View Full Version : Stomach pain/SNRI withdrawal
I begin with the fact that I do suffer from health anxiety. I am under no illusions about this and have CBT weekly to combat it.
I have recently decided to stop taking one of my psychiatric drugs (Effexor venlafaxine) because it is notoriously referred to as side-effexor and am concerned about the long term implications of SSRI/SNRI use(I took it for 12 years at 150mg). I have not taken a dose for 7 days.
The usual horrendous side effects of brain zaps and nausea are bad enough but I am also getting intermittent sharp stomach and bowel pains. I had a colonoscopy last September which was all okay and was diagnosed with IBS. I also had a stomach scan last year which was ok. Just wondered if anyone else has withdrawn from venlafaxine and also had stomach/gastric pain?
I really dont want to go back to the GP and end up with an endoscopy six weeks down the line (with associated uncontrollable anxiety that this will trigger) if this is likely to be withdrawal symptoms or IBS. The pains are not constant and generally not specific to one tight area of the stomach. Much worse in a morning. My blood test results were all okay and also liver function. No blood in stools though a little loose. I have a lot of nausea but this is a very common side effect of venlafaxine withdrawal.
Am I just catatastrophising about the stomach pain?
Since you have done a bit of research into venlaxafine withdrawal, frankly I'm really surprised that you would go on and cold turkey it. :ohmy: It is one of the worst for discontinuation. Sorry, but it's true. And yep, the stomach pain etc could very well be part of it. I suggest that if you have any still in the house, take it for heaven's sake. (Your normal dose). You should start to feel better within hours. Keep taking it on time and get into your gp immediately. Honestly, any side effects from the Effexor were either long gone for you or very low-key, unless you had just started up on them again? Whatever long-term effects you are worried about, do discuss them with your doctor, maybe he can put your mind at ease. :hugs:
Effexor requires a doctor's supervision when withdrawing, and a very slow schedule unless you want to be very ill. Don't know what else you are on, too, but good luck getting it worked out to where you are comfortable with how you feel.
Marie xx
ps. I'm on Effexor/venlaxafine, and that's how I learned about the withdrawal stuff, researching after the fact, lol! Fortunately, it seems to be working for me, so I have no plans to come off it at all!
Thanks for reply. I had a period of about 6 months off them after cold turkey last time. I had been back on them for only about 5 weeks so thought cold turkey this time would be a lesser deal. I'd read that many people choose to cold turkey as side effects occur on tapering anyway and this was better than a protracted period of head tremors when I'm trying to get back to work.
Ugh, I can't imagine! But I'm a bit of a baby anyway. Head zaps coming off Zoloft were bad enough when I withdrew slowly on a schedule. But I was able to continue working, once I found out what it was. Wish the doctor would have warned me, would have been nice ...
May the Force be with you, my friend,
Marie
This whole thing with the doctors not warning people etc. is what really worries me about these drugs. The vague, esoteric and sometimes plain mythical explanantions for the efficacy of these compounds whiffs of conjecture at best and charlatanism at worst. If they dont really know how they work how can they be aware of unwanted long term effects. That is probably me being over dramatic but if a doctor doesn't know or neglects to tell people about profound neurological side effects like head tremors then either more research needs to be done or more training/regulation imposed re. prescribing it so universally. At no point was I ever told about discontinuation syndrome when I first went on venlafaxine in the early 2000's.
To read about people resigned to spending their entire lives on these drugs because they cannot negotiate the withdrawal period is surely a major caveat for not prescribing in the first place. Allbeit a very lucrative aspect for the drug companies (cynical?). I have to qualify all this by saying I am probably being paranoid as a result of a particularly rough period health anxiety.
No problem about the paranoia. Personally I admit I am completely OCD about googling drug effects. Actually, I started off by deliberately looking for positive news about ven, and that's what led me here. A (now old post) by Pinkdove, who has happily gone about her life but pops on occasionally to put an arm around an old friend. ... But, I digress!
When I have a question about a drug, I go online and usually avoid the comments links because they will tend to be uninformed or dramatic. Wherever possible, I look for studies. Real, double-blind studies with results and conclusions. Yes, I may have to get definitions for some words, but I tend to get the gist of them. Or I look at the reputable sites for what they have to say ...
Here is what I found out on NAMI (National Alliance on Mental Illness (US):
Are there any risks of taking Effexor ® for long periods of time?
To date, there are no known problems associated with long term use of venlafaxine. It is a safe and effective medication when used as directed.
This is from NCBI PubMed (US National Library of Medicine National Institutes of Health):
Long-term side effects of newer-generation antidepressants: SSRIS, venlafaxine, nefazodone, bupropion, and mirtazapine.
Masand PS1, Gupta S.
