rmce72a: Effexor withdrawal with Prozac bridge

[rmce72a]

My symptoms are getting worse despite holding at Effexor XR 73 mg that I have been tapering from 75 since May 28. Tinnitus, anxiety, sadness are worse than they have ever been. I have not changed anything in my routine. I don't know what to do. I cannot take magnesium as it worsened my symptoms when I tried it, and I'm afraid that fish oil will do the same. So discouraged.

[ChessieCat]

If you are still of menstruating age, what stage of your cycle are you at?

[rmce72a]

I am well past that. I am 74. I am also tapering from poop out.

 

 

[Altostrata]

Please describe the anxiety more. Is it worse at any particular times of day? What thoughts precede it?

[rmce72a]

I always have morning anxiety which is probably cortisol, but I can usually accept and work through as normal. Yesterday, however, the shakiness and overall anxiety increased throughout the day. In an effort to distract, I did a quick grocery store stop and was nervous but ok. No particular thoughts that should have caused anxiety. I know that anticipating any change in my routine and engaging in any task always increase anxiety, but nothing like yesterday's level. I keep thinking that if I could just get my dose lower and I could somehow feel better, but I am reluctant to reduce for fear of only making things worse.

[Altostrata]

Can you try a slight updose to 75mg?

[rmce72a]

75 mg is my starting dose. Doesn't that mean that I am starting all over? Hasn't some healing occurred after 12 weeks, or is that not possible? In addition, I was having depression, anxiety, dizziness, tinnitus, palpitations, etc. even before I began the taper. I have taken Effexor 75 for over 20 years, and these symptoms began nearly 3 years ago. After reading here, I am convinced that the drug pooped out back then and I have been in a form of withdrawal without even realizing what it was. I have all kinds of tests over the last couple of years, and I am otherwise healthy for my age (74) according to my doc. It has to be the Effexor. 

 

[Altostrata]

I meant 74mg, sorry.

 

32 minutes ago, rmce72a said:

I was having depression, anxiety, dizziness, tinnitus, palpitations, etc. even before I began the taper. I have taken Effexor 75 for over 20 years, and these symptoms began nearly 3 years ago.

 

Were these symptoms constant over 3 years?

 

Were there any times you accidentally skipped a dose of Effexor, or took it off-schedule? In the last 3 years, did you add any other drugs, such as an antibiotic? Do you ever drink alcohol?

 

 

[rmce72a]

No, they were not constant. I rarely take antibiotics because I am very sensitive to them, and I have never skipped a dose of my Effexor. The only meds I take are Effexor XR 75 and Clarinex 5mg for allergies. 

 

In 2019, I began having heart palpitations and sadness/crying spells, dizziness, diarrhea, worsening sleep even though nothing in my life warranted it.  They worsened into 2020 when the doc suggested I increase by 37.5 which I did not do. I felt that there had to be a physical reason. Later I saw a cardiologist who did treadmill, echocardiogram, etc and found no problems. He prescribed a beta blocker (metoprolol) which I took for a short time but stopped when the tinnitus started. I also had begun having shortness of breath and panic attacks.

 

In 2021 I began seeing a therapist and a different PCP who also suggested I up the Effexor dose. The new PCP also did lung function tests for shortness of breath and had me wear a heart monitor for a month. No problems found. Concluded it was anxiety. I also developed tinnitus. I explained that I had absolutely nothing in my life that would cause anxiety/depression, panic attacks, and the physical symptoms I was having. He said it was probably from some unresolved life trauma blah, blah, blah. He also had me do a Genesight test that shows I am an ultrarapid metabolizer. He suggested a Prozac bridge, adding another AD (can't remember what, but I didn't take it.) He also said I probably had IBS and prescribed something I did not take. Instead, I cut out gluten, dairy, caffeine, and nearly all sugar. I don't drink, so alcohol isn't a factor.

 

I have continued with therapist who has taught me some coping skills that I still use, and they have helped. I have been able to control sinking into panic attacks, but I still have all the physical symptoms of sadness, poor sleep, itching, tinnitus (worse when I am even slightly stressed by simple everyday things), poor appetite, dizziness, occasional heart palpitations, anxiety and nervousness.) Stomach issues are much better on my very limited diet with only occasional diarrhea. Some days are better than others. Some days I feel like I am hanging by a thread.

