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My history with medication started when I took a leave of absense from college in 2001, after my first semester. I moved back across the country, lived in a friend's dorm room, got a job, got an apartment, and decided to seek help for depression and trouble focusing. I was prescribed Ritalin. Over the years (see signature for meds), I was given meds for depression, sleep problems, ADHD, and eventually Bipolar II. In October of 2013, I left a job both over ethical concerns and because I wanted to work for myself. I lost access to the medications I was on at the time, though, because of an insurance SNAFU. By mid-2014, I was practically non-functional, though I was also trying new meds and working with a therapist. In 2015, I ended up unable to work, moving to my parent's home, and getting SSDI. Many of the meds I've tried since then (and before) gave me immediate adverse effects, or soon after I started taking them. In 2021, Lexapro was added, and that gave me constant nausea, but I was determined to stick it out. I had to use cannabis constantly in order to not feel like throwing up. Then, when I learned about laws in a couple states passing that explicitly allowed medical providers to deny care for "religious or ethical reasons," targeting queer people (I'm a trans* guy and gay), I threw temper tantrums like a two-year-old at both my therapist and mother for two days, and became extremely activated. At first I was ranting out of terror, and then angry at their lack of empathy. It was both called-for and out-of-line. Then began a flurry of activity. I felt like myself, and like I was developing good boundaries. I told people about many painful things from the past. I was also, in retrospect, not well, but when my APRN told me to stop taking Lexapro because "people say you've been acting out of character," I was livid, because I finally felt like myself again, and it was traumatizing to hear about those laws being passed and have people to tell me to calm down because it wasn't an immediate threat. I told her that sometimes when someone experiences something new, they act in a new way; it's objectively true. I don't know. I developed panic attack symptoms, had trouble regulating my body temperature, had more than the usual variations in energy level, and had a lot of sleep disturbances. My proprioception was often way off. I compulsively spent money, but in a way that made half-sense. A few months into the Lexapro, I developed some movement disorder symptoms, sort of only half-controllable unwinding stretching, triggered also by physical therapy for severe pain and stiffness in the right side of my neck. The stretching felt good, but then I got tight again. That was particularly weird. I often had very firm boundaries over the spring and summer, getting to the point of yelling when my concerns about my safety as a queer person were being thrown back in my face. Some people told me I was hard to follow, but others could follow me fine. All of my emotions were amplified. At one point I hit a wall with my fist in my mother's house, and dented it. I offered to fix it or pay to have it fixed, but that offer was rejected. In the fall, without prior warning, my family changed the locks on my place, and threw away whatever they thought was trash, and I lived in long-term Airbnbs until March. I somehow managed to close on a house in February, and started living in it in March. The place was indeed horrible, in terms of cleanlinees, but advance notice and dealing with it more directly would've been better. Of course, they don't know what my living spaces always look like. Throughout the winter and spring, I had migraines a lot of the time. In March of 2022, things got psychedelic. I've never done hallucinogens, actually. I've also never had any hallucinations or delusions... until maybe this stuff. I was in part wrapped up in fantasies about finding a way back to having my family in my life, and in part seeing patterns and thinking I had outsized influence on the world if I interacted with them right. I saw problems and became fixated on them. I was sometimes, in my thinking, straight-up delusional. I went for lots of drives, exploring patterns - real ones having to do with the development of the highway system - but why? I became very tuned-in to my emotional intelligence, and spent a lot of time dancing and acting to music, and feeling through the layers of meanings in the lyrics. I can't remember if I'd decided to stop/cut back the Xanax before or after this. In late March, I ran out of gas on the highway, without my phone, really only needed a tow truck, but since I didn't have anyone to call for help and was very amped up, I ended up involuntarily hospitalized in another state, with no way to reach anyone. First, I was in an emergency room, and got the bends very bad from something. I was lucid dreaming, and spinning around in the bed. They injected me with something, I don't know what. When I got to the hospital, I half-thought it was all a mistake and someone might come get me. I opted to be there for three days under my own power. Since I had no access to my meds, this