CharlieBrown13: Reducing venlafaxine and escitalopram

[ChessieCat]

5 minutes ago, CharlieBrown13 said:

I tried to stop olanzapin last weekend after taking it for 6 days at a low dose (between 0.3 and 1.25 mg), but the anxiety was so overwhelming that I started it again, I take now 0.25 mg twice a day.

 

Please add the doses and the dates of dose changes to your drug signature.

 

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[CharlieBrown13]

@ChessieCat

Done 🙂

I know, you don’t recommend anything but fishoil and magnesium. But do you think, because of the nerve-burning, I should take Vitamin B despite this? It’s like I’m alive on fire…

Maybe it’s the subsiding of the small dose of diazepam.

[Altostrata]

15 hours ago, CharlieBrown13 said:

I tried to stop olanzapin last weekend after taking it for 6 days at a low dose (between 0.3 and 1.25 mg), but the anxiety was so overwhelming that I started it again, I take now 0.25 mg twice a day.

 

@CharlieBrown13 , taking this tiny amount of olanzapine is not terrible if it helps you. What happens before and after you take a dose of olanzapine?

 

My guess is reinstating an antidepressant is not a good idea for you, you are recovering from a severe adverse effect caused by antidepressants.

 

It's very common for symptoms to come in waves. Hang in, this should get less intense as time goes on.

[CharlieBrown13]

11 hours ago, Altostrata said:

taking this tiny amount of olanzapine is not terrible if it helps you. What happens before and after you take a dose of olanzapine?

I think maybe it smoothes the fear spikes a little bit, although I’m not really sure about that because it’s always there.

And I can sleep better, I get more tired about one hour after I take it.

 

11 hours ago, Altostrata said:

My guess is reinstating an antidepressant is not a good idea for you, you are recovering from a severe adverse effect caused by antidepressants.

I think you’re right and I’m too afraid to test it out and make things maybe even worse.

 

11 hours ago, Altostrata said:

It's very common for symptoms to come in waves. Hang in, this should get less intense as time goes on.

I know. I just wish that time goes on a little faster. But unfortunately the grass does not grow faster if you pull on it…

[Altostrata]

7 hours ago, CharlieBrown13 said:

And I can sleep better, I get more tired about one hour after I take it.

 

Sleeping is a good sign! Yes, olanzapine would make one tired. That little bit is having an outsized effect. This indicates your nervous system is sensitive to drugs.

 

Please try to stay calm while you convalesce. You had a medical accident, you need to recover. You are doing better already.

[CharlieBrown13]

11 hours ago, Altostrata said:

Please try to stay calm while you convalesce. You had a medical accident, you need to recover. You are doing better already.

Unfortunately, I had not only a medical accident, I’m in a horrible withdrawal too. My body is rebelling with diarrhea and vomiting and I have the feeling, I’m loosing my mind, I’m confused and feeling distant to the world and have this horrible chemical fear.

No, I’m not doing better. But thank you, @Altostrata, for your effort.

[CharlieBrown13]

@Altostrataet all

I don't know how to hold out.  

I've been living with friends for 10 days, but they are already extremely stressed by me.  I can't go to my 86-year-old mother.  I don't have many options, one of which is to go back to the clinic.  

Then I will definitely be given higher doses of antidepressants and probably lorazepam.  I don't want any of that.  
But I don't know if I can hold out the withdrawal like that, I had a very strong desire not to be here any more tonight. It felt like a bitter black knife in my soul, absolute agony, for many hours. Does anybody know that?

So I'm wondering whether re-dosing one of the two medications I was taking might not be an option to reconsider again.  Or, although this is not what this forum is for, take another AD and taper that off? I know I had an adverse reaction, but now I'm in a very severe withdrawal.  It’s now nearly six weeks that the medication was stopped.
 

I just don't know what to do next, I don't know where to go.

 

If anybody has a good idea, please answer me. 
Thank you.

[JesusSavemefromWD]

I am really sorry ….. among my many symptoms I also had the “black soul knife” feeling, if you see in my signature I have used the term “ soul ache” I believe it’s the same symptom as it really felt like someone was squeezing a knife in my soul…. That symptom has left me now.  I am sorry I don’t have anything else to say other than that this symptom will go away. I just prayed for u …

[JesusSavemefromWD]

Please wait for a moderator to advice you , but why do you say you had an adverse reaction? It seams you had serotonin toxicity cause you were both on an SSRi and an snri at high doses. 

