Relapse or Withdrawal

[DemelzaandRoss]

I suffer from Health Anxiety. Have taken A/D off & on for 12 years. I cannot tolerate Citalopram or Escitalopram as they lower my sodium rate. Mirtazapine sedated me & Sertraline gave me unbearable stomach issues.
Finally prescribed Venlafaxine 37.5 ER. These worked well, thought still slightly anxious. S/E difficult…. violent nightmares & 2 stone weight increase.
Decided to stop them last November. GP suggested taking every other day in November & every 2 days in December & then stop. Had been taking various A/D then Venlafaxine since June 2020.
6 months down the line my HA is terrible. Also Waking up with dreadful anxiety feelings. Head feels jumbled, eyes feel pressurised as do ears. Legs feel heavy. Crying at the slightest thing. Sometimes feel slightly better in the evenings.
In a dilemma. Not sure whether to start taking Venlafaxine again if it’s a relapse or suffer the daily torment if withdrawal. GP said I have to make my own mind up.

Have you had any therapy for the health anxiety? When did it start?

My HA began in my 20s. In late 60s now. I mainly coped until 2012 At that stage started first course of Citalopram. Had Counselling. Stopped Citalopram in 2018. Anxiety returned following family death & Covid situation. Began A/D again in June 2020. Couldn’t tolerate Citalopram any more or the others mentioned in my post. Had more counselling which helped a bit but only when on Venlafaxine.
Wanted to come off drugs due to weight issue & violence at night especially towards my DH Venlafaxine also raised my BP & cholesterol levels.

Can you recall what started it? Where either of your parents anxious?

Yes, my father was a Normandy Veteran, critically injured at age 20. My mother was in the Red Cross in WW2 & witnessed a civil accident, in which her father was blown up & died. Father had nightmares always & Mother OCD. Both my Grandparents died of cancer when I was 13 & this gave me a Cancer/Death phobia.

Poor you. Anxiety is so horrible. I do think there is a good chance it is rebound anxiety because in my opinion you came off the venlafaxine a bit too quickly. It should really be done over 6 months or so
https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants
Not that that's much help! Sorry. Has your doctor suggested pregabalin? Gets a lot of bad press and it took a year of my psychiatrist trying to get me to agree to start it but eventually I agreed and it has made a huge difference to my extremely debilitating anxiety and panic. Not sure if GPs will prescribe though - you might need to push for a psych referral. Or go private if you can afford it.

OK, so at a very young age you were surrounded by parental trauma and fear which was compounded by losing both grandparents as a young teen to drawn out illnesses and death. This instilled a very natural fear of the same thing happening to you, which still exists. I can't comment on if/how/when you should reconsider the medication but it is possible to deal with the underlying health anxiety.

My GP hasn’t suggested pregabalin, but seems to have distanced herself from my medication anyway. Presumably as HA patients are their worst nightmare.
I am thinking of referring myself privately for a second opinion & will mention this drug.
Having seen the Panorama programme about A/D withdrawal, it seems possible that I should have taken a lot longer to taper off. This maybe why I’m feeling bad atm. Have been taking a half a lorezepam sometimes to feel normal again.
Regarding the original reasons for HA I do accept that my problem originated from my teenage years. Anxiety is sometimes uncontrollable even though I try so hard not to catastrophise.
Thank you both for your advice so far.