By the time I got home today at 6pm I couldn't take it anymore- I took my night dose of Effexor. I felt so light headed and numb and tingly. The headache responded pretty well to aspirin. I'm getting used to the top of my head tingling. But when I feel like I am going to pass out- that is the really hard part to deal with.
Of course I know I am going down on it way too fast. But yesterday was an accident- forgetting my AM dose- and after feeling so much more alive emotionally- I just can't get myself to go up on my dose, even to go back down again more slowly. So I will put up with these withdrawal effects and hope that I don't get too debilitated. And for the last 150mg, I will go down much more slowly. I suspect that is where it is going to get very hard, getting off the last bit of it. Or maybe not. Maybe the rest of my meds will give me enough of a buffer that it won't be so bad.
Nobody properly warns you when you go on these meds how bad it can be to get off of them. You should be able to go to detox or something. When I would try to go off of Zyprexa in the first year and would start getting manic, I didn't understand it was a withdrawal effect. I thought it was proof I needed the drug. No one told me. And when I said I wanted off of Zyprexa, no one tried to wean me off- instead they tried to switch me to other antipsychotics, which always had intolerable side-effects- so I went back to Zyprexa.
But I am down to 5mg, which I am ok with for now. I think it does help with the depression- and soon I will no longer have the Effexor on board.
The morning wasn't too bad- I think I still had enough Effexor in my system from the nighttime dose. But as the day progressed I felt worse and worse. Now I just want to collapse. My whole body tingles, and I feel very weak and lightheaded. And yet, I made it through the day at work, and even stayed late to make two splints for a patient (which turned out well). All is not lost. I can do this. As I tell all of my patients- it is just going to take time.
I don't remember how much Effexor I was taking and I'm sure that it wasn't a huge dose because we were experimenting to find an antidepressant that worked without giving me hypertension (some strange thing) but I went off Effexor cold turkey and it was awful for a while but I seem to remember that the awfulness was faster than I expected. Not that I'm recommending the cold turkey approach; I know that I had to leave work one day and I think I was off for another day or two because I felt bad (if I'm remembering the right drug and I'm pretty sure I am because I remember being in a very specific place in a specific nursing home and realizing that I HAD to go home NOW. I can't remember if I started imipramine while I was doing the cold turkey thing or if there was time between. I know that I did go on imipramine and that I'm pretty sure it was after several days of no AD because we needed to know if it also caused HTN. It was just a weird problem I had for a while after I had a bad reaction to Risperdal with my normally low BP skyrocketing to 200/100 and my legs swelling to nearly double the usual size. After I came off the Risperdal ADs caused the same issues for a while until I finally had to take a beta blocker for a while but after a year my body adjusted and was fine again. It was weird. But I know Effexor was a big HTN culprit and that I was disappointed because it worked for me.
ReplyDeleteIf you do get off it and need something maybe look at Emsam? You've said the MAOIs were great for you and Emsam is easier than the old ones. At the lowest dose there are no restrictions and after my psychiatrist met the person who developed Emsam she learned that thee wasn't much research supporting MAOI restrictions for Emsam but the FDA put them on because it was safer with it being an MAOI. At 12 mg I've not been allowed to mess around but at 9 (my usual, the middle dose) I can have small amounts of anything except that I can't because of having migraines that make it impossible to know if I'm having MAOI issues or just a migraine.
JMJ
I think I might have the same trouble with orthostatic hypotension with Emsam, or at least that it my fear. I was so debilitated by it when I was going on the other MAOI's, and for quite a while until my body adjusted- I couldn't risk this while working. I passed out or blacked out multiple times.
ReplyDeleteI left a comment and it isn't here. Sorry if you deleted it; I won't repost again!
ReplyDeleteBut I just wanted to let you know that I have a very low BP normally and Seroquel has caused orthostatic hypotension so bad that there was a time that my dr. was considering putting me on a med to increase my BP (obviously before the MAOI). And while I know that it was a potential issue because I remember them checking frequently and having a couple days at the beginning that my BP dipped kind of low I also had my Seroquel doubled at the same time. So I don't think I had any BP issues related to Emsam and I would be at risk.
I did have orthostatic hypotension for a while after I went on Emsam but that had more to do with the Seroquel and I needed more benzos fo a a while because it was stimulating in the beginning. I did have 2 falls from that, one of which is why my left leg is in a big purple cast as we speak, but again I don't think the Emsam was at fault.
We've had a few periods of time where we've had me spot-checking my BP to see if the MAOI/high dose Seroquel was making it really low or causing orthostasis and it just stays low all the time. In the hospital when my nerve block quit working and they didn't have anything really effective to give for pain since I was due to be discharged soon my BP went up from the pain, all the way to 120/72. They commented on how good that was with the pain level and I laughed because that's really high for me.
It's maybe at least worth asking your psychiatrist about. I really don't think it is nearly the major side effect that it was with the old ones. In fact I'm pretty sure that was why Dr. Brain didn't want to put me on the old ones and fought with the company that makes Emsam to get a free supply. I've been on pretty much all the antidepressants except the newer ones and Emsam has been the best and has had the fewest side effects by far.
JMJ