Nicki1722: Effexor withdrawal

[Nicki1722]

I need some advice. My doctor put me on Celexa to use as a bridge to get off of Effexor. I started it on Tuesday and it's now Friday. I took 2mg for 2 days and am now at 4 mg in addition to the 13 beads of Effexor. I continue to have facial flushing and leg burning but am not dizzy. I still have some anxiety but am starting to feel better. How long do I stay on both medications? When do I drop the Effexor? My doctor wants me to get stable on 10mg of celexa before I drop anymore Effexor but I don't want my brain to get used to both medications! Then how long do I stay on the celexa until I can begin to taper it? Thank you. I'll update my signature to include this information too.

[scallywag]

To my knowledge there isn't much information about using Celexa (citalopram) as a tapering bridge drug.

 

Would you summarize the symptoms you were having that prompted your doctor to prescribe this unorthodox combination?

[Nicki1722]

I have not been able to get stable and I have not made any changes for months. Dizzy all the time. Facial flushing and leg burning. Fatigue. Anxiety. Brain fog and fuzziness. Ear popping and crackling. Just in general feel like im dying. She said she wanted to try another medication because I was having such a hard time. She knows my plan is to eventually be completely off all meds sooner rather than later.

[Sheri755]

Hi Nicki!

 

I sympathize with you as I am also struggling to get off Effexor. I had a year long taper starting at 300 mg to 18.75 mg (two week hold). I had been holding at 37.5 for months not knowing what to do. I had a smooth, symptom free taper until I jumped off at 18.75 as recommended by my psychiatrist. He said it would be out of my system in a few days. Ha!

 

I had to reinstate at a dose of five beads after three months. I've thought about updosing but keep reading "slow and steady wins the race". I do wish that I had found this site last year but we can't go back, only move forward with the guidance of the amazing staff here.

 

I experimented with supplements, way too much. I was looking for relief from the bedridden, wide eyed terror that has been tormenting me only to discover that it's actually hinding the healing process and probably making my symptoms worse.

 

So, I just wanted to share my Effexor experience with you after what I've learned, the VERY hard way. My CNS is finally starting to settle down now that I'm holding on five beads and only taking high quality fish oil and sipping Magnesium Glycinate in water, as far as supplements go.

 

As you know, 99.9% of naturopaths, psychiatrists, PCP, etc, etc, have no clue about anything regarding withdrawal. I love JanCarol's thoughts on your journey in her post above. Everyone here is truly amazing, aren't they?

 

Wishing you all the best and hoping that you stabilize soon.

Sheri

[Nicki1722]

Thank you for sharing your story. Yes it's awful how uneducated healthcare professionals are regarding this ever increasing issue. I hate that I am using celexa to assist with the withdrawal by it's a risk I am willing to take. I am feeling better thank god and it's only been a week. Once I'm all calmed down and stable I plan to continue my journey with Effexor.

[Nicki1722]

So I looked under using the Prozac bridge for Effexor and there was a segment containing information about using celexa as a bridge drug due to its long half life. I just don't know when or how to decrease the Effexor!! I'm currently on 5mg of celexa and 14 beads of Effexor. I still have symptoms from withdrawal of Effexor. Do I wait until these go away? My pdoc would like to see me go up to 10mg celexa, wait for everything to calm down then decrease the Effexor.

[Nicki1722]

My doctor recently added celexa as a bridge to get off of Effexor. How long do I take the celexa and Effexor together? I'm currently on 5mg of celexa and 14 beads of Effexor and still have withdrawal symptoms but they are not as bad. It's been 1.5 weeks on the celexa. Please help!

[Altostrata]

Hello, Nicki.

 

I moved your post from the Prozac switch topic. It contains vital information.

 

Was the improvement with Celexa immediate or did it take some time to settle in? Has it gradually gotten better?

