KarenB: slow Effexor taper

[Fresh]

Well done Karen , thankyou.   We're a nosy bunch and everyone wants to know everything about your history . . .lol. 

[KarenB]

Wanted to share something about self-care that feels amazing to me.  I've spent the last four or five weeks in a big, deep, heavy sadness/depression.  My response (after the first two days' panic) was to slow right down, notice all my feelings and care for each one as it came.  And I mean really slow.  Like 'sit up in bed in morning, think: how do I feel?, okay?  no, feel sad, what do I need?  time to stare out window at lovely sky, okay, do that...now am I ready for breakfast?...

 

And then three days ago I realised:  My period had arrived and I'd had no PMS.  Not a bit.  No snapping, grumpy, horrid, mean, defensive, outbursts.  And also, no aching heavy stomach which often stays with me most of the month.  It's like a miracle, because usually I have a week of PMS, and a slow lead up to my period, which is usually 3-4 days early.  This month it was exactly on time, with no horrid lead-in. 

 

And I feel amazed.  My brain keeps saying 'look what can happen when you properly care for yourself...'  I realise one good episode doesn't make a pattern, but I'm over the moon anyway

[dalsaan]

One good episode may not make a pattern but it's a very good first step to one. Good on you for listening to you, all of you, and walking gently with it.

 

Thanks for sharing

 

Dalsaan

[KarenB]

Any thoughts/clarity hugely appreciated - my brain is going round in circles and I don't feel I'm able to get a clear understanding of what is going on with me.

 

To summarise:  Never got fully functional on Venlafaxine over the last year.  The last three months got less and less coping, then totally crashed into big sadness for the last month.  Tried to accept and care for myself.  Picked up a little for a week.  Yesterday and today crashed again - very sad, crying, trouble sleeping, hot ears, exhausted, napping on and off all day, irritated, defensive, horrid dreams, wriggly feet and very strong need to keep rocking at night and on waking.

 

Possibilities: 

1.  My husband thinks it's just more childhood-trauma things coming up for me to work through (because my inner-child voice has got very strong this last week).  Could be true - there's always something.

2.  Venlafaxine dosage too low (150mg/day) and therefore not working as well anymore so am having trouble coping with all my old issues of anger, depression, exhaustion etc.  My doc would say this is true and want to increase dose.

3.  Venlafaxine dose too low, so am experiencing withdrawal symptoms.

 

Don't want to increase dose at all.  But would I need to in order to stabilise before I could even consider tapering?  But fear that increasing wouldn't work anyway.

I'm so confused - perhaps I should just wait, say, another month and see what happens?  I hate this.

[Fresh]

Hi Karen ,   from your sig.  it looks as though you haven't ever recovered properly since the 2013  June/July taper.   Everything you've described sounds to me like protracted withdrawal symptoms.     You might have continued to improve when you returned to the full dose in August 2013 if you had waited , but you followed the best advice you had at the time.

If you're going to try increasing the venlafaxine ,  you could go up by 10% increments and monitor it as you go.  No sense in going up too fast - it could backfire.

It's good to see that you've had some improvement since July 2014 , but I agree with your options 2 and 3 above , you've been on this dose for a good long while now.

 

Fresh

[KarenB]

Thanks Fresh for your thoughts - Protracted withdrawal is something I hadn't considered.  

 

I feel very unsure about increasing my venlafaxine dose - what if it just keeps needing more and more, and I never reach a stable point where I can start to taper from?  Has anyone else tried increasing after such a long time - in order to try stablilising before tapering?  Did it work?  

 

Also will I ever stablilise if I just stay waiting on this dose?  A year is a long time, so I feel that I won't.  Therefore I need to do something.  

 

Feel stuck.

 

Thanks for listening/sharing,

Karen     

[KarenB]

Please can I have some help?  I Just read the reinstating pages, and see that reinstating after a month might mean it could go really wrong, esp if I've got sensitized to the Venlafaxine.  And it's been a whole year!  'Fresh' has given me some helpful thoughts on my other questions in the above posts, but it's a big decision and I would love the experience/advice of some others too, if someone has time. 

 

I know this is a busy site, I just feel scared - have I got myself stuck on this dose now and it will be hard to reinstate or taper off?

 

Karen  

[Petunia]

Also, am having this major depressive episode currently, and am wondering if pills are doing much for me anymore?  ......

 

How do people know if they are better enough, of if the pills are just masking all those bad old symptoms.  I have done huge amounts of work at counseling, but feel quite scared of discovering I'm still an angry raging person.  Not good for a mother...

