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DH coming off Venlafaxine. Christ this is hard.(46 Posts)
I desperately need advice / support / real-life experiences of others who either have, or who know someone who, has successfully come off long-term anti-depressants and not needed to go back on them!!
DH has suffered from depression for his entire adult life (and probably most of his childhood too). I met him when he was 25; he is 40 now. I cannot remember exactly when he started taking anti-depressants but it was around the time of the birth of our DS, who is now 9.
During the time that we were together but before he was taking anti-ds, he had many, many depressive episodes, suicidal feelings, complete inability to get out of bed in the mornings sometimes, and became addicted to exercise in order to try to beat the low mood. He has had several episodes of counselling / CBT but is unwilling to fully take on board the discoveries he has made about himself ....
I cannot go into full details about how ill DH has been in the past, partly because I just can't bear to relive it and partly because it was so awful that I have blocked large chunks of it from my memory.
When DS was born, DH hit rock bottom and I literally dragged him to the GP and begged, in tears, for help. DH agreed to go on anti-ds. He was on citalopram for a couple of years, then moved onto venlafaxine which he has been on for years, with huge success. He has not had a major depressive episode the entire time he has been taking it. He has had the occasional period of stress / low mood, but has managed to deal with it and has done really well.
A few months ago he decided that he was going to come off the venlafaxine. He wanted to just stop, but I said that there was no way I would support him in this, and that he had to do it under the guidance of the GP (I had a nightmare coming off seroxat many years ago, before the DCs were born). So he went to the GP who advised him to reduce his dose by half, do this for 4 weeks, then reduce by half again, etc etc. So he has been doing this for the past few months and is now on 1/8 of the dose he started on - it's only about 6mg per day now. He is a teacher, so the summer holidays seemed the logical time to do this.
Every time he reduces the dose he is just AWFUL. Completely on edge, moody, tense, sleeping all the time, unmotivated, snappy, and generally horrible. It lasts a week each time, then it calms down as his body and brain adjust to the new dose, then we start again in three weeks' time with the same cycle.
He went down by half a dose a few days ago and I don't think I can cope. He is obviously struggling, and is not even able to make civil conversation about neutral topics. He cannot bear to be in the room with the DCs (9 and 6) which is a pretty important thing to bear in mind, as I work and he is supposed to be looking after them Tues-Fri during the holidays. He has been struggling so much that I've been booking babysitters as much as possible, and taking the kids to work with me when I can (I own a shop, so this is possible) in order to spare him - and them. His "thing" when he is depressed is to chant "I hate myself, I hate myself" over and over, and this cannot happen in front of the DCs.
But babysitters are not cheap, and this cannot continue for ever. I can literally see him turning back into the depressed shell of a man he was before he started taking the anti-ds, and it is heartbreaking. And so, so frustrating, as there is an easy solution: take the anti-ds!!
I guess my question is: is it reasonable of him to continue reducing the dose when we are ALL suffering as a result? Should I try to persuade him to go back to a slightly higher dose? - not as high as he was on at the start, but maybe go back up to somewhere between 12 & 25mg (he was on either 50 or 75mg to start with) as that seemed to be OK when he'd got over the first horrible week ...????
In case it doesn't come across in my post - I really, really feel for him. I have been in his shoes. I was lucky that my depression/anxiety wasn't caused by a permanent chemical imbalance and that a combination of meds and therapy "cured" it. But he has a wife and a family, and a job (and nobody there, and not a single on of our friends, knows anything about this). He has responsibilities, which he is incapable of fulfilling when he's like this. And term starts next week, and I am so worried that he will spend all his energies on appearing well at work, and will then be extra difficult at home (he has form for this).
We have no family support (mine are all dead; his are probably the cause of his depression - his parents sent him to boarding school in the town they lived in at the age of 6 and his father has serious, yet undiagnosed, MH issues, and his mother is a functioning alcoholic who enables his father). I have nobody to talk to in RL about this.