[Nicki1722]

It was immediate, as in I started with 1mg and felt it that day. Not all the symptoms are gone but Most notably the dizziness and foggy brained feeling are gone. At first I felt like I had taken an anxiety pill. However, I now still get random anxiety throughout the day for no good reason and sometimes a feeling of intense panic that leaves as quickly as it comes on. I still get a very flushed face and feel weird at times. My energy is back in full force and I'm slowly introducing exercise back in as well. I just don't want my brain to become accustomed to both meds but I also want to do this safely and stabilized, which I know I am still not.

[Altostrata]

That is a good sign. You might not want to increase the Celexa, you seem to be stabilizing. It will take some time for your system to settle down, see The Windows and Waves Pattern of Stabilization

 

What times of day do you take Celexa and Effexor?

[Nicki1722]

I take them both in the morning. Do I continue to take both until I'm stable? Then work on the Effexor?

[Nicki1722]

Hi all. I've been on Zoloft 50mg since 11/4 (going on 8 weeks). My Effexor withdrawal has gone away but now I have side effects from the Zoloft. My anxiety comes and goes and my depression is stable. However, I feel weird all the time, I could lay around on the couch and do nothing all day. I have zero motivation, although I force myself to do stuff. The biggest complaint is feeling off, which then gives me anxiety because I feel so weird. Is it too early to try and lower the Zoloft? Any suggestions? My ultimate goal is still to get off of everything. Thanks in advance.

[KarenB]

The weird feeling could well be from abruptly stopping celexa and effexor, and also from the disruption of starting another drug.  That's a lot for your body to adjust to, and 8 weeks is not that long in those circumstances. 

 

I would hold at that dose for a bit longer yet, and make daily symptom notes.  Particularly watch for any symptoms worsening or improving.  These notes will provide the clues for what your next step should be. 

[Nicki1722]

Currently I am still experiencing what I believe to be side effects of the Zoloft. I am on week 10 of taking it and feel well mentally but am not all here. I kind of feel like I'm high or something. I also have been getting horrible vertigo spells that come randomly. I have to sit down just because the room is spinning. I plan on trying to decrease the Zoloft when I get back from Mexico in 1.5 weeks to see if that is the culprit or if it's still the Effexor withdrawal. Sigh.

[Nicki1722]

I'm now back from Mexico and plan to try and reduce my Zoloft by 10% once I get a prescription for liquid. I'm scared to death but hope it helps with these side effects and the underlying Effexor withdrawal doesn't come back. I'm exhausted all the time, still have anxiety that I believe is being caused by the Zoloft, have horrible memory problems and feel so weird all the time.

[Nicki1722]

I need some serious advice. I've tried cutting 10% of my Zoloft and am a complete mess. Should I go back to the normal dose and wait longer to level out? My anxiety is out of this world and I can't stop crying! Please help.

[PoetJester]

Hey Nikki,

 

I was just reading your thread.  I quit Zoloft in 2014 and it seemed like I cried for about 2 years afterwards.  I also didn't sleep much in those two years.  I had been on Zoloft and zyprexa for a number of years and withdrew from them for a year in 2005 and when I reinstated, I developed the crushing fatigue that you were talking about.  for the next 8 years, I could not get off my couch and hardly ever left my apartment and slept 15 hours a day and was still exhausted all the time.  Basiclally all I could get myself to do during that time, was cook basic meals and watch tv and occasionally read a book.   I quit the pills cold turkey in feb of 2014 and felt better mentally and spiritually, but couldn't sleep anymore.  It's a pretty lousy trade-off.  these days my short term memory is often non existent and I feel like a shell of my former self from the exhaustion of having to go 3 years with little to poor sleep. 

 

it sounded like you were doing better on the Effexor and Celexa combo in October.  The crying thing is pretty common with Zoloft wd from what I have read.   hopefully trying to get off zoloft doesn't screw up your sleep as well. I don't cry much anymore, but it's mostly because I feel emotionally spent after 3 years of wd.  withdrawal mostly doesn't really offer good choices.  either you can sit around without much motivation but at least have a stable mood or you can start to lower doses and gain some energy, but them become an emotional wreck.   I wish I had better advice for you, but it seems like once these pills start to poop out on us, we are kind of stuck.  I have noticed that people who consciously quit the pills and have bad withdrawals and then reinstate, often go back to being how they were before- functioning and pretty happy.  for others of us, it's a long hard trying road.  I wish you the best of luck however you chose to go.

