EXTREME irritability

[SweeterShimmer]

Right now, my pdoc and I decided that it might be beneficial to try a med washout period. So, I have been trying to get off Effexor for the last few weeks. I had been on 75mg since November. I started by alternating 75mg one day with 37.5mg the next, then 37.5mg for one week, then 37.5mg every other day. I didn't make it a week with 37.5mg every other day because the withdrawal was so bad. So now I am taking 25mg generic immediate-release venlafaxine for one week, then 12.5mg for one week, then stop. Since going to the 37.5mg Effexor XR I have been even more irritable than usual, and now I am EXTREMELY on the 25mg immediate-release. I also started taking Loestrin 24 this month (this is the first time I've ever taken any kind of birth control pill), so I don't know if that is making me irritable, or if it's the immediate-release venlafaxine, or withdrawal from the Effexor in general, or the combination of all three causing my irritability to go through the roof. I saw my pdoc last week, and I wasn't scheduled to see her again for four weeks (would have been three, but spring break is that third week). I saw my T yesterday, and I got the feeling that maybe she thought it would be a good idea to try to see pdoc sooner, so she is going to have the secretary call me tomorrow to see if there are any openings left this week or next (pdoc is only here one day a week). I'm also worried because the week of break is when I'm supposed to be stopping the venlafaxine completely. Because I just saw her last week, should I wait at least one more week to see if the irritability calms down at all? I mentioned it to her last week, but I think it's worse now. It's the kind of irritability where I just want to crawl out of my skin because I'm so uncomfortable.  I think it tends to be worse in the evening, which I am attributing to the short half-life of the venlafaxine.  Anyone have any ideas as to where it's coming from-- withdrawal, Loestrin, the change to immediate-release, etc.?
I should probably mention that that I'm also on 100mg of Lamictal, which is at least indirectly affecting my irritability because the memory problems, clumsiness, and general "stupid" feeling that it causes is incredibly frustrating.  I also take xanax and klonopin as needed, and I've needed it A LOT lately.

Thanks in advance for any ideas!  

[SweeterShimmer]

Thanks for your response!  I started the pill because I just found out that I have endometriosis, so I'm not actually using it for contraception at all.  It took me a really long time to give in and take it, but the pain was becoming unbearable (and I have a high tolerance for pain) so I figured it was worth trying for at least month.  Maybe it won't even work, and I'll have to stop it anyway, but for now, I think I need to give it at least one cycle.

There is a opening with my pdoc tomorrow.  I thought it would be better to give it another week to see if anything changes, and also to see what happens when I go down to 12.5mg in a couple of days, plus I just saw her last week, but she doesn't have any openings next week.  So it's either tomorrow or three weeks from tomorrow... Plus, now I think that I having that phenomenon that happens when something is bothering you, and as soon as you go the doctor it feels better.  Maybe it's just a mood swing. haha

Thanks again!

[bernie40]

This is difficult!  With so many changes of meds going on at the same time it is really impossible to tell what is causing what (I've been there!!!).  First off, is there any way you can manage without the birth control pill while you come off your other meds?

The BCP can alter your mood, more commonly the combined pill but the progesterone only pill can also cause mood swings.

Venlaflaxine can cause the symptoms you are describing, so it could be that.  

So, as you said it could be any one or a combination of the multiple med introductions and withdrawals.

I would certainly see your pdoc sooner than intended and consider using an alternative method of contraceptive for the time being.  I had to do that when I changed from one med to another and started the BCP at the same time, my moods were terrible.  I am back on my BCP now and everything is fine.

Good luck.