 

I struggle with supplements. I occasionally take one half of a chewable vitamin, but magnesium caused my anxiety to worsen. Haven't tried fish oil because I don't want to make things worse. I am at a loss as to what to do. I believe (and I may be totally wrong) that the Effexor stopped worked and my body began having a kind of withdrawal. I don't know how else to explain any of this, and neither does my doctor. He wanted me to cut dose in half, then 2 weeks later stop. (the usual line) Fortunately, I had found this site by then, and knew that I could not do that. I explained that I was going to start bead counting and taper slowly down. Although he does not endorse nor agree with this (says it is contrary to his training), he has agreed to go along with me in my taper journey and monitor me. I have a check-up next week. 

 

I am feeling better tonight, but it has not been a good day. Lots of tears, tinnitus, dizziness, and general hopelessness and frustration. I am nearly 75 years old, and I don't have a lot of years left, but I would like to spend them in some sort of peace. I am so angry that I was put on AD for mild fibromyalgia 25 years ago. I was a fool to simply continue to take the med without questioning what it was. Now here I am in the sunset of my life in misery. BUT I am a tough old broad and willing to do the work. I just need the correct pathway forward. By the way, just writing this has ramped up my tinnitus something awful. Anyway, thank you for all you do and for your kind attention to my situation.

 

 

 

[FindRest]

I’m sorry you are going through all of this. I am not a mod, but had some thoughts to share with you. I’m wondering if 3-4 years ago you ever stopped a medication you had been taking for awhile? Many, if not all, of your symptoms sound like some kind of protracted withdrawal. Personally, I have never heard of Effexor poop out causing all of the symptoms you are going through, nor a decrease from 75 to 73mg. 

Many of us who were suddenly taken off Effexor or other drugs were left with a sensitized central nervous system (CNS). This causes most all of the symptoms you describe. Your sensitivity to other medications and supplements makes me wonder if your CNS was traumatized in the past, before all of this started.

 

Since you said you had all of these symptoms for years prior to reducing to 73mg, I don’t think it’s the reduction. And, like I’ve said, I don’t think it’s poop out.

 

Do you recall stopping any other medication 3-4 or so years ago? Did you have some other health crisis back then? Did the manufacturer of your Effexor change (including the place it is manufactured) prior to that? What manufacturer are your current pills/capsules?  These are just some things to think about. You don’t need to answer my questions, I just wanted to give you some food for thought.

 

There just seems to be something else at play here to me. I hope you can figure it out and get some relief soon.

[rmce72a]

This does make sense. In 2017 I had minor surgery for  meniscus repair on my knee that required general anesthesia and I vomited for 3 days after because I didn't tolerate the anesthesia well. I probably didn't take Effexor for 3 maybe 4 days then, but I have never missed my dose unless I am vomiting and can't keep it down.  As I recall, I didn't have any kind of what I now know are withdrawals at the time.

 

When my palpitations began, a cardiologist did all the heart tests (echo, treadmill, etc.) and says my heart is fine. He did have me taking metoprolol for a while, but I stopped taking it 4 months ago because I read it can contribute to tinnitus and anxiety. He says that since my blood pressure is ok, I should be fine without it.

 

Also, I have always taken the name brand Pfizer Effexor, so no manufacturer change. I am just stumped. I can't remember when the tinnitus started. I have had it for at least a year and a half. I know I have some hearing loss and tinnitus can accompany that, but my tinnitus gets worse when my anxiety worsens, so I don't think I can blame it all on hearing loss.

 

Today has been a decent day with symptoms, except for the tinnitus, of course. If I could just get rid of that, I know I would be less stressed and certainly more comfortable.

 

How are you doing with your taper? I see that you are approaching the end of your journey. Congratulations and hope things continue to go well for you. Many thanks for your comments. I truly appreciate your input. Take care and keep in touch.

