Finn: Hello

[Jemima]

It's been three weeks! I mean, yeah, perhaps I don't practice the best self-care. I consume lots of caffeine and sugar, but isn't enough enough? Maybe, I should call my psychiatrist and tell her I'm really suffering from Effexor withdrawal. She knows I'm trying to get off it and agreed with the decision so maybe she could help? IF ANYTHING CAN HELP! Some people don't recover from the damage done by anti-depressants, right? Their little Serotonin receptors never grow back. Come on, neurons, I believe in you!

 

Sugar and caffeine will definitely aggravate your withdrawal symptoms. Antidepressants are stimulants and so are sugar and caffeine, so you're just adding to your pain by consuming a lot of both.

 

I'm really not sure what you mean by "isn't enough enough?" Three weeks of discomfort in withdrawal is nothing compared to what lots of people have to endure - years in many cases. As for your doctor, she's likely just going to tell you to increase your dose of Effexor or give you a script for a different antidepressant. THERE IS NO CURE FOR ANTIDEPRESSANT DISCONTINUATION SYNDROME except time and patience. There is no quick and easy fix. The only thing that helps is tapering very gradually, listening to your body as you go, and adjusting the dose accordingly. Insisting that this shouldn't be happening to you doesn't help a thing. It is happening to you and it's smart to do the best you can and move on.

 

I don't know where you got the idea that some people don't recover from antidepressant damage. There is absolutely no proof of that anywhere that I've read. You might want to take a look at the article excerpt that Basildev posted for a really good explanation of how recovery takes place:

 

The Windows and Waves Pattern of Recovery

 

At this point, I'm not clear on the dose of Effexor you're taking. Are you still at 75 mg.?

[peggy]

Hi Finn,

 

Effexor can be really difficult to get off, but it is possible, especially seeing you haven't been on very long. One thing that helped me when i was having difficulty at one point was to record my symptoms once a day and then try not to focus on them for the rest of the day. Even when we are feeling well our physical self goes through many feelings through out the day, but they tend to be in the background and we don't focus on them unless they are particularly intense - i think we just get a bit too focussed and obsessed when we are in withdrawal.

 

Self care is very important, especially for you as you have had many episodes of depression. You need to do the hard work in your withdrawal - it's not just a matter of waiting for the drug to work its way out - you still need to address the reasons why you have had so many depressions...

 

* Reduce your caffeine and sugar - I love my morning coffee, but i keep it to one a day.

* Sugar is something that we should ALL get rid of, empty calories that serve no purpose (unless you are a diabetic and you are having a hypoglycemic attack)

* Exercise at least 4 times a week

* Practice good sleep hygiene to get the best rest you can

* Have a nutritious diet that covers all your food groups

* Nurture positive relationships

* Start a regular meditation practice

* Stay OUT of family dramas - talk to your psychiatrist about ways to develop healthy boundaries.

 

I am sure you can add many things to this list -

[Altostrata]

Definitely taper off the caffeine and sugar.

 

And what else peggy said.

[Finn]

I say enough is enough because I have a constant excruciating headache. I can only take so much aspirin and Tylenol, but it is impossible to do anything without at least some relief from the pain.

[Altostrata]

Caffeine could be adding to that, and sugar does no one any good.

[Finn]

So, the headaches has lessen for the most part so I'm going to try to reduce again--by the recommended 10%.

 

I was at 75mg, which was one pill, but while taking apart the capsules, I've noticed that the beads inside the 37.5mg capsules are bigger than the beads inside the 75mg capsules so it is much easier to work with the 37.5mg capsules even though 10% of 75 is closer to 75 than 37.5. I only have one refill and a few pills so I'll have to call and ask for more from my doctor. Although she may find this odd because remember, I'm supposed to be taking 75mg for two weeks and then 37.5mg for two weeks...Uh huh.

 

But seriously, here's my dosing logic:

 

Starting dose: 75mg, 75mg capsule

10% Reduction= 67.5mg, reduction of 7.5mg

37.5mg stays the same, 37.5mg-7.5mg= 30mg (30/37.5=.8, so 80% of total pill weight)

36 beads in 37.mg pill, reduced by 80% = 29 beads, so one whole 37.5mg cap. and 29 beads from another cap.

 

I am trying to reduce caffeine because it is making me jittery in an unpleasant way, and I'm still using half an antihistamine tablet at night. I don't if I need it to sleep, but I stay asleep at night--as opposed to waking up with a headache at 3am. The headache medicine I was taking when it was really bad actually had caffeine in it, but if it isn't as awful, I can use ibuprofen

[Altostrata]

If I were you, I'd stick with the 75mg capsules so your bead-counting remains consistent.

