Lys: Alternating Effexor and Trazodone to stop Effexor?

[Lys]

Hi all, 

 

I am new here but I've been reading posts since last fall, when I started weaning off the Gabapentin I was put on a month before, pre-herniated disc surgery. Surgery went very well, stopping Gabapentin was a horrific nightmare of about 5 months. However, the results were so amazing I felt encouraged to get off Effexor as well. I was put on Effexor for fibro, stopped cold turkey when I got pregnant (wowza!), then was put back after postpartum depression. Six years later, here I am. 

 

So now comes the question: My recommended taper for Effexor XR 75 is Effexor ER 35 (morning) + Trazodone 50 (evening) for a week, then half the Effexor for a week, then stop the Effexor. (Whatever I do with Trazodone afterward is left as an exercise  to the taker...). I haven't found any information about this particular combination, and after the Gabapentin saga I consider myself an expert googler I can see that Trazodone itself is highly questionable, although the doses that I did take proved to me that I hadn't had deep sleep in years ( and that despite the daytime grogginess). 

 

Can the good people of this forum provide some insight into this combo? In particular, are the two medications in any way equivalent in effects, or am I going in withdrawal overnight and starting again in the morning?  Taking the trazodone before the Effexor ER is completely out of the system lessens the "brain shut-down" effect, so maybe?

 

My previous effects going cold turkey off Effexor were severe nausea, vertigo and horrifying "other" gasto-intestinal symptoms . After Gabapentin, which had shocking vertigo plus a whole host of other physical and mental symptoms (like bouts of extreme rage), this doesn't seem too bad, which is why I agreed to a fast taper.  

 

Internet suggestions I have found helpful up to this point to mitigate symptoms: Omega-3 in large quantities, protein snacks (edamame and toasted pumpkin seeds worked particularly well), ginger and liberal curry-like spice combos in the food, sun and sweat-inducing exercise (my garden has never been so weeded and trimmed). 

Edited May 29, 2017 by scallywag
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[mammaP]

Hi Lys, welcome to SA. I have moved your topic from tapering to the introductions forum. You will get more replies here and this will be your topic to be updated when you like and ask questions specific to your taper. 

 

It will help us of you can fill in your signature with your drug history.  We don't need the details of how or why in the su=ignature, just the drugs and does, and when they were started and stopped. This means we can see it at a glance at the bottom of each post wich means we don't have to go back through the topic to find the info. 

 

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

When did you take trazodone for sleep? Have you taken it since your doctor prescribed it to bridge with effexor? 

We would not recommend the cross taper (bridge) with trazodone, it is a different drug and will not stop withdrawal from effexor. It is a tricyclic and effexor is SNRI. Sometimes people use prozac but often that doesn't work and makes the taper problematic. We recommend tapering the original drug very slowly to avoid withdrawal.  When you C/T because you were pregnant, often the pregnancy hormones cushion withdrawal and after baby is born the withdrawal really ramps up, and is diagnosed as PND, the drug is reinstated and the withdrawal gets better. 

 

How long have you felt stable after the gabapentin withdrawal? It might be better to wait a while to make sure your brain has recovered properly from the withdrawal before starting to taper effexor.  I will find some links for you to help you to have a successful taper. Read up carefully before you stert so you know what to expect, and work out which will be the best way for you. Personally, I would suggest a micro taper , I tapered effexor and at lower doses was harder so cuts had to be smaller biut can be more often so it doesn't take longer but is more gradual than the 10% of the curremt dose we usually advise. 

 

Tips for tapering effexor 

 

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

 

Why taper 10%

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Micro taper

 

http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

Preparing to taper

 

http://survivingantidepressants.org/index.php?/topic/1789-preparing-to-taper/

[Lys]

Thank you very much for your answer. I came to the same conclusion after trying trazodone for 4 days, given the morning nausea and the evening brain shut-off moment. Also, it gave me great sleep, but ever increasing daytime jitteriness that was going nowhere good (there is a useful thread on this board explaining why). The fact that I couldn't see anybody trying anything like that concerned me as well, so I stopped it shortly after posting this thread.  It took about 72 hours to fully get out of my system. 

