John: Effexor withdrawal on a delay?

[Nikki]

I think the anxiety and agoraphobia I experienced in 2008 was a direct result of stint in detox when they CTd Klonopin (gave me Ativan) and fentanyl and oxycodone all at same time (I had weaned myself down to 2 oxycodone IR/day) -

Those 3 days did more harm to me both physically and psychologically - it triggered anxiety and agoraphobia I didn't have previously and it's very similar to anxiety I've felt during this w/d - I hate addiction medicine-

Hindsight - a *****

 

Barbara I had no idea about benzos triggering anxiety, Alto said there could be a paradoxical effect. Wow.

 

The harm both physically & psychologically that you have experienced with anxiety is something I believe happened to me and alot of other folks. I think it's like a PTSD.

For me ~ anxiety now frightens me. The anxiety itself is a trigger for more anxiety.

 

I can talk about this here, I don't think too many other (civilians) get it.

 

Hugs

[Barbarannamated]

This was discussed in thread 'Correspondence with R. Shelton' in the Scientific Journal section (I apologize for not inserting link...have not figured out how to copy and paste in some applications on new tablet.). Dr. Shelton has been one of the few docs to acknowledge and discuss this (with Alto). I've had mixed reactions to his work, but I believe he's doing what he can in very muddy waters. I DO NOT agree with how he attempts to spin off PTSD-ish reactions as a new entity to be treated although he does lean toward therapy after mentioning pharmacologic interventions.

I did not meet with him but will be returning to Nashville sometime soon.

[John]

I counted a few full pills of 75mg XRs and some have 250, others have 248 and some even had 230. Why would this be? Wouldn't this make the pills all different strengths? And this isn't going to make for an easy taper.

[Altostrata]

10% of the pellets is APPROXIMATELY the same as 10% of the milligrams. Your nervous system may not be so sensitive as to require the greater accuracy of weighing by milligrams.

 

Capsules and tablets also contain filler and coatings and weigh more than the milligrams of drug they contain.

 

The pellets vary in size and number per capsule. The number of pellets per capsule also varies by dosage.

 

Because of this, counting out pellets is only an approximate measure for a taper. Weighing and going by milligrams is more exact.

[John]

In case you missed my story, I was on Effexor XR 75mg for about 5 years. I went cold turkey from it 18 months ago, and for the first month or so had panic attacks and zaps and then went away. 2 months after, I developed severe anxiety. A feeling that I never had before. It was an undescribable feeling, but it was extreme fear; an inner tremor that was horrifying, yet not a panic attack. This feeling was with me constantly for about 5 months. 2 months into it, I reinstated the same doseage of Effexor, but it wasn't until 3 months later when the feelings started to become intermittent and somewhat less severe.

As the months went by, the feelings got further in between and less severe. I was at a point where I would get "spells" a few weeks apart, and even when I had them, they only lasted a few days and werent too bad. Last month I decided to taper off them since it seemed like I might of been at a plateau, and possibly as long as i'm on the Effexor I may never get completely better. I took 13 pellets from the pill and took that for 4 weeks. I felt no different, so after the 4 weeks I removed another 13. 2 weeks after for a day I had that funny feeling in my chest; the feeling like a panic attack is imminent. It never came, and a day later it was gone. This is the 3rd week in my 2nd taper, and yesterday I felt a little like I did when I had the cold turkey feelings, and now today I feel even more so. Not to the same level, but more than I did in many months. Yesterday I added 3 more pellets to my pill, making the total removal count of 23, but of course I dont feel any better.

Do you think these feelings are due to the taper, or is this another random spell from the cold turkey? If it is from the taper, should I add back more pellets, and if so, how many?

[Rhiannon]

I would say that you are probably experiencing the effects of your taper.

 

Given how bad it was before, I understand how scary it must be now to feel this.

 

As you are obviously aware, you can't expect to feel better overnight when you reinstate slightly.

 

I am not as familiar with Effexor withdrawal and tapers as I am with other drugs. I don't know how many pellets there are in a capsule so I don't know what percentage of the total 13 pellets is. I do know that cuts of more than 10% are usually not considered a good idea.

 

What I do know about psych drug withdrawal in general is that once you've had a previous attempt to quit too fast, or a CT, you're more likely to have trouble in the future, and it's important to take future tapers extra slow.

 

Hopefully someone who knows more about Effexor tapers will chime in here as far as how big your cuts have been. If 13 pellets is more than 10% then I would say yes, reinstate more, and then hold until you stabilize, however long that takes. If 13 pellets is about 10% then you might want to consider just holding your taper where you are until you stabilize, and then waiting another week or so before continuing your taper. Sometimes 10% is too much, I'd try a smaller cut next time.

