peng: my battle with venlafaxine

[peng]

New here, so will hope to fill in fuller history later.

I am 71 and have had depression to varying degrees 1977 to date.

Managed to work full time 1964-2001, though.  12 years on irregular shift pattern 1964-1977.

 

Last month, went to new younger GP who arranged blood tests, (after I had given him my list of ill-health symptoms!)

Blood, mostly OK, but indicated low folic acid, he said.

I am on 5mg daily folic acid tab for last 5 weeks.

 

I do feel better (carrying out lots of small projects in my retirement).  Had so many ups and downs in last 40 years, though, that I think this may be a placebo effect.

 

However, a more positive side of me thinks I may be on the way to breaking through the wall where "the drugs don't work anymore" at 225mg Venlafaxine slow release.

 

I have been on Losec (Omeprazole 10mg) for decades, too.

I read that it can spoil your absorption of certain vital items in the vitamin B family, at least? 

 

Thanks for reading, all.

Edited July 24, 2016 by scallywag
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[scallywag]

Welcome to Surviving Antidepressants (SA), peng.
 
Glad you're feeling better with the folic acid.  Did your doctor recommend the 5 mg dose? I recall reading/hearing that we (almost everybody) should be careful with megadoses of folic acid -- at the very least take megadoses for short periods of time only to address deficiency.  I hope your GP has you scheduled for follow up labs. If not, you can request a 6 month follow-up.
 
If and when you're ready to reduce your Effexor dose, please read these topics that are relevant to your situation:

Why taper by 10% of my dosage?

Tips for tapering off Effexor (venlafaxine)

Using a digital scale to measure doses

Counting beads in a capsule versus weighing

[peng]

Thanks for welcome, advice and good links, scallywag.

 

Yes the GP put me on the 5mg amount of folic.  He will arrange for follow up blood test.  

The links look interesting - I have planned (yet again) to cut down on the Effexor, but the information on here and elsewhere about tapering is much more helpful than the guesswork I used before.

I realise I will never get down to zero mg after 15 years on Effexor, but as time goes buy you do not set your targets so over ambitiously.

[JanCarol]

Hey Peng, never say never!  

 

Even if you set out to reduce your dose, you may find the improvement in your condition to be so great that you keep going.  It might take years - but - once you start to reduce, you have hope of feeling better.

 

I'm not sure if you were put on Deplin or not, there is a discussion of that, here:

http://survivingantidepressants.org/index.php?/topic/1328-deplin-the-l-methylfolate-swindle/

Don't be fooled by the title, there is a balanced presentation here - it helps some, it doesn't help others.  These drugs strip us of all kinds of vital micronutrients - B-vitamins (esp B12) magnesium, calcium, and stimulate our endocrine systems in ways they weren't meant to go.

 

Please Put Your WIthdrawal History Into your Signature  (or your drug history, as the case may be).  

 

Also, consider putting your drugs into the interactions checker:  http://www.drugs.com/drug_interactions.html

You may be surprised to find that the drugs are not as helpful as you think

 

For one, the omeprazole is really not designed for long term use.  It weakens the bones, and can cause muscle problems.  (and then maybe you wouldn't need to much antidepressant, or folic acid!)  Tips for Tapering Off Stomach Acid Blockers or PPIS - esomeprazole lansoprazole omeprazole  and That Acid Reflux Pill May Be Causing Your Health Problems .

 

I found that the combination of my psych drugs, statins, and PPI (stomach acid) - shut my brain down in 3 different ways, until there was "nobody home."  So, when I check in with p-doc, she had no choice but to try and add meds to "lift the depression" when really, I just needed to come off the statins and PPI (and that was so successful, I came off the psych drugs, too!)

 

Welcome to SA!

[Altostrata]

Welcome, peng.

 

Yes, omeprazole interferes with the absorption of B vitamins in the gut. If you have low B vitamins -- not even a deficiency -- that alone can cause low mood and other ailments. This alone (plus working an irregular shift when your "depression" started) could cause the condition for which you are taking an antidepressant.

 

If you are not taking omeprazole for a very serious condition (indigestion doesn't count), you may wish to taper it and restore proper gut function. Then, when you eat your green leafies, you will get all the folate and other B vitamins you need (except for B12, that comes from animal products) from food rather than a pill.

 

You need all the B vitamins, not just folate. Please consider your apparent folate deficiency -- that's why supplementation seems to help -- a red flag about your nutritional status.

[peng]

Forgot to say, I have actually been tapering the 10mg omeprazole for a couple of months.

I am removing 27 of the beads per day just now and will remove an extra couple each day unless I get a kick in the guts!

