[Closed] Coming down, stoping anti-depressants, any advice?

Wind down gradually rather than just stopping abruptly.

Talk to your doctor.

Thats a fairly large does IIRC. So as Cougar says you need to wind down slowly. Id be thinking something like 4 steps and at least a week for each one. so down to 112.5 then 75 then 37.5

Have you done anything to change the circumstances that led you to take it? If not you will likely be back to square 1

Speak to your doctor. Or if you are 100% sure that you do not want to do that there will be an online guide somewhere.

http://www.clinical-depression.co.uk/anti-depressants-withdrawal/successful-venlafaxine-reduction-programmes/

I'm bookmarking this for next year, but as has already been said, get advice from your GP, and make sure you have a way of dealing with what triggered it all in the first place.

Thanks, and yeah, I've been on these for about 3 1/2 years with varying does'. I've also had two phases of CBT (1:1 and group), and spoken to my doc previously about changing meds. They suggested phasing the Venlafaxine out and bringing in Mirtazapine in. However, since my diagnosis I, and we (my family) have taken some significant life changes to support a healthier life for us all, including a move to Spain. So, it feels like the right time, I'm not, nor have ever really been suicidal, so am mostly wondering about and side effects relating to the next two weeks, and especially if any here have gone through a similar thing, and if anything particularly helped.

I should also add, that I really value what anti-depressants gave me, in fact without them there may not be a here and now, it's just that in my wife's words, they seem to have devoided me of my personality, and it feels like the right time.

I have first hand experience of this and there are two things I can say from that (very very hard) experience.

The first is, for god's sake, come down slowly, don't just stop. Whatever your doctor suggests follow it.

The second, be prepared to accept that you might need to go back on them if it doesn't go well (and you'll know if this is happening because everyone around you will tell you).

It's been a tough six months in our house for precisely this reason and now things are back on an even keel because we reversed the decision (these are SSRIs BTW).

The desire to come off them was understandable in some ways and not in others. If you were diabetic and had to take Insulin for the rest of your life, of Factor 8 for heamophillia, you wouldn't question it. So if you need psychoactives its no different, it carries no more stigma.

I hope it goes well for you and wish you all the best.

Id be thinking something like 4 steps and at least a week for each one. so down to 112.5 then 75 then 37.5

That's a very aggressive reduction for SSRIs. It takes a few months to normalise to a new dose. I'd reduce by something like 10% a month. De-risks having a set back.

NB I've decided to stay on Citalopram for life, as I just prefer being on it to off.

I stopped taking venlafaxine ealier this year, because I felt like you describe.
You're supposed to taper off them; definitely do this.
I tried to go cold turkey last year; not recommended; think I lasted 1.5-2 days before I went wrong.
I think I halved my dose (1 capsule per day instead of 2)
After a while I did one capsule every other day.
And then I just stopped.
I read about people splitting capsules, or going onto tablets (which are not as potent IMO) but I didn't bother with this. Granted, I felt a bit odd for a few weeks after stopping, and I did a few stupid "out of character" things. But aside from that it was fine.
You'll probably be able to work out how quick to come off them yourself, no doubt it varies from person to person. As soon as you start feeling a bit weird, take some more. The side effects aren't worth it.

That's a very aggressive reduction for SSRIs.

Venlafaxine is not an SSRI.
Although apparently it's the worst thing to come off. I've stopped taking SSRIs in the past cold turkey, but not this thing. So definitely taper off it.

The desire to come off them was understandable in some ways and not in others. If you were diabetic and had to take Insulin for the rest of your life, of Factor 8 for heamophillia, you wouldn't question it. So if you need psychoactives its no different, it carries no more stigma.

A really salient point. I realise that meds may be a very real part of the rest of my life. I am not opposed to this, but feel that I have lost sense of reality in some ways, maybe overly 'numbed' to me and my emotions?

What I would also add, is that in many ways I have come to terms with my anxiety and depression, I've spoken very openly about it, on here, social media and with my friends. I have come to terms with it in many ways, and am not ashamed anymore.

EDIT - Mental Illness is not something anyone should feel ashamed of. What I mean is that I have accepted my diagnosis and condition, and view it in the same way that a person with any other debilitating condition may do.

Whether or not I can function without and medical intervention I am unsure, but I feel somewhat confident in my position, I've been down someone times before but this time I feel I know where I am coming from...

Venlafaxine is not an SSRI.

