Narcissus: just another Effexor story

[Rhiannon]

Narcissus, great news! I am quite encouraged to hear that you were able to travel to Vietnam (that's a huge physiological/neurological stress, to travel halfway around the world, to such an unfamiliar environment) and that you seem to have done okay, and most important that you seem to have been able to recover and bounce back from that pretty well.

 

What I have been seeing is that as people do finally stabilize and improve, it's still a fragile stability. Which then proceeds to become more robust over time. (Although I'm not sure if people ever do become as solid as they were before the whole drug/withdrawal ordeal. But that's another story, and it appears so far that the vast majority of people end up with lives they can be quite satisfied with.)

 

During this recovering-but-still-fragile period you still need to be pretty careful about stuff like messing up doses, or traveling halfway around the world, or other stressful stuff. (As you found out on your trip, when you had those bad hours, although as above, I think it's quite a good sign that you recovered from that trip pretty fast.)

 

I think you're going to bounce back faster than you would have six months ago, for sure, and you're going to go back to feeling quite improved most of the time. And I definitely think you are going to become well enough to taper, and it won't be too long now before you can safely try that, but I feel like if you can just give yourself a little more time in this stable (albeit fragile) state to continue to do some healing (which I think is done more efficiently once we get stable), you'll get to a more robust kind of stability as the months go along. And then will be a good time to start a cautious taper. (Cautiously. Small cut at first, no more than 5%.)

 

tl;dr: I think you can start thinking about tapering but it's not quite time to actually start doing it yet. The time will come, and soon. Be patient, allow a little more healing time, you've had a few very rough years.

[Narcissus]

Thank you, Rhi!  What a great supportive response.  I'm definitely not ready to start a taper, I'm just warming up to the idea I think.  As for my dosing mistake, I lost a day in transit with the time change and forgot to adjust my pill case.  Oh well. 

 

I was invited on the trip by my family, I thought about declining, but I figured I should go even if it set me back a bit.  It was difficult sometimes but I'm glad I went. 

 

Feeling pretty encouraged at the moment.  This thing really does get better. 

[mammaP]

Wow, that is some achievement Nar and I'm really pleased that you managed to do it and recover pretty fast.

 

You will soon be able to start your taper again and if I were to start tapering effexor again I would do the micro

taper, it takes time but seems to be gentler and just a little longer than the 10%  that needs some long holds.

 

I am now down to 1 bead and feeling very pleased about that! 

[LoveandLight]

Vietnam! That's somewhere I'd love to go when I'm well hopefully! I've read your thread and you write brilliantly.

[Altostrata]

Narcissus, how are you doing?

[Narcissus]

I'm fine, Alto, thank you. Not quite as hopeful as I was in January but still fairly stable. The underlying fluish symptoms persist and it's hard to imagine them lifting. I've reached a delicate, imperfect equilibrium where I feel anywhere from okay to good throughout the day, but if I'm not careful, particularly with eating, I get to feeling pretty lousy. My memory and ability to concentrate is often quite obviously impaired, even while I'm feeling good. This worries me since I do need to return to school at some point. My continuing intolerance to exercise worries me too, it's one thing that doesn't seem to have gotten much better over time. I'm going to visit my acupuncturist soon, the treatments are often helpful when I'm feeling "stuck", as I am now a bit.

 

On many days I find myself feeling joy and gratitude, which would have been hard to imagine a year ago. Still, I can't help but wonder when I'll feel strong, clear, normal again. And then I ask myself, what if I never do? Could I still live a good life? I think so, yes. But of course I'm still banking on recovering.

 

Tapering is feeling frightening and far off again, I'm keeping it mostly out of mind for now.

 

It's nice checking in, it helps to me to see where I'm at. Thanks for the reminder, Alto. I hope you and all my other withdrawal friends are well.

[Hopefull]

Hi Narcissus,

I have read through your thread and you really have a way with words. I especially loved the post with the beautiful picture of angeles surrounded by bright light. From the last post you seem to be doing pretty well.How are you now? Have you started tappering?

