Tapering off antidepressants
If you’ve been following my antidepressant journey over the course of 2019, you’ll know I began gradually lowering my daily dose of 150mg of Venlafaxine in February, the idea being to eventually come off it entirely. Due to my own past experience, friends’ recollections and the vast number of horror stories out there regarding coming off antidepressants too quickly, I decided to take a whole year coming off of mine. I would reduce the amount I take by 12.5mg on the 1st of every month for twelve months, in the hope this would minimise or nullify any side effects or withdrawal symptoms that might be caused. Venlafaxine has worked pretty well for me, after all. I’m in no rush and who knows if this is a good idea or not - with no advice from a practitioner as to how long I should be taking them for, after eighteen months total and four or five of feeling, on average, mentally well, this seems like as good a time as any.
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This all went smoothly for the first three months and I didn’t feel any negative changes at all, only a lowering of the hyper-vigilance I’d been experiencing (increased sensitivity to bright lights, intrusive sounds etc) that many a time has made my day job in a supermarket difficult. I’m also getting far fewer night sweats now and feeling much less like i’m overheating most of the time, both of which were pretty unpleasant and annoying side effects to have! This, coupled with no obvious mood changes, is definitely at the top end of hopes and expectations for coming off medication for mental health. Everything seemed to be going swimmingly. I even made it through some really tricky stuff in the first quarter of the year - including falling out with my landlord, the stress of moving house, and upheaval of having to move back in with my parents for four weeks before I could move into my new place - that other than some mild anxiety, hadn’t caused a dip in mood at all.
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On the 1st May however, when I lowered another 12.5mg to equal 100mg, totally a reduction of a third from what i’d been taking at the start of 2019, this all seemed to change - or did it? It’s what you hear the most when discussing taking medication for mental illness - whether it be antidepressants, mood stabilisers or another type, when going on or coming off them it is so hard to know what is a side effect or withdrawal symptom and what is a symptom of something else entirely, which can often be normal reactions to everyday life.
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Good sleep is not a skill I am blessed with. My poor sleep is often so disruptive to my daily life that I wouldn’t hesitate in spending one of three magic wishes on good sleep for life, if Genie’s lamp so happened to fall into my lap. I wake up regularly every night and can’t remember the last time I slept through. Now and then, however, I have periods of insomnia in which it seems like I can barely stay asleep through the night. I had a few nights of this at the beginning of May which led to feeling more depressed than I had in a good while. Concurrent with the insomnia, I experienced unexplainable all-over itchy skin for four days. This disappeared as quickly as it came, and was particularly bizarre as itchy skin isn’t generally something I experience. I had no dry skin, rash or swelling and it hasn’t returned since.
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My mood was without a doubt far less stable in May than it had been for the few months prior. There were marked days of depression and a big increase in negative thoughts and self-doubt. I had weeks with no embroidery commissions, money became incredibly tight and I had to borrow from friends just to afford food and pay my bus fare to the day job. I felt so low and lost with the pressure I was putting on myself to do more and be better (see my previous post), that I couldn’t do anything at all. Come mid-May, gradually and then suddenly I found myself in the worst depressive episode i’d had in twelve months.
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So what will it be? Have fewer brain meds lead to my recent episode or has life simply been a bit more difficult over the last month or so? Do all the possibilities feed into one other? It’s so hard to know, and then there’s the danger of overthinking it and creating more problems than you actually have. I think it’s likely the lower medication played its part. It certainly won’t have helped considering all the other stuff I’ve had going on. Maybe 100mg is something of a stickler amount for me - more than that keeps me well and less leaves me a little rocky. Or maybe my brain is simply adjusting to this gradual lowering of antidepressants and needs more time to regulate itself again? I’m not really going to know until I continue lowering my dose. I decided to stay at 100mg through June instead of going down to 87.5mg as planned. Considering my instability in mood in May, it’s probably wise I let my brain regulate itself on its current dose rather than going too low before i’m ready. As for July onwards, i’ll take it as it comes.