whatshappening: Did I reinstate too late?

[whatshappening]

I was starting my third effexor taper 7/2015 -6/2016 and down to 3 mg untill nerve conditions of numbness, buzzing, tingling, burning and buzzing sensations in limbs started. I didn't know what was happening and neither did my doctors and thought I had some other illness such as MS, fibromyalgia etc. Did numerous tests with no diagnosis. Anxiety and insomnia was at an all time high so Doctor reinstated full 37.5 mg dose on 6/30 and up to 75 mg in 1 week. Because the nerve conditions also were not allowing me to sleep the doc gave me clonazepam. 

 

Later I was then given lyrica to help with the nerve conditions. but After a one week trail of lyrica in August I discontinued immediately due to some paradoxical effects of jerks and muscle fasciculations and also decided the   clonazepam   might also be a culprit and started a  4 week taper  with the help of mirtazapine for sleep.   

 

While this was going on only through the course of my own research did I come to the conclusion that the nerve conditions I was suffering were initially from SNRI withdrawal symptoms. September faired better as the initial withdrawal symptoms seemed like they were being resolved after a few months back on effexor so then I figured the effexor was helping with that...Great! but....

 

As soon as I was done with the clonazepam some of the initial nerve symptoms I experienced in June have returned. Not sure if the clonazepam was masking it. So now my issue is that I'm at a higher dose of the effexor than when I started and the withdrawal symptoms has not been entirely reversed and don't know what to do at this point? Taper off effexor? I'm still using mirtazapine for sleep because because the nerve condition of either a jerk, adrenaline surge, numbness etc will keep me up. Please help me I'm desperate!!!

Edited October 1, 2016 by scallywag
highlight doses, add tags

[scallywag]

whatshappening -- Welcome to Surviving Antidepressants (SA)

I'm sorry that you've had such a difficult time coming off Effexor and other medications because of undereducated, misinformed medical advice.

A request: Would you summarize your history in a signature: medications, doses + dates for starting, changing dose, as well as discontinuations & reinstatements, in the last 12-18 months particularly?

• If you can't remember actual start or stop dates, please provide month & year, e.g. "May 2016" or "mid-July 2016."
• Any drugs prior to 18 months ago can just be listed with start and stop years.
• Please include all
  • prescription drugs you take even those that aren't for a psychiatric condition.
  • supplements
  • over-the-counter medications, and/or
  • street drugs you take, if any.
• You don't need to include symptoms or diagnoses other than the initial condition that led to prescribing the first  drug. 
• The purpose of putting medication and withdrawal history in your signature is so that we can see it at a glance to answer your questions. A list is easier to understand than one or multiple paragraphs.
• You can find instructions in this topic: Please put your withdrawal history in signature

When a someone is taking multiple medications, we ask that that you post an interactions report.  Please include Follow the link below to get your report. Just select the text, copy it and paste it in a post here.  Link to interactions checker on drugs[dot]com:
Drugs Interactions Checker.
 
You probably need to hold at current doses for a few months.  You've been through several changes and shocks to your CNS (central nervous system). Your symptoms are most likely explained by these challenges to CNS stability.
 
To assess whether your symptoms might be caused by something else, please keep notes on paper of the times of your doses and your symptoms, when they arise or change intensity. Here is a link to a post that describes the kind of notes that are most helpful for this task:
Take notes of doses and symptoms.
 
Some topics about withdrawal and tapering:

• Before you begin tapering -- what you need to know
• What is withdrawal syndrome
• Why taper by 10% of my dosage?
  
   
• Tips for tapering off Effexor (venlafaxine)
• Tips for tapering off Lyrica (pregabalin)
• Tips for tapering off Remeron (mirtazapine)
   
• How your brain responds to psychiatric drugs - aka "Brain remodeling"
• Youtube video, 4 minutes: Healing from antidepressants

[whatshappening]

Thank you for responding scallywag. I updated my signature as you requested. Can you please review if this is good?

 

I've been making a symptom journal since this all started.

 

I plan on holding as you suggested since I thought the effexor corrected initial symptoms but now see that they are back. I'm concerned that the symptoms will not get better as I have been back on effexor for over 3 months now and even at a higher dose. If the parasthesia symptoms don't get better does it make sense long term for me to still be on this drug?

[Altostrata]

Welcome, whatshappening.

