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Default Oct 13, 2019 at 01:07 AM
  #1
I'm not special or anything. I know so many people here have gone through a thousand med changes. They've done it bravely, full of hope, and uncomplaining, for the most part, from what I can tell.

However, this is the first med change for me in over 12 years. I'm all read-up on the possible withdrawal symptoms and what I can expect that way. (I think, perhaps, I may have read too much, as I've got myself into a complete state!)

I'm going from Effexor XR to Lexapro. I was almost at the max dosage for the XR, when I began experiencing rapidly more hair thinning on the top of my head, after my last increase. I also did NOT see a sufficient discontinuation of my depression symptoms or my anxiety (not for years---I've been just "inching" along with improvements), so I'm changing course for several good reasons.

I know about the danger of profound anxiety and panic symptoms when going off of Effexor XR. I am beginning a walking program which I've been procrastinating on for quite a while (that's the professional, holistic suggestion for coping, among other things.).

If there's anything else anyone can suggest, I'm all ears.

I promise to consider anything kindly offered. Thanks!
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Default Oct 13, 2019 at 03:43 AM
  #2
I've gone through lots of medication changes but I don't think most of them have been "bravely, full of hope, and uncomplaining". I get a lot of severe and uncommon side effects, lots of meds that don't work like they do on the majority of people, even a few severe allergic reactions, so for me, med changes are extremely anxiety-inducing. I desperately want the new medication to help, to fix me, but I'm always so worried about how I'll react to it physically as well as mentally/emotionally. And I probably complain a fair amount to family and friends.

I read up on withdrawal symptoms and also what I can expect from the new meds. (crazymeds.net is a favorite resource) Then I have to kind of let that go to a certain extent because there's no way to know which symptoms I might actually experience. Maybe none at all. Expect the best but prepare for the worst, you know?

I do breathing exercises and meditation to help with the anxiety. When I'm in panic mode meditation is difficult so I've found that Buddhist chants work well for me because they're something for me to concentrate on. First the words, then the pace and rhythm of the chant. Any kind of personal, religious or secular, mantra could work.

For the breathing exercises there are a couple that work best for me. There's an app (can't remember what it's called but there are probably several similar) that is basically a simple counter. Press it and hold while you breathe in. Then again as you breathe out with the goal of matching the first amount of time. Keep repeating until the panic recedes. The other is just to breathe in for a count of 4. Hold your breath for a count of 4. Breathe out for a count of 4. Repeat. Anything that makes you focus on your breathing, consciously slowing it, let's you get out of the panicky or even just really anxious, mental state.

Walking is great. I used to swim a lot when I had better access to a pool. Anything to burn off some of that nervous energy. If you can do it with a buddy that's even better.

I love those adult coloring books and find them very calming. Anything creative and simple that keeps my hands busy and my mind off my fears and agitation. Calm distractions.

A close friend of mine has found it very helpful to put a rubber band on her wrist. Each time she starts to get anxious or panicky she snaps it against her skin. It's just a tiny disruption of the thought patterns and a quick focus on the physical instead of the mental.

Hopefully, something in all that will help you a little. Go easy on yourself. It's a stressful process so try to make room in your schedule for little breaks throughout the day, even for just a few minutes, to find a bit of calm and self-care.
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Default Oct 13, 2019 at 05:04 AM
  #3
Do you by chance have an emergency anxiety/panic attack medication plan for yourself? If not, maybe you should look into that.

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Default Oct 13, 2019 at 11:08 PM
  #4
No, bp, I don't. Doctor was behaving in the local Medical Centre pattern---"I'm a very busy doctor person, and I actually don't have much time to give you today", when I received my schedule for titration. She only said to call there if there were any massive problems. But I can tell you that I would be very hesitant to do that, as they are aces at letting me down when I need them most. (All I've ever seen are G.P.'s---I do not have access to a psychiatrist.)

Historically, I have gotten a lot of "no's" from them when I inquire about additional anxiety medication. They seem to belong to that genus of doctors who insist strongly that my main med should be eliminating any need for them.

Please feel free to expound on anything you feel would help!
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Default Oct 13, 2019 at 11:11 PM
  #5
And thank you for your reply, Ember. Those are excellent suggestions, and I had not considered them in a long time. Great reminder!

Breathing has helped me in the past, getting over momentary panic situations. I have never done a formal routine but it does make a lot of sense!, especially now.
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Default Oct 14, 2019 at 11:48 AM
  #6
Hi, I understand the feeling; but, to put you more at ease, you could tell yourself that the med you're transitioning to will have similar effects as the Effexor does. And so, if the titration of each medicine is properly executed, you won't have anything to worry about.

I do have some questions though.

Does your doctor understand that using Lexapro and Effexor together can potentially cause serotonin syndrome? I am asking because it is a possibility. I hope your doctor knows how to taper the medications correctly so that you don't experience this serious reaction. You also said you're on a high dose of Effexor so this is even more important.

Are you tapering off of the Effexor at a gradual rate? This is really important so you don't experience serious withdrawal effects!

Also, you should probably make sure you're going up on the Lexapro at a rate that's consistent with the rate you're going down on the Effexor.

Also, Effexor XR is an SNRI, while Lexapro is an SSRI, both of which are medical lingo. But Effexor generally has a stronger effect against depression, (in my experience--I'm not speaking for everyone here).

Have you thought of any other antidepressants other than Lexapro to switch to?

I think asking these questions of your doctor may be important in putting you at ease. Obviously, you don't have to ask them of you doctor if you already feel comfortable with the med switch. I just give them as a general guide.