[Narcissus]

Hey, Hopefull, thanks for the kind words. Looks like you may have missed my check in above. Haven't started my taper, definitely not there yet. Hope you are well.

[Altostrata]

Thanks, Narcissus. Good to hear you're feeling somewhat better.

[Narcissus]

Not feeling much better on most fronts.  Fell asleep without taking the Effexor about a month ago, I've been trapped in a wave since then.   I went into my acupuncturist last week hoping for some improvement.  The treatment didn't provided any relief, feeling fairly discouraged about that.  I know, it's silly to expect results every time but the fact that the acupuncture DOES occasionally produce a nice lovely window makes it hard not to anticipate relief.  

 

I'm a little troubled by how closely chronic fatigue syndrome mirrors my symptoms.  From the aches (I'm increasingly getting lower back pains), fogginess, poor memory, alcohol/exercise intolerance, and blood sugar issues, they're all on the symptoms list for CFS.  The reason I'm troubled is because the prognosis for CFS is unclear.  And yet here we tend to say that for withdrawal syndrome the prognosis is quite good, that most go on to achieve a full (or near full) recovery.  So while it seems like a semantic issue whether or not I choose to say I have withdrawal syndrome or CFS, one says I'll recover and the other makes no promises.  Strange, isn't it?

It may be that there's more recovery going on that I realize, and that I'm blind to it because of the wave I'm in at the moment.  But jesus, if a night of missed Effexor can still derail me for a month (and counting), how and when am I ever going to get off this nasty stuff?  

Ugh.  Could use some encouragement.  

[Lexy]

I can tell you that you are not alone, I have everything you describe, missed pill or not. i thought I was the only one that went through so much after just missing a dose or two.

Two weeks ago I missed a dose and was late taking the following one. I attribute this to my foggy brain. I've had more aches and pains than usual.

I am sending you healing thoughts.

[Hopefull]

Hi Narcissus,

You can only hope for better tomorrow.

Some days are good, other days are crap.

That is the nature of the ad wd beast.

 

It might take a little while for you to stabilize. Keep going! That is what you have to do!

[Altostrata]

Like withdrawal syndrome, CFS has an autonomic component. There can be a lot of overlap among the symptoms.

 

People with CFS, though, tend to be sick a lot, with conventional colds, flu, etc.

 

Hang in there, Narcissus. You'll get through this rough patch.

[Altostrata]

Narcissus, how are you doing?

[Narcissus]

Thanks for checking in, Alto.  I've been waiting for a good and clear moment to respond, shouldn't be too much longer.  

[Hopefull]

Hi Narcissus,

How are you doing these days?

It has been a while.

I hope that you are doing well.

Let us know how you are.

Best wishes, Hopefull.

[Narcissus]

Hello all,
 

It's been a long while (nearly two years!) since I've posted.  I've been tired, and to be honest, discouraged.  Things have not improved much, if at all, over the past two years.  I am moderately functional, studying part time, and out and about during the day.  But I continue to suffer from significant fatigue, brain fog and exercise intolerance.  There is a constant cloud of tiredness and fogginess, a malaise that hardly ever lifts now, though it fluctuates in intensity.  The worst symptoms are the cognitive ones, with my concentration and short term memory suffering more than ever.  If anything, these cognitive difficulties seem to have gotten slightly worse over time.  

I work once a week (bartending), and I'm taking two courses toward completing my undergraduate degree.  I can only handle a few classes as the stress sends me over the edge, and my ability to concentrate is so poor that schoolwork takes me much longer than it should.  I've always struggled with concentration, but I'd say I'm at about half of what I once was.  All of this leads to great concerns about my ability to develop a career and support myself after graduating (at this rate, still a ways off).  I saw a doctor recently for the first time in a long while.  She has had some exposure to chronic fatigue and related disorders, she's asked that I take a few blood tests which I intend to do tomorrow.  I've also started seeing a psychologist to help structure my life better, since the brain fog (now like a mild amnesia) makes all planning or purposeful activity very difficult.  The sense of life passing away, as in a groggy dream, often oppresses me.  But there are still ups and downs, and times of grace and acceptance.