True: 'selective serotonin and norepinephrine reuptake inhibitors (SSNRIs)'

The side effects aren't worth it.

For me the side effects seem to be a headache, heightened emotions, tearfulness and 'jet-lag' type symptoms, i.e. spaced out head.

Definitely not cold turkey. The potential to undo the good work is not worth it.

I made decisions to try to sort the underlying issues. I got myself a different job (as my situation was thankfully solely work-related), and came off an admittedly small dose of citalopram during my notice period. The notice period was three months, I refused to be stressed during that period, and unsurprisingly as soon as I'd handed my notice in, people started to be nice as it sank in that they were actually losing a good employee (all told).

My new job is ramping up in terms of stress and I am still very new to it (only 8 weeks in and already creating a budget for next year and having meetings with the CEO). I am wary at the moment, but my new colleagues seem collaborative and realistic so, I am hopeful. If it gets too stressful, then I won't let it get like last time. I will talk to management if things get too much, and if I don't get the support then I'll start looking again. I'm determined not to go back 'there'. Broadly speaking, I am hopeful about my new job, so fingers crossed.

So in short, don't be rash, be confident you have sorted the issues enough not to need to go back, then phase out gradually. There's plenty of time to be 'clean', don't jeopardise it by rushing.

Good luck.

I'm going the opposite way, been coming off 45mg Mirtaz (2 months on this and 75mg Ven) yesterday was my last 15mg Mirtaz and today was my first 150mg Ven, so far so good

Echo above, seek proper advice and don't go cold turkey!

😀

When did you stop taking them OP?

I'm considering starting taking something again. Exercise has got me from my worst ever point back to near normality. However, there are just one or two things still bothering me that exercise isnt shifting.

Just remember that you trusted the doc enough to go onto the pills in the first place, so seek their help and trust in their advice to come off them too. You wouldn't self-medicate (hopefully), so don't self-unmedicate, either.

I'm coming off citalopram at the moment, i cut from 20mg to 10 mg over 3 weeks then cold turkey. Horrid, so poorly! Blinding heaaches, "rushing" sensation, dizzy, eye pain! I went back on 10mg and withdrawl effects went. I now take 5mg every 2-3 days hoping to very slowly wind it down. Sometime the GP will prescribe you something else with a shorter half life to wind down on, i think fluoxetine? just don't do cold turkey, it was horrendous!

Goodluck

Jim

I was on many different medications. Nothing seemed to work and the next one my psychiatrist would prescribe was always stronger. I ended up on Riseperidone anti psychotics. These turned me into a zombie. I told my doc I wouldn't take them any more and that I was pissed off with all the pills and needed to try a new method.
I weaned off as per the docs instructions slowly and went private to a therapist.
Should have done that a long time ago. It turns out much of my problems came fro the fact my body was so pickled with whatever they gave me it changed me and this made me angry that I wasn't as I once remember. Doc saw anger, increased the strength or added something else. Catch 22.
I'm now off everything and am actually not bad. There are times when I struggle but think, actually, who doesn't struggle sometimes? That's life. It's not always fun and games. When you can accept that, you can move on.
Mail in profile OP if you need a chat.

Just remember that you trusted the doc enough to go onto the pills in the first place, so seek their help and trust in their advice to come off them too. You wouldn't self-medicate (hopefully), so don't self-unmedicate, either.

Firstly, I respect your viewpoint, and to some extent agree that with all medical conditions it is right an proper to seek the viewpoint of a medical professional. But, I would also say that the most powerful treatment I have received in terms of impact was 1:1 CBT. It challenged my behaviour and perspective in a safe and friendly way, informed me of the technical aspects of anxiety and depression and empowered me with strategies to use when encountering these factors.

What is apparent within the burgeoning NHS is that while the need, ergo demand for talking therapies is high, patient access to these IMHO 'vital' services are limited. For me, I have been through many dark times, my relationship with my wife and family has managed to survive this, and it is with their support, and with open communication that we have decided to take this step.

There are times when I struggle but think, actually, who doesn't struggle sometimes? That's life. It's not always fun and games. When you can accept that, you can move on.