Best of luck!
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Default Oct 15, 2019 at 12:33 AM
  #7
Any particular reason for choosing Lexapro? Also, do you think the problems you started having with Effexor were because of Effexor specifically or that whole class of medications? If it's not all SNRIs, I was going to suggest trying duloxetine (Cymbalta). Might make the cross-taper less unpleasant.
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Default Oct 16, 2019 at 02:50 PM
  #8
Thanks ski bum and peacelizard. I will answer you both, here.

The Effexor IS being tapered off, slowly. I have a period of a week-to-2 weeks wherein it is my decision (upon the cessation of withdrawal symptoms) to begin to introduce the Lexapro, at a very very small dose. There is enough of a window there to protect my from serotonin syndrome, I believe.

When I made suggestions as to what I would like to take, based on the reading I had done, I got a blank stare from my doctor (not unusual at this office) and was told she preferred Lexapro to the other options I had in mind. That was the end of that conversation. (I had the same experience when I was first diagnosed. My doctor then was ridiculously cold, humorless, and detached, and in no mood for listening to input from me on anything. Just letting you know, I've historically had very little say in my treatment.)

I am switching to an SNRI because there is a much lower chance of hair loss as a side effect. The hair thinning situation has really sent me to hell, frankly, just as I had been starting to make some real gains with my social anxiety and my confidence, overall. (As I mentioned above, it sped-up when I increased my Effexor dose ---hardly an encouraging thing.)

I have made a lot of improvements over the last 12 years, since being diagnosed. The Effexor did a lot of good. But now, I need to give different meds a chance because I've plateaued, and am not getting any more benefits from the Effexor, at all. Also, any improvements I did see were frustratingly glacial in their arrival, at best.

I'm on day 4 of the weaning off period, and so far, I'm doing alright. Not too much trouble, knock on wood. Only mild but manageable headaches, the mildest and very short-lived moments of nausea, and wooziness. No brain zaps, and no flu-like symptoms, yet!, and nothing like what I was prepared for.

Thanks to everyone who's contributed. You're all very kind.

This will all become part of a medication journal, at some point.
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Default Oct 16, 2019 at 05:34 PM
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Hope all goes well!
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Default Oct 17, 2019 at 01:33 PM
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I hope it goes well for you!

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Default Oct 17, 2019 at 01:54 PM
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How are you doing?

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Default Oct 17, 2019 at 04:19 PM
  #12
Hope it goes well!

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Default Oct 17, 2019 at 10:06 PM
  #13
Thanks for asking, HC.

So far, I'm only experiencing mild, but brain-wide headaches. I can even manage them with just Tylenol. (They are dull, but they are very much present.)

Aside from that, I'm having only the slightest nausea. The bouts of it are amazingly brief. It seems to happen mostly when I get stress-inducing news (as I did yesterday).

I was so prepared for it to be a roller coaster ride from hell. The things you hear and read about going off of Effexor make pretty good fodder for nightmares! But I'm doing so much better than I expected. I hope the rest of the schedule goes this smoothly.

Love you folks! We have the best people here.
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Default Oct 22, 2019 at 11:37 PM
  #14
Hi, anyone who checks-in. Am experiencing an elevated level of anxiety, especially at night. It's not bad, though. Manageable with a pot of hot tea and some familiar old CBT.

I'm pretty ready to move on the the introduction of my new medicine.

Thanks to all who have looked in!
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Default Oct 23, 2019 at 01:05 AM
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Quote:
Originally Posted by MuseumGhost View Post
Hi, anyone who checks-in. Am experiencing an elevated level of anxiety, especially at night. It's not bad, though. Manageable with a pot of hot tea and some familiar old CBT.

I'm pretty ready to move on the the introduction of my new medicine.

Thanks to all who have looked in!
@MuseumGhost

Excellent!!

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Default Nov 05, 2019 at 07:53 PM
  #16
Update:

I'm a little past half way through my med change.

I am, with every small dropping-off of the Effexor dose, having headaches and some other mild symptoms, especially for the first 2 days after. These include that slight wooziness you can get, headaches, a little bit of brain buzz (they don't really qualify as full-grown "zaps"), and a touch here and there of heightened anxiety and agitation/emotional vulnerability. Again, all of these are mild, and leave almost as quickly as they come, for the most part.

So, again, it is different from what I normally experience on a day-to-day basis, but it's completely manageable. Please, don't let fear of horrible effects keep you from getting off of Effexor, if you need to.
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Default Nov 11, 2019 at 05:24 PM
  #17
Thanks for the updates, MG. I'm glad things are going well.
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Default Nov 12, 2019 at 07:53 PM
  #18
I have gone through med changes and been absolutely terrified, no lie. Almost every time things went much more smoothly than i had expected they would - especially when cross-switching to another, similar medication. The exception to that is a benzo.

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Default Nov 20, 2019 at 11:49 PM
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Thanks, everyone. I am not done with it all yet. Apparently I am not going to get off without some hitch along the way.

3 nights ago, I had my very last dose of Effexor ( at a very small amount). But since then, it's been nothing but terrible intestinal distress (pardon the frankness---it's been almost non-stop diarrhea), along with some powerful headaches, and awful muscle aches.

This last step is the worst. Immodium and Tylenol are now my best friends.

Let's hope this works itself out, soon!
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Default Nov 23, 2019 at 09:02 AM
  #20
Thanks for the updates MG. I'm on Effexor and am terrified of coming off it, glad that until recently it has been manageable for you. I'm sorry however that you got bad withdrawal effects at the end. I hope that they go away soon.

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