Antidepressant withdrawal - doctor recommendations?

laura_li

Hi all,

I'm suffering withdrawal symptoms from the anti depressant venlafaxine.

Although it only takes a one minute google search to find abundant information on the symptoms this causes, I couldn't find any doctor who believes me if I'm explaining my symptoms to them:
- extreme anxiety
- shaking
- nausea if I move my head
- splitting headaches constantly
- confusion

This is going on now for two weeks and counting. It's so awful that it's driving me to the edge of sanity.

Does anybody know a psychiatrist who acknowledges the reality of anti-depressant withdrawal symptoms and could help me? I'm getting a bit fed up with doctors who prescribe those drugs and don't know what happens when you stop them.

Thanks a bunch!

Laura

PS: I wanted to post some links regarding the topic but I'm not allowed to since I'm a new user in the forum. Here's some articles you can find Google search:

"Playing the Odds: Antidepressant ‘Withdrawal’ and the Problem of Informed Consent" By STUART SHIPKO, M.D.

"Antidepressant Withdrawal Syndrome" By Christopher Lane in Psychology today

laura_li

Hey, if anyone sees this and has also been injured by taking or stopping venlafaxine, send me a personal message. Maybe if there's many of us we can get a solicitor to help.

neelyohara

I started taking Venlafaxine when it first came on the market and they denied any discontinuance syndrome. I mean completely. It wasn't on the literature, the packet inserts and it was completely denied by psychiatrists.

I had some bad experiences having missed or taken a dose later than scheduled. My head would spin, I'd have headaches, a sensation as though electricity was running through my brain... also an almost 'delayed reaction' with my vision... I'd turn my head to look at something and it felt as though it took my brain a second or two to catch up (it's hard to explain!).

Once I missed a dosage and became really ill - so ill that I could hardly function and went to bed. Then I missed the night dose. The next day I couldn't move and stayed in bed = more missed doses. I went to the doctor later that day and she sent me into hospital. Multiple tests and they tell me I'm fine.

I go home and crawl into bed. For whatever reason the meds came into my mind, I took them, went to lie down... within a couple of hours I was great. All the symptoms gone.

I couldn't miss a single dose. I keep spare tablets everywhere. In my desk at work, in my bag, in my car. Within hours my head will start to spin.

Early on my psychs denied any of these symptoms. There was definitely no way it was withdrawal and they'd start quoting literature. Then the complaints started and the court cases. Then they revised the literature to include info on withdrawal.

I'm still taking it. Perhaps 13 years or so? I've never had to wean myself off of it, I imagine if I did I'd have to take time off work and not drive. My dosage has gone up and down, I've taken the max dosage at times.

I'd never, ever, suggest that somebody not take an antidepressant but I do think they should be taken more seriously and reactions explained. The first antidepressant I took was Seroxat and it was the worst year. You expect a couple of weeks before the meds kick in... but bloody hell. I wanted to die. I was supposed to be on medication that would help me and life was getting harder and more painful. Now I read about the increased risk of suicide with Seroxat and I wonder if that's what I went through.

I'm surprised that nobody will take your withdrawal seriously - it's well documented. The only thing I can suggest is that you keep searching, call around, find a doctor familiar with it. I know of cases where patients have divided up tablets until it go to the stage where they switched to a liquid form and just reduced the dosage incredibly slowly. Perhaps ask your chemist what is available.

Good luck!

looksee

How quickly did you come off op? I agree there is no interest on the part of many doctors, and flat denial that it happens. I am not sure how close we are getting to medical advice here, but I will say that I tried to get off a similar medication after a very short period on it (couple of weeks) a few years ago and I had to re-start it then wean off very very slowly (months rather than weeks) till in the end I was taking literally a tiny crumb of tablet every two days, and even then I got some of that horrible sensation you describe as electricity in the head, which is as good a description as any. It did stop eventually but took a long time.

bd2012

Hi op. From your post it's not clear if you tapered off the drug or not. From experience it is extremely important to taper off venlafaxine slowly. I had very unpleasant symptoms coming off the drug (electric shocks mostly). I was on 75mg for approx 1 year 9 months. Doctor didn't want to know about it and even told me they weren't available in 37.5mg for tapering purposes. From talking to my pharmacist I discovered otherwise, I went to another younger doctor who was very supportive abd prescribed the 37.5 straight away. By tapering down and using the half strength over time I managed to come off the meds completely. Now I did still have some side effects but not as bad as tapering off from 75. I guess my point is to stress the importance of coming off this drug slowly and incrementally.

