Finn: Hello

[Finn]

I don't know the exact degree of the high liver enzymes, but I'm assuming it isn't a serious problem because the doctor just asked me to come back in a month for another test, so I either have an irresponsible doctor (actually her nurse told) or the problem isn't an immediate threat. I see my psychiatrist (who thinks I stopped taking Effexor after my last appointment and have been taking another antidepressant since) on the 5th and the endocrinologist for the blood test on the 17th. I wanted to have as little Effexor in my system as possible by then so the test wouldn't create a false positive that would result in liver tests and ceasing other medicines. I've been quick about the decreases because I figure I'm numb and sick with Effexor or without it.

 

Honestly, I worry that this lack of focus and feeling is just a progression of whatever was "wrong" with me. Before any drug, I was having trouble concentrating and feeling properly too, so I'm not going to believe I'm okay until I can feel again. After months of not feeling from depression, I thought a drug would return me to normal, but that never happened. I was also worried depression would turn into me losing my mind, and I hoped it would stop that degradation. But it was the treatment that really hurt...

[Finn]

I'm grudgingly going to hold at my current dose until I feel better. I'm going too fast, and if it is only making the numbness worse, than I need to be more patient.

[Finn]

Upon further review, I'm going to up 6mg again and hold there. It's a 15% reduction from the last time I felt semi-okay, which was around two or three weeks ago. I'm badly dizzy and irritable, and I need someone relief. That should help, right?

[Altostrata]

You might want to make a much smaller updose, say 5%, to see if that helps.

[Finn]

^ That was good advice.

 

I ended up going up to 53mg after 49mg, and I think I spent two days suffering from pains of increasing dose. Yesterday, I went back to 49mg, and I'm going to sit here for a while. I think I caused myself unnecessary pain.

 

I've been feeling really awful for the past couple of days because I had hormonal problems on top of the usual withdrawal. I have a theory that I'm suffering so terribly from decreasing because Effexor somehow threw off my hormones even worse than they are from just pcos alone. Since I've been on it, my period-related emotional/ physical suffering has been way worse than ever; previously the only thing that gave me such bad headaches was hormones so it's reason there's a connection. I'm "supposed" to be on birth control or an anti-androgen drug to help with hormones, but I haven't ever taken them because I don't identify as a woman and so putting estrogen into my body, with all its effects on appearance, isn't something I want (of course, I'm scared to tell my doctors that I'm transgender, and I'm also scared to transition so it never comes off, despite being relevant to my care). Something has to give, though, to lessen the severity of this time when everything is way worse.

[Rhiannon]

^ That was good advice.

 

I ended up going up to 53mg after 49mg, and I think I spent two days suffering from pains of increasing dose. Yesterday, I went back to 49mg, and I'm going to sit here for a while. I think I caused myself unnecessary pain.

 

I've been feeling really awful for the past couple of days because I had hormonal problems on top of the usual withdrawal. I have a theory that I'm suffering so terribly from decreasing because Effexor somehow threw off my hormones even worse than they are from just pcos alone. Since I've been on it, my period-related emotional/ physical suffering has been way worse than ever; previously the only thing that gave me such bad headaches was hormones so it's reason there's a connection. I'm "supposed" to be on birth control or an anti-androgen drug to help with hormones, but I haven't ever taken them because I don't identify as a woman and so putting estrogen into my body, with all its effects on appearance, isn't something I want (of course, I'm scared to tell my doctors that I'm transgender, and I'm also scared to transition so it never comes off, despite being relevant to my care). Something has to give, though, to lessen the severity of this time when everything is way worse.

 

I can't say I know much about it--I think Alto probably knows more--but there are definitely connections/effects between antidepressants and hormones. So, for what it's worth, you're not crazy.

 

I'm glad you're holding. I just wrote a reply to Narcissus about how valuable it can be to just Do. Nothing. and allow your CNS and your body's natural healing, balancing processes time to do their work.  I know how hard it is when one is in that state of constant perseveration, thinking, analyzing, where every single minute is an hour in h***, and a day feels like a year, and the thoughts just run over and over and over again, and the idea of waiting, the idea of time passing, feels impossible and intolerable.

