baroquep

baroquep: Pristiq taper help - advice needed

231 posts in this topic

Hi Chessie, yes, it's a little shocking to find out how long it takes to get these drugs out of your system safely.  Think once you realize just how damaging they are, it's human nature to want to stop the drug as quickly as possible, I know I did.  Didn't think I'd ever find the patience to keep it slow and steady.  Thank God I found SA.  Wouldn't have been able to do this without this site.  A big thank you to everyone, especially you as you've helped me immensely.  Your support and kindness is much appreciated.  

 

Journal - Day six of the taper with no symptoms yet ... imagine they will pop up at the most inopportune time today, lol.  Have a few errands to run so am going to try and get moving and to get them out of the way and spend the rest of the weekend relaxing.  Looking forward to some downtime, didn't make any plans this weekend as I just want to take it easy.  Received the ashes of my beloved Cookie on Thursday and while I miss her terribly, it is very comforting to have her back at home.  The urn is beautiful, a ruby red shaped heart that fits into the palms of my hand which I can also place in one of her favourite spots.  

 

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Journal - interesting that I didn't feel any withdrawal symptoms at all yesterday.  Could be that I didn't notice them because I was busy and distracted running errands or that I'm much more hyper-vigilant to the symptoms when I'm at work and notice them right away.  Could also be because I'm still sick and the head-cold is buffering symptoms that I'd normally feel on day six.  Highly doubt I'm out of the woods yet ... speculating that stress levels certainly play a part.  Hoping this little experiment of reducing early to coincide with my workweek doesn't backfire and that I've just delayed the inevitable.  In any event, I'll enjoy the relative calm while I can.  

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Journal - Withdrawal symptoms showed up yesterday afternoon, lots of pressure on my head and around my eyes.  Didn't lift weights as I didn't want to make it worse.  Today the symptoms are much more pronounced than yesterday.  They are also much more pronounced than my reduction on January 5th.  Pressure from yesterday has turned into a headache today.  Unfortunately it doesn't look like I'm going to be one of the lucky ones that can reduce every three weeks.

Could also be because I reduced to 49.0 from 54.67 instead of to 49.2 which would have been exactly 10% ... will be reducing by exactly 10% at the next reduction.  Thought I could sneak a tiny bit extra off the compounded prescription seeing as I was so close to 49.0, but even the tiny 0.2% has made a big difference.  The wrath of Effexor notices every little smidge you try and take away, so no more playing around with dosages, learned my lesson.  

While, symptoms are manageable I'd like the next reduction to be more than just manageable.  Have been sick during this reduction so that could have something to do with it, but probably best to err on the side of caution and just stick to the 10% every four weeks.  Hard to keep that as a focus as when I start to feel better again, the urge to reduce faster is still pretty strong.

So my little experiment to try and "schedule" the worst of the withdrawal for a Saturday and Sunday was an abysmal fail ... oh well, you live and learn.  

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Hi baroque

 

Being sick and losing your kitty may both be factors in getting stronger withdrawal symptoms this time.

 

But remember it's better to get off comfortably than quickly and be uncomfortable.  It will take as long as it takes, but it will happen, maybe not as quickly as we'd like.

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Hi Chessie, yes, dealing with difficult emotions this month for sure and the cold obviously didn't help things.  And yes, for sure it is better to get off comfortably rather than quickly.  Find that when I'm feeling awful, it feels like it is going to take forever but when I adjust to the new dose, I start to feel so good, that I can't wait until the next reduction.  

Journal - woke up this morning with a slight headache though it went away by mid-morning without taking any Advil, so that was a bonus.  Big difference from yesterday, so while the head pressure/headache yesterday was pretty intense, particularly because I very rarely get headaches, I'm not feeling any withdrawal symptoms tonight and feel pretty good.  Almost back to normal ... the desperate/depressed, feeling sorry for myself emotion from yesterday has lifted and I'm back to feeling optimistic again.  

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Journal - woke up with a bit of a headache and was okay until my vision started going really blurry and I was unable to focus, otherwise a relatively symptom free day.  