Best of luck op

neelyohara

laura_li wrote: »

Does anybody know a psychiatrist who acknowledges the reality of anti-depressant withdrawal symptoms and could help me? I'm getting a bit fed up with doctors who prescribe those drugs and don't know what happens when you stop them.

I still don't understand how they won't acknowledge a well publicised and accepted fact. Not only with venlafaxine but with other anti-depressants. Bring the pack insert with you to your next appointment. Psychs will have far more indepth knowledge and literature on the subject but the layman version included in every packet is this:

Discontinuation of treatment
Withdrawal symptoms, when treatment is discontinued, are common, particularly if discontinuation is abrupt (see section 4.8). In clinical trials, adverse events seen on treatment discontinuation (tapering and post-tapering) occurred in approximately 31% of patients treated with venlafaxine and 17% of patients taking placebo.
The risk of withdrawal symptoms may be dependent on several factors, including the duration and dose of therapy and the rate of dose reduction. Dizziness, sensory disturbances (including paraesthesia), sleep disturbances (including insomnia and intense dreams), agitation or anxiety, nausea and/or vomiting, tremor and headache are the most commonly reported reactions. Generally, these symptoms are mild to moderate; however, in some patients they may be severe in intensity. They usually occur within the first few days of discontinuing treatment, but there have been very rare reports of such symptoms in patients who have inadvertently missed a dose. Generally, these symptoms are self-limiting and usually resolve within 2 weeks, though in some individuals they may be prolonged (2-3 months or more). It is therefore advised that venlafaxine should be gradually tapered when discontinuing treatment over a period of several weeks or months, according to the patient's needs.

Also included:

Withdrawal symptoms seen on discontinuation of venlafaxine
Abrupt discontinuation should be avoided. When stopping treatment with venlafaxine, the dose should be gradually reduced over a period of at least one to two weeks in order to reduce the risk of withdrawal reactions (see sections 4.4 and 4.8). If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate.

In regards the legal side drug companies are armed to the teeth with legal advisors. I guess your case would rest on if you were advised of the problems with discontinuing treatment - and if you started venlafaxine within the last couple of years then the packet insert will have included this information. You would need to check the history of the packet inserts to see when information was added. The shelf life is 3 years so you could count back three years from when you first took the medication. From memory some mention of withdrawal and discontinuance issues were included in literature as far back as 2000 but do check that. And any revisions to that text. Good luck.

laura_li

Hey all,

apologies for not posting. My notifications must have landed in the spam folder. I was told by the doctor to quit the medication cold turkey because of a side effect I was experiencing. I wish I had continued. I would have survived the side effect much better than this. I was only taking the medication for 5 days!!! Now I'm sick 4 weeks and counting.

It is really incredible how clueless doctors are about the issue. I found help in an american forum about tapering (just google it, it's easy to find). I re-instated a tiny dose (1mg) of Sertraline (different SSRI that I had at home). I'm still not entirely sure if that was a smart idea or not. I still have the withdrawal symptoms but they got a much more bearable. Especially the feelings of being doomed to suffer forever, the despair, the racing thoughts, the anxiety and the shaking have gotten better.

But I'm a bit worried I'm just prolonging the problem. I'm trying to taper down from 1mg by dissolving the tablet in a measured amount of water. But even going down by 0.1mg makes all the symptoms to come back after some days.

My therapist is in complete denial the problem exists. She tells me to snap out of it and refuses to search information. I find her behaviour a lack of respect. These symptoms are really a handful to handle and she just tells me to snap out of it. It's so frustrating!!!

Cheers,

Laura

neemish

When I was coming off cymbalta, the best advice I could find was to taper down the Cymbalta, go onto another SSRI (Prozac was recommended) and then ween off that. I was lucky in that both my psych and GP accepted that coming off any SNRI was a nightmare. My GP was especially helpful. I have to say it was a pretty miserable five weeks and in the end, I wasn't able to drive with the side effects of tapering down the cymbalta. And like yourself, I had the awful anxiety so had to take something to take the edge off that.

The whole process took about 6 weeks - I didn't stop meds completely but when onto Sertraline which I find much easier to tolerate.

The only thing I would say is if you are not getting the support you need from your docs, look around and see if you can get it elsewhere. Are you in the public system? If so, could you ask to see a different member of your team? Or is there another GP in the practice you attend? Trying to manage your own meds when you are so anxious etc is not a good idea. Google can help, but don't forget that you get all the crazy advice along with the sensible.

orlyice

Hey

I was on it for 6 months and had to come off it very quickly, found out I was pregnant, psychiatrist took me off all my meds immediately, and I was on high dosage, 75 in morning and 150 at night.

