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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by bigcat on March 11, 2006, at 10:54:28
i had been taking effexor for 3 1/2 months with partial, fleeting success, constantly having to raise the dose just to regain what ended up being little more than my "average" depressive state. A few weeks ago, recognizing the futility of chasing the dose up and understanding that I had no stable "future" with the drug, I tried coming off it. I came down from 375mgs (where I had been for a few weeks)and was doing pretty good for a few days, but maybe a week after I had taken my last pill, I entered into a severe depressive state. It was extremely painful and spooked me, so I went back on the effexor. About a week later, I decided I would just suck it up and deal with an awful withdrawal, get it out of my system for good. This is the decision I made and that I am going to stick with. It has been 11 days since I took an Effexor. All 11 of these days have been equally bad. Today was as bad, if not worse than yesterday. Each day I get up thinking, "ok, this has to start easing up". I can fully appreciate the advice to "go back on a small dose and wean off EXTREMELY SLOWLY". Basically, I think it's gonna suck any way I do it, and now that I've been clean for 11 days, I don't want to touch the stuff.
My only "withdrawal" symptom is this worsening of the depression, where the suffering and anxiety just become increadibly intense and overpowering. I can't even speak my head is so clouded with this throbbing misery. There are no phsysiological withdrawal symptoms like nausea, sweating, headaches etc. I just feel really, really low, with the anxiety and obsessive self-awareness and hatred on full blast. It's coming up on two weeks since I had any in my system, and I thought I would have turned the corner by now. How long do you expect this to last? I have years of experience taking every kind of psych drug imaginable, and recall many instances of the depression becoming profoundly more intense upon discontinuing a drug, but I am literally NO better, probably even a little worse than I was the first week I stopped taking it. My normal depressive state, which is pretty darn sh*tty let me tell you, is still miles better than this. I'm living a 24/7 panic attack. Tell it to me like it is- don't be afraid to be the bearer of bad news. How long?
And while I'm here, what d'yall think about anafrinil/clomipramine? My first psych issue to surface was undiognosed OCD which hit about 15 years ago, the depression settling in and closing out my mind about five years after that. While the "classic" OCD symptoms have largely diminished over the years, my depression has always been highlighted by severe anxiety, obsessive and incessant worrying, and social phobia. My mind is so loud, and all my energy is channelled into worrying, to the point where no original thoughts can arise. i don't have access to my mind. i'm stoned into stupidity, have no memory or ability to concentrate whatsoever, and can only say the most mundane things. Every day just presents new ways to experience the same brand of horror. I've heard anafrinil can take a long time to start working, and in previous trials, I never took it for more than a month, and tolerated it ok (no major side effects).
Another part of me says to screw meds altogether. Either way, I'm going to start CBT and take some Fish Oil 'cause I got nothing to lose but my paychecks at this point. I hate feeling so powerless and watch from the sidelines as my "life" moves on without me. thanks for listening my friends.
-matt-
Posted by ed_uk on March 11, 2006, at 10:54:28
In reply to Effexor withdrawal crisis and anafrinil issues, posted by bigcat on March 8, 2006, at 21:06:00
Hi Matt
Nice to hear from you :)
>About a week later, I decided I would just suck it up and deal with an awful withdrawal, get it out of my system for good. This is the decision I made and that I am going to stick with.
Matt, I think you're being a bit silly! Abruptly stopping Effexor is not useful or helpful in any way.
>. It has been 11 days since I took an Effexor. All 11 of these days have been equally bad. Today was as bad, if not worse than yesterday. Each day I get up thinking, "ok, this has to start easing up". I can fully appreciate the advice to "go back on a small dose and wean off EXTREMELY SLOWLY". Basically, I think it's gonna suck any way I do it, and now that I've been clean for 11 days, I don't want to touch the stuff.
The thing is, if you return to a low dose and taper slowly it will suck a lot less :)
>And while I'm here, what d'yall think about anafrinil/clomipramine?
I think it's a potent AD...........if you can tolerate the side effects :)
Take care Matt (and be good to yourself)
Ed
Posted by bigcat on March 11, 2006, at 10:54:28
In reply to Re: Effexor withdrawal crisis and anafrinil issues » bigcat, posted by ed_uk on March 9, 2006, at 13:33:20
thanks ed. what dose/taper plan would you recommend? the thing is, when I drop even 37.5mg from my regimen, I feel awful, so I don't even know if going back on a small dose might (a) help at all, or (b) just make me have to go through all this sh*t again/draw out the process. it has to end, right? i read a post about a guy wanting to quit effexor cold turkey and someone warning him that this could have "permanent" consequences. i am a little afraid that I'll still be feeling like this a month from now. it has to pass eventually, no? as bad as it is, I accept it at this point, I just want some reassurance that it's normal to still be feeling this awful (aching back muscles, shallow/short breathing, potent anxiety) 12 days after dosing. I can deal with another 12 days if I must, but could I have caused some kind of permanent situation where this severity of depression will be my new reality. i "miss" my old depressive state. it was much more tolerable. WILL THIS LET UP? this is where I want someone to tell me that they had an awful month long withdrawal from effexor, that eventually let up after the fourth week or something. i was only on the stuff for 3 1/2 months with no major side effects except insomnia, which is the norm for me anyway. i'm definately freaking that I may never recover from this.
