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Comment by joflicu | Hacker News Reader

I hope someone can help me. I was slowly tapered off Effexor (started at 225mg and then slowly to 125, 75, 25). I was overcome by an existential dread that colored every living moment. I landed up in the hospital - only to resume. Has anyone had experiences like this to share? I want to get rid of this medication again this year but am afraid to start. I am well-balanced and happy at work and life atm.

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Sorry to hear that. I've been on that rollercoaster, but by the sound of it not nearly that bad. On one hand, if you're happy now, why try to get off them? On the other hand, if you're determined to stop for whatever reason, talk to a psychiatrist or medical professional you trust, and discuss a plan to deal with than if it comes up again. Is it in any way similar to what caused you to start taking the meds in the first place? Has the root cause of that been addressed? Have you tried CBT, or any other therapy? Stoicism (which CBT is based on)? There might be done short term remedies to help through the withdrawl if it's just a short term thing - best to discuss these with a professional, but I've heard that sleep deprivation (skip one night of sleep; lessens depression for a week or so) is one possibility. If you can try to approach the problem with an external, interested perspective it might help; I was quite amazed at what my brain and body were doing in withdrawl despite feeling quite miserable - aside from the brain zaps, I had a funny effect on Effexor where if I looked up and to the left, I would hear a sound like two darts flying past my left ear. Hope it works out for you.

Thank you for the response. Yes - I have more tools in my mental arsenal now (meditation, stoicism). The problem is: when the dosage was lowered, it was not clear whether I was seeing a relapse or it was withdrawal. I am amazed by the sleep deprival note you mentioned (something I was not aware of at all) - thank you for that. Why stop? Because of sexual side effects (I don't want my partner to suffer my lack of drive) and weight gain. I am glad I am happy and stable now - the question is: is this my drug or am I recovered?

I'm not sure if this is helpful, but I was on 75 mg of venlafaxine (effexor) for several months to a year. Then my insurance ran out. I thought I had an additional month worth of doses, but it turned out that I only had a few doses left. I basically ended up going almost cold-turkey. I basically spent an entire week either sleeping or reading fiction in bed. The brain zaps and nausea felt terrible. I think I am lucky that I can sink that much into fiction and I won't notice the passage of time. After about a week I had to attend an event and during it I felt fine.

I have to say though that venlafaxine didn't really do anything positive for me, nor did the previous SSRIs. I still got the side-effects and withdrawal symptoms when I missed a dose though. I assume they don't work for me because that wasn't my problem in the first place. My own guess is that my issues are from ADHD, but I've only intermittently had insurance since then so I haven't been able to find out.

My experience wasn't like yours, but the withdrawal was terrible. I've read about it online and it seems that many other people seem to have found withdrawal from venlafaxine to be really bad.

Thank you for relating your experience.

My effexor comedown was rather severe, and also resulted in shivering episodes and an overnight ER visit. This was years ago.

I blame the doctor, who switched me immediately to Lexapro with zero tapering on either side. Effexor is something that really should be tapered very slowly.

If its making life awesome though, why get off of it? The stuff gave me lots of confidence and was the only thing that ever regulated my weight and energy levels.

Unfortunately people react differently. You might have better luck tapering over an even longer period.

I've been on Venlafaxine (the generic name for Effexor) and went from I believe 300 mg to 200, 100, 75 - I was able to drop the dosage once a week, but that's my experience. It could take you longer, or you might need to work with your doctor to switch to another medication that you may have better results tapering off on.

And if you're not really ready to get off of it, don't rush it. Better to deal with the side effects of being on it rather than being hospitalized or worse.

At what dose did you start feeling that way? Or was it when you stopped completely after 25mg?

The side effects were creeping in slowly - till they became too much to bear. Its like a slow invasion.

I think the key may be to very, very slowly wean yourself off. You might have to get pretty radical, like 1mg reduction per week. (That's ~2 year taper - obviously an excessive example but these drugs are weird.)

Just curious - you do you - but if you are well-balanced and happy on the meds why do you want to taper off?

Flip that around: Why would you want to be continually reliant on a designer drug for the rest of your life just to feel normal?

To me, that defines a dystopian nightmare. I'd sooner go without than be shackled to the pharmaceutical industry.

I get the cost/corporate thing. But I take a view that I am 100% ok with any substance any one person wants to take and believe that it's ok (and possible to be normal) with continued dependent use (especially if it has benefit, like living a happier or more productive live). And in fact with harder drugs it seems to me a lot of the problems would be solved if we give 100% reliable access with no impurities.