 

Do these nerve symptoms occur or get worse at any time of day? Do your symptoms follow a daily pattern?

 

Why did you go off clonazepam? Does the mirtazapine aid your sleep?

 

Please use the Drug Interactions Checker as Scallywag suggested and post the results in this topic.

[whatshappening]

Scallywag, I went to the drug interaction link and plugged in my prescriptions. here is the update!

Interactions between your selected drugs

Major venlafaxine  mirtazapine

Applies to: Effexor XR (venlafaxine), mirtazapine

Using venlafaxine together with mirtazapine 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.

Switch to professional interaction data

Moderate clonazepam  venlafaxine

Applies to: clonazepam, Effexor XR (venlafaxine)

Using clonazePAM together with venlafaxine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

Switch to professional interaction data

Moderate cholecalciferol  magnesium oxide

Applies to: Vitamin D3 (cholecalciferol), magnesium oxide

Ask your doctor before using cholecalciferol together with magnesium oxide. If you are undergoing chronic kidney dialysis treated with cholecalciferol you should avoid magnesium oxide. Using these medications together can cause high magnesium levels, particularly in chronic kidney dialysis. This can cause nausea, vomiting, flushing, low blood pressure, a slow heartbeat, drowsiness, coma, and death. High magnesium levels may also play a role in the development of bone disease in dialysis patients. 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.

Switch to professional interaction data

Moderate clonazepam  mirtazapine

Applies to: clonazepam, mirtazapine

Using clonazePAM together with mirtazapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

Switch to professional interaction data

Minor clonazepam  magnesium oxide

Applies to: clonazepam, magnesium oxide

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed. 

For clinical details see professional interaction data.

[whatshappening]

Welcome, whatshappening.

 

Do these nerve symptoms occur or get worse at any time of day? Do your symptoms follow a daily pattern?

 

Why did you go off clonazepam? Does the mirtazapine aid your sleep?

 

Please use the Drug Interactions Checker as Scallywag suggested and post the results in this topic.

 Hi Altostrata 

 

In May of this year I had some numbness in arms and feet but was told it was carpal tunnel or a pinched nerve in my neck or probably standing too long at my retail job. Then in mid June it worsened to tingling, burning sensations, and buzzing in all extremities especially when trying to sleep at night. My right leg felt a little weaker when walking as well during this whole time. 

 

For clonazepam, I started developing muscle jerks and muscle fasciculations when trying lyrica for nerve condition. Dropped the lyrica after a week but the muscle jerks and fasciculations still continued and worsened after 2 weeks. that's when i figured it probably was the clonazepam as well. Used mirtazapine to help taper off clonazepam and give me some sleep while doing so.

 

Mirtazipine helps with sleep better than clonazepam even though it still is very broken and I get up every hour or two. 

 

All nerve issues are more apparent when trying to rest/sleep (shut my mind down) which is why we've tried several meds for sleep to get me past the point I don't notice the nerve symptoms too much. 

 

I feel like I'm stuck between a rock and a hard place and don't really know what to do going forward. I do know for sure I don't want to add any more meds or change my current doses unless it is hurting me to be on it.  My doctor is useless and doesn't seem to know much about withdrawal syndrome. 

 

Your thoughts would be much appreciated.

[Altostrata]

Your nervous system needs to settle down from all the drug changes. Be patient and treat it gently, it will gradually get better over time. This can be very frustrating, hang in there.

 

Keep very steady with your drug schedule. What time do you take your drugs now?

 

Many people do better with fish oil and magnesium supplements, see
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/

 

We recommend magnesium citrate or magnesium glycinate. This can help you relax at night.
 

[whatshappening]

My doctor thinks I'm a rat in a testing lab. No more! I plan on holding. I feel like I'm in withdrawal intolerance from the Effexor though and not sure if it's helping to be on it. I will look into the the two magnesiums you suggested. I also use a magnesium chloride oil spray from Amazing oils that I spray on my hands and feet as well.

 

I take my effexor at 5:30pm and mirtazapine an hour before I go to sleep.

 

last night was a little rough since the numb hands would keep happening not allowing me to drift off at all. I Finally slept at 5am but always waking up a few minutes after to numb hands that I have to shake off. One scary thing happened this morning were I had a quadruple body jerk while lying down. Look like I was being electrocuted. 

