rmce72a: Effexor withdrawal with Prozac bridge

[rmce72a]

I have read CheesieCat's info on drug "poop out" and how withdrawal differs from withdrawal when the drug has not pooped out. After being on Effexor for 20+ years, I am convinced it has pooped out and so does my doctor. Since I do not want to increase Effexor or go on a different drug, how should taper differently from this pooped out drug? I was never prescribed this drug for anxiety/depression, but for fibromyalgia which is ok now. Instead, I have developed extreme anxiety and depression over the past 3 years or so. Could this drug have actually caused that by altering my brain chemicals?  

[brassmonkey]

The main sign or poopout is that the drug seems to have stopped working and you ger WD type symptoms while taking your full dose. After 20 years it is quite likely that it has pooped out. Once this has happened there are two options, increase your dose which may help but the drug will poopout again fairly soon. Or you can reduce the dosage.

 

Reducing the dosage is handled just like any other taper. It's just that you might not see any results for quite some time. I was in severe poopout when I started to taper, and it took two and a half years before I really noticed any progress. But it did happen, I just had to keep the faith that it would.

 

I would highly recommend using the Brassmonkey Slide Method if you decide to reduce. We have been having great success with members reporting very mild symptoms from the reductions. But again, you may not see much change for quite a while.

[Greatful]

@rmce72a

You might find this interesting 

Have you heard of Robert Whitaker? He is the author of Anatomy of an Epidemic 

Here is a quick interview with him.  https://youtu.be/5VBXWdhabuQ

I also have a book Your Drug Maybe Your Problem by Peter Breggin M.D. and David Cohen PH.D

 I am so sorry you were put on these for fibromyalgia, crazy to use a mind altering drug for that.  

Learn what you can about these drugs and stay focused on slowly weaning off.

 

You got this🌞

[rmce72a]

Thank you, thank you Greatful and Brassmonkey. Since I really don't have any other emotional support in my withdrawal, this forum is my lifeline. I am following Brassmonkey's micro taper guidelines, but 2.5 per week has proven far too fast for me. I have only reduced to 72.7 since May 26. Right now I seem to be in a wave. On days like this, things seem hopeless, but I will learn from and trust all the advice I find here. I will certainly look into Whitaker, Breggin, and Cohen. Again, thank you for the help. It means more to me than you can ever know.

[rmce72a]

I have read this topic carefully because I am tapering from Effexor XR 75. I have taken the drug for more than 20 years, and began have various problems almost 3 years ago that I now understand as withdrawal. I am down to 73mg after 2 months, and still have had some withdrawal symptoms. I am learning to hold longer and make very small bead reductions. Alto, am I doomed to a difficult withdrawal and even protracted withdrawal because I was taking a pooped out drug for three years before I found this site and figured out the problem?

[ChessieCat]

7 hours ago, rmce72a said:

I have read this topic carefully because I am tapering from Effexor XR 75. I have taken the drug for more than 20 years, and began have various problems almost 3 years ago that I now understand as withdrawal. I am down to 73mg after 2 months, and still have had some withdrawal symptoms. I am learning to hold longer and make very small bead reductions. Alto, am I doomed to a difficult withdrawal and even protracted withdrawal because I was taking a pooped out drug for three years before I found this site and figured out the problem?

 

Generally with poop out, after you make a reduction you start to feel a bit better and then as time goes on you slowly start to feel worse again.

 

Whereas withdrawal symptoms usually start soon after making a reduction and then as time goes on you slowly start to feel improvement.

 

Q:  What pattern are your symptoms after you make a reduction?

 

Brassmonkey wrote the following post which can be found here Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”

 

On 7/6/2020 at 5:43 AM, brassmonkey said:

 

Tapering out of Poop-out or tolerance is the second option and it can be a very frustrating process because there may be no visible results for quite a while.  There is not a lot of information available on time frames because Poop-out is not a well-documented phenomenon.   Once improvements have started to appear they will increase in fits and starts.  Progress can be monitored by comparison with the poop-out baseline.

 

 

 

[Altostrata]

@rmce72a when was your last reduction? Did any new withdrawal symptoms emerge? What times o'clock do you take your drugs, with their dosages? How's your sleep?

 

Please do not make any dosage changes until we sort this out.

