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spacecadet: life after effexor/welbutrin; cognitive difficulties

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healthyliving   
healthyliving

Hello all!

 

After tapering, I stopped taking both Effexor and Welbutrin in August of this year. Although feeling overall more healthy without pumping these toxins into my body, I am finding the cognitive difficulties I am experiencing to be distressing. I feel that my memory and concentration have been severely impaired, and generally feel "dumb" and out of it. I've been taking fish oil and magnesium and go running several times per week. Just wondering if anyone else has experienced this as well, and what helped improve these problems. 

 

Thank you!

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Shep   
Shep

Hi, spacecadet.

 

Welcome to Surviving Antidepressants (SA).

 

Cognitive difficulties are very common after coming off these drugs. I'm glad you're taking fish oil and magnesium, as they have a way of calming the nervous system.

 

How is your sleep? I'm finding that as my insomnia improvements, so does my memory. 

 

Can you tell us more about your drug history? How long were you on Effexor and Wellbutrin and what dose? Also, how fast did you taper off?

 

Here is some information to get you started: 

 

What is withdrawal syndrome? 
 
The Windows and Waves Pattern of Stabilization

 

How your brain responds to psychiatric drugs - aka "Brain remodeling"

 

  

 

 

Please feel out your signature. Here is how: 

 

Please put your withdrawal history in your signature

 

This is your thread to list your symptoms and ask plenty of questions. I'm glad you found us for information and support. 

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healthyliving   
healthyliving

Thanks for your response Shep. I am really impressed with the knowledge and support I've seen so far through this forum. My journey with these medications began before moving away to college when I was 19, as I have always been a particularly anxious and shy person. Although doing well on Effexor for quite some time after I graduated,  it seemed to make underlying issues with anxiety and depression worse. Effexor was uped to 300 mg and 150 mg of welbutrin was added. This combination of drugs exacerbated my anxiety, and lorazepam was then introduced. After many months of this toxic cocktail, my body simply couldn't tolerate these medications any longer so I began to taper at the beginning of 2016. 

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Shep   
Shep

Hi, spacecadet.

 

Since you've had about 7 years off and on exposure to these drugs, that's a long time, especially at such a young age. But I also was exposed to a lot of these drugs as a teenager, and am off everything and healing.  You'll heal from this, too, and go onto have a great drug-free life.

 

You may benefit from a reinstatement of a very small amount of an antidepressant, however, I'm going to ask the other moderators to weigh in, especially since you came off two. 

 

In the meantime, please take a look at this thread:

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

I hope you feel better soon. 

 

 

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KarenB   
KarenB

HI Spacecadet,

 

Following on from Shep, I'm wondering if you can read the Symptom Checklist and let us know if you spot any that you are experiencing? 

 

Thanks for your signature.  Could you add into it the 300mg effexor, details about Lorazepam, and details of how you tapered, including the last dose you were on for each drug before jumping to 0?  Having all these details helps us to give you more accurate suggestions when considering a possible reinstatement. 

 

Thanks,

Karen

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healthyliving   
healthyliving

I think the problems that are most bothersome to me is the "brain fog", feeling dumb, and difficulty concentrating/remembering things that would not normally be difficult to me. Panic and anxiety are also problems but I know it will improve with time. I read the article about neuro emotions and definitely can identify with that. Feeling very irritable, prone to panic, and not quick witted like my normal self makes me not want to be around others. I am also having issues with energy and feel exhausted more often than not. 

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Altostrata   
Altostrata

Welcome, spacecadet.

 

Do you have surges of anxiety? Were they more intense before, as you were coming off the drugs? Do they happen any particular time of day?

 

How is your sleep?

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healthyliving   
healthyliving

When I first came off the drugs, it was a constant state of worry and anxiety. I would be fixated on mistakes that I had made or things that happened years ago. I also started a temp job several weeks after coming off the drugs which was very challenging for me. It was very hard to be around others and feel as though my work and myself were being evaluated. This is where the panic became a real issue for me. For many weeks I only went in for half days because I felt so uncomfortable at this time. My memory was so impaired that every time I went into work it was like a blank slate, not remembering what I had done or been told in previous days. I couldn't process information and everything seemed to go through one ear and out the other. 

