Thegreek: effexor withdrawal or relapse?

[thegreek]

hello everyone,

 

since july 22nd i quit effexor xr after 11 years. ive been on 75mg since the beginning diagnosed with anxiety disorder, never needed a higher dose, never seriously wanted to quit as it seemed to work. in 2013 i came off a divorce, have a lovely daughter, lost my business and had to take care of my mother who started to have alzheimer like symptoms, happy days i know.

 

by the end of 2013 i realised i had bruxism, never noticed it before, so i think its from the drugs, started also to feel more stressed than usual and having high blood pressure, and sweating for no reason. doctor advised to increase dosage by 37.5 mg, i never did, instead went to my patron saint prayed and decided to change my life.

 

in february i halfed the dose to 37.5mg, no problems whatsoever, felt even better, stayed on 37.5 until june and started to taper, i missed a pill first once every 3 days for 2 weeks, no symptoms, then every other day for 3 to 4 weeks, no symptoms, finally for the last 2 weeks i took one every 3 days, started to have very slight agitation and after 2 weeks quit.

 

i dealt with all the symptoms, agitation, insomnia, headache, musclepain, and every day that passed i felt better and better. the third week i begun to be hypersensitive but started to sleep better, bizare thoughts started to enter my mind like suicide, i never had thoughts like that so i knew it was from the drug, so all these thoughts dissapeared as strangely as they appeared a few days later.

 

i visited a new doctor last week and he prescribed citalopram 10 mg and xanax 12.5 for sleeping, also gave me a multivitamin supplement, i said i will try the xanax, but refused to go into ads again as i wasin the middle of withdrawal, oddly his response was that these drugs have no withdrawal symptoms!!

 

can anyone please advise me what to do, i take the supplement as prescribed but i am afraid to take any more drugs. please i need your lights, and sorry for the long intro.

Edited September 14, 2014 by Karma
added paragraph breaks to make it easier to read

[mammaP]

Hi and welcome to SA. The doctor who said these drugs have no withdrawal

doesn't have a clue! This makes me so angry, I wish doctors would keep

up to date, it is now medically recognized and called SSRI discontinuation

Syndrome.

 

I'm afraid you tapered far too fast, and suffering for it. I would immediately

Reinstate effexor, just a few beads might be enough. Try 5 beads and see if

it helps. It might take a few days to have an effect but could help within

hours. When you have stabilised, hold that dose for a few weeks then start a

Slow taper.

You are right to avoid another drug, you were OK with effexor

So should reinstate that one. I would be very very cautious with zanax as it

is a benzo and highly addictive. Take it for a few weeks and you will need

to taper off that too. The insomnia is the worst symptom of effexor withdrawal

but may be better after reinstating.

 

Here are some links for you to look up that will help you understand what is

happening and why I suggested reinstating. I was in the same position after

tapering too fast so can empathize!

 

http://survivingantidepressants.org/index.php?/topic/3079-about-reinstating-and-stabilizing-to-stop-withdrawal-symptoms/

http://survivingantidepressants.org/index.php?/topic/272-tapering-off-effexor-venlafaxine/

 

It would help us if you can put your drug and tapering history in your signature strip,

there is a link at the top of my signature that tells you how to do that.

[thegreek]

hi,

 

thanks for the reply. are you sure it will work after i ve off the drug for almost 2 months? i just opened a 37.5 mg tablet and there are more than 100 beads of different sizes inside, how do igo about doing that?

im scared shitless of these drugs, maybe its better tojust wait and see? how long does it take for the nervous system to relax without reinstating?

[Karma]

Hi thegreek,

 

Welcome to our community.  After being off of Effexor for 2 months there is a good chance that reinstating the drug in a small amount will help alleviate the withdrawal symptoms.  As MammaP recommended try taking just 5 assorted sized beads every day at about the same time for the next 4 days and see how you feel.  You may need to increase by a few more beads to get to a stable place, but we can help guide you as you report back how you are feeling.

