Over the past few weeks I have been tapering off of Efexor-XR—an antidepressant—on the advice of my doctor. A number of people on Twitter have suggested that I write an account of the experience, perhaps to help others who discontinue the drug.
First, a little background. I have Major Depression. I was first diagnosed in 2001, although a later psychiatric assessment suggests I have had Depression since the mid 1990’s (my early teens). Throughout my Depression I have felt frustrated that my doctors have only ever treated me with medication, that they simply “threw drugs at the problem” to get me out of their office. Mid-2007 I began searching for a doctor that would take my Depression seriously.
It took me about four doctors to find one that was willing to refer me to a psychiatrist for a Mental Health Assessment. I was also put on a Health Plan and given a referral for Cognitive-Behavioural Therapy. Unfortunately, one of those doctors outright blamed me for a sexual assault I’d experienced, and as a result I had a breakdown and was placed on Efexor-XR. So much for not throwing drugs at the problem.
Two years later, and the Efexor no longer works. The decision was made to discontinue the drug, tapering off by 37.5mg a week (down from 225mg), beginning 9 August 2009.
Efexor has a very short half-life, so missing a single dose is enough to cause discontinuation effects. I’d accidentally missed a few doses before, and knew to expect the brain-zaps, fatigue, and headaches, so I asked the doctor how I could deal with the discontinuation. Sadly, my doctor pretty much shrugged off these concerns and said that I would be perfectly fine as long as I came off the Efexor slowly enough.
I was not—and am not—”perfectly fine”.
The third day of discontinuation was my first and only day of work. Despite how awful I felt, I told myself that I wasn’t contagious and that I just needed to be brave and I could keep on working. I told myself I could handle the vomiting and the diarrhoea; I’d just need more sudden unexpected breaks. I told myself if I stayed really still (and didn’t move my eyes sideways) that I wouldn’t get the brain-zaps: just keep my eyes front and work. I even told myself that paracetamol would handle the headaches. And that was all fine and dandy except that I couldn’t actually work. I hadn’t counted on the mental confusion, concentration problems, and general fog. Turns out you can’t be a web developer if you are too confused to code.
I went home halfway through the day after squinting at TextMate all morning in failed attempt to comprehend my own job. I couldn’t make any sense of what I was doing from one moment to the next, so I went home and I slept. It’s one of very few times I’ve felt I’ve actually “lost my mind”.
I slept nearly the whole week. Over the course of the week I noticed improvement towards the end, but then I had to reduce dose again and so it began all over again.
For the first few weeks I was able to do very little besides sleep. Even gentle walking caused big problems with brain-zaps and vertigo, so I barely left the house. And then at a certain point the discontinuation effects shifted, and started having major psychological effects as low Seratonin levels and cabin fever kicked in.
From here it gets difficult to give an articulate account of the effects. The first major change is that I stopped being able to sleep, stretching out to a randomised 30 hour + wake cycle. And of course, with the sleep deprivation, low seratonin, and cabin fever, my moods (and behaviour) are going haywire. One minute I’m giggly, the next I’m having frightening thoughts of self-harm. I am also aware that my behaviour is upsetting people I know online (I’ve been reproached a couple of times over Twitter) and I’m struggling to simply be myself instead of alternating between whiny and asinine.
So, what’s the final word? I don’t think I really have one. It would be seem easy to say “never use Efexor, it’s horrible!”, but I have to admit that when it worked, it worked well for me. This entry is simply to give an account of what it’s like to discontinue it. If you have to take Efexor, make sure you know what you’re getting yourself into, and make sure you have doctors, psychologists, and psychiatrists that are supportive and available. Find someone open-minded who will support you with your side effects and make sure you have good friends to help you through.
I don’t know where I’m going from here. The doctor has suggested Cymbalta as the next drug. I’m afraid it will be like Efexor all over again, so the doctor’s giving me a couple more weeks to “settle down”. I’ve asked for a referral to a psychiatrist.
Also, I think this might be the most difficult blog entry I’ve ever written.
Very courageous to put this out there. I tried efexor and it just made me numb and dead inside. My wife has been using it for many years and it is effective. I chose to fight on without drugs.
Comment by Colin Campbell — September 25, 2009 @ 3:23 am
Thank you for sharing what is clearly a painful and distressing experience for you. I hope we can all be a bit more understanding over on Twitter, it just wouldn’t be the same without you!
I hope it all clears up for you sooner rather than later.
Comment by joshnunn — September 25, 2009 @ 11:50 am
So this is what you’ve been doing while I’m sleeping.
This is very productive, and I’m glad you’re writing this and doing it.
This helps me too.
You can get through it, and I’ll be there with you.
<3
Comment by posty — September 25, 2009 @ 12:37 pm
I cannot begin to understand the level of frustration this is causing you. I too suffer from depression (not as bad as yours however) and have been taking SSRIs for years now. I upped my dose for a while, then stopped because I felt better – BIG mistake. They say these drugs are non-habit forming, but I disagree. The withdrawal symptoms – even from reducing your dose are horrible.
Kudos to you for pushing for professional treatment and being wary of medications to solve the problem. Unfortunately, for me, I have resigned myself to continued (low doses) of SSRIs for the rest of my life.
Hang in there with the knowledge that there are many people who love and support you.
Comment by baxters — September 25, 2009 @ 1:34 pm
Writing this all out – while hard – can be really helpful, both in sorting out your brain and in helping other people in similar situations. I know that my experience with Efexor (I was only on 37.5) was pretty horrible, but at the same time, it was comforting to know that I wasn’t the only one who felt that way when getting off the drug (and getting on, for that matter).