 

At this stage in the process, my problem with sleep is oversleeping and feeling totally exhausted all the time. If I have trouble sleeping I take melatonin which works well. But I feel like a toddler who needs to nap or is quite content sleeping the day away. 

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KarenB   
KarenB

So would you say those surges of anxiety have gone now?  Or lessened?  We're just working through all the clues here ...

 

Regarding your exhaustion, it is common in w/d.  However sometimes it may have another or additional cause.  Since I began tapering effexor I experienced extreme fatigue.  Like you say, I could easily nap all day.  Breakfast would wear me out.  Eventually I got my iron levels tested and they were drastically low.  Since beginning a gentle iron supplement my energy has really picked up.  I have since discovered that a/ds can cause low iron - now if my doctor had been onto it she could have told me that from the start... :angry:

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healthyliving   
healthyliving

I will look into an iron test to see if that has anything to do it with it. Recently had a thyroid panel done which came back normal. At this time I would say my anxiety is probably worst being around others or people I don't know. My close friends and family know what is going on so I feel comfortable, but being around people I don't know or doing unfamiliar tasks (trying to learn a new job) with a partially functioning brain is very embarrassing to me. I spent many lunch breaks coming home and crying because I felt other people could tell there was something wrong, and I wasn't understanding or remembering basic tasks. 

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Altostrata   
Altostrata

Given your symptoms and the risks of taking the drug again, if I were you, I would not reinstate any drugs.

 

Try to maintain a regular schedule, get up in the morning, and go out in the natural light and walk at least a half-hour each day. Gentle exercise helps your nervous system to reset.

 

KarenB has a good idea -- have tests to see if you need some nutrients. How is your vitamin B12 level? Do you eat meat?

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healthyliving   
healthyliving

So you don't believe reinstating the 5 beads would help with the brain fog and anxiety in my case? I have had lab work done (not sure if it included b12) but all of it came back normal. And yes I do eat meat and am not on any kind of restrictive diet. 

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Shep   
Shep

When I first came off the drugs, it was a constant state of worry and anxiety. I would be fixated on mistakes that I had made or things that happened years ago. I also started a temp job several weeks after coming off the drugs which was very challenging for me. It was very hard to be around others and feel as though my work and myself were being evaluated. This is where the panic became a real issue for me. For many weeks I only went in for half days because I felt so uncomfortable at this time. My memory was so impaired that every time I went into work it was like a blank slate, not remembering what I had done or been told in previous days. I couldn't process information and everything seemed to go through one ear and out the other. 

 

At this stage in the process, my problem with sleep is oversleeping and feeling totally exhausted all the time. If I have trouble sleeping I take melatonin which works well. But I feel like a toddler who needs to nap or is quite content sleeping the day away. 

 

 

Hi, spacecadet.

 

In response to your current question about reinstating, I wanted to re-visit this older thread.

 

You state a lot of symptoms in the past tense - "I was in a state of worry and anxiety" and "for many weeks I only went in for half days".

 

It sounds like you're progressively getting better.  Are you now able to work full days? 

 

Since reinstatement at this timeframe carries more risks, it's good to look back and really see what progress you've made. How would you rate how you feel now with where you were several months ago? 

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healthyliving   
healthyliving

That was a temporary position for work and is now over, so I am looking for work again. Feel like I'm in limbo at the moment and can't tell if reinstating would help or not. 

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Shep   
Shep

Hi, spacecadet.

 

In this post here, you state you started tapering your drugs in 2016, but in your signature, you state you came off the lorazepam at the end of 2015. Do you mean you came off the lorazepam in 2015 and it's the Effexor and Wellbutrin tapers that were in 2016?

 

Brain fog and other symptoms can also be from the lorazepam withdrawal, so it's important to figure out which symptoms are coming from which class of drugs. Please note that lorazepam is a benzodiazepine and benzodiazepines carry great risk of reinstatement after you've been off for more than two weeks.

 

In your signature you mention reintroducing Wellbutrin and having an adverse reaction. Do you remember the Wellbutrin dose you reinstated at? Also, do you have a date or the number of days / weeks it was reinstated after having come off the drug? 

 

Reinstatements do carry risks, especially this far out and with a previous reinstatement not being effective.  Also,  your symptoms may still be from the lorazepam taper, these are all factors should be considered. If you have more details, it will help. 