 

Here is our thread on tapering off of Effexor, it has information on counting out beads and other helpful information: http://survivingantidepressants.org/index.php?/topic/272-tapering-off-effexor-venlafaxine/

 

It is not better to just wait and see how it goes.  There is a short window to reinstate the medication and alleviate the withdrawal symptoms.  After that it is anyone's guess how it will go.  We often see people here who have waited too long and are in prolonged withdrawal.  There is not much we can recommend when that happens - we don't want that for anyone. 

 

These drugs aren't like aspirin where once the drug is out of your system they no longer have an effect.  These drugs cause changes in the brain and we need to give the system time to rebuild and adjust once we remove the drug from the system.

 

I understand your fear, but your best shot really is to reinstate a small amount of the drug.

 

Karma

 

[thegreek]

hello again,

 

i did as you suggested and took 5 beads last night and it seems to be working, i slept better and my anxiety and headache subsided, also i feel more optimistic. how is it possible to have such a fast response from just 5 beads? could it be placebo or my brain is starving for the drug? how long should i stay on the 5 beads, could you tell me how to store the remaining beads? should they be put back in the coating after tapering?

i would like to thank you from the bottom of my heart, i think you are doing a great job in helping others as especially in my country there are no doctors that even heard of tapering.

[bubble]

Hello,

 

I'm very happy for you because it is unmistakenly obvious that reinstatement is working for you! I can imagine your relief especially since, as Karma said, for those people whose window for reinstating has closed, things get horrible and can last for years, unless they take more medication and higher doses.

 

Before anything else I'd like to warn you that reinstatement is not a miracle cure which restores us immediately to our level of feeling and functioning before we discontinued medication. There are no quick fixes like that. You will take some time to stabilise. Since you were off medication for quite long, that recovery time might take a few months and it will happen in the windows and waves pattern. This means you will have hours/days/minutes when you will feel like you describe above, with little or no symptoms but also moments, initially probably more, when you will feel very bad. It's important to know that this is normal and not to react to symptoms by changing dosages. What destabilised central nervous system needs to recover is time and stability.

 

This thread will explain many things to you: http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

 

When it comes to your question of whether this is a placebo, no it's not and there is even research which explains how that is possible: the lowest doses of drugs make most impact on our CNS. You can check this thread: http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

As I said, my guess is that it will take a few months to stabilise. Your brain has experienced a trauma and it needs to heal. What you can do to help is treat it gently. You will find  a lot of valuable information here. Take some time and familiarise yourself with the rule of 3 KIS: http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

At such low doses, the side effects of the drug are low but it still gives our brain the chance to rewire itself to functioning without drug. When you have time you might also want to read posts on this thread: http://survivingantidepressants.org/index.php?/topic/6447-best-of-sa/

 

As far as I know those beads are pretyt stable so they don't need soem special storing. For convenience sake you might put them in a small jar so that you don't have to open the capsule every time to count 5 beads.

 

 

You can also read about the only two supplements which don't cause problems for people with sensitised CNS: omega 3 and magnesium: 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/

 

Keep us posted. This is still a difficult period but you will make it. 

 

Best,

 

Bubble

[thegreek]

hello again,

 

sorry to bother you with all my questions, i know you are busy but will i need to updose till 37.5 mg, which was my last dose and reduce from there or stay at 5 beads which equals about 2 mg? im barely fuctional and i need to travel by the end of the week.

thanks once more

[bubble]

No problem. Just ask any questions you might have.

 

You might have to updose some time in teh future but slightly.  But after 2 months off it won't be nowhere near your previous dose. And we will cross that bridge when we get there. Since the reinstatement is working, give it time. 

 

It is very, very hard but try your best not to react to symptoms. They will come and go. Treat yourself as gently as possible. Minimise your obligations, put everything down to a bare minimum and put yourself in the centre. Find the time to do anything you feel like doing and give yourself space to feel any way you feel like feeling. Treat yourself with a lot of patience and gentle care as if you were nursing a broken and aching leg.

 

Stick with the dose. It's not the dose that brings recovery but stability. There is no right dose that would remove withdrawal symptoms now. The only effect that updosing can achieve is disrupt the recovery. The brain is trying very hard to achieve a homeostasis under the given circumstances and changes are disrupting it and annulling all its hard efforts.

