flong: Effexor XR Tapering

[Fresh]

" I'm trying to help her figure out the best way for her to get even 12.5mg doses she can take once every two days. "

 

You are helping her do something we don't support because it's dangerous.

She will do far better taking half the dose daily , than dosing on alternate days.  I haven't heard of anyone getting stable

doing it by dosing on alternate days.

You've said several times that she can't take a daily dose because it builds up in her system.  That is exactly why we are suggesting she needs smaller doses.  25mg is too much in one hit.

[flong]

Just for the record, Wellbutrin can be VERY hard to come off of, even if it's done carefully.

I've gone from my max dose of 200mg down to 25mg. Two weeks ago I began spreading that dose out from 24 hours to 28 hours. Even that decrease has affected my system like you wouldn't believe.

My body is reacting as if I have a flu/cold. And insomnia, which I don't normally have. I have been feeling really out of it, forgetful, and at times VERY short and angry about things that would normally not bother me. And as for the things that normally bother me, they're 100x worse. I am having to push out suicidal thoughts, they don't belong, and I know it's just the system fighting with the drug. I'm in the middle of a nightmare. It's just really hard to ignore the hardest parts of life when my defenses are totally down like this.

However, I've been in a constant state of withdrawal for almost exactly 4 years now...I know what's going on at least, and if I can tough it out and wait it out I'll stabilize and be okay again.

I hope everyone is well.

[Lexy]

So sorry you are going through this after finishing your Effexor taper.

Have you thought about updosibg a little then decreasing slower?

Per your sig you have been decreasing more than 10% monthly.

Were you stable before decreasing Wellbutrin?

[ChessieCat]

"Two weeks ago I began spreading that dose out from 24 hours to 28 hours."

 

Why are you extending the time between doses instead of reducing the amount of the dose and taking it every 24 hours?

 

By extending the time between doses you will be suffering interdose withdrawal.  This will be very destabilising to your CNS.  You are going a cold turkey for 4 hours followed by a reinstatement, and then repeating it over and over again.  Your poor brain will not know whether it is coming or going.

 

I suggest you read the following:

 

Keep it Simple, Slow and Stable

 

Why taper by 10% of my dosage?

 

Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

[flong]

I can't believe I didn't think this out properly. When I got down to my final one bead of effexor I spread it out over 28 hours and spread it out until there was nothing. I thought I was at the lowest dose of this stuff too really. My compounding pharmacy told me they crush up the 100mg tablets and divide them into 4 capsules. I was worried that by going to 12.5mg they're dividing the capsule into 8 and it might get tricky to divide it right or something. I have about 20 of the 25mg left, and I guess I'm going to divide them into half and take them like that for a while. But the question is, when do I stop? I guess this isn't low enough of a dose yet? I'm going to read the links you posted above. Thank you so much.

 

"Two weeks ago I began spreading that dose out from 24 hours to 28 hours."

 

Why are you extending the time between doses instead of reducing the amount of the dose and taking it every 24 hours?

 

By extending the time between doses you will be suffering interdose withdrawal.  This will be very destabilising to your CNS.  You are going a cold turkey for 4 hours followed by a reinstatement, and then repeating it over and over again.  Your poor brain will not know whether it is coming or going.

 

I suggest you read the following:

 

Keep it Simple, Slow and Stable

 

Why taper by 10% of my dosage?

 

Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

[scallywag]

Your compounding pharmacy can make smaller beads. I talked with a CP in the west end of Toronto and they were willing to compound Cymbalta for me as low as 0.5 mg or 1 mg. They have the knowledge and the equipment to make small doses.

 

Chessie is using compounded tablets of Pristiq.  She got them made in different dosages so that she can taper slowly.  Kind of like currency with nickels, dimes, quarters, $1, $5, etc.

 

That may be more challenging here in Canada. You'll have to get your doctor to write a prescription for it. The pharmacist will likely be willing to help you figure out what you need for a 3- or 6-month prescription.

[flong]

I just phoned the pharmacy and they said doing 12.5mg capsules should be no problem. I'm thinking of ordering 10mg or even 5mg. I might be wrong, but it doesn't really seem like the dose is the issue, whether it's 200mg or 25mg, I never noticed much difference in dropping until I started spreading the doses out over 28 and now over 30 hours. I think spreading it out was the wrong thing to do, and according to the links ChessieCat posted, this is exactly right.

I also noticed this a bit with Effexor...that the amount of the dose wasn't as important as actually GETTING that dose, no matter the amount.

One thing is for sure though, I need to make a decision. I'm pretty scrambled today, and have "made up my mind" about 6 times. Sitting here going crazy isn't much fun. Thank you very much for your help.

