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DrugSlave: Tapering Effexor

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DrugSlave
1 hour ago, Meimeiquest said:

I totally, totally agree with Alto’s theory of why withdrawal syndrome happens, but I think part of it is having a loss of resilience from other factors making the brain more vulnerable.  

Great observation. You very well could be right. Hmmmmm...I'm going to think about that...

 

I tried 5 or 6 different cpap-type machines and different masks as well. None of them worked for me. Your job sounds interesting.

 

I'll check out the brain website you mentioned.

 

Thanks for all your detailed replies and I wish you luck and good health Meimeiquest! 

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peng

I am not a medical person or mod, DrugSlave.  Could be a drug slave, though!

I am coming to the view, after a 2 year effexor taper that hit the buffers badly, that some of us* will probably be destined to fail withdrawal from effexor.

I am more negative, though, due to being 73 and having been on effexor since c2001.

In my particular case, I have concluded that my awful symptoms returning this summer are due to the "original depressive illness returning" and not due to withdrawal syndrome.  

See my thread's recent posts for more, if you wish.

Not meaning this post to be a downer on people's hopes, but merely a pointer for some to reexamine their previous history that brought about the original sudden descent into ill health, and trying to reduce an unending period of years of suffering for, possibly, taking the incorrect action with this notoriously difficult drug.

Best wishes.

 

* in my particular case, childhood/youth PTSD remap of brain and subsequent defensive thinking processes.

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DrugSlave

Meimeiquest, my wife and I have researched the retrainthebrain/Dnrs system. I've decided to go for it. I am going to buy the DVDs. I read on the site about creating new neural pathways to promote healing. I was familiar with all the science behind it. I've read a number of sources talking about that stuff for chronic fatigue and how the body is stuck in fight or flight mode. I tried Joe Dispenza's program of self healing. I read his book about the Placebo effect. The theory behind it is similar. It didn't work for me but I can see how it could work for others. 

 

I cured my chronic pain using TMS. It is also similar to the DNRS system in that it is about retraining your brain, changing your thought patterns, etc. I applied TMS techniques to my chronic fatigue/withdrawal symptoms but it didn't work. However, since I've had success in the past with retraining my brain, I think this is worth a shot.

 

Also, since my symptoms are not improving like in others, I suspect there is another element to my situation. Perhaps the withdrawal symptoms have been hard wired into my mindbody. It makes sense to me to attempt to rewire it.

 

Many thanks for the info

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DrugSlave

Peng, I read the last page of your intro thread. Sorry to hear of your suffering. I hope a Mod comments on your thread soon. Like I said in a previous post, I understand why you have changed your mind about continuing to taper considering your age. So do you think your symptoms are a combination of withdrawal and a relapse of your original illness? What questions do you have for the mods?

 

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DrugSlave

I did DNRS for two months. I didn't see any improvement. I stopped about a week ago. They say to do it everyday for 6 months. It is not easy to do...maybe I should keep at it but I'm losing faith it can help. I did it a little different than the way they teach it because I had to adjust it to work for me. 

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DrugSlave

So I have been holding for almost 6 months. I have not fully recovered from the latest cut. My baseline symptoms have not improved for 6 years. Now they are a little worse and I'm worried they might remain that way permanently.

 

Should I updose slightly? I'm not sure it would help after 6 months holding. I think the latest withdrawal was caused by cutting too fast over several drops and it caught up to me. Or, could it be that 23.5mg is too low for me?

 

In 2013, I held at 27mg for 7 months after experiencing acute  withdrawal. I recovered from the acute withdrawal after 6 to 10 weeks and returned to my baseline symptoms. I then slowly updosed up to 37.5mg but it did not help. This time is slightly different though because I haven't fully recovered from the acute withdrawal. 

 

Thanks

 

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ChessieCat

How have you been after your other reductions?

 

What type of Effexor are you taking?  I ask this because of the following:

 

Taper by cutting up regular venlafaxine tablets
Regular Effexor tablets come in 25mg, 37.5mg, 50mg, 75mg, and 100mg doses. Because it's half-life is so short, it is taken 2 or 3 times a day.

 

Have you seen this?

 

On 8/24/2016 at 3:49 AM, brassmonkey said:

Hi Wantrelief-- Thanks for dropping by.  I posted this to DesertChild yesterday where I talk about poopout, stabilization and WDnormal.  I gives a bit of my background.

 

"You call it withdrawal normal, as said above when you have reached a base-line which is as good as it gets for you. Now I guess, I can start to think about that. "

 

As good as it gets for that moment.  WDnormal is a sliding scale of reference for tracking overall improvements in ones condition. As you're learning this is a very slow process and at first changes in WDnormal are very small and slow in coming. As time passes and ones body heals those changes become more pronounced and more frequent. But it can be frustratingly slow at first.

