SoapSoup: Coming off Effexor / venlafaxine

[SoapSoup]

I was diagnosed with a dissociative disorder in July 2020, and put on 20mg of citalopram. In around August 2020 I was put on 0.5mg of Clonazepam also. I was also put back on my contraceptive pill in October 2020 which I had been taking since 2014, but stopped taking shortly before the dissociation started. I recovered fully by December 2020, and tapered off the citalopram by cutting it down 20>15>10>5 over a few months. Also tapered the Clonazepam the same way 0.5>0.375>0.25>0.125. Stayed recovered until around June 2021. Symptoms returned along with fatigue, more severe memory problems. Put back on citalopram but didn’t last longer than a few days. Tried sertraline 50mg for two days, bad reaction.

 

Now a month into 75mg Effexor, one week on 37.5mg IR, and 3 weeks on 75mg XR I feel even worse, like a ghost who doesn’t exist at all. No memory, no sense of time, completely spaced out and detached, feel like I am dead/not here. No emotions and no real sense of survival. Doctor is not helpful, no one understands. I don’t even understand. Getting worse on the Effexor, would like to come off it ASAP. Struggle to think clearly or logically so can’t really count beads. Any advice or help appreciated. 

 

 

Edited October 28, 2021 by ChessieCat
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[Onmyway]

Dear @SoapSoup, 

welcome to SA. I am so sorry you have been having such a hard time. It seems like you got delayed withdrawal reactions to your initial course of citalopram and clonazepam and the subsequent fast taper. Were the June symptoms triggered by ingesting alcohol/pot or some stressful situation? The reinstatement of citalopram was likely too strong for your body which was by now partially adapted to the lack of citalopram. The subsequent trials of medications likely caused further chaos for your nervous system which seems to be now quite destabilized and hence reacting to the introduction of yet another medicine. What your body needs to recover is stability. The question now is what to do with the Effexor to which you seem to be reacting adversely. 

 

We usually recommend stopping cold turkey if you have been on the drug for two weeks or less and a very fast taper (over a couple of weeks) if you have been on it around a month. This will probably make things worse for a while. But in your case, you are between a rock and a hard place. Staying on these drugs is torturing you and will cause further physiological dependence and cutting them will likely (temporarily) destabilize you. It will be up to you what to do but we would not, in this case suggest a long taper for you. Your choice would be between cold turkey and fast taper - over a week or two.

 

One thing you could try, which is unusual and risky, is to stop taking the medicine and see if it makes you much worse in a couple of days. This drug leaves your body pretty quickly so whatever effects there may be, you will feel them very quickly. If things don't feel worse within a week you can stay that way. If they do feel worse, you can reinstate a small amount. We don't usually recommend this experimenting and I am only suggesting it because the drug makes you so much worse. 

 

Can you please list your drug history in your signature so we can refer to it quickly? 

How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

I am so sorry you are in this situation. Are you getting support from a good therapist? While I don't know your story, a lot of dissociation comes from trauma and it might be helpful, once you are stabilized, to seek a good trauma therapist that can help you cope. I have to say that given your extreme reactions, you are likely sensitive to all kinds of psychiatric drugs now and could be for a while so I would advise to not do more trials and avoid other drugs like alcohol/pot even caffeine for a while. If you are taking supplements, some of those can be activating for people in withdrawal as well. You may wish to consider taking magnesium and fish oil which can be helpful in recovery but try a small dosage one at a time to make sure that you don't have paradoxical reaction to them. 

 

This will get better, be sure of that! But the road to that will not be easy.

 

Take care of yourself 

OMW

Edited October 29, 2021 by Onmyway

[SoapSoup]

@Onmyway I do not do any drugs or drink, and I don’t smoke pot. How would you recommend I stop this drug? It’s a capsule with beads inside, so I’m a bit lost. 

[ChessieCat]

6 hours ago, Onmyway said:

Can you please list your drug history in your signature so we can refer to it quickly? 

How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

As requested, please create your drug signature.  Thank you.