 

Your compounding pharmacy can make smaller beads. I talked with a CP in the west end of Toronto and they were willing to compound Cymbalta for me as low as 0.5 mg or 1 mg. They have the knowledge and the equipment to make small doses.

 

Chessie is using compounded tablets of Pristiq.  She got them made in different dosages so that she can taper slowly.  Kind of like currency with nickels, dimes, quarters, $1, $5, etc.

 

That may be more challenging here in Canada. You'll have to get your doctor to write a prescription for it. The pharmacist will likely be willing to help you figure out what you need for a 3- or 6-month prescription.

[jmncrr]

Flong,

 

I've been reading your thread.

 

 

Sounds like your finally going to get off Effexor with smaller beads.

 

My question for you is. Did you have any anxiety with your Effexor taper after you started taking Wellbutrin?

 

If you did have it, did it get worse when you started Wellbutrin?

 

My research tells me Wellbutrin is prescribed for anxiety sometimes, and is very effective for some people.

 

Thank you, and good luck

[flong]

I actually finished Effexor completely back in February. Now I'm trying to get off Wellbutrin. I started Wellbutrin in the middle of my taper off of Effexor in November 2014, and am now coming off it.

The interesting thing is, these two drugs have similarities. So when I stopped Effexor finally, Wellbutrin carried some of the effects with it. Those parts are obviously why it's so hard to come off it...because my system thinks those parts the Wellbutrin took over are simply the Effexor still.

I had a lot of anxiety rooted in a very real life situation, and that carries forward, especially now that my defences are down. I can only imagine the Wellbutrin helped with that. However, if my new diagnosis is correct and I'm possibly bi-polar (who knows), it explains why I was having panic attacks and psychotic symptoms for years on Effexor, and why they're basically gone now (aside from when I'm doing a decrease and in withdrawal).

Anyway, today I am a bloody mess. Thanks to everyone who has chimed in here, I'm sure you all know how much it helps.

[Altostrata]

Hello, flong.

 

Most likely, the reason you had those reactions to Effexor is because those are adverse effects of the drug, not because you're bipolar. It's a myth that an adverse reaction to antidepressants means you're bipolar and very unfortunate that many physicians believe this.

 

Clearly, since you've stopped having those symptoms since you went off Effexor, they're not your underlying condition.

 

Yes, the tapering method of delaying or skipping your dose is not effective. Please be sure to take Wellbutrin at the same time each day. Your nervous system is happiest when it is stable.

 

Are you taking fish oil and magnesium supplements? see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/
 

[flong]

About 85 hours ago I took my last dose of Wellbutrin. I had tapered down to 25mg and had spread it out to well over 24 hours, which is not reccomended. But since my system was already in flux I decided to just eliminate it altogether. It feels like the wrong thing to do, I might need to reinstate this drug, as my biggest fear is permanent damage. Today is the worst so far. From almost everything I've heard, people are supposed to be able to get off this stuff without much trouble. Well, for me, it's every bit as terrifying as getting off Effexor.

[flong]

I just took 6.25mg, and will take 6.25mg in the evening. I'm going to stay on that until I feel better, and then hold. I've learned my lesson. I am not going up to a full dose since it's mostly been out of my system for over 80 hours. As per usual, your advice has been better than my own gut feeling. This drug is nothing to mess around with.

[scallywag]

You may get some w/d symptoms still at 6.25 mg. Please keep letting us know how you are doing.

[flong]

It's over 12 hours after taking that micro-dose and I feel a million times better.

Maybe this is tmi, but I woke up this morning literally shaking and drenched in sweat and ran to the bathroom and threw up and basically crawled around the apartment for 45 minutes crying.

I've gone through IV opiate withdrawal before, and it wasn't as bad as this. What gives? I'm not wonderful right now or anything, but I'm so much better than this morning.

Anyway, I'll take another 6.25mg at 1pm tomorrow. Taking this slower is obviously the right thing to do.

[scallywag]

I'm sorry that you are having such challenging symptoms.

 

You say that your last dose of 25 mg Wellbutrin was 85 hours before noon on Nov. 16, so sometime on November 12.

 

Please consider reinstating your previous dose of 25 mg of Wellbutrin as soon as possible.  After your symptoms have subsided, we'll work with you to calculate tapered doses and how to achieve them.

[flong]

Does anybody know of a detox centre that specializes in antidepressant/psychiatric medication withdrawal? I phoned CAMH which is where I thought would be most likely to have one. But they don't apparently. I'm going to phone back Monday and ask to speak to one of the doctors on staff, they'll know better than whoever is operating phones on weekends.

Stabilizing a bit more, still only taking about 3/5 of the 25mg dose, but it is doing the trick. Obviously the problem isn't the dose. The problem is when I try to take it away. Lesson learned. I have to be patient and smart like I was before.