lead to my going cold-turkey off of Wellbutrin, Lamictal, Adderall, Xanax, and Lexapro. No one evaluated me there, but they tried to get me to take something (wouldn't tell me what). I felt pretty much fine, but half-believed it must be some kind of elaborate prank, under the influence of drugs, trauma, or both. From then on, things got even weirder. I started to forget to pay bills, I became convinced there was something seriously wrong with the electricity in my home, and no consequences mattered. I had total blindness to how my actions affected others. In May, I again ended up needing a tow truck (the gearshift became disengaged), without my phone. I got extremely sick in the car, got a tow truck instead of a hospital this time, but got kicked out by the driver of the tow truck because of the smell. I had auditory and mild visual hallucinations, very "creative" thoughts, and ended up taking two weeks to get back home. I simply let the car go, bought another car (but got a ticket for driving without insurance and driving an unregistered vehicle, and now have a warrant out for me in another state), worked on it a little but lost focus and bought an even more messed-up vehicle, worked on that, and then stopped caring. I developed bad chemical sensitivity for a month or a few (even my skin barrier was weird), and had movement disorder symptoms spring up after exposure to chlorine, followed by lotion and CBD oil. Could also be psychological, in part. I got a big lump on my scalp, a rash on first the left and then the right side of my neck, ingrown hairs on my knees. I had to re-wash everything I'd washed at a laundromat. I'd have to make movements in response to sounds, or feel prickling or burning in my toes response to seeing certain people, or other unknown causes. It's still happening a bit. I trashed the office space I was renting, because I had increased sensitivity in my nerves, and thought there was something corrosive going on I needed to clean up with salt, baking soda, some natural cleaning supplies, and clean cat litter, but also couldn't focus, and ended up leaving behind a massive mess and giving the owner no notice, after being two weeks late with rent, after the guy I'd hired decided he wasn't going to stick around. I've had a lot of scary physical symptoms that felt like they could become blood clots or heart attacks, but those haven't happened for months. For a while I had so much tension in my trunk area, it felt like my pelvic bones were eating themselves, all prickly. I have more feeling on my left side than my right. Usually when I wake up, some part of one or both of my hands is numb. I had a lot of strong anxiety, on and off. There's a lot I've left out. These days, I'm dissociated and flat, but also have extreme avoidance behaviors, a different kind of anxiety. My frustration/obstacle tolerance is almost nothing. I don't have a temper about it, my brain just short-circuits. Pretty much I sit around smoking hand-rolled cigarettes, and drinking filtered water with ginger in it, thoughts about my family or others swirling around, wishing I could trust new people and/or had local friends. I wish I could hand power of attorney to someone and tell them what to take care of. If I can get started on something, I manage to change my address somewhere, or make a payment plan on a credit card, or do some small thing, like pre-rinse clothes in the sink. The stuff I paid to have packed and stored, whatever was at the apartment that wasn't thrown away, I haven't been able to face and has probably been thrown out for non-payment by now. I've been to a primary care doctor twice, and have an appointment with a neurologist in October. I got basic bloodwork done and was fine; tried to get a toxin or heavy metal panel done but couldn't. Probably what I thought was toxin exposure was in fact withdrawal stuff, though. I've been trying to find a therapist who I can get to without a car and who takes my Medicare plan, but no luck so far. As far as I can tell, what's happening is CPTSD, PTSD, and polypharmacy withdrawal interacting. As weird and bad as things are, it's not like they weren't often like this even before I was ever prescribed anything. For example, I've almost never been able to care about "self-care," unless it's to make sure I'm not judged or otherwise for another's benefit. I can see a lot of "self-sabotage" in many of the things I've done, pathological narcissistic acting-out, some victim/savior/persecutor dynamics, but it all seems a bit extreme for it to be "just" trauma.

I’m withdrawing from both Effexor / venlafaxine and Wellbutrin / bupropion for 4.5 and 2.5 months respectively. I’ve had occasional ocular migraines for decades. Wedge-shaped visual disturbance that starts in center of my vision, then gets bigger as it moves off to the side and disappears in about 20 minutes. Sometimes a very minor headache follows but no pain otherwise. I’ve noticed that since the several withdrawal symptoms started, I’ve been having ocular migraines more frequently, though not every day. Doctors have always told me not to worry about them. But might the greater frequency be a known symptom pattern in withdrawal?

