HELP Please! Reinstate Effexor or bridge with Prozac?

You are not alone!

In June I was on 450mg of Effexor. I had been on this medication at this level for fifteen years.

I was also on thirteen other medications, six of them psyche meds. I no longer take Effexor at all. I am currently on 40mg of Latuda and 150mg of Wellbutrin. I was in fact off of these as well until my provider forced me back on them. Long story.

My understanding is that Prozac can help with the withdrawal effects of Effexor, though I have no experience with it.

Here are the steps I took to get my life back. In my opinion in the order of importance.

Exercise: I started at fifteen minutes of walking. I now exercise two hours a day.

Nutrition: I stopped eating foods that trigger depression. Refined sugar and simple carbohydrates. I increased my protein and fruits and vegetables.

I dismissed these interventions for years and lost everything except my life. I have come to believe that what I put into my body and how much I move can never be counteracted by a pill I take once a day.

Next up was lab tests.

I insisted that my PCP run detailed blood work to include hormone levels. All psych meds mess with the bodies hormones. In my case I had testosterone levels below critical levels. My PCP put me on a low dose of testosterone gel. My testosterone levels have returned to normal and I will be discontinuing the TRT in thirty days.

I insisted that my providers see me regularly. Therapist monthly, med provider every six weeks and PCP. Once they knew that I had planned on killing myself before contacting them, they paid attention.

By far the most important thing I did was take responsibility for figuring out what was wrong with me and getting better.

It started with a book by Christoper Palmer MD, “Brain Energy”. That lead to my own research. All I had to do was a simple Google search.

My answers were on the first page. Like sand on a beach the information is everywhere.

As for Effexor/Venlafaxine, this is a very powerful medication that has many side effects and a very short half life. In my opinion it should never be prescribed except in the most extreme cases and then for only a short period of time. Using it like prednisone, high initial dose with rapid tapering.

If I could rewrite mental health care I would prescribe the following treatment plan:

Fast acting medication to deal with the emergency.

Immediate psychotherapy.

Concurrent lifestyle changes (yes, diet and exercise).

Full medical work up to include detailed laboratory tests.

Seems like a lot maybe, but mental health for me is a life and death issue. I had a shotgun in my hand with plans to blow my head off.

As fate would have it I decided to mow the lawn and listen to the book I mentioned above.

Research will support that the plan I was able to build with the help of my providers is based on the best unbiased current recommendations from the most respected institutions in the world.

Unfortunately the overwhelming majority of mental healthcare is stuck in the dark ages. None of my providers were aware of ninety percent of research I brought to them.

The good news is that most providers are so overwhelmed they are happy not to have to do the work themselves.

I restate that the most important thing I have done is take responsibility for my own wellbeing.

I wanted a pill. I wanted a quick fix. I wanted someone else to fix me.

I lost everything and everyone that ever mattered to me.

Everyone can heal. For me it just had to get bad enough for me to do the things I secretly knew I needed to do all along.

This board has been a life preserver for me. Hopefully my posts might be helpful to you.

I wish you the peace you deserve.

By the way I am not wealthy, I live on SSDI and there is nothing special about me. I am a sixty year old white guy from an all to typical middle class American household.

My story may be extreme but I am pretty ordinary.

I can feel your struggle and pain in your message. I am so sorry this is happening. I agree with all of the great points from dfb. Looking at your food, water, vitamins, exercise. Keys to getting our overall minds in the right place.
In the short term, it sounds like you need a plan before your next psychiatrist appointment. Does your current doctor ( the one who prescribed the prozac to replace the Effexor) have an electronic chart that you could send a message? It sounds like you have come off of the large dose of Effexor and the symptoms you are having may not necessarily be withdrawal effects from Effexor but simply that you are not taking anything at a substantial enough dosage to manage the anxiety. When did the doctor prescribe the prozac and have you been taking it?
I have a long history with anti-depressants and have immense empathy for where you are at. One other note, have they prescribed you any type of anxiety medication? Ativan?
In good health,
SF

I was on 75 mg Effexor for about 15 years. I weaned myself off twice, but unsuccessfully because I did not do the bead-counting or weighing procedure. I recently went back on the lowest dose available in capsule form: 37.5 mg. It took about a week to feel ok. My doctor knows little about withdrawal from these meds, so I am thankful for reliable online resources. I have read about the Prozac bridge, but nothing that tempts me to try it. I would suggest you try Effexor to stabilize yourself for the present, and when you are ready, plan a withdrawal method that has a better chance of success for you. Here is one method, from another long-established support group: https://www.survivingantidepressants.org/topic/17671-the-brassmonkey-slide-method-of-micro-tapering/

I should add that my withdrawal experience was similar to yours--after two months of feeling ok, crushing anxiety struck, and fear about every little thing, worse in the morning, slightly better by evening. After two months of that hell, I had enough. I know how to taper off the right way now, so I am optimistic that I can do it when I am ready.

Thank you for your reply. I have checked my hormones, and they are within normal ranges. Regarding diet, I think I eat pretty clean, not too much carbs, but right now I can't really eat until late at night so I drink a protein powder shake in the morning. I do have to make an effort with exercise. I tried walks and skipping rope so far. I've looked in Wellbutrin to help me feel something, but it's a bit risky as it can cause even more anxiety. For sure it is riskier than Prozac I think. My doctor prescribed Ativan (Lorazepam) and Buspar, but I try not to use Ativan as it is a benzo that causes dependence very quickly. Buspar affects serotonin, so it's the same question mark as Prozac. It could mean having to wean off it too.