Posted by Phillipa on March 11, 2006, at 10:54:28
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by bigcat on March 9, 2006, at 19:59:30
You could also try luvox for OCD a sedating SSRI. Sounds like that might be something good for you right now. Fondly, Phillipa
Posted by ed_uk on March 11, 2006, at 10:55:17
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by bigcat on March 9, 2006, at 19:59:30
Matt
Start by taking 37.5mg Effexor. See how it affects you. Write back :)
Ed
Posted by spriggy on March 11, 2006, at 10:55:17
In reply to Re: Effexor withdrawal crisis and anafrinil issues » bigcat, posted by ed_uk on March 10, 2006, at 15:13:30
I've never been through Effexor withdrawal but my Lexepro withdrawal was nearly as bad as me on the stuff.Anyway, I got much worse and the anxiety was horrific; you explained it well.
The thing that got me through (besides crying and weeping on the floor) was taking Xanex. Could you ask for a benzo? it will DEFINITELY help the anxiety part of the withdrawal and bring a little peace/comfort to your mind.
I also took 2 Benadryl at night and it helped me sleep. I read it was helpful in withdrawal from SSRi's (benadryl) so it may help you as well.
Posted by SLS on March 11, 2006, at 12:44:25
In reply to Effexor withdrawal crisis and anafrinil issues, posted by bigcat on March 8, 2006, at 21:06:00
Hi.
I don't think very much is understood about the phenomenology of the discontinuation syndrome of drugs like Effexor. All I can say is that it has been my experience that a taper that is gradual enough to prevent withdrawal symptoms from appearing is preferable to a rapid taper or abrupt discontinuation.
It is difficult to say whether your depression is the result of a withdrawal rebound or is actually a return to a baseline state that you haven't fully appreciated. Maybe the Effexor was helping you more than you realize. I'm sure it was still inadequate, though.
Just an idea I came up with:
I have had success discontinuing Effexor 300mg within 2 weeks using what I like to call a flexible-dosing strategy. It generally requires that you take 3 or more doses a day. You take a very small dose as soon as you begin to feel the withdrawal effects reappear. I like to take just enough medication to last 6-8 hours, at which point I take another dose. It doesn't work if you take so much at any one time that it lasts 24 hours. Ideally, what happens is that you need smaller and smaller doses to last the 6-8 hours. Eventually, you will reach a point where no further dosage reductions are possible. Your current dosage will last 8 or more hours, but any further reduction will not allow for more than 4 hours. At this point, you can try to discontinue the drug entirely.
I find that it is not necessary to be precise. I have learned to do it by "feel". However, some people will actually count the pellets contained in the capsule and reduce the dosage based on the number of pellets ingested. I have just sort of "eyeballed" the amount taken. I have also used the 25mg tablets, biting off smaller and smaller pieces during the taper. I feel it is essential to wait and allow for the withdrawal symptoms to reappear before taking the next dose. It optimizes the time it takes to taper and might force the system to reregulate itself faster.
This has been a pretty weak explanation - sorry. You can find more stuff in the archives by using the search function. You can try using the keywords "flexible" and "SLS".
Do you have any questions that I could perhaps answer now regarding the flexible-dose strategy?
You know, if you are to go to another serotonergic drug next, you might see the withdrawal symptoms of Effexor disappear almost immediately upon starting it. Anafranil would qualify.
- Scott
Posted by bigcat on March 11, 2006, at 17:25:34
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by SLS on March 11, 2006, at 12:44:25
thanks ed, scott, and squiggles. my quality of life is so low right now anyway (i live at home, minimum wage job, no friends) that i just wanted the effexor out, and oh well, just hit the nasty withdrawal head-on, not have to drag out the process. i'm foolish, but I'm sure some of you may have gotten to that point before where you see all pills as poisons and just want it all out asap, come what will. the present is awful, no doubt, but I can accept this willingly if i could get some kind of reassurance that the withdrawal will lighten up eventually. i started to feel crappy after bringing the effexor dose down just a little, and I think that gradually weaning off it could make the present more tolerable, but it could also just drag out the process. i've gone 12 days without effexor, and today was easily the worst day of my life. But my eye is looking a week or two down the road, when this has to start easing up, right? i don't want to drop a 37.5 mg Effgexor right now to make tonight and tomorroaw a little easier, but then just tack on more time to the withdrawal process. i think I may get some Anafrinil in my system by tommorrow morning. How long does this sh*t last for?