I've refrained from my posting largely because of my lack of improvement, which I thought might demoralize people.  It's also unclear to me how much of my experience continues to be related to withdrawal.  The ups and downs of withdrawal seem to have given way to something milder but still quite debilitating.  The furious waves of withdrawal are largely gone (unless I lose sleep or miss an Effexor dose), but so are the windows of clarity and remittance.  This feels like different territory, something more akin to Chronic Fatigue Syndrome than true anti-depressant withdrawal (even if withdrawal was the original trigger).  Still, I am very careful to take my Effexor every night, as missing it makes everything flare up nastily for a while.  I have not budged from my 75 mg dose and, so far, I do not think I intend to.   

There are times when I think, "This is fine, I can live like this," and times when I think I can't bear it any longer (like after a stressor).  There are probably more of the former.  But the longer this goes on, the more I think that this might be my new norm.  And it's not an easy norm, even when things are relatively smooth.  At my best my energy and concentration are probably 50% of what they once were.  Memory is closer to 30%, and exercise ability is now non-existent (how much of this is due deconditioning, it's hard to tell).  This is probably not a helpful way of thinking about it.  But it's hard to forget how much easier, more healthful life was 4 years ago...even if it's time to retire that standard.

That's all pretty jumbled and not very clear, but I felt the urge to post, and figured I should seize the urge.  I hope I haven't worried anyone with my case, I feel pretty anomalous on most fronts.  I'm sure that many of the people I remember are in much better places, and that several have moved on entirely.  Wishing everyone well, and to those who are struggling, that you may have more grace than I!  

[Hopefull]

Hi Narcissus,

 

It is really nice to hear from you.

It is great that you are studying and working one day a week,even though you are struggling with cognitive issues. I think that you should be proud of your self for accomplishing your goals.

I don't think that your post is demoralizing. You are straightforward and you tell it like it is.

Are you planning getting off Effexor in the future?

Could Effexor be affecting your memory in the long run?

Good luck with everything and keep us updated.

Best wishes, Hopefull.

[Petunia]

Hi Narc,

Wow! Has it really been 2 years. I'm sorry you haven't seen much improvement, but so glad you posted to let us know how you are. Like hopefull, I also think its great that you are getting on with your life, working towards accomplishing goals, even if its at a slower pace than you would like.

 

Because you are still taking Effexor, and don't plan to stop, I wont write anything about stopping it, but I doubt your current symptoms are withdrawal related, apart from when you forget to take it on time. Obviously, its not helping, but as your experience has shown, trying to come off it hasn't been possible so far.

 

I'm still recovering after being drug free almost 4 years. Much improved, but still getting symptoms, mostly early in the day at a much reduced intensity. I've had long windows, lasting days and months of feeling completely recovered, but still in the cycle of windows and waves and at the moment, I'm in a wave, so its back to basics. I'm also still very vulnerable to stress with low exercise tolerance, apart from when I'm in a window, and then I'm able to do a lot more.

 

Its interesting you mentioned CFS, that's how I feel when my symptoms have subsided for the day. Not terrible, but certainly not the kind of life anyone would wish for. I long for the day when I get my old mental clarity back and enough energy and motivation to do more than one or two things a day. I've experienced this during windows, so I know its possible. There's actually a fair amount of overlap between the symptoms of protracted withdrawal and CFS. There's a topic in the symptoms forum about it, yes, I just found it, not surprisingly, you have posted there, here's the link.

 

Something else I found interesting, is the theory that CFS is caused by mitochondrial damage. Its now understood that psychiatric drugs damage mitochondria too. But thankfully, it appears to be temporary and treatable.

 

Its great to hear from you, please stay in touch.

 

Petu.

[Altostrata]

I am sorry you are still feeling poorly, Narcissus. But I'm happy to hear from you, you are a good person, I've always enjoyed your virtual company.

 

Hang in, perhaps there are things that can be done to improve your health. We'll always be here for you, please let us know how you're doing.

[peng]

Best wishes for you Narcissus.

Your illness is making you think your post is jumbled - your writing is excellent, actually.   Be confident of that!