 

I'll bore you with a bit of my history so you can see how I came up with the idea of WDnrmal.  Many people find the time frames upsetting but I truly advocate going very slowly.   I'm one of the "lucky ones" in that I have only been on one drug, all be it for 23 years now, which makes things a lot easier to sort out. I originally started on Paxil for Spontaneous Outbursts of Violent Anger and it really helped.  In reality I should have been through counseling instead of being drugged, but that's an irrelevant part of the story.  After many years on the drug it wasn't working as well so I updosed.  That helped sorta but a few years later I needed to updose again.  That helped for a few months, then I started down hill.  It took a number of years and becoming totally messed up to figure out I was in severe tolerance, or what we lovingly call "poopout".

 

Just making the decision to do something about it was a terrifying experience but after 18 years of being drugged, my marriage on the rocks and about to lose everything (probably even my life) I decided to do something about it.     Again I was lucky and found a site called PaxilProgress before I made any changes. That started the entire process.  I liked the idea of the 10% taper, but made a couple of modifications to make it gentler, and started with that.

 

Nothing happened. I felt as bad as I had been.  Six weeks passed and I did my second drop. Nothing happened, except maybe I felt a bit worse.  This pattern kept up for about 18 months.  When one day it hit me, "I hadn't felt as c***** for the past several weeks".  It took another six months before I again noticed that things had improved.  During this whole time all I could do was move doggedly forward making the best of it and learning to put up with and work around the symptoms.  I really had no other choice.

 

A little after two years I had my first widow.  It lasted about fifteen minutes, and it wasn't until several hours later I realized it had happened.  That was the point that it sunk in that the process really did work.  Except for that window the rest of the time was heavy brain fog, DR, no short term memory, dizziness, all the symptoms we know and loath.  Another window opened briefly a few months later, and I noticed that I wasn't as "out of it" all the time and that I was gaining a little control over the symptoms by Acknowledging them, Accepting them and letting them Float off as I went about my life.

 

Finally after three years of tapering I felt like I was making progress. I could see that I was improved from where I had started even though I knew I was by no means better.  I also could see that I was doing better that I was just six months before.  I realized that my "base line of feeling like c***" was improving or how my WD symptoms normally felt was improving.  Hence WDnormal.

 

These last two years, it will be a total of five this fall, have brought fairly steady improvement.  I can see improvements on a month over month and sometimes week over week basis.  To the point that many people would say I'm back to normal by the way I function.  I know I'm not because I am still taking the drug and will be for the next several months. During my time on and tapering off of paxil I have learned a huge amount about myself, life and how to deal with things.  

 

I feel like I'm rambling now, but I hope this helps explain some of the process and you don't find it too disheartening because of the time frames involved.

 

 

If everything has been the "same" for a long time, it might be time to make a reduction.  Sometimes a drug causes an issue which they are supposed to help.  You could do try a small reduction of maybe 1%, 2% or 2.5% and see how things go.

 

Have you seen this?  It's a gentler way of tapering.  the-brassmonkey-slide-method-of-micro-tapering

 

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DrugSlave

Thanks ChessieCat. After previous reductions in the last year I would get 1 to 4 days of new or worsening symptoms and then it would go away. I was making cuts every 4 weeks. I improved slightly for the first four months after the latest drop but not in the last two months.

 

I take Effexor XR. I am familiar with the brass monkey slide but the first time I read the above quote.

 

I wasn't expecting someone to suggest reducing again. I see that Brassmonkey got worse as he tapered and then started to feel better. But some ppl feel worse and worse the lower they get on Effexor. I have been working 3 afternoons a week for a few years now but in the last 5 months I've been working from home because of the increased symptoms. If I get any worse I might not be able to work at all.

 

Now maybe I was simply reducing too fast. If I go slower I might be ok. But I've had three episodes of acute withdrawal. Two of which I did not fully recover from. Other sufferers seem to improve over time. My baseline symptoms have not improved for almost six years.

 

Many thanks and peace to all :)

 

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ChessieCat
4 hours ago, DrugSlave said:

But I've had three episodes of acute withdrawal. Two of which I did not fully recover from.

 

You may be adding stress to your situation from anticipatory anxiety.  This is understandable.  Sometimes we recognise and acknowledge that we are scared to do something, but sometimes it is subconscious.