[rmce72a]

 I dropped from 72.9/73.0 to 72.7 last week, symptoms returned (headache, sinus pressure, dizziness, no appetite, weepy) on 7/14-/16 so I upped back to 72.8/73.00 on 7/16 and 7/17 where I have been for 2 days and am feeling better. (Hard to getting exactly same dose because of bead differences. Yesterday and today (7/17-7/18) symptoms gone. I didn't do anything differently except for dropping a tiny bit last week. Sleep is fair, but still wake up 3-5 am but can sometimes nap on couch until dawn. I take the capsule at exactly the same time every day. (7PM) After reading about tapering "poop out" and withdrawal on this site, I am afraid that my sensitivity may be related to that. I'm sure I have been in poop out for nearly three years which accounts for how much worse I have been feeling even before taper. Over the past 2-3 years, I have grown depressed, developed anxiety and panic, tinnitus etc which are all withdrawal symptoms. My dr has checked me thoroughly, and says I am healthy otherwise. That was when I joined this group to educate myself. According to what I am reading, this has to be poop out. I don't even know why I have continued on this drug for so many years. Was originally prescribed for fibromyalgia related to an immune system disorder which has since corrected itself. The doc just kept prescribing and just kept taking. I had no idea what I was doing to myself. What a fool I have been. Anyway, it is what it is. Now I am here, following the wonderful advice you and others provide, and am working to help myself. My doctor wanted me to do the usual drop from 75 to 37.5 for 2 weeks then go off (with or without a Prozac bridge.) Thank God I had already consulted this site and knew the consequences, so I refused. I told him I intend to count beads and do it safely if he will keep prescribing. He is on board, although reluctantly. He says it is contrary to his medical training. (DUH!) But he had agreed to work with me while I do it my way. Thank you again for your help and patience. I have no other support in this but this site and my therapist. You are my lifeline. Bless you.

[Altostrata]

If your symptoms occur after dosage reduction, they are withdrawal symptoms.

 

How are you measuring your dose?

 

You've been taking Effexor since 1999. Were there times you forgot to take a dose? How often did this happen in the last 3 years?

[rmce72a]

No, I have never forgotten a dose. I am very careful with meds since I am very sensitive. I count the tiny beads in name brand capsules. As for measuring my doses, since the number of beads per capsule varies, I count every bead in every capsule and calculate the amount per bead. Then I take out the number of beads to get the dose closest to what I took the day before. If I am trying to get 73.0, because of bead count differences, the dose may be 72.9 or 73.1.

 

I started at 75mg in late May by taking out one bead the first 3 days, 2 beads the next 3 days, and so on until I was removing 6 beads at the end of the second week. I began having nausea, extreme dizziness. I found this site, and I learned that I needed to be more precise which was when I began bead counting on 6/7. I found that 6 beads put me at about 73.2 which is what I considered my starting point. By the end of week 4, I was at 72.6 and was having frequent symptoms and concluded I was going too fast, so I went up to 72.8-73.0 and held there until last week when I tried dropping to 72.6 and symptoms developed again. Currently I am holding at 72.8-73.0 and plan on staying there for a couple of weeks unless you advise otherwise. 

 

In summary, I am down from 75 mg in late May to 73mg now 2 months later. I had hope to be able to reduce by at least 5% as you advise here, but I'm not sure that is even possible. Am I looking at a 70+ month taper? I hope not, especially since I am 74 years old and had hoped to spend my few remaining years more peacefully. Overall, I am in pretty good health for an old broad. (wink) Thank you again for your kindness and hard work to help all of us.

[Altostrata]

You may want to use a scale to measure your dose more accurately. See Using a scale to weigh and measure doses
 

It could be that you can reduce by one bead at a time. See Micro-taper instead of 10% or 5% decreases

[rmce72a]

I am holding at 72.9/73. Today symptoms are increased with dizziness, a little nausea, anxiety, tinnitus. I haven't done anything differently. ChessieCat says that tapering from poop out can be difficult, but I am trying so hard to do everything right. After 9 weeks and only coming down to 73mg from 75mg, I am wondering if getting off this drug will ever happen. I will continue to hold here and see what happens. How will I ever know when to drop again. If dropping from 73.0 to 72.7 was a problem a few weeks ago before going back to 73, does this mean my body refuses to adapt and let go?