[Rhiannon]

Benzos are prone to having paradoxical effects, such as panic attacks.

 

In the case of Xanax and Ativan (both short-acting benzos) it's not just the paradoxical effects that can cause panic attacks, although Alto is correct, benzos can produce paradoxical effects.

 

The problem with Xanax is that it reaches peak blood levels in less than two hours and then begins to drop. If you take Xanax regularly, when the blood levels drop you will generally experience increased anxiety and panic in between doses. This is called "interdose withdrawal."

 

I used to take Xanax nightly. Now that I'm dosing it regularly throughout the day, I realize that for all those years I was experiencing daily bouts of interdose withdrawal, which was a big part of my "anxiety" problem for which I was given OTHER meds.

 

If you must take Xanax daily, then you need to take it every four hours or so to keep blood levels even.

 

I don't think this is likely to be a problem if you only take it once a week or so. Not sure, but it's my impression that unless you take a benzo every other day or so for at least a few weeks, dependence is not likely to develop. But it's a slippery slope, as they say, and I would just never recommend starting a benzo for anxiety unless it was a matter of life or death and there was absolutely no other choice. Benzos are nasty drugs. Not to be taken lightly.

 

(On the benzo boards, I say the same thing about ADs, by the way. Try absolutely everything else for depression before starting a drug. There are so many nonmedical options that can be tried first.)

[Altostrata]

John, I moved your new post here. When you want to ask questions about your particular situation, you can ask them in your Introductions and Updates topic, and you don't have to describe your recent past again. You can review the topic as a kind of a journal.

 

As you go down in dosage with Effexor XR, taking out the same 13 pellets becomes a larger and larger percentage of your dosage. You need to REDUCE the number of pellets you remove to keep the same percentage of decrease.

 

For example (offhand I don't know how many pellets are in your capsules), if 13 pellets is 10% of 75mg Effexor (7.5mg), and you remove them, you're taking 67.5mg Effexor XR. If you take out 7.5mg from 67.5mg, you're reducing by 11%, leaving 60mg Effexor XR. If you take out 7.5mg from 60mg, you're reducing by 12.5%.

 

The percentage gets larger and larger.

 

If you keep the number of removed pellets constant, you are accelerating the rate of taper. If you increase the number of pellets you remove, you are accelerating your taper even more.

 

The emergence of withdrawal symptoms indicates you should take out fewer pellets, not more pellets.

 

How long are you holding after each decrease?

[Altostrata]

Rhi is absolutely correct.

 

If you're sensitive to benzos, even if you take them only occasionally, you may get that rebound of anxiety when they wear off. They're diabolical little critters.

[John]

I've been holding for 4 weeks between each decrease.

[Altostrata]

If I were you, I'd back up in dosage. I think you've gone a little too fast by taking 13 pellets out each time.

 

If you were down 26 pellets, go back to taking out 20 pellets. Yes, people can be that sensitive, especially with Effexor, Paxil, Cymbalta, etc.

[Nikki]

They're diabolical little critters.

 

 

Fell out laughing...I guess that could be said for all psychmeds

[John]

But i'm not sure if this is from the residual withdrawal from the cold turkey or from this one.

[Altostrata]

No way to tell. Are you keeping notes about your taper and symptom pattern?

[John]

Since I posted this question, I started dropping at 5% increments. I must be very sensitive, but after I drop, I start getting symptoms ranging from 3 weeks after to 1 week after. When this happens, I told the drop longer than 4 weeks; i'll wait 5 or 6 weeks till the next drop. My symptoms after each drop are different everytime too; sometimes its a "charged" feeling, others its fear (or dread), sometimes it's mixed with zaps occasionally and others with stomach issues. I don't want to go lower than 5% since this is already going to take me into 2014. I'm tapering from 75mg of XR, and they no longer make the tablet version of Effexor. Anything else I can do to really minimize the symptoms?

[strawberry17]

One of the best bits of advice I got, was throw the calendar/schedule away, listen to what your body is telling you and it sounds like you're getting the hang of that one.

 

Others here might have tips on supplements, but what works for me is trying to have a healthy diet, a general multivitamin, high EPA fish oil capsules, exercise and relaxation/sleep and stay from stress (if that's possible).

[Altostrata]

I agree, go slower.

 

You might want to put your taper on hold right now and let your nervous system settle. It might then be better able to tolerate decreases.