 

This is my personal opinion, if it was me, I'd be making a tiny reduction and see how things go.  You would need to try and be as calm about it as you possibly can so as not to confuse worry stress with withdrawal symptoms.  It could be that you have reached tolerance.  See:  tolerance-or-poop-out

 

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DrugSlave
3 hours ago, ChessieCat said:

 

You may be adding stress to your situation from anticipatory anxiety.  This is understandable.  Sometimes we recognise and acknowledge that we are scared to do something, but sometimes it is subconscious.

 

This is my personal opinion, if it was me, I'd be making a tiny reduction and see how things go.  You would need to try and be as calm about it as you possibly can so as not to confuse worry stress with withdrawal symptoms. 

 

You are a wise Cat, that is for sure. :)

Yes I am stressing out. I just did some yoga. Does a fella good.

Yes I could try a small reduction, try to relax, do yoga and take walks. A small reduction is unlikely to cause lasting negative effects. I've had a stressful year in addition to my withdrawal issues. Perhaps I can work on my state of mind to improve how I feel overall.

 

3 hours ago, ChessieCat said:

It could be that you have reached tolerance.  See:  tolerance-or-poop-out

 

I read some of the posts in the link. I may not be understanding correctly but I originally took Effexor for chronic pain not anxiety or depression. Is there a difference between "tolerance" and "tolerance withdrawal"? So tolerance or poopout means that the drug is no longer helping in the way it was initially. I don't think that applies in my case. I overcame the chronic pain using other means. I no longer need Effexor for therapeutic reasons though it messes with my mood. 

 

Thanks

 

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ChessieCat

Effexor is an SNRI.  It is an antidepressant.  In your case it has been used off-label.

 

Reaching tolerance means that the drug is no longer working the way it was meant to work, which is to treat depression.

 

The drug may actually be causing some of the issues you have.  Your Drug May Be Your Problem by Dr Peter Breggin.

 

It actually has a "proper" name Tachyphylaxis:  identification-and-treatment-of-antidepressant-tachyphylaxis

 

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DrugSlave

So, are you thinking that perhaps the reason I am not able to stabilize while holding is that I'm still taking Effexor? Others seems to improve over time while I am not. Could it be that I need to taper for several more years and completely get off Effexor in order to heal? In other words, the issue is not so much withdrawal from the drug, but the fact that it is still in my system.

 

 

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DrugSlave

Alto asked me a while ago to give my daily symptom pattern and I did but I'm not sure I did it right after reading posts from others. I'll try it again. If I'm still not doing it correctly please let me know.

 

My daily symptom pattern:

 

10am - I wake up at 10 everyday. I drag myself out of bed. I'm grumpy and barely functional for an hour. My wife let's me be because she knows I need this time to wake up.

 

10:10am - take 2000mg Fish Oil, Vitamin D

 

2pm - Often my symptoms improve after 2pm but not always.

 

Afternoon - I avoid naps if possible but on average one or two days a week I nap for about 3 hours; like in the morning, I need an hour to wake up afterwards

 

6:30pm - I take this wonderful pill called Effexor XR 23.5mg

 

8:30pm - I usually go to bed around 8:30pm. I lie in bed until 11 or so and then fall asleep.

 

The only time I am active is during the afternoons. One or two days a week I will have so little energy and feel so crappy that I do nothing all day except feed myself, brush my teeth and lay on the couch. Those days I usually spend 16 or 17 hours in bed over the 24 hour period.

 

On good days I am active for maybe 8 hours. My main symptoms are fatigue, unsocial, irritable, depressed (circumstantial I think).

 

thanks

 

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ChessieCat
5 hours ago, DrugSlave said:

So, are you thinking that perhaps the reason I am not able to stabilize while holding is that I'm still taking Effexor?

 

No, I think you may be confused about what stabilizing is.

 

When we take a psychiatric drug it introduces chemicals to the brain and the brain changes.  The brain is always trying to regain homeostasis, or level things out, so when we take a psychiatric drug that changes the chemicals in the brain, the brain's response is change things, or adapt to getting the drug.  When we take some or all of the drug away the brain starts trying to level things out.  This is what creates the withdrawal symptoms.  People have different options.  They can either hold at the dose (or not take any drug if they have stopped completely) and the brain, over time, will level out again.  If the symptoms are unbearable, taking a small amount of the drug (reinstatement) or a tiny bit more (updose) can give the brain a bit more of the drug it is used to getting and the brain doesn't have to level out as much.  A bit like the difference between a road with some minor bumps and a road with huge pot holes.  The period after is when a person is stabilising, or levelling out as their brain adapts and they get fewer and/or milder  withdrawal symptoms.

 

What may be happening in your case is that you are getting side effects, the drug may be causing the issues (as per Your Drug May Be Your Problem) and/or you have reached tolerance.  The reason I am making these assumptions is that you haven't changed your dose for 6 months and you have also been feeling the same way for a long time.

