I was prescribed 250mg of Venlafaxine
Effexor (the time release capsules) for depression. I had been
prescribed a number of other antidepressants in the past and my
psychiatrist felt that this one might be helpful where others
had
failed.
I was on the drug for 8 years without any
noticeable benefit. My psychiatrist kept me on this medication,
even though it didn’t help my depression, as each time I suggested
changing the medication it was considered that I wasn’t stable
enough to withdraw from the drug.
I think many of us on psychiatric
medication are placed in this “catch 22” situation. When we are
relatively stable, our doctor may feel that things should be left
as they are in case any change in medication makes us more
unstable. Yet when our symptoms become overwhelming, there’s a fear
that changing medication could make us even worse. This seems to
apply even if there is no real benefit from the medication in the
first place. I’m raising this as I think it always needs to be a
decision which we, as patients, have some control over – what drugs
we take and when we decide to come off them. Additionally, I
believe, that the time scale at which we withdraw from any drug
should be determined by us. We know our own bodies best and it may
be that the rate set by a clinician is too fast for us to cope
with. Coming off this drug should feel as comfortable for you as
possible. I stress that withdrawal from any psychiatric medication
should always be with medical supervision and support.
Although I was suffering from depression at
the time, I finally persuaded my psychiatrist to allow me to stop
taking Venlafaxine and try an alternative antidepressant. She gave
me a list of all the possible withdrawal effects and I began to cut
the dose down by 25mg. I left several weeks between each cut in the
medication and reduced it when I felt that I was ready to make
another cut. However, the lower the dose became the more withdrawal
effects I suffered and the more extreme they became. Additionally,
my mental health deteriorated significantly with each reduction in
the dose. My psychiatrist kept telling me that she would find an
additional medication which could help with the withdrawal effects,
or that she would look up an alternative antidepressant which could
be “dovetailed” with my coming off Venlafaxine, but she failed to
do this. Since Venlafaxine capsules are only available in 25mg, the
final cut was to Venlafaxine tablets so that I could reduce from
25mg to 17.5mg before stopping the drug completely.
The most pronounced withdrawal effects I
suffered from included: increased insomnia and excessive sweating
followed by horrible 'chills' (a bit like having a bad bout of
flu). However, the worst withdrawal effect, for me, was
extreme mood swings. I would suddenly become overwhelmingly
aggressive and violent. This behaviour was really out of character
for me. The slightest thing would trigger these violent outbursts –
sometimes there was no apparent reason. I was totally unable to
control these 'rages'. It was very frightening for me and others. I
would start throwing things around, being very verbally abusive and
physically attacking people. On two occasions the police were
involved, and at one point this led to my being arrested and held
in police custody. I had never been arrested before. I also began
to self-harm in ways I had not done in the past. By the time I had
reached the lowest possible dose I was so unstable that I needed to
be admitted onto an acute psychiatric ward.
I still had withdrawal effects for several
months after I had taken my final dose of Venlafaxine. All the
clinicians I discussed this with told me that it was out of my
system and I couldn’t be suffering withdrawals anymore, but I was
certain that I was. Other patients I know who have stopped taking
Venlafaxine have shared this experience. It would seem that it
takes a person’s body, and mind, some time to adjust to not taking
this drug. I don’t know if any research has been undertaken into
whether Venlafaxine still hangs around in cells, muscle tissue etc.
Certainly, my experience is that the withdrawal effects took some
months to subside.
My advice to anyone who is on Venlafaxine
and wants to stop taking it is:
- never stop taking this drug abruptly
- always seek medical advice and
support
- come off this drug slowly, but at your own
pace – you will know what feels right for you
- ask your doctor if there are any other
medications which can be prescribed to help with the withdrawal
effects
- ask your doctor if there is another
antidepressant which you can start while you are withdrawing from
Venlafaxine.
Finally, this is my experience of
coming off this medication. You may find that your experience is
not as severe or that you suffer from different side-effects.
SD - January 2011
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