 

Nonetheless if you can manage to allow it to, time will pass, and almost always--except in very, very rare cases, extremely rare--I see everyone improve and heal with the passage of time, and actually faster if they don't keep perturbing their system with ups and downs and changes in meds.

 

"Faster" being a very relative term when, as I said, a day can feel like a year. But hang in there. I've seen many people walk this road successfully. There's no reason you can't be one of them.

[Finn]

Well, according to my psychiatrist, Effexor doesn't affect or interfere with my hormonal levels, and she was confused I was even asking.

 

I was told the dose of Effexor I'm taking isn't doing anything for depression, which of course, is irrelevant because I'm taking it now to prevent withdrawal suffering, not to help me function, which it never did. To be fair, my doctor isn't necessarily just pushing meds. She is pushing me to do something about the depression so I feel better. Yeah, she'd give me another prescription , but she's been encouraging me to get into therapy too. *sigh* Honestly, though, I'm not necessarily depressed now. I just feel awful between cyclical hormonal fluctuations and withdrawal. I can only continue this taper and hope I eventually get well.

[Finn]

Not affecting hormones...yeah, right...as soon as my period ended (and presumably my hormonal levels went back up), I felt much better--less physically ill. I still have the headache, dizziness and nausea, but it is improving. Before Effexor, I barely noticed my periods so I will not believe there's no connection. Now, I can almost feel "good" under this layer of head pain and disorientation. I'm holding at 49mg for the foreseeable future.

[Barbarannamated]

That doctor really needs to do her homework. SS/NRIs wreak havoc with the endocrine system, including both the HPA axis and the (OAT) Ovarian - Adrenal - Thyroid axis and all hormones.

 

I'm glad you're feeling a bit better.

[Finn]

I am feeling a bit better. I do definitely have times when I am dizzy, and I wake up with a headache, but since holding at 49mg, I have less unbearable symptoms. Right now, gastric issues are bothering me the most, but those might be coming from starting spironolactone (to maybe reduce androgens so estrogen can be the dominate hormone in by body, like it should). I feel vaguely like my normal self, which is mostly good because the better I feel in the process, the more likely I am to stick with a slow taper.

[Barbarannamated]

That's an interesting approach to increasing estrogen, Finn. Do you know why your doctor chose to use a steroidal agent and NOT use estrogen of some sort to directly increase estrogen level? I assume your androgen/testosterone was high..?

[Finn]

I have PCOS, which was actually diagnosed on symptoms (acne, excess hair, insulin resistance, not getting period) so my androgen/testosterone were never significantly high. They might have been a little higher than normal, but my then endocrinologist said while it isn't that high compared to average, for me it could be very high. I was prescribed that med because I have ridiculous acne on my face (and thighs and neck if we're getting technical), and it should improve if androgens are reduced. The other option I was given was a birth control pill which contains estrogen, but I turned it down because before Effexor, my hormones weren't a problem (and I don't want to feminizing effects of estrogen). I've been taking Metformin for a few years, which has helped with insulin resistance and lowered androgens. I'm thinking Effexor lowered my estrogen levels and threw off the balance I had achieved from my treatment so that's why I'm getting horrible symptoms around my period. This should (maybe?) improve with time as I get off Effexor, but until then, I have to do something,

[Barbarannamated]

Thanks for a lot of great info, Finn. I had onset of *adult acne* shortly after starting SSRIs in 30s but never made the connection (never had as teen). During another flare in 2010, a dermatologist prescribed Spironolactone but I wasnt comfortable with derm messing with hormones.

 

I'll have to reread your post when I'm feeling better. Sounds like we have much in common on the endocrine front.

 

Thanks again and I apologize if I asked questions you addressed previously.

 

B~

[Finn]

I'm not sure how many others have experienced a disturbance in hormonal balance after starting an antidepressant medication. I do know there's an overlap between pcos and depression diagnosis (for hormonal and effects of pcos symptoms) so I might try asking around that community for answers.