 

All these pills ever do is suppress emotions and mask symptoms, they don't cure anything.  If someone is 'better' while taking these drugs, its most likely because certain difficult emotions are being chemically suppressed.  That's if the drugs work at all.  If you've done a lot of counseling, that's great and I'm sure its helped.  But if the counseling has been the kind which helps you manage your difficult emotions, then you need to be able to experience your emotions in order to learn how to manage them naturally.  If you are tapering off slowly, if any anger is going to re-emerge, it should do so slowly, then you will be able to address it in counseling.

 

If your original problem was overwhelming anger and you've already learned how to manage it through counseling, then you have the skills to be able to manage it now.  No one is an angry, raging person, we all experience anger and rage, some of us more than others, we are not our emotions, they are something which flow through us and some of them are very uncomfortable.  We need to learn healthy ways to be able to tolerate them.  Some people learn how to do this in childhood, others not.  I didn't.... and ended up on drugs as an adult.  The drugs took the edge off my anxiety, but caused depression along with other increasing side effects and health problems.

 

I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker.

 

Please can I have some help?  I Just read the reinstating pages, and see that reinstating after a month might mean it could go really wrong, esp if I've got sensitized to the Venlafaxine.  And it's been a whole year! 

 

- have I got myself stuck on this dose now and it will be hard to reinstate or taper off?

 

Reinstatement means that someone has stopped taking a drug completely and then starts taking it again.  You are still taking venlafaxine so the reinstatement information doesn't apply to your situation.

 

I've read through your thread and think you may be experiencing a combination of things.  Some of your original issue, caused by your early trauma which you haven't yet completely healed from.  Protracted withdrawal from escitalopram, which the venlafaxine didn't mask completely, although it may have helped a little, and side effects (depression) caused by the venlafaxine.  This is just my opinion, and I don't know, but its what it looks like to me.

 

If I were in your situation I would continue with a very slow and careful taper off the venlafaxine, combined with continuing counselling for the early trauma and to learn how to tolerate difficult emotions.  I'm not sure what kind of therapy you are having, but DBT is good for learning emotion tolerance. 

 

If you're wanting to come off medication and learn how to manage life without drugs, then I don't think increasing venlafaxine at this point is going to get you closer to your goal, I just don't see that its helping all that much and it may be making things worse.  Perhaps you could hold for a while, until you're feeling more stable physically, until your nervous system has settled down more, then you could continue tapering.

 

That's just my take on things, none of us can know for certain what's happening and ultimately you have to make your own decision about what you want to do.

 

Please let us know what you decide.

Edited January 19, 2016 by Petunia
fixed name on quote for privacy

[KarenB]

Thank you so much Petunia - you took a lot of time there to get a fix on my issues and I'm so grateful.  Ha, can you tell how desparate I feel?    What is it about these drugs that gives us such big fearful feelings?  

 

I have to admit that I much prefer the idea of tapering down without increasing to try and stabilise first.  I want off!!

 

I do need to learn to manage anger etc naturally.  I've learned a lot, but lately as things are not so good, I see where I need to learn more and practise more, and get myself more space.  Feel like I'm fraying away .  So 'yes' to original issues.  And 'yes' to protracted withdrawal.  

 

As to depression, I definately had it before any anti-depressants, and it went away when I first went on them, but then it's been there just as bad as ever for the last few years.  I feel like all the a/ds have done for me is mask and muddle issues so now I hardly know where I am or what causes what. 

 

I am still going to counseling with a lovely woman whom I trust.  She helps me learn CBT, EFT, and other things, plus she makes me feel understood.  I've told her about this forum, hope she reads it.

 

I will make any decision slowly - like you say waiting to settle a bit first, and get a family visit out of the way too. 

 

I can't thank you enough for your support and sharing your understandings,

Karen

[KarenB]

Update:  Changed my screen name as hubby thought it wasn't good to be so easily identified.  Probably right, but I hate that it has to be that way - It's really important to me to feel I don't have to hide anything in order to feel okay about myself.  Ah well...

[KarenB]

Thanks.  Have just done a report for Escitalopram, the first ad which caused my wd problems.  Will do another for Venlafaxine when my eyes have a computer-break .

[KarenB]

Evening everyone,

 

I've got my scales, I've spent a few months preparing and caring for myself, there are meals in the freezer, I've told all my good friends, hubby is on board, and I've spent today re-reading all all the 'Read This' posts in the forums.  Feel ready to start decreasing. 