 

If you had been taking the drug for depression, then you might be thinking that what you are experiencing now is relapse of your original condition.  But because you weren't taking it for depression, it may be that the drug is causing you to feel the way you are.

 

You stated:

 

21 hours ago, DrugSlave said:

 

I no longer need Effexor for therapeutic reasons though it messes with my mood

 

 

I hope my explanations might help you to understand why I think trying a small reduction might be a good idea.  If you made a small reduction and things stayed the same /didn't worsen then you would know that you are going in the correct direction.  You might even feel a bit of improvement.  If things didn't get worse, you could then try a larger reduction amount.

 

Unfortunately the only way to know is to try it.  That is why I suggested a small reduction.

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ChessieCat
5 hours ago, DrugSlave said:

Could it be that I need to taper for several more years and completely get off Effexor in order to heal?

 

You don't have to be off the drug completely.  As you taper, the healing / adaptions happen as you go.  After getting off completely the brain will still need to make some more adaptations, but not as big as if you had stopped the drug at a higher dose.

 

I ended up on an AD after about 15 years of major life issues, so my depression was caused by external stresses.  If I had received counselling and been taught non drug techniques to help me cope, I most probably would not have "needed" an AD.  I have found that as my dose has got lower I have felt more like I did before ever taking an AD, and I have been on them for at least 25 years.  As my dose got lower I realised that I have been numbed for a long time.  I learned CBT 4 years ago and I use techniques that I have learned here on SA in the last 3 years.  Even though I am going through a very difficult time at the moment I am coping well using what I have learned, and my dose is now down to 5.5mg.

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DrugSlave

ChessieCat, I just read a bit of your intro thread. I hope things improve for you. It sounds like you are taking all the right steps.

 

I called the pharmacy today and I am decreasing from 23.5mg to 23.1mg, a 1.7% drop. What you wrote made sense to me and going down is a better direction that going up. I think I was dropping too fast before and the cumulative effect of successive decrements caught up with me, I don't think that 23.5mg or 23.1mg is too low for my system. Plus, Effexor is not doing anything therapeutic for me at this point.

 

I've been thinking about CBT for a while now. I've done therapy in the past and I really don't want to do it again but doing CBT on my own is something I'd like to try.

 

Thanks again for all the help and all the effort you put in with the links and quotes, etc.

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ChessieCat

Please remember to keep notes.  It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.

 

Example:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

 

CBT is just one non drug tool.  CBT challenges our thoughts.  This can be very helpful.  There are other times when a different tool is needed.

 

Non-drug techniques to cope

 

Claire Weekes was a doctor who suffered from anxiety and learned and taught ways of coping.  There are YouTube videos.  Claire Weekes' Method of Recovering from a Sensitized Nervous System
 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

And these:

 

"Change the channel" -- dealing with cognitive symptoms


Change cognitive framing - Redirect - Another Way

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DrugSlave

Cool, I will use some of those techniques. CBT works for some ppl with chronic fatigue syndrome. I keep seeing Claire Weekes' name. I watched one video. I will watch more. I start the 23.1mg pills next week. 

 

Wow, there are a lot of non-drug techniques in those links. This site and the people on it are great.

 

 

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ChessieCat
45 minutes ago, DrugSlave said:

This site and the people on it are great.

 

We aim to please help.😄

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DrugSlave

It's been two weeks since I made the last drop. I've had some bad days but I don't think it's any worse. I only got four weeks of pills so I'll have to decide in a week's time what I want to set the next dosage to. I think I might change from 28 pills to 30 to give me a couple of extra days next time. I find all the withdrawal symptoms don't kick in until 3 weeks after a change.

 

Peace and love to all out there

 

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ChessieCat
34 minutes ago, DrugSlave said:

I think I might change from 28 pills to 30 to give me a couple of extra days next time.

 

Personally I find working with weekly periods is better because then my dose reduction always occurs on a Saturday.  So you might want take this into consideration.

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DrugSlave

Yea, I know what you mean ChessieCat.

I might call the pharmacy tomorrow for my next dosage. It hasn't been three weeks yet but I don't think I'm getting worse symptoms. I might drop 2.2% from 23.1mg to 22.6mg...for either 30 days or 5 weeks. I'm going super slow for now because I still haven't fully recovered from reductions 7 months ago. 

 

All comments appreciated

 

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DrugSlave

I decided on a 1.7% reduction from 23.1mg to 22.7mg over 5 weeks. Super cautious for now. I felt pretty good today... according to my journal, the best day in almost two months. I worked from home this afternoon but I think I could have gone in. 

 

I've been going for walks and doing yoga. Both activities seem to help a little.

 

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