All of my symptoms in bolded, for ease of quick scanning for relevance by anyone interested. I have ended up on this website after lots and lots of google research to pin down the cause of my incessant symptoms of a low-grade migraine headache and constant nausea that I have been experiencing for 10 days straight now. My Migraine History: I have been getting migraines fairly regularly (about 2 or 3 each month) since middle school. but they are pretty mild, as migraines go. About 25% of the time, one will be preceded by an aura that is a lightening-shaped blind spot or blurry vision and then the headache will be very severe. And occasionally, one will be accompanied by severe nausea. But normally, my migraines are just quite painful headaches accompanied by heightened sensitivity to light, sounds, and smells. With ibuprofen and extra sleep, they are usually completely gone within 30 hours. During puberty and especially pregnancy, my migraines were more severe in all aspects: nausea, sensory sensitivity, and pain. My Venlafaxine Withdrawal/Discontinuation Symptoms: I did not connect these symptoms to the cessation of Venlafaxine until recently because 1. I did not know that physical symptoms could be related to the cessation of antidepressants. 2. The onset of symptoms did not occur until 5 days after my last half dose of Venlafaxine. 3. I was only on Venlafaxine for 27 days (including a half-dose for the last 7 days). I only made this correlation after several days of googling possible causes, and after including symptoms that I had previously dismissed as insignificant and inconsequential in my internet searches I started experiencing a persistent nausea that did not seem like food poisoning or stomach flu (no stomach cramping, etc.) 14 days ago. There were/are waves when the nausea is worse throughout the day, and a constant malaise otherwise. Unlike the stomach "flu" or food poisoning, there is/was no stomach cramping or urge to vomit. On the 4th day of no relief, I realized that it was just like the nausea I get that sometimes accompanies my migraines. I hadn't equated it with a migraine previously, because there was no headache. I started taking ibuprofen periodically, treating it as if it were a migraine. On about the 5th day, I could feel a headache "trying to set in", which is my usual precursor to an impending migraine (although historically the nausea, if it develops, does not come on until after the headache presents). Since then, I have had no improvement in symptoms. On about day 6, I started googling possible migraine prescriptions and was considering seeing my M.D. the following day, if there was no improvement. I also started googling the combination of all my other mild/querky symptoms to see what else it could possibly be, if not a migraine. These other sporadic symptoms had each seemed inconsequential as they had come and gone here and there, and were easily dismissed. But I was starting to realize they might be related. Muscle Weakness in my biceps that I had noticed when using a steering wheel or when filing through clothing racks while shopping. Crying and/or the feeling that I needed a good cry, without provocation, that felt very similar to PMS (although this was about 10 days after my last menses). Brain Fog in the middle of conversation. I will have to concentrate really hard to remember what the conversation is about, and what I was going to say next. I will forget what my husband told me just minutes ago. Word Recall Difficulty both while texting/typing (spelling) and in conversation (vocabulary). High Pulse Rate of 88pm, which was noted at the medical appointment that I had on the fourth day after my last dose of Venlafaxine, when I felt great. Chills Hot Flashes/Feeling Flushed Sinus Congestion which was present before, but is now much worse, especially at night. Nausea that feels like "Morning" Sickness when there is 0% that I am pregnant. Yes, 0%. At times, I can tell that I will feel better if I eat, and at other times I can tell that eating will make me feel worse. My best time of day is the first 3-4 hours after waking up. Shivers not related to body temperature this one I just experienced last night, and suspect (hope!) is more likely related to my inadverdently taking 2 different antihistamines (diphenhydramine and cetrizine) at the same time! Very pronounced and fast onset of "prune skin" on the soles of my feet, followed by Extreme itchiness on the soles of my feet Another really bizarre symptom that I think might have another cause. ??? I had sprayed the soles of my feet at bedtime with magnesium oil two nights in a row, as I have done in the past when experiencing a severe migraine. I did not bathe or shower until a third night. 5 minutes into my bath, my feet (and only my feet) were EXTREMELY pruny, as if I had been soaking for more than an hour! I have found nothing online indicating that this wierd fluke may be related to the magnesium oil, nor to antidepressant withdrawal/discontinuation. After the bath, my feet were excruciatingly itchy (just the skin, not the nerves) for at least 30 minutes! After much reading on this and other similar forums, I contacted my P.A. that has been assisting in my medication management for the last 3 months. I am going to reintroduce 5 beads of Venlfaxine tonight and see if it makes a difference by the time my afternoon appointment rolls around tomorrow. She is doubtful that any of these symptoms are related to the antidepressant, so I hope this works. I really hope that my experience, along with the litany of literature I will be leaving with her tomorrow, convinces her of this very real and very under-reported issue!