 

What are you doing to help with your symptoms of anxiety? Have you tried meditation or yoga? You may find some ideas to help with some of your symptoms:

 

Non-drug Techniques to cope with emotional symptoms

 

Because you went on these drugs for, as you say, being rather shy and anxious, learning new skills will definitely help you as you heal. And if they are helpful during withdrawal and you keep practicing them, they will serve you well into the future. 

 

Many of us find that the process of coming off these drugs and coping with withdrawal makes us more confident than we were before we went on these drugs. So as painful and distressing as this is, know that you're going to heal from this and that you got off some very toxic drugs that many people never escape from. 

 

I hope some of these ideas are helpful and you can get back into the workforce soon. 

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healthyliving   
healthyliving

Thank you for your words of wisdom. To answer the above questions, I completed the lorazepam taper in 2015, and did a separate taper for welbutrin/effexor which was completed in august of 2016. I reinstated the full dose welbutrin xr 150 mg 2 months after I stopped taking it. At this time, I was not aware of the sensitivities to the full dosage which is described on this forum, I was simply trying to reduce withdrawal symptoms I was experiencing. 

 

It's nice to hear that many people regain their confidence after coming off of these drugs. Unfortunately, that is not the experience I am having at this time. I hope that will improve in the months to come. Like I previously mentioned, the heightened anxiety paired with concentration and memory impairment makes me very self conscious and avoidant of social situations, moreso than I have ever experienced in the past. I don't feel like myself but am trying to be patient with the process. 

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Shep   
Shep

Thanks for this additional information.

 

When you came off lorazepam, how did you taper off the 3 mg? Also, how long were you on it?

 

Lorazepam is a very potent benzo, 10 times more potent than Valium, according to the Ashton Manual. So 3 mg of lorazepam equals 30 mg of Valium. 

 

Do you remember what withdrawal symptoms you had coming off lorazepam before you started coming off the antidepressants? 

 

It's quite possible that the Wellbutrin reinstatement was at too high a dose. With entire cocktails of drugs, it becomes difficult to tell what is coming from what, so if possible, knowing the withdrawal effects that came from the benzo as opposed to the antidepressants will help you decide if reinstating an antidepressant will help. 

 

If you had memory problems and anxiety from the lorazepam withdrawal, that can still be affecting you this far out, especially coming off that high a dose. I came off a high dose of Klonopin, a similar drug, and memory problems and dp/dr are still a problem more than 30 months out. I was on benzos for 30 years, so my withdrawal is complicated by that, but memory problems are not uncommon for even short time users. 

 

How much sleep are you getting now? Are you able to do yoga, tai chi, listen to mindfulness videos, etc? Weighing what you're able to do now also helps make this decision since going back on an antidepressant after 5 months is more difficult. 

 

 

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healthyliving   
healthyliving

This is frightening to hear. To be entirely honest with you, I do not recall having any problems stopping the lorazepam. I cut back by .5 mg per week or every two weeks for many months without issue. Probably the biggest sudden difference I experienced was when I stopped the effexor. 

 

This is still a problem for you after 30 months? 

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Shep   
Shep

That's very good news that you didn't have trouble stopping the lorazepam, especially from a relatively high dose. 

 

Yes, I still have some memory problems, even 30 months out. But I was on a lot of psych of psych drugs for 30 years. But I'm still able to work and am recovering. 

 

Did you have any other problems besides memory problems coming off the Effexor? If you do consider a reinstatement, it's helpful to know which drug caused the most dependency, as going back on any of these drugs at 5 months off does carry risks. Can you differentiate the Effexor from the Wellbutrin withdrawal? 

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KarenB   
KarenB

I don't feel like myself but am trying to be patient with the process.

What you wrote here, spacecadet, really is the nub of the whole thing.  It's horribly uncomfortable, and even more difficult to manage when it takes so long to see improvements.  But with time things will get better.  Reinstating at this point does bring risks (as Shep noted above), so it would need to be your own decision.  I think if I were in your shoes I'd not be reinstating.  I'd be working on ways to reduce and manage anxiety.  You've mentioned a few other symptoms, but because anxiety affects how we cope with all the other symptoms, it's a good one to start with. 

