DrugSlave: tapering Effexor

[DrugSlave]

I updosed to 37.5mg. I did weekly increments of 0.3, then 0.6, then 0.9 for several weeks. Then an increment of 1.5mg for 5 days and finally another increment of 1.5mg to 37.5mg. No change in symptoms yet.

 

Given my history, how long should I hold at 37.5mg? I have been at 37.5 or less for 15 months and I still have life changing chronic exhaustion. I work about 20 hours a week and spend the rest of the time in bed or the couch. I socialize and exercise less than 10% of what I used to. I am existing, not living.

 

I have given up on the idea of getting off Effexor. I just want to stabilize at a low dose. I felt much better when I was on 150mg.  I’m thinking about staying at 37.5mg for 2 months and then updosing again if I don’t get any relief. Eventually I want to stay at a full capsule, either 37.5mg or 75mg because I don’t want to count beads for the next 40 years of my life.

 

thanks everybody! 

 

p.s. I had a lot of trouble updating my signature. I kept getting an error saying I exceeded 750 characters even when I decreased the signature character count to fewer than what it was before. It wouldn't let me save more than 11 rows even when it was less than 300 characters.

[Lexy]

Fatigue is one of my main symptoms along with body aches too. I'm only 19yr old and my body feels so much older.

I am starting to increase the fish oils and mag.

 

I also ran into trouble with the sig line.

[cymbaltawithdrawal5600]

about the sigs: I think they can now only be 12 lines period. And if I am not mistaken, spaces and blank lines count toward the character limit. It was changed somewhere around the beginning of the year, I think. See the 'read this first' section of the forum for the topic, scroll up from the last post.

[DrugSlave]

Thanks for the repies. Ok, I read the topic on the new signature rules.

 

Boy I'm tired. Got out of bed at 2...didn't make it to work....I might try magnesium.....

 

Man I hope I can stabilize on 37.5mg but I'm not too hopeful....even after being on 37.5 or less for over a year I am going to increase all the way up to 75mg again if that's what it takes to get relief from this fatigue...

[bubble]

hello DS,

 

been reading a few of your last posts. I've also had dreadful problems with fatigue lately. That has become the most pronounced symptom. But I actually found it to be a welcome change from anxiety. I agree it's not living but existing, yet, it was a kind of painless existence.

 

I have no idea what would help. In my case I think it could be explained with a high dose of Xanax that I'm trying to taper.

 

Honestly I don't see how increasing would help... hope it gets better!

[DrugSlave]

Bubble said: "Honestly I don't see how increasing would help... hope it gets better!"

 

Thanks for the reply Bubble. You caught me off guard with that comment. Perhaps you are correct. I saw your post where you quote ‘Rhi’ and talk about the benefits of holding and stabilizing.

 

However, I have heard stories of other people updosing and finding relief. Though in my case it could be different since I've been at 37.5mg or lower for 15 months now. I felt much better when I was on 150mg than now at 37.5mg. Last year I held at 30mg for 4 months and then dropped to 27mg and held for another 7 months and didn't get any relief at all. But maybe I should just stick with 37.5mg and maybe I will feel better in a reasonable amount of time, who knows. I guess I would eventually get better if I stayed on 37.5 but do I want to wait 5 years? Would updosing give me relief faster?

 

I really need a break. I experienced mild fatigue for the first 9 years I was on Effexor. Then I started withdrawing. The first 6 or 7 months was fine. I didn't feel any worse until I got to 75mg. Does my system want a dosage between 94mg and 37.5mg or just stability?

 

Since I no longer plan on getting off Effexor completely, long term I would be better off on 37.5mg than 75mg. If I do decide to updose further, I would stop and hold if I felt any relief in the fatigue. If I felt good again, I would then either slowly taper back down to 37.5 or updose to 75mg depending on the dosage.

 

Perhaps, the question should be:

 

Should I hold at 37.5mg indefinitely or should I wait for a couple of months (or more) and if I don’t see a reduction in symptoms, then updose? 

[Altostrata]

What part of the world are you in, DS?