 

A recap and expansion of my profile now:

Going way back in time (1960-85), gastric acidity and reflux was so bad from teenage years onwards, that in 1985 I received Nissen's fundoplication surgery to "rearrange plumbing" around the gullet area/hiatus hernia.  This procedure was carried out on the NHS by a top man in Edinburgh after I had been put onto Nardil for a few weeks.  Needless to say, the years of very irregular shift patterns 1964-77 had not helped the GERD.

 

I had thought the anxiety/depression would go when the reflux stopped after the op. but it did not.  Huge disappointment - back on to the Ativan, until docs realised I should be taking antidepressants, too.

So, Anafranil 1985-ish to 2002 when Venlafaxine became the "new one worth trying." 

 

Curiously, the only drug I found I could call a miracle drug was the Omeprazole I was prescribed after the operation when Zantac and Cisapride had not helped one bit.

Omeprazole stopped GERD dead in its tracks.  Amazing to be able to eat and drink almost anything without discomfort and sickness following!

 

So, no crippling, chronic gastric trouble 1985-2016 - only(!) a legacy of moderate depression to cope with.  I retired 3 years early at 57 in 2001.  Did not too bad, I believe, keeping working all that time and helping raise 3 children to adulthood. My wife? - I met her at work in England and cannot have been luckier.  She is a farmer's daughter and has been blessed with good health so far.  We are both 71.  

 

Returning to the present challenge, I will have to watch what my body tells me as the omeprazole dose diminishes.

A couple of nights ago I had a touch of indigestion after a small binge (ginger beer - 5% alcohol, toasted cheese and some dark chocolate).  "Hell mend you!", my Scottish mother would have said.

 

Next day I was fine, though.  Pre-Omeprazole, I would have been in agony and with an upset stomach for four days or more. 

 

Currently taking:

212.5mg Venlafaxine XR, hopefully going to taper, 

c6mg Omeprazole,

5mg Folic Acid, these last 3 items prescribed by GP.  Plus

4x EPA 300mg capsules (Omega 3). 

 

I bought a rowing machine last year and hope to help wage the battle by doing some exercise every other day (or 2  or 3).

 

Good luck all and I hope someone finds something helpful in my saga of the struggle.

[Altostrata]

It could very well be that your "depression" has been caused by shift work (affecting your sleep), digestive problems (caused by a hernia), and going on and off psychiatric drugs for 40 years.

 

"Depression" can be a side effect of benzos, which you've been on and off several times. Going off or switching drugs can cause symptoms (post-acute withdrawal syndromes) that might be mistaken for "depression." Low B vitamin status can cause "depression."

 

What does your "depression" feel like now?

 

Your digestive system may have changed over 30 years. You need to go off omeprazole gradually to allow your own natural gastric acid production to come back. In addition, your gut bacteria, which aids normal digestion, might need to repopulate or shift in composition. Please go easy on your digestion for a while.

[peng]

Many thanks for your interest and comments, As.

Current position is I am feeling considerably better since being prescribed the 5mg Folic Acid last month!

I think my new GP and advice on here may help me progress a bit now.  Hope so, but prepared for setbacks.

 

I have cut Venlafaxine SR 225mg by 5.5% to 212.5mg since 13 July 2016.  (27 days after Folic commencement.)  No adverse effects.  And only one brain zap in 2 weeks!

10mg Omeprazole now down to that dose less 30 beads today.

Most dramatic change is lifting of mood and drive.  Still fatigued and very tired at times, but the mood and drive lift helps hugely, allowing me to take up different projects in and outside the house.

 

I will be seeing GP on 4 August for review.  I will ask him if he will arrange for blood check.

 

How does that sound?

 

My depression score a month ago gave "moderate depression - seek help."

I must do another later today - it will certainly have improved.

 

Best regards.

[peng]

Update: Depression questionnaire today gave "possibly slight depression...."

[Swede]

Hello! Glad you are feeling better after taking folic acid. I tried some of that and b-complex and had bad reactions. Luckily i eat bananas everyday.

 

Did you experience any sideeffects when taking anafranil?

 

Take care peng!

[peng]

Swede, asked, "Did you experience any sideeffects when taking anafranil?"

 

Absolutely - it was just that the Fluoxetine made me act out of character in an undesirable way.  (Over confidence, boldness, getting into problems at work as a result.)  Other folks are OK with it though.

[Swede]

Yes sideeffects are very individual. I had them too but i must say out of those 4 antidepressants i've tried anafranil/klomipramin worked best. I could sleep alot and deep, i wish i could say that nowadays. Scary that they can change our personality.

[peng]

Hi Guys,

 

Tomorrow I have appointment with my Doctor.   A follow up after being put on 5mg Folic Acid.  (It was low in my blood tests several weeks ago.)

 

Currently taking daily:

212.5mg Effexor (1st taper after 225mg)

4mg Omeprazole (several weeks taper from decades at 10 or 20mg)

5mg Folic Acid

4X PuraEPA caps. (1200mg EPA)

 

Now I know from previous decades of stomach acidity symptoms, that nowadays, I almost never experience a taste/sense of acidity.