 

Complicating the story was the Effexor XR to IR switch, not the same thing at all. I would get out of my system fully at the kid's bedtime, creating serious household havoc. So I switched to half of the 35.5mg Effexor IR pill twice a day (9am and 4pm, with the calmest point being kid's bedtime). There is a gap in coverage in the night, but oddly that seems to be the least problematic part. On the contrary, I wake up without the overwhelming brain fog I used to have in the morning, and my memory retrieval seems to have improved. I seem to be stabilizing at this dosage after a week (after days of feeling Effexor getting into the system, peaking, and getting out of the system, severe nausea and dizziness, never mind headaches), but I will be moving very slowly after that. The threads detailing how to get consistent smaller doses are very welcome. 

 

When I was diagnosed with postpartum depression, multiple doctors told me: "Oh, if you take anti-depressants when you get pregnant and cut them, you are guaranteed to get postpartum depression." Now they were telling me?!? Couldn't they tell me that when they put me on anti-depressants for pain, knowing I'm trying to get pregnant? I tried to fight it but it got downright dangerous. Now I'm in a much better place physically and mentally. Maybe it's too soon after Gabapentin, but I actually learned a tremendous amount from cutting that and Omeprazole/Ranitidine, and I felt I was ready. I hope that's true! 

 

Good luck with the Tramadol. I got one dose of that some 18 years ago for TMJ pain and started having suicidal thoughts, totally out of the blue. Completely freaked out my boyfriend (now my husband), which wrote the name down to ensure I never get that prescribed again. I was never anti-medication, but I'm becoming convinced that much too often doctors throw something at the wall to see if it sticks, without regard for possible damage. 

[mammaP]

Glad that you found out about multiple doses for IR effexor, it is a problem when someone switches from ER to IR, getting the whole dose in one hit, then the withdrawal is a nightmare as you discovered.  Take care and listen to your body.  Don't make any changes if you are feeling any symptoms of withdrawal, your brain needs to catch up with the lower dose before dropping another dose. Eventually, it catches up and can take a long time to stabilise.  You are doing your homework which is brilliant and hopefully, you will do just fine. 

[Lys]

Nausea subsided, dizziness mostly subsided, I felt pretty stable. Then... 2 days ago my allergies, which were barely under control in the last few years, flared up massively and are triggering asthmatic episodes. As it's far from the worst time of the year, I don't see how it's not related. Google  to the rescue -- histamine intolerance issues? OMG, what else would this nasty medicine do?

[mammaP]

You might find some helpful topics in the self-care forum about histamine. There is a sticky with important topics on symptoms. Look at diet, or type histaminesurvivingantidepressants.org into google and it will bring up the topics. 

[Lys]

Thank you. I looked around the forum and the recommended sites and it was an interesting read. I never thought about it, but the positive anti-depressant effects I had (improved sleep mostly), started disappearing in the same time period as my allergies started ramping up. Throw a PPI in the mix in that time period, which also acts on histamines, and looks like the makings of a big problem, which might get bigger after I cut Effexor off entirely. Which I absolutely will. As soon as I can pick myself of the floor... I feel really exhausted.

 

I upped my allergy and asthma medicine temporarily, dropped everything I was using to help with nausea, and increased my carb intake (I had lowered it to almost non-existence), and it seems to help.  All my symptoms and the circumstances could point to a candida die-off as a possible culprit, which I didn't think was really a thing, but I'm changing my mind about a lot of things these days, so why not this one? 

[Lys]

Stabilized, got some sense of humour back, then cut afternoon does in half. Not too bad symptoms this time, although it triggered something wonky in my circadian rhythm (melatonin comes from serotonin, so possibly not surprising?). I have a feeling that this will sort itself out when the morning dose matches the afternoon dose.

 

Since it turns out I will be travelling internationally the full month of July, I had to speed up the withdrawal schedule. Not ideal, but immediate release medication and continuous jet lag do not mix, as I have learned in the past with other medications, and if I am to be excruciatingly nauseous and dizzy on airplanes, I would rather do it without Effexor. Mentally, I'm doing well, so I'm soldiering on. (Note that I don't recommend this schedule -- do the sensible thing and cut slowly! But I will record what happens next, either as a warning or reassurance to others )

 

Got some positive effects also: mind is waking up from a long slumber, memory retrieval is still improving, and my weight has visibly started to move downward despite the large quantity of pumpkin and sunflower seeds I constantly munch on to settle my stomach.