Serotonin Toxicity vs. Serotonin Discontinuation Syndrome: I have had very severe chronic serotonin toxicity. Neuralgia and neuropathy developed over a 4 years period to include the entire right side of my body. Level 8-10 pain daily for 12 weeks before anyone figured it out. Given injectable IMITREX to" help" -- wrong, made it worse, could have killed me! The toxicity started wrecking my ANS: sweats, chills, loosing 1/2 - 2 lbs daily for months, high fevers, low fevers, high blood pressure, migraines, vertigo, bowel issues, at points inability to walk or voluntarily move my body. Basically, hell. The pain was so severe that I would dissociate — once for 3 whole days. Are there any resources here or elsewhere that offer in depth information about Serotonin Toxicity? The toxicity was caused by receiving TMS treatments. Transcranial Magnetic Stimulation. I had one round of 36 treatments 4 years ago, got me out of depression and "coincidentally" a developed neuraligia/neuropathy at the same time. Again had TMS this past December - February. The doctor who treated me is a leading researcher, psychiatrist, runs a program training other docs to give TMS treatments and I mean it -- a really a lovely woman, smart, and compassionate -- told me when I was asking if the TMS was giving me muscles spasms and increased nerve pain, "That's an issue for your neurologist." Previously she had also told me that one of the ways that TMS works, is it increases the effect of serotonin based medications. She didn't see Serotonin Syndrome sitting in front of her and asking her "What's going on here?" Today the pharmacist told me that TMS reduced the blood/brain barrier. WARNING: TMS + Venlafaxine caused serotonin toxicity for me, be cautious! Another smart compassionate and more curious woman and — my psychiatrist figured it out after I delivered her all the puzzle pieces I had been collecting. She told me to immediately stop the Imitrex and start a taper of Venalfaxine. VERY SLOWLY, though she didn't give me specifics on what slowly meant. I came up with what I thought was slow taper, and half way through had to double the length. I tapered Venlafaxine in 3 months from 225 to 0. I had taken it for 10+ years. Psych meds for 25 years. I had to, because it was quite literally killing me. But now of course, I'm ten days off and I'm feeling pretty sick: Parkinson-like movement symptoms being the chief concerning symptoms, especially when combined with the vertigo. I take a few moments to "Get going" when I want to move. And then I lurch around for another 10 seconds until my body remembers how to walk. I have the bruises to prove it! At times, just standing still my whole body shakes like a tree in the wind. I keep dropping things and have no strength in my hands. Can someone inform me what this is? Is this part of Discontinuation Syndrome? Its kinda freaking me out. I also have the usual! discontinuation symptoms! ringing ears, painful eyes, weird noises in my head, muscle twitches, nausea, diarrhea, brain fog, EMOTIONAL!, Over energized and completely fatigued. Visual disturbances. Muscle and joint pain almost everywhere. Swollen hands. Itching skin so bad I thought I was having anaphylaxis and went to the ER two days ago. Surprised I could remember all my symptoms, cause really the brain fog + zero memory issue makes it so this post took me several days to write, in several 1 hour sessions. I used to write semi-professionally. So this is actually a symptom as well. Last night, I had about 2-3 hours of uncontrollable rage (self directed violence) that was provoked by sensory overload. Embarrassing, terrifying. Is this part of Discontinuation Syndrome? I know the best remedy for "discontinuation syndrome" is reinstatement. I tried 3 mg prozac. Got nerve pain from head to toe within 4 hours (a symptom of Serotonin Toxicity). BUT, on the flip side the next day a started feeling better. My psychiatrist is going to look at all the possible SSRI and SNRIs to see which one might be possible in a micro dose. I spoke to my psychiatrist today and she suggested 20 mg non-extended release venlafaxine twice a day, with a a slower taper. I need to figure out what a slower taper would look like. I read 10% decrease per month? Is that correct? Any resources, advice on that? BUT, the thing is, I don't think any boosting of serotonin is a good idea for me right now given how extremely ill I got from serotonin toxicity. AND YET, my "discontinuation" is fairly severe, so I’ve decided to go back on. I’m choosing nerve damage because I don’t want to risk long term discontinuation syndrome. I will get myself ready to be in pain. What's worse: body wide neuropathy (nerve damage) in both