 

I hope your trip is not a source of stress for you although any activity can be so in acute withdrawal.

 

Keep us posted.

[thegreek]

hello,

im thinking of reistating the drug alltogether because i need to be functional , could you tell me what the effects would be if i do that and if it will help at all , the doctors seem to be in denial so any feedback is greatly appreciated.

thanks

[mammaP]

I would not go back to the full dose, you could have an adverse reaction.

Going too high then having to drop again due to side effects will throw

your nervous system into chaos. Take it slow and allow time to stabilize.

It is very tempting to go back to full dose but after so long off it can do

More harm than good. You felt better after reinstating, have your symptoms

changed since then?

[bubble]

As MammaP says, from what we have seen antidepressants and the way they work is very different to how other drugs work. If you have a fever or an infection, you take a higher dose of an antibiotic and it usually works. 

 

But antidepressants change our brain physically and that changes take years. Your brain has been changing having incorporated the drug into its functioning for 11 years.  Then it was seriously traumatised for 2 months when the drug was abruptly torn out from its structure. Is it realistic to expect that something that took 11 years to form, 2 months to adjust to trauma of tearing connections will be undone now in a matter of weeks or days?

 

We all have that absolute need to be functional. None of us is in a situation to be able to afford not to be functional. I'm not saying this to scare you and your situation is not so complicated but people would lose jobs and homes over this. I'm just saying this to underline what I wrote earlier: there are no quick fixes. Any attempts to speed things up, cause more damage.  But I wrote about that in my previous posts at length

 

It's your call but as much as we would like to tell you something different, that's what we have expererience of and see happen. Before I came here and learnt about withdrawal, my doctor put me on another medication and a higher dose than my previous one. That's the usual response. Still it took me a few months to get sort of functional and many months more to feel the way I felt before I stopped taking the drug.

 

After the next attempt I came here, reinstated and it again took me months to recover. Except that this time I didn't end up on a maximum dose. In both situations I simply had to find the time to recover. I had to find a way to function with diminished capacity for months. 

 

Sorry we don't have a better answer. 

[thegreek]

no, deep inside im calm, and really the headache and anxiety have really subsided, however igot some burning sensations last night which come from reinstating the drug. i need to go see my daughter in france sometime soon which is a long way by car from where i am right now, and at the same time find something to do. all this is stressing because of negative thoughts, how am i going to do this all alone etc, silly when i ve done it a 100 times and nothing ever happens; sometimes i wonder if it would have been better to be on cocaine or something similar.

 

thanks for being there

[bubble]

I'm glad you seem to be under a lot less stress than most of us who have to work to make ends meet, have small kids, etc. 

 

If you had some symptoms like burning sensations emerge, imagine what increasing would do.

 

although you did something 100 times before this time is different so it might be good to try and see if somebody can keep you company. I drive very rarely and sometimes simply don't dare. 

 

What happened with that burning sensation? Did it disappear, lessened, increased?

 

It would be very good to update your signature with the information on when you reinstated and how much so that we can see it every time you post.

 

hang in there.

[Karma]

You have just been on the reinstated dose for 3 days by my count.  I think you will find that as you keep taking the 5 beads you will continue to have improvements in your most uncomfortable symptoms.  The burning sensation is a withdrawal symptom and as your system continues to heal it should subside.

 

Your withdrawals are causing you to have negative thoughts.  Sometimes it is helpful to name it when it happens so you can see the thought as an object and then it may have less effect on how you feel.  We call it neuro-emotion.  Here is a thread on it:  http://survivingantidepressants.org/index.php?/topic/137-neuro-emotion/

 

I find it helpful to log my symptoms daily to see if I'm improving, staying the same, or getting worse.  Here is a thread on tracking and rating symptoms daily: http://survivingantidepressants.org/index.php?/topic/1779-rate-symptoms-daily-to-catch-withdrawal-early/

 

Give yourself time to stabilize and then you can slowly taper off of the drug completely. 