 

16 minutes ago, SoapSoup said:

How would you recommend I stop this drug? It’s a capsule with beads inside, so I’m a bit lost. 

 

Please see Post #1 of this topic about how to get non-standard doses:

 

tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine

 

[SoapSoup]

I have done my signature. That post talks about tapering by removing beads, which I don’t have the capacity to do… 

[ChessieCat]

18 minutes ago, SoapSoup said:

which I don’t have the capacity to do

 

Would you might telling me why you aren't able to do this?

 

Did you read all of Post #1 or only the part about capsules with beads in?  There are other ways to get your dose, including prescription liquid and the 3 following methods:

  

On 5/6/2011 at 1:01 PM, Altostrata said:

At the end of the taper: Make a liquid from venlafaxine extended-release beads

If you have generic venlafaxine XR or Pfizer Effexor XR or Efexor XR in gelatin capsules filled with tiny beads, you probably will want to reduce by counting beads for most of your taper. But when you're down to 9 beads, how do you taper by 10%?

 

You can make a liquid with water from those beads. This has been proven to be stable (for 30 days) and effective: Rosa, N. F. D., & Sharley, N. A. (2008). Stability of Venlafaxine Hydrochloride Liquid Formulations Suitable for Administration via Enteral Feeding Tubes. Journal of Pharmacy Practice and Research, 38(3), 212–215. https://doi.org/10.1002/j.2055-2335.2008.tb00841.x

 

When the beads are dissolved in water or pharmacy liquid, the drug become immediate-release venlafaxine with a much shorter half-life. You may wish to take it 2 or 3 times a day (see the section above about immediate-release venlafaxine).

 

  

On 5/6/2011 at 1:01 PM, Altostrata said:

Make a liquid suspension of immediate-release venlafaxine tablets

 

 

On 5/6/2011 at 1:01 PM, Altostrata said:

Have a compounding pharmacy make capsules with custom dosages, or a liquid
Compounding pharmacies can weigh Effexor or Effexor XR and make up capsules for you of specific dosages. They can make a liquid of regular Effexor.
 
The only drawback is this can be quite expensive.

 

[SoapSoup]

I’m very severely dissociated, 24/7, I’m surprised I can even type this post as it doesn’t feel like me doing it. I think Effexor is making it worse 

[ChessieCat]

Thank you for creating your drug signature.

 

How did you feel when you first started taking citalopram back in July 2020?  What was the reason you stopped it?

 

Please add the date you started the venlafaxine in October 2021.

 

Are you able to get immediate release venlafaxine tablets?

[ChessieCat]

Please answer my questions as soon as possible.

 

I have asked the senior mods for their assistance.

[SoapSoup]

When I started citalopram it was because I’d started experiencing panic, anxiety, and dissociation. I didn’t feel like the citalopram did anything, it didn’t change how I felt but it didn’t make it worse. When I recovered, I was told to stop taking it slowly so I did. My hormones were out of whack and going back on the pill seemed to “fix” this, so I felt much better. for some reason it all came back, despite being back on that pill, so that’s where the merry go round of medication started again. 
 

I’ve added the date for venlafaxine. 
 

I can’t get hold of my doctor or the prescribing psychiatrist, mental health treatment in this country is a joke. I’m feeling stuck and lost and unable to communicate how I feel or what I need because I honestly have no idea at this point. Thank you for your help 

[ChessieCat]

Please try and stay calm.  One of the senior mods will hopefully respond soon.

 

If you are not able to count beads, do you think you would be able to open a capsule and add it to a measured amount of water.  You would then need to use a syringe (no needle attached) to measure out a dose?

[SoapSoup]

It’s very very hard, I feel like giving up a lot. 
 

I’m sorry I’m so useless, I don’t know if I would be able to do that, I don’t have access to the equipment 

[ChessieCat]

What mg strength capsules do you have?

 

Do you still have any of the 37.5mg IR tablets?

[ChessieCat]

Do you have a friend or relative who would be able to help you with getting what you need and helping you make a liquid?