Yeah, I'm really reluctant to start Prozac. I just panic because all I feel is anxiety. I feel no joy thinking of Christmas coming. Interactions with my family members make me feel like I am a robot. Makes me feel so broken and dead inside.

I never had crushing anxiety before like this. This is for sure withdrawal. I don't want to use Ativan because I'd really have to use it daily, and that means quick dependence. Benzo withdrawal is even worse I hear. I leave Ativan for EXTREME moments, like a couple of times I woke up in panic. Took half of my 0.5mg pill.

I asked my doctor about Ativan, and she said absolutely not.
You are correct: your symptoms are withdrawal. I was afraid to express how awful I felt, I felt so bad. I replayed disastrous scenarios in my head. I didn't want to go anywhere or do anything. I lost my appetite and 15 pounds. Physical exertion helped the most, though I had to force myself to do it. Effexor, with all its side effects, is better than that daily drag, though I hate being on the stuff.
To help manage your anxiety in the short term, try "therapy in a nutshell" on you tube. https://www.youtube.com/results?search_query=therapy+in+a+nutshell+anxiety+

Doctors know very little about withdrawal. Many are afraid to go through it themselves, yes prescribers take meds too. The DSM, just added “brain zaps” as a side effect of Effexor withdrawal recently. I had doctors telling me I was imagining things for years.

The most difficult part of dealing with psych meds is that they effect the whole body and most providers treat them like they only effect the brain. Thinking that science can alter critical chemicals in the brain and not alter the rest of our biology seems ludicrous. Nonetheless that is how most providers proceed.

Anxiety is not in my head! It is in my body! Anxiety is telling me something is wrong and I need to find out what it is?

You have gotten a lot of good suggestions from the people on this board

These are the steps I take.

Is it my environment? Humans have feelings. Know it or not we are effected by other peoples feelings, (just ask the spouse of someone who is depressed), some people call it a persons vibe.

I do not spend time with people who make me feel anxious or force me to retreat into myself. My family is severely damaged, it is hard for me to be around them. I used to take drugs and drink alcohol now I just stay away. I spent Thanksgiving walking in the park and talking with the homeless and a surprising number of other family refugees.

Is it my biology?

Did I exercise today? Am I adequately nourished? Enough good food to fuel my cells. Have I eaten something that triggers me? Sugar, ultra processed foods, too much caffeine.

Is something bothering me that I am not paying attention to? Did I say or do something hurtful? Did someone hurt me, purposely or accidentally? Are the horrors of the world too much for me right now.

What medications did I take? Could my anxiety be triggered by the medication or the lack of medication.

In the beginning going through this was like going through a checklist. It was hard and took time. Now the whole process is automatic and simply the way I live my life. I guess therapist call it mindfulness and self care. For me it just feels like I am fully conscious all the time.

I didn’t say it was easy. Being conscious all the time can be painful. Mostly, however it is wonderful.

The best part is simply going through the checklist eases my anxiety by helping me focus on what matters, the here and now. I also know pretty fast that if I can’t find peace that there is something biologically wrong and the search for answers continues.

It won’t come as much of a surprise that seeking the answers has become my answer.

There is no shame in using medication when it is called for. Ativan kept me from yelling at the people I care about on more than one occasion. Stopping it was easy as long as long as I exercised, got adequate nutrition and good sleep. I no longer take it at all but would not hesitate to take .5mg if I felt overwhelmed. Giving me the space I need to work through my “self care checklist”. Wow, does that seem a bit cheeky.

You will find peace! Don’t stop looking! It is right around the next corner.

I didn’t get to read through all these comments I glanced and i apologize the site is hard to navigate. To the point… I’ve been on Effexor er (Venlafaxine) for 20 years. Always on the manufacturer TEVA. Long story short i can only take TEVA brand of Venlafaxine if I don’t I go into serious withdrawals with the new generics which I’m prolly not allowed to name. And this maybe deleted. I’m just giving a heads up for my friends on Venlafaxine xr for long term watch for different manufacturers/brands. Only long term 10 years or more. I’ve always had TEVA. And they were back ordered on an Ingredient so the Venlafaxine scripts were filled by other manufacturers. Teva is now producing the generic Venlafaxine. Just call around pharmacies. If your anything like me 15-20 years on this script you’re going through severe withdrawals if you don’t take it. And these new generics don’t work for me. But again I’ve been in it that long and my CNS is used to the ingredients in Teva. And no I don’t sell anything. I can’t even find it. I’ve been taking old prescriptions. I saved. I’ve been trying to get off of it so I was dropping dosages until they ran out of TEVA and I went into morning panic attacks heart pounding again and I don’t want to freaking do anything. It’s just terrible. So I’m taking expired effexor which I told my doctor it’s just not as potent. Which beats these other generics. I was just letting my fellow Venlafaxine XR friends know.
If they happen to see changes in mood. Watch the brand. Good luck all!

Hi there, if I were you, I'd start bridging with another Effexor brand or another antidepressant to get used to it before you run out of the TEVA one. Is it a capsule with beads or tiny tabs inside? If you can, I would do 3/4 TEVA and 1/4 other brand first for 2-3 months and see how you feel. Then 1/2 each. I hope you are doing a hyperbolic 10% taper when you say you are trying to get off of it. After 20 years, I would definitely do a bridge with another antidepressant. I wish I had done that from the start. I'm asking my doctor today for Prozac and planning to take 5mg. Looking for a pharmacy that sells 10mg tablets that I can break in half. I might have been able to tough it out if I hadn't lost my job as I hit withdrawal 🙁 Completely a mess now.