[Altostrata]

On 8/4/2022 at 6:47 PM, rmce72a said:

In 2019, I began having heart palpitations and sadness/crying spells, dizziness, diarrhea, worsening sleep even though nothing in my life warranted it. ... [2020] He prescribed a beta blocker (metoprolol) which I took for a short time but stopped when the tinnitus started. I also had begun having shortness of breath and panic attacks.

 

Please explain more about this period. It was in 2019? About what month? The tinnitus started after you too metoprolol? How long did you take it?

 

59 minutes ago, rmce72a said:

This does make sense. In 2017 I had minor surgery for  meniscus repair on my knee that required general anesthesia and I vomited for 3 days after because I didn't tolerate the anesthesia well. I probably didn't take Effexor for 3 maybe 4 days then, but I have never missed my dose unless I am vomiting and can't keep it down. 

 

What month was this in 2017? Could it have been late 2018? How long did it take you to recover, what were your symptoms?

[rmce72a]

Knee surgery was in June, 2017.

 

I took metoprolol for about 3 years as I recall. Started at 25 mg per day in 2018 or 2019?, but I started taking just a half dose (12.5 per day) in 2020 until I stopped it altogether in May of this year.

 

[FindRest]

Were you on any antibiotics after your surgery or anytime directly prior to your symptoms starting? Fluoroquinolone antibiotics are notorious for causing terrible CNS problems in some people. Most of them have the letters “flox” in them, ie: levofloxacin, ciprofloxacin (Cipro), etc..

 

I was put on metoprolol after my open-heart surgery. I could only tolerate it for a couple of weeks. I’d consider 3 years being a long time. It too must be tapered very slowly. There are some forums on metoprolol withdrawal on other sites. It looks like severe tinnitus is a very common withdrawal symptom from metoprolol. Could this have been when your tinnitus started? Withdrawing it too quickly can also cause many of the symptoms you are going through. 
 

Thanks for asking about me. I am down to 5.1mg (I need to update my signature!) It’s been a very slow process, with multiple health hurdles related to COVID. But, I’m getting there!

 

[rmce72a]

Thank you for your response. I think I had tinnitus while on metoprolol which was one of the reasons I decided to stop it to see if that would help. I didn't actually taper. I just took half doses for a while then stopped it completely.  I will read about abrupt stopping to see if that may be contributing to how I fell. Thank you so much for the info. Take care and be well.

[Altostrata]

Metoprolol is known to trigger tinnitus. This may be a long-term adverse effect of the drug.

 

On 8/4/2022 at 6:47 PM, rmce72a said:

In 2019, I began having heart palpitations and sadness/crying spells, dizziness, diarrhea, worsening sleep even though nothing in my life warranted it.

 

Please explain more about this period. Did anything happen that might have caused these symptoms? A virus? Urinary tract infection? A course of antibiotics?

 

[rmce72a]

Nothing happened that I can recall. No illness, antibiotics, UTI. Other than the metoprolol discontinuation, nothing else significant has occurred except the Covid jabs and booster, but they were long after I started feeling ill.

 

Right now my biggest concern is my bead counting.  I am holding at 73mg for 4-5 weeks and I seem to be having fewer awful days, but I am still concerned with bead counting accuracy. As I have described, I count every bead in every capsule, calculate the dose per bead, then get as close to 73 as I can.  My doses this week have been Mon 73.15, Tues 73.04, Wed 72.95, Thurs 73.18, tomorrow will be 72.97 and Sat will be 73.05. Those are as close as I can get to 73 given the variations in beads per capsule. 

 

FindRest has suggested that I may be de-stabilizing myself with these slight variations instead of using the average of 3 capsules, but I don't understand how an average of 3 is more accurate that counting every bead. Ugh. I am not opposed to weighing, but scales vary too, from what I read. I just want to reduce using the most accurate method I can. Using averages in multiple capsules seems to be a risky as the varying number of beads per capsule.

 

Now that I have been holding for a month and show signs of stabilizing a little, I don't want to take any wrong steps.  

[Altostrata]

Your dosing is accurate enough. It must take a very long time to calculate the dose per bead. How many beads at a time are you taking out and discarding for a dose?