[DrugSlave]

Ottawa, Ontario, Canada

[bubble]

Just an idea: when was the last time you checked your physical health and physical parameters that can cause fatigue? I don't know, liver tests, thyroid? 

[DrugSlave]

I have done those tests recently...thankyou

[Petunia]

DS, are the only symptoms you are experiencing fatigue, tiredness and lack of motivation to socialize? (probably due to being tired).

 

My guess is that if you stayed at 37.5 long enough, you would eventually start to feel better and get more energy, how long it would take I don't know.  If you decide to continue with your plan to keep increasing until you find relief, stick with the small amounts and long holds so you can avoid increasing symptoms.

 

But I just read back through much of your thread and I'm confused.  You went on effexor for pain and from what I read, it seems that effexor caused the symptoms which are bothering you the most now, and yet you are updosing?

 

The way I understand your situation, and I might be wrong, is that the effexor helped somewhat to reduce your pain, but caused fatigue which in turn made you lack the energy to socialize and do other things.  So, you started to taper - probably too fast and that cause additional symptoms, leading to general nervous system destabilization. 

 

Now you are slowly updosing, but I can't figure out why.  If you are updosing in the hope of increasing your energy levels, I don't think that will work because effexor caused that problem right from the start.  If you are updosing to try and relieve other symptoms which you haven't mentioned recently, I think they would have been caused by destabilization from previous too fast tapering and in that case, holding would probably be more helpful, even if it takes a long time.

 

What symptoms are you having at the moment?

 

It might help to read back through your thread from the beginning.

 

Petu.

[DrugSlave]

Petu said: "But I just read back through much of your thread and I'm confused.  You went on effexor for pain and from what I read, it seems that effexor caused the symptoms which are bothering you the most now, and yet you are updosing?"

 

Thanks Petu. I’m a little embarrassed to say…..I didn’t really think of it that way….I guess I'm feeling desperate for relief as soon as possible. I felt more tired as soon as I started taking Effexor back in 2003. The withdrawal has made it much worse. I felt much better at 150mg than I do now. I held at 27mg for 7 months with no relief. I decided to try an increase to 37.5mg to see if that would help. I guess out of desperation I started to think, screw it, if I don’t feel better at 37.5mg I will continue increasing. Withdrawal appears to be caused by a combination of reduced medication in your system and destabilization. Maybe I’m giving too much weight to the dosage and should be giving more concern to stabilizing.

 

My 3 symptoms are: Fatigue (by far the worst symptom), lack of desire to socialize, aversion to alcohol

 

I used to have an active life doing lots of different things including sports and socializing. Now I do very little.

 

I have changed my thinking in the last few days. I’m starting to think that holding at 37.5mg for a long time is the way to go. The dose will be more precise at a full capsule and I’ll just have to wait until the withdrawal symptoms subside. Updosing is too risky and not a good option long term. In fact, I might even stay on this dosage for the rest of my life.

 

Thanks so much to all you guys for helping me to sort this out. You guys rock!

[Altostrata]

Thanks, DrugSlave. Please let us know how you're doing.

 

Quite frequently, people find they cannot drink alcohol while taking an antidepressant. You may have to let that go.

[DrugSlave]

For the first 10 years I was on Effexor I could drink beer no problem. It has only been the last year and a half since I've been experiencing withdrawal symptoms that I haven't been able to consume alcohol. I am hoping to drink beer again once these symptoms fade.

[Skyler]

For the first 10 years I was on Effexor I could drink beer no problem. It has only been the last year and a half since I've been experiencing withdrawal symptoms that I haven't been able to consume alcohol. I am hoping to drink beer again once these symptoms fade.

Lot of folks in that boat here. I can't drink.. well, once a month I sneak a beer, and I mean ONE beer, albeit one tall and stiff micro brew. I have tinnitus, and like with alot of other WD Sx, alcohol makes mine worse. Sad, but unfortunately true. I had a very stressful day, and really wanted to stop for a brew, but I'm really making headway with tapering of late.. doing well, but the tinnitus is starting to ramp up.. so it was make a cut this WE (I think), or hold for a few rather miserable days extra due to the beer. The taper won. -(

[bubble]

I think this realisation of yours is very important: Maybe I’m giving too much weight to the dosage and should be giving more concern to stabilizing.