Oh, and thanks for reading. That was really loooooooong; guess I needed to get it all out!
wow venlafaxine in liquid format - that'd be handy. Has your dh had his gp appt yet? I'm doing ok. Will probably see gp this week as they've taken my prescription off repeat and am almost out. I don't think I want to drop to nothing (although last gp I saw didn't seem to think it'd be a problem - don't think I want to risk it!)
Yes, indeed - how are you feeling at the moment AlteredState? DH has booked an appointment with the GP to discuss whether to switch to the capsules (and to ask if he can an get Venlafaxine in liquid format to use with a syringe - much easier to measure and reduce the dose gradually. I did this when I came off seroxat/paroxetine although I still ended up needing to switch to Prozac for the last month).
I'm afraid I did get tough with him and tell him, kindly but firmly, that he needed to do something to ameliorate the withdrawal symptoms - i.e. investigate slow release capsules or switch to another antidepressant in the short term - because if he didn't, he would be doing the withdrawal whilst living elsewhere. He honestly had not realised how tough it has been for the DCs and me; he just kept saying "I can do it" to which I replied, "yes, YOU can do it but WE can't and this is NOT just about YOU!" He was really shocked. He had chosen to bury his head in the sand and not read up on the withdrawal process because it was too scary..... which I understand, up to a point.
Sadly his overall mood is definitely noticeably lower and he is getting stressed and blowing up over the smallest thing. I still think he needs to stay on the meds. He has been on citalopram before, so that might be the way to go.
Thanks MrsMc. Sharp knife it is then . I was worried about altering the slow release mechanism (for want of a better expression) of cutting a tablet that is presumably designed with bulking agents and coated etc to gradually release the active drug ingredient. I will have to practise pill cutting on some spare 225mg tablets .
Fingers crossed for next stage. If dh is patient, capsules could be the way to go.
I really like the sound of the long release capsules! Excellent idea, will ask DH if the GP can prescribe those ...
AlteredState: he's cutting the tablets in half with a very sharp knife.
Yes I think you are spot on LongTimeLurking - I have been confusing the withdrawal symptoms with the depression.
AlteredState: DH is cutting the pills in half, yes.
Dreading the next stage - where he goes on to half a pill every other day .... I just don't see how he will ever feel well if he's missing the meds every other day. Need to switch to Prozac before we get to that point.
Oh and don't confuse the withdrawal effects (anxiety, agitation, mood swings, sweating, stomach upset, brain zaps, sleeping problems, tearfullness, etc.) with return of the depression..... most likely it is the withdrawal effects which can last a long time in my experience.
Venlafaxine is 'like crack' according to one American psychiatrist. By far the worst withdrawal syndrome from any of the modern antidepressants in my experience - only paroxetine comes close.
The GP may be right when he suggests changing to another medication to stabilise the symptoms and then withdrawing from that - it is a well known and test method for getting off certain medications. Something like Citalopram or Fluoxetine (prozac) would be ideal as they quite mild and have a really long half-life which means the withdrawal is much less evil.
If he is on the immediate release venlafaxine then another option would be to change to the extended release version. This is because the 'XL' version is a capsule containing tiny balls of the medication and you can open up the capsule and remove just one or two balls which would allow him to reduce the dose extremely slowly over a long period of time.
Ah thanks joan i honestly didn't think of that . Did he have a pill cutter? Cutting my sertraline from years ago wouldn't have been a problem but my venlafaxine now is round and without a 'score' mark to help divide it.
i think my dh had to cut pills in half at one stage
MrsMc I didn't know venlafaxine came in smaller doses than 37.5mg. You couldn't tell me what brand he takes as I was dreading the 37.5mg to zero drop but if there's one out there perhaps I can highlight it to my gp. (Please don't tell me he's off the counting-the-tiny-pills-out-the-effexor- capsule variety of patient !!)
That's good he's settled down MrsMc. Bit confusing that he wants off meds when he seems to benefit and without side effects when on them. As know one else knows apart from you, him and his gp couldn't he pretend he didn't take them .
My reduction is going ok thanks but am doing it oh so slowly - 10 months to go from 225mg/day to 75mg/37.5mg daily on alternate days . But I was suffering with side effects (exhaustion and extreme mood swings at high dose, rather than long periods of low mood, and awful pins & needles in hands/feet though also have a carpal tunnel syndrome diagnosis so wasn't until I dropped below 150mg that I discovered most of the tingling was venlafaxine side effects .