[Altostrata]

The magnesium spray is very good, if you like it, keep using it.

 

Do your hands get numb in the evening after you take Effexor?

[whatshappening]

The magnesium spray is very good, if you like it, keep using it.

 

Do your hands get numb in the evening after you take Effexor?

 

nope. but now I'm wondering if it's the magnesium spray since I use my hands to rub it on at night. Just trying to connect the dots. The numb hands happened as an initial symptom back in June so I only started using magnesium oil for a week now but the numb hands started up again in the past few days. But as mentioned I finished my last clonazepam a week ago as well.

[Altostrata]

Do your hands always feel numb or does this get worse at night?

 

Do you do a lot of typing on the keyboard?

[whatshappening]

Do your hands always feel numb or does this get worse at night?

 

Do you do a lot of typing on the keyboard?

 

just when trying to sleep but it's immediate to that relaxed state of mind. i could be just lying down not trying to sleep and it doesn't get numb.

 

Yes I type but not a lot. My doctor said I have mild form of carpal tunnel. However it never hurts during the day nor does get numb during the day. It seems now that I'm not on the clonazepam my nervous system is just over sensitized at this time so any nerve irritation is 100 times more vulnerable. Would you say this is true with any previous injuries or pain when coming off any psychiatric drugs?

[Altostrata]

Yes, it could be your hypersensitivity is exaggerating the arm symptoms. You might do some stretching exercises before bed, stretch your arms above your head.

 

Acupuncture might help.

[ChessieCat]

Here is SA's topic on acupuncture

 

I understand that you are wanting treatment for your hands but it is worth noting the information in Posts #5 & 8.

[whatshappening]

thank you. In fact prior to seeing your post about acupuncture I just came from my naturopathic and had some acupuncture done today.

[scallywag]

Your post in tuxg's intro topic:
 

hi I am in a similar situation. Been on about 3 mg. of mirtazipine for about 6 weeks now for sleep and to help taper off clonazepam which I am now done with as of 2 weeks ago. I am also on 45 mg. effexor which makes this a little more difficult. I know the best route of what has been advised is to taper off effexor first then mirtazapine. When i tried a 1 year taper off effexor I ended up getting nerve issue withdrawal symptoms this pass June when i got down to 3 mg. Therefore I'm back on effexor hoping to reverse some of the nerve issues and stabilize before attempting to taper again. I'm only using Mirtazapine currently to help sleep pass the nerve issues.

It would seem like the more logical route would be to taper mirtazapine first since I have been on that less time and at a lower dose. And since I am still trying to stabalize nerve issues with effexor I would need to stay on that versus mirtazapine. But any advise or thoughts would be greatly appreciated please. I really would only like to be on one pill.

It's best to post your questions in your introduction topic, whatshappening. That way all your updates, questions and replies are in one place.

 

Effexor is a tricky little monster.  Usually we suggest that you taper that first because the mirtazapine could act as a "cushion" for some of the bumps on the Effexor withdrawal road.

 

Are you taking Effexor XR? Do you take it once/day or 2x/day?

[whatshappening]

Your post in tuxg's intro topic:

 

hi I am in a similar situation. Been on about 3 mg. of mirtazipine for about 6 weeks now for sleep and to help taper off clonazepam which I am now done with as of 2 weeks ago. I am also on 45 mg. effexor which makes this a little more difficult. I know the best route of what has been advised is to taper off effexor first then mirtazapine. When i tried a 1 year taper off effexor I ended up getting nerve issue withdrawal symptoms this pass June when i got down to 3 mg. Therefore I'm back on effexor hoping to reverse some of the nerve issues and stabilize before attempting to taper again. I'm only using Mirtazapine currently to help sleep pass the nerve issues.

 

It would seem like the more logical route would be to taper mirtazapine first since I have been on that less time and at a lower dose. And since I am still trying to stabalize nerve issues with effexor I would need to stay on that versus mirtazapine. But any advise or thoughts would be greatly appreciated please. I really would only like to be on one pill.

It's best to post your questions in your introduction topic, whatshappening. That way all your updates, questions and replies are in one place.

 

Effexor is a tricky little monster.  Usually we suggest that you taper that first because the mirtazapine could act as a "cushion" for some of the bumps on the Effexor withdrawal road.

 

Are you taking Effexor XR? Do you take it once/day or 2x/day?