 

Poetjester

[Nicki1722]

Oh lord no. The best I have felt in awhile was recently on the Zoloft. Not great bUt better than before going through Effexor withdrawal. I felt horrid on celexa.

[PoetJester]

Oh sorry, I must have misunderstood your earlier post. be careful of Zoloft wd then. lots of crying and insomnia, from my experience anyways. I would just stay stable at 50 mg for awhile if I were you since it sounds like the 10% cut is causing the tears and anxiety. I used to cry into my food and soak multiple dish towels with snot and tears during my Zoloft wd.

[scallywag]

Nicki, when did you decrease Zoloft by 10%? Sometime between January 22 and yesterday, but it's helpful for us to know the actual timeline.

 

Also, please put that date and decrease in your signature.

[Nicki1722]

Oh yes, sorry about that. The decrease was 2/2/17 and I went back to 50mg last night (2/20) after crying for hours On end yesterday. So it was 11 days until I felt the decrease hit me. The 11th was the first day I was really emotional. Then I had a couple decent days, then cry two days in a row, to crying everyday.

[scallywag]

Sometimes it can take more than a few days after a decrease for the w/d symptoms to surface. It could be that you've discovered an important timeline for your tapering. 

 

About earlier this month: Your drop on Feb. 1 from 50 mg to 40 mg was a 20% reduction. You've discovered (unintentionally) that large a reduction doesn't work for you.

 

A little arithmetic that is sometimes difficult when we're dealing with drug side effects and/or withdrawal symptoms:

10% of 50 mg is 5 mg; so the taper dose on the first step down from 50 mg is 45 mg.

10% of 45 mg, is 4.5 mg, so the taper dose is 40.5 mg.

 

If you need assistance calculating these, please look at the links in my signature, either the online spreadsheet or nz11's "The works" downloadable excel file. You can also ask here in your thread. Many of us like to flex our math muscles to help others.

 

Let yourself get good and steady back on the 50 mg before even thinking about another decrease, okay? Then give yourself another 2 weeks.

[Nicki1722]

Oh goodness. No I really did only a 10%drop. I just obviously suck at math lol. I was doing it in grams using a scale and multiplying my pill times 90%.i thought about that last night after I posted this and was like "crap! I was at 45mg not 40mg!" Anyways, since the 10% drop gave me so many problems I'm wondering a couple things. 1) should I do 5% drops and 2) could the Effexor still be messing with me? *sigh*

[scallywag]

Not a problem.  It always helps to have other pairs of eyes and other brains looking at our calculations!

 

After you've stabilized, it would be wise to consider a more conservative approach, either 5% reductions or the "Brassmonkey slide."
 
Here is a post where brass talks about the slide and another post where I give an example.

[Nicki1722]

Thanks so much! I'm going to stay at 50 mg for awhile until I attempt this again.

[Nicki1722]

Ok. So I found out I'm pregnant. Now I'm really wanting to try and get off these meds! What do I do?

[KarenB]

There is a lot of information all the way through this thread:  http://survivingantidepressants.org/index.php?/topic/4394-antidepressants-during-pregnancy/  which is a good starting point for making decisions.

 

Obviously being on the lowest dose possible is optimal, however you also don't want to become destabilised due to tapering too fast.  You're currently trying to stabilise, I think? 

[Nicki1722]

That is correct. By not feeling the best still!

[Nicki1722]

Hi all. I've recently reinstated 37.5mg Effexor and a looking for advice as to how to taper off 50mg Zoloft safely. I've been on it for approx. 5 months with 3 weeks at 75mg. I just started back onto 37.5mg Effexor 5 days ago and already see my withdrawal subsiding. Everyday seems to get better. Please let me know how to get off this Zoloft now! TIA!

[scallywag]

Nicki -- our suggetion for tapering off Zoloft is the same as for any drug, 10% decrease once per month. Going faster than that risks creating symptoms:

Why taper by 10% of my dosage?.