[Finn]

For it to remain consistent, I'd have to stick with the 37.5mg capsules since I've always used those. Sorry if I wasn't clear!

 

So, the headaches are here despite the 10% decrease. They seem to be worse in the morning and at night. There's no dizziness and minimal (like really infrequently) brain shocks so it is definitely an improvement.

[Altostrata]

Okay, 37.5mg capsules it is.

 

Give it some time, symptoms will take some time to stabilize.

[Finn]

Ugh, so I refilled the prescription for the 37.5mg capsules, and I got a different generic (it was TEVA, now AUROBINO). This capsule was more than beads, making it much more difficult to count. I should probably just get a scale for better accuracy.

[Altostrata]

You can request a specific generic. Still, you're going to have some variation in the number of beads from capsule to capsule.

 

You may want to get a scale, or you may want to switch to micro-tapering one bead at a time. See

 

http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

Tapering Effexor

[Finn]

I had no idea you could request certain generics!

 

I ordered the scale. I don't trust the consistency and accuracy of my counting, and I want to do what I can to maybe lessen the headache. Next time I decrease dose, I might try 5% to see if it helps.

[flower]

Finn would you let me know how the scales work out for you..I'd like to get a set ..

[Finn]

Sure, I ordered it on Amazon though so it might take a bit of time to get here.

[Finn]

I've noticed that the headaches are way worse in the morning/early afternoon and evening. When I wake up, it hurts and at around 8/9pm, but at say 5pm, it is fine. Could it be the way I'm metabolizing the drug, like it doesn't hurt when the level is highest in my blood, but when it decreases, the pain comes back?

 

The other thing is I get these weird moments where everything seems surreal for a spilt second. I got it when I was starting Effexor too.

[Rhiannon]

That thing where everything seems surreal is called derealization. It's a not uncommon side effect of psych drugs and withdrawal.

[Altostrata]

When are you taking Effexor?

 

Do the headaches pattern with when you're taking any other medications or supplements?

[Finn]

I take it early in the day, before noon usually. I take supplements with food, and there isn't really a set time when I take any one of them. Do you think it is worth it to try to isolate one that might be causing the headache? It could also be hormonal, I guess since I know my reproductive hormones are not normal. I've been assuming it is Effexor because the headaches started with it (and first the other ad I was on) and worsen when I changed dose. I had a CT scan last year because I told a doctor about my headaches, which made them worry, and it was normal.

[Altostrata]

You've had these headaches continuously since you've been taking Effexor? Or was it since you cold-turkeyed Zoloft?

 

When do you take NAC?

[Finn]

You've had these headaches continuously since you've been taking Effexor? Or was it since you cold-turkeyed Zoloft?

 

When do you take NAC?

 

I did get headaches when I started and stopped Zoloft, but they weren't this bad. The worst came during the first month of Effexor, then after that while I was on 112.5, they were only intermittent. The headaches have been bad and constant since the first time I tried to get lower Effexor dose. I shouldn't be too surprised that it hurts now; when I was going up in Effexor, my brain felt weird and hurt too.

 

I usually take NAC in the morning and at night, but I am not always consistent, like sometimes I'll take it only in the am or the pm. Yesterday, I took it in the morning, but I didn't get a headache in the evening so I don't think it is causing it. Could taking NAC and then not taking it cause headaches? Is there a long-term negative to NAC? I read somewhere that it can actually cause oxidation damage in high dose over time? Aren't I taking it to prevent that? Urgh, I'm confused and worried that I'm actually hurting myself now. Should I have a schedule that I stick to of when I take supplements?

 

Today the pain is different. It's like a burning, stabbing pain that shoots through my head--but is also like a tenderness in the top back of my head. Usually, it is a dull pain pervasive through-out or focused in the front of my head. What is happening to my brain?

 

I used the scale for the first time today, and my bead counting was pretty accurate.

[Altostrata]

Keep notes on paper about your symptoms and when you take your drugs and supplements. Try to stay on a regular schedule so you can tell what's causing what.

[Finn]

In what to me seems like a shocking turn of events, I haven't had a headache in a few days. I've noticed some depressed feelings, though, but they responded to more positive thoughts. When I made a large decrease, it took the headaches around five weeks to decrease. At 10%, it was two weeks for them to lessen.

 

Tomorrow I might try going down again, by 5%. I'm at 67.5mg so that would be 64.13mg.

[Narcissus]

Glad the headaches have let up.

 

While withdrawing from Effexor I've had a more or less continuous head-ache, and it shifts in terms of the areas of my head that are affected and the sensations that are produced. I never used to have head aches. Sounds like you're experiencing something similar.