 

Are you taking any other drugs?

[rmce72a]

I really don't mind the counting and calculations. Right now, my calculations require removing 6 or 7 beads, depending on the bead dosage. I just want to get this right. I take only 1 5mg Clarinex anti-histamine per day. That's it. I stopped the 25mg metoprolol in April.

 

 

[Altostrata]

"Fewer awful days" may be a good sign. Please let us know how you're doing.

[rmce72a]

I have had several what I would call stable days without much nausea, dizziness. I am able to get broken sleep for 5 or six hours which is enough, but tinnitus is still a problem. It gets much worse when I am even slightly stressed.  I spent an afternoon with grandkids yesterday which was fun and positive, but I find that even happy stimulation affects me.  Today I have been feeling nervous and I woke up at 3:30AM which I have not done in a while.  I am thinking I may try a drop to 72.7 or 72.8 in a few days. I have been at 73 for nearly 6 weeks.

[rmce72a]

I have some Effexor capsules that are 2 years old. I wonder if it's still safe to use them/

[Altostrata]

Please look on the package to see the expiration date.

 

On 8/3/2022 at 5:59 PM, rmce72a said:

My symptoms are getting worse despite holding at Effexor XR 73 mg that I have been tapering from 75 since May 28.

 

Having windows would suggest your symptoms are getting better, not worse.

 

The tinnitus might be from something other than Effexor.

[rmce72a]

The package indicates an expiration a few months ago, but I was hoping it is still safe to take. I have read that most drugs are safe past their expiration date.

 

Also, since I am feeling more stable, do you think it is safe to reduce from 73.00 to 72.7?

 

By the way, I do have an appt to see an ENT next month who can maybe shed some light on this tinnitus problem.

 

Thank you

[Altostrata]

Your drug may have lost potency, which could affect your tapering. Please get a refill and use fresh capsules to taper.

[rmce72a]

Will do. Thank you

 

[rmce72a]

I am not using outdate meds. My Effexor XR 75 mg is  fresh and it is those I am using. I just had some old 37.5mg from when he tried to up my dose that I thought I may be able to use down the road. I will toss them.

 

I am in week 8 of holding at roughly 73 and plan to lower dose to 72.8 this week following slow taper. The problem for me now is that I have been having many bad days for the past 2 weeks that shouldn't be happening since I had seemed to be stabilized. I am not sleeping well, a nervous wreck every day all day, slight headaches, anxiety, nasty tinnitus and weepy spells. These began long before I started to taper. I know, probably a wave. But I still think that part of this is a reaction to a pooped out drug since this has been going on for nearly 3 years, not just when I began my taper in late May.

 

Today, I am really feeling done with it all. I am tired of living hour to hour practicing mindfulness, deep breathing, etc. I am tired of not finding joy in anything. I am tired of searching this site day after day looking for encouragement and techniques that might (or might not) help, although I do appreciate all of it.

 

Part of all this is that I don't have time left. I am 75 and have been on Effexor for 20+ years and 5 years on Prozac before that, all for fibromyalgia. I can accept that I may be tapering for the rest of my life, but what does it matter if I do not feel well throughout the process? If I could experience some sort of normalcy while I do this, I would not be so discouraged.

 

No, I am not suicidal, only because I am close to my 6 grandchildren who would never understand nor accept that their grandmother took her own life. Without hope to feel well again, they are my only reason for living. Sure, I love my husband and sons, but they would be just fine without me. Only my husband knows of my health issues, and although he wants me to be well, he doesn't really know HOW to support me, and I don't know how to explain it to him.  For 48 years, I have always been the family problem-solver and fixer, and he does not know how to respond to this wife whose illness he cannot understand.

 

Anyway, unless someone suggests otherwise, I guess I'll continue at 72.8 for a while and see how it goes. Meanwhile, I will count the hours until bedtime when I can get a few hours relief from this misery that is my life. Love to all.

 

 

[rmce72a]

 

Losing hope

 

Started tapering from Effexor XR75 in late May. Went a little faster than I should have at first tapering too quickly to 73. Have had some good days, ok days, and really bad days, which I expected, but today is different. I have not felt this bad in so long.