[CharlieBrown13]

7 minutes ago, JesusSavemefromWD said:

but why do you say you had an adverse reaction?

That’s what Altostrata said.

[Altostrata]

Serotonin syndrome is a serious adverse reaction.

 

Many people have felt that deep, nearly indescribable despair after a psychiatric drug disaster such as the one you experienced. Please put your mind to persistence. You will need to let the symptoms fade.

 

How long do you feel the effect from a 0.25mg dose of olanzapine?

 

You'll need to plan for convalescence. Are your friends willing to continue to help you? If you have assistance, can you live in your own apartment?

[CharlieBrown13]

1 hour ago, Altostrata said:

How long do you feel the effect from a 0.25mg dose of olanzapine?

@Altostrata

I don’t feel it any more, there seems to be no more effect.

 

Since yesterday, I have that burning of the nerves in the body constantly, without fading sometimes and I really don’t know how to go on with this.

I had these symptoms last year after the application oft the gadolinium contrast agent, too,  when all this started.

I believe, at that day in October 2020, my neurotransmitters were „killed“ (or something like that) because afterwards I got the symptoms of severe withdrawal although I wasn’t taking any antidepressants before. But it was the poisoning of the gadolinium. I lost half of my hair three weeks later and had massive diarrhea for about 4 weeks, had brain fog and lost my memory temporarily. And had the burning of the nerves.
The difference then was that I was taking hydromorphon because of the pain in my back and that I got anhedonia in the course and then didn’t feel anything anymore. No feelings, but no pain either.

 

But back to now- what if this burning is a expression of a lack of serotonine at the nerves since it started approximately two weeks ago, ca four weeks into withdrawal, came an went and now it’s constantly there? And maybe I can’t sleep anymore because there’s now not enough serotonine  any more to build melatonine (and because of the constant pain)?

We all want the doctors to think outside their box, but what about us? What if I really don’t have enough serotonine any more now, if my body just can’t produce enough on its own since the event with the gadolinium? And the withdrawal now made it much worse?

This burning is so horrible and added are this fear and despair. It’s a torture from day to day, it hurts so so much. And if there is something to my theory, it won't stop. I have no idea, what to do now, it literally feels like burning from inside, 24/7.

 

And no, I can’t live on my own, I think.

[Arti]

Hello @CharlieBrown13I dont want interfer

But you write about strange symphtoms after Tomographie with contrast liquid 

I had similar, meanwhile i think i had a thyrotoxic crisis 

Maybe you had the same and it is Not From gadolinium

Also the lost of hair are a typical Symptom 

The contrast liquid Contains jodine

https://www.forum-schilddruese.de/service/schilddruese-news/schilddruese-news-2015/news-2015-07

Do you have problems with thyroid?  

I am to sick at the Moment to write more but maybe you can Google about that 

I wont confuse only help. 

Greetings 

 

 

 

[Altostrata]

@CharlieBrown13, while theories of serotonin depletion are popular there is no scientific basis for your visualization. It sounds like you had an adverse reaction, maybe allergic, to gadolinium contrast agent, probably having nothing to do with serotonin.

 

Please put your mind at rest regarding the state of your serotonin receptors. They were overstimulated by the combination of escitalopram and venlafaxine. The body's defense mechanism for this is downregulation of receptors, but in the natural course of things, they upregulate again (but full upregulation may be gradual).

 

Serotonin syndrome had an effect on the rest of your body, too. You are probably feeling the after-effects of that, as well as antidepressant withdrawal.

 

We don't know where the burning sensation comes from regarding psychiatric drug adverse effects, but we have seen it and the other symptoms very gradually go away.

 

A grueling insomnia is a very common withdrawal symptom from all psychiatric drugs. You are producing melatonin, but your nervous system is so sensitized, its activation overcomes your normal circadian rhythm and parasympathetic activity.

 

These topics explain how to support the return of your normal ability to sleep by calming your nervous system:

 

What is the sleep cycle?

 

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

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

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

 

Melatonin for sleep: Many people find it helpful

 

When your nervous system has been over-stimulated by antidepressants, drugs that are used to control seizures, such as benzodiazepines and lamotrigine (and gabapentinoids), may be helpful to calm it down. They reduce that inter-cellular hyper-activity.

 

Some members with withdrawal syndrome have found quetiapine and other antipsychotics, which also tend to slow people down, to be helpful to assist recovery. In my view, the antipsychotics are higher-risk drugs than the seizure drugs -- but if it works, it works. 

