Lexy: tapering off Effexor

[Lexy]

Well it's been a week since  I made the switch from effexor IR to brand name Effexor XR. 

 

 

I was doing frequent dosing with the IR, and  I was having a lot problems such as vertigo, headaches, nausea, etc.

 I first made the change from IR to XR was in the morning at 18mg with no problem decreasing the immediate release by the same amount. Next I switched the last dose of the IR to XR which was 6mg.

After I picked up the 20mg reincapsulated XR from the compounding pharmacy I started the 20mg twice a day keeping 4mg in IR.  I think that's where I went wrong. I thought since I had only one week off from spring break I should just make the transition immediately.  

 

THe day after the switch I experienced a depressive mood swing that started 10:30am (about 2 hours after I took the 20mg XR, the night before I had taken the 20mg in XR too).  

Depression 

Mar 2/Sat - Depression level 8 

March 23/Sun - no depression

Mar 24/Mon -  depression back on -  level 7.5 starting at 10:30am

Mar 25/Tues - 7.5   starting at 10:30am    Decreased pm XR dose to 18mg

Mar 26/Wed  -  7.0   starting at 12:30pm         Decreased am XR dose to 18mg

MAr 27/Thurs - 6.5  atarting at 12:30pm   

Mar 28/Fri   -   6.3 starting at 12:30pm 

 

Symptoms that have gone are: vertigo, dizziness, headaches, and the nausea.

I am not sure if the decrease of XR by 2mg is helping or if it's that my system is getting used to the XR.

Should I go lower in the XR and add back to generic?

[Altostrata]

I can't follow what you're doing, Lexy.

 

What is the relationship of your symptoms to when you take your drugs?

 

If I were you, I would take the entire dosage in Effexor XR, divided into a morning and evening dose. Keep it simple.

[Lexy]

morning 8:00 am

 

18mg XR -  two hours later depression lasting mostly all day. 

4mg IR

 

night 8:00 pm

18mg XR

4mg IR 

 

Ive had fatigue and body aches constantly since about 3 months ago.  

[Altostrata]

I don't know what's going on. You've made a lot of changes and your nervous system didn't like it.

 

The daytime depression might be from an overall decrease in your dosage, i.e. a withdrawal symptom, I guess.

 

Given you've made so many changes, you might hold for a good while now keeping your dosage pattern very regular.

[Lexy]

Well yesterday I had a mild panic attack which I hadn't had for a long time.  Depression wave was about a 7.

I couldn't take it anymore and decided to make the change back to where I was at before the depression.  

 

Last night I decreased the nightly dose in XR and increased the immediate release.  I again did the same  for the this morning's  dose.

Up to now no mood swings…crossing my fingers.

 

I believe that the generic immediate was giving me headaches, vertigo, and nausea EVERYDAY.  I have not been decreasing for two months and before that by only .25mg. 

However the XR might be too strong or because it lasts longer in my system is wreaking havoc on my CNS.  I guess I have to find a balance and hold for a while.  

 

I was trying to recollect when I first started taking this drug,  I was on generic immediate release up to 75mg and then doctor combines both increasing to 150mg by changing to XR.  Following was six weeks of agoraphobia, social anxiety, and increased levels of panic attacks.  As soon as I decided to quit this crap by cutting half dose all that went away the very next day.  How could I have forgotten all this?  

 

Maybe I should not be playing around and switching back and forth, but if i could have another day like today would be such a blessing.  As I'm writing this I am at a baseball season opener, feeling a little dizzy but  seats are way up high.   I wouldnt have thunk yesterday!

[Hudgens]

So difficult to figure out what and what not to take and how much. You've really been through the wringer. Good to hear you had a little rest from it all today. I consider depression-which I never had before tapering-to be the worst of the withdrawal symptoms. Hard to believe I could get through hours of it at a time, day after day, and yet I did. You Do get through it and then, strangely enough, begin to forget the worst of it.

[Lexy]

Are there any supplements for the body aches? I take Tylenol or Advil, but doesn't help.

[Lexy]

Today I had mood swings, both irritability and depression, anxiety, body aches and vomited.

Maybe I shouldn't have made the switch to Effexor XR. Is it too late to go back to immediate?

[Lexy]

I had an outpatient surgical procedure where I requested I did not want to feel any kind of pain, my dentist gave me a morphine injection.  For the following 3-4 days I had NO zaps whatsoever.  I felt almost fine just a little tired.  NO brains zaps, no mood swings, no anxiety, less body aches.  

 

Today they're ALL back.

 

Could it have been the morphine??

[DrugSlave]

Hmmmmm....that's interesting.....could be...

 

Besides the last few days, are you adjusting to the effexor XR?

[Lexy]

Before the morphine injection mood swings had lessened in quantity although not in intensity.