 

I am in week 8 of holding at roughly 73 and plan to lower dose to 72.8 this week following slow taper. The problem for me now is that I have been having many bad days for the past 2 weeks that shouldn't be happening since I had seemed to be stabilized. I am not sleeping well, a nervous wreck every day all day, slight headaches, anxiety, nasty loud tinnitus and weepy spells. These began long before I started to taper. I know, probably a wave. But I still think that part of this is a reaction to a pooped-out drug since this has been going on for nearly 3 years, not just when I began my taper in late May.

 

Today, I am really feeling done with it all. I am tired of living hour to hour practicing mindfulness, deep breathing, etc. I am tired of not finding joy in anything. I am tired of searching this site day after day looking for encouragement and techniques that might (or might not) help, although I do appreciate all of it.

 

Part of all this is that I don't have time left. I am 75 and have been on Effexor for 20+ years and 5 years on Prozac before that, all for fibromyalgia. I can accept that I may be tapering for the rest of my life, but what does it matter if I do not feel well throughout the process? If I could experience some sort of normalcy while I do this, I would not be so discouraged.

 

No, I am not suicidal, only because I am close to my 6 grandchildren who would never understand nor accept that their grandmother took her own life. Without hope to feel well again, they are my only reason for living. Sure, I love my husband and sons, but they would be just fine without me. Only my husband knows of my health issues, and although he wants me to be well, he doesn't really know HOW to support me, and I don't know how to explain it to him.  For 48 years, I have always been the family problem-solver and fixer, and he does not know how to respond to this wife whose illness he cannot understand.

 

Anyway, unless someone suggests otherwise, I guess I'll continue at 72.8 for a while and see how it goes. Meanwhile, I will count the hours until bedtime when I can get a few hours relief from this misery that is my life. Love to all.

 

 

 

•  
• Quote

 

Prozac 10mg 1990-1999

Effexor XR 75 mg capsules 1999-present

Began slow taper removing beads - 

6/7 - 6/10 Effexor 73.2mg           6/11-6/14  Effexor 72.9mg   had nightmares, tinnitus, anxiety;

6/15- Effexor XR 72.6mg             6/16 - 6/20 Effexor XR 72.8  had nausea, heart palpitations, anxiety, tinnitus

6/22-7/4 hold Effexor XR 72.9-73.1          7/5-7-11  Effexor XR 72.62

7/11-present After experiencing symptoms, I am holding at 72.9-73.0 but still have symptoms

 

Edited August 23, 2022 by ChessieCat
added topic title before merging with intro topic

[rmce72a]

I am trying and trying to get this right. I am tapering at a rate of .001 from last dose. Brassmonkey advises to continue even while having symptoms since I am tapering from poop out. I held at about 73* for 9 weeks *I say about because counting beads will not give me the same exact dose every day. So, my dose amts have been from 73.15 to 72.93 depending on the day's bead count. I assume that I am as stable as I am going to get, so I am planning to reduce to 72.87 tonight. (7 beads @.305 a bead = 2.13. 75-2.13 means I will take 72.87.)  I am concerned that my bead count for tomorrow allows me either to take 8 beads=72.73 or 7 beads = 73.01. (capsule contains 264 beads = .284/bead)

 

I am beginning to think that my symptoms are from something other than tapering. My diet is no alcohol, caffeine, sugar, gluten, dairy), sleep is ok 6+ hours a night, no other meds except for 5mg Clarinex (antihistamine for allergies) no trauma or disruptive events. I just don't get it. Yesterday I felt fine, the day before was terrible with anxiety/panic, high tinnitus, slight dizziness, fatigue. Today I'm back in the misery again with heart palps, high tinnitus, anxiety/panic, headache. I understand the windows/waves, but I', wondering if there isn't something else going on. I welcome any advice or ideas about any of this. Bless you all.

 

[ChessieCat]

3 hours ago, rmce72a said:

no other meds except for 5mg Clarinex (antihistamine for allergies)

 

Q:  Are you able to try going without the Clarinex for a few days and see if it might be causing an issue?