 

I take effexor xr. That is the one I have been taking for 5 years. it's the one that gave me problems getting off. 

[scallywag]

Are you taking it once a day or as a split dose with some in the morning and some later in the day?

[whatshappening]

Are you taking it once a day or as a split dose with some in the morning and some later in the day?

I take the effexor once a day. The mirtazipine is taken 1 he before bed.

[scallywag]

Thanks for that information. When trying to determine whether symptoms are adverse effects or are from withdrawal, the best tool is a log of medications and symptoms. Here's a topic that describe the type of notes that are most helpful:
Take notes of doses and symptoms
 

[whatshappening]

Thanks for that information. When trying to determine whether symptoms are adverse effects or are from withdrawal, the best tool is a log of medications and symptoms. Here's a topic that describe the type of notes that are most helpful:Take notes of doses and symptoms

 

Thank you scallywag. I have a written journal of the past few months but do I need to write it here in my post every day? Also, if you could clarify how I am to use this forum. Each time I have a different question am I putting in this same intro post I created, do I start a new topic, do I log on to others posts if my question or situation is similar to the subject posted? Let me know.

[ChessieCat]

"Each time I have a different question am I putting in this same intro post I created, do I start a new topic, do I log on to others posts if my question or situation is similar to the subject posted?"

 

If a question is about your own situation it is better to ask it here in your Intro/Update topic.  That way you keep all of your history in one place and the answers will be there for both you and other members to see.  If you ask your questions in other topics they may get missed.  You are welcome to join in the discussions on other topics.

 

If you see another member's post and you want to ask about its relevance to your own situation, you could quote, or copy and paste it and post it in your own topic, or at the very least, mention the member's SA name.

[whatshappening]

"Each time I have a different question am I putting in this same intro post I created, do I start a new topic, do I log on to others posts if my question or situation is similar to the subject posted?"

 

If a question is about your own situation it is better to ask it here in your Intro/Update topic.  That way you keep all of your history in one place and the answers will be there for both you and other members to see.  If you ask your questions in other topics they may get missed.  You are welcome to join in the discussions on other topics.

 

If you see another member's post and you want to ask about its relevance to your own situation, you could quote, or copy and paste it and post it in your own topic, or at the very least, mention the member's SA name.

 

good to know.  thank you chessie cat. 

[Kay]

hello

whatshappening

 

I'm working on gathering plaintiffs to file a lawsuit for the drug Effexor XR, it sounds like you could be an eligible plaintiff. If you are interested in finding out about joining the lawsuit, please visit this link to my post about it here: http://survivingantidepressants.org/index.php?/topic/12939-effexor-xr-tardive-dyskinesia-lawsuit/

[whatshappening]

hello

whatshappening

 

I'm working on gathering plaintiffs to file a lawsuit for the drug Effexor XR, it sounds like you could be an eligible plaintiff. If you are interested in finding out about joining the lawsuit, please visit this link to my post about it here: http://survivingantidepressants.org/index.php?/topic/12939-effexor-xr-tardive-dyskinesia-lawsuit/

 

Hi Kay,

I know your lawsuit is on movement disorder. My problems were with paresthesia related symptoms (numbness, tingling, burning sensation etc). Please advise.

[whatshappening]

Within the past month I have managed to taper my mirtazapine from 3.75mg down to 1.75mg. The decision to do this was based on having to hard of a time getting up in the morning before 8:30am. But now that I'm down to 1.75mg I've just been so spacey and lethargic during the day time. I still get the same amount of sleep as I did on 3.75mg so I'm just confused as to why the sudden lack of energy and tiredness. It's like my brain is in a bubble and I'm a walking zombie. I didn't feel this way on 3.75mg or even the doses after that. Does anyone know if this feeling gets worse as you go further down on mg? I want to do a gradual taper down to 0mg so sleep during the night is not affected but this spaced out feeling during the day makes me want to do a faster taper.

[scallywag]

Within the past month I have managed to taper my mirtazapine from 3.75mg down to 1.75mg. The decision to do this was based on having to hard of a time getting up in the morning before 8:30am. But now that I'm down to 1.75mg I've just been so spacey and lethargic during the day time.

Reducing from 3.75 mg to 1.75 mg is a 53% reduction in a month. You are having symptoms because that was too large a dose reduction. Please read Why taper by 10% of my dosage?