How’s your work handling all this, btw? If you’ve found an employer prepared to hang onto you while you re-find your brain, they’re a sadly rare breed.
Comment by Jessica — September 25, 2009 @ 1:34 pm
Well written, T.
I’m glad to hear you’re coming out the other side. As we’ve talked about, that’s a horrible drug to come off.
Remember to keep talking; those of us who know the experience will keep listening.
You’ll make it.
W
Comment by WarWraith — September 25, 2009 @ 2:02 pm
This is all great but many people are having success with this medication and i am currently in the 1st week of taking this drug. I feel negative potings like these are only scaring people who the medicine might actually help their life. There are plenty of positive things being said about this medicine and more to the point most probably thousands of people are having sucess and because of this have no need to waste theyre time saying how great the medicine is or was as they have better things to do with theyre life than typing how great life is. Well id just like to say, thanks for scaring the life out of me even more than i am already! Theres a great saying, if you dont have something good to say then dont say anything at all! I have taken them for over a week now, made me feel a bit freaky but im going to prsist as my life has recently been a living hell and i am hoping that these so called monster pills will actually help me out of a very dark place. Once again, thanks for shitting the pants out of me, i hardly have any left now!
Comment by KEVSTA — October 21, 2009 @ 9:10 am
KEVSTA: I understand that many people have success with their medication, and not everyone is affected the same way. If I didn’t mention it in the original entry, I’m sorry.
If the benefits of Efexor outweigh the negatives for you, then certainly carry on using Efexor. As I mentioned, it was very effective for me, for a period of two years. Hopefully you will not have the same problems I did coming off the medication.
I’m sorry my entry scares you, but I was asked to write about my experiences. There’s no point me lying about it. Hopefully your experiences will be different.
Comment by Taryn — October 21, 2009 @ 9:50 am
@KEVSTA I have repeatedly warned people about taking Efexor, I too had benefits at first but it became a nightmare of a drug for me. I hope you do not have such an experience with it. I don’t see how letting others know their experiences with an anti-depresants can be a bad thing, whether it is positive or negative. These are serious drugs we are talking about. I’d like to be know if something was potentially harmful.
Comment by Ben — October 21, 2009 @ 10:00 am
KEVSTA:
I was also on efexor for about 1 year and I can tell you I will never recommend this drug to anyone. I hated it and all of the horrible side effects whenever I missed it for only an HOUR. I agree with all that Taryn has said here and also know of other people in the same situation that agree with me as well.
Your comment confounds me really, saying that people aren’t wasting their time writing up positives about the drug? It’s called “reviews” mate, you might want to look up what a “review” is.
One week is not long enough for you to be able to tell how good the drug works for you and you should possibly have done your research before taking the drug.
Efexor is actually quite outdated as an Anti-depressant/anxiety drug as opposed to the newer updated drugs of the type as the newer ones have less withdrawals than any other.
Efexor is by far, in my opinion one of the worst things a person could ever be on and I would not recommend it to anyone.
Comment by Alicen — October 21, 2009 @ 10:03 am
That reminds me (if you’re still on here, mate), read up as much as you can on Efexor. Ben hits the nail on the head about making informed choices.
Comment by Taryn — October 21, 2009 @ 10:05 am
[...] my Pro account was about to expire, I was very sad. I’ve not been working recently due to depression and medication changes, which has meant I’m on sickness benefits. I’m hoping to return to work soon, but in [...]
Pingback by Remember The Milk rock my socks « Taryn Hicks: Semi-Regular Thoughts… — November 18, 2009 @ 11:39 am
Wow… that was amazingly strong of you to be soo honest and upfront with your depression and the effects of tying to come off the drugs!!!
I too suffer from depression (recently properly diagnosed) and have a perscription for Efexor sitting on my kitchen bench staring at me… and after reading up on a lot of the issues and side effects that it has caused people i am seriously reconsidering that as an option…
thank you sooo much again for you honesty and i wish you all the best for the future!
Keep on smiling!!!
Comment by meeee — November 23, 2009 @ 8:07 pm
I appreciate your honesty Taryn. Doctors and psychiatrists tend to describe my concern of side effects and going off medication as just another symptom of Anxiety disorder. However it takes a lot of planning, i.e. how much time can I get off work – it’s impossible to carry on as normal! I am going off Efexor and on to another medication that is more sedative and can be taken at night. Also my problem is more with anxiety than depression. I’m hoping to make the transition while I take two weeks leave.
Comment by D — January 17, 2010 @ 11:42 am
HEY GUYS ARE THESE REPORTS ON JUST EFEXOR OR EFEXOR-OR
I HAVE BEEN ON EFEXOR-XR FOR 7 MONTHS 75MG
AND HAS WORKED FINE STARTING TO FEEL LIKE I COULD COME OFF IT OR GO DOWN THE DOSAGE BUT WILL SEE MY DOCTOR BUT I CANT SAY ANTHING BAD ABOUT IT
Comment by mitch — January 17, 2010 @ 1:47 pm
PLEASE LEAVE COMMENT
Comment by mitch — January 17, 2010 @ 1:48 pm
I can’t say I’ve seen the side-effect with all-caps before. That’s a new one, Mitch!
The article is written about Efexor-XR, to answer your question.
Comment by Taryn — January 17, 2010 @ 1:53 pm