Anyway good luck with the rest of his taper/switch.
Venlafaxine/Effexor is known to be one of the hardest psych meds to go through withdrawal from - some people even suffer piercing brain "shivers" and choose to remain on it for life rather than go through withdrawal.
Ironically I managed to come off this in around 8 weeks by tapering the dose and had a shocking withdrawal from citalopram instead.
MrsMc im so pleased. hope things continue more stable.
AlteredState - hello! How are you getting on with reducing your dose?
Just wanted to update: DH's mood has settled and we are now able to talk productively about what the next steps should be .... He desperately wants to be off all medication, but understands that this may not be achievable in the timescale he wants (or ever). He is willing to talk to the GP about switching to sertraline/Prozac/anything else that might have an easier withdrawal, and he also accepts that he may need to stay on a low dose of Venlafaxine long-term....
I am very scared about the next reduction in meds, in 3 weeks' time, but we will cross that bridge when we come to it....
Thank you all so much for posting and for sharing your experiences. X
Hi OP sorry you're suffering with this. I read with interest because I'm coming off venlafaxine too. You mentioned that he was taking about a week to 'settle' after each dose decrease. Is this not working this time? Or do you mean he is still not well after he settles? Does he think that he is depressed/miserable or does he think that he's fine?
I have nothing useful to add about whether your DH should or shouldn't try to come off of Venlafaxine (although I can't see me ever coming off of medication, every time I try I just sink.)
But, I tried Venlafaxine a good few years ago. It did nothing for me at all, so after a few months I weaned off it. Good god, that was a nightmare. Over the years I've tried many anti-depressants, most haven't done a thing (the only thing that's helped me so far is 200mg amitriptyline), but I've never had such problems coming off of a med. Cutting the Venlafaxine dose made me feel indescribably awful, & bear in mind it didn't have any effect on my mood in the first place. I ended up breaking the capsules apart & counting the grains inside, every day I would take one grain less. It was the only way I could wean off of them.
Sorry I can't be much use on the should/shouldn't side of things though, I hope it all works out.
No brilliant advice Mrs but just wanted to sat I completely understand where you are coming from. Dh is long depressed (and a teacher with a nightmare family and reluctance to deal with stuff by trying to change his mindset!) and every so often he decides he wants to ditch the meds and everything goes tits up. We're also in the situation where he refuses to tell anyone that he is suffering so I don't have anyone to vent to.
I know it sounds selfish to insist that a partner takes meds but when the impact of them not doing so is complete devastation then something has to give. I love dh to bits but I am no longer willing to expose my dcs to his mood swings and emotional 'coldness' when he is in the grips of unmedicated depression. I know that he withdraws in order to deal with his feelings but I how the hell do you explain that to two kids who are getting their heads bitten off for making the slightest bit of noise in their own house?
I bloody hate depression and would give anything for dh not to have it . Off to check out Rethink.
Sorry to hijack but just want you to know that you're not the only one in this situation.
Also make a GP appt for yourself.
Ooh x-post with Joan there, quite freakily reading my mind Joan!
We are trapped in a vicious circle though, so I CAN'T talk to him frankly about what my limits are - because he isn't well enough at the moment to deal with it properly. He has taken that option away from me, by selfishly stopping his meds. I am so, so angry.
I would say focus less on 'this is what meds you, dh could try' and 'this is where you, dh can live' and more on what you, MrsMc, are feeling/able to bear.
Thanks all. You are all talking a lot of sense!
I'm ringing Rethink tomorrow from work.
Spoke to DH briefly earlier re switching over to something like Prozac or sertraline for a bit, and going back to the GP.... He made it very plain that he sees this as HIS decision, and his alone, and then refused to discuss it further.
I am tempted to tell him that he can't live with us until he's sorted himself out, frankly. I can't even bear to be in the same room as him at the moment. How the hell did it come to this?
Talk to Rethink before you go. Do come back to update if you can. Thoughts are with you.
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