 

Just one question:  I currently take Effexor at 75mg in the morning then 75mg at night.  To me it makes sense to decrease each of those doses equally by 10%, so that my dosage doesn't bob up and down, up and down each day.  Have I got that right? 

 

Thanks in advance,

Karen (who is feeling a little, but not too much, nervous )

[Dan998]

Yep, that seems correct. 

[Fresh]

Sounds like you'e good to go Karen.

 

Do you feel stable since you switched to Effexor?

[mammaP]

Don't cut by 10% on each dose Karen, that would be a 20% cut in total. Cut each dose by 5% to make the 10% total and keep the doses even. 

If you listen to your body and don't push through when you experience any withdrawal symptoms you should be just fine.  If you feel withdrawal it

means the cut was either too big or too soon, you will soon get the feel for it and how your body responds

[mammaP]

Sorry, ignore the last post, you are right by cutting 10% off each dose, my brain is not playing ball today! 

[KarenB]

Thanks for the help - Dan, Fresh and MamaP,

 

Not sure if 'stable' is the word, but I'm managing things - sypmtoms, emotions etc.  Nothing has improved since switching to Effexor, or since the rough summer, or the generally difficult year prior.  So I'm learning to sit with things, note things down, manage the day-to-day stuff.  I now believe the drugs are causing me a lot of trouble.  Time to start leaving them behind. 

 

'Do you feel stable since you switched to Effexor?'

[KarenB]

Hello everyone,

 

Today is day 17 since making a 10% cut from my Effexor.  I've been keeping a daily detailed chart, ticking off symptoms I experience on a long list of possible w/d symptoms.  Dizziness is my one consistent symptom.

 

Day 1 was fine, day 2 horrible and I felt scared, then I had improvements steadily for a week, then ups and downs.  Since day 14 it's definitely been harder, with more symptoms, including nightly nightmares, wriggly feet, hot ears, anxiety, irritation, exhaustion, excess saliva ... and others.

 

But overall I feel I am managing things.  Keeping lots of time to go slow and rest is vital for me.  If I get too much going on I simply get overwhelmed, cry and stop functioning.  Then I'm pretty much useless for a day or two.  So I'm going carefully and slowly.

 

I've narrowed life back to two basics:  treating me well, and treating my family well.  I feel okay.  And a large part of that feeling comes from remembering all the people on here who have got through this.

 

So thanks lovely people .     

[Fresh]

Good to hear from you Karen.    Hopefully at day 17 the worst is over and your current symptoms will start to recede from here.

Many people find 5% cuts less disruptive (less symptoms).   Maybe something to try next time.

 

[mammaP]

I agree with Fresh Karen, it looks like a micro taper may be better for you with smaller cuts but they can be more often. 

 

Check out the micro tapering thread here. http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

And Rhiannon's slow taper.... http://survivingantidepressants.org/index.php?/topic/2364-the-slowness-of-slow-tapers/

 

Having tapered effexor myself I would recommend staying where you are until you have been stable for 4 weeks before cutting again. Cutting while your nervous system is still shaky will mean more withdrawal. 

[KarenB]

Good to hear from you Karen.    Hopefully at day 17 the worst is over and your current symptoms will start to recede from here.

Many people find 5% cuts less disruptive (less symptoms).   Maybe something to try next time.

 

Thanks Fresh - I think I will try that when I make the next cut.  Will look into how long people leave between 5% cuts, but I imagine it also depends on how long I take to stabilise, really.

And MamaP - waiting for 4 weeks of stability sounds long, but also a good idea.  I don't want to worsen anything.  Is nice to hear from someone who's tapered effexor.

[KarenB]

Okay, just read some topics on slow tapering, and feel like I don't know my body/reactions well enough yet to figure out a slow taper.  Am thinking therefore of making a 5% cut next time I've stabilised properly, then waiting another month to see how it goes.

 

Or, if I get my head around slow tapers in the next few weeks of waiting to stabilise, I might do that. 

[KarenB]

Hello again,

 

Wondering if anyone else here has had a symptom of a strange feeling before falling asleep in the evening.  Hard to describe, and it sounds odd, which makes me feel reluctant to share, but I guess I really just want to get some other ideas/experiences about it.  Basically I was still awake, just waiting to fall asleep, and I suddenly felt or noticed I was different, like I wasn't me in the usual way anymore.  I was a little white box or cuff, and I had been turned the wrong way and put on the edge of the world.  And because I was the wrong way I couldn't connect with the world anymore. 