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Journal - Had a dull headache on and off most of the day.  But tonight I had a spell of nausea came over me like a tidal wave.   Had to really focus on not being sick.  While the headaches are not much more than a continuous dull ache now, I am really thrown off by the nausea, especially since I've been at this new dose for 11 days.  Normally I would be starting to feel a lot better by now, so this is a little disappointing to still be feeling strong withdrawal symptoms almost two weeks later.  So this is new.  Haven't been lifting weights this week because I don't want to tax my CNS anymore than necessary.  Looks like I may have to hold a lot longer than I'd planned.  My rule of thumb is to not another reduction unless I've had at least two full symptom free weeks ... fingers crossed.

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Journal - seem to be slowly stabilizing at this new dose though I can still feel minor withdrawal, dull headaches continue on and off and get that weirded out feeling now and again but I can ride it out and challenge my thoughts, or just get busy and distract myself so nothing major but still feel like it's just an arm's length away now and again.  Sleep is better now and I'm sleeping through the night more often than not so that is a major bonus.  Hopeful that I will be in a position physically and mentally to reduce 10% the 20th of February.   

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Nothing major in the way of symptoms is GREAT! :D  I hope the next decrease is as smooth as this last one.

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Thanks Scallywag, Yes, having no major symptoms is a nice feeling.  Glad things are going well with your taper, you are getting close!!!

Journal - withdrawal symptoms have slowly settled.  Headaches are gone and the weirded out feeling faded away.  This is actually the best time in the adjustment period when the symptoms have settled and I can notice the benefits of a much clearer mind and hope returns.  Feeling confident that I will be able to reduce again on the 20th.  We have a long weekend coming up here in Ontario and I've booked Friday off as well for good measure.  Getting closer to the 50% mark which didn't even seem possible at the beginning.     

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Journal - Reduced to 44mg today.  Excited but also a little nervous.  Guess it's better to feel nervous than overly confident.  Hopefully this month, the worst of the withdrawal symptoms will hit next Saturday and Sunday and not wait faithfully until I'm back at work.  Not sure why the pattern changed last month as normally I'd start feeling the withdrawal six days after a taper.  Oh well, guess the only thing you can count on in withdrawal is the unexpected.

One thing I have noticed since being back on Effexor is that I am gaining weight without really changing my diet.  While I have been adding extra protein to buffer withdrawal, am surprised to notice that that I've gained about five pounds since being on Effexor since September last year.  Am hoping that this isn't a trend and that the weight will drop back off as I reduce the dose.  If all goes well, I will be on 10mg by the end of the year.  That thought alone keeps me patient and hopeful that I'll eventually get this drug completely out of my system and it feels good knowing that I'll only be dealing with small doses a lot faster than I initially thought.  

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You are doing really well.  I hope this drop goes okay for you.

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Am so pissed off after reading this information regarding Effexor (Pristiq is concentrated Effexor) induced memory loss, poor cognitive function and decline, etc.  This is something that was happening to me and getting worse as the years went by.  I couldn't even recall the name of a movie I'd seen a couple of nights previously, simple instructions, word retrieval ... my short-term memory was shot.  I have a really hard time understanding WHY Effexor or any of these anti-depressants are being handed out like candy by family physicians ... do they even bother to research these drugs before prescribing them?  Honest to God ... It's disgusting what pharmaceutical companies are willing to do increase corporate profitability ... obviously willing to sell their souls for a buck.  

 

In a study of the tolerability of venlafaxine at a dose range 75 to 600 mg per day for treating DSM-IV major depressive disorder “failing memory” was reported at all doses in 44.4% of cases. The severity of venlafaxine-induced memory loss was also noted to increase with dose and length of treatment.[32] As memory loss may have a significant impact on the patient’s ability to function in his community or place of work, this adverse effect should be an important consideration when prescribing venlafaxine in an out-patient setting and suggests that venlafaxine is most suitable for the treatment of in-patients.

 

source: ^ Harrison CL, Ferrier N, Young AH (June 2004). “Tolerability of high-dose venlafaxine in depressed patients”. J. Psychopharmacol. (Oxford) 18 (2): 200–4. doi:10.1177/0269881104042621PMID 15260908.

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They do research them, but the manufacturers' R&D Marketing teams manipulate the studies in many ways manipulations to make the drugs look more effective and less harmful than they are.

 

If you're up for a stomach-churning read, get a copy of Anatomy of an Epidemic, by Robert Whitaker. It's eye-opening reading. The Toronto Public Library has copies on shelves and through the online e-book borrowing service "Overdrive."