Oh yeah, I firmly believe in "your body, take what you want". Just that I want to take what I want, not what I get hooked on from pharmaceutical solutions.

Whether or not you want to be, maybe you are. And if it helps you function better, why is that bad?

I’m continually reliant on prosthetics for the rest of my life just to see normally. Other people are forever reliant on wheelchairs or pacemakers or medication that stops their immune system from tearing up their organs. And that’s ok!

^ This guy gets it

After having spent a few years studying the neurology of aging, and having my life saved by SSRIs at age 33, I've concluded that SSRIs are very much in the same category as eyeglasses, especially since 1/6 of the population takes them.

The human brain is the most complex thing in the universe. Its not perfect. We can make it better, stronger!

Because then you're not human, you're a chemical zombie.

Do you say that about people taking daily heart medication, or people with cochlear implants?

Comments like this are horribly counter-productive to people struggling with mental illness.

Imagine saying to a diabetic, "Why would you want to be continually reliant on a designer drug for the rest of your life just to feel normal?" Or closer to target, to an anorexic/body image patient, "Just eat!"

For some people it truly is life or death with anti-depressants. Some people are in shitty situations with dysfunctional brains that are actively working against their best interests. Is it really that bad that literally taking a pill solves some people's issues. Perhaps anti-depressants are over-prescribed, but damn, a pill that aligns your brain to be able to rationally handle day to day issues seems pretty neat!

If you're successfully treated by a generic anti-depressant, please ignore the hyperbole of the above commenter. If you feel you no longer need the support of your medications, work with your psychiatrist to safely wean off them. There is no impending dystopian nightmare nor is there any shame is taking anything daily to manage your mental health.

For those people, these drugs are fantastic! I should have conditioned my comment to exclude those people.

EDIT: I should add, if I got diabetes and had to take insulin, I would be pissed to the point that I'd make it my sole goal in life to find a way to live without having to take insulin.

To me, it is absolutely infuriating that I can be required to take a drug just to live. I fully understand this stuff works great for people - by all means use them! For me? I'd rather get sick and fail than live with it forever.

(Yes, I'm irrational, excessively autistically stubborn, and all the other negative things you're thinking about me. :)

> I should add, if I got diabetes and had to take insulin, I would be pissed to the point that I'd make it my sole goal in life to find a way to live without having to take insulin.

I feel like you're ascribing it to some sort of moral failing then that someone would turn to medication for help. These things aren't always under people's control.

> I'd rather get sick and fail than live with it forever.

In the case of type 1 diabetes that could literally mean death. These hypotheticals are very easy to lay out, but much, much harder to live with.

I was like that. Managed to get off of antidepressants for probably 6 or 8 years, and thought that I had an introspective enough personality that I could be aware of, and condition myself to, not have a recurrence which required going back on them.

It came on so slowly that I didn't really notice, and most people around me who you would imagine should have noticed also did not. I finally hit a breaking point, and started therapy and medicine again. It has completely changed my life around, and possibly saved it.

Would I like to live without it? Well, I would like to not need it, but if it is a given that I do, then I most certainly will continue using it. I've experienced the alternative, and there is nothing preferable about it.

> it is absolutely infuriating that I can be required to take a drug just to live

It _is_.

> I'd rather get sick and fail than live with it forever.

It's easy to say that now. When you've not slept for three days, and that happens so often it's become routine, or you've not used the phone in _months_ due to the anxiety it causes, it's not so easy.

Agreed. There's the great saying that says that healthy people have many dreams, but a sick person only one.

I'm already taking HRT every day for the rest of my life, might as well take an SSRI to help my brain work better too.

Venlafaxine (Effexor) costs 20c a dose for generic versions. Inthe US, where drugs are expensive. Under 10c (euro cents) here. I doubt the industry is TOO excited about ‘shackling’ people to it.

Being a slave to my OCD vs. having some semblance of control over it is not even a question.

I am not a pharmacist but I can think of a few reasons:

- Cost: drugs are not free, neither are doctors, though with proper health care, it is rarely an issue.

- Time: these are prescription drugs, and you may need regular visits to a doctor

- Convenience: not having to carry meds with you is one less thing to think about

- Unavailability: you may find yourself without access to your meds at the very worst time (ex: stuck in a foreign country). You definitely don't want to experience withdrawal in an already stressful situation.

- Tolerance (if applicable): You may need to up the dose regularly in order to have an effect, until you can't go further.

Why? Because of side effects. The sexual side effects are terrible. I am sure it has contributed to my weight gain. I am not sure there are studies on what happens after decades on this drug.

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