[peggy]

Hi John,

I concur with the slowing down...I also get a delay with some withdrawal symptoms. I get initial headachy, funny sleep for a couple of days then it clears up - but i sometimes get another layer of more emotional symptoms - usually about 2 weeks after a drop if it is going to happen. My aim is to have at least 2 weeks of feeling good before i drop again. This drop i plan to wait longer - only because i think it might be helpful to have a longer period every now and then

[John]

Is hypertension a withdrawal symptom of Effexor?  I've never had it, but I noticed that I now do after tapering off of it.  Im at ~45mgs from 75.  When I took my pressure today it was on average about 135/90.

[John]

After stopping Effexor cold turkey, I went through months of hell of extreme anxiety.  I restarted Effexor with no relief, then about 5 months later began feeling better.  2 years later, i'm still tapering from 75mg and now im up to 45mg.  I drop every 5 weeks only about 5 pellets, and i still get occasional panic attacks, sometimes that "doom" feeling anxiety, and depression.  I never had any of this before i took this pill.  Could the cold turkey activated this depression which will be with me for life?

[GiaK]

it's very unlikely that it will last for life...even those of us sick for many years as a result of withdrawal get better eventually.

 

hang on...it's a heck of a ride, but in the end most of us come out way ahead of the game...it's a potent life-changer and we learn many things that generally keep us from taking much of anything for granted ever again...

 

it will be better...and basically nothing is forever...everything changes. This too will pass...

[Altostrata]

You might wish to decrease by perhaps one or 2 pellets at a time. It will be slow, but you'll get there.

[John]

You might wish to decrease by perhaps one or 2 pellets at a time. It will be slow, but you'll get there.

Do you think its possible just a few pellets can make all the difference?

[Altostrata]

Of course. Many people here find a micro-taper is more effective.

[mammaP]

I am tapering effexor too and Alto is right, I have been tapering one bead at a time for months now 

and can say that just one bead can make a huge difference. I tapered to 5 beads then jumped off

only to be hit by withdrawal a few weeks later. I reinstated and am now down to 4 beads and will stay

there until I am stable for at least 4 weeks, then I will switch to liquid to complete my taper.. 

It just is not worth rushing it, eventually you will get to zero and going slowly means you can get

there without the crippling withdrawal symptoms. 

 

I have to add though, that I have side effects with effexor that will be with me until I'm off it

completely but they decrease in intensity with each drop. 

[Francis]

I dont know about effexor specifically (I am dealing with celexa withdrawal), but I have the same fears.  Its so scary to think that Im broken.  BUT I have to remember when I was at 0.6mg and held at that amount for almost 2 months, I started to feel a lot better.  It really is amazing how sensitive our bodies can get to tiny reductions in these meds.  Even after going through it, it was difficult for me to accept that a 0.05mg reduction could throw me for a loop.

[Lexy]

John can I ask how you are doing?

I'm on effexor also.

[John]

John can I ask how you are doing?I'm on effexor also.

Hi, i'm still chugging along; down to about 41mg from 75.  I each drop seems to be different; one time will be minor, another time much more severe, although I dropped the same amount and span of time.  I just got over a biggie this time around.  I was on the verge of panic attacks for about 4 days in a row, along with "fluttering" of the heart.  Very uncomfortable.  Other times i'll get random frightened feelings, and other times i'll get brain zaps, and others a combination of symptoms.  I noticed during a symptom "attack" i'll get OSA (Apnea) symptoms.  I even wet the bed twice because of it.  Before all this the last time I wet the bed was when I was 8.  Im 41 now.  When the symptoms go away, i'll sleep as quiet as a mouse.  Very confusing.  I've been tapering for about 2 years, starting with 10% reductions, then realizing that was too much for me, so I went with 5%.  It wasnt until the last 2 or 3 tapers that symptoms have been getting worse, and sometimes they wont occur until the 4th week of tapering.

[kaza31]

hi there john

 

ive been on hold at 87mg this past five weeks I want to stabilise for a while.. Have been having thyroid problems so I want to start feeling good for a while before I start another reduction..

 

Last week I was getting that OSA(apnea) feeling you describe... at least I think that's what it was..

it was a feeling of everytime I must have been on the verge of falling asleep, I suddenly woke up with a jerk/body jumping,, but also with a weird feeling with my breathing.. it wasn't like I was gasping for air or anything, more a weird sound in my breathing/like a missed breath or someithing.. hard to explain it.. Plus I was having bad hot flashes and sweating..

 

However this week my sleep is better again, Im falling asleep easier and touch wood haven't had the breathing thing since..