[Finn]

^ Very similar

 

I'm at 64mg now. Weirdly, no bad headaches yet, maybe restlessness, though, but I'm not sure if I can ever blame Effexor completely. I get really anxious when my mother is upset, and she's been on edge so I'm anxious from that. I know I was told to avoid family drama, but when there's someone who is either constantly yelling at you, saying you're not doing enough/ being disrespectful or demanding reassurance on everything, it is hard to separate yourself...

[Finn]

And I have felt really weird most of the day, like I started off restless when I posted earlier. That gave way to a feeling like my mind is blank and sluggish and derealization. I'm like second-guessing everything. I feel weird but I know nothing is really weird, if that makes any sense.

[Rhiannon]

Yep, sounds like withdrawal to me...Fun, fun, fun.

[Finn]

So, I was minding my own business this morning, and my endocrinologist called to inform me that my blood test from Monday showed slightly abnormal liver enzymes. I take Metformin so I have liver tests regularly to ensure it is functioning properly. In the past, they have all been fine, and I have taken Metformin since for four years. Yes, Metformin could affect the liver, but I'm young so that doesn't make sense. Has anyone had or heard about Effexor damaging the liver? Could the combination of Metformin and Effexor put extra strain on the liver? This is upsetting to me 1. because OMG, MY LIVER and 2. I don't want them to disallow me to take Metformin because unlike Effexor, I need it to stop my blood sugar from skyrocketing and crashing. Also, I don't drink, and none of the supplements should cause this (NAC does the opposite!).

 

http://www.livestrong.com/article/33128-liver-side-effects-effexor-xr/

[Altostrata]

If Effexor is reacting with or has reacted with other drugs you've taken, this can affect liver enzymes. You should let your endocrinologist know about this.

 

Also see this Drug Interactions Checker

[mammaP]

Hi Finn,

I had an abnormal liver function test after starting Effexor.

That was followed by more tests but all seemed fine.

The same happened again, and again. Each time the lab

recommended further investigation but in the end the gp

just said "oh that's nothing, it's normal for you"

No-one ever suggested that meds were the cause but I

always suspected the effexor.

Apparently I have raised liver enzymes in my blood

but it isn't a problem. Story of my life!

I just read a patient information leaflet and it says that 'slight

changes in blood levels of liver enzymes' are unknown because

frequency cannot be estimated from available data.

Hope all is ok for you.

[Narcissus]

Finn, try not to interpret so much. What you're describing is withdrawal, plain and simple. The best you can do is accept and allow yourself to feel what's happening to you, eventually it will stop. Interpreting what's happening can be a form of resistance. Besides, there's really very little to interpret. I say all this because I'm extremely analytical myself, and during flare-ups I always end up trapped in these horrible heated labyrinths of hellish introspection. The pain of withdrawal is a dead end, it leads nowhere except back to a drug pounded nervous system trying to readjust itself. Understanding this, it's often best not to hop on the analysis train.

 

Hope things are okay on your end. Hang in there.

[Finn]

Accept that...this is how I feel right now and while I am as I would like to be, I can get there one day...I'm going to take up mindfulness and meditation and be more assertive with myself. I literally take every little feeling and thing and turn it into something of life determining consequence...I'm an analyzer and a rationalizer

 

Thanks again, friends.

[Finn]

I feel pretty rotten- in a fog, nauseous, headachy. I'm probably pushing too hard, go down too quickly (5% every couple of days), but after I got the news that my liver function is abnormal, suffering might be better than having the Effexor inflame it further.

[Finn]

I feel brain dead, like a zombie, maybe.

[Altostrata]

How often are you making decreases? You may need a hold right now.

[Finn]

Every few days I've been decreasing.

 

I am having a lot of trouble concentrating on anything. It's like things are just passing right through my mind with little retention. Is that withdrawal?

[Rhiannon]

How often are you making decreases? You may need a hold right now.

 

That's what it sounds like to me, time for a good long hold to allow things to stabilize and settle down. It sounds like you've been tapering very fast. From reading your recent posts it sounds to me like things are ramping up (which is not surprising), and even if you hold now, there's a lag time too, so it sounds like you may need to really just stop cutting and give your brain's healing enough time to catch up with the cuts you have made so far.

 

It's a constant balancing act between your concerns about toxicity and your liver, and the need of your brain for time to heal. I go through that too. If I were experiencing what you're experiencing, I would hold at current levels of the drug for a few weeks unless my doctor felt that my liver enzymes were so high I was in danger of liver failure in the near future. (I don't know your levels so I don't know how critical your situation is.)

 

It's not ideal, but you just have to do the balancing act. At least that's how I see it.

 

Oh, and: All the symptoms you describe in your posts sound exactly like withdrawal to me.