I'm Done Taking This Pills
January 30, 2013 1:45 PM   Subscribe

I want to be done with my pills. So I stopped taking them. Just making sure that what I'm experiencing right now is normal because if it's not I've got a phone call to make.

I've been on Venlafaxine 75mg for a while for anxiety stuff, and Pristique before that. I'm on the instant release better swallow it the first time because it tastes like shit variety. I've also only been taking it once a day instead of twice like it's designed for because it's been working like that.

Yesterday for some reason I didn't take it. Went to work after a rough-ish day in class and had what would have before been a breakdown of a day. Slid over to point on the line, couldn't keep up with both watching for everyone else's stuff and having my own stuff done. But where before I would have just come home and gone all suicidal or at least really pathetically shit down I got through it.

So today I decided consciously not to take the pill. 2 days in a row without for the first time since I started about 18 months ago. Went through the day definitely more light headed than usual, with a bit of almost noxiousness that could very easily be from being light headed. I'm like that, it's weird, whatever. Other than that it just feels like my brain's in a plastic bag that's being squeezed around it. Not blood flow cut off, just the inward pressure part. I should probably note that this is something I felt before I started on the pills, but this is closer to when I went from drinking way too much Coke to almost none.

Is this sort of thing normal? Is there a lower dosage I could switch to so it's not just a cold turkey stopping for me? If not, is halving the pill an option? Is there something I should be watching for to indicate that there's a big problem? Is there some advice you can give/information I can give that I'm missing because I'm trying to write this before I leave for work?

Obviously you're not my doctor, and I should talk to him. Thankfully he's all but said that he'd love to never see my in his office ever again while not pushing me to get off the pills.

I should probably also note that while my wife is really supportive and would do just about anything to help me out, I don't see her while she's awake except for my day off and maybe weekend mornings depending on when I wake up. This week that day off is tomorrow.
posted by theichibun to Health & Fitness (32 answers total) 1 user marked this as a favorite
The tags you have on this question should never have to live together.

Call your doctor and talk this out.
posted by skrozidile at 1:49 PM on January 30, 2013 [20 favorites]

You sound anxious and incoherent. Please talk to a doctor ASAP about your plans. It's possible to make some regrettable decisions when you're impaired and don't realize it.
posted by Nomyte at 1:49 PM on January 30, 2013 [33 favorites]

It's called SNRI discontinuation syndrome and Venlafaxine is the big daddy of bringing it on. You need to speak with your doctor ASAP about giving you a lower dosage (I think 37.5 mg is the lowest, with 75 mg being the next step up) and taking that lower dosage for however long your doctor says is the tapering period. Otherwise, you're risking your well-being.
posted by griphus at 1:49 PM on January 30, 2013 [38 favorites]

Quitting an SSRI cold turkey is a real bad idea. Get thee to the doctor please.
posted by kelseyq at 1:50 PM on January 30, 2013 [6 favorites]

Venlafaxine -- Effexor -- is really, really hard to get off of for some people. A taper is virtually always recommended. This is going to get worse, probably much worse, before it gets better. You should go to the ER, see your doctor, or see a new doctor if you're not comfortable with yours.
posted by kate blank at 1:50 PM on January 30, 2013 [3 favorites]

SSRI/SNRI discontinuation syndrome, aka withdrawal. Venlafaxine is known to be particularly hard to get off - when I wanted *out* completely of SSRIs my doc switched me to Prozac first then weaned me off that. Call your doctor, please.
posted by radioamy at 1:52 PM on January 30, 2013 [4 favorites]

You need to call your doctor. You can't go cold-turkey off of anti-anxiety drugs. You can become suicidal.

You typically "step-down" taking smaller and smaller doses.

My MD is also a Pharmacist and he's pretty much told me that he's never taking me off of Celexa because of the benefits I'm getting and because getting off of them is so unpleasant and pointless that it's not worth doing.

YMMV, but talk to your doctor.
posted by Ruthless Bunny at 1:53 PM on January 30, 2013 [2 favorites]

(When I say "risking your well-being" I don't just mean "it is bad for you," I mean you're liable to do some stupid, stupid shit in this state, and it can have severe repercussions for your job, social life, home life, etc.)
posted by griphus at 1:53 PM on January 30, 2013 [4 favorites]

Alright, got it. I've got some food I can take with me in the car and pills left plus a refill. I'll make the call tomorrow after I get out of class.
posted by theichibun at 1:55 PM on January 30, 2013 [3 favorites]

You really need to talk with your doctor ASAP, and be honest about how you've been taking the medication (once a day instead of twice a day as prescribed) as well as your sudden "cold turkey" attempt. It's absolutely OK to decrease your meds and even stop them if you're not getting a benefit from them, but going off Effexor (venlafaxine) is notoriously hellish; you really need proper medical advice.
posted by epj at 1:58 PM on January 30, 2013 [1 favorite]

Cold turkey on SSRIs is a terrifically bad idea.
posted by entropicamericana at 1:59 PM on January 30, 2013 [1 favorite]