 

I can also relate with the flutter heart feeling, its very strange, I haven't had the brain zaps but do get a crawling sensation across the left hand side of my head regularly..

 

take care

 

make sure to keep us updated

its good to read other peoples  posts relating to coming off Effexor

 

all the best

Kx

[Lexy]

Hi John

 

I agree in regards to slowing and holding longer. I was tapering in the beginning at around 10% every month

I was tapering down a little every week until I wrote down my signature I realized I had been going

Down too fast and not holding enough.

 

I feel impatient a lot of the times and I know

This will take a lot longer than I expected. I feel all the symptoms you are describing. If it's not headaches

That last for weeks, it can be dizziness or vertigo, I feel the zaps all the time, they get worse

When I don't take fish oil.

 

I take benadryl at night an hour before bed and I usually don't have trouble falling asleep.

I will awaken a couple times but fall back to sleep.

 

I hope you will continue to keep in touch as I truly believe we will get off this evil effexor with

The help and support of everyone here.

[btdt]

Since I posted this question, I started dropping at 5% increments. I must be very sensitive, but after I drop, I start getting symptoms ranging from 3 weeks after to 1 week after. When this happens, I told the drop longer than 4 weeks; i'll wait 5 or 6 weeks till the next drop. My symptoms after each drop are different everytime too; sometimes its a "charged" feeling, others its fear (or dread), sometimes it's mixed with zaps occasionally and others with stomach issues. I don't want to go lower than 5% since this is already going to take me into 2014. I'm tapering from 75mg of XR, and they no longer make the tablet version of Effexor. Anything else I can do to really minimize the symptoms?

I did not taper not really failed then went cold turkey off 150mg of effexor I do not recommend it.  I had sever gastric issues and infections which required antibiotics.  Tho you do not say which type of gastro upset you have there are two things that come to mind... diarrhea the cure for this is probiotics open the capsule mix with a small one size serving of apple sauce.  I had an extreme case and used three capsules three times a day I would suggest starting with one.  There is also a thread I was just reading that says probiotics can cause an issue with histamine I am waiting for a response as to what this is... so maybe you will want to search that before you try probiotics... the laco bif... type not the yeast type of probiotics... Acid refulx was the other major issue I had when I quit... and some of the drugs they gave me to treat this cause extreme depression... be away of this and look up every drug they give you... if the acid reflux is bad you will need. it ... don't lay down sleep sitting up.  pariet was the non depressive acid stopping drug for me.  Acid slowing drugs are proton pump inhibitors and all of them reduce the acid in the stomach which can lead to an inability to break down Vit B12 as you need Acid to get the B12 from your food. Just so you know... one thing always seem to lead to something else.  If you can get by without the ppi it is best.  Recurring lung infections may be a sign you have an acid problem and need a ppi as the acid gets into your lungs when you lay down to sleep.  Tums work... so does baking soda to control acid if it is not too bad.  Don't eat acid foods... best idea... but often not enough in my case at least.  

[btdt]

As for the title of the thread Yes withdrawal is delayed. 

When I finally quit taking Effexor I did not feel too bad until between 6 and 7 wks off.  At this point I went to bed with what I thought was the flu as it felt just like the flu however it did not go away.  The next six months were mostly spent in bed symptoms changed from then on... currently 5+ years off E. Some people have reported getting hit with withdrawal a few months after to several months after quitting. 

 

We certainly need some research so you questions can be answered with certainty.

[John]

As for the title of the thread Yes withdrawal is delayed. 

When I finally quit taking Effexor I did not feel too bad until between 6 and 7 wks off.  At this point I went to bed with what I thought was the flu as it felt just like the flu however it did not go away.  The next six months were mostly spent in bed symptoms changed from then on... currently 5+ years off E. Some people have reported getting hit with withdrawal a few months after to several months after quitting. 

 

We certainly need some research so you questions can be answered with certainty.

Yea, I got hit like a ton of bricks the first time I went off Effexor cold turkey.  Took 3 months for the withdrawal to begin.

 

hi there john

 

ive been on hold at 87mg this past five weeks I want to stabilise for a while.. Have been having thyroid problems so I want to start feeling good for a while before I start another reduction..

 

Last week I was getting that OSA(apnea) feeling you describe... at least I think that's what it was..

it was a feeling of everytime I must have been on the verge of falling asleep, I suddenly woke up with a jerk/body jumping,, but also with a weird feeling with my breathing.. it wasn't like I was gasping for air or anything, more a weird sound in my breathing/like a missed breath or someithing.. hard to explain it.. Plus I was having bad hot flashes and sweating..