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Help needed ... for the last two reductions I've been reducing 10% every three weeks instead of the usual four and think I might be running into trouble.  Withdrawal symptoms hit today, bam, the fourth day, they just came out of nowhere ... no warning at all.  One second I was good, the next my mind felt the usual weirded out feeling I hate, only even more pronounced than last month.  This is very unusual for me as I normally don't feel withdrawal symptoms for at least six days after a reduction and they are fairly mild.  

So, am thinking two things, first that every three weeks is way too fast for my system, or that I'm reaching the point where I have to reduce the percentage of the taper less than 10% and push back to reducing every four weeks.  

I'd honestly convinced myself that I'd forgotten to take my pill this morning because the withdrawal hit so quickly, so I ended up leaving work at lunch to get the damn pill into my system before going into full withdrawal.  Unfortunately for me, I did take this morning's dose, much to my surprise, so that was obviously not the problem.  

 

So my question is do I go back to 49.0 OR should I persevere through the present withdrawal symptoms (providing it doesn't get any worse than this) and go back to four week holds?  I'm apprehensive about going back to 49.0 only because it may cause my CNS further disruption by bouncing the dose around.  The withdrawal isn't horrific (yet) and knowing what I know now, I could probably persevere through until my brain settles again, as much as I hate feeling like this.  By no means is this as bad as when I first switched from Pristiq to Effexor but getting a little too close for comfort.

I know I was forewarned by ChessieCat and KTP not to shorten the hold but I had to find out for myself if I was going to be one of the lucky ones that could reduce a little faster, obviously not ... sigh.  Was hoping that I could get rid of a larger percentage while my dose was still high but obviously my CNS is having none of that.  

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Hi baroquep,

 

If your withdrawal symptoms get to the unbearable stage you only need to updose a small amount, possibly add an extra 0.5 or 1 to your current dose.  That may be enough to reduce the worst of the symptoms.  These drugs are strong so even though the suggested amount seems minute, it may be all that is needed.

 

I can understand you wanting to try and get down faster.  I think we all do.  However, don't see it as a "failure", just a lesson that from now on you need to be extra careful.

 

You might be able to go a bit faster than the equivalent of 10% 4-weekly by doing 3 weekly holds with a smaller % drop.  I'm not up to doing the calculations at the moment, but I'll see what I can come up with a bit later in the day once my brain has warmed up.

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Okay, just did some calculating.

 

Doing a 7.5% reduction every 3 weeks is the same as doing 10% reduction every 4 weeks.

 

This means that if you reduce 8%, 8.5%, 9% or 9.5% every 3 weeks you would be going faster than a 10% drop every 4 weeks.

 

Mathematically savvy folk probably could have worked that out in their head with no problems but I'm a visual person and had to do it using a spreadsheet.  However by doing it the way I feel comfortable with, I am confident that I got it right!  And anyway, I love puzzles so it was right up my alley.  Once I realised that 7.5% 3 weekly is equivalent to 10% 4 weekly I thought "oh yes, of course".  It was much simpler than I was making it but I had fun doing it.

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Hi ChessieCat, thanks for getting back to me.  Found out yesterday just how much of a fire-breathing dragon Effexor withdrawal can be if you are not careful.  I will heed your advice and not make this mistake again.  At the end of the day, am not sure what was worse, the shock of withdrawal symptoms four days early and thus throwing me off big time or the actual withdrawal symptoms themselves.  Today they are much more manageable so I don't think I'll have to take any extra beads, for now at least.  Will hold steady at 44.0 for the rest of the prescription and renew it at the same dose at the end of the month if I feel I need to.  Obviously a two week symptom-free hold is just not enough time for my brain to recover.  
 