[SoapSoup]

75mg XR tablets. No I’m only given my medication 1-2 weeks at a time, so I only had 1 week of 37.5 

[ChessieCat]

So you have tablets, not capsules.  I thought you said before that they had beads in them.

[SoapSoup]

Sorry I meant to say capsules. 75mg XR capsules, with lots of little white beads inside 

[Onmyway]

4 hours ago, SoapSoup said:

@Onmyway I do not do any drugs or drink, and I don’t smoke pot. How would you recommend I stop this drug? It’s a capsule with beads inside, so I’m a bit lost. 

Hi @SoapSoup

My first post offered suggestions since you've been on the drug for less than a month

 

1) Cold turkey

2) cold turkey with reinstatement of necessary

3) fast taper - half for a week and then half for another week 

 

@ChessieCathas also offered tips on the practicalities of cutting doses on the thread.

 

There isn't, unfortunately, much I or we can do remotely to help count beads or to bring a syringe. You'll need to figure that out yourself or find someone who can help in person.

 

Take care of yourself

OMW

 

[Altostrata]

Hello, @SoapSoup

 

It sounds to me like you are having an adverse reaction to 75mg venlafaxine XR. It may be too strong for you. Do you have any way to get a prescription for 37.5mg venlafaxine XR?

 

If not, I would take 20 of the beads out of the 75mg capsule. Put the capsule back together, take the rest at the same time each day. Please let us know how you're doing.

[SoapSoup]

@Altostrata hi, thank you. 
I probably can’t get an Rx until Monday at the earliest, and that’s if my doctor will agree to it. 
 

I will take 20 beads out today and see how I go, I did not take any yesterday. 

[Altostrata]

Be sure to consistently take out 20 beads, and take the rest in the capsule at the same times each day. Please keep notes of your symptom pattern  after this reduction, how you feel before and after taking the drug. We're going to be asking about it.

 

Your doctor needs to understand 75mg is too high a dose for you. How to talk to a doctor about tapering and withdrawal? What to expect?

 

You'll need to continue to reduce from the 75mg capsules for a bit, before switching to the 37.5mg capsules. If your doctor insists on prescribing 37.5mg IR, which would be odd, it needs to be taken twice a day to match the level of 75mg ER.

[SoapSoup]

I wake up with distorted hearing, and burning sensations all over my body, which are intolerable and distressing, pressure in my head and complete dissociation… I can’t take this anymore 

[SoapSoup]

@Altostrata, hello. 
 

How long should I take out 20 beads for? Thank you 

[Altostrata]

Did reducing the dosage by taking out 20 beads bring about any changes in your symptom pattern? Are you able to get a prescription for 37.5mg?

[SoapSoup]

On 11/8/2021 at 4:53 AM, Altostrata said:

Did reducing the dosage by taking out 20 beads bring about any changes in your symptom pattern? Are you able to get a prescription for 37.5mg?

No changes. Still feel like I’ve died 

[ChessieCat]

On 11/8/2021 at 3:53 PM, Altostrata said:

Are you able to get a prescription for 37.5mg?

 

Please answer the second question that Alto asked.  Thank you.

[SoapSoup]

31 minutes ago, ChessieCat said:

 

Please answer the second question that Alto asked.  Thank you.

Sorry I didn’t see. Yes I have an Rx for 37.5mg 

[Altostrata]

What is your estimate of how much venlafaxine in milligrams you are removing in the 20 beads? Is it 1/4 of the capsule?

[SoapSoup]

Sorry I was gone for a long time. I managed to get off venlafaxine and was put back on citalopram 5 days ago. I don’t know if this was wise but I’m at a loss. 

[SoapSoup]

Please help if you can 

[ChessieCat]

Q:  What sort of help are you asking for?

 

Please update your drug signature.  We need to see every dose change and the date you made that change and also the last dose and the date for that last dose for venlafaxine.

 

Also please add the date you started citalopram and what dose.  If you increased the dose after starting it, please also add the date and the dose for that.

 

This links goes straight to your drug signature.  Remember to Save.

 

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