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Shortcake: Effexor withdrawal. When will it end?

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Shortcake   
Shortcake

Hello all!

I am new here. Looking for people who are going through this as well. I was on 150mg of effexor xr for 17 years. 3 years ago I slowly started tapering down. I made it to about 20mg (I was taking 140 little balls out of the 37.5mg capsules). I had been super stressed and started drinking lemon balm tea, holy basil, chamomile, and taking l-theanine and all this apparently caused seratonin syndrome. I went to the ER and the ER doc stopped my effexor. I thought that's fine since i want off them anyway... The first 3 days I took 1 mg ativan morning and night to get through the worst. I have some great days where I feel better than I have in years and then some days I feel the withdrawal hard. Nausea, dizziness, headaches, light headed, feeling like I'm in a dream, anxiety constantly... I feel like I'm buzzing all day, panic attacks, insomnia.

Tell me this gets better soon. I only have 3 more months off work... I'm getting so tired of fighting all day. I don't know how much longer I can do it.

Edited by scallywag
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PoetJester   
PoetJester

Hey Shortcake,

 

I don't like telling you this, but the withdrawal can go on for years. I am three years off of Zoloft and zyprexa. the nausea and light headedness went away within weeks of quitting the meds, but the insomnia and fatigue can go on for years. Like you quitting the meds was a mixed bag, I felt better and was clearer in the mind, but the poor sleep is maddening and leaves us exhausted and like shells of ourselves after a while. I am about worn out at this point, but I have been reading some encouraging stories of reinstatement lately. People seem to get back to their lives quicker through reinstatement (sometimes within a week to two) , while going down the long road of withdrawal can take years.

 

Poetjester (Derek)

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Shortcake   
Shortcake

I'm okay with the insomnia and fatigue. Its all the other symptoms that need to gom. I can't function... and I need to. By reinstatement you mean going back on the drugs?

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PoetJester   
PoetJester

Yeah, reinstating means going back on the drugs, but there are a lot of people who keep plodding ahead in withdrawal and some do seem to get better, but it takes a lot of time. The problem with extended insomnia and fatigue is that it starts leading to cognitive problems- forgetfulness, horrible short term memory, exhaustion, etc. it seems to depend what kind of wd symptoms you are having as to how successful withdrawal will be. I live alone on a fixed income so it's easier for me to handle some of the stresses of wd, but for people with jobs it can be almost an impossible burden. I have read a few really hopeful success stories lately of people who have gone through withdrawal for a year to even 5 years where they start nearly losing their minds, or are housebound and miserable crying every day for a year or else like me, feel like one of the walking dead as the toll of extended insomnia or very poor sleep quality wears us down to the nub and makes us feel pretty passionless, about like zombies, and who have reinstated or gone back on the drugs and within a week to a month are back to their own selves again- happy and active. if you like I can refer you to these stories. I am on a facebook page for both people taking Zoloft and and another one for members of this site who are in wd.

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ChessieCat   
ChessieCat

Hi Shortcake and welcome to SA,

 

So that we can make suggestions based on your drug history would Please put your Withdrawal History in Signature.  Please include details for the last 12-18 months of  all drugs, dates, doses and discontinuations & reinstatements.  If you can't remember dates, please write it as "early March" or "mid-August".  Please provide a summary of any drugs prior to that which can just be listed with start and stop years. Please include all prescription, non-prescription drugs and supplements you are currently taking. If you are using a phone there are instructions in Posts 9 & 10.

 

Once we have more detailed information about about your tapering history and at what dose and when you stopped we will be better able to know whether a reinstatement of a very small dose may be helpful.  If you do decide to try a reinstatement please let us know before taking it so we can suggest a dose.  Please do not go back on your previous dose (and definitely not any higher) because your brain will have already made some adjustments since you have been off the drug.  The idea of reinstating a small amount is to get withdrawal symptoms to a bearable level, not to get rid of them completely.  After stabilising you could then taper off the drug.

 

Please check out these links, and especially read Post #1 of reinstatement. 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

Tips for tapering off Effexor (venlafaxine)

 

These helped me to understand SA's recommendations:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

You can ask questions here in your Intro/Update topic and journal your progress.

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KarenB   
KarenB

Welcome from me too, Shortcake.  I am tapering effexor, slowly but in a manageable way.  Chessie Cat had all the right information for you, so once you come back with the details then you'll be able to start working on a plan.  It's good to have you here - you'll find lots of support and people who understand.

 

Hugs,

Karen

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Altostrata   
Altostrata

Welcome, Shortcake.

