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Mental Health (Expert Forum)
Effexor : withdrawl § depression - how do you know what is what?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Effexor : withdrawl § depression - how do you know what is what?
by vaappe, Oct 03, 2004 12:00AM
I have been on taking Effexor since late December 2004, after a work related "burnout" which led to zero energy, anxiety and eventually depression. I reacted very well to the meds, despite being very sensitive to them. I had to start on only about 10mg, and I only ever went up as high as 75mg - after a month of slow increases. Psychologically, I rebounded almost immediately, and have been supporting my recovery with job changes, CBT, yoga, quitting smoking and a lot of rest and relaxation.
In May 2004 I began to reduce my dosage, with my therapist & doctor’s blessing. I did it very slowly, with medical supervision. After 8 weeks, I was off of Effexor completely, having suffered very few/mild withdrawal symptoms. Unfortunately, after about 2 weeks of being off them, I suddenly experienced extreme anxiety, irritability, depression and even self-harm fantasies, which I have never experience before in my life. I had been tracking my mood using a CBT quiz, and therefore was able to monitor this change. Both my doctor and therapist suggested I go back on. I starting taking a very low dose (alternating between 1/4 & 1/2 of a 37.5 tablet), and felt better almost immediately. Since then, I take either 10 or 18.75mg every day or other day.
So now, I feel great - happy with my job, my life, my relationships, my future, and naturally, I want to GET OFF Effexor! But each time I try to reduce the dose, or even go a day or so without taking it, not only do I experience headaches, nausea, dizziness, flu-like symptoms, but I also get the anxiety, irritability and end up very very sad. Intuitively, I think these must be withdrawal symptoms rather than actual underlying conditions. But, the trouble is, the moment I start to experience them, I am too low to rationalise suffering through it. Instead, in my anxious/depressed state, I panic, and think: “I am not really well after all, it is all an illusion based on the medication, and I will be stuck on them for the rest of my life." And I think: "If I don't go back on the meds I am going to get worse/more depressed and go crazy and die,” so I start taking the Effexor again. Once back on the medication, I feel fine again - and start to fret about getting off.
Meanwhile, I regularly hear on the news (especially here in the UK) about the risks of ADs - increased risk of suicide, damages to the immune systems, metabolism, and of course difficult withdrawal. All this makes me more determined to resolve this situation.
Do you have any sound advice (besides speaking to my therapist or doctor, which I do regularly)? How can I get off the medication for once and for all? How can I know if I am suffering withdrawal or still suffering depression? Are these common experiences? If I do persist through the withdrawal depression – how long could I expect it to last? Any insight would be so very helpful! I think if I can understand this phenomenon I am more likely to get over that final hump. Thanks!
In May 2004 I began to reduce my dosage, with my therapist & doctor’s blessing. I did it very slowly, with medical supervision. After 8 weeks, I was off of Effexor completely, having suffered very few/mild withdrawal symptoms. Unfortunately, after about 2 weeks of being off them, I suddenly experienced extreme anxiety, irritability, depression and even self-harm fantasies, which I have never experience before in my life. I had been tracking my mood using a CBT quiz, and therefore was able to monitor this change. Both my doctor and therapist suggested I go back on. I starting taking a very low dose (alternating between 1/4 & 1/2 of a 37.5 tablet), and felt better almost immediately. Since then, I take either 10 or 18.75mg every day or other day.
So now, I feel great - happy with my job, my life, my relationships, my future, and naturally, I want to GET OFF Effexor! But each time I try to reduce the dose, or even go a day or so without taking it, not only do I experience headaches, nausea, dizziness, flu-like symptoms, but I also get the anxiety, irritability and end up very very sad. Intuitively, I think these must be withdrawal symptoms rather than actual underlying conditions. But, the trouble is, the moment I start to experience them, I am too low to rationalise suffering through it. Instead, in my anxious/depressed state, I panic, and think: “I am not really well after all, it is all an illusion based on the medication, and I will be stuck on them for the rest of my life." And I think: "If I don't go back on the meds I am going to get worse/more depressed and go crazy and die,” so I start taking the Effexor again. Once back on the medication, I feel fine again - and start to fret about getting off.
Meanwhile, I regularly hear on the news (especially here in the UK) about the risks of ADs - increased risk of suicide, damages to the immune systems, metabolism, and of course difficult withdrawal. All this makes me more determined to resolve this situation.
Do you have any sound advice (besides speaking to my therapist or doctor, which I do regularly)? How can I get off the medication for once and for all? How can I know if I am suffering withdrawal or still suffering depression? Are these common experiences? If I do persist through the withdrawal depression – how long could I expect it to last? Any insight would be so very helpful! I think if I can understand this phenomenon I am more likely to get over that final hump. Thanks!
Doctor's Answer
by Roger Gould, M.D., Oct 06, 2004 12:00AM
, Oct 06, 2004 12:00AM
I have some insights that might help, but not knowing you, all you get here is an educated guess, so here it is. It sounds to me like you begin to have a withdrawal effect that would probably be tolerable as long as done slowly as before, but you panic and read too much into these symtpoms, and project them into the future as everlasting, and ever intensifying. In that way, you catastrophize, and your symptoms become intolerable because of this added, and incorrect, interpretation. Next time you try, keep this in mind, expect your panic and catastrophizing, but be aware of it and ride that part through. You can also discuss this phenomenon with your therapist.
God bless all of you. Be kind to yourself------all this junk that you are going through is not your fault and it is real and you will get through it.
God bless----sandy