[Narcissus]

Hi Narcissus,

 

It is really nice to hear from you.

It is great that you are studying and working one day a week,even though you are struggling with cognitive issues. I think that you should be proud of your self for accomplishing your goals.

I don't think that your post is demoralizing. You are straightforward and you tell it like it is.

Are you planning getting off Effexor in the future?

Could Effexor be affecting your memory in the long run?

Good luck with everything and keep us updated.

Best wishes, Hopefull.

Thank you Hopefull for your encouraging words.  It hadn't occurred to me to be proud of my progress in school and life...I feel behind on so many fronts.  I still need to adjust my expectations based on my health, it seems.  Thanks for the reminder to do so!

 

At this point, I have no plans to get off the Effexor.  As to what effects it might be having, I really have no idea.  But I'm inclined to think the difficulties I'm having don't stem from the Effexor.  It'd be wonderful if I I just had to get off the drug everything would be fine...but I think, at this point, that it might do more harm than good.  Or that, it would put me out of commission for quite a while, which I don't think I could put with.  I already feel so behind in life. 

 

Thank you again for your warm words.  I hope you are well!

[Narcissus]

Hi Narc,

Wow! Has it really been 2 years. I'm sorry you haven't seen much improvement, but so glad you posted to let us know how you are. Like hopefull, I also think its great that you are getting on with your life, working towards accomplishing goals, even if its at a slower pace than you would like.

 

Because you are still taking Effexor, and don't plan to stop, I wont write anything about stopping it, but I doubt your current symptoms are withdrawal related, apart from when you forget to take it on time. Obviously, its not helping, but as your experience has shown, trying to come off it hasn't been possible so far.

 

I'm still recovering after being drug free almost 4 years. Much improved, but still getting symptoms, mostly early in the day at a much reduced intensity. I've had long windows, lasting days and months of feeling completely recovered, but still in the cycle of windows and waves and at the moment, I'm in a wave, so its back to basics. I'm also still very vulnerable to stress with low exercise tolerance, apart from when I'm in a window, and then I'm able to do a lot more.

 

Its interesting you mentioned CFS, that's how I feel when my symptoms have subsided for the day. Not terrible, but certainly not the kind of life anyone would wish for. I long for the day when I get my old mental clarity back and enough energy and motivation to do more than one or two things a day. I've experienced this during windows, so I know its possible. There's actually a fair amount of overlap between the symptoms of protracted withdrawal and CFS. There's a topic in the symptoms forum about it, yes, I just found it, not surprisingly, you have posted there, here's the link.

 

Something else I found interesting, is the theory that CFS is caused by mitochondrial damage. Its now understood that psychiatric drugs damage mitochondria too. But thankfully, it appears to be temporary and treatable.

 

Its great to hear from you, please stay in touch.

 

Petu.

Thank you, Petu, for your kind and empathetic words.  

 

I'm so glad to hear about those nice long windows that you're having.  Those are hard earned, I know.  You say that you feel almost completely recovered at times, that's wonderful news!  What do you do during these times of energy and clarity?  Not that you need to "do" anything.  

 

Interesting about mitochondrial damage...I've heard a bit about that.  What sort of treatments do they suggest for healing?  I'd like to start playing around with supplements again.  I see that you have some listed in your signature, which is helpful.  Do you have a current regimen?

[Narcissus]

I am sorry you are still feeling poorly, Narcissus. But I'm happy to hear from you, you are a good person, I've always enjoyed your virtual company.

 

Hang in, perhaps there are things that can be done to improve your health. We'll always be here for you, please let us know how you're doing.

Thanks Alto.  Likewise re: virtual company!  

 

Yes, I'm sure there are things that can be done.  At this point, I'm most concerned about my ability to exercise.  Just walking is enough now to dredge up flu-like symptoms, whereas I was running at the beginning of withdrawal.  I'm hoping that I've just become deconditioned, and that I can work back to being able to exercise again.  There's some CFS guide that suggests graded exercise while taking one's heart rate, finding the rate at which symptoms tend to creep up and trying to stay under it.  I may try that if I can get up the gusto.