Spot on fella 🙂

I agree with above advice to take it very slowly. I know someone who had side effects if he didn't take his venlafaxine dose at exactly the same time each day. Obviously they were particularly sensitive and not everyone will have that experience but it's wise to be cautious. Go slow and get advice 🙂

On a slightly separate note, I've tried just about every antidepressant in existence and can't tolerate any of them. However, after a couple of difficult years and counselling, I'm doing much better despite being off meds.

but feel that I have lost sense of reality in some ways, maybe overly 'numbed' to me and my emotions?

Only you can know. I just hope it works out for you.

From the more detailed post it does sound like you might be ready to taper down. Take professional advice tho and do it slowly. Perhaps as pointed out more slowly than I suggested

Are you taking controlled or immediate release?

Nothing much to add but I've been on 150mg Sertraline for a couple of years now and am trying to cut right down or stop completely.
Taking 50mg daily now but still have out of it feelings and get incredible low periods.
Not sure what to do any more but sometimes wonder if I'm being numbed, hence the cutting down.

150mg is not a particularly high dose and at that dose there is not much tweaking of the N. I came off Venlafaxine 10 years ago over about 6 weeks with no withdrawl symptoms whatsoever, it was really easy, yet it has a very bad reputation in this regard. You could be lucky or unlucky everyone is different. Speak to your doc about sensibly tapering off it.

I now take Lamotrigine used as a mood stabiliser come anti-depressant and with it no side effects it really has turned my life around, BUT is an absolute bugger for me to come off even by reducing the dose by just 1/6 every 6 weeks. I decided it was simply not worth it, it works, so why change just for the sake of being anle to say I am drug free.

Reading this I kind of feel glad that ADs did nothing for me (well nothing positive, got side effects which is why I came off them within 6 months), so this isn't something I have to go through. Started CBT a few weeks ago (though we haven't really hit the CBT yet I don't think), 4.5 years after first going to the GP, and 10 months after going back and getting referred - the trouble it seems with this is that those who need it more are less likely to chase things up - or maybe that's just me.

Sorry, totally OT, just joining in the chorus of those who've taken ADs.

I too am thinking of coming off citalopram. Feel very disconnected emotionally from the world, but at the same time I'm scared to come off the tablets knowing how low I was beforehand. A very difficult decision OP and I wish you every success.

GJP- I tried lamotrigine but even one-quarter of the smallest dispersible tablet dose available completely stopped me from sleeping. I gave up with it after 2 weeks!

Definitely taper down the dose you take very gradually. I would suggest you talk to your GP and ask them for any advice they may have on how this is best done too.

There are many medications where a gradual reduction of dose is the best way to stop. It's not limited to those for mental health. My opinion as a user of citalopram is that there is a lot of fear regarding these drugs that many don't feel when taking drugs for physical issues. We need to get past that.

Interesting from Jimbobo. I'm looking to come off 20mg of Citalopram in the spring, which is a low dose, partly as I'm no longer sure if I'm "better" or just permanently drugged up.

Those of you who have gone down the private counselling route, how did you find someone, and what sort of cost is it?

Epa omega 3 oil (buy liquid rather than capsules its cheaper and less likely to be rancid) and some multi B might help you stay on track once off

Those of you who have gone down the private counselling route, how did you find someone, and what sort of cost is it?

madweedavey - Member 
I'm considering starting taking something again. Exercise has got me from my worst ever point back to near normality. However, there are just one or two things still bothering me that exercise isnt shifting.

I'd still keep clear of them. Exercise is the best drug in my opinion and the nagging remains I found was sorted by lifestyle changes and making the exercise social, lots of group rides but also a dose of solo get lost in the countryside and clear my head rides.

Keeping occupied also, and having projects to do. Bike n+1 is good if you build bikes. Always something to build or repair. 😀

Somewhat concerned SSRIs were the first thing the GP jumped to on first visit. I flat refused. They got me some "holistic" chat bollox. I say bollox but it kind of worked in that I realised talking about your childhood was garbage and suddenly became determined to sort it out for myself.

When did you stop taking them OP?

It's been four days, not feeling too bad. I realise there can also be flu like symptoms, and I have felt chilled despite being in 23c Spain 🙂

jimbobo - Member
I'm coming off citalopram at the moment, i cut from 20mg to 10 mg over 3 weeks then cold turkey. Horrid, so poorly! Blinding heaaches, "rushing" sensation, dizzy, eye pain! I went back on 10mg and withdrawl effects went. I now take 5mg every 2-3 days hoping to very slowly wind it down. Sometime the GP will prescribe you something else with a shorter half life to wind down on, i think fluoxetine? just don't do cold turkey, it was horrendous!

