.bmj.com/bmj/2021/01/25/paul-garner-on-his-recovery-from-long-covid/

I wonder if his theory on this may help with withdrawal symptoms from drugs as well (i.e. if it is possible to diminish symptoms and retrain bodily reactions through conscious thoughts and feelings)? 

 

💕 from Miranda 

[CharlieBrown13]

Yes, I will stay here for a few weeks and everyone is very, very nice. And everything is very calm in here.

 

25 minutes ago, MirandaN said:

I, too, have fears for dp, physical symptoms not going away and fears for my cognitive skills not returning etc. Both you and me have jobs where cognitive skills are fundamental. I don't know if it is helpful for you (or you have perhaps already thought about this since long), but I have recently started trying to visualize my body and brain doing what they can in every moment to heal. I have realized that my body and brain need encouragement to do their job. They need my mind to cheer them on and tell them they are doing a great job in order to keep healing well. Some people call this practising "self love". I am not at all very good at this myself, but I think it makes sense somehow. The body and mind are connected. If I let my mind run off with negative thoughts, it may affect my healing negatively. If I encourage my body to heal and cheers it on, it may easier find ways to heal. You have probably already thought much about these things, but I thought I would write it down anyway. 

 

This is a very good idea, I'll start with it later this afternoon. For the last few months I have been meditating regularly on the back pain, where you then visualize that you can change the shape and color of the pain and that definitely brought something.  Why not also for the brain (even if it doesn't really want to like I want ...). I will cheer up my stressed nerve cells and you do the same in Sweden!!

 

And thank you for the link to the article!

Its so good to talk to you 💕!!

 

btw, what is your profession?

 

Cheers

 

Charlie

[Altostrata]

Yes, your symptoms should gradually go away, but it could take months before you feel mostly well again.

 

Be careful not to shake up your nervous system further with even ordinary drugs such as caffeine or alcohol. Your nervous system is in a vulnerable state, even antibiotics can cause a bad reaction.

 

It's good you can sleep, this is important. If your symptom pattern worsens significantly and progressively over several days, you might want to consider a tiny amount of diazepam per day, a fraction of the lowest dose tablet. Be careful not to trigger a defensive paradoxical reaction from your nervous system, it needs to rest from chemical stimulus.

[CharlieBrown13]

6 hours ago, Altostrata said:

Be careful not to shake up your nervous system further with even ordinary drugs such as caffeine or alcohol. Your nervous system is in a vulnerable state, even antibiotics can cause a bad reaction.

Thank you, Altostrata!

I don’t drink alcohol or caffeine, only lots of water…

 

6 hours ago, Altostrata said:

 

It's good you can sleep, this is important. If your symptom pattern worsens significantly and progressively over several days, you might want to consider a tiny amount of diazepam per day, a fraction of the lowest dose tablet. Be careful not to trigger a defensive paradoxical reaction from your nervous system, it needs to rest from chemical stimulus.

I hope I don’t need that. The only thing I take is very rarely a headache pill (ibuprofen)

[CharlieBrown13]

How I explained to my friends why I don't want to take another antidepressant right now (respectively never)

 

The CNS is like a pendulum that is swinging wildly in its currently irritated state (withdrawal or, in my case, high serotonin)

The pendulum swings are the symptoms we all have, the higher the amplitude the more symptoms. 
The aim is that the pendulum swings only very slightly around the „baseline“, e.g. when you are excited or have "normal" fear or something.  This is then more or less the healthy normal state.  

In the beginning you are usually far from the baseline, but over time you get closer and closer to it. Until you reach it 😊!
How long the pendulum swings wildly varies from person to person, but SOMETIME it WILL calm down. Every pendulum!  
Unless there is a new impulse from outside, be it another drug, alcohol , whatever, everything that’s not good for you, then it starts to vibrate more wildly again and it takes even longer until a state of rest occurs.  

Slowly tapering off from the start prevents large swings in the pendulum, but small swings cannot be avoided because every change in dose is a new impulse.  Some people have a less sensitive CNS, which then only vibrates slightly, and accordingly they have fewer withdrawal symptoms.

And some people are very sensitive, so even with small impulses it vibrates more, and that means more symptoms.

 

And yes, they understood 😊

[Memphisto]

hello charlie,

 

you described that very well, I can fully agree with that. I hope our pendulum comes to rest quickly.

 

I had wild dreams before waking up this morning and woke up with moderate anxiety. It's been better since breakfast and at 2 p.m. it's almost back to normal.

 

I wish you a lot of healing and a nice Sunday.

 

healing greetings

memphisto

[CharlieBrown13]

Dear Memphisto,

thanks for your nice comment!!

Sometimes it is easier to present an analogy with friends and family, it is often easier to understand and perhaps less stressful for them.