 

It's nice to return.  I'd forgotten how much comfort there is to be found here, thanks to your and the moderators great efforts.  Thank you for all that you do.

[Narcissus]

Best wishes for you Narcissus.

Your illness is making you think your post is jumbled - your writing is excellent, actually.   Be confident of that!

 

Thank you peng!  Wishing you well.

[Petunia]

 

 You say that you feel almost completely recovered at times, that's wonderful news!  What do you do during these times of energy and clarity?  Not that you need to "do" anything.  

 

Interesting about mitochondrial damage...I've heard a bit about that.  What sort of treatments do they suggest for healing?  I'd like to start playing around with supplements again.  I see that you have some listed in your signature, which is helpful.  Do you have a current regimen?

 

 

During my first long window, I found myself outside working in the garden, painting walls and fences and catching up on outside projects I had been planning since the start of withdrawal.

 

My last long window stretched over about 2 months and it coincided with the release of the game that swept the world for a while called pokemon go. I was running around all over my neighborhood with a new iPhone, trying to 'catch them all'. I want to get back out there and try and catch some of gen2, now they've been released, but its not happening while I'm in withdrawal normal.

 

I started juicing during the middle of last year, which I think may have helped a bit, but what I'm trying now for the CFS type symtoms and possible mitochondria damage is coq10 or ubiquinol to be exact. I've been taking it for about 2 - 3 weeks now. It hasn't made anything worse and I'm not as tired or exhausted as I was. Its not a huge improvement, but a subtle change for the better, so I'm hoping that with more time it will help more.

 

I haven't done a lot of research into treatments, I'm trying this first. It seemed like the easiest thing. I'm very skeptical about anything which is claimed to treat..... well just about anything really. For every symptom or complaint there are people willing to sell you a miracle treatment. It takes a lot of time and energy sorting out fact from fiction, so this is as far as I've got. The fact that I've had long periods of feeling great and almost fully recovered, make me believe that this is really just withdrawal and not related to any underlying condition or new illness, but its possible I guess.

[bubble]

Hello Narcissus!

 

I can't believe it's been 2 years and I was really happy to hear from you (although not happy to hear you are struggling). Like Hopeful I'm also impressed with your working and studying (the extent to which you are doing it is not so important). You need to give yourself more credit.

 

I can also confirm that for many years now I've been experiencing very similar symptoms to what you are reporting that resemble CFS (even at my best). I just happen to view them as a sign of a destabilized CNS and a brain that is busy healing itself.

 

Have you tried some really low intensity exercises such as yoga or chi gong? (I don't know when you wrote that but I remember you account that rather vigorous physical exercises would make you feel better). It's so frustrating that the only predictability in this process is that there is no predictability...

 

What I have noticed is that my fatigue decreased somewhat as I have decreased my drug burden. I don't know if you are familiar with the story of Brassmonkey. He started tapering while still quite unstable and gradually got better. This is just a hypothesis but maybe reducing the drug burden might bring about lessening of symptoms which hold didn't accomplish. Do you have any particular reasons not to consider tapering still?

 

I'm so glad you have shared how things are with us. Sometimes it seems we know all about ourselves and our path but the experiences of others always give us fresh insights. We are definitely stronger when we are together

[JanCarol]

Hey Narcissus - 

 

I know - I'm a stranger to you, but I feel I know you as you are one of the "old timers."  Good to meet you, finally, after reading your wisdom all over the site!

I just read your thread, and am touched by how warm and intimate "the old" SA was.  Back before we got too big to check in with everyone every day.  It's an awesome thing that Alto has done, providing us this place, and the information to get us through.

 

I'm going to be the fresh voice, the lone voice in the room.  And I won't take it personally if you disagree, because I am not in your shoes.

 

The ups and downs of withdrawal seem to have given way to something milder but still quite debilitating.  The furious waves of withdrawal are largely gone (unless I lose sleep or miss an Effexor dose), but so are the windows of clarity and remittance.  This feels like different territory, something more akin to Chronic Fatigue Syndrome than true anti-depressant withdrawal (even if withdrawal was the original trigger). 