 

If indeed my acid is low, this will mean certain essentials will probably not be getting absorbed, eg the Folic?

Also, it seems to be known that PPIs like Omeprazole hinder the functioning of ADs?

 

Is it worth raising the subject of things like Magnesium and Calcium with my Dr?  Or anything else along those lines?

 

After taking the Folic now for over 7 weeks, the most dramatic positive changes are a lifting of mood and drive.  This has allowed me to get up earlier (going to bed earlier too) to "do stuff" - and with enthusiasm.

 

On the downside, I am still suffering from extreme fatigue, particularly after about 1300 hours.  An hour long nap has been essential on a couple of days a week. was so exhausted.

 

Any input on the above themes will be appreciated.

 

Best wishes to all. OX

[peng]

Anyone?

[peng]

Not a great outcome at the doc this morning.  Used to worse, though, after 39 years on these head drugs.

 

"See how Folic Acid goes for another month."

"Will perhaps refer you to ME specialist re extreme fatigue, too."

 

Raised question of total fatigue - the spirit is willing but the flesh is weak - had to give up on rower machine yesterday after 5 minutes and had to have nap of one hour 1400-1500 hours prior to that.

Mentally more drive, but tiredness and aches and pains thwart my ambitions.  (Sore shoulders, neck and at times head.  Rotator cuff problem, etc.)

 

He issued nasal spray prescription for sinus (bad taste on swallowing for past year - little post nasal drip. though.)  4 doses of antibiotics last year for sinus and dental abscess problems.

 

Best wishes, all.  I know some of you are far worse than me and younger.  It is so sad, but where there is a will there is a way.  XO.

[Swede]

I wish i could give you some advice peng!! You take care of yourself!!'

[JanCarol]

Hey Peng - 

 

Withdrawal can look like chronic fatigue.  Chronic psych drug effects can look like it, too.  

 

When did you drop to Effexor 212.5?  It was a reasonable drop, but that was just a couple of weeks ago, right?

 

Be patient with yourself.  

 

Here's 2 links for the night:

Six Mistakes I've Made In Withdrawal

and

http://survivingantidepressants.org/index.php?/topic/6722-auto-immune-diseases-triggered-by-ssri-withdrawal/

 

(this doesn't mean you have ME or any other immune disorder - it means that withdrawal looks a lot like this.)

 

How are your joints, do you get "tendon soreness" with your fatigue?

 

I hope you see the sun today.

[peng]

Swede and JanCarol, thanks for replies!

 

JanCarol, the links reveal stuff worth examining closely.  Many thanks.

Many of us will be able to relate to Alexjuice's mistake list.

 

I reduced from 225mg to 212.5mg Effexor 3 weeks ago.

 

Interesting titbits in the links about people hitting problems with overexercise.

I reckon I only have a fixed quota of "spoonfuls" of energy per day, to coin someone's neat analogy.

[peng]

I take my Effexor in the evening at around 1800 hours.

 

Would there be a better time, say, in the morning?

 

Regards, all.

[Swede]

I took my medicines right before sleep if I remember correctly. Don't know if that was making any difference at all at the time. Nowadays I take my thyroidmedication daytime.

 

Have a good weekend!

[VitaminB]

Hello,

 

You could get a SpectraCell or NutrEval test to get a really good picture of your B-vitamins complex status. That is what I have been doing for the past 2 years. I got on "methylated" versions of folate and b-12 and also discovered a B2 deficiency. B2 is needed for B6 to work. My B6 was low too. I have been taking 10mg of riboflavin-5-phosphate and I haven't had this much energy in a long time!!! Really good results!! 

[peng]

Thanks for that, VitaminB.

Something to look into.

[peng]

Dose tapering update.

 

Tapered down to 200mg Effexor last night from 212.5mg (-5.9% after 23 days.)

 

Omeprazole now tapered down to about 3mg by bead removal after decades at 20-10mg.

 

This thread is for "updates".  Does one keep updating the history at the bottom of each post, too?

 

Also, any good recommendations for over-the-counter magnesium supplement?

 

best wishes, all.

[ChessieCat]

Hi Peng,

 

Please update your signature with date and dose for the drug every time you make a change.  This will keep your history current and can be seen at a glance.  Click on the drop down arrow next to your name (top right) click on My Settings and then Signature on the left hand side.

 

 

This is the link for Magnesium where people discuss what they use.

[peng]

Thanks for that ChCat!

[JanCarol]

So Peng, you did another taper down to 200 on 7-Aug, right?  Please reflect that in your signature.

 

Yes, this is your journal for tracking changes, and progress, and feelings and fears and symptoms.  You will find it a valuable aid to reminding yourself what works and what doesn't.