[rmce72a]

By the way, I keep trying to update my dosage info, but it doesn't seem to save. I do to my profile and enter new drug info and click save, but my profile still shows up the old way.

 

[Altostrata]

Suggest you go back to 75mg. Effexor can by very, very difficult to go off.

[rmce72a]

Does going back to my original dose mean that tapering is hopeless?

[rmce72a]

I am pretty devastated to go back on Effexor. How will I ever get off this drug that is causing me side effects   even though it has pooped out? I just don't know what to do or where to turn. I know how hard Effexor is to stop, but staying on it means I will be sick for the rest of my life.

[LarryS]

"Two or 3 years ago I began having panic attacks, depression, and anxiety which I have never had in my life, and I have lived through and coped some trauma but always was able to handle whatever life threw at me. I think, as this is just my theory, that Effexor has altered my brain and CNS to the extent that it no longer functions properly and when it stopped working, all the symptoms of withdrawal hit me.

 

My taper is not going well. I started 9 weeks ago and am only down to 73 from 75mg and having some nasty withdrawal. I am counting beads. Did you do that?"

 

@rmce72a Sorry to hear you are in the poop out phase of Effexor.  I started tapering after five years on the drug and did not reach poop out phase.  BrassMonkey apparently has experience with poop out, so listen closely to his advice.  I have learned a lot from BrassMonkey.

 

I am not a moderator like BrassMonkey, so any advice I give may not be of the highest quality.  That being said, I have counted beads from the beginning of my tapper by dropping 10% and holding for 4 weeks.  I have decided to up dose several times in the past.  Based upon my own experience, I may have been better off (time wise) by trying to hold longer at the current dose and seeking the advice of a moderator before making my decision.  I have just read your entire thread and have an idea of what you are going through.  I'm glad to hear that you are in generally good health, this is a definite plus.

 

Since we are of similar age, you will understand when I say, even with relatively good health, we most likely have some medical issues by this time to deal with.  Try to figure out which medical issues are not tide to Effexor withdrawal.  This may help you hone into the medical issues that are truly related to Effexor withdrawal.  This shortened list of medical issues will help you better decide if your taper is going well.

 

Some people who come here, eventually wean off the drug.  Some quit.  One needs a good reason or two to get off, and determination to stick with it.  You have both, and you can do it.  I'm not saying it will be easy.  Best wishes toward progress.

 

Now that I have posted to your thread, an easy way to get to my thread is to click on my picture identification.  Or you can choose to follow me, which will give you alerts after I have posted on my thread.

[Chlo]

@rmce72a

Hello sweetheart, how are you today? Just checking on you🌻

[rmce72a]

Hello Chlo. I am so glad to hear from you. I've been worried about you. I had a rough couple of days this week, but Thursday and Friday were better. Today is so-so, and thank you for asking. Even though Alto suggested I go back up to 75mg, which is square one, I am holding at 73 to see how it goes for now. I just don't want to give up on getting off this drug.

 

How about you? Are you feeling any better? You are dealing with so much, and my heart aches for you. Please let me know how you are doing.   Love, Rebecca

[LarryS]

I take a generic brand of Effexor, labeled Venlafaxine.  You take the name brand Effexor.

I have learned from reading on this site that name brand Effexor contains about three (3) sizes of beads.  This fact makes it very difficult to get an average milligram value for each bead.

Let me boldly say, I believe your current method of determining values for beads is flawed.

In the beginning of your tapper, consistency in the amount of Effexor taken in not as critical as at the last phase of the taper when you are below about 10 to 15 milligrams.  So perhaps you can ease you mind a bit.

 

I recommend that you read @mammaP  thread.  She was in the same Effexor situation that you are in.   Read about her method for tapering name brand Effexor.

As I recall, mammaP tried switching to liquid Effexor, but this did not go well for her.

 

I suggest coming up with an average mg value for the different size beads.  I have not read of anyone who has done this, but that should not stop you from trying.

Accumulate the count from 5 to 10 capsules.  Come up with an average amount of small, medium and large beads from the multiple capsules.  This counting can be done over time as the need to open a capsule becomes necessary.

 

I find using Pyrex bowls easy to use.  Pore the contents of the capsule into a medium bowl.  Separate the largest beads into a large bowl.  Spread them out in a single file along the edge of the bowl.  Count and tally the largest beads.  Pour the counted beads into the smallest Pyrex bowl for keeping.  You may want to consider a separate small bowl for each size of bead for storage.