 

Many of us have found it life-changing. It doesn't mean you will have to stay on this for the rest of your life. On the contrary, I think that now your chances of getting off completely have increased dramatically. When we stop focusing on dosages and symptoms and especially stop trying 'fixing' a symptom by changing the medication, things start moving forward. I hope you experience the fruits of such approach soon.

 

good luck!

[DrugSlave]

Thanks again Bubble. You and Petu helped to convince me. Actually back at Xmas time when I first started updosing, I had no intention of going higher than 37.5mg. I'm kind of relieved now. If I stay on this dosage forever, it's the smallest full capsule available, so it makes sense that way. However, if I really stabilize and feel much better down the road, there is a small chance I might try a very slow taper. But it definitely won't be anytime soon. Good luck with your tapering!

 

Skyler, sorry to hear about your tinnitus. Congrats on getting off Benzo. I really miss having a few beers with the boys. Someday....

[DrugSlave]

I'm not improving. I read the "windows and waves pattern of recovery" topic. I get windows and waves but there is no overall improvement over time. In January 2013 and May 2013 I had acute withdrawal symptoms after decreasing the dosage. It took 6 to 10 weeks for the acute withdrawal symptoms to go away - head and eye symptoms, crying spells, depression, etc. Since then I've been in protracted withdrawal. Zero improvement over time. In fact, it might even be a wee bit worse.

 

I've had blood tests for thyroid and liver problems and they all came back negative.

 

Shouldn't I be seeing slight improvement over time? This is worrisome.

 

Symptoms: chronic fatigue (worst symptom), feel unwell, lack of sociability, aversion to alcohol

[DrugSlave]

Are there other people out there who are not improving? Has anyone experienced a long plateau in recovery and then started to get better? I thought I would see some improvement from a 7 month hold. I thought I would improve after updosing. I guess I'm in for the long haul....

 

best wishes to everyone!

[Petunia]

Hi DrugSlave,

I'm probably not the best person to be answering your post, because I also feel like I'm not seeing much improvement, maybe others will be able to share more hopeful stories, but I do have something which may help.

 

I often feel like I'm just as bad as I was at first and can't see any improvement, but when I really think about it and read back through my journal, I can see that my symptoms were a lot worse in the beginning and that I'm able to do a little more now.  Its so difficult when our lives are not the way we want them to be and nothing but time and waiting seems to be all we can do.  But people do recover, there is a new recovery story in the success section, Clare came back after 3 years and shared her story here:

 

http://survivingantidepressants.org/index.php?/topic/6106-clare-i-survived-hell-after-withdrawing-from-effexor/

 

I know there are others here who have had to hold for a long time after an updose, but then started to improve.

 

Petu.

[Lexy]

Drugslave

 

Thats exactly how I feel.

 

I started on this crap on Aug of 2012.  Updosed to 150mg made me feel worse and chose to cut my dose in half after 6 weeks.  

Since late Oct of 2012 my life has been taken over by this drug.  I haven't had one good day since Aug 2012.  

 

I feel for everyone whose been on this  drug for so long.  

 

Recently I switched from immediate release to extended release.  I actually am doing 28.5mg on XR and 13.5mg on immediate release.  I felt I had to do something because the headaches, vertigo, and nausea were nonstop.  Now incorporating the XR, I am getting mood swings and crying spells.  I don't know which is worse.  All I can say is that vertigo was 24/7 and mood swings last hours, it can even skip a day, however when they do come it is very dark and sad.  

 

Chronic fatigue and body aches is an everyday thing, but I would be content if it were just that.

 

I know the 50% cut in the beginning was huge, but the doc never warned me.  And when i could barely get out of bed i started tapering about 10%.  I should have gone much slower, maybe i wouldnt be in this hell hole.

 

I know someone who got off this drug within 3 months from 112.5mg and she's been having mood swings also.  I just wonder if prolonging this may not be any easier than tapering.

Sorry I cant help, at least you know YOU are not the only one.  You are not alone.