 

and

 

But I'm inclined to think the difficulties I'm having don't stem from the Effexor. 

 

CFS / ME is a lot what my condition looks like too.

 

Is it from the withdrawal?  Or the years on the drugs? Or the surgeries (I've lost thyroid and ovaries while drugged)?  Or just stupid lifestyle choices?  All of the above?  It's what I tell people when they ask why I cannot be at a thing at 8 am, or why it's easy for something to be "too much."

 

But you are going to school, taking classes - you are braver and more energetic than you give yourself credit for!  (More than me, the thought of a deadline makes my legs go to jelly!)

 

I've been on all the supplements for decades now, and the only thing that seems to help me - is breathing, yoga, diet, a bunch of tiny practices which, when combined carefully, might give me a few more spoons for the next day.  The Spoon Theory by Christine

 

There's a lot of new research coming out for ME.  The sufferers stood up and roared, when they were prescribed drugs and  "gradual increase in exercise."  They proved that the studies which showed that "what they really needed was CBT" were bogus, and that they had a real condition which needed support.  I've learned that most of the management CFS / ME is similar to the management of depression (for me), or the management of autoimmune disorders.  Taking care of yourself.  Finding out what you need, managing your stress, and following your pleasure and curiosity.

 

There's an elephant in the room.  As a new, fresh voice in this thread, I hope you won't be offended by my storytelling.  I'll tell it like a story, so that you don't have to attach to it if you don't think it's accurate.

 

You had some bounces between 150 and 75, and finally settled on 75.  You settled on 75 waiting for it to settle *enough* to taper.  But it never quite happened, because you'd been on Eff for years - now 6-7 years?  Is that right? 

 

I've found that tachyphylaxis (poop out) starts to happen (different in different people) at about 5 years.  The drugs are good for a year or less (3 months, if you trust the studies), but over the long term they start to do things.  The longer you are on them, the less effective they seem to be.  And the greater toll they take.

 

One of the things they do is they damage the endocrine system, the digestive system, and of course, the neurotransmitters. (hence the fatigue - add in the mitochondrial thing, and yep.)   Another thing they do is poop out.

 

So - as part of my story - while you were stabilising - and you did get better on a stable dose - at the same time the Effexor was pooping out on you.  Tolerance.  So you never got to "well enough to taper," but the drug is not helping now, either.

 

I reckon, if tachyphylaxis is the case, you can increase the dose, or, you can start tapering.  I cannot with a clear conscience recommend increasing the dose to match your tolerance.  But I wonder, if you did or tried a micro-taper - if you would start to feel better by getting down some in dose?  I have to suggest that this might be possible.

 

There are other protocols for you to look at - diet (gluten, dairy, FODMAPS, GAPS I don't know what you have done about diet), thyroid testing (I would venture that nearly all long term use of these drugs results in a thyroid / adrenal / hormonal imbalance) - or even check for Hashimotos or other autoimmune disorders.  These might help support you and find a few more spoons for you to get through the day.

 

I agree with Bubble about gentler exercises.  Yoga.  Tai Chi, Chi Gung have helped me immensely when I was too tired.  Breathing exercises help support your internal organs, endocrine, lymph, and even muscles.  After 5 years of being unable to finish a yoga class, I'm back to karate, weightlifting, a more "normal" exercise routine.  But I don't neglect my Chi Gung which supported my journey here.

 

But what I am most concerned about is that "poop out" effect of having been on a drug so long.  I'd love to see you well and thriving.  You deserve some goodness, so please consider my story, and if it helps you, I will be Grateful.

 

I hope you see the sun today.

[DrugSlave]

Hey Narcissus,

 

I'm sorry to hear you are still suffering. We posted on each others' intro threads a few years back. It's puzzling how withdrawal seems to affect everyone differently...no two people seem to have the same symptoms. I guess biodiversity might be the reason. That being said, I don't know anyone with a more similar story to me than you. I have chronic fatigue similar to CFS with flu-like symptoms, intolerance to alcohol, no improvement (I see you say that you have had little to no improvement) and oh yea, stuck holding on Effexor for years, scared to taper any further.

