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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by stjames on August 26, 2000, at 2:40:49
For those of you having problems with withdrawal
from AD's, I'll sum up the basics that people here say
works. Taper dose to as low a possible and the substute
and long acting AD, Prozac is the best it seems, for a few days.
Prozac is very long acting, like month(s), so a few doses
and you will coast off the Prozac slowly, avoiding the
withdrawal. This is well established protocal in dealing with
withdrawal from other meds, ie, moving from shorter acting to longer acting
meds. Doc Bob's Tip's mentions the Prozac trick. It has been
written about in publications. Share this info with your doc.If I stop Effexor I get some of the problems y'all get, but they
last just a few days. I take a benzo, Atavin, for this that works very
well. Stops the shocks, the wired feeling, I don't snap at people, cry, ect.
I would suspect for those having a really hard time for an extended period
Klonipin would be ideal to give 24/7 control. Of course,
here we go down the path of an adictive med. However, ~.25 mgs
for 1 to 2 months (or ~.5 mgs atavin 2X/a day) could be stopped
with out problems of adiction in most. If I was going thru
the kind of withdrawal effects mentioned as of late and they lasted more than a few days
I would call my doc and ask, demand if need be, something to
make it stop. Using a benzo for this has a good benifit to risk ratio and it is
short term.james
Posted by Sunnely on August 26, 2000, at 23:18:46
In reply to Withdrawal from Antidepressants 101, posted by stjames on August 26, 2000, at 2:40:49
James,
Thanks for the great post. Please allow me to add a couple of suggestions.
For some, SRI (selective reuptake inhibitor) withdrawal symptoms can be protracted and very distressing even with very slow taper of the antidepressant, or switching to a drug with a long half-life (e.g., Prozac). The following are a couple of innovative approaches to ease these withdrawal symptoms.
1. An Expensive Proposition.
For those who continue to experience nausea, headaches, stomach distress, and diarrhea, despite slow taper of the antidepressant, ondansetron (Zofran) may help. The plausible explanation is that ondansetron relieves the nausea and headache by acting at the central (brain) 5HT3 receptors, whereas it relieves the stomach distress and diarrhea by acting at the gastrointestinal 5HT3 receptors. Ondansetron is a medication more commonly used for the treatment of nausea and vomiting during radiation therapy and chemotherapy. (See reference # 1).
2. A Cheap Trick.
For those who continue to experience nausea, sensation of dizziness, vertigo, unsteadiness, and feeling of "spaced out," the use of ginger root may be of help. Ginger root has been widely used as an alternative treatment in the dysequilibrium associated with motion. Its use in seasickness and vertigo has been established. (Vertigo means the disorientating sensation that the world is whirling around you, or you around it.) The dose of ginger root is 1100 mg (two 550-mg capsule) three times a day. Partial or complete amelioration of symptoms has been reported within 24 to 48 hours without ginger root side effects. Treatment should be continued for approximately 2 weeks after SRI discontinuation. (See reference # 2).
References:
1. Raby WN: Treatment of venlafaxine discontinuation symptoms with ondansetron (letter to editor). Journal of Clinical Psychiatry 1998;59:621-622.
2. Schechter JO: Treatment of disequilibrium and nausea in the SRI discontinuation syndrome (letter to editor). Journal of Clinical Psychiatry 1998;59:431-432.
Posted by Caroll on August 27, 2000, at 10:01:52
In reply to Withdrawal from Antidepressants 101, posted by stjames on August 26, 2000, at 2:40:49
> I am in the military...Air Guard. I was just informed that they can kick me out of the service because I am taking anti-depressants. I have been taking Effexor
for 1.5 years trying to deal with a stress and other depressions and life in general.
Two weeks ago a quit cold turkey because I am afraid that if I keep taking it I will be kicked out of the military and I only have 3 years left before I retire.
I have been sick, tired, unable to sleep, nervous, crying..even over commercials.. I don't know what to do! I am scared and getting paranoid about everything people say. My head feels like it's swimming in quicksand and I'm getting buzzy feelings in my head. Can someone out there please tell me what I can do?
> For those of you having problems with withdrawal
> from AD's, I'll sum up the basics that people here say
> works. Taper dose to as low a possible and the substute
> and long acting AD, Prozac is the best it seems, for a few days.
> Prozac is very long acting, like month(s), so a few doses
> and you will coast off the Prozac slowly, avoiding the
> withdrawal. This is well established protocal in dealing with
> withdrawal from other meds, ie, moving from shorter acting to longer acting
> meds. Doc Bob's Tip's mentions the Prozac trick. It has been
> written about in publications. Share this info with your doc.
>
> If I stop Effexor I get some of the problems y'all get, but they
> last just a few days. I take a benzo, Atavin, for this that works very
> well. Stops the shocks, the wired feeling, I don't snap at people, cry, ect.
> I would suspect for those having a really hard time for an extended period
> Klonipin would be ideal to give 24/7 control. Of course,
> here we go down the path of an adictive med. However, ~.25 mgs
> for 1 to 2 months (or ~.5 mgs atavin 2X/a day) could be stopped
> with out problems of adiction in most. If I was going thru
> the kind of withdrawal effects mentioned as of late and they lasted more than a few days
> I would call my doc and ask, demand if need be, something to
> make it stop. Using a benzo for this has a good benifit to risk ratio and it is
> short term.