 

It only lasted a few seconds, and I felt quite freaked out, then I came back to being me again, and it felt like a relief.  But It shook me up, and I've been feeling shaken all day, and crying/overwhelmed a lot.  Could it be tapering?  I don't want to make too much of it, and part of me keeps thinking that it was just a random falling-asleep thing, but then it was also so horribly real.

 

And it was surprising in that the three days beforehand my symptoms had been gradually improving after a rough week of dizziness.  

 

I'll be very grateful to read of anybody's experiences with this.

Love Karen 

[Fresh]

It certainly could be from withdrawal/tapering a bit fast. Karen.  

What decreases have you done since your first one in May?

[clearday]

 Basically I was still awake, just waiting to fall asleep, and I suddenly felt or noticed I was different, like I wasn't me in the usual way anymore.  I was a little white box or cuff, and I had been turned the wrong way and put on the edge of the world.  And because I was the wrong way I couldn't connect with the world anymore. 

 

It only lasted a few seconds, and I felt quite freaked out, then I came back to being me again, and it felt like a relief.  

 

I'll be very grateful to read of anybody's experiences with this.

 

Hi Karen -

 

Seven months after I CT'd Lexapro, I laid down to bed one night. While laying there, awake, out of nowhere, all of sudden it felt like all the connections in my brain were dissolving one by one, and that I was disappearing from existence. It was extremely frightening. I got up out of bed, and told my wife "something terrible is happening to me". I was really scared. That sensation never happened before, or since.

 

Turns out, that was how my delayed Lexapro withdrawal began, seven months after stopping the drug. That sensation heralded the delayed onset of a two-month long Lexapro WD insomnia wave, very common with SSRI/SNRIs. By the end of the wave, my normal sleep patterns had been restored. I sleep fine now.

 

Other strange experiences during bedtime have happened over the course of my withdrawal. Makes sense, since sleep onset and waking involves sleep chemical transitions in the brain that result in dream states, REM etc., Weird things happen during that time, especially with these drugs. Serotonin is a key player in the biochemistry of sleep architecture.

 

Another unique experience I had was during waking. I laid there in bed, fully awake, face down in my pillow. All of a sudden, I was looking into a room, fully 3-D, well lit, colorful, very clear and detailed. It was not a vivid dream, I was fully awake; but the imaginary room seemed like reality. I was amazed. It lasted five seconds. Never had that before or since.

 

I see that you're on Effexor -

 

It was during Effexor withdrawal that I had my most vivid, detailed, prolonged, intricate plot dreams ever. I used to wake up and say to myself, "Steven Spielberg should get ahold of that script, what a movie that would make". I enjoyed those few vivid dreams back then, they were interesting, not disturbing. I noticed other people on here coming off Effexor report vivid dreams. But Effexor withdrawal was tough.

[KarenB]

Hi Fresh,

I've made no more cuts since the initial cut of 10% - today is day 24 since beginning tapering.  My plan was to ride this out, then wait to enjoy a month of stability, then do a very low cut, say 1%.  Perhaps if I don't see much improvement as day 28 approaches, I could consider a slight reinstatement.   

 

There are so many variables to this tapering business, and I know from reading your story that I have it easy compared to some.  

Thanks for continuing to be there for us all,

Karen 

[KarenB]

    

Other strange experiences during bedtime have happened over the course of my withdrawal. Makes sense, since sleep onset and waking involves sleep chemical transitions in the brain that result in dream states, REM etc., Weird things happen during that time, especially with these drugs. Serotonin is a key player in the biochemistry of sleep architecture.

 

Thanks for your detailed reply, Clearday.  It's reassuring to read that it was not ongoing for you, and that it perhaps isn't so strange considering the circumstances. 

 

It intrigues me, the similar themes we encountered of disconnection from existence or from this world.  Our brains must feel like utter crap dealing with these drugs - insidious.  It also reminds me of my worst times on Effexor when all I could think was 'I want to be nothing.' 

 

I'm so grateful for what I've learned here about neuro-plasticity and healing brains.  Otherwise I'd be horribly disillusioned right about now . 

 

And yes, every night since I began tapering I've had awful nightmares or utterly vivid dreams.  Before tapering I had them frequently, but not every night.  My husband also comments that I could write thrillers/horrors from them.  I find the dreams so real that I cannot say 'it was just a dream.' 

[clearday]

    

It intrigues me, the similar themes we encountered of disconnection from existence or from this world.  Our brains must feel like utter crap dealing with these drugs - insidious.  

 

Like you said, thank goodness for neuroplasticity.

 

I have experienced other strange brain sensations during the night during the last 7 months. They evolve over time; they talk of "morphing" of symptoms as we heal and progress through recovery. 