 

Karma

 

 

[thegreek]

hello,

 

thank you for your interest, last evening i had this hot flushes and my blood pressure was too high, i took a xanax to calm down i think its from the drug, i remember having them when i first started taking it but without the blood pressure. about the trip i managed to convince a friend to come with me so this is settled. by theway i too have a small kid, i need to work also for a living, and  just got divorced , so a great deal of stress is involved in my life, the problem is my condition everything else is fixable .

 

thank you

[bubble]

I'm sorry if my remark about your circumstances was insensitive. I just wanted to let you know that we are all in the same boat and that you are not alone in this.

 

It's great you found a friend to go with you.

 

As somebody who is suffering heavily from Xanax dependency I have to warn you of how addictive it is. Not to mention that it can cause rebound anxiety. If I could go back in time I would never have taken it. How often are you taking it and how much?   

[thegreek]

i am not taking it on a regular basis, i took 0.125 last night because i had to drop the blood pressure, this was the third time. i dont really like taking it, it makes me feel strange. by the way how longdo you think i should stay on this dose? the last doc i saw suggested i switch to citalopram, any comments would be greatly appreciated

[bubble]

Did they say what might be causing your blood pressure? It seems to be one of your original symptoms.

 

We are not doctors here but from everything we've seen and our own experience we don't recommend changing drugs but rather sticking with the devil you know. The more drugs you  change, the more sensitised and destabilised your CNS will get. Having been on one drug only is actually an advantage for you.

 

If you are worried about weight gain, at such a small dose the side effects of a drug are very diminished but since they are so powerful they still affect the CNS as you've experienced yourself.

 

Given the very long period your CNS struggled without the drug and that you have reinstated very recently I don't think you should be thinking about reducing any time soon. Probably in a few months. I stopped taking 2 drugs at the same time which is a particularly bad idea so it took me 4 months to feel stable enough to start a very slow taper.

 

I would focus on recovery now and not on getting off the drug. There will still be quite a rocky road ahead of you...

[thegreek]

good morning

 

what i meant is when it will be safe to increase, as effexor lasts only 12 hours, itake it before i sleep, withdrawal symptoms appear during the day, would it be wise to take a little more during the day or split the beads? it also seems to affect my stomach, the xr version didnt do that, any suggestions?

[bubble]

I don't have  a personal experience with Effexor so hope somebody else will chime in.

 

Have you stidied the link we gave you on tapering and other info on Effexor?http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/

 

This si what I found there: Because of its short half-life, taking regular Effexor necessitates taking the tablets every 12 hours.

People who are very sensitive may have some difficulty with a switch from an extended-release form to regular Effexor. One technique to make the switch gradually would be to convert only part of the extended-release dosage to immediate-release tablets.

You would then be able to cut up the immediate-release tablet or make a liquid from it to reduce by 10%.

Or, use the bead-counting method until you get down to 37.5mg, then convert to regular Effexor and make a liquid from it to finish the taper.

It's good that you make a question here before making a decision. I believe somebody will have an answer.

[thegreek]

yes i ve read the tapering method, i think the immediate release is hurting my stomach. i will visit the shrink later today to ask if i can raise up to 18 mg by emptying half the 37.5mg xr capsule, i dont see any other way.

[bubble]

I can understand your concern over stomach issues. Have you tried taking it after meal?

 

 I' m concerned with the idea of going to 18 mg after you have been off the drug for so long and especially since reinstating the small amount produced such good results. If i were you, I wouldn't do it but of course it is your call. 

[Altostrata]

Welcome, Thegreek.

 

What kind of Effexor are you taking? If the capsule is Effexor XR, each of the beads is extended-release, it's in the coating on the beads.

 

Are you taking Effexor XR or regular Effexor? If regular Effexor, you need to take it twice a day.

 

You need to give any dosage change at least 4 days to fully register in your system. You've barely given the 5 beads a chance to act. Still, you might get waves of withdrawal symptoms for quite a while as your system stabilizes.

 

When you say you get withdrawal symptoms during the day, at what times and what are they? Please keep notes on paper to track your symptoms.