 

I know that might sound flippant - 'hey, just figure out how to be less anxious!' - so please know that I've had to do it myself.  (Still do, sometimes).  I know it's hard and slow and, actually, scary because when you're anxious all you want to do is hide.  And it's hard because just the idea of managing anxiety can make you more anxious...

 

So baby steps is how I've approached it.  Find yourself one small thing, one small way in, from the big list of things people do to manage anxiety.  And then quietly sit with it, get a feel for it, for how you might introduce it to your life.  You can put it down and back away whenever you want.  Then go pick it up again.  Try it out a little.  Try it again.  Maybe find a small way you can make it a regular, habitual thing in your life.  Once you've got accustomed to it, you can increase how often you use it.  Or, go back to that list and find another little thing to add in to your life. 

 

It's nice to hear that many people regain their confidence after coming off of these drugs. Unfortunately, that is not the experience I am having at this time. I hope that will improve in the months to come. Like I previously mentioned, the heightened anxiety paired with concentration and memory impairment makes me very self conscious and avoidant of social situations, moreso than I have ever experienced in the past.

It happens for people over a great range of time-frames.  You're not in a 'Never Basket', just a 'Not Yet Basket.'

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healthyliving   
healthyliving

Curious to know if this is a side effect for anyone else being completely off of these drugs. I notice I'm having difficulty with very basic things like READING. Im not sure if it a concentration issue, comprehension issue, or perhaps both. This has never in my life been an issue and as a college educated individual I find this "side effect" to be terrifying. 

 

Also, looking at myself in the mirror, I look and also feel DRUGGED after being off of this stuff for several months. Is this a sign of tapering too fast? I look sedated even when completely sober. I get the concept of self love and compassion, but to be quite frank, I look awful. 

 

Last but not least, I feel like time is passing by and nothing is happening. When I do have the energy to get out of bed, I do a few simple things and look forward to going back to bed. This is not an acceptable way to be living at 27 years old. Unemployed, living at home, and sleeping life away is an absolute joke. I can't help but feel extraordinary anger towards the prescribing doctor, and the thought of pursuing legal action crosses my mind frequently. In regards to earning potential and quality of living, I feel like these things have been robbed from me. 

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scallywag   
scallywag

spacecadet - Cognitive symptoms are common. Link: Brain fog; blank mind; comprehension, cognitive and memory problems.

 

Your anger is valid, righteous and directed at the right person. If you can, put your limited energy and attention, both valuable resources, into finding tactics that help you cope with the symptoms.

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healthyliving   
healthyliving

Came to SF this week to spend time with family and after experiencing unbearable panic and anxiety had effexor xr 37.5 mg called into a local pharmacy. I ended up taking 1 pill of this medication in the evening and woke up the following day totally drugged with huge pupils. Obviously determined this was a horrendous idea and did not continue to take anything further. I told a good friend of mine what was going on and he recommended trying out his memory assessment software, and my scores were absolutely mortifying. My short term memory is on par with dementia or early Alzheimer's. 

 

I am 27. 

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KarenB   
KarenB

It would seem that family can cause unbearable anxiety even for those who are not in w/d.  Family should come with a warning label ;).  I hope you have started to feel better since the one-off pill? 

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healthyliving   
healthyliving

Thank you but it was not being around family that was the problem, but being in the city with what I can only describe as a partially functioning brain. I am so tired of feeling spacey and out of it (I guess that would be considered depersonalization?), which makes it impossible to get anything done. I'm not even sure if I should be driving my car in this state. I really do wonder how long these problems will last. My patience is wearing thin. 

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JanCarol   
JanCarol

Hey Space - 

 

really, like Karen, Shep, and Scally were saying - cognitive, memory, reading, comprehension - are all reasonable symptoms for the withdrawal.

 

I'm sorry you took such a big dose of Effexor on 3-Feb.  Please make a note of that on your signature, as it may cause a bump down the road.  Was it brand name effexor?  When you open it up, is it tiny little beads, or is it something else (like "mini tablets")?  Because normally, after you've come off of 37.5 effexor in 2016, we would suggest a reinstatement of only 5 beads.  If you have "mini tabs" we'd have to think about something else.