If you do want to get off the effexor, you have to do it very, very carefully. Your psychiatrist will probably prescribe generic prozac to ease you off. Google "effexor brain shakes" to see what the withdrawal symptoms are like.
posted by Oktober at 2:00 PM on January 30, 2013

Step down, don't cold turkey. I never had so much as a headache when I tapered off. Your doc will help.
posted by Sidhedevil at 2:04 PM on January 30, 2013

Not a good idea. Talk to your doctor.
posted by Guy_Inamonkeysuit at 2:05 PM on January 30, 2013

Oh, and there is a 37.5 dosage, so you can absolutely taper off from 75.
posted by Sidhedevil at 2:05 PM on January 30, 2013 [1 favorite]

DEFINITELY consult your doctor as soon as possible. You can certainly taper off, lower your dosage, halve pills, etc., but you cannot go off of a med like Effexor cold turkey without putting yourself at serious risk for very bad side effects.

Here is CrazyMeds' recommendation on how to (slowly) stop taking Effexor, under the supervision of your physician.

I went off of my scrip of 40mg daily Celexa/citalopram one day after taking it for about 8 weeks and hating the incessant brain fog; within 72 hours, I suffered a total break from reality unlike anything I could have ever dreamed -- replete with dozens of far-reaching, long-lasting decisions that were made while I was completely insane, yet appearing to be a perfectly functioning member of society to everyone outside of my head.
This was followed by over a year of brain zaps, wherein my very grey matter, inside of my skull, felt like it had been immersed inside one of those wacky hand buzzers about 30 times a day. Oh, boy, you do not want brain zaps. Fuck a bunch of SSRI discontinuation syndrome. I am now 100% fine without any meds at all, but I will forever maintain that -- while I am as mistrustful of psychiatrists/Big Pharma as anyone you'll ever meet -- mucking about with your psychological chemistry on your own is ill-advised at absolute best.

Re-up your Effexor and consult with your doctor before taking any further steps. You can get off the pills, it just might take a little while longer than you'd like. Good luck!
posted by divined by radio at 2:06 PM on January 30, 2013 [4 favorites]

Cold turkey is a bad idea, but honestly, I did a gradual taper off Effexor and when I went from 37.5 mg to nothing, it sucked just as bad. The consensus I've found is that Effexor withdrawal is just a shitty, shitty experience overall, no matter how long the tapering off period is. Sorry.
posted by book 'em dano at 2:08 PM on January 30, 2013

Effexor is supposed to be one of the worst of the anxiety meds to get off of as far as withdrawal symptoms. I don't recommend stopping cold turkey, but although uncomfortable, it's probably not actually physically dangerous. But why do that? Just talk to your doctor and they can help you wean off. If for some reason you can't talk to your Dr., yes, you can probably halve your pills, then quater, and so on to wean off. There's plenty of info online about this, and other people's experiences. One interesting phenomenon is what people call "brain zaps." Do a little googling, and talk to your doc. You sound just slightly incoherent, which is probably a withdrawal side effect.
posted by catatethebird at 2:08 PM on January 30, 2013

Do not go cold turkey! Even with tapering off, you have to be careful and let your doctor know if anything is off. I tapered off an SSRI and it made me, well, crazy. You really have to communicate with your doc ASAP if you feel off, you aren't happy with the meds, whatever. Seriously, griphus is right - you can really mess up your life if you don't.
posted by Autumn at 2:29 PM on January 30, 2013

My shrink had me go from 75 to 37.5 to half of a 37.5 (I actually counted out the little pellets, but you can estimate) and I had zero issues, even though I ordinarily have problems with headache (both migraines and cluster headaches). But everyone is different, of course.
posted by Sidhedevil at 2:30 PM on January 30, 2013

Yeah, you don't just stop Effexor cold turkey. Call your doc and talk to him about tapering down as Sidhedevil did and you'll be fine. I don't really recommend quitting SS(R/N)Is in general unless you've dealt with the things that led you to need them in the first place, but if that's what you're going to do at least do it responsibly, pls. (I'm not a doctor, but I've seen too many people think "oh, I'm fine now, I'll just stop taking my meds" when they're really not fine at all)
posted by wierdo at 2:46 PM on January 30, 2013

Another point: You've decided to quit your meds, that you say have been helping, because for ONE DAY you got by without them. That's not even a data point; that's just interesting.

One of the sure-fire signs (to me) that a person needs more help with a mental health issue is that they rationalize why they no longer need the meds they're on. I've seem it ... god, too often to count amongst my friends and their families. A rational person backs off their longterm drugs (of any type) by discussing it with their doctor, and then making an informed decision (including a safe withdrawal plan).