 

I know you are afraid, and rightly so, of more drugs. But you might do better with a little more quetiapine. If you're using a liquid, it is immediate-release and has a half-life of only 7 hours. You might find taking 0.25mg three time a day, with doses 8 hours apart, to be helpful.

 

Being psychotropics, all of these drugs will incur physiological dependency within a month of regular use. But we have experience in tapering all of them. In last resorts, we suggest taking very low micro-doses to start (as you have done), to find the lowest effective dosage. This is important because adverse effects tend to be dosage-related, and we have seen people with nervous systems sensitized by adverse drug events will react badly to "normal" dosages.

 

You seem very stressed by worry about inconveniencing your friends. Did you ask them directly how they feel? Perhaps they are concerned about you and willing to care for you. Or can you get visits from a home health aide so you can convalesce in your own home? Have meals delivered? Perhaps your friends can help you arrange that.

[prot85]

My strong advice for you is to review your knowledge on antioxidants. You can start from the works of professor Lester Packer (one of them being The antioxidant miracle). Then you can continue with those of Abraham Hoffer. All the best!

[CharlieBrown13]

Thank you very much for your long and detailed answer, @Altostrata, 

 

10 hours ago, Altostrata said:

We don't know where the burning sensation comes from regarding psychiatric drug adverse effects, but we have seen it and the other symptoms very gradually go away.

 

The very worst symptom of all is this all consuming fear. It starts when I wake up an it doesn’t go away till I go to bed, albeit it’s a little better in the evening. It’s like I’m in prison, because I can’t do anything, everything triggers it even more (if possible),  reading, listening to music, writing, meditating everything. And prisoners can relax in their cells at least, which I can’t. I can’t leave the house, because I’m a prisoner in myself.

 

I’m a just a bundle of fear.
 

Do you really think, this will get better in time? Have you seen it? 
Otherwise, it’s no life at all. 
 

 

10 hours ago, Altostrata said:

But you might do better with a little more quetiapine. If you're using a liquid, it is immediate-release and has a half-life of only 7 hours. You might find taking 0.25mg three time a day, with doses 8 hours apart, to be helpful 

Do you think, I should change from olanzapin (currently 0.25 mg in the morning and 0.2 mg in the evening) to quetiapine?

 

10 hours ago, Altostrata said:

 

You seem very stressed by worry about inconveniencing your friends. Did you ask them directly how they feel? Perhaps they are concerned about you and willing to care for you. Or can you get visits from a home health aide so you can convalesce in your own home? Have meals delivered? Perhaps your friends can help you arrange that.

Yes, I asked them, and for now it’s ok. But Christmas is coming, their children are coming home (I live in the room of the daughter) and I’m very difficult to be with. I have to be alone in the house on my own most of the time, too much talking or stimulation is too much for me, but I can’t be alone (in my own home for example), I need to know someone’s near.

I still have strong suicidal thoughts, because this fear is so terrible to endure. 

And I tell my friends every day about that. 
So I can’t go to my mother (or my brother), it would kill her to hear that. 
 

I have to ask again- do you think, the fear will subside?

 

Thank you for your support!!

[CharlieBrown13]

I have so strong SI.

[JesusSavemefromWD]

9 minutes ago, CharlieBrown13 said:

I have so strong SI.

Please stay strong…. Just try to make it to your pillow tonight. That’s what I do when things get unbearable 

[CharlieBrown13]

46 minutes ago, JesusSavemefromWD said:

Please stay strong…. Just try to make it to your pillow tonight. That’s what I do when things get unbearable 

Thank you for your kind words!

[JesusSavemefromWD]

5 minutes ago, CharlieBrown13 said:

Thank you for your kind words!

I know how hard it is … I am , unfortunately, talking out of experience….. is your fear any better later in the day? Mine reduces a bit about an hour before I sleep …. Remember it’s a chemical fear, it’s unbearable I know, but can’t really hurt us.

[CharlieBrown13]

7 minutes ago, JesusSavemefromWD said:

I know how hard it is … I am , unfortunately, talking out of experience….. is your fear any better later in the day? Mine reduces a bit about an hour before I sleep …. Remember it’s a chemical fear, it’s unbearable I know, but can’t really hurt us.

Sometimes it is. But right now, I see no sense in enduring all of that torture any more.