 

It is very unlikely that combination of herbs caused serotonin syndrome. Rather, it sounds like you developed withdrawal symptoms from reducing Effexor too fast.

 

How long has it been that you quit Effexor? Do you have any left? 

 

If it's been a short time, you might try reinstating 10 beads a day.

 

How long and how often have you been taking the Ativan? Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.

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Shortcake   
Shortcake

I don't believe I had withdrawal from going down too fast. I had slowly been weaning down over 3 years. At the time, each week I would remove 10 little balls from the 37.5 capsules per week. Take it for a week, then thd next week remove 10 more. At the time I was stopped on them, I had been taking out 140 little balls. The next week I would have removed 150 little balls. So I was at about half of 37.5mg. In the er they did a test with my reflexes and eye movements which showed mild seratonin syndrome. I had been drinking those herbs from morning until night.

The first few days of withdrawal were bad but I was on ativan so mostly slept. Then I felt great for a while. Now one month later and theyre bad. I'm nauseous and dizzy, having frequent panic attacks, anxiety is bad. I do have generalized anxiety disorder but its gotten crazy bad and now I have panic disorder as well.

I'm off work for 3 more months and think if this doesnt get better in the next month then I will go back on my effexor and wean off at a later date. I still have some 37.5 capsules that have 140 little balls removed and then some of my 37.5 mg full capsules.

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Shortcake   
Shortcake

Oh and I came off January 3rd. So it has been exactly 1 month off them.

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Shortcake   
Shortcake

Is it not possible that these symptoms will go away soon? I thought over 3 years was a slow taper... only taking out 10 balls a week for the last 6 months. And then stopping at half of 37.5mg. Ugh. Please tell me theres hope.

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Shortcake   
Shortcake

Thank you for all the information. After reading it I see that 10 balls out a week may have been too much.

 

So what do I do now? I can't handle the withdrawal symptoms. I have been off the effexor for one month. Never actually calculated the dosage but I assume it was about 17-20mg? I want off this drug but if these symptoms last too much longer I can't do it. I was going to wait another month but theyre just getting worse.

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Shortcake   
Shortcake

Sorry I really am in such a brain fog right now and I keep remembering thibgs. This past summer i was taking out 3 little beads a week... then went to 5 a week then thought well this isnt bad, then started with 10 beads a week in the fall.... which is when i started having more anxiety and panic. So too fast a taper and discontinuation. So how do i fix it?

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Ali4   
Ali4

How much have you reinstated? 5 beads wasn't bad? 10 was too much? If I were you stay at 5 for 4-6 weeks and if you need to go up more from there add a couple more, don't add to fast your body needs to adjust. Good luck!! Ali

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Shortcake   
Shortcake

I havent reinstated at all. I tapered over 3 years and was on 17-20mg and was stopped abruptly on January 3rd 2017. So exactly one month ago. I have been completely off them for one month. But i want to reinstate if it will get rid of this horrible withdrawal. But at the same time i feel like i should tough it out and hope it goes away after another month

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scallywag   
scallywag

Shortcake -- Welcome to Surviving Antidepressants (SA)

 

Since your last dose of 17-20 mg Effexor was on Jan. 3 2017, you are still in the period when reinstatement is more likely to be effective. The risk of it not working or of reinstatement intensifying symptoms increases. Or said another way: more time since last dose, higher risk.

 

About reinstating:

 

The inserts in all the newer antidepressants and many other psychiatric drugs advise reinstatement of the medication if withdrawal symptoms appear. This is all medicine knows about how to treat withdrawal.

 

For people who are about 4 weeks out, we suggest that people consider taking a much lower dose than their "pre-jump" dose. From the topic about reinstating:

 

Start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find relief from antidepressant withdrawal symptoms by reinstating as little as 1mg-5mg. [based on having taken 20 mg previously]

 

Please read the posts, especially the first one in the topic:

About reinstating and stabilizing to reduce withdrawal symptoms.

 

And

 

I don't believe I had withdrawal from going down too fast. I had slowly been weaning down over 3 years. At the time, each week I would remove 10 little balls from the 37.5 capsules per week. Take it for a week, then thd next week remove 10 more. At the time I was stopped on them, I had been taking out 140 little balls. The next week I would have removed 150 little balls. So I was at about half of 37.5mg. In the er they did a test with my reflexes and eye movements which showed mild seratonin syndrome. I had been drinking those herbs from morning until night.

...

My "taper" off Effexor XR in 2004/5 was exactly the same as yours - about 10 beads per week. I started from a (low) 37.5 mg dose. I was lucky to have only about 6 weeks of difficult symptoms that then abated gradually.