I’m very happy for you that the fear seems to be a bit less?!  
I very much hope and keep my fingers crossed for you that all of this will soon be history for you ... !!  
 

Have a good Sunday afternoon and lots and lots of healing to you too!!

 

Greetings Charlie

[Altostrata]

Actually, your serotonin production is probably normal, @CharlieBrown13, but various receptors are either desensitized or sensitized, that's what's causing the nervous system instability.

 

The body's operation as conducted by the nervous system is like a symphony. In withdrawal, you've lost a section of the orchestra, the conductor is confused, and everybody's off a little, with some members trying too hard.

 

But a pendulum is a good metaphor, too, for the recursive way the nervous system corrects itself, eventually coming back to equilibrium.

[CharlieBrown13]

Good morning, @Altostrata

5 hours ago, Altostrata said:

Actually, your serotonin production is probably normal, @CharlieBrown13, but various receptors are either desensitized or sensitized, that's what's causing the nervous system instability

So I have to be patient (like everybody else here…). Mornings are, to say the least, still very suboptimal.

 

5 hours ago, Altostrata said:

The body's operation as conducted by the nervous system is like a symphony. In withdrawal, you've lost a section of the orchestra, the conductor is confused, and everybody's off a little, with some members trying too hard.

I like that 😁!!

[Altostrata]

What happens in the mornings?

[CharlieBrown13]

I think it has to do with the cortisol peak, like you said in one of your last posts (my morning cortisol level is way too high anyway, I had it tested).  
I wake up around 5:30 am, this intense fear settles in my stomach, I'm drowsy and  I have this slight depersonalization. That lasts until about noon and then it slowly fades.
All of this symptoms only started in the last three weeks, when the situation got so acute (I had the dp last year before starting therapy, but not inbetween)

[Altostrata]

You might find you can reduce this reaction in the early morning by minimizing light stimulation with blackout shades and a sleep mask. It's triggered by early morning light.

[CharlieBrown13]

8 hours ago, Altostrata said:

 

You might find you can reduce this reaction in the early morning by minimizing light stimulation with blackout shades and a sleep mask. It's triggered by early morning light.

 

Thank you, Altostrata!

It’s a bit difficult with blackout shades here in the clinic, but I tried the sleep mask. And it was better 😊!

 

[Altostrata]

You're still in the hospital?

[CharlieBrown13]

Yes.  Tomorrow is the rounds with the chief physician, then we will discuss how to proceed.  I will keep you up-to-date!

[CharlieBrown13]

@Altostrata

I still struggle a lot with my ability to think, to remember and depersonalization. If one gets better, the other gets better too, it’s closely related.

Does it make sense to do brain training (such as sudoku or finger exercises)?  I notice that I get very tired with Sudoku (easiest variant 😔), or should the brain relax in peace? Do you have experience with this?

[Altostrata]

Recovery will be very slow, but you're improved already. 

 

You might occupy your mind with whatever pastimes are engaging. It's better to do this than to worry while time does the healing. Also, get at least 1/2 hour of gentle exercise, such as walking, every day.

 

[CharlieBrown13]

Altostrata, you are absolutely right, I know that.
I just find it so very scary not to be able to think clearly or as good as not at all.

I don't want to be afraid and yet I am.

I am afraid that there is not enough time left or that I am not healthy enough to take care of my mother, she is 86 and I just love her very much. 

Sorry for whining, I know that a lot of people here who are in worse shape than me (and I’m thinking about them a lot).
And I think about you and this forum, what I would’ve done 12 days ago without your help.
 

I’m walking about an hour every day, that's good for me. And the therapies here, art therapy and occupational therapy and a little bit of sports. It’s a very peaceful atmosphere here.

 

And sorry, that my answers are always much longer than I actually want them to be.. 😬

 

[Altostrata]

No problem. You'll very gradually feel better and out of the hospital. 

[CharlieBrown13]

Another update- 14 days after stopping Escitalopram (25 mg) and Venlafaxin (50mg) due to a serotoninsyndrom.

 

So far, I have not had any (new) withdrawal symptoms, as I had all the symptoms while taking the medication, all of which had worsened significantly in the three weeks before stopping.

 

The following has improved:

Anxiety (still slightly in the morning), diarrhea, nausea, vomiting (no longer), blood pressure (normalized), tremor, muscle twitching, sweating.  
Sleep is good, about 6-7 hours.  

 

Constant, sometimes more intense: 

depersonalization, then combined with anhedonia, strong cognitive limitations, brain zaps, tinnitus, dry mouth, brain fog, dizziness.

 

I walk 5-6 kilometers every day, eat as healthily as possible and take fish oil and magnesium, do Sudoku to train the brain, drink lots of water and do hot liver compresses every day to help the liver detoxify (a very old home remedy, a tip from my mother, who is a physiotherapist).

 

I am not able to work because I cannot think properly and because of the dp.