[Memphisto]

dear Charlie,

 

I'm so sorry your days are so bad right now. I know this all-consuming fear all too well. in these hours there is nothing for me that could somehow make it more bearable. I'm just trying to take the time off the clock and save myself into the evening.

 

You can trust me and everyone here, it won't stay that way forever. A year ago I was also much worse than today. I still have days when I am tormented by the fear of waking up. but today I can say yes it is less intense with time or there are fewer of those very bad days. I have a lot more good days today when I'm no longer afraid. These sudden peaks of fear are also much rarer and shorter than before.

 

I also know the feeling, when things are particularly bad, that you absolutely have to act. I want to do something to change my condition as soon as possible. but the only thing that helped me was time. I stopped taking coffee a year ago and tried to eat a poor histamine diet. I don't have to do any of that anymore today. I drink my coffee in the morning and at noon and it doesn't trigger any anxiety attacks.

 

I firmly believe that you will come back there too.

 

please hang in there 🌄

[CharlieBrown13]

Thank you so much, Memphisto,

 

I appreciate your kind words.
But none of you stopped cold turkey of a high dose of two ADs at once. You’re still on a very low dose and tapering, aren’t you?

 

 Thank you though 🙏

[Memphisto]

no, I did not stop cold. my situation was that with many dose changes on mirtazapine, I was becoming increasingly unstable. at the same time I stopped escitalopram almost cold when I reduced it from 10 mg to 1.5 mg with a sense of proportion within about 4 weeks. only then did I start to slowly reduce the escitalopram with a DIY solution. About 4 weeks later I was in acute withdrawal like you are today. my symptoms were like yours, but not as intense.

 

but I have read here and in the German forum of people who stopped cold and later recovered.

 

I know we keep looking for reasons and asking why. Unfortunately, I am also not good at accepting when things are really bad. and when it starts again, it pulls the floor from under my feet. this is always bad if you have previously felt normal for days. I then need time to say to myself, hey it's not as intense and as long as it was a year ago and tomorrow it can be normal again. and most of the time it actually is again.

 

 

🌄

[Altostrata]

13 hours ago, CharlieBrown13 said:

Do you think, I should change from olanzapin (currently 0.25 mg in the morning and 0.2 mg in the evening) to quetiapine?

 

My mistake. I was referring to olanzapine. What is the effect of the morning dose? How do you feel before and after it?

 

13 hours ago, CharlieBrown13 said:

I’m a just a bundle of fear.
 

Do you really think, this will get better in time? Have you seen it? 

 

Yes, we answer this question all the time. It will get better -- but slowly. You need to persevere one minute at a time.

 

The Windows and Waves Pattern of Stabilization

 

"Is it always going to be like this?"

 

The small reduction in symptom intensity you experience sometimes in the evenings should get more frequent, longer, and more pronounced.

 

You had no choice but to go off both drugs abruptly, they were causing a potentially fatal iatrogenic condition. To some extent, your system is relieved that they're gone -- but it is still destabilized from the lack of biochemical input.

 

You would do best recuperating in a quiet environment under your control. Can you arrange for home health aides or private nurses to help you in your own apartment? Often the hospital can refer such people to assist patients at home. Perhaps friends can drop in now and then to see if you need anything during the day?

 

Please find strength to get through this bad time. Patients need you. You will slowly be better able to take care of yourself.

 

 

[CharlieBrown13]

Dear @Altostrata,

8 minutes ago, Altostrata said:

My mistake. I was referring to olanzapine. What is the effect of the morning dose? How do you feel before and after it?

I usually wake up (if I’m sleeping) with massive fear, even though it’s very dark in the room and I wear a sleep mask. Then I take the olanzapine (0.25) at 7.00. The fear, or today the absolute desperation in my soul with SI subsides a little in the afternoon.

Do you think, I should stay at that dose for now (0.45 mg/day) or should I try to reduce a little further within the 4-weeks window?

 

13 minutes ago, Altostrata said:

Yes, we answer this question all the time. It will get better -- but slowly. You need to persevere one minute at a time.

I know, I’m sorry for asking… it’s just that at the moment I can’t believe the fear will ever go away.

 

16 minutes ago, Altostrata said:

Can you arrange for home health aides or private nurses to help you in your own apartment? Often the hospital can refer such people to assist patients at home. Perhaps friends can drop in now and then to see if you need anything during the day?

Today I talked to my friends where I’m staying currently, I can stay a while longer, just have to change the room. I’m very relieved about that. They know I want to be at my room most of the time, or if possible, go for a walk with the dogs.