 

It's such a shame that neither of us were given advice to go slower and to continue to taper to a dose of fewer than 10 beads before stopping entirely.

 

Please have a careful read about reinstatement and come back here to ask questions. If you'd like an initial reinstatement dose suggestion, please post to let us know.

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Shortcake   
Shortcake

Thank you I will read more on it. Did you taper all the way down?

 

My dilemma right now is whether to tough it out and hope the symptoms all go away soon or to reinstate. But right now I feel really hopeless. I'm sick of the symptoms. My head feels really messed up. I have a toddler to care for. Luckily my mom is staying with us to help while I go through this. I just want to be okay again. My plans as NEVER to go off this drug fast... hence it taking 3 years just to get to 37.5. But the er doc took me off. My own family doctor is useless. Told me all symtpoms would be gone in 2 weeks. Thiugh when i had asked her about weaning 3 years ago her suggestion was 1 pill every second day... so that says enough about her knowledge.

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Shortcake   
Shortcake

I would like help with reinstating please. I have 37.5 mg capsules. And i also have some that have 140 bead removed. I will need help figuring out how to determine how to get to 1mg by counting the beads. I know itll inolve math but right now my brain cant handle this stuff. Its actually really scaring me.

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Shortcake   
Shortcake

Also... i read this on there

"Your present condition. If you have symptoms of hyper-reactivity, alerting (anxiety, panic, sleeplessness), you may be too sensitive for reinstatement. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 1mg (if you had been taking 20mg Celexa)."

 

I DO have those. So I'm scared and I don't know what to do.

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Cipramillion   
Cipramillion

WD symptoms are just too real at even microscopic levels of these drugs. I reinstated at a ultra low dose of Lexapro. 1 mg was too much for me, but 0.5mg took the edge of the worst symptoms. If you want to reinstate, start at a very low dose and take it from there. You can always updose later if you need to.

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scallywag   
scallywag

I did taper Effexor XR to zero. I am working my way to zero now with Cymbalta, a drug that is an SNRI similar to Effexor.
 
Here's what I suggest:

  • Take 3-5 Effexor unaltered-fresh-from-the-bottle/foilpak capsules.
  • Get two small bowls or containers. Label one "unknown" and the other "counted"
  • Put the capsules in the "unknown" bowl.
  • Take a capsule from "unknown" bowl, open it and empty the beads on a surface that allows you to count them.
    Tip: I use a sheet dark-coloured paper placed on a rimmed cookie sheet. The dark paper allows me to see the beads and the rimmed cookie sheet prevents the beads from rolling off the surface.
  • Count the number of beads. Record that number on paper.
  • Put the beads back in the capsule. Put the counted capsule in the "counted" bowl.
  • Repeat steps 4, 5 and 6 for each capsule until you have a count for all capsules.
  • Calculate the average bead count per capsule.
  • Calculate the # beads/mg:  beads/mg = average bead count / 37.5 mg

Hope that helps. you'll have to do the counting, but we can assist with or check the calculations.

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Shortcake   
Shortcake

Do you guys think its best that i reinstate right now? Is that basicallt what you need to do if you came off too fast? Im just really scared right now.

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Cipramillion   
Cipramillion

Reinstatement or not, just know your symptoms will get better over time. When you are in WD it is hard to think that way, but it gets better. I was so sick and never thought i would make it. After some time things started to look brighter. Now im much better and It is strange to think back on how it was a year ago. Reinstatement did help me,

but i still had symptoms. Stabilizing is a relative term in this game. Wish i could give you an answer, but only you can make a choice on what to do next.

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Shortcake   
Shortcake

Its just that i only have 3 months left of paid time off work. After that... how do i pay rent? I just need to get better. With or without the drugs. My daughter needs me and if i cna only function on these drugs then thats what i will do. Right now i am really bad. I cant handle it.

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scallywag   
scallywag

Do you guys think its best that i reinstate right now? Is that basicallt what you need to do if you came off too fast? Im just really scared right now.

 

Reinstatement is the only known effective "treatment" for withdrawal symptoms. Reinstatement doesn't work for everybody but it's more predictably effective the sooner after last dose reinstatement occurs.

 

Given my own experience with stabilizing on a daily dose (I'd been doing a skip-days approach) and what I've seen and read from others reinstating vs. others who've given it time, if I were in your situation -- parent of a young (?) child, being the only income in household, facing a return-to-work date  in 3 months -- I would give low-dose reinstatement a fair trial.