 

Last couple days have not been good, especially last night.  I felt anxiety and panicky, not quite a full blown panic attack.  Im so afraid that these panic attacks that I had before the pill will start up again.  Today is the first day I have awoken with anxiety.  Mornings are usually  better for me. however,  late afternoons  I feel so fatigued and drained from school all I can do is sleep it off.  

 

WHen on the full dosage on immediate release I seldom experienced mood swings and anxiety.  Or at least not as intense.

Do you think these (anxiety and feelings of panic) are all Wds? Or could it be the XR?  

[Lexy]

I haven't been able to add another line to my signature.

 

I"m at 42mg

[DrugSlave]

Lexy said: "Do you think these (anxiety and feelings of panic) are all Wds? Or could it be the XR? " - I doubt it's the XR. I would guess your system is still adjusting to the switch from immediate release to XR.

 

It's funny that you feel better in the mornings. Mornings are the worst time for me. I usually feel better as the day progresses.

 

I had to reduce my signature to 11 lines with the new changes.

 

take care Lexy
 

[flong]

Somewhere I read that Effexor works chemically on the exact same brain receptors as opiates do. If this is true, your reaction to morphine backs this claim up further. However, morphine is a pretty irresponsible replacement for Effexor

If you're at 42, you're still going down, which is always good. Have you stabilized any more overall since March when you were having so many problems?

[Lexy]

Hi Flong

 

How are you doing? Last time I heard from you, you were doing well. I am so happy for you.

Wishing you all the best in all your endeavors.

[Lexy]

update:

 

8:00am 16.52mg Effexor XR

1:00pm   7.00mg immediate release

6:00pm   7.25mg IR

9:00pm  10.14mg XR 

________

 

40.91mg total effexor

 

I am still trying to stabilize on the switch to effexor XR.

 Mood swings have lessened somewhat, anxiety has been lower.  

Yesterday I decreased by .31mg (one bead)  of Effexor XR and today I have felt dizzy, mood swings, and headaches all day.  I seem to be able to drop the immediate release easier than the XR.  

 

Should  I first taper off the immediate release or alternate between the two?

I have also tried to take off .31mg of XR while at the same time adding .25mg of the IR, but that is subtracting only .06mg.  

 

 

 

Any suggestions?  I can't even try to bring all  this to the attention of my doctor...

[DrugSlave]

Lexy, I wish I could help you but I don't know enough about IR to comment. I hope someone comes along with some advice. I really hope you are able to make your pill taking routine less complicated.

 

take care

[Lexy]

http://www.madinamerica.com/2013/08/ssri-discontinuation-is-even-more-problematic-than-acknowledged/

 

I just read this article by Dr Shipko.  

He states some people will never be able to get off antidepressants.  Also that tapering does not prevent discontinuation symptoms that can appear after the end of a slow  taper.  

This is very distressing.  

[Altostrata]

See our discussions about that article by Dr. Shipko.

 

Lexy, if you're having symptoms, it might be a good idea to hold everything constant for a month. No changes, no reductions, no switching around from one form of the drug to the other, no changes in schedule.

 

I think your constant experimentation has gotten you into a sticky wicket.

[Lexy]

Thanks I will

[flong]

I am good, thank you.

Regardless of what anybody says, I'm convinced that anybody can get off even the toughest SSRIs and SNRIs. I've seen it with several people I know and have met. Sometimes there are lingering effects that last for a very long time, but honestly most of those people are "cold turkey" people.

I'm a bit worried about getting right to the end, but so far so good.

The whole thing is, trying your best to accept that there may be parts of tapering that you can't handle...that you may need a break, some time off to gather yourself and let your system recover. This is absolute key.

[Lexy]

Flong

 

So good to hear from you!!

I was feeling quite down after reading that article…thanks for bringing up my spirits!

 

I do know someone who was on Effexor for 2 years at 112mgs.  She was decreasing by 10mgs every WEEK for almost 4 months.  Currently she's been off of it for 3 and half months.  ALthough she did suffer from mood swings and anxiety she says they have disappeared.  Of course it's too early to tell, however I'm praying for a success story for all of us.

Keep in touch

[Altostrata]

People differ in their tolerances for dosage changes. A very small, unfortunate minority find they cannot go completely off no matter how slowly they reduce. Dr. Shipko is correct in mentioning this. He wants patients to know the risks.

[Lexy]

I have been on a depressive wave all week. Right after my finals I had decreased by .50mg. I wanted to decrease a little faster than I had been during school, however I just can't seem to decrease more than .25mg.

 

I have an appointment with Dr. Prey on June 16th. I spoke with him briefly on the phone...I asked him if he believed in debilitating withdrawals from these meds in which he replied, "Yes I do, unfortunately many of my colleagues do not."

That's all I needed? I'm so tired of seeing my pdoc who only patronizes and makes me feel that all wds are coming from me and not this evil drug he put me under.