[DrugSlave]

Petu - thanks for the email. I did see that success story from Clare. Fantastic. I'm sorry to hear that you are not seeing much improvement. I did a 4 month hold and a 7 month hold with no overall improvement (except for the acute withdrawal symptoms). Although I know many people are much worse off than I am, I find it disconcerting that others find they are improving over time and I have not. Nothing.  I guess I can't expect relief this soon after I updosed. I plan to stay at 37.5 for a long time so hopefully I will start to improve.

 

Lexy - wow, I can't believe the Effexor had such strong withdrawals for you even though you were only on it for only 2 months. What scary poison we are dealing with.

 

"I just wonder if prolonging this may not be any easier than tapering." - I wish we knew the answer to that. It seems to make sense to stabilize before continuing with tapering. However, holding didn't give me any relief in the past. I would think that if I kept tapering right now it would prolong the suffering.

 

I read some of your intro thread. I hope you are able to figure out the XR vs immediate release dilemma you are having. I have always taken XR so I don't have any experience with immediate release, but I would think that you would be better off when you are able to stick with one of them. Changing your meds all the time causes destabilization. thanks for the email...best of luck....

[DrugSlave]

My head feels so weird today. Exhausted, discouraged. It is so difficult to stop letting withdrawal rule your life. I feel so crappy all the time I can't help but think about it constantly......Why do I feel this way today? Why am I worse than yesterday? When is it going to stop? Should I be doing something else? etc. etc.

 

I guess it's part of being human. I don't find it helpful though. I think we are constantly trying to "fight it". I would like to just accept it and move on. Just live everyday accepting the illness, live in the moment and try to enjoy life. But I can't. I can't stop thinking about it and questioning every aspect of it. It is so overwhelming. When anyone asks me "How are you?" or "what's going on?" or "how was your weekend?". I can't think of anything else. "Ummmm, well I slept 16 hours yesterday and saw lots of TV, I looked outside once I think.....how was your weekend?".......ugh

 

I'm not improving and I find that really hard to accept. I guess I will feel better again someday but it's hard to see it now. What I want to do is just take my pill each day at the same time and forget about it. Just live.

[Annabel]

Hi Drugslave,

Sorry you are feeling so despondent and discouraged. 7 months is a long time!!

I wonder if it would be helpful to make a kinda plan of how you can do one thing a day to try and take care of yourself,like going for a walk and making a point of noticing the day, the trees, the sky and how the world is out there.

Recently Nadia started a topic in "Symptoms and self care" called The importance of feeling good! There are some great suggestions of how to manage ourselves while we are all trying to get through our "drug journey". Lots of simple things are on the list!! Best wishes and I hope you have some better days!   

[DrugSlave]

Thanks Annabel, the longer this takes to stabilize the more convinced I am that I will be on Effexor for the rest of my life. Imagine how long it would take me to taper the rest of the way and then recover if I can't even stabilize after all this time! Frig that.

 

Thanks for your suggestion on reading the topic in self care. I'll check it out.

 

Peace

[Petunia]

Hi DS,

 

I'm sorry you are having a bad day, I can certainly understand your frustration, you are not alone in feeling this way, we have to do the best we can to get through this difficult process, taking each day as it comes.

 

Hang in there.

Petu.

[DrugSlave]

Thanks Petu, you are the best! 

 

I did read Nadia's post in symptoms and self care about the importance of feeling good. Yea, maybe I do need to connect to nature more and stuff like that. I do like hiking and we have a small garden. Also, that article about how social isolation can be the number one risk factor in disease was interesting. I am absolutely socially isolated. I socialize very little compared to my life in the past. Paradoxically, I don't feel lonely because I don't feel well and I don't feel like socializing. I WISH I felt better and FELT like socializing but I don't. So I feel socially isolated, but not lonely. Anyway, it can't be good.

 

I've been pretty depressed over the last month. I think it is circumstantial depression rather than withdrawal, however I could be wrong. I finished updosing 7 weeks ago but I don't think it was related to that because I didn't have any flareups or new symptoms. 5 weeks ago my mood was much better. I think it may have started when I read the "Windows and Waves" post that describes how after all the ups and downs, over time people feel better. I am NOT feeling better over time. This worries me but I do think I will eventually feel better.