Your path is clearly one of rationalizing. I'm not saying you're bad, nor whacko; I'm just saying that if you really can come off these drugs, you have plenty of time to do so. Mental health is something that requires longterm efforts.
posted by IAmBroom at 2:47 PM on January 30, 2013 [22 favorites]

I actually got off Effexor with only mild 'brain zaps' but I was taking a low dose, and I felt like shit for a year afterwards.
posted by Charlemagne In Sweatpants at 2:49 PM on January 30, 2013 [1 favorite]

IAmBroom speaks truth. I've never been on Effexor but I've been on Paxil and I will say that I never noticed the effects of skipping a day, but after two days I would feel out of sorts and after four I would be getting full-on zaps.

In the end I titrated it down very slowly over a period of months and it was fine. However, the several times that I tried to quit cold turkey (or just forgot/was unable to take them for a few days for whatever reason) it sucked pretty bad.

After one day of skipping, the amount of medication in your bloodstream is probably still at therapeutic levels. You feel the same as when you were on the drugs because you still are on them. It's not until you've stopped for a few days straight that your medication levels start to drop and you start to have withdrawal and/or the return of the symptoms that you were treating in the first place.
posted by Scientist at 4:59 PM on January 30, 2013 [1 favorite]

Nthing that quitting Effexor cold turkey is an extremely bad idea. FWIW, I was weaned off Effexor (and I was on a very high dosage) with practically no side effects. Under the psychiatrist's supervision, I took the next lowest dosage for two-three weeks and continued this pattern until I reached the lowest dosage (37.5 mg). However from that dosage, he had me open up the capsules and dissolve 1/2 the contents into a small glass of orange juice; once I adjusted to that we went down to 1/4 for a week or two before stopping them completely. Obviously consult with your doctor before trying this, but I really feel that this method (as opposed to stopping cold turkey from 37.5mg), allowed me to come off of Effexor without any of the problems that I had read a lot of other people have had to suffer through.
posted by kaybdc at 6:34 PM on January 30, 2013

Scientist: "After one day of skipping, the amount of medication in your bloodstream is probably still at therapeutic levels."

Effexor is unusual in that it has a very short lifetime. It's twice daily because it doesn't last much more than 12 hours.

Upon rereading, I'm not surprised the OP felt better not taking the pill for a day. Taking one non-ER pill a day is not a good thing to be doing. It leaves you essentially in permanent withdrawal. Take medicine as prescribed. It's written that way for a reason.
posted by wierdo at 8:27 PM on January 30, 2013 [3 favorites]

Is there liquid Effexor available? When I went off a SSRI (can't remember if it was Paxil or Zoloft) I had crazy-bad withdrawal even on the lowest pill dose so they put me on the liquid so I could taper down to zero 1 mg at a time. Maybe that would be an option for you?
posted by rabbitrabbit at 9:54 PM on January 30, 2013

I just wanted to echo that this is a terrible idea. I've stopped taking Effexor multiple times. Tapering off (the last time i stopped) was mostly fine, but the times I stopped taking it cold turkey were absolutely awful.

In my experience, I felt fine for a little while, and then found myself having the worst anxiety attacks of my life.

I've made bad decisions and quit several SSRIs cold turkey without discussing with my doctor first--Effexor was the worst by far. (Also ill never quit a drug like that cold turkey ever again)
posted by inertia at 8:17 AM on January 31, 2013

You have gotten a lot of good advice already. I have been on both Effexor and Pristiq. I did the taper down and then went over to Prozac and it was fairly painless. I tried a quick taper at first on my own and I had very bad withdrawls. Prozac is a lot easier to get off. Also, I used a double dose of fish oil at the time which seemed to also help. GL.
posted by heatherly at 9:40 AM on January 31, 2013

For ongoing support and ideas re: getting off antidepressants and anti-anxiety meds, there are excellent forums at Paxil Progress. Some (not all!) meds can be broken down into infinitesimally smaller doses with water titration (where you dissolve the dose into water, put it into a beaker and drink a little less each day), for example. I highly recommend it. The people there have been through all of this and are very helpful, compassionate and resourceful.
posted by sweltering at 12:33 PM on January 31, 2013

I'm not marking best answers because it would be stupid to have everything be the best.

But a serious thank you to everyone.
posted by theichibun at 5:57 AM on February 1, 2013

Nooooo you're doing it all wrong!!

I'm on effexor as well - I take the extended release 225mg once a day.

Because it leaves your system really quickly, I definitely notice symptoms the next day if I forget to take a pill. It's not pleasant and it's not good for you. Please don't decide on your own how much or when you should take this medicine. It needs to be monitored closely and you can't just decide that you only want to take it once a day instead of twice. You can talk to your doc about the XR (extended release) version so you only have to take it once a day.

Coming from someone that was very hesitant to get help for my anxiety and it took me many years of bad anxiety before I got help, I understand why you don't want to rely on meds. I get it, I do. But at the same time I look at what effexor has done for me and I am so grateful. I am so much happier and it turns out that I don't HAVE to be nauseous every day from anxiety! I can be normal!

Please talk to your psychiatrist (and if you don't like him/her, get a new one) before you make these decisions. You should not be determining on your own when to stop or how often to take these meds.

Good luck!
posted by Georgia Is All Out Of Smokes at 9:14 AM on February 1, 2013

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