 

Journal - feeling a little better today compared to yesterday.  When the withdrawal symptoms hit yesterday, it was such a shock and really took me by surprise, blurry vision and that most familiar feeling of my brain being in a vice and feeling slightly paranoid that everyone could notice that I was feeling loopy.  Trying to get my confidence back today but think it's going to take a while.  Feeling wobbly on my feet today.  Lately I've been feeling a little distracted and somewhat in a fog.  Slammed my finger in the door the other day as I didn't notice quickly enough that my hand was still in the door when it automatically swung shut.  Have had this feeling before where it feels like the wheels in my brain aren't turning fast enough to keep up with what is going on around me.   Am a little disheartening to have to move the date back on my Scallywag chart, but in the long run it is absolutely for the best.  Am now a little worried that I've screwed things up by trying to go faster and that 10% is going to be too much next month as well.  Guess I won't find out whether I've reached that "oh oh" point in the taper or if this early withdrawal was just the result of trying to reduce the hold by a week, so will have to wait and see.  In any event, guess there is no point in stressing what will or won't be and just remind myself to expect the unexpected when it comes to Effexor withdrawal.  

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Journal - Feeling a lot better today though still not back to withdrawal normal.  This reduction threw me for a major loop and have been having a hard time regaining my confidence.  Physical symptoms are gone, bugged out eyes, head pressure, vertigo, diarrhea but feel hypervigalent and anxious that this reduction hasn't gone as smoothly.  So my observations are that, for me anyway, a reduction every three weeks brings on more profound withdrawal symptoms which is a major concern.  Unfortunately, my focus is still on getting this drug out of my system sooner rather than later.   When I look at my Scallywag chart, the difference in milligrams left by the end of the year is really negligible, 14mg vs 10mg so it's just not worth the mental aggravation to go faster which results in stronger withdrawal symptoms just to get that extra 4mg out by year end.  So there is it, still have not completely embraced the fact that it is going to take me at least five more years to be free of anti-depressants.  Need to take a cue from ChessieCat in that I have to try and shift the focus to how far I've already come, rather than on how much further I have to go, but man, it's hard when you feel like crap  :ph34r:

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Hi Baroquep, it is hard when you can't see the end of tapering but the time does pass and with smaller cuts you can get off and live your life while on the way. In my experience it just is not worth rushing, you will end up suffering and that is no fun! It is 5 years now since I started tapering and I am on my last one. I was delighted when I started the last leg of my tapering thinkingbthat within a few months it will be over but my body has other ideas. I have to go so slow with tiny drops and it will be at least another 2 years making 7 in total.  I tapered effexor for 3 years in total. What I thought was a slow taper took a year, no real problems just some minor withdrawal for a day or so after each drop.  A month after stopping I started awful withdrawal and had to reinstate. It was 7 months before I was stable enough to restart my taper and that time was awful with massive withdrawal waves.  It was another 18 months or so to taper the 1mg I reinstated at! I am not trying to put you off, just say that it is better to go very very slow and be functioning, getting better and better as the doses lower, than suffering withdrawal.

 

Listen to your body and if a cut causes problems have a long hold to let your CNS settle, then make smaller cuts. You will get there in the end, even a snail will get where it needs to be eventually! 

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Accepting can be hard.  When I felt really awful I would tell myself that I know what this is and I just need to get through this day.  Knowing and understanding the withdrawal symptoms helped me.  At least when I felt crap I knew what it was rather adding the "not knowing" or second fear to the mix.  The other thing which I have found helpful is what I think they call mindfulness.  Noticing the withdrawal symptoms, not trying to fight against them and reminding myself I'm feeling this way because my brain is healing.  It's like when a sore is getting better and it is itchy and driving you nuts.

 

This is temporary.  You have learned from experience and won't go as fast next time so once you get through this awful patch and you go a bit slower hopefully you won't feel this bad next time.

 

And remember, you have gone from 50mg Pristiq to about 22mg (equivalent) in 5 1/2 months.  You have done well.  But it is time to slow down.  The goal is to get off comfortably, not quickly!

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Hi MammaP & ChessieCat, thank you very much for your thoughtful responses.  It does help to read encouraging, supportive messages from women who are well into their journey and know of what they speak.  Am sure I will get through this funk, and hopefully closer to acceptance as time goes on.  Best wishes to both of you.  

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That's just one of the reasons why this site is so valuable!

 

Have you been practising acceptance?  We have to make the effort to do it.  The more we do it the more automatic it becomes.  I've just done a google search and found this "Acceptance means perceiving your experience and simply acknowledging it rather than judging it as good or bad." from how-to-practice-acceptance-for-mindfulness

 

When it comes to withdrawal symptoms, it is what it is!  You can't change it.  Of course you can worry and stress but that isn't good for you and I believe that it actually slows the healing process because it diverts the brain's attention from healing to dealing with the stress.