 

Sometimes it feels like bubbling, or percolating liquid in my brain.

 

Sometimes wavy feelings, similar to brain zaps but slower and less intense. I was still getting rare, occasional brain zaps at night, up until a month or so ago (up until 15 months after being drug-free).

 

Other times it is an actual physical sensation of "knocking" inside my brain.

 

Strange indeed. Usually noticeable when I wake up in the middle of the night, or upon waking.

 

So I guess all that stuff is going on during all hours of sleep. 

 

And yet, I have slept great almost every night for the last seven months, regardless of all that's going on inside there. 

 

Overall, I am progressing as expected according to windows and waves, and have done a lot of healing.

 

I get the impression that all these brain sensations -while startling and bizarre - are nothing to worry about. Just part of the healing process. 

[KarenB]

Overall, I am progressing as expected according to windows and waves, and have done a lot of healing.

 

It's really good to hear that, encouraging. 

[KarenB]

Now at day 37 since my inital (and only) cut.  Still no overall improvement, just ups and downs.  Yesterday was my worst day over all. 

I am considering up-dosing a very small amount to see if it alleviates the dizziness and nausea and exhaustion.

 

BUT, I am concerned as before I started tapering I was already experiencing a lot of what I believed were reactions to the Effexor or even just my underlying depression:  dizziness, exhaustion, intense sadness, nightmares, hot ears, dissoctiation, anxious, fearful, wriggly/kicking legs when waking etc.

 

The only 'new' symptoms since tapering are nausea, increased saliva, and a one-off freaky hallucination thing.  All the other things have increased in severity since tapering, but are not new.  Though I am starting to wake before dawn - that's new.

 

So I feel I am quite sensitized to Effexor, and may cause more trouble by up-dosing.

 

Anyone have any opinions or experiences of working this out when there were pre-taper symptoms? 

[Farout]

Hi Karen

 

I get those weird transition-between-wake-and-sleep issues all the time. It is my reaction to them that has differed in withdrawal.

 

Before I touched ADs I welcomed the woozy weird stuff as just being my brain giving way to sleep. In withdrawal they became a major source of anxiety - still do sometimes in waves.

 

If you are in protracted withdrawal from your earlier meds then separating pre taper symptoms from post taper won't give much insight.

 

There is possibly going to be a lot of bizarre sensations, thoughts and feelings on this journey. We all worry that we are going crazy or that it's relapse at times but it gets better. The fantastic people on here will be able to help you trust and recognise your own experiences.

[KarenB]

Hi Farout,

 

Thanks for sharing your experiences - helps remind me it is normal for this situation. 

 

Also, I hadn't really considered the fact that i may be in protracted withdrawal from earlier meds - thanks for pointing that out. 

 

God, there's so much to think of, and I just don't feel able to analyse all this stuff and come out with a sensible decision.  I've pretty much got my life on hold due to exhaustion, dizziness and nausea.  It's hard on my kids, and it's wearing out my husband who is having to do the work of two parents. 

 

The thought is always with me - updose and get possible relief (or possible worseness), or let things be.  I hate this situation, and I hate not being able to figure it out. 

 

So thanks for sharing your hopefulness,

Karen

[Farout]

I will leave advice on updosing, etc to the mods but I want to reassure you that, whatever you decide it does get a lot better.

 

I had a recent doings with some antibiotics (I'm through the worst of it but I'm dizzy and my face still tingles a lot) but before then I was 3.5months with no symptoms at all.

 

Be kind to yourself. We mums are the first to criticise ourselves but you are not well at the moment. These symptoms are real and truly terrible. If there was an acknowledged physiological cause no-one would be expecting you to just suck it up. You need to rest.

It's hard to explain to people who haven't been through it. Heck, it's hard to explain to yourself sometimes!

[KarenB]

Hey, thanks again Farout,  That means a lot - it's hard to find positive ideas when so tired and feeling yuck.

 

Today I'm leaning towards not updosing, just resting, nurturing and waiting for some settling, unless one of the staff here think something different...

 

I hope you are okay in your new wave.  (Actually that's a good heads-up for me to steer clear of antibiotics).

[Farout]

How are you feeling today?

 

Don't worry too much about antibiotics - if you're really sick you need to take them, just be careful which type. Apparently I was on a known offender; clarithromicin. You can always ask here before you start anything and if any weird stuff starts up then you will know it's not you. It's the tablets.

[KarenB]

Feeling better each day now, such a relief.  All the negative thoughts are gone, and I'm really only feeling a slight dizziness.  It's lovely being able to do stuff again.