[Finn]

Don't mind me, just venting. Last night and today, the headache has been really bad. I've been holding at 49mg, but I'm worrying (most likely irrationally) that I'm not measuring the dose precisely enough so I'm fluctuating by a few mgs everyday, which is why my mind is never healing. I'm also afraid I might have missed Monday's dose, which could be why I felt emotionally fine yesterday but head hurt and dizzy. But that would have been completely an accident.

[Finn]

This morning I had the follow-up test for my liver. I don't know yet how it will turn out, but the first one showed the GOT/AST level was 47 when it should be less than 38 (for this particular lab). That really doesn't seem that high, but it still wasn't abnormal at all before.

[Rhiannon]

This morning I had the follow-up test for my liver. I don't know yet how it will turn out, but the first one showed the GOT/AST level was 47 when it should be less than 38 (for this particular lab). That really doesn't seem that high, but it still wasn't abnormal at all before.

 

I agree, that's not that high. Just keep an eye on it and see if it continues to climb. I'm sure your doctor will tell you if there is cause for concern.  (They might be clueless about psych drugs but they usually know their liver enzymes.)

[Finn]

A week ago, I made a reduction of 6mg, from 49 to 43, and yesterday I did another 6. This may sound crazy, but it allowed me to get to 37.5mg (ie. not having to weigh beads). I figure once my body figures out what I did, it will start complaining, but I can easily hold at this dose for as long as I need. I'm just going to try to remain calm for live through it.

 

I actually never heard from my doctor about the liver enzymes. I'll call Monday since it'll have been two weeks.

[spidey]

When I was on Effexor my periods were CRAZY heavy and painful. While on Cymbalta they became sparse and infrequent and for about 6 months now have stopped altogether. It's weird, I feel like I'm 13 years old again waiting for the onset of puberty. Yes, I do believe these things screw with your hormones......among other things.

[Finn]

Ah, mine at the opposite--light, BUT the symptoms surrounding them, irritability, sadness, tiredness, headache, etc, are ridiculous. I dread this week of the month like I ever did before. But despite what my doctor said, it seems a lot of women report hormonal disturbances.

[Finn]

I called, but I still haven't heard back about the liver enzymes.

 

My attempt at lessoning my period-related suffering with spironolactone may have worked to reduce the pre-period wave of acne, but it didn't really help with the emotional/other symptoms that cropped up due to Effexor. I've been more tired than usual, more emotional, etc, but the fact that I made a reduction in dose right during my low estrogen point in the cycle couldn't have helped.

 

I haven't yet at a constant bad headache as a result of the reductions this past two weeks. I might be a bit spacey and flat.

[Finn]

I haven't yet at a constant bad headache as a result of the reductions this past two weeks. I might be a bit spacey and flat.

 

 

Alas, I have found the true symptoms of this latest reduction! I feel exhausted, like I'm being stepped on and my body weighs a billion tons and/or I've been drugged into a hazy, semi-delirious state. Of course, beneath this thick haze, I feel good/ like myself, this spark of excitement and hope. So my mind is partially blank, partially sadness and partially alright.

[Altostrata]

Might be a good time for a hold.

[Finn]

I am holding. I've been doing so for maybe two weeks.

 

Last week, I had trouble falling and staying asleep, and in the past three days, I've been exhausted, like sleeping much longer and feeling fatigued all day. Is that normal for withdrawal or should I look for other possible causes?

[Narcissus]

Quite normal, Finn.  Sometimes there'll be a few days where I have to sleep 12 hours or more, and I'll feel exhausted throughout the day.  I take this as a (somewhat erratic) sign of progress.  

[Finn]

^Good to know but so sorry that you know what I'm talking about. It is especially annoying since in general, I am feeling better so I sort of don't want to be sleeping all the time.

 

Another thing: this week I've been getting this searing pain in the middle (presumably where the spine is) of my upper back. I thought it was because of the pillow I was sleeping with so I replaced my crappy old one with a better one (the cheap version of the memory foam pillows, which I love), but I'm still getting the pain radiating through my back.

[Altostrata]

You may want to try chiropractic or acupuncture.

