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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by sufergirl on September 29, 2018, at 0:17:48
I have been on effexor (75 - 225mg) for 18 years.
As a child i had episodic anxiety and as a young mother 3 episodes of PPD. Then, i had 3 episodes of major depression. With complete remission of symptoms in between - each episode lasted about 8 months and were about 3 - 4 years apart. They also came on SUDDENLY and started with this obsessive thought about whether or not i would sleep. That was related to my PPD where my main symptom was not being able to sleep and I worried that if i couldn't i would have a breakdown or something terrible. So one day, it seemed i was fine and the next day i would wake up with this thought 'would i sleep tonight?'
This thought would CONSUME my every waking moment and would gradually morph into depression. The first couple of times i had it i tried every possible alternative therapy possible; chiropractic, colonic therapy, homeopathy, herbal treatments, hypnosis, chinese medicine, acupuncture and there were probably others. I also started to exercise a lot. Gradually it would get better only to return 3 or 4 years later. On the 3rd episode I got a lot worse and started to feel suicidal. I was referred to a psychiatrist (because i refused to take medication - my mother had told me i shouldn't - even though by now i was 40 LOL)
The psychiatrist prescribed me effexor which i agonised over, but in the end chose to take it. Within 3 weeks i was so much better. However, since being ON effexor, i can't get OFF it. Each time i try to come off, I relapse in a shorter and shorter time frame. My dr says it's the nature of depression. Recently I followed the advice of one of those anti medication user boards that call all sorts of bodily symptoms to be a 'withdrawal effect' I reduced my dose down in incremental amounts, excruciatingly slowly over 2 years and got down to 14mg and then WHAM back into depression/anxiety - tried again a few times with the same results only to finally accept that my condition requires medication for life.
I am OK with that. But I am thinking that maybe effexor has run it's course with me - i have little motivation and not a lot of interest. I run my own business and employ 10 people so I have stuff to be interested in, if only I could be.
We have talked about transitioning to another medication, but i am worried about 'rocking the boat' - it's not sinking, but is that good enough? One of my fears is that when I get depressed when i come off effexor is that ONLY effexor will rectify it - that the symptoms are due to effexor discontinuation, rather than return of depression.
I am asking for feedback here, because i have been a LONG time reader (and first time poster) and value the insights and knowledge of the members.
My Dr has suggested Valdoxan (agomelatine) but i am afraid that there will be no serotenergic effect to counteract effexor's withdrawal. She has said that once I am on a lower dose of effexor she can start me on valdoxan because of the different mode of action.
If you have got this far - thank you - can i have your thoughts on my ramblings?
Posted by rjlockhart37 on September 29, 2018, at 14:55:51
In reply to is it me or effexor withdrawal, posted by sufergirl on September 29, 2018, at 0:17:48
effexor is known for its withdrawal symptoms, i mean it's all over the internet, it has bad effects when stopping. But at the same time, it is effective, it has higher response rates than Prozac and the other SSRIs, effective, but what happens is level on it, you noticed improvement but after time it's kinda like the mind adapts to it, but when it's removed then that's when its bad.
alternatives to medicines, yes like cognitive behavior therapy, and seeing a therapist, yes that can help, but i did that and still, was sinking no matter how much stimulus put in the schedule, i was falling behind. I took Prozac years ago and noticed improvement major, but yes....it leveled and felt it wasn't working, but when didn't take it, major sink in daily activities.
this is a link on effexor withdrawl, it gives the descriptions as your describing
https://www.verywellmind.com/brain-shivers-as-effexor-withdrawal-symptom-1065516One thing ... maybe you could ask about is Buspar, it is anxiety med but it works on serotonin, increases certain levels....i don't know how the mechanism works, but that would be a very good candidate for what asking about. This is just a support board, that's no medical advice but just keep that in hand.
Posted by rjlockhart37 on September 29, 2018, at 15:01:37
In reply to Re: is it me or effexor withdrawal, posted by rjlockhart37 on September 29, 2018, at 14:55:51
actually my bad, that was an extreme withdrawal link, it said having shivers during Effexor discontinue, don't think that's the case, but if you google effexor, almost links talk about withdrawal symptoms as bad as harder drug withdrawal. Ask about Buspar or even a low dose benzo to help with anxiety
Posted by sufergirl on September 29, 2018, at 15:22:35
In reply to Re: is it me or effexor withdrawal, posted by rjlockhart37 on September 29, 2018, at 14:55:51
> effexor is known for its withdrawal symptoms, i mean it's all over the internet, it has bad effects when stopping. But at the same time, it is effective, it has higher response rates than Prozac and the other SSRIs, effective, but what happens is level on it, you noticed improvement but after time it's kinda like the mind adapts to it, but when it's removed then that's when its bad.
