Posted by SLS on June 7, 2005, at 7:10:04
In reply to Re: Effexor withdrawal - rebound depression » SLS, posted by meliss337 on June 6, 2005, at 21:19:11
Hi.
> I've asked you a couple of questions before, I think, and hopefully you might be of help here - do you know if it's more likely that depressive symptoms during withdrawal are actual relapse if you've had more than one "depressive episode"? (and even then, I'm not sure I have, or if my second "episode" was because of withdrawal from the first drug I was on, Celexa).
It would be informative to know how people with no risk factors for depression would react to Effexor withdrawal. Let's say that Effexor had another use that was completely disconnected from mental illness. Would these mentally healthy people also experience a rebound depression? Since we don't know that, I think it would be prudent to suggest that even a rebound depression is an indicator of the presence of a depressive diathesis (vulnerability to illness). If this is true, it makes an especially strong argument for the gradual tapering of dosage as the method to discontinue Effexor - and probably all antidepressants. In other words, relapse is less likely the more gradually the antidepressant is withdrawn. This is not to say that everyone who experiences a rebound depression will go on to relapse.
> The reason I went on antidepressants in the first place (ended up being celexa 40 mg) was situational, at a stressful time in my life about 3 1/2 years ago. Then in fall of 2003 I tried going off celexa by myself, and it coincided with bad life events as well/stress, and I thought the depression was back, and then they put me on the GREAT Effexor, and I was on 150 for another year and a half, have tried weaning off, and am down to 50 mg. now (and am SO irritable lately). Would you consider that transfer from celexa to effexor another depressive "Episode" or just withdrawal? Does it make a difference if my mom has always sort of been depressive, so it might be genetic?
Genetics confers vulnerability, but not necessarily the precipitation of illness. Often, it is stress that leads to the first depressive episode and and an upset in brain function. For many people, if the illness is left untreated, the amount of stress that triggers subsequent episodes becomes less and less, until the depressive state finally becomes free-running and not dependent on stress as a trigger.
> *Sigh* I just want to think that I'm not naturally "depressed" and that I can get through this and not need medication again.I wish for me the same thing. I am a hard worker, and would be very determined to deal with psychological issues through psychotherapy. When I discovered that my condition was biological, I became very angry. It meant that depression was not within my control to manage and recover from. There is something about being tethered to a medication in order to feel well and functional that feels restrictive. Dependence on medication is an unpalletable idea to most of us. I have learned through education and experience to accept it until science discovers a better way.
> I have a great life right now - great family, awesome boyfriend who I'll hopefully be with forever, friends, etc.
> I want to think my irritability/depression right now is more just the withdrawal...
You should hope that it is withdrawal. Withdrawal is a temporary state and a passing event. If you taper your medication the right way, you shouldn't have to experience even those things. Irritability can be a symptom of either withdrawal or the relapse into depression. Tell the people close to you that you are going to try to discontinue medication, and to expect certain things that are part of a withdrawal syndrome. If your boyfriend knows what to expect and why, I doubt he will assign any kind of responsibility to you personally. He can only become more supportive.
I see nothing wrong with your trying to discontinue medication. Just be aware that the recurrence of depression within the first 4 months is usually an indicator of a need for long-term treatment. Do whatever you need to in order to keep the wonderful life you have built for yourself. A risk that is taken with the removal of a particular medication is that one might not respond to it as well to it the second time it is used. However, I don't think you are taking much of a chance of this happening to you if you return to the medication promptly if you discover that you need it.
Review the post archived on this board "Withdrawal" and read some of the suggestions others have offered as to how to remove Effexor successfully. I like using a flexible-dosing strategy where I take small amounts of medication several times a day, every day. There's more to it, but there are more detailed explanations available here. Most of them have my name attached to it <trying to be modest>.
Did this help at all?
- Scott
poster:SLS
thread:508498
URL: http://www.dr-bob.org/babble/wdrawl/20050519/msgs/508961.html