[Finn]

It's been kind of a toss up lately for me. Some days I feel dizzy and over-stimulated, some just dizzy, some my head hurts. This morning I felt like I was in a daze and then the usual set in. Emotionally, I've been between flat and down. Is this a normal fluctuation: when I first make a reduction, I feel a jolt of emotion for the first few weeks, but as I stabilize at that dose, I sink back into the blah, flatness?

 

But on a maybe good note, I started a part-time job at a grocery store.

[Narcissus]

 

 

when I first make a reduction, I feel a jolt of emotion for the first few weeks, but as I stabilize at that dose, I sink back into the blah, flatness?

 

Yes, this is the pattern for me too except with a shorter time frame.

 

Part time at a grocery store sounds nice, I trust they don't have you doing anything too strenuous?

[Finn]

^ I'm not actually certain what the duties of my job entail. When I was at the interview, the manager was like "where are you interested in working. we're hiring all over the store." I said produce because I like fruit. lol. I'm going for my first job training next week so I'll know then. I imagine it will be stocking fruit/ veg on shelves and making the packaged fruit containers. I do strenuous exercise frequently so if it is a bit intense, I should be used to it.

 

I've made so larger than jumps so maybe that's why my time frame is longer than yours.

[Skyler]

People in produce who KNOW produce are very good!  Couple weeks back, I asked where the Naval oranges were.  The person on duty said they were not carrying them anymore, instead they had Florida oranges. He looked blank when I asked what kind of Florida oranges they had.  I pointed out that Florida was a state, whereas Naval was a type of orange, but got a blank and condescending look... evidently I was just too dense to realize that Florida oranges were the name of the oranges (when I choked down another response, I looked at the label which said Valencia.. sigh).

 

Seems the store was opting to carry more seasonal peaches, tangerines, etc as opposed to the grapefruit size Navel oranges they had carried.  But no one in produce was able to put that together... argh.

[Finn]

I started my job today. It isn't too strenuous. The only part that might be a bit stressful is that I work at 7am and spend time in a cooler where it is quite cold. But yeah, not so bad.

 

It's been a month at 37.5mg, and let me say, I'm not too excited about decreasing again.

[Rhiannon]

I started my job today. It isn't too strenuous. The only part that might be a bit stressful is that I work at 7am and spend time in a cooler where it is quite cold. But yeah, not so bad.

 

It's been a month at 37.5mg, and let me say, I'm not too excited about decreasing again.

That's so great that you are feeling well enough to start a job! There's nothing wrong with holding a little longer if you feel you want to. I probably would if it were me just starting a new job. It's up to you of course!

[Finn]

*sigh* While I do feel good enough to work, my body seems to be taking it hard. I get home at like 2pmish, and I'm run down and exhausted. Some of the exhaustion comes from not getting a full 8 hours of sleep for sure, but I shouldn't be this dead, this easily. That's where the withdrawal comes in, right? I should have more energy and think more clearly, but whatever, at this point, I'm happy if I can make it through the day without being driven too crazy by obsessive, depressing thoughts (the reason behind the drugs, not withdrawal from them).

 

Since I've been working and thus, putting more stress on my body, I've had a stronger feeling of surrealness/ disassociation and more frequent waves of disorientation. Aside from this suffering, I feel down right pathetic...like: congratulations, self, a year after you graduate you finally get a job at a store. So now, as opposed to just having the internet and tv shows in my life, I have a job, the internet and tv shows. Go me! My life sure is swell! (don't mind me, I'll just be in a corner whining like the immature, entitled child that I am)

[Finn]

I'm continuing to feel run down and exhausted. In fact, it has probably gotten worse, which makes sense because remember everything is a bunch worse during the week or so of and around my period. Although, my period is like three days late according to my period tracker app. I don't know if it has anything to do with anything, but I have noticed I've been getting a rash on my wrists that is like little red bumps

 

As bad as I feel, I'm going to reduce again because I simply want this drug out of my system.

[Narcissus]

 

 

As bad as I feel, I'm going to reduce again because I simply want this drug out of my system.

 

Do what you must, but this is the sort of statement that tends to send up red flags around here.  The "I just gotta get this stuff outta my system" approach is why I've been sick for the past 8 months.  Just be careful.