 

37.5 is a huge reinstatement.  We do things much tinier around here - to prevent those spacey, drugged out symptoms and various side effects.

 

I do believe that you could be helped by a tiny tiny reinstatement, but nothing so extreme as you took.  Just 5 beads, and give it 4 full days to actually start working.

 

I would also call your doctor and get a copy of your blood panels.  What doctors say is "okay" with thyroid is not always "okay" with patients!  For example, Hashimotos antibodies show up sometimes 3 years before it affects the normal thyroid blood tests.  And most doctors just use TSH.  If you have exact numbers, then you know what the doctor has run - and you can decide for yourself if this is "okay" or not.  Others here can help you:  http://survivingantidepressants.org/index.php?/topic/1593-thyroid-symptoms-hypothyroid-hashimotos/

 

Two other things to consider:  I'm a huge fan of fish oil.  I do believe that it soothes an inflamed brain, lubricates nerve endings, and helps the whole system fire better.  Also, magnesium is present in something like 200 biochemical cascades in the body.  Learn more, here:  Magnesium and Omega-3 fish oil

 

I was lucky, I tapered slowly, and as I tapered, my brain gradually started coming online - over about a year's time.  Even better, my passion and caring for life came online; I had no idea how much that was dragging me down before.  I still have some reading comprehension problems, but if I care, and persist, and re-read a lot (I'm much slower than I used to be), I can get through.  We generally can get by on far less than we think we need.  Also keep in mind, like Alto said - gentle exercise and sunlight will help immensely.   

 

One last thing, healing happens in waves and windows.  For me, the windows came more easily if I just learned to appreciate the tiny things.  I started by reading young adult fiction - it was easy to get into, and very enjoyable.  Maybe feeling the sun on my skin, or the grass under my feet is the best I can have that day.  But that was 5 minutes of pleasure.  If you appreciate tiny pleasures, they will string together like pearls on a strand, and the windows will open wider.  But recovery is not linear, either - and a window may be followed by a wave, where things get harder.  Learn what others have said about this process here:  Waves and Windows

 

I'll leave you with a quote about road works, and the recovery process.  Know that when you are struggling, you are healing.  The more you let go, and let your body heal itself, the better it will be.

 

 

I really like Bubble's phrase:  "Brain is closed down for repairs."  I'd like to expand on that a bit - parts of your brain are closed down.  Imagine very complicated road works with about 25 intersections coming together.  This week, the traffic lights are shut down, and you need a cop to manage the intersection.  When that is repaired, well, maybe they need to re-do the shoulders, so they can divert traffic onto them for later when the lanes are being repaired.  Then there's the repairing of the lanes - it doesn't all happen at once.  Sometimes they need to rip up the old tarmac, change all the drainage routes, relocate the services for electricity and plumbing, get down to the foundation, and re-grade it, lay new gravel, then steel rebar, pouring concrete foundation, then laying the asphalt.  Sometimes you will go for 5 months, and the road is still closed, but you can't see what they are doing to it!  Each phase requires time to set and dry.  Then you can paint the lines on it, and go to another part of the intersection - perhaps one of the other incoming roads needs the same treatment.  Perhaps there are exit ramps and roundabouts and flyover lanes that need repair.  Each of which takes time.

 

Now imagine the millions of networks in your brain healing - they don't just, "heal" and be done.  It's a construction process, like Bubble was saying.  Road works for the brain. 

 

Just my way of saying, be patient with yourself.  It might be the tarmac this week - but the lines aren't on the road and you're disoriented.  Maybe the signals are crossed at the intersections, or the signs are removed or there are detours.  Be gentle with yourself, be patient with yourself.  It's a complex process, and the gentler you are, the more easily you will heal.  It does no good to shake your fist and yell at the construction guys while they are doing their work!  So just wave (lol, wave!) at the worker, declare to yourself, "This is yet another symptom of withdrawal," and drive carefully past the obstacle.

 

 

I hope you see the sun today!

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healthyliving   
healthyliving

Thanks for the response. It is the generic venlafaxine XR capsules with the beads inside.

 

Another thing I am curious to know is if effexor is chemically similar to meth? I read somewhere that it was and am not sure as to the accuracy of that claim. Pretty scary stuff. 

 

I am definitely struggling with the fact that I feel like my life is being put on hold to go through this process. 