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Shortcake   
Shortcake

Okay. Its weird because i had the initial withdrawal for the first few days then for a couple of weeks i was feeling SO GOOD. Then all of a sudden the withdrawal hit me again harder than before and im so confused. Why does it come later?

*counting out beads now*

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Shortcake   
Shortcake

First capsule count is 180 beads. And i had been taking out 140. How do i calculate the percentage?

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Shortcake   
Shortcake

Okay so i was down to about 8mg when i was stopped abruptly. And i still have this bad withdrawal? But had been having withdrawal symptoms mildly for about 2 months. So i had been going down about 2mg a week when i started having withdrawal.

What would I reinstate with at that low a dose before?

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Cipramillion   
Cipramillion

For many people WD symptoms follow a pattern of waves (periods of worsening) and windows (periods with less symptoms). Different factors, like lifestyle, stress and other aspects of our health might contribute to the course of the symptoms. It is very common to experience "on/off" periods/patterns when it comes to WD symptoms. Reinstating might reduce the symptoms and you can try to stabilize for some time before gradually taper at a very slow rate.

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Shortcake   
Shortcake

And yes. I'm a single mom. I have a great job that pays wonderfully, but i need to be thee to get paid lol. No child support. She has no father. She is almost 3. So thankful for my wonderful family who has stepped in while i go through this.

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Shortcake   
Shortcake

Capsule 1: 180 beads

Capsule 2: 188 beads

Capsule 3: 186 beads

 

Was taking approx 44 beads a day when I was stopped abruptly 1 month ago.

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Shortcake   
Shortcake

If i take half a benedryl and ginger gravol the symptoms subside a bit.

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scallywag   
scallywag

Many people experience a honeymoon of no symptoms lasting several weeks after the first few days. The CNS (central nervous system) starts adapting to the absence of the drug fairly quickly but sooner or later it can't make changes fast enough to keep symptoms at bay. You can learn more about that at these links:

One theory of anti-depressant withdrawal syndrome

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

Youtube video, 4 minutes: Healing from antidepressants

 

Bead to milligram calculations:

 

Average # beads per 37.5 mg capsule = 184.7, so 185

 

1 mg = 4.9 beads; for your calculations use 1 mg = 5 beads, or each bead = 0.2 mg

 

If you were taking 44 beads daily, that is approx. 8.8 mg. (44 / 5 = 8.8)

 

Reinstatement:

If you reinstate now, try between ¼ and ½ of your last dose, so between 11 and 22 beads. Pick a number between 11 and 22 beads. Take the same number of beads at the same time each day. If you have new severe symptoms or dramatic worsening of your current symptoms, stop the reinstatement. Otherwise, give yourself about 2 weeks: 4-5 days for the Effexor to reach a steady state and another 10 days for your CNS to start to stop the frantic work it started when you stopped taking Effexor.

 

If you choose to reinstate later, please do not try doses as high as 11 or 22 beads. Your CNS may well have made further adaptations in Effexor's absence.

 

Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

 

Please read: How long to stabilize after reinstating or updosing.

 

Let us know how things go for you.

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Shortcake   
Shortcake

Thank you so much Scallywag. I appreciate all your help. I am very nervous doing this. Have people had a lot of success with reinstating? Would it be better if I reinstated lower, say 11 beads?

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Shortcake   
Shortcake

P.s. I have health anxiety.

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KarenB   
KarenB

Hi Shortcake,

 

The lower option is usually better as it's easier to slowly move up if needed, but harder to manage if you reinstate too high and end up feeling awful.  

 

Those who reinstate closer to the date of their last dose are more likely to be successful in their reinstation.  So at 1 month out your chances are good (not guaranteed, but good). 

 

It's very useful that you recognise your health anxiety.  Do you have ways of managing this?

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Shortcake   
Shortcake

Hi Karen,

 

Sometimes I can use self talk to talk myself down. Sometimes I have to use ativan. I had everything under control until early fall when I started to taper down fast and obviously too quickly. Im really kicking myself. I didn't realize this was withdrawal and kept tapering. Even the er doc didnt recognize withdrawal... but misdiagnosed as seratonin syndrome and stopped the meds abruptly.

Having bad anxiety/panic right now. I want to go to the hospital but mom is here with me and says I'm fine. Distraction seems to make it okay too.

 

I took melatonin tonight to help me sleep but i think it makes me more anxious. And now talking about it makes it more so. Then i took half a benedryl because thst seems to help my physical symptoms but now im freaking out wondering if theyve messed me up. Im just really scared.

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