>
> alternatives to medicines, yes like cognitive behavior therapy, and seeing a therapist, yes that can help, but i did that and still, was sinking no matter how much stimulus put in the schedule, i was falling behind. I took Prozac years ago and noticed improvement major, but yes....it leveled and felt it wasn't working, but when didn't take it, major sink in daily activities.
>
> this is a link on effexor withdrawl, it gives the descriptions as your describing
> https://www.verywellmind.com/brain-shivers-as-effexor-withdrawal-symptom-1065516
>
> One thing ... maybe you could ask about is Buspar, it is anxiety med but it works on serotonin, increases certain levels....i don't know how the mechanism works, but that would be a very good candidate for what asking about. This is just a support board, that's no medical advice but just keep that in hand.
>
>
Thanks- i know this is a support board, Interestingly, I dont get get a lot of the physical withdrawal symptoms just the heightened psychological ones. I have done CBT but it seems like when Im in an episode i cant see the forest for the trees.
I also meditate daily which i think helps.Buspar is not used in Australia. I am very aware of effexors withdrawal difficulty in terms of coming off - i painstakingly counted the beads in the capsules , removing tiny amounts every 3 weeks- I didnt have any problem until i was 3 weeks into 14mg when suddenly i was hit - thats why i am unsure about depression or withdrawal or if it was just too long on too little dose.
My dr is good, but doesnt necessarily look at it from anything but this is your condition , maybe it is, but because i had so long between episodes before i went on antidepressants i am confused. I might add, that I havent ever relapsed whilst on a decent dose in 18 yesrs- except just recently, but i had been on an opiate for two weeks for a surgical procedure and i wondered if stopping the opiate suddenly triggered depression. I had Mild physical withdrawals for a week then the depression/anxiety- it seems all about kindling
Posted by rjlockhart37 on October 6, 2018, at 0:07:40
In reply to Re: is it me or effexor withdrawal, posted by sufergirl on September 29, 2018, at 15:22:35
a good option is Remeron, it's a serotonin, it's used with Effexor and may be a good choice, i don't know why Venlafaxine creates withdrawals but it's....like an opiate or harder drug withdrawal type
Posted by bleauberry on October 9, 2018, at 7:49:43
In reply to is it me or effexor withdrawal, posted by sufergirl on September 29, 2018, at 0:17:48
I agree with you that rocking the boat after 18 years is likely not a good idea.
If Effexor is still in the game but not what it used to be, then we can turbocharge it and breath some new life into it.
There are only 3 substances I know of that can do that and do it fast. You can even do it on-demand.
The lack of motivation you feel is only going to be made worse by any other antidepressants. Whether you switch or add, either way, it will get worse not better. Certain antipsychotics (Zyprexa or Ability) might help a bit but not enough to make the side effects worth it.
Ritalin, Adderall, or Modafinil. Try adding one of these to your Effexor. You will know within a day to a week whether it is right for you or not. No long trials needed. No upsetting of your life is needed. The reason for these is because they boost the dopamine system, which is being squashed by Effexor, squashed by all antidepressants - dopamine is the motivation/pleasure chemical in the brain. It's being squashed out because Effexor is mostly serotonin, secondarily norepinephrine, and very little dopamine.
Here's a real example. Me. I needed motivation. My depression wasn't as bad as it had been but I was just dull. I tried Adderall. Within hours I was in the deepest darkest depression I had felt in a long time. So I knew that was the wrong one. A week later my doc had me try Ritalin instead. Within hours I felt normal for the first time in maybe 30 years. Normal. Not high. Not buzzed. Not drugged. Just plain freaking normal! It was mind blowing. So obviously, I loved Ritalin.
For several years I battled against the emotional numbness of prozac by combining it with Modafinil, or even better was its European ancestor Adrafinil, and a small dose of Zyprexa which boosts dopamine a lot when combined with prozac. Eventually all that pooped out.
For longterm use I think Ritalin is by far the safest of the 3. Adderall is basically the same meth on the streets, just legal and controlled.
Anyway, I would suggest you and your doctor go in the direction of stimulants added to Effexor because that is the most likely strategy to actually work as desired, the most likely strategy to work fast, and most likely strategy to not upset your routine, and the most likely to not rock an 18 year old boat.
in my opinion
> I have been on effexor (75 - 225mg) for 18 years.
>
> As a child i had episodic anxiety and as a young mother 3 episodes of PPD. Then, i had 3 episodes of major depression. With complete remission of symptoms in between - each episode lasted about 8 months and were about 3 - 4 years apart. They also came on SUDDENLY and started with this obsessive thought about whether or not i would sleep. That was related to my PPD where my main symptom was not being able to sleep and I worried that if i couldn't i would have a breakdown or something terrible. So one day, it seemed i was fine and the next day i would wake up with this thought 'would i sleep tonight?'