 

I decided I need to do something. I tried many things to improve my symptoms but nothing worked. I have been holding on 37.5mg of Effexor for 3 and a half years with no improvement. I've decided to start tapering again. Maybe I can be your guinea pig.

 

More details:

 

I wish you the best of luck and hope you feel better

 

[brassmonkey]

Hi Narcissus-- Thank you for the kind post on my thread.  It's good to see you back.  Starting a new taper for the first time is scary enough, but to restart one after having so much trouble stabilizing really takes guts. Do you have a plan in mind as to how you want to handle this?  If you could bring us up to date with what's been going on we could come up with some ideas that might be of help.

 

Brassmonkey

[Narcissus]

Hello all,

Brassmonkey, thank you for reviving my thread.  I was inspired by your success story yesterday.  Reading it has caused me to reconsider, after seven hard years, trying to taper off Effexor again.

My situation is more or less unchanged since two years ago.  I continue to feel foggy and fatigued.  I’m physically exhausted much of the time, and exercise continues to cause flare-ups of other symptoms.  Meanwhile my memory and attention are significantly impaired, making it difficult to keep track of tasks or to remember what I’ve done throughout each day.  When the cognitive fog is heavy, I find it hard to think and form sentences, I’ll struggle to respond to people socially and when people are talking to me, I’ll have a hard time following what they’re saying.  There’s some rise and fall in these symptoms but they’re more or less constant.  The cognitive symptoms are by far the most pervasive and distressing.

On a more positive note, I’ve been slowly moving my life forward over the past few years.  In the spring I earned my long-overdue bachelors degree in psychology, graduating with a 4.0 and gaining admittance to the Columbia School of Social Work, where I’m slated to start in January.  I’m renovating an old shotgun house in New Orleans, where I’ve established a community of supportive friends.  I have a beautiful girlfriend that I adore and enjoy spending time with.  If I avoid physical and psychological stress, eat low-sugar food at regular intervals, and sleep 8 to 9 hours a night I can function somewhat normally, even if there’s always a malaise of symptoms stewing in the background.  I’m now thirty-one and I feel a little behind on becoming a mature and independent adult.  But overall, I’m not nearly as sick or as isolated as I was at the beginning of withdrawal.

Still symptoms persist, and I'm growing concerned about my ability to tolerate the rigors of full-time graduate study.  I’m even more worried about my inability to concentrate and attend to people, essential skills for someone launching a career as a social worker and therapist.  The cognitive fog is constant, even when I’m not having a flare-up.  How can I expect to be useful, to appear as a competent therapist, if I can't even follow what people are telling me?  If I can't remember what they've said in previous sessions?  If I'm deeply tired and distracted and I have to struggle to speak spontaneously?

JanCarol, I’ve returned to your message several times, I’m sorry for never responding.  I am now considering, as you’ve asked me to, the possibility that the Effexor is contributing to my symptoms.  Either you’re right, and I’m suffering from some form of prolonged Effexor “poop-out,” or else withdrawal has destabilized me in a way that I don’t seem to be recovering from.  I’m anxious for some hope, for something to proactively work on, and so I’m gravitating toward the poop-out idea.  Even if it doesn’t ultimately reduce my symptoms, I like the idea of getting off the Effexor, which I don’t think is doing me much good at this point.   

I am NOT, however, willing to undergo the terrors of acute withdrawal again.  It’s taken too long to establish this delicate equilibrium, and I have too many plans and projects now to be out of commission again. 

What do the folks here advise in terms of a taper given my history?  I am currently at 75 mgs of Effexor, where I’ve held for the past 7 years.  I was considering starting with the 10% reduction, either all at once or with Brassmonkey’s weekly sliding approach.  Brassmonkey’s approach sounds more conservative, but more complicated and costly given that I want to use a compounding pharmacy. 

I should say that I’m a little distressed at the timeline for the taper.  The 10% method looks like it’ll take something like 3 years before I’m down to 1 mg.  Brassmonkey’s would take considerably longer with a two week hold after each 10% reduction.  A slow taper is reassuring in that it’ll be less disruptive of my life.  On the other hand, if it’s true that the Effexor is contributing to my symptoms it means waiting longer until I feel the benefits of quitting the drug.