Oh the side effects were horrific, anxiety, insomnia, diarrhoea, cramps, headache but the worst was the electric shocks feeling to the brain, like there was an electric current running between your skull and brain, which was accompanied by shaking and cold sweats. Have to say after 10 days to 2 weeks the symptoms eased greatly. I know everyone is different so I hope things ease off for you x

Youngblood.III

Anyone get extreme night sweats while on it?

orlyice

Youngblood.III wrote: »

Anyone get extreme night sweats while on it?

I did, mostly when I started on the meds and when the dosage was increased. I've lost count of the times I had to shower in the middle of the night. Used to settle down a bit for me.

laura_li

Same here... I have to change clothes a couple of times per night.

@neemish: You're totally right. I will try to change doctors. I'll soon have an appointment with one who is supposedly specialised on this. I'll keep everyone posted.

I have been researching a bit. We can report our withdrawal symptoms and adverse reactions through the European database. Currently the drug manufacturers claim the withdrawal symptoms are "mild and short lived", which in my opinion is a plain lie. If we report our withdrawal symptoms, maybe they will be forced to change their wording.

www. adrreports.eu (remove the space in the middle of the url, I still can't post links)

Cheers,
L

laura_li

Hi all,

I just wanted to keep everyone updated. Now it's 6 weeks after stopping the venlafaxine.

I have found a doctor who is at least listening to me, although I'm not 100% sure he believes me about the withdrawal symptoms. He seems to be putting it down to the underlying depression. But I'm hoping I can get him convinced with a bit of patience, he's nice.

I stopped the Sertraline by now, I'm starting to feel slight improvements but I'm still nowhere near the pre-medication me. Still can't work, can't focus, super depressed, crying fits, migraines, palpitations, sweating etc.

It'll get there, I'm sure. It's just a challenge of patience.

Cheers,
L

Macavity.

I weaned off Effexor XR (Venlafaxine) last Summer after being on antidepressants for almost a year. The withdrawal took pretty much everything out of me, both mentally and physically. I do believe that period was the closest I have ever been to killing myself. I experienced all of the symptoms described in the OP as well as aggression and horrible brain zaps. It's a nasty nasty drug, that in my case had no benefits whatsoever.

I have found that GPs generally like to play down any negative side effects regarding SSRIs/SNRIs. As a consequence I am quite distrusting of medical professionals in general now.

OP, you are over the hard bit now, just keep going and things will continue to improve. Best of luck.

laura_li

Thanks MacCavity! Good to hear I'm not alone and good to hear that you got through this in one piece!

If anybody is in a similar situation and wants to meet up just to share experiences and interchange courage, feel free to PM me.

laura_li

I just wanted to update, for future reference:
I'm still suffering withdrawal. I still haven't found a doctor who acknowledges it.

When I tell the doctors "It's written in the product leaflet that the withdrawal can take months", they just respond: "Oh, they just write that in the leaflet to cover themselves, it doesn't take this long".

The arrogance of doctors is really scary. If anybody knows a GP who acknowledges prolonged withdrawal, please let me know. I can really use a supportive GP at the moment.

Irishchick

I weaned myself off the stuff over a couple of months. Docs said the same to me that I shouldn't have been experiencing withdrawal. Utter denial even though I was in bits.

The only way I could get off it was to open up the capsule and take one little tablet out every week until there was none left. I felt nothing up until the last 2 little tabs in the capsule and I weaned myself off them even slower by cutting one in half for a week and then into quarter for a week and a bit .

I would say it took me about 6 months. Tedious but I suffered very little

laura_li

Just checking in. I'm still totally sick from this crap. It's been almost four months since I stopped and I have still withdrawal symptoms. My doctors are still in denial. It's so frustrating. They're nice but they refuse to read the leaflet of the medication or do any kind of research. I even bring them printouts of studies that show antidepressant withdrawal can last for months.

They're like the little kids covering their eyes pretending nobody can see them. Utter denial.

greenfrogs

laura_li wrote: »

Just checking in. I'm still totally sick from this crap. It's been almost four months since I stopped and I have still withdrawal symptoms. My doctors are still in denial. It's so frustrating. They're nice but they refuse to read the leaflet of the medication or do any kind of research. I even bring them printouts of studies that show antidepressant withdrawal can last for months.

They're like the little kids covering their eyes pretending nobody can see them. Utter denial.

Would you consider going to a&e?

laura_li

greenfrogs wrote: »

Would you consider going to a&e?