Continue the counting for each size of bead.  

 

Now that all the beads have been counted, we may determine an average value in mg for each size bead.

You will need to use your judgement for the next part.

Designate the smallest bead having a volume of 1.  By eye judge if the medium size is 2 times, 3 times or 4 times the volume of the small bead.

Judge the large beads.  How many times greater is the volume of the largest beads in comparison to the small bead?

 

Now I can create an algebraic formula for determining the average approximate number of milligrams that is in the large medium and small beads.

 

I want to calculate mg per bead.  I will choose some example bead volumes, since I have no idea of what thy might be.

Example:  Small bead equals 1 always.   Medium bead equals 3 times the volume of a small bead.  The large bead equals 6 times the volume of a small bead.

I will use a fictitious number of beads.  Example:  60 small beads, 40 medium beads, 20 large beads in the average capsule.

 

Summary

60 small beads with a volume of 1

40 medium beads with a volume of 3

20 large beads with a volume of 6

 

Determine the number of volumes:  60 X (1) + 40 X (3) + 20 X (6) = 300

 

Determine the milligrams per volume:    75 mg / 300 volumes = 0.25 

 

Determine the milligrams per small bead:       0.25 X 1 = 0.25 mg / bead

Determine the milligrams per medium bead:  0.25 X 3 = 0.75 mg / bead

Determine the milligrams per large bead:       0.25 X 6 = 1.50 mg / bead

 

Say you are ready to drop a certain percentage of your previous amount of drug taken.

First calculate the amount of drug you want to take in mg.

Second, choose the mixture of the three sizes of bead that would get you closest to the amount you want.

Consistently take that amount through the drop period.

I now realize that my engineering training has come up with an option, not seen before on Surviving Antidepressants.  Ha Ha ☺️

 

Other options to consider are.

Switch to a generic brand like mine, which has 200 small consistently sized beads per capsule, which make it easy for counting and matching any desired milligram intake.

Switch to liquid form of your name brand Effexor.

Switch to a capsule made by a compound pharmacy.  This is more expensive.

Do a bridge to a different drug.  This site recommends Fluoxetine HCL.  Its half-life is much longer than Effexor.

 

I have enjoyed writing this to you.

Take Care  @rmce72a  

 

[Altostrata]

On 7/23/2022 at 11:18 AM, rmce72a said:

I am holding at 73 to see how it goes for now.

 

If you're feeling better, I would stay at this level for a while, let your nervous system settle down.

[rmce72a]

I am not sure if I am posting this question in the right place, but here goes. I am counting beads in 75MG Effexor XR capsules. I have read all the stuff about weighing, and I'm not sure I can do that accurately, so I want to stay with bead counting. My question is Since the bead sizes in each capsule vary from teeny to medium to large, can I safely assume that the small beads contain less medicine than the large beads or does the size difference just mean that some beads just have a thicker coating of the time release element?

[ChessieCat]

I haven't checked these posts, but I did a search for the word size in the Tips for Tapering Effexor topic so you might find what you are look for there. 

 

https://www.survivingantidepressants.org/search/?q=size

[ChessieCat]

You could also have a look through these.  I did a site search for bead size.

 

https://www.survivingantidepressants.org/search/?q="bead size"

[Altostrata]

Don't overthink it. At 73mg/day, take a random selection of the beads and figure the dosage evens out from day to day.

[ChessieCat]

On 7/26/2022 at 3:05 AM, rmce72a said:

Since the bead sizes in each capsule vary from teeny to medium to large, can I safely assume that the small beads contain less medicine than the large beads or does the size difference just mean that some beads just have a thicker coating of the time release element?

 

Even for me getting my Pristiq compounded there was no guarantee that I was getting a consistent dose every day (I have watched youtube videos showing how they mix the crushed tablet with filler and then fill the capsules).  I didn't want to crush and weigh so I decided to accept that there might be some small variations day to day and tell myself that I was doing the best I could.

[rmce72a]

Thank you. I will do the best I can which is all we can do.