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Altostrata   
Altostrata

Effexor is not chemically similar to meth, but it can be stimulating.

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healthyliving   
healthyliving

I read on someone else's thread that they compare their anxiety to having smoked too much weed, including paranoia, overthinking, and feeling generally physically uncomfortable. This particular comparison definitely resonated with me as my anxiety takes a similar form. I used to smoke weed regularly (although I don't anymore) and it is very challenging when your sober self takes on such intense and overwhelming anxiety. Hoping this will improve. 

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healthyliving   
healthyliving

Yesterday I tried reinstating 5 beads of effexor to see if it would make any difference. WOW. I'm shocked that such a small amount of anything could have such profound and noticeable effects. The fogginess and anxiety seemed to improve substantially, HOWEVER, there was a overwhelming feeling of being drugged or "on something" which I didn't like at all. In all honestly, I spent the entire day fixated on how dramatically this drug alters our functioning. This may be an obvious statement, but I was in my early 20's when I started taking effexor and certainly didn't do the necessary research and critical thinking before signing up for this ride. I even noticed that my vision became less blurry and I could see more clearly yesterday. Disheartening to think I spent so many years on such a potent drug, acting and feeling as a stranger to myself. 

 

How this **** is legal is a mystery to me. 

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mammaP   
mammaP

Try 4 beads SC, this happened to me when I reinstated effexor, 5 beads was too much so reduced to 4 and that was much better. It is unbelievable how powerful they are and a doctor would prescribe at least 37.5 to reinstate then wonder why the patient reacts badly! 

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healthyliving   
healthyliving

Not sure how I functioned for so long on 150 and even 300 mg!! Did you notice your withdrawal symptoms subside after that small reinstatement? Im actually thinking just taking one or two effexor beads might do the trick. 

 

I was hell bent on being off of everything in August of last year and may have done my taper too quickly. I tried to tough it out for many months and hoped it would improve. Those months were miserable and I was convinced i had some sort of permanent brain damage. The powerful withdrawal experience is certainly misunderstood and underappreciated. 

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mammaP   
mammaP

Yes ir was almost immediate! 5 was too much so went to 4. I did get high but didn't recognise it at the time. That wore off though and I had some bad waves but they always passed. I waited 7 months before I restarted my taper and took 2 years to taper off those 4 beads. 

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healthyliving   
healthyliving

Although improving slowly but surely, I still am experiencing cognitive difficulties that bother me greatly. I used to be able to read and took great pleasure in reading, and still can't make it through any considerable length of anything without forgetting what i'm reading or just not processing it. 

 

I just recently learned about the benzo withdrawl process, and realize I tapered two antidepressants within the same time period of benzo cessation. Unfortunately I was not educated on that process in and of itself, but what's done is already done. So on one hand I do feel enormous pride in having come off three psych drugs within about a year and half, but still am not where I want to be.

 

I am fortunate enough to have supportive friends and family throughout this process, but their patience is definitely wearing thin and everyone thinks I should be further along than I am. I did have a temp job for a brief period of time earlier this year, but am not working as of now and am still living at home. Not knowing which direction to take in terms making money is certainly an added stress that is driving me a little crazy. Does anyone have any recommendations for work while dealing with this?

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healthyliving   
healthyliving

Having the memory of a carrot is also an issue. 

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KarenB   
KarenB

Good to see you again SpaceCadet.  I'm a reader too, and I agree it's disconcerting not being able to read like we used to (I used to get through 2-3 novels a week).  I can share from my experience that it does come back!  I spent the first almost two years of my w/d being unable to concentrate on any novels. I watched movies instead - very strange for me.  A few months back I realised I felt like I could read again.  So I got a book from the library, and over a month, in short bursts, I read it.  The next few months I found that the amount I was reading was increasing.  I'm now up to about a book per fortnight.  So - there is hope! 

 

You might like to print this out, and stick it on your fridge for friends and family to read, cause you are actually doing great.

 

How Psychiatric Drugs Remodel Your Brain

"A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along).

 

It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected."

 

I don't know about the work issue - I'm lucky enough to be supported by my hubby.  I recall seeing some threads here that might help.  Try googling 'SurvivingAntidepressants job/work.' 

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