Goodluck

Jim

I echo the 'rushing feeling', previously, when in a bright sunny environment, or perhaps a particularly happy scenario I experienced what I assumed to be a release of serotonin, somewhat 'causing' the eyes to flicker?

The 'rushing' feeling is more akin to a set of pulses of blood within the skull. My eyes are also watery, however I think that is more of an allergic reaction to different pollen as I have had this checked out before.

On a separate note, I note that many of us have made reference to the 'bad times', or outfall of depression, and perhaps some relating to reduction on meds. Outside of one of the 'obvious' consequences of anxiety and depression, do people feel ok in talking through what these 'bad times' are?

For me, paranoia is certainly a factor, also period of 'rage', outbursts of profanities, self harm (i.e. hitting myself in the head), isolating myself, endeavouring to control my environment to the nth degree, feelings of helplessness when I am unable to do so, trying to seek perfection in all things, pursuing to disaster when I can't...to name a few.

However, I recognise these traits, and most, if not all are more due to my condition rather than the meds themselves (on or off). What I do recognise is that the most destructive traits of these are still present when on meds, and these in particular have been the most damaging to my work life.

Please keep us updated.

I tried to jump off citalopram overnight and couldn't believe how much it messed with my emotions/balance/senses

I'd imagine I'm not the only one on SSRi etc that now can't quite be sure what 'normal' is any more, how to get there, and whether it is better there or not!

Good for you for speaking out and talking to others, while it is of course a unique experience for everybody I'm sure we can relate to aspects of your journey.

Wish you all the best.

MCTD- I am having counselling but it's not private, it's through the NHS Improving Access to Psychological Therapies (IAPT) department. I didn't have to wait long but I did have to kick off a bit. I was feeling suicidal and can't take antidepressants, so my only option was talking therapy. IAPT offer a few different types of therapy and they involved me in the choice. My counsellor is brilliant and he's got a great sense of humour.
I've tried private counselling in the past but it's a bit hit and miss as to whether you "click" with the counsellor. Having a good relationship with the counsellor is vital.

Thanks vickypea - had some group CBT through NHS and some counselling through work, which helped but not sure resolved much.

If you don't feel the counselling is working, ask for another counsellor. I went through god knows how many until I found the right one.

What iolo says- you might have to try a few to get the right one. I tried 3 sessions with a woman who I just didn't get along with, and some sessions with a bloke who kept it very distant and impersonal which I felt was cold, though others may prefer that. My counsellor and I swear like troopers, I think we encourage each other!

I'm on Citalopram ATM (20mg) & have forgotten to take them on occasion. we were on holiday in August for my 60th & was going part time from early September, I forgot to take them for 4 days but felt no ill effects. Now that I'm actually part time from the sodding prison service I feel like I should just drop the meds altogether.
I knew the cause of my problems but that's mainly gone now, thank ****.

Good luck OP.

Good luck OP.

Thanks all 🙂

Start owing off them in the spring, it's much easier over the summer than the winter because you feel better in the summer than winter. My doc will only consider coming off in spring

chrismac - Member
Start owing off them in the spring, it's much easier over the summer than the winter because you feel better in the summer than winter. My doc will only consider coming off in spring

POSTED 9 HOURS AGO # REPORT-POST SHARE

I understand this in the U.K., but I recently move to Costa del Sol for this very reason 🙂

Your delusional if you think your Doc knows what's best for you - they're ponced up shills for big pharma - read the P.I.L. ( patient information leaflet - that should be inserted in these medications - those side effects - They'll only compound your problems in the end - Also do some homework on the D.S.M. - the Psychiatrists hand book - Incrementally it's being amended to the point where literally anybody can be deemed suffering from a mental condition .

noltae - you've made some interesting and pertinent points but this thread really isn't the place for it. May I politely suggest you start a new thread, it will allow me to link to an NHS document that has worrying implications for all.

Thanks. 🙂

I generally disagree that doctors are in league with Big Pharma. I genuinely believe they want to help patients.
But, I was shocked when I was prescribed duloxetine (for migraine prophylaxis and depression) and read the P.I.L. and prescribing information which both state that you should come off the drug gradually, tapering the dose. However, they only have 2 sizes of capsules so it's actually not possible to taper the dose. Having a short half-life means it's not ideal to reduce the dose by taking it every other day. I got advice from a professor of pharmacy that people have to open the capsules, count the beads (approx 200 per capsule), remove 10% and put the other 90% back in the capsule, and then take it (and so on, reducing the number you take very gradually). It's outrageous to expect patients to do that, the Pharma who make them should be making a series of smaller dose units available.
Thankfully, it gave me severe stomach ache after 2 weeks so I was able to stop taking it immediately.

