Venlafaxine/Effexor withdrawal - help

[Guest -S-]

Hello everyone,

I'm just looking for a bit of advice on what I should do right now. Apologies that this is long and rambling - my concentration is all over the place and it's taking me ages to write this post and try and stay on track.

Basically, for a bit of background, I've been on ADs for about a year. I've gone from citalopram to mirtazapine, then duloxetine, then venlafaxine (and in the past I've been on prozac, risperdal and dothiepin also). I have a family history of bipolar and have struggled with depression (and the rest) for most of my life (I'm 28). I'd tried to get help a few times in the past to no avail, and a year ago things got bad enough that I decided to try again. I was referred to the SHO at my CMHT who never really seemed to hear what I was telling him, and when he left, I was passed on to the consultant who seemed to instantly pick up on the fact that a lot of what I experience seems more chemical/biological (although I still don't have a diagnosis as such), and long story short, she decided that a mood stabilizer would work better and that she would put me on lamotragine/lamictal.

Now, I've not had much support in terms of being offered talking therapy and such, and my pdoc appts have always been very short and to the point. So, after a five minute appointment last week which resulted in me being given a prescription for lamotragine, I realised that I didn't really understand why I had been given it, what the implications would be - basically I didn't really feel informed (despite my own research) and I didn't feel comfortable, so I didn't start taking it. I'd taken my last dose of venlafaxine, which was 225mg a day. Pdoc didn't want me to taper me off that or anything, just take the last venlafaxine one day, get on to the lamotragine (25mg) the next (to increase by 25mg a fortnight).

When I am uncomfortable, confused and unsure, I hide. So, rather than doing the sensible thing and ringing the CMHT, I didn't take the new tablets right away. I didn't take them the next day either, or the next, and so on. So, to finally get to the main point of my post, I have now gone from taking 225mg venlafaxine on Wednesday (which I'd been on for a few months) to taking nothing at all. So, you can probably guess how I am feeling right now.

The withdrawal is absolutely unbearable. Day 3 today and I am in a real mess. My head feels like it's going to melt or explode. I am incredibly dizzy. My lips and hands are numb. My head is pounding, I'm alternating between shivering and sweating. I am exhausted but can't sleep. My head keeps jolting, my ears are weird, I'm hearing things that aren't there, and I've lost count of how many times I've been to the toilet feeling like my stomach is going to fall out of my body. I keep bursting into tears, and my whole body feels bizarre. My dreams, when I do sleep, are weird (and that's an understatement).

I know this is my own fault, I know it's extremely irresponsible of me, and I know better! I do know that I've been stupid to go from 225mg to nothing, but it's not really intentional, I didn't mean it - I just got scared and confused about everything. I guess what I am asking is - what the heck do I do? It's Sunday tomorrow - does feeling like this warrant a visit to an out of hours surgery? What can they do - would they think I was wasting their time? Would they give me more venlafaxine? Would taking the first dose of lamotragine as I was supposed to actually help alleviate this? If I feel like this tomorrow, I just don't know how I'm going to get through another day. Getting through tonight is proving hard enough as it is.

I suppose I'm in a bit of a 'nothing is helping and there's no point in anything so why bother with my meds anyway' sort of place right now - feeling angry with myself and wanting to be free of it all, even though stopping meds dead like this is going to do nothing but make it worse. What can I do? I feel like hell. Please help me out with some advice, because my head is a mess.

[Velvet Elvis]

I'd call and see if you can get more of the venlafaine, yeah. Really the easiest way to come off it is to go on a serotonic drug with a longer half like prozac or nortryptiline, then start your taper off the fex, and then taper off the bridge drug.

Going from that high a dose of Effexor to nothing must be murder.

[lucidity]

eesh coming off that high of a dose cold must be a real mess. I came off of 175mg of effexor in hospital and they just kept feeding me Valium and the dt was still horrible. I would defeinately get some kind of medical advice/help it's not good to quit cold. Especially with a dose that high. I hope you feel better soon.

[AnneMarie]

Call your psychiatrist's office and leave a message about what you are feeling do. Ask what you should. Ask when you can get an appt.

Going to the surgery might get you a small quantity of effexor to hold you over until you can see your pdoc. It might get you a different type of short-term med. If you are in a bad way, I would hope it gets you something to help.

It's unlikely that starting lamictal would have made a difference. As VE described, taking a low dose of longer acting SSRI and then weening from it is the easiest way off effexor. Unfortunately, not all pdocs got the memo.

PS, Lamictal is a good med. There are people here with depression who use it with success. There also are people with bipolar who like it for the same reasons. I am one of them. It manages my depression quite nicely.

[Guest -S-]

Thank you for the replies, all. Managed to speak to my pdoc's secretary who got a prescription for 75mg venlafaxine for me to pick up in the morning to take alongside the lamotragine. Seems pdoc forgot to do that in the first place.

I'm just hoping that that dose isn't too low and that this stops this week. Today has easily been the worst so far and I need it to go away.