 

I hope you see the sun today!

[JanCarol]

Hello,

 

You could get a SpectraCell or NutrEval test to get a really good picture of your B-vitamins complex status. That is what I have been doing for the past 2 years. I got on "methylated" versions of folate and b-12 and also discovered a B2 deficiency. B2 is needed for B6 to work. My B6 was low too. I have been taking 10mg of riboflavin-5-phosphate and I haven't had this much energy in a long time!!! Really good results!! 

 

VitaminB - we are reluctant to recommend B-vitamins to someone who is in withdrawal or is tapering.  They can be overstimulating, even when there is a deficiency.  Peng is working to bring the omeprazole down, which is addressing the cause of the deficiency.  When he is fully off the drug, he can evaluate if additional B vitamins will be of assistance.

[VitaminB]

 

Hello,

 

You could get a SpectraCell or NutrEval test to get a really good picture of your B-vitamins complex status. That is what I have been doing for the past 2 years. I got on "methylated" versions of folate and b-12 and also discovered a B2 deficiency. B2 is needed for B6 to work. My B6 was low too. I have been taking 10mg of riboflavin-5-phosphate and I haven't had this much energy in a long time!!! Really good results!! 

 

VitaminB - we are reluctant to recommend B-vitamins to someone who is in withdrawal or is tapering.  They can be overstimulating, even when there is a deficiency.  Peng is working to bring the omeprazole down, which is addressing the cause of the deficiency.  When he is fully off the drug, he can evaluate if additional B vitamins will be of assistance.

 

 

Yes, I have heard this from Beyondmeds.com that some people's nervous systems are so sensitive that they can't tolerate supplements. I am sorry that I am so eager to share my enthusiasm on the subject of supplements at the cost of anyone being over stimulated. I still think getting the tests done is important, because you can monitor your progress through time. 

 

I still take a full line of supplements during my taper. For me, I see it as essential to my basic health, so that after I get off the drug I am not dealing with deficiencies. 

[JanCarol]

http://survivingantidepressants.org/index.php?/topic/1068-vitamin-b-complex-supplement-reaction/

[peng]

Thanks both for trying to help.

I am doing fine at the moment so can wait and maybe try out supplement ideas later.

Appreciate your interest, guys!

XX

[peng]

I am taking about 8mg Omeprazole to keep the indigestion, gastric discomfort at bay just now.

I did go down to about 5mg last week or two, but had to resume larger dose.

I am now realising the - presumably very expensive - Nissen's Fundo. surgery in 1985 may not have been working, and that all my relief from stomach acidity, reflux, etc. has been down to the 10mg or more Omeprazole.

 

Disappointing.  I am wondering how seriously, or otherwise, 5-10mg of Omeprazole daily affects the absorption of some of the B vits?  I may be stuck on it.

 

Effexor now down to 175mg/day since yesterday.  (Down from 225mg in July.)  Feeling best than for a couple of years!

 

I dare say the prescribed Folic Acid 10mg/day for last 80 days has greatly contributed.  (Also, from my own hunch, now taking 300mg Magnesium Citrate/day. - Views, anyone?)

 

Tomorrow I am going to health centre for blood tests.  GP asked for this to see what my readings, particularly Folic Acid are now.

[Swede]

Take care Peng!!!

[peng]

Extreme fatigue back again, last few days.

Coping, just having to sit around reading, etc.  No work outside or on rower.

 

Disappointing after apparent great relief from it in July on being prescribed Folic Acid 5mg.

 

Currently taking:

162.5mg  Effexor

5mg Omeprazole

5mg Folic Acid

1200mg EPA /day

B12 drops daily wef 23Sep2016

283mg Mg Malate

Multivit. for over-70s wef 8/10/16

 

Yesterday, adding one tspoon Maruka honey to tea and coffee, instead of sugar.

Eating more fruit/veg, Brazil nuts, Cashews.

 

Any thoughts, please?  Could drop B12, for example.

[scallywag]

Have you started, stopped or changed the amount of anything you're taking recently If not, then it's likely a wave. 

 

The Windows and Waves pattern of stabilization

 

Another consideration is what you are eating. Have you made any major changes there?  Are you eating enough protein and vegetables?

[peng]

Still eating a good basic diet with fish, chicken, eggs plus juiced veg/fruit.  (including berries, prunes, spinach)

Recent changes are added "multivit for over 70s" a week ago. 

Added B12 drops from 23 Sep. (2 weeks ago.)

[scallywag]

It could be something in the multi. We usually suggest that people avoid supplements with multiple ingredients because it's difficult to identify which component is causing a negative reaction.

 

Can you link to a page that lists the components of the multi you're taking?

 

It might also be that the high dosage of folic acid has done its job and is now interfering with the absorption of important nutrients. When were you last tested for serum folate levels?