[DrugSlave]

I have a new problem to add to my stress. Management at work is giving me a hard time. I've been working sporadic hours. I call in late almost everyday and I miss 1 to 3 days per week. I average about 50% of my normal full-time hours. I explained to my doctor and to management that I am exhausted and don't feel well. The mornings are the worst, and I usually feel better as the day progresses. So, I told them I have good days and bad days and my energy levels and overall health changes hourly. 

 

Anyway, my supervisor and the manager who are friends of mine are supportive though sometimes in misguided ways. They basically gave me 2 choices: work a fixed, part-time schedule with the possibility of working from home on a laptop if I don't feel I can make it to work or go off work completely and apply for disability. They both want me to leave work and apply for disability. The manager is acting bizarre. I don't know if she is confused and doesn't know how to handle it but she is being hard on me. She said she is concerned about the other members of my team and how they are seeing me suffer. Gee thanks. Sorry for being so selfish that I want to work through my illness and expose others to my misery. Also, it is unclear whether they will approve the part-time work scenario....it was fuzzy....either way I have to go back to my doctor...

 

Disability insurance has already turned me down. I applied telling them I am still working part-time but want my salary topped up. They said they don't normally do that, disability is meant for people who are off work. Plus they said I need to medically prove the withdrawal is causing me to miss work and they said I might have missed some deadlines. (the disability form says you need to apply within 8 weeks of getting sick...I applied a year later after my sick leave ran out).

 

1. Should I fight through it and work? I don't feel all that welcome anymore, but screw it. I will be get some social interaction, feel good about accomplishing something, being out in the world and I won't have to worry about fighting with disability.

 

2. Stay home? Yes I can work on myself, but I would be even MORE socially isolated. Plus I would have to re-apply with disability insurance and fight those weasels for compensation. Plus if I get turned down over and over, there will be stress over having no income. We are probably ok for 6 months and then we would have to borrow money or something. But maybe it would be good for me, not sure. I could bike, work on the garden, etc. I would have to force myself to socialize more with friends/family. Maybe my GP could send me to a psychiatrist who could fill out the disability forms for mainly depression rather than withdrawal. That might be easier to get approved.

[Altostrata]

You are in a difficult position. I was in a similar situation.

 

Most jobs are not set up for sporadic workers. If you cannot do the work, you need to think of reducing your hours.

 

Your manager no doubt feels she is in a very awkward situation and is behaving awkwardly.

 

If I were you, I'd take the offer of part-time work.

[DrugSlave]

Thanks Alto, I am curious why you like the part-time offer better?

 

Of course, things could go sideways for either scenario. It's really unpredictable how I'm going to feel. Working and taking a rest every other day doesn't guarantee anything. I guess if I can work from home it will increase my availability. I can work a bit, take a break, etc. Sometimes if I push myself too much though, I pay for it later.

 

For the disability option, I worry that if I go see a psychiatrist and ask him to help me with the disability claim, he may suggest that I bridge with Prozac and taper off Effexor by taking a pill every second day and be off completely in a month. Knowing what I do now, I would never agree to such a ridiculous plan but what if he tells disability that I'm not complying with the suggested treatment? I could just stick with my family doctor, but his word would not carry as weight as a specialist's would for a disability claim.

[Altostrata]

I like the part-time offer better because

 

1) Weren't you already turned down for disability?

 

2) Keeping busy part-time at your job will help you heal.

 

3) You have a chance to go back full-time when you feel better.

 

4) Arguing to keep a full-time job when you clearly cannot put in the hours will make you look bad and damage your reputation at work.

[DrugSlave]

Thanks again Alto, I really appreciate you taking the time. "Keeping busy part-time at your job will help you heal." - I think you are right about that....

 

I discussed it with a friend of mine from work and my wife. I'm going to see my doctor and ask that he recommend that I go back part-time. I'll ask to work from home when I don't feel well enough to go in to work. Hopefully it will work out but if it doesn't, I can also reassess in the future and consider leaving work and re-applying for disability.

 

I'll have to push myself more at times, but I'll have time off in between work days to recover. Plus I'll have 2 workdays a week off where I don't have to feel guilty about missing work and I can work on my recovery instead. The weather is getting better, I can go biking on good days and stuff like that....