 

However this week my sleep is better again, Im falling asleep easier and touch wood haven't had the breathing thing since..

 

I can also relate with the flutter heart feeling, its very strange, I haven't had the brain zaps but do get a crawling sensation across the left hand side of my head regularly..

 

take care

 

make sure to keep us updated

its good to read other peoples  posts relating to coming off Effexor

 

all the best

Kx

I dont think what you had was OSA.  I sometimes wake out of a panic because i'm struggling to get a breath.  Oddly enough, sleeping is never a problem for me.  I fall asleep, and stay that was usually for 8 hours or more,

 

 

Since I posted this question, I started dropping at 5% increments. I must be very sensitive, but after I drop, I start getting symptoms ranging from 3 weeks after to 1 week after. When this happens, I told the drop longer than 4 weeks; i'll wait 5 or 6 weeks till the next drop. My symptoms after each drop are different everytime too; sometimes its a "charged" feeling, others its fear (or dread), sometimes it's mixed with zaps occasionally and others with stomach issues. I don't want to go lower than 5% since this is already going to take me into 2014. I'm tapering from 75mg of XR, and they no longer make the tablet version of Effexor. Anything else I can do to really minimize the symptoms?

I did not taper not really failed then went cold turkey off 150mg of effexor I do not recommend it.  I had sever gastric issues and infections which required antibiotics.  Tho you do not say which type of gastro upset you have there are two things that come to mind... diarrhea the cure for this is probiotics open the capsule mix with a small one size serving of apple sauce.  I had an extreme case and used three capsules three times a day I would suggest starting with one.  There is also a thread I was just reading that says probiotics can cause an issue with histamine I am waiting for a response as to what this is... so maybe you will want to search that before you try probiotics... the laco bif... type not the yeast type of probiotics... Acid refulx was the other major issue I had when I quit... and some of the drugs they gave me to treat this cause extreme depression... be away of this and look up every drug they give you... if the acid reflux is bad you will need. it ... don't lay down sleep sitting up.  pariet was the non depressive acid stopping drug for me.  Acid slowing drugs are proton pump inhibitors and all of them reduce the acid in the stomach which can lead to an inability to break down Vit B12 as you need Acid to get the B12 from your food. Just so you know... one thing always seem to lead to something else.  If you can get by without the ppi it is best.  Recurring lung infections may be a sign you have an acid problem and need a ppi as the acid gets into your lungs when you lay down to sleep.  Tums work... so does baking soda to control acid if it is not too bad.  Don't eat acid foods... best idea... but often not enough in my case at least.  

 

You must of read my mind; heartburn is another symptom I failed to mention.  Which drugs cause extreme depression?

[John]

Hi JohnI agree in regards to slowing and holding longer. I was tapering in the beginning at around 10% every monthI was tapering down a little every week until I wrote down my signature I realized I had been goingDown too fast and not holding enough.I feel impatient a lot of the times and I knowThis will take a lot longer than I expected. I feel all the symptoms you are describing. If it's not headachesThat last for weeks, it can be dizziness or vertigo, I feel the zaps all the time, they get worseWhen I don't take fish oil.I take benadryl at night an hour before bed and I usually don't have trouble falling asleep.I will awaken a couple times but fall back to sleep.I hope you will continue to keep in touch as I truly believe we will get off this evil effexor withThe help and support of everyone here.

I've been taking tons of supplements for years before I began going through this all including Omega 3, and none of these seem to matter with the symptoms.  Evil is putting it mildly.  I call it the devil's pill.

[John]

Today is the first day ever I felt like I did 3 years ago when I went cold turkey from 75mg to 0.  I went cold turkey 3 year ago in June, come September, felt fear, sweating, doom, etc.  I reinstated the full amount in that December, and wasnt until May or June I started feeling better eventually turning to normal about a year and a half ago.  I began tapering at that point 10%, seeing that was too much went to 5% and now 3%.  I'm down to 41mg, and last week began having panic attacks, but they would go away quickly.  Now today out of nowhere I feel like I did 3 years ago in September.  Anyone have any insights or advice?

[Jemima]

Is hypertension a withdrawal symptom of Effexor?  I've never had it, but I noticed that I now do after tapering off of it.  Im at ~45mgs from 75.  When I took my pressure today it was on average about 135/90.

 

I'm sorry this post got ignored. Yes, fluctuating blood pressure can be a withdrawal symptom.  Mine was all over the shop for the first six months or so, but it settled back down.  Do keep an eye on it though in case you should be one of the few individuals whose blood pressure gets to dangerous levels.