CNS and ANS? Or Parkinsons like movement issues, vertigo, fits of rage, and the risk of long term discontinuation syndrome? OR??? Is there something I can do about discontinuation that will not raise Serotonin? I'm pretty freaked out by realizing I'm in between two really horrible things, and I do not know with certainty what to do. Please make any responses concise and focused on the above question. I've got major information processing issues. (In the end it took me several hours to write this post. I tried to keep it focused. THANK YOU! -------------- What I am doing: EXERCISE I am making myself go out and do gardening every day. Hard physical labor. Somehow this works for me. Can't explain it. I don't question it, though it is making my muscles sore from the work out. Figure I’m regaining the strength I lost with 4 years of nerve pain. Most days I use foam rollers and yoga therapy (my profession) to soften the rocks in my muscles. And ice baths (fabulous for my nerve pain and muscle spasms and migraines) DIET: I drink lots of water and coconut water, lemon, mint. Basic diet for past 5 months: DO EAT: above ground vegetables, meats, fish, eggs, seeds, nuts, water. DON'T EAT: grains, no fruits, no dairy, no root vegetables (EXCEPT gratefully purple potatoes, parsnips and turnips :-) ! RECENT DIET ADJUSTMENTS Reinstated coffee and it seems to help me move a bit more smoothly. :-). Added Rice and bananas as foods I can eat when I'm still horribly nauseous and ravenous simultaneously. HERBAL TINCTURES: burdock, kava, lobelia, turmeric, white willow, and valerian. CURRENT DAILY MEDS: Felodopine for High blood pressure Oxcarbazepine for nerve pain Naproxen (Aleve) as an antidepressant (anti-inflammatories do help) Levothyrozine (hypothyroid) Levothyronine (hypothyroid) Singular for asthma Medical Marijuana — PCP, neurologic and psychiatrist all endorse this. Cannabis (oral infusion in cocoanut oil 2-3 times a day and vaping) Helps with the nerve pain, anxiety and depression. Total game changer for allowing me to be physically active and do things I enjoy and need to do to feel like I’m actually living — i.e. gardinging, socializing. Question: is cannabis seroternergic? Anyone know? PRN MEDS * Valium 5 mg PRN for muscle spasms, and at this point for the anxiety, irritability. Usually take 0-4 each day, depending on how bad things are. I chart it every day. Aware it is addictive. * Bendydryl (two OTC pills) with Promethazine suppository for neurological pain and nausea. Works OK for pain. * Low dose Ketamine nasal spray when the neurological pain is beyond bearing (to stay out of the ER) I’m finding that a single dose really puts the brakes on the discontinuation syndrome and have been using it that way. Previous does for nerve pain were 4-16 depending on the severity of the pain. CURRENT SUPPLEMENTS: Methylated B vitamins (I lack 1 of the genetic pairs for methylation) Vitamin D 5000 iu. for depression Alpha lipoid acid for neurological issues N Acetyl Cystine for neurological issues Reservatrol for neurological issues CoQ10 for neurological issues PAST: 10+ years venlafaxine ER 25 years psych meds. First ten years took almost all of the possibly relevant ones. Side effects and ineffectiveness. Starting 2 years ago I started slowly weaning off meds. I've gone from 14 meds to 7. Diagnoses: PTSD Major Depression Anxiety Sleep disorder "Post Lyme Disease" An auto-immune system problem? Migraines (Serotonin toxicity?) Neuralgia and neuropathy through out the right side of my body Yours truly, UrbanFeral -------------------- Med / discontinuation history. 2002? to 2016 Venlafaxine ER. First antidepressant that worked. Alas due to combination with TMS (transcranial Magnetic Stimulation) I developed chronic serotonin syndrome, extremely ill since January 2016. Tapered over 3 months from 225 to 0. (too fast!) It was easy till I got to the 37.5, and then discontinuation kicked in. As of 6/20/16 going back on 20 mg non-extended release, twice a day and beginning a slower taper. 2012-2016. One at a time, slowly I eliminated medications from 14 to 7. DX Plaquenil which had been treating post Lyme non-specific autoimmune disorder. Safely got off it over a 4 month period. DX Spironolactone for heart arrhythmias and high blood pressure. No issue getting off it. Lunesta for insomnia, tapered off over a 4-5 month period. Ativan - stopped taking it when I started taking Valium this year to control severe muscle spasms. Cannot remember what else I got stopped taking. 1992-2002, over 20 different medications tried alone or in combination that were either ineffective or had bad side effects. I'm going to work on a complete list. It's going to be real piece of work.