 

18 minutes ago, Altostrata said:

Please find strength to get through this bad time. Patients need you. You will slowly be better able to take care of yourself.

Thank you so much for always answering and encouraging me! I hope, someday I will be able to work again.

[Altostrata]

55 minutes ago, CharlieBrown13 said:

Do you think, I should stay at that dose for now (0.45 mg/day) or should I try to reduce a little further within the 4-weeks window?

 

No, I think you should increase the doses. You are getting some relief when that tiny dose reaches peak plasma in 5 to 8 hours, but it's so small, you're metabolizing it quickly.

 

If 0.25mg makes you too dopey, you might take 0.15mg 4 times a day, see if that's better. Consider this a temporary crutch to allow your nervous system to settle down and your body to get some exercise.

 

Moving around will help you recover.  Can you walk with the dogs in a peaceful place? Petting the dogs is good for you, too. Your nervous system responds to their simple affection.

 

Trusting your friends is good for you, too. It sounds like you might be blaming yourself where there is no blame. Take up a practice of forgiving yourself. Suggest you say, "I forgive myself" to yourself frequently.

 

Set your mind on self-care in the next minute, not worry over the future. You will be back caring for patients, and you'll be an even better doctor having needed care yourself.

[Frogie]

@CharlieBrown13

 

I just wanted to stop by and let you know what you are feeling is normal for wd symptoms. @Altostratais giving you the best information you can get from the internet, in my opinion. And I've had the quackiest doctors you could get.

 

I had/have the same symptoms as you, in total fear. I can relate, it's a very scary situation. But, it does go away. Mine has for the most part. It still visits me once in a while. I had that feeling at 3:30 this morning. I just talk to myself, reassuring myself that it will subside. Eventually it does. The sleep will get back to normal eventually also. Most nights I'm now sleeping 4-5 hours. I'll take that any day of the year.

 

Self care is the best medicine. Nice hot showers, walks (awesome you can walk dogs). Even just petting my dog brings me to a calmer level. 

 

We are all here for you. Rooting for you everyday. Don't forget that. If you need to talk, I'm here to answer any questions I may be able to help you with.

 

Like I said, you're in the best hands by far with Altostrata helping you.

 

Take care,

Frogie xx

[CharlieBrown13]

8 hours ago, Altostrata said:

No, I think you should increase the doses. 

Really? Increase the doses? I’m so very hesitant about that…

 

8 hours ago, Altostrata said:

Moving around will help you recover.  Can you walk with the dogs in a peaceful place? Petting the dogs is good for you, too. Your nervous system responds to their simple affection.

I know. But currently even leaving the house is an issue because of the fear. 

 

8 hours ago, Altostrata said:

 

Set your mind on self-care in the next minute, not worry over the future. You will be back caring for patients, and you'll be an even better doctor having needed care yourself

Thank you, that’s a nice picture!

[ChessieCat]

8 hours ago, Altostrata said:

No, I think you should increase the doses. You are getting some relief when that tiny dose reaches peak plasma in 5 to 8 hours, but it's so small, you're metabolizing it quickly.

 

[ChessieCat]

8 hours ago, Altostrata said:

If 0.25mg makes you too dopey, you might take 0.15mg 4 times a day

 

[CharlieBrown13]

@Altostrata @ChessieCat

ok, now I understand. I think I‘ll try another small dose in the afternoon.

[Kiasofia]

Hi @CharlieBrown13

I just want you to know that we are many here on the forum who are thinking of you and sending you warm wishes. No human should have to endure what you are going through. It seems impossible when you are in the middle of it, but it does slowly get better. Please continue to hang on, one moment at a time❤️

[getofflex]

Hello Charlie Brown.  I just want you to know I'm thinking about you and praying for you.  Hang in there.  You are getting the best help with Chessie Cat and Altostrata.  

[CharlieBrown13]

Caution, Triggerwarning

 

 

 

 

 

 

 

 

 

 

Every day, I have so strong suicidal thoughts, I can barely fight them any more. Each day I consider going back to the clinic,  knowing I would get a lot of drugs and nothing would get better.
But I would be alive. For now.

Do those thoughts subside eventually? Has anybody else had these feelings so strong over many days or weeks? 

 

What can I do?

Can it be the Olanzapin? Should I stop it? Or taper off?

 

And if something happens to me, please tell the world about it.

[Sunnyhope]

Hi @CharlieBrown13  
I am also thinking about you and praying for you.