[scallywag]

CAMH Yikes!  Docs there are far more likely to add medications and increase dosage than help you taper them. Most medical professionals interpret symptoms occurring after the acute period as a recurrence of the original condition. The flow chart used is quite simplistic:

Symptoms → Diagnosis → Medication

 

We don't know of any clinics that support SSRI or other psych med withdrawal. The vast majority of facilities who assist people during withdrawal are treating w/d from opiates and benzos. Those who profess to have knowledge and experience with the other psycho-neuro-active medications run programs that have people coming off multiple medications in one or two months. Given your reading and research, I hope you'll agree with the assertion that such an approach is likely to yield very poor results.

[flong]

Yes. And I was afraid of all of that.

Admittedly I am having a much harder time getting off this final bit than I had anticipated, more trouble than anyone would probably believe except for people on this forum.

My sister gave me a great analogy. It's like when a woman is pregnant, she can go an entire 9 months and suffer through it all, but at the very last point she absolutely needs help pulling the thing out of her. I'm right at that last point now. I need help.

I won't start another psychiatric medication under any circumstances. But I get the feeling at some point somebody is going to try to push benzos on me, like vallium or something. I'm prepared for that maybe. But I don't know. Going to see family doc on Monday. Who knows, maybe she'll know something I don't.

Still recovering from the drop to nothing for several days. Hoping the symptoms clear up even more now. Feeling quite a bit better overall at least.

 

CAMH Yikes! Docs there are far more likely to add medications and increase dosage than help you taper them. Most medical professionals interpret symptoms occurring after the acute period as a recurrence of the original condition. The flow chart used is quite simplistic:

Symptoms → Diagnosis → Medication

 

We don't know of any clinics that support SSRI or other psych med withdrawal. The vast majority of facilities who assist people during withdrawal are treating w/d from opiates and benzos. Those who profess to have knowledge and experience with the other psycho-neuro-active medications run programs that have people coming off multiple medications in one or two months. Given your reading and research, I hope you'll agree with the assertion that such an approach is likely to yield very poor results.

[ChessieCat]

I've just flicked through your topic and can't see this posted anywhere.  It may help you to be assertive:

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

[flong]

I've just flicked through your topic and can't see this posted anywhere.  It may help you to be assertive:

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

Thank you very much for those two links. Ive gone over them and have a better idea of how to talk to my family doctor today.

 

I'm feeling quite a bit better after reinstating about half of my dose. I'm taking 6.25mg about twice a day...I'm going to hold at exactly 12 hours between doses for a while until I can organize this a lot better (and feel better too).

 

Going to see family doctor today to discuss any kind of help she can think of, hopefully there's something she has in mind. Going to see a different doctor tomorrow who does more natural healing.

 

The bottom line is though, at some point I'll need to come off of this stuff, and I need help with it.

Edited November 21, 2016 by scallywag
lines at paragraph breaks

[flong]

I've mostly stabilized at 6mg twice a day, noon and midnight. I'm planning on being here at this dose for a while.

 

One really strange note is that since I made that drop and then tried going off completely, I have had zero headaches and no signs of migraines. Very weird.

 

I'm looking for any doctor that has experience in coming off this medication with somebody who is extremely chemically sensitive to changes in dose. As per usual, I'm sure the advice I get here will be of more value, but it doesn't hurt to try.

 

I've been reading some books on trauma and PTSD, including "The Body Keeps the Score" by Bessel Van Der Kolk, which is the most thorough and straightforward account of the condition I have ever read. Anybody who suffers from this owes it to themselves to read it. It is helping me understand how and why I have been feeling this way for the last 2+ years...and I'm especially looking forward to reading about treatment.

 

I hope everyone had a nice Thanksgiving. Hugs all around!

[Lexy]

As another very sensitive to dose changes, I'm so glad to hear you are stabilizing.

We must remember the 3K's...Keep it slow,Keep it simple, Keep it stable.

Hope you had a happy thanksgiving as well.

[flong]

I'm holding at this dose and probably will for a while. I haven't recovered as I had hoped. Giving it time. Hopefully I haven't really screwed anything up for good...that's always a big fear.

Going to see a psychiatrist on Friday for the sole purpose of asking him if he has any advice on tapering. I am not hopeful, but I'll try anything that might work.

On the bright side, I've been working with somebody who specializes in helping people recover from PTSD. It's probably the best decision I've made since the start of this journey. My whole way of living is slowly changing for the better. Slowly being the key word. I finally have a spark of hope that I won't be trapped by what trauma is doing to me or the grip this drug has either.