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Journal - seemed to have stabilized somewhat from the last reduction though brain fog and forgetfulness are persistent.  Am overly tired lately even though I'm sleeping through the night but finding that even after a full nights sleep, I wake up feeling unrested.  Yesterday I had a long nap in the afternoon and had no trouble falling asleep or sleeping through the night.  Feeling very impatient and annoyed today and was ready to snap at the first person that looked at me the wrong way.  Obnoxious coworker has switched from crunching celery to crunching chips with her mouth open and wanted to tell her to STFU.  Met another coworker for lunch and burst into tears over the recent death of my cat Cookie.  While most of the physical symptoms have abated, the heightened emotional ups and downs are still with me.  Brain fog, emotions and feeling distracted are starting to weigh on my mind.  Even still, the usual antsy feeling of wanting to reduce faster is back ... not sure why that extra week hold seems so far away after a reduction.  Based on last reduction, once bitten, twice shy so I won't be reducing again until a full four weeks have passed which will bring me to March 20th.  Might even wait until the weekend as my granddaughter's birthday is on the 26th and I don't want to be in withdrawal stress and want to enjoy the day.  Wish I could retire soon, some of my coworkers really get on my nerves.

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Journal - feeling slightly better the last few days, though the brain fog is starting to affect my work ... inability to stay focused on the task at hand, easily stressed and overwhelmed by things that really don't matter.  Talked to my pharmacist last night and told her that I'm not going to reduce every three weeks anymore and depending on how the next reduction affects me, that we might have to lower the percentage of the monthly reduction.  Unless I start to notice a marked improvement over the next week, I may call her back and ask her to make up another month of 44.0, just to be safe.  Have a sneaking suspicion that I am either getting close to my personal "uh oh" point or that last month's reaction was a blip from trying to speed up the taper to every three weeks.  Will not, under any circumstance, do that again ... just so not worth it.  

  

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Journal - today was a major disappointment ... totally unable to focus at work.  Things that I would normally consider a challenge, overwhelm, anger and frustrate me.  This last reduction has not gone well at all.  Not only did the withdrawal hit me hard and fast, what little recovery I have is negligible.  My emotions are still all over the place and every so often, I get this thought that I'm better off dead.  I realize that it is only a thought and part of withdrawal, so I've just been ignoring the thought when it pops into my head, but it's disturbing nonetheless.  Called my pharmacist today and told her that I was going to hold at 44.0 for at least another month ... will stay put at this dose until I feel some genuine progress.          

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Journal - took the day off work today ... am tempted to take the rest of the week off and try to come back down to earth.  Unfortunately I know that even a few good days of rest is not going to magically "fix" the shock to my brain.  Don't have any physical symptoms which is great but unbalanced emotions and cognitive decline is getting worse, not better.  Is this what it feels like to be lobotomized by psychotropic drugs?  

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Journal - still having trouble processing information, managing stress, getting easily overwhelmed and it's been quite the challenge at work.  Hoping that I will stabilize by the end of April so that I can continue to taper.  After talking to my pharmacist, we've decided that I am going to hold at 44.0 mg for another month and then lower the percentage of the next two reductions to 7% a month which will bring me to 50% of my original dose.  If the next two reductions cause me the same type of difficulties, I will stay at 37.5 mg for at least six months and reevaluate from there.  Not happy about having to put the brakes on so soon but there is really no other alternative.  

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Hi baroquep

 

Newtonsmom has just posted an update which I think might interest you.  From her newest post:

 

"If I had known when I cut back that first dose in May of 2012 it would be 4.5 yrs later when I took my last dose, I would have been hopeless.  I realized my beginning doses were changed too frequently.  I should have slowed down.  When I got sick the first year, I should have stayed at that dose and waited until I was well to keep reducing.  I had to get to know my body and I learned that 6 weeks is a cycle for me, not 4 weeks.  Toward the end, I kept making the doses ridiculously minor and when I went off- nothing.  For quite a while, 4 days into a change, I would have a blow-up or crying jag.  Then, as I got toward the end, they seemed to happen at 2 weeks and then nothing.  I joked with the pharmacist how negligible the dose was but he understood.