Although I'm not sure what this new doctor can do for me because I'm adamant about not going on any other drug.

[alex]

Dear Lexy: Don't go on any other drug; let you wonderful resilient body heal...

I am 22 months off 150mg of Effexor that I took for more than 4 years, and I'm doing much better.

Have patience and you will make it.

[Narcissus]

Best of luck with the new doctor Lexy. I'm in a wave too, let's hope it reaches shore soon.

[Lexy]

Thank you all for your kind words. I'm so grateful for this site to meet people like you.

 

Yesterday was horrific...

This depression starts at about early afternoon feeling gloomy (level 5.5) starts escalating by 4:00pm (level 7) feelings of impending doom.

At 7:00pm it's at its highest point (8) Yesterday It got so high (9) Which led me into a frenzy of fear and panic.

I took a quarter of a Xanax and also smoked some medical mj. This helped to bring me back down to a 6 and fell asleep.

I'm already fearing for today.

 

In the early afternoon I took one extra bead hoping that this would alleviate wds could this have made it worse?

Could this be the result From micro tapering by 3% last month....faster than what I was doing before?

[Annabel]

Hi Lexy,

 

Your wave sounds horrible, maybe try being somewhere else at 4pm today somewhere you feel safe while you ride through the depression, if it hits again. Hang in there, I will check in again to see how you are later!! 

[Narcissus]

 

 

In the early afternoon I took one extra bead hoping that this would alleviate wds could this have made it worse?

Could this be the result From micro tapering by 3% last month....faster than what I was doing before? 

 

I'll let someone more familiar with tapering chime in here.  But I think what Alto said here bears repeating:

 

 

 

Lexy, if you're having symptoms, it might be a good idea to hold everything constant for a month. No changes, no reductions, no switching around from one form of the drug to the other, no changes in schedule.

 

Why not try holding for a bit?  

 

I'm not doing too hot myself, I'm sure things will improve for us soon.  Just hang in there.

[Lexy]

Thanks Annabel and Narcissus

 

Trying to hang on and staying put.

[Lexy]

Last week has been horrible.

 

Depression starting in the afternoon and peaking between 6-7pm.

Before last week I was having mood swings that would last 1-2 hours.

 

I'm trying to hold on until I see a new pdoc who believes in wds, except I don't know how he can help without prescribing something else. I think he'll want to try to do the Prozac bridge.

 

I have been very adamant about not going on any other drug, but I'm getting hit so hard with wds that I'm contemplating asking my aunt whose on 20mg Prozac for a couple of pills.

 

Before the effexor I was prescribed Prozac which I took only for 3 days because it made me feel so depressed right away.

But now it's like I'm being hit with these awful waves of depression anyway.

 

 

Question:

Does The Prozac bridge work only when decreasing the effexor?

 

Should I take a half capsule 10mg Prozac to see if this helps my depression wave?

[Narcissus]

Lexy, I know things are hard but I don't think introducing Prozac will help at this point.  It can be hard to shake the sense that we have to DO something (see a doctor, introduce a drug, etc) when things are bad, but I think it's best to try to leave that state of mind.  Holding still seems like the best option to me.

 

I'm so sorry you're struggling, it will get better.

[Lexy]

Thanks I'm holding.

How are you today?

[flong]

Hey Lexy. Very important info here. Please don't "bridge" or mix Effexor with Prozac. Those two drugs have SERIOUS interactions. For example, I pulled this from webMD:

 

"

Serious - Use Alternative: Effexor XR oral + Prozac oral

Prozac oral and Effexor XR oral both increase affecting serotonin levels in the blood. Too much serotonin is a potentially life-threatening situation. Severe signs and symptoms include high blood pressure and increased heart rate that lead to shock.

"

I had serotonin syndrome once. I combined Effexor XR with cough syrup. It was easily one of the top 3 worst experiences of my entire life. You can actually die from it.

The best advice I've heard so far is to hold steady for at least a month. Don't increase, don't decrease, and no matter what, don't add anything else to the broth!

When we're in distress, we want to change things in order to fix it. It's human nature. What you're going to have to do is ignore that way of thinking! Which isn't easy, because it's built right into us! Stay the course for the next month. I bet you'll start feeling a bit more normal as time goes on. Your body and mind know how to deal with it...you just have to work on outsmarting your natural instincts to make a change every time you don't feel right!

[Lexy]

Thanks so much.

I'm too chicken to take anything else.

I will stay put.

 

I wonder why symptoms come in the afternoon ?

Today it's been anxiety which also started about noon time.

[flong]

I've had a rough few days. Every time I think I've got this thing all figured out, it reminds me that I'm not in charge and to keep being patient.

During the day is usually the best time for me. Between 3am and maybe noon the next day seems to be the danger zone.