[whatshappening]

 

Within the past month I have managed to taper my mirtazapine from 3.75mg down to 1.75mg. The decision to do this was based on having to hard of a time getting up in the morning before 8:30am. But now that I'm down to 1.75mg I've just been so spacey and lethargic during the day time.

Reducing from 3.75 mg to 1.75 mg is a 53% reduction in a month. You are having symptoms because that was too large a dose reduction. Please read Why taper by 10% of my dosage?

 

 

Hi scallywag,

would this apply to even short term use? I was taking 3.75mg for 5 1/2 weeks (8/29-10/4) and then started the decision to taper on 10/5 last month. With 10% every 3-4 weeks it would take me longer to get off versus the actual time for intended use. Your thoughts would be much appreciated.

[whatshappening]

 

 

Within the past month I have managed to taper my mirtazapine from 3.75mg down to 1.75mg. The decision to do this was based on having to hard of a time getting up in the morning before 8:30am. But now that I'm down to 1.75mg I've just been so spacey and lethargic during the day time.

Reducing from 3.75 mg to 1.75 mg is a 53% reduction in a month. You are having symptoms because that was too large a dose reduction. Please read Why taper by 10% of my dosage?

 

 

Hi scallywag,

would this apply to even short term use? I was taking 3.75mg for 5 1/2 weeks (8/29-10/4) and then started the decision to taper on 10/5 last month. With 10% every 3-4 weeks it would take me longer to get off versus the actual time for intended use. Your thoughts would be much appreciated.

 

 

I forgot to mention. I tapered with these increments: 3.0 mg (9 days), 2.5 mg (11 days), 2.25 mg (11 days), and now 1.75 mg for 8 days currently.

[scallywag]

Your symptoms are telling you it's too fast.

 

Reducing dose by more than 10% weekly/biweekly is applicable when it's the only medication you've taken and you've taken it for a month or less. That isn't your situation: since June of this year you

- went off then back on Effexor,

- started clonazepam and tapered off, (possibly too quickly, all I know about benzodiazepine is how to spell it)

AND

- started mirtazapine in August.

[whatshappening]

Lol..Well looking at it that way I your right of course.

 

I just dont want my body to get used to another pill long term which is why I'm so eager to get off mirtazapine as quickly as I can. As for The clonazepam, I had to do faster than normal as I had developed paradoxical symptoms from it.

 

I will hold more than 3 weeks at a time and resist the urge to taper more than 10%.

 

I appreciate your feedback.

[scallywag]

The CNS (central nervous system) starts adapting to a medication in as little as 2 weeks. If you want to minimize the risk of your symptoms getting worse and lasting for a long time, your best bet is to taper more slowly than you have so far.

[whatshappening]

4 minutes ago, Altostrata said:

@whatshappening, you're tapering too fast. Please update your Introductions topic.

Hi alto,

I would hardly say it's fast, I have been tapering from 37.5mg since july 2017 and down to 9mg currently using the 10% cut of current dose every 6 weeks. By the way, how do I update my into topic?

[Altostrata]

@whatshappening, this is your Introductions topic.

 

Your nervous system is telling you it needs to rest from all the tapering you've done. Your nervous system makes the call on this. You've said you've had a hard time in your taper for a while, but you've continued despite the warning signs. Now you're getting a bigger warning sign.

 

If I were you, I'd stop tapering for a while, maybe several months, maybe even updose by a bead and hold for a good while.

[whatshappening]

23 minutes ago, Altostrata said:

@whatshappening, this is your Introductions topic.

 

Your nervous system is telling you it needs to rest from all the tapering you've done. Your nervous system makes the call on this. You've said you've had a hard time in your taper for a while, but you've continued despite the warning signs. Now you're getting a bigger warning sign.

 

If I were you, I'd stop tapering for a while, maybe several months, maybe even updose by a bead and hold for a good while.

Yes I will stop for a bit. I did updose once earlier this year. I was at 11 mg when I noticed withdrawal symptoms happening so went up to 13mg (sweet spot). It only stabilized for a month then symptoms came back despite my updose and hold at 13mg so I figured I would just keep going. 

 

Aside from this, do you have any thoughts on beta blockers? Can you forward me to a thread that talks about this. I appreciate your guidance.

 

[Altostrata]