 

cheers

[bubble]

Hello DrugSlave,

 

I've read a few of your last posts with great interests because I'm also struggling with medication and work.

 

I have to say that I envy you in a way since in my country I don't have any of the options you have ;( And those that we have I don't dare exploiting because they would turn me into a permanent social outcast.

 

My boss and colleagues at work don't know about my problems. Or they do have an idea but only because when I was on a sick leave they saw a code which said acute stress reaction. I think the law doesn't allow me any flexible forms of working: flexitime, working from home, working part-time. Maybe I could inquire about that but to get it I would have to pathologise myself so badly that I would on the other side get stigmatised as a psycho, a nervous wreck or something like that. So I prefer nobody knowing about my struggle. 

 

Also we have only permanent disability status which you can only acquire if you are totally disintegrated person which you prove by spending months on end in hospital without the possibility to be "cured". 

 

I hope it doesn't come across like "you don't know how lucky you are" but I just couldn't help comparing our situations.

 

As you say, pushing myself to be at the office every day, stalls my healing and makes things hard for me. After having a bad night, I finally calm down towards morning and fall asleep only to be awaken by the alarm clock to stagger to work.

 

But I have no other option: it's work or no work. I've been working like this literally forever. I even studied on and off meds. But I could never afford myself not to work so had to do it. Actually the reason I'm on meds is so that I could be functional enough to work.

 

As you and Alto say, I began to recognise that having a structure in the way of work was at the same very important for my recovery. Interaction with other people taught me new skills, stopped my negative thinking, I proved to myself that I can accomplish things even when I would feel absolutely useless, etc. In balance, it's been more of a positive than a negative factor. I also learnt that I had to demonstrate a better self-care, learn how to deal with stress, lower my self-expectations...

 

 

Part time sounds a great thing to me too. 

 

(Sorry to contradict you but I don't think you will feel like this for long time still, let alone forever I felt like Humpty Dumpty many times before but would again feel alive like never before after such episodes. It's good to try and focus on one day at a time instead of projecting our present anguish into the future...).

 

I look forward to reading about your progress and I'm glad you read that thread with great tips on little things that can make a big difference.

 

best,

bubble

[Altostrata]

I think it's great DS has a work environment so supportive his managers offered the option of part-time work. I say yes.

[Lexy]

drugslave

 

How are you today??  I know exactly what you mean about not improving.  I know I switched from immediate to XR and that alone will take time to stabilize however, I had been on immediate and micro tapering for such a long time that I felt  I had to do something.

 

I have a different living situation in that I am in college and taking few classes…I also recommend that you change to part time.  It seems thats a good all around decision for your emplloyers and and yourself.  We need to have some semblance of normal life ie., social contact, work or school.

I am here for you.

[DrugSlave]

Hi Bubble, thanks for the email. I thought Europe would be more progressive on work disability issues. I guess it depends on the country. Yes, we are lucky in Canada although our current government is slowly chipping away at worker's rights among other things. I can't believe they have a code for "acute stress reaction". Here, the doctor is not allowed to tell work what the health issue it. Just what the work restrictions are. It's a shame you have to suffer through forcing yourself to go to work like that. I'm taking at least 50% of time off as sick leave without pay. I got turned down for disability. Where I work, short-term disability covers the first 2 years of being off. It is very difficult to get but you can re-apply over and over until they give in sometimes. To get disability beyond 2 years, you have to be in a vegetative state with tubes sticking out of your nose. Even blind people or paraplegics get turned down.

 

Bubble said: "Sorry to contradict you but I don't think you will feel like this for long time still, let alone forever ;)". - I'm guessing you are getting that from my signature. I meant that I probably will be on 37.5mg forever. I do believe I will get better. I just don't plan to taper any further at this point. It's too difficult and debilitating. Yes you are right, it's best not to worry about the future.

 

I do plan to work on healing myself by using those tips and changing my thought patterns. The power of the mind should not be underestimated! (that is how I cured my chronic pain....using TMS therapy)

 

Best of luck with work Bubble!