>
> james
Posted by stjames on August 27, 2000, at 19:44:20
In reply to Re: Withdrawal from Antidepressants 101 » stjames, posted by Caroll on August 27, 2000, at 10:01:52
> > I am in the military...Air Guard. I was just informed that they can kick me out of the service because I am taking anti-depressants. I have been taking Effexor
James here....Why not try the ideas Sunnley and i mentioned in this thread ?
james
Posted by Jonathan on August 28, 2000, at 18:55:01
In reply to Re: Withdrawal from Antidepressants 101, posted by Sunnely on August 26, 2000, at 23:18:46
> For some, SRI (selective reuptake inhibitor) withdrawal symptoms can be protracted and very distressing even with very slow taper of the antidepressant, or switching to a drug with a long half-life (e.g., Prozac). The following are a couple of innovative approaches to ease these withdrawal symptoms.
>
> 1. An Expensive Proposition.
>
> For those who continue to experience nausea, headaches, stomach distress, and diarrhea, despite slow taper of the antidepressant, ondansetron (Zofran) may help. The plausible explanation is that ondansetron relieves the nausea and headache by acting at the central (brain) 5HT3 receptors, whereas it relieves the stomach distress and diarrhea by acting at the gastrointestinal 5HT3 receptors. Ondansetron is a medication more commonly used for the treatment of nausea and vomiting during radiation therapy and chemotherapy. (See reference # 1).
>
> References:
>
> 1. Raby WN: Treatment of venlafaxine discontinuation symptoms with ondansetron (letter to editor). Journal of Clinical Psychiatry 1998;59:621-622.
>Sunnely,
Thanks for these two interesting new solutions to the common and serious problem of antidepressant withdrawal. Coincidentally, AndrewB has recently posted info on obtaining ondansetron (Zofran) for a different problem, serotonin-induced cognitive impairment.
http://www.dr-bob.org/babble/20000822/msgs/43509.html
An alternative 5HT-3 antagonist that might be less expensive and more accessible than ondansetron (for those whose pdocs will not prescribe meds for off-label uses) is the antidepressant mirtazepine (US Remeron, UK Zispin).
If I'm correct, there may be someone reading this who has switched from Effexor or an SSRI to mirtazepine with no intervening drug-free period and been protected from withdrawal effects by mirtazepine's 5HT-3 antagonism. It's possible, however, that the usual starting dose of 15 mg/day may be too low to block enough 5HT-3 receptors, in which case one would need to escalate quickly to 30 or even 45 mg/day to prevent the previous antidepressant's withdrawal symptoms.
Can anyone out there comment on this from practical experience?
Jonathan.
Posted by stjames on August 28, 2000, at 19:58:11
In reply to Remeron for SRI Withdrawal? » Sunnely, posted by Jonathan on August 28, 2000, at 18:55:01
An alternative 5HT-3 antagonist that might be less expensive and more accessible than ondansetron (for those whose pdocs will not prescribe meds for off-label uses) is the antidepressant mirtazepine (US Remeron, UK Zispin).
If I'm correct, there may be someone reading this who has switched from Effexor or an SSRI to mirtazepine with no intervening drug-free period and been protected from withdrawal effects by mirtazepine's 5HT-3 antagonism. It's possible, however, that the usual starting dose of 15 mg/day may be too low to block enough 5HT-3 receptors, in which case one would need to escalate quickly to 30 or even 45 mg/day to prevent the previous antidepressant's withdrawal symptoms.
Can anyone out there comment on this from practical experience?Jonathan.
Yes, you would want to go higher than 15 mgs, for my
experience with Remeron.james
Posted by Caroll on August 28, 2000, at 20:42:51
In reply to Re: Withdrawal from Antidepressants 101, posted by stjames on August 27, 2000, at 19:44:20
The problem is that the military may still try to kick me out if I'm taking any type of (in the words of my commander)"feel good drugs". Is there any other way to stop feeling like this? Besides the withdrawl I just plain feel yucky!
> > > I am in the military...Air Guard. I was just informed that they can kick me out of the service because I am taking anti-depressants. I have been taking Effexor
>
>
> James here....
>
> Why not try the ideas Sunnley and i mentioned in this thread ?
>
> james
Posted by Jeanne on October 12, 2000, at 9:12:08
In reply to Re: Withdrawal from Antidepressants 101 » stjames, posted by Caroll on August 27, 2000, at 10:01:52
I have reading about withdrawal from antidepressants with interest. I have a related question:I recently switched from Prozac/Wellbutrin(in combination)to Effexor. I have felt spacey,dizzy,wired ever since. The doc I see for med checks says that shouldn't be a side-effect. I have never experienced anything like this before.I tell him it's like I want to "shake my head" to clear it out. I want to get off it because I'm sure these side-effects are directly a result of effexor(taking 150 mg. down from 225 with no reduction in symptoms).Has anyone else experienced the "spacey" feeling while taking the drug??Thanks!!
Posted by KARIN C. on October 20, 2000, at 17:13:33
In reply to Re: Withdrawal from Antidepressants 101, posted by Jeanne on October 12, 2000, at 9:12:08
> I have reading about withdrawal from antidepressants with interest. I have a related question:I recently switched from Prozac/Wellbutrin(in combination)to Effexor. I have felt spacey,dizzy,wired ever since. The doc I see for med checks says that shouldn't be a side-effect. I have never experienced anything like this before.I tell him it's like I want to "shake my head" to clear it out. I want to get off it because I'm sure these side-effects are directly a result of effexor(taking 150 mg. down from 225 with no reduction in symptoms).Has anyone else experienced the "spacey" feeling while taking the drug??Thanks!
THE REASON I GOT OFF OF EFFEXOR WAS THE "SPACEY" FEELING I HAD, ESPECIALLY IF I MISSED A DOSE AND TOOK IT LATER IN THE DAY! I AM ON DAY THREE OF BEING DRUG FREE AND IT IS TERRIBLE!!! TALK ABOUT BEING SPACEY!!! I AM GOING ON WELLBUTRIN NEXT I THINK, ANY SUGGESTIONS? KARIN C.
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