[flong]

Almost one year since I posted here. I've been on the ride of a lifetime. Here it goes:

The last two months have been by far the most crazy of my entire life by far. Over the last few years I noticed I had been losing weight...went from 185 down to 145 or less and no diet change. Was feeling run down, digestive issues, weird sensitivities and allergies, etc. Just general weirdness all around. I started taking a few nutritional supplements over the last six months starting at different times. Mid-September I started taking a B100 supplement. Within a week of starting it I had this MAJOR "stress reaction". One tiny thing absolutely released the floodgates. In a nutshell, it triggered a panic attack that didn't even begin to let up for almost an entire month. I didn't eat or sleep during that time, body shook continuously, my brain basically checked out and nothing but the essential functions for life operated. Oh, and the medical system was zero help, and continues to be zero help. Long story short, I realized it might have been the B100 complex causing it after reading a thread on drugs.com where other people had similar reactions. But that was a month and a half ago, and I'm still only about 50% better.

I had the 23andme genetic test done and I know now that I have a broken gene for metabolizing Folic Acid (as well as numerous other things, like the specific COMT gene mutation which deals with serotonin, dopamine, epinephrine, norepinephrine, and melatonin, all the things I've had trouble with over the years). So basically I was not only overdosing on folic acid, but the entire methylation system was unable to function. This is stuff like digestion, cell division, and all kinds of systems that feed into other systems like the transulfuration pathway.

I basically went insane. At the same time these various body systems shut down, my CBC levels came back fairly normal because my body was still alive, further confusing doctors.

I also learned that my Histamine pathway is messed up, which is why high histamine foods give me trouble.

I found someone who was trained as a medical doctor, went through med school, but branched off. She uses this technology to help treat her patients. She doesn't prescribe medications. But she does use natural supplements, like zinc, molybdenum, magnesium, omega 3, and probiotics, all of which I'm taking in small amounts currently.

Unfortunately I've had to start taking something to help me sleep. An old medication called Nozinan. It doesn't seem to have any side effects, and shouldn't be too hard to come off when I need to. Hopefully!

I am also on 1mg of Wellbutrin in the morning, and 1mg at night. I'll be on that until my health stabilizes in a huge way...I'm hoping for the best.

Any comments or advice is always more than welcome. This is brand new for me, I am all ears.

[whatshappening]

On 12/2/2017 at 1:50 PM, flong said:

Almost one year since I posted here. I've been on the ride of a lifetime. Here it goes:

The last two months have been by far the most crazy of my entire life by far. Over the last few years I noticed I had been losing weight...went from 185 down to 145 or less and no diet change. Was feeling run down, digestive issues, weird sensitivities and allergies, etc. Just general weirdness all around. I started taking a few nutritional supplements over the last six months starting at different times. Mid-September I started taking a B100 supplement. Within a week of starting it I had this MAJOR "stress reaction". One tiny thing absolutely released the floodgates. In a nutshell, it triggered a panic attack that didn't even begin to let up for almost an entire month. I didn't eat or sleep during that time, body shook continuously, my brain basically checked out and nothing but the essential functions for life operated. Oh, and the medical system was zero help, and continues to be zero help. Long story short, I realized it might have been the B100 complex causing it after reading a thread on drugs.com where other people had similar reactions. But that was a month and a half ago, and I'm still only about 50% better.

I had the 23andme genetic test done and I know now that I have a broken gene for metabolizing Folic Acid (as well as numerous other things, like the specific COMT gene mutation which deals with serotonin, dopamine, epinephrine, norepinephrine, and melatonin, all the things I've had trouble with over the years). So basically I was not only overdosing on folic acid, but the entire methylation system was unable to function. This is stuff like digestion, cell division, and all kinds of systems that feed into other systems like the transulfuration pathway.

I basically went insane. At the same time these various body systems shut down, my CBC levels came back fairly normal because my body was still alive, further confusing doctors.

I also learned that my Histamine pathway is messed up, which is why high histamine foods give me trouble.

I found someone who was trained as a medical doctor, went through med school, but branched off. She uses this technology to help treat her patients. She doesn't prescribe medications. But she does use natural supplements, like zinc, molybdenum, magnesium, omega 3, and probiotics, all of which I'm taking in small amounts currently.

Unfortunately I've had to start taking something to help me sleep. An old medication called Nozinan. It doesn't seem to have any side effects, and shouldn't be too hard to come off when I need to. Hopefully!

I am also on 1mg of Wellbutrin in the morning, and 1mg at night. I'll be on that until my health stabilizes in a huge way...I'm hoping for the best.

Any comments or advice is always more than welcome. This is brand new for me, I am all ears.

 

I know it's been a while since you have posted. But how are you doing now?