 

If you are not able to go without it, then you might observe the timing of when you take the Clarinex and when the palpitations start.

 

If you can go without it and you do not get the palpitations, then you could take one after a few days to see if the palpitations occur.

 

One thing to consider is that you might not have had any issues with the Clarinex in the short term, but it might be causing issues in the long term.

 

From https://www.drugs.com/sfx/clarinex-side-effects.html#consumer

 

Quote

tachycardia, such as, fast, pounding, or irregular heartbeat or pulse

 

From https://www.rxlist.com/clarinex-side-effects-drug-center.htm#consumer

 

Quote

 

Post-Marketing Experience

Because adverse events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. The following spontaneous adverse events have been reported during the marketing of desloratadine:

 

Cardiac disorders: tachycardia, palpitations

 

 

[rmce72a]

Thank you. I can go without Clarinex. I have taken it for 25 years and have stopped it from time to time. Since it seems to help a little with allergies, I have just continued to take it. I will stop taking for a few days and see what happens. I take Clarinex every day, but the heart palps only happen when I am feeling high agitated or anxious like today. 

[Altostrata]

On 8/4/2022 at 6:47 PM, rmce72a said:

He prescribed a beta blocker (metoprolol) which I took for a short time but stopped when the tinnitus started. I also had begun having shortness of breath and panic attacks.

 

As explained before, tinnitus is a known adverse effect of metoprolol. It is possible the other symptoms were also an adverse reaction to this drug.

 

I am sorry this is so discouraging. You are in a difficult position. I'm afraid we don't have any easy answers for you. 

 

It is possible your symptoms are from something else, or an adverse reaction to Effexor itself. If an adverse reaction, they probably would be worse shortly after you take Effexor every day, but maybe not, since you're taking the XR version.

 

As we age, our liver function becomes less efficient, and that may bring on adverse reactions to drugs previously taken without such reactions. If they were an adverse reaction to Effexor, they probably would diminish as you decrease Effexor. 

 

This may not affect the tinnitus, however, which may be a legacy of metoprolol.

[rmce72a]

Thank you so much. I, too, just don't know what to do. I do not seem to have a symptom increase after taking Effexor. I take it religiously every evening at 7 with food. I feel that there has to be a reason; I just don't know how to find it. I think that is more than a coincidence that all my physical problems started 3 years ago when Effexor apparently pooped out. It was then that I became so deeply depressed and started having panic attacks and severe anxiety with no aggravating life events. Prior to that, all was well.

 

It doesn't make sense to me that with such careful tapering (down from 75 to 73 in 3 months) that I continue to have such severe symptoms some days. Yesterday was lovely, but today has been miserable with all heavy symptoms all day. It is as if something flips a switch! I eat the same things always to avoid reactions: oatmeal, hard-boiled eggs, green beans, baked chicken or beef, gluten-free crackers. I try to distract myself, deep breathe, use coping techniques recommended here and by my therapist, but when my symptoms are really bad, nothing seems to help much. 

 

Today I looked for neurologists in town who might be able to shed some light on my CNS health. I don't know if that will do any good, but I am getting pretty desperate. I hate to even consider the possibility of AD therapy since I think Effexor is the reason I'm in this mess. Any help anyone can give me would be so welcomed. I am sobbing as I write this, because I am losing hope. I am a strong, proactive woman and always have been, but this situation is something I can't seem to get a handle on. Much love and thanks. Rebecca

[Altostrata]

It appears your symptoms may have started when you took metoprolol. It may have interacted with Effexor or it might have destabilized you on its own. Please read up on adverse effects of your drugs.

 

30 minutes ago, rmce72a said:

Yesterday was lovely, but today has been miserable with all heavy symptoms all day.

 

As explained before, it is typical for withdrawal syndrome to have a sporadic waves-and-window pattern. It appears you are stabilizing. Please keep this in mind when you have waves.

[rmce72a]

Thank you so much for your help. You are a treasure and a lifeline.

[rmce72a]

Well, I have been without Clarinex for 3 days and the only difference I notice is itching. However if there is any chance at all that taking this antihistamine will make withdrawal worse in any way, I'll take it. What do you think?