I think that I’ve asked this before, but has anyone experienced improvements during tapering?  Or is it only after the drug has fully left the system that our bodies begin to recover their old equilibrium? 
 

I’d really appreciate any advice or feedback anyone might have.  I feel pretty certain that I’d like to try to taper again.  But it’s daunting, and when I think back on my previous withdrawal experiences I start to lose my nerve.  I am deeply grateful this community has been here for me over so many years.  Thank you to Alto and to all the tireless moderators for providing us with structure and guidance throughout this long, hard process.


 

[ChessieCat]

Congratulations on achieving your degree.  That is one huge achievement when you have been struggling with cognitive issues.

 

It may not be poop out.  It might simply be a side effect of the drug.  They do, after all, numb us.

 

It's understandable that you are daunted.  Part of what has kept me patient is remember how bad my withdrawal was when I first arrived here.

 

You may not need to do a slower than 10% taper, however you might find it less stressful to start with a small reduction which will hopefully help you to see that you don't need to be scared of tapering.  It's no good adding stress to the taper because you will then not be able to work out what is withdrawal and what is added stress symptoms.  If the first reduction goes okay, then you could try reducing by a larger percentage.

 

 

[brassmonkey]

It sounds like you are really getting things together in spite of the WD problems.  Let's work to keep it that way.  Effexor is extremely brutal in the way it treats our cognitive abilities, from what you describe I don't think you've hit poopout yet.  That would make things a lot worse and they would be going downhill instead of holding steady. This is a good thing.

 

You're right about how this is going to take a long time.  I did a quick calculation and a 10% Brassmonkey slide from 75mgai will take about six and a half years.  BUT,  and you see that it a big but, it's not going to be all suffering.  We tell people that ADWD is not linear, that is to cover the window and wave aspect of healing.  There is also the WDnormal aspect that needs to be taken into consideration.  This is the rolling average of the way we feel over time.  As the taper progresses our overall situation improves a little at a time.  So six months from now you should be able to look back and say "yea, over all I feel better".  Once you have made a significant reduction in your dose, things should be noticeably better, your mind a bit clearer, not as tired, more social.  It happens gradually so it can be hard to see, but it does happen.

 

This isn't to say that there won't be blips along the way.  There are several dose levels that seem to be "mile stones" and can cause some trouble getting past them.  It usually means slowing down for a month or so, buckling down and getting through it.  Once the mile stone is past things smooth out again for a while.  Listening to your body and giving yourself a break when things start to go south is key. Also understanding that it is part of the process and nothing to panic over really helps.

 

Even though my taper took five and a half years it wasn't all bad.  I was in severe poopout in the beginning and it took quite a long time to break out of that, almost two and a half years.  You are in a good stable state and don't have to face that.  Once I was out of poopout there was a slow and steady improvement through out the taper.  I can't say things will be 100% by the end of the taper because they won't be.  Once the jump to "0" is made there is still a lot of healing to be done.  I was feeling pretty good when I made the jump, but I am very surprised at how much better I'm feeling a year and a half later.

 

It all comes down to one of three choices: 1. Do nothing and  slowly decline and eventually move into poopout while making your new life a mess. 2. CT, feel great for a few months and then crash and face a number of years to stabilize and recover fighting severe symptoms the entire time, or 3. do a slow well planned taper, take control of the process, work through the rough patches and make as much of life as you can. 

 

I'm not trying to make a sales pitch here, just trying to give some information and perspective. Like I mentioned in my earlier post, starting a taper is a very scary thing, especially if one is familiar with the symptoms and has a blossoming new life to take into account.

[kostakonkordia]

@Narcissus

Hey Narcissus, 

I've read you're introduction, it sounds really daunting what you have been through the last 10 Years or so... 

I just wanted to ask you how you are doing and if you are considering to start tapering again. 

I think there is hope to everyone to be honest... 

I like you're profile picture btw ;))) 

Greetings from Vienna 

Kosta