I did. That was actually the only place where they believed me these were withdrawal symptoms. They sent me back to the GP as "he would be the one who knows best how long this will last". Sigh....

greenfrogs

laura_li wrote: »

I did. That was actually the only place where they believed me these were withdrawal symptoms. They sent me back to the GP as "he would be the one who knows best how long this will last". Sigh....

What about your pharmacist. Did you ask any of them if others had experienced similar.

I'm reducing my meds from tomorrow. I was speaking to the pharmacist today and asked her if people experience withdrawal symptoms from reducing the meds. She said no usually it is when they stop the meds altogether. It might be another place to get information.

laura_li

greenfrogs wrote: »

What about your pharmacist. Did you ask any of them if others had experienced similar.

I'm reducing my meds from tomorrow. I was speaking to the pharmacist today and asked her if people experience withdrawal symptoms from reducing the meds. She said no usually it is when they stop the meds altogether. It might be another place to get information.

The pharmacist wasn't very helpful either unfortunately. But I got a lot of help on a website called survivingantidepressants. org.

It seems that people are very different. Some experience next to no withdrawals and they just last a week. Others suffer for months or years. I'm probably one of the rare, unlucky ones. That's also why doctors are so unfamiliar with it.

I hope all goes well with your reduction. Did the pharmacist give you a proper taper plan?

greenfrogs

laura_li wrote: »

The pharmacist wasn't very helpful either unfortunately. But I got a lot of help on a website called survivingantidepressants. org.

It seems that people are very different. Some experience next to no withdrawals and they just last a week. Others suffer for months or years. I'm probably one of the rare, unlucky ones. That's also why doctors are so unfamiliar with it.

I hope all goes well with your reduction. Did the pharmacist give you a proper taper plan?

Yah the internet can be great for meeting others with similar issues. You poor thing though. It sounds terrible what you're going through.

No the gp just reduced my meds from 100 mg to 50mg. I'm not sure if or even will they will be reduced again.

laura_li

greenfrogs wrote: »

Yah the internet can be great for meeting others with similar issues. You poor thing though. It sounds terrible what you're going through.

No the gp just reduced my meds from 100 mg to 50mg. I'm not sure if or even will they will be reduced again.

Yeah, the last couple of months have been the single worst nightmare of my life. I've lost quite a lot to those meds. I'm lucky I'm still alive.

Are you taking Venlafaxine? Cutting the dose in half just like that seems like a bit of a risky move. You might be ok, but I've dropped from 37,5 to 0 and I was in hell. In the forum I went to they recommend not to drop more than 10% of the dose per month.

Did the GP say why he is cutting the dose in half?

greenfrogs

laura_li wrote: »

Yeah, the last couple of months have been the single worst nightmare of my life. I've lost quite a lot to those meds. I'm lucky I'm still alive.

Are you taking Venlafaxine? Cutting the dose in half just like that seems like a bit of a risky move. You might be ok, but I've dropped from 37,5 to 0 and I was in hell. In the forum I went to they recommend not to drop more than 10% of the dose per month.

Did the GP say why he is cutting the dose in half?

No I'm on sertraline. I wanted the dose reduced. As it is 6 months since I'm feeling better the doctor agreed. The doctor told me to ring her if there are any issues and she will put me on 100mg again.

laura_li

Hmmmm, I don't want to scare you or anything, but some people don't respond well to big cuts. Doctors usually don't know much about that. Have you had a big dose change before? Did it go well?

Sertraline has a relatively short half life, so 4-5 days after the dose cut, you should be able to see if you have any problems. If you want to be on the safe side, you can make a smaller drop by cutting the pill, wait for a week and see what happens.

I'm just cautious because I've been burnt so badly. It wasn't just unpleasant, I was close to going psychotic and physically very, very ill. For some people changing the dose is really dangerous, while others can just tolerate it no problem. It's really weird.

I know that in most patient forums they recommend dropping only 10% per four weeks.

Pugzilla

Physical addiciton to antidepressants isn't possible. You can get a discontinuation syndrome, which subsides within several days, but this isn't the same as having withdrawal symptoms.

laura_li

Pugzilla wrote: »

Physical addiciton to antidepressants isn't possible. You can get a discontinuation syndrome, which subsides within several days, but this isn't the same as having withdrawal symptoms.

I can't post links unfortunately, but anyone interested can search for:

Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review
Fava G.A.a, b · Gatti A.a · Belaise C.a · Guidi J.a · Offidani E.c

New insights on the antidepressant discontinuation syndrome.
Harvey BH, Slabbert FN.

Playing the Odds: Antidepressant ‘Withdrawal’ and the Problem of Informed Consent
By STUART SHIPKO, M.D.