Thanks for the reply RobLee. I was in early recovery from addiction when I was first put on Celexa 11 years ago...I have been continuously medicated with antidepressants since. I have a history of what I will call "active" and also "resolved" PTSD, and have personally found EMDR treatment by an experienced clinician over a 6 month period to be more helpful than any medication for my PTSD. The only "re-experiencing" symptoms I've had since this treatment have emerged in response to trauma experienced since treatment, and I plan to resume EMDR treatment shortly. I can't emphasize enough how important it is to work with an EMDR practitioner who has real training in trauma well beyond EMDR...usually a well rounded clinician who takes their EMDR training and practice very seriously (eg: has been supervised in the development of their EMDR competencies). EMDR can be done very badly or very well.
Back to meds:
While on celexa in early recovery I went up to 60 or 70 mg...I gained some weight which wasn't unwelcome but it wasn't helping me to get off the floor (physically and emotionally), let alone function. I advocated to be put on effexor because I had met others further along the path who had similar combinations of struggles who found it to be a lifesaver. They tapered me up to 150mg over 3 days...I honestly felt like I was on some kind of ecstacy for about
3 days, but not in a bad way;) Then my mood and anxiety just...levelled right out...I could function. Within a few weeks I was a totally different person. I remember not being able to cry easily once I got up on Effexor...that wore off, but it took at least a year or two. Sexual side effects were minimal and non-existent in the long term. Over those 8 years I would see my family doc if I felt like I was starting to go dark again, and a small dosage increase always seemed to help.
I have a friend who has sadly passed away. He was on Effexor for almost 10 years. I remember him telling me it had stopped working, but I didn't understand what that really meant or what it could feel like until I hit the same wall a few years later. In hindsight I really wish I had offered to advocate for him...because I don't think he ever felt good again, I don't think he found an alternative that worked. Personally in my experience of trying to talk to my psychiatrist about
my Effexor not working he has been exceedingly skeptical, warned me it is probably doing "something" I just don't realize it, and advised me to remain on it while also on Wellbutrin, and then Trintellix also. I explained I had known others who had similar experiences with Effexor and he wasn't terribly interested. I told him I was coming off the effexor and that if I had withdrawal symptoms that would tell me that its doing something...he cautioned me not to do this but was aware I was doing this. I had NO withdrawal symptoms whatsoever...and I KNOW what they feel like for effexor, just from weaning my dose down in the past. Withdrawal symptoms for Effexor are considered especially challenging because the drug has an extremely short half-life...in other words it leaves the system rather quickly, rather than over time after taking the last dose, within 24 hours you can have some pretty uncomfortable symptoms (headaches, sleeplessness, confusion etc.). One can often physically feel the brain kind of pining for it...hard to describe.
My advice for anyone on effexor is to understand that because it has such a short half-life, one needs to consider alternatives to simply coming down one standard pill-sized increment to the next. If weaning off or down, I can't express how much pain and discomfort you can avoid by getting your prescript
ion filled by a "compounding pharmacist" who can convert the effexor into a liquid suspension...this way one can literally taper down by as little as a one mg ever day or two. Most/many docs are not well aware of this alternative but it's the way to go in coming off or down from effexor. That is unless it is no longer working!
Trintellix is so new and it scares me how widely and easily it is being prescribed. Half the psychiatrists don't seem to know about
it, the other half have samples waiting from pharma reps. I met with a prescribing pharmacist (they can do that where I live) recently who had a lot to say about
the messed up prescribing practices of many psychiatrists. As consumer I believe we have to educate ourselves as much as possible, ask questions, read instructions in great detail, and not be afraid to ask a second opinion. Pharmacology in psychiatry is very far from a precise science...if you don't ask good questions, you get what you get. Good psychiatric care involves supervision through med changes, follow up, and a high level of ethical competency. It also requires psychiatrists to educate clients about
potentially serious side effects. Good psychiatric care should begin with appropriate suggestions for medication with the SMALLEST side effect profiles, and should only work towards medication with more substantial side effect profiles if less invasive treatment is unsuccessful. I say this because I have seen so many people prescribed antipsychotics (neuroleptics) for SLEEP, which is frankly insane.
Thanks for responding to my thread. Hopefully we will get more folks in on this