Tips for tapering off Zoloft (sertraline)

[Nicki1722]

That doesn't risk my brain getting used to both medications? And Zoloft is making my vision very blurry which is why I need off of it. And I'm pregnant and would love to not be on two antidepressants at once.

[scallywag]

After 5 months on Zoloft, your CNS (central nervous system) has made adaptations to the drug.  Discontinuing Zoloft means that your CNS has to undo these adaptations. Going too quickly risks withdrawal symptoms. Please look at/read these links:

How your brain responds to psychiatric drugs - aka "Brain remodeling"

Youtube video, 4 minutes: Healing from antidepressants

 

Decreasing slowly minimizes the risk of w/d symptoms; decreasing quickly is likely to decrease your side effects. You are in a tough spot.

 

Joseph Glenmullen, in his book The Antidepressant Solution, suggests linear 25% decreases. Some people find that works, many others find it too fast.  It's one thing for a board-certified psychiatrist to recommend a 25% taper -- s/he can stay in touch with the person tapering and prescribe adjustments to the medication. As an online peer network we don't have those advantages.

 

If you have medical support for decreasing more aggressively than 10%/month and you know that they will respond quickly and effectively to problems, follow that advice. How fast you decrease is ALWAYS up to you.

[JanCarol]

Hey Nicki - once again, I come back to visit and you've had major changes.

 

On Celexa, off it.  CT Celexa and Effexor, add Zoloft.  Held Zoloft a few months, but reacted to 10% taper.  Added back Effexor.

 

I know you are pregnant.  Now you are stuck on both drugs.  It's a hard tradeoff - if you come off the drugs quickly for your pregnancy - the withdrawal can be equally stressful to the baby.  There is a chance that - with your hormones all oxytocin and baby-loving - you might get some tapering done without symptoms during your pregnancy (but those symptoms might hit as soon as you give birth)

 

You may need to focus on self-soothing.  Bumping your drugs up and down, adding and subtracting them is not a good long-term strategy for getting off.  In fact, it's a good pattern to set up kindling:  Limbic Aling - Hardwiring the Brain for Hypersensitivity

 

Pick a dose and stay on it.  Right now, it sounds like 50 mg Zoloft and 37.5 mg Effexor

 

When you feel better, you can start tapering.

 

Were you trying to bridge back to Effexor?

 

Because drugs.com says this:

 

 

sertraline  venlafaxine

Applies to: Zoloft (sertraline), Effexor (venlafaxine)

Using sertraline together with venlafaxine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

So - back to the coping techniques.

 

Self Soothing.  When I was a baby, I was in foster care for the first 9 months of my life.  No Mummy, just a lot of teenagers who liked to coo over me - but to a baby, that primary bond is so important.  I didn't realize until recently, that during that time I developed a self soothing technique that would serve me the rest of my life.  Mom always called it "rubbing my feet" - I would sway my feet back and forth until I settled down.  No, just moving one foot, against the sheets or in my slippers, is enough to self soothe.  I learned at a very age, a very simple technique to self soothe.

 

You, instead of switching drugs all the time, need to find a way to survive the drugs you have.  

 

Non Drug Techniques for Coping with Emotional Symnptoms

 

Breathing for Well Being

 

Meditation While Moving

 

Mindfulness and Acceptance

 

and

http://www.recovery-road.org/acceptance

(there's a great cartoon on this page, it's short, but it addresses the distress of withdrawal quite clearly)

 

I hope you see the sun today!

[Nicki1722]

Update. Up to 150mg of Effexor and no Zoloft. Not doing well. Have vision problems 24/7. Feel like this is never going to end.

[marx]

Hey, Nicki, how are you doing now? Have your vision improved?

[Nicki1722]

When do you know it's safe to try and taper a little down on your medication? I've been 5 months on 150mg Effexor. I can't tell what is side effects and what is withdrawal anymore. I'm doing much better but still just feel off. I also am at 7 months of pregnancy and would like to decrease my dose a little for the baby. My OB does not think it's necessary but I, as a mother, feel like it's the right thing to do.