[rmce72a]

I am currently holding at 72.9-7.0 Effexor XR down from 75 mg which I taped in June to 73. I have been holding for several weeks due to symptoms. (Tried to change this info in my drug signature, but can't seem to make it show in my posts) Anyway, I have been experiencing more symptoms for a few days, and I can't understand why. I haven't changed the dose and realize it is just a wave, but I can't imagine why since nothing has changed. I am tapering from poop-out, which I think happened 3 years ago. I didn't realize that the physical problems I started to have were, no doubt, the result of pooped-out Effexor. (dizziness, heart palpitations, itching, tinnitus, eye floaters, poor sleep, anxiety, IBS.) 

 

I am 75, which probably adds to the difficulties, but I am in excellent health. (According to my dr, I am in good health for a person of 60!) He has done heart tests, thyroid tests, and other things and everything looks good. I was put on this lousy drug for fibromyalgia, not depression/anxiety. Those things only developed when the drug pooped out. I have even taken a leave from a job I love and hope to return to.

 

I learned here that tapering from poop-out is more difficult, although I can't really understand why. I would think that if the drug is no longer doing what it is supposed to do, getting off it would be easier, not harder. Anyway, I just checked in here today to whine, I guess. I tried magnesium which made me worse. I have not tried fish oil because I am soooo sensitive to drugs and supplements. Any words of wisdom and encouragement would be welcomed. Thank you all and take care.

[rmce72a]

I have been holding at 73mg (or as close as I can get with beads counting) for 6 weeks and can't seem to stabilize. I went from 75 mg Effexor XR to what I'm guessing was about 73 by randomly removing beads for the first couple of weeks.  I found this site, learned how to taper correctly, and started Brassmonkey's micro taper. Some days are pretty symptoms-free, but most days I do have dizziness, tinnitus, poor sleep, etc. I don't want to go back to 75 and start over. Should I just hold here for a while? I am trying so hard to follow all the instructions.

[ChessieCat]

I've moved your new topic to the existing topic and responded to it there:

 

tolerance-or-poop-out-or-tachyphylaxis

 

[methuselah]

3 hours ago, rmce72a said:

I have been holding at 73mg (or as close as I can get with beads counting) for 6 weeks and can't seem to stabilize. I went from 75 mg Effexor XR to what I'm guessing was about 73 by randomly removing beads for the first couple of weeks.  I found this site, learned how to taper correctly, and started Brassmonkey's micro taper. Some days are pretty symptoms-free, but most days I do have dizziness, tinnitus, poor sleep, etc. I don't want to go back to 75 and start over. Should I just hold here for a while? I am trying so hard to follow all the instructions.

 

This may be your withdrawal normal (wdnormal) which brassmonkey writes about here -

 

[Altostrata]

On 7/29/2022 at 3:39 PM, rmce72a said:

Some days are pretty symptoms-free, but most days I do have dizziness, tinnitus, poor sleep, etc.

 

How many days per week are symptom-free? How has this pattern changed in the last week?

 

We expect that, as you hold to stabilize from withdrawal symptoms, they will go up and down but gradually tail off, with more windows than waves. See The Windows and Waves Pattern of Stabilization

 

[rmce72a]

Symptom days are so unpredictable. Last 10 days were: 

             Thus, Fri-ill        Fri-manageable symptoms       Sat, Sun some symptoms but not ill   Mon - ill

              Tues, Wed manageable symptoms            Thus, Fri-ill    Today  manageable

*ill = nausea, very dizzy, loud tinnitus, no appetite, extreme fatigue, weepy 

*some symptoms = occasional nausea and dizziness overall tiredness but can function

*manageable = feeling closer to normal  (can function, some energy, light tinnitus, dizziness with quick head movement)

Overall sleep is 5-6 hours with occasional wakening 

 

Since how I feel varies so much from day to do even with not much change in routine/diet/stressors, I'm not sure when it is safe to drop dosage and hold again.

 

Thank you so much for helping me.

 

 

                             

[Altostrata]

You are experiencing the waves and windows of stabilization after a dosage reduction. Eventually, your symptom pattern will stabilize. Then you can consider another reduction. Let's talk about this when your symptom pattern becomes more regular.

 

Many people find fish oil and magnesium supplements 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. Please let us know how you’re doing.

[rmce72a]

Thank you Alto. So then I should assume that even though I am tapering from poop-out, I still need to stay at 73 even though I have been here for 6 or 7 weeks?

[Altostrata]

That is correct. Please do not get overly focused on "poop out".