>
> This thought would CONSUME my every waking moment and would gradually morph into depression. The first couple of times i had it i tried every possible alternative therapy possible; chiropractic, colonic therapy, homeopathy, herbal treatments, hypnosis, chinese medicine, acupuncture and there were probably others. I also started to exercise a lot. Gradually it would get better only to return 3 or 4 years later. On the 3rd episode I got a lot worse and started to feel suicidal. I was referred to a psychiatrist (because i refused to take medication - my mother had told me i shouldn't - even though by now i was 40 LOL)
>
> The psychiatrist prescribed me effexor which i agonised over, but in the end chose to take it. Within 3 weeks i was so much better. However, since being ON effexor, i can't get OFF it. Each time i try to come off, I relapse in a shorter and shorter time frame. My dr says it's the nature of depression. Recently I followed the advice of one of those anti medication user boards that call all sorts of bodily symptoms to be a 'withdrawal effect' I reduced my dose down in incremental amounts, excruciatingly slowly over 2 years and got down to 14mg and then WHAM back into depression/anxiety - tried again a few times with the same results only to finally accept that my condition requires medication for life.
>
> I am OK with that. But I am thinking that maybe effexor has run it's course with me - i have little motivation and not a lot of interest. I run my own business and employ 10 people so I have stuff to be interested in, if only I could be.
>
> We have talked about transitioning to another medication, but i am worried about 'rocking the boat' - it's not sinking, but is that good enough? One of my fears is that when I get depressed when i come off effexor is that ONLY effexor will rectify it - that the symptoms are due to effexor discontinuation, rather than return of depression.
>
> I am asking for feedback here, because i have been a LONG time reader (and first time poster) and value the insights and knowledge of the members.
>
> My Dr has suggested Valdoxan (agomelatine) but i am afraid that there will be no serotenergic effect to counteract effexor's withdrawal. She has said that once I am on a lower dose of effexor she can start me on valdoxan because of the different mode of action.
>
> If you have got this far - thank you - can i have your thoughts on my ramblings?
Posted by sufergirl on October 23, 2018, at 19:48:35
In reply to Re: is it me or effexor withdrawal » sufergirl, posted by bleauberry on October 9, 2018, at 7:49:43
> I agree with you that rocking the boat after 18 years is likely not a good idea.
>
> If Effexor is still in the game but not what it used to be, then we can turbocharge it and breath some new life into it.
>
> There are only 3 substances I know of that can do that and do it fast. You can even do it on-demand.
>
> The lack of motivation you feel is only going to be made worse by any other antidepressants. Whether you switch or add, either way, it will get worse not better. Certain antipsychotics (Zyprexa or Ability) might help a bit but not enough to make the side effects worth it.
>
> Ritalin, Adderall, or Modafinil. Try adding one of these to your Effexor. You will know within a day to a week whether it is right for you or not. No long trials needed. No upsetting of your life is needed. The reason for these is because they boost the dopamine system, which is being squashed by Effexor, squashed by all antidepressants - dopamine is the motivation/pleasure chemical in the brain. It's being squashed out because Effexor is mostly serotonin, secondarily norepinephrine, and very little dopamine.
>
> Here's a real example. Me. I needed motivation. My depression wasn't as bad as it had been but I was just dull. I tried Adderall. Within hours I was in the deepest darkest depression I had felt in a long time. So I knew that was the wrong one. A week later my doc had me try Ritalin instead. Within hours I felt normal for the first time in maybe 30 years. Normal. Not high. Not buzzed. Not drugged. Just plain freaking normal! It was mind blowing. So obviously, I loved Ritalin.
>
> For several years I battled against the emotional numbness of prozac by combining it with Modafinil, or even better was its European ancestor Adrafinil, and a small dose of Zyprexa which boosts dopamine a lot when combined with prozac. Eventually all that pooped out.
>
> For longterm use I think Ritalin is by far the safest of the 3. Adderall is basically the same meth on the streets, just legal and controlled.
>
> Anyway, I would suggest you and your doctor go in the direction of stimulants added to Effexor because that is the most likely strategy to actually work as desired, the most likely strategy to work fast, and most likely strategy to not upset your routine, and the most likely to not rock an 18 year old boat.
>
> in my opinion
>
>my dr doesn't add stimulants.... i think she is a good dr - she is definitely conservative - i don't have much experience with them.
she has been talking to me about rTMS therapy and has written a referral if i choose to go that route. i may make the appointment and talk to them about what i could expect. I am not too concerned about them pushing me into a treatment as there is a long waiting list so likely would only recommend if it was feasible.
My goal would be to be on as low as possible (if not off ) effexor. I have read that people can come off meds and have maintenance rTMS if it works.But i am back to that - is it depression when i relapse quickly after coming off effexor or is it a discontinuation effect - and if it is a discontinuation effect, does that have biochemical different pathway in the brain (albeit similar symptoms) that is not responsive to rTMS.
Sometimes i am convinced I overthink things
This is the end of the thread.
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