 

I'm happy to say that 3 months out I've had no problems from Effexor."

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Hi Chessie, thanks for pointing out that link, the timing is priceless, so thank you.  Read Newtonsmom's thread last night.  Am prepared to hold at 44.0 mg for as long as it takes for me to regain my balance before attempting another reduction, even a smaller reduction.  Looking back, I realize that I did have cognitive difficulties after a reduction before which seemed to resolve so am going to hang onto that bit of hope.  It's obvious as I write this, that the desire to get this drug out of my system is so strong that my focus is still on the end goal rather than being in the present moment where I really need to be.  In any event, will see how I'm feeling next month and reevaluate before making another reduction to my current dose.  Appreciate your support, it means a lot to me.  All the best to you.    

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received a timely email this morning ... 
 

When time passes 

and nothing seems 
to change, we are afraid

that we are caught in a whirlpool 

taking us around and around and 

going nowhere. We don't want to be 

pressed into a mold that keeps us from 

moving forward. Within us is the power 

to move mountains. Frustration and 

confusion can glaze that power so 

we become negative... but we 

are powerhouses, and we 

can break through.

 ~ 
We 
are children 
of Light and we 
cannot be held 
against our 
will.
 
Joyce Sequichie Hifler
~•~

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Help needed ... I can't think straight anymore and right now am in jeopardy ... am making mistakes that is affecting my bosses law practice and if I have a job by the end of the week, I will be utterly amazed.  would I just make things worse if I tried to updose?  or should I just keep things the same and hope that this brain fog will resolve itself before I lose my job?

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There's nothing that will make a difference immediately. 

 

You must have had a doctor prescribe the Effexor to switch from the Pristiq.  How closely has s/he been following your progress?

 

Talking with your boss about having a health issue may protect your income and job. Afterwards, you should summarize the conversation in an email, send it to your boss and bcc your personal email address.

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Thank you for your response Scallywag.  I've managed to get an appointment with my family doctor for Thursday (she's semi-retired and only works three days a week now).  I did have a conversation with the doctor-on-call who advised me to just stay on the same dose until I see my MD.  I have been reluctant to see my MD prior to this as she knows very little about withdrawing from antidepressants and I thought I could ride it out ... unfortunately it is taking a lot longer to stabilize after the taper on February 20.  I've tried coming off of these drugs under my MDs supervision twice before with disastrous results and that is why I have been relying on my pharmacist and SA more than my MD.  Yes, am planning on talking with my boss tomorrow when he is back in the office and hopefully that will be enough to save my job.  

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I've just done some working out using the online dose calculator in Scally's signature.

 

If you had stayed on Pristiq and tapered by 10% every 4 weeks you would have been at 26.6mg on 2 March and 23.9 on 30 March.  If we are using double the dose of Pristiq for Effexor then it would have been 53.2mg 2 March and 47.8mg on 30 March.

 

Using this calculation at the beginning of March you are between 3.8mg-9mg lower than if you had tapered by 10% every 4 weeks.

 

If you do decide to updose I suggest you try a very small amount and see if it helps to clear the fog. I'm thinking that 0.5mg or 1mg increase may be enough.  But start low and give it at least 4 days to see if things improve, keeping notes.

 

Let us know what you decide and Keep it Simple, Slow and Stable

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Hi Chessie, I had been reducing exactly 10% every month, with the exception of January and February, where I decreased an additional 0.3% over those two cuts.  Had I continued to stick to 10%, I would have been at 44.3 instead of 44.0 where I am now.  Obviously that extra 0.3% decrease on top of the 10% has made a huge difference, along with reducing the last two holds from four weeks to three weeks.  I guess I really should have known better, but thought the extra 0.3% over two cuts wasn't going to make a huge difference though I've been proven wrong.  

Am seeing my family doctor on Thursday but am extremely hesitant to discuss this with her as she really has no idea how to taper off of these drugs.  The first time, she had me taper over three weeks and the next time over three months, both times were a disaster.  I think for now, I am going to stay on the 44.0 for as long as it takes to stabilize and then try to taper again somewhere down the road.  This whole experience has been a real eye opener as to how powerful even a small percentage tapered off of this drug can have such a profound effect.  Am done for now at least ... maybe I'll try again in another year but for now, the most important thing for me is to remain sane and employed.  

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