I'm on Citalopram ATM (20mg) & have forgotten to take them on occasion. we were on holiday in August for my 60th & was going part time from early September, I forgot to take them for 4 days but felt no ill effects.

I would think you'd need to go a week or more before you noticed anything. I'm on the same dose and did get ratty on the two attempts I've had at coming off them. Wife prefers me on them as do I (prefer myself on them), hence decided just to take them for life. Once a year the GP asks if I want to stay on them and that's about it...

[quote=vickypea ]Having a good relationship with the counsellor is vital.

Definitely. I had some counselling before which I'm not sure really helped me at all. After my session this week I'm really thinking this is going to work - not because of anything specific in the session which was mainly filled with my negativity, but because he happily abandoned what he had planned in order to go with the issues I was having this week (and commented at some point that he'd probably extend my sessions).

I guess I'm in a similar but different position to you, as it seems my only option is counselling - not because I can't cope with ADs, but because they appear to make no difference (and yes I did try a few). Well realistically my only option is probably huge changes in my life, but I kind of need the counselling to enable me to get there.

It's been four days, not feeling too bad.

Stick at it then! I ended up with some strange zapping sensation in my head, along with feeling really hot.

aracer: good luck with the counselling. My counsellor never has a plan for a session, they're all guided by where I want to go, and he was fine with extending the number of sessions past the standard 6.
It's not so much that I can't "cope" with antidepressants, but all of the SSRIs and SNRIs give me severe stomach pain, and one of them also exacerbates my migraines. I've not tried mirtazapine or amitriptyline because I don't want to feel sedated and gain weight. I really tried with lamotrigine twice but I literally didn't sleep for 2 weeks even on a tiny dose so the dr told me to stop.

Day 6 in the Big Brother house... Start off feeling ok, no really sleepy with 'jet lag' type symptoms. Perhaps more to do with no sleep though, as apparently the hours of 00:30-04:30 are optimum for street protest in Granada!!!

Day 9 (I think), mornings much easier, loads more energy. Still weeping eyes, not just spontaneous tearfulness, but hay-fever like itchiness and constant weeping. Head rushes have subsided greatly, much more of a background echo now.

In terms of temperament, I feel energised, much more human, but feel I need to self-regulate again as life stresses can cause me to vocalise my frustration in a unsophisticated manner. I'm very much more self-aware though, and feel confident I can work through this.

Good to hear that things are going well for you OP.

I have been on 2 kinds of AD: Fluoxetine and Sertraline. Coming off Fluoxetine was quite straight forward with little in the way of side effects, but Sertraline is a different kettle of fish completely and so far I have only come down from 100mg to 50mg.

The first week wasn't too bad, but then I had 3 weeks of intense dreams/flu-like muscle pains/terrible earache caused by TMJ pain.

I think that I am over the worst of it now, but it was pretty nasty and not something I would like to go through again.

If I ever come off them completely I will taper, going down in steps of 12.5mg every couple of weeks. The thought of going from 50mg to nothing leaves me cold.

Any updates op.
I’m on 150mg Of venlafaxine and have been on it for a year.
I was originally prescribed for anxiety after the death of a very close friend who I cared for while he fought lung cancer.but then developed depression after starting taking them. The ven has helped with the anxiety but the depression especially recently is getting really bad so want to stop the ven and see what happens.

Did any ven users suffer loss of libido and erectile dysfunction?

I have a friend....

No erectile dysfunction, but sometimes fail to “arrive”

Not failed to arrive but on arrival it felt like little Derek had been hit with a toffee hammer.

Apart from little derek how are you finding ven?

Derek, toffee hammer and failure to arrive are both known side effects....I once over heard in a pub while waiting for a pint......

Been on Venladaxine for just over a year, for me it's removed the low lows but that I'm constantly exhausted, as in will happily sleep all day.....if it was possible, going to chat to the GP to see what's what, as this isn't a great way to live! But it's not helped with the lack of energy but neither did the sertraline maxed out either.

I do really dislike the black dog?