JJCC

[JJCC]

hi 

 

i really want to type a good intro except tbh i've reached my lifetime limit of psychiatric and therapy intake sessions and i'm struggling to see this intro post as something different... communication in general is extremely exhausting for me and i really just want to ask a question about electrolyte balance...

 

so i'll just vomit a list of random stuff into this text box: i am in my 40s, male, diagnosed conditions are tourette's (vocal mild, motor severe), add-i (extremely severe), chronic major depression, kinesthetic synesthesia -- all conditions have been present since early childhood and have remained mostly unchanged. i am also prone to migraines and seasonal vertigo (the latter gets milder with age), and debilitatingly ticklish (which might be relevant because i think it's linked to why i experience certain drug side effects). i'm in relatively good physical health otherwise.

 

i take 30mg adderall xr daily + 5mg adderal ir 7 hours later (50mg mydayis is ideal but insurance does not cover) and am satisfied with that as it greatly improves my quality of life. the 30+5 schedule was the result of a lot of careful tuning. i am stopping 225 mg effexor xr. i have poor cyp2d6 function but did not receive that test until well after starting effexor. the only other medication i take is pepcid for reflux.

 

i smoke approx. 2 packs every 3 days. i do not do any other drugs. i do not smoke marijuana, i have never used cocaine, and i rarely drink these days. the only other drugs i have ever done were psychedelics, and it has been a few decades.

 

i do not like antidepressants but every few years i'll go on a run for a few years, always as a last resort. i used to prefer zoloft but about 4 years ago i tried effexor instead because zoloft caused too much general apathy. i chose effexor because my mother takes it and i figured if it works for her (although now i'm not sure if it does) then might as well. i have tried other antidepressants; but side effects were always unmanageable: i tend to get hit with all of the rare sexual side effects for any given drug, and every single motor control side effect imaginable, for some reason, and they never go away until stopping the drug. 

 

for effexor, though, the only real physical side-effect that never went away was excessive sweating.

 

generally speaking it takes me about 72 hours to stabilize after an effexor dose increase. also, on missed dose, i will start to feel it within about 12 hours (just a feeling of strangeness + vivid dreams), and after almost precisely 36 hours i'll suddenly get hit hard with balance issues, slurred speech, brain zaps, and become prone to cataplexy attacks (the cataplexy triggers are repeatable, consistent, and hilariously specific - let's just say that if you tell me a good joke or give me great news then touch my feet i'll just completely deactivate like a scruffed cat, haha - very weird experience).

 

incidentally, depakote virtually eliminates a lot of the motor control withdrawal side effects (quickly, too, within an hour or two). however i do not take this and will not start. i discovered this after i experienced my first missed dose cataplexy attack but we didn't know what it was at the time and my psychiatrist, fearing a TIA, put me on depakote as anti-seizure protection for a few days until i could get to a neurologist to identify what happened.

 

i won't get into why i want to stop effexor except to say that i think it's causing more problems than it's solving, my career in particular is at high risk right now, and also this 4-5 year run is my longest on antidepressants and i'm not comfortable with that. also i'm starting to realize that it seems to be doing something weird to my emotions (hard to explain so i wont unless asked)... and i've noticed a huge increase in my tendency to dissociatively respond to stress. because of enzyme function test results, a few months ago i considered getting desvenlafaxine level lab tests then switching to a roughly equivalent dose of pristiq. but i just decided to stop entirely instead.

 

i stopped kind of cold turkey about 2 weeks ago. the timing was because my psychiatrist is on maternity leave, i was running low on effexor (150 + 75 = 225), and tbh i just didn't really feel like calling the substitute psychiatrist. so i dropped the 75's and took 150mg for a few days until i ran out of those two, then i just stopped. that was about... a week-ish ago.

 

it's been hell since, but... i seem to be slowly but surely crawling back into reality. my gut feeling is that i'll get through the withdrawal ok eventually, but my fingers are solidly crossed. i'm not concerned about long term withdrawal syndrome at this time but get back to me in a couple weeks on that. i've been emotionally and physically all over the place since stopping but i just assume it's par for the course. but i'm also experiencing a lot of overwhelming anxiety that i think might be 4 years of effexor-suppressed stress all coming out at once, if that makes sense (like, real life things that i should've been concerned with but wasn't, and now suddenly they're all hitting me).

 

i seem to at least have gotten through the suicidal depression part of the withdrawal. there were about 3 mercilessly bleak days that basically consisted of me determining that the only logical solutions to the remaining mysteries of quantum mechanics were solidly in the realm of profound nihilism and that i was an illusion. the only thing that got me through it was the fact that my cat loves the absolute crap out of me; so making her purr was my sole reason for existing last week, haha (which really, isn't much of a change from normal now that i think about it).

 

 

sooo... that's my intro but like i said i really just want to ask about maintaining electrolyte balance because effexor withdrawal, dehydration, and *over*-hydration all have exactly the same set of symptoms and since stopping every single fluid in my body is taking every opportunity to come out of every possible hole it has access to, plus some. 

 

also i have questions about venlafaxine vs desvenlafaxine pharmacokinetics, mostly out of curiosity. i've had no luck with my own research because "venlafaxine" and "desvenlafaxine" are used interchangeably in a lot of lower quality information sources but there is enough of those that it just completely pollutes search results.

 

 

i'm not actually sure how to ask a question cause all the "new post" buttons are disabled except for in this forum. so i'm just assuming i have to type this intro to get that privilege. 

 

 

in any case thanks for making this site and i really do hope that everybody here is able to get through whatever they're going through right now because this stuff sucks no matter how mild or severe it is. 

 

j

 

ps generally poor sense of time + overall lack of structured life + confusion of the last few days + logistically complicated real life events = don't trust the precision of "2 or 3 days" above, i'm actually not entirely sure when my last dose of effexor was i'd have to work backwards to figure it out. but i'm pretty sure this has all happened in the last 2 weeks. overall though my state has been best described as "utter confusion".

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry you are dealing with these symptoms from stopping the Effexor.  Cold turkeying a drug is a tough way to stop.  This puts you at risk of developing long term protracted WD.  When you say 

 

On 7/31/2022 at 12:06 PM, JJCC said:

since stopping every single fluid in my body is taking every opportunity to come out of every possible hole it has access to, plus some. 

I assume you are having vomiting and diarrhea?  If this is happening all day every day, there is cause for concern.  How often is this happening?  Also, can you possibly please try to work out when you jumped off the Effexor?  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

You may benefit from a very small reinstatement of Effexor.  Going back on a small dose of your drug, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

You want to know about the pharmacokinetics of venlafaxine vs. desvenlafaxine.  I'm no scientist, but I can give you some links with some basic information about these drugs.  Also, check out https://www.drugs.com

 

This link about venlafaxine contains information and some other reputable links about the drug: 

 

About Effexor and Tapering

 

This link is about desvenlafaxine: 

 

About Desvenlafaxine and Tapering

 

As far as maintaining proper electrolytes, the best way to do this is eat and drink things that are high in potassium, sodium, chloride, and magnesium.  This would include ripe bananas, melon, oranges, orange juice.  This article has more foods that are good to eat: https://www.healthline.com/health/fitness-nutrition/electrolytes-food.  You will also need to drink lots of liquid to replace what is being lost.  Also, eating white rice, bananas, apple sauce, toast, crackers, boiled or baked potatoes I can help. Also, try pedialyte, and sports drinks that have electrolytes, like Gatorade.  

 

Please keep us posted on how you are doing.