jmirov: Effexor Tapering and St John's Wort

[jmirov]

Greetings everyone. My heart goes out to all of you suffering with this stuff.

 

I'm a 37 year old American man living in Northern Germany and have been taking Effexor XR 225mg for about 10 years. I married a German girl who passed away from Cancer a year ago leaving me and our 2.5 year old son.

 

In my early twenties, I spent 4 years serving in the Marine Corps and started noticing I had mood swings that effected my ability to do the job on a daily basis. I remember having this horrible feeling in my chest like I was on the verge of having a heart attack. I felt really out of balance and could barely perform my job. I was crying alot and had all the typical symptoms of depression. I saw a psychiatrist who prescribed Zoloft but I quickly rejected (less than a week) it after feeling how nasty it made me feel and the immediate dampening of my libido. So I finished my service contract feeling generally unbalanced and anxious.

 

I was eventually prescribed Effexor XR 225mg. At the time, I had no idea what I was getting into. It did actually rid me of anxiety but at the cost of my precious libido, emotional dulling, personality changing, etc. I could not, and still cannot feel romantic gratification as normal.

 

I tried many times (4 or 5) early on to withdraw ( always way too fast ) and it always ended with severe symptoms and full reinstatement. I have lost ten good years to this damn drug.

 

So now, I am 1.5 years into a taper and have managed to reduce to 50% of the original dosage (112.5mg). I take a 75mg generic form capsule each with 6 pellets inside. I split the pellets into four pieces  and reduce by one of these 1/4th pieces (~3mg Venlafaxine).

 

At the beginning of the taper, I was reducing by 3mg every week. I would feel brain fog and a bit of nausea for a couple of days and then return to "normal." I would halt the reductions when life required some stability. This seemed to work well enough for a long time. Then there came a point last year when the symptoms ramped up and it was clear they weren't going away. In retrospect, I think this may have been the catch up point of all the reductions.

 

Out of desperation, I went to a local drug store and got some St. John's Wort. Here in Germany, they sell pharma grade St. Johns Wort in every corner drug store. I popped two (600mg) and in less than an hour felt that warm rush up the back of my head and my brain was once again online. I felt so good with the addition of the SJW and thought it may produce a "Prozac Bridge" type effect. I was too optimistic and tried doubling and even quadrupling the reduction amounts. This led to symptoms straight away.

 

Then I hit a new low a month ago which led me to take another 300mg of SJW (total 900mg now) and an up dosing from 94mg to 112.5mg Effexor. To up dose, I simply added (1.5) 12mg pellets. This was too much of an increase and I felt agitation, restlessness and anxiety for a few days. Instead of holding and waiting to stabilize, I decided to reduce and or eliminate the SJW (big mistake). I endured 5 days in a mentally shut down zombie state before reinstating the SJW (900mg) which almost instantly returned my mood to "normal."

 

Then today, I took the entire 900mg SJW together with the 112mg of Effexor first thing in the morning and it upset my stomach and my mood crashed while walking with my son early this afternoon. I had to call my in laws to immediately pick up my son and I went home and took a 300mg SJW which again provided relief. I think I need to space out the SJW and once I stabilize continue the reducing at a slower 3mg every two or three weeks instead of every week...... 

Edited March 5, 2017 by ChessieCat
added spacing and drug tags

[brassmonkey]

Hi jmirov-- Welcome to SA.  I'm sorry to hear that you're having so much trouble with your meds lately.

 

Please be very careful about mixing effexor and SJW.  Even though it is sold over the counter SJW is a very strong SSRI and must be treated as such.  Mixing high doses of it with a dose of effexor can be very dangerous and put you at risk for serotonin syndrome.  Mixing up your doses as you have for the past while will also cause large swings in your symptoms and can leave you highly sensitized to the drugs which will make getting off of them a real challenge. Right now you need to take a uniform dose of each medication at the same time each day to allow your brain and body to stabilize.  This could take several weeks. To do this I would keep the effexor at the dose you've been taking (112mg it looks like) and take the SJW at the smallest dose that gives you relief.  Do not just stop either medication.

 

Once you get stable, then you can consider continuing your taper.  The SJW, being an SSRI must be treated as one while tapering, as does the effexor.  Once we get you stable, then we can address how to taper the drugs.

[jmirov]

Thanks BM. Yeah the recent upping/downing is definitely to blame as I was relatively stable for a while taking the two together....

[ChessieCat]

Hi jmirov, welcome to SA, although I can see you joined back in 2013!!!

 

As BM said, you need to get stable on a regular dose of your drugs before commencing your taper.  Below are some links which you might find helpful as you prepare to taper:

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Keep it Simple, Slow and Stable

 

st-johns-wort-hypericum-perforatum

 

I found these helpful for understand SA's recommendations:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

This is your Intro/Update topic where you can ask questions and journal your progress.  Click "Follow" top right and you will be notified when someone responds.

[jmirov]

Greetings all. I have been tapering Venlafaxine for about a year and a half starting at 225mg. I was making 3mg cuts every week (which I realize now was too fast). I would have relatively mild symptoms immediately following a reduction which would dissipate after a few days. This went on for a long while until one day I found myself in crisis after a reduction. Out of desperation, I started taking 600mg St. John's Wort (~6mo ago) which did seem to help at the time. But now I feel as I've complicated my problem with the addition of this new drug. To make things worse, I started making even bigger cuts shortly thereafter thinking the SJW was a kind of a serotonin "buffer". I ended up with symptoms shortly thereafter and updosed the Venlafaxine by 18mg at once. I started having Serotonin toxicity symptoms from this increase and decided to quit the SJW and after 5 days of withdrawal effects from this sudden change I reinstated the SJW at 600mg. I feel like the effects of the up-dosing of Venlafaxine have greatly subsided but now I've over burdened my system with the SJW. I would like to return to a slower taper of only the Venlafaxine. My wonder is: shall I continue taking the SJW at 600mg for a bit longer or could I start with a 150mg/week taper soon?