Posted by SLS on March 12, 2006, at 8:39:38
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by bigcat on March 11, 2006, at 17:25:34
> How long does this sh*t last for?
That is difficult to say. There are people who report that their withdrawal symptoms have lasted for weeks, if not months. However, these seem to be the same people who discontinued the drug abruptly.
I have a hypothesis that the withdrawal syndrome is self-reinforcing via a process known as kindling. The longer one allows the withdrawal syndrome to persist unmitigated, the longer it will last and the more severe will be its symptoms. For this reason, I believe that you would be better off starting another serotonin reuptake inhibitor or returning to Effexor and tapering. Some people actually find success in replacing Effexor with Prozac and tapering the Prozac. The extremely long half-life of Prozac and its active metabolite (7-9 days) acts to gently reduce blood levels.
- Scott
Posted by LadyKate on April 13, 2006, at 2:01:51
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by SLS on March 12, 2006, at 8:39:38
I have been tapering myself off of Effexor for about 3 weeks now....I've been on 75 for about a year. The xanax helps the daytime symptoms like the weird but not unpleasant electrical zings, fatigue, naseua, and (anyone else get angry?), but oh-my-freaking-god the nightmares are terrible!!! I've had nightmares in my lifetime but NOTHING like these...Its like I'm conscious and fighting for dear life to wake up, and then I wake up but my body is still asleep so I can see everything but I CANNOT MOVE. I just had one and woke up, caved, and took an effexor and a xanax. All I have is the effexor 75s so I've been taking like one every 4 days and thats as long as I can go before taking another one. I can handle everything but the nightmares....they are UNREAL.
On the positive side, the kidney problems that I have been having for the past year on Effexor have been disappearing. (Imagine that.) I've spent a lot of time at the doc for the past year about the kidney thing, and it wasn't until about page 36 of the effexor "fine print" medical study that I found that particular "side effect" and realized what the problem was...hence the decision to taper off.
Like I said, I can handle everything but the nightmares. Anyone had success getting past this part of the withdrawal??
Posted by SLS on April 13, 2006, at 7:41:56
In reply to Effexor withdrawal...NIGHTMARES!!!!!, posted by LadyKate on April 13, 2006, at 2:01:51
You really need to take smaller and smaller amounts of Effexor every day in order to prevent withdrawal. Skipping days does not work.
Many people open the capsules and count pellets.
Personally, I have had success with a flexible-dosing scheme that involves taking very small doses of Effexor several times a day. I begin doing this once I'm down to 37.5-75mg a day. I basically use Effexor like one would use aspirin to treat a recurrent headache. I wait until the withdrawal symptoms just begin to reappear before taking my next dose. I try to take only as much as is necessary to last 6-8 hours. One of the advantages to flexibility is that you don't have to be so exact with dose sizes, as long as you wait until the next reappearance of symptoms before taking your next dose. Just try to approximate doses such that you don't go more than 12 hours before needing to take more.
I have had success coming off of 300mg of Effexor within two weeks on several occasions. Previous to trying the flexible dosing strategy, I experienced a pretty intense withdrawal syndrome.
From what I have seen, it seems that the longer you allow intense withdrawal symptoms to persist, the longer it takes to recover once the medication is discontinued. People who claim that withdrawal symptoms lasted for weeks and months are the ones who chose to discontinue the medication abruptly - go cold turkey.
People here report that using Benadryl (diphenhydramine) helps to lessen the intensity of withdrawal symptoms. I don't know if it will help with the nightmares, but hopefully you won't have them anymore once you change your withdrawal strategy.
Skipping days does not work.
- Scott
Posted by petalson on April 16, 2006, at 21:01:15
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by SLS on March 12, 2006, at 8:39:38
you just hang in there your almost through to the other side of the horrible medicine yes i had nightmares and still wake up at night scared of the dark what the h is that. i have been off for 3 weeks now and started on wellbutrin cuz i just felt physically sick now i feel balance again i tried without something but that olde effexor sure does a number doesnt it . well take care and god speed it will be better i promise peace marsha
Posted by LadyKate on April 17, 2006, at 14:36:30
In reply to Re: Effexor withdrawal crisis and anafrinil issues, posted by petalson on April 16, 2006, at 21:01:15
Thanks for the support and the advice. I've decided to continue to go without until the symptoms get too bad and then take one, wait a few days, etc. I'm taking xanax for some of the symptoms and anti-naseua meds. I've changed my diet (more veggies less refined carbs), and have been getting excersize. This all seems to be working pretty well so far...it's amazing how much better my body feels, especially my kidneys. I also have lots more energy and motivation. Yay! :)
This is the end of the thread.
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