Author information
Abstract
Anecdotal reports have suggested that the long-term use of selective serotonin reuptake inhibitors (SSRIs) may be associated with significant weight gain, sexual dysfunction, drug interactions, and discontinuation symptoms. Are these effects inevitable or can they be managed effectively with the appropriate interventions? In reviewing published, controlled clinical trials, it has been noted that many depressed patients experience weight gain during remission with or without treatment. Most antidepressants appear to produce a 3- to 4-kg weight gain after 6-12 months of therapy, which may be managed with nutritional counseling and exercise. The exception is mirtazapine, which appears to be associated with significant weight gain early in therapy. Antidepressant-induced sexual dysfunction is also common but may be managed with the addition of an antidote or substitution. Drug interactions are most common with fluvoxamine, nefazodone, and fluoxetine because these agents are more likely to affect the metabolism of commonly prescribed medications. It may be possible to prevent discontinuation symptoms with a cross taper to another antidepressant or by slowly tapering the antidepressant.
PMID: 12585567 [PubMed - indexed for MEDLINE]
Other than that, it is recommended that blood pressure and cholesterol be monitored during treatment, and that if sustained high levels occur then patients may need to discontinue use. Not recommended for the elderly or children. And of course there's the usual warnings about serotonin syndrome and drug-drug combinations, MAOIs etc. Really, 150 is not considered high dose with venlaxafine, more like 350mg+. Since those doses are higher than what is recommended (but can be prescribed by psychiatrists), there are not per se large qualified studies taking place for these. But psychiatrists like all doctors are required to report all adverse events, and these are very rare it seems.
What is it that you are afraid of? What was missing for you when you took Effexor before, long term, why did you come off of it? Have you spoken with your doctor about these concerns?
Are you taking steroids for any conditions? These can have huge repercussions in terms of anxiety. Finally, have you tried alternative therapies and been tested for thyroid issues (which can mimic mental problems), vitamin deficiencies and genetic inability to break down folic acid into methofolate (which can cause anxiety), and are all treatable without the use of psychotropic drugs? Then there are CBT, meditation, light therapy and talk therapy. How do you feel when you are not on any medications? Do you function well, with normal ups and downs, or do you have major relapses in anxiety or depression?
If there is nothing else that can help you, as is the case of many of us here, then it could just be that your medications need adjustment to ease your anxiety and dispel unwarranted paranoia. I'm not talking about being drugged up, I'm talking about bringing dosages to where your symptoms are resolved. That's what I'm seeking. I'm not there yet, but my doctor has treated others with my diagnosis with Effexor successfully, and I have every hope to be among them. The side effects are pretty manageable if I work at it. Taking the extended release capsules helps.
And, please, this is not a criticism, just a suggestion: you must realistically consider that non-compliance with a drug regimen especially so early into treatment is likely have adverse effects towards outcome. You want to get better. You cannot just stop taking one or another drug or adjust dosage willy-nilly and expect not to feel worse.
Honestly, I believe I would be paranoid too if I did that. How awful it must feel for you to have taken this all into your own hands when it is your mental health that is at stake. I would be terrified. Do go and dump this all into your doctor's lap. It is his responsibility to help you to get well and he has the training and expertise to do so, whether or not you are confident in that right now. He may want to refer you to a specialist. Just honestly put it all to him and then DO what he tells you to do. There must be a little flicker of hope inside you? Reach out for the help you need. We are rooting for you here.
Marie xx
I readily admit that my prejudices against venlafaxine are somewhat ill informed but I can only go on my experiences of having taken it at varying doses from 150 to 300mg over a 12 year period. Thanks for the information from NCBI which was really enlightening. I also take mirtazapine and quetiapine.Weight problems used to be a real problem after first taking mirtazapine.
I used to drink really heavily but have been alcohol free for 12 months now. I know a lot of my opinions are informed by anecdotal evidence but venlafaxine related alcohol issues do seem to correlate. There is little doubt in my mind that venlafaxine contributes to excessive alcohol consumption and the capacity to drink more along with other obsessive behaviours like smoking and excessive eating (particularly sugary foods). I noticed after stopping taking venlafaxine for a 6 month period that I completely stopped these behaviours.
I started to have constant problems with health anxiety about eighteen months ago so the psychiatrist recently decided to put me back on venlafaxine. Within weeks I was back to obsessive eating after losing a ton of weight. I haven't started drinking again but this has definitely become harder after resuming venlafaxine. Thats another reason I was so eager to go cold turkey and withdraw from venlafaxine this time.
I was also sick of going to my GP about various seemingly unrelated physical problems only to be told that will be a result of one or other of the psyche meds. I have recently been told by my GP that stomach lining is affected by venlafaxine and with a history of excess alcohol this just compounds the potential gastric problems. I have spoken to the psychiatrist about coming off all the meds but dont have the patience for year long withdrawals as I am particularly susceptible to the head tremors regardless of tapering regimes. It just seems that every new episode of anxiety is usually countered with venlafaxine reinstatement or increased dosage. It seems to be the weapon of choice.
Going cold turkey is pretty dumb in hindsight though and not worth exacerbating an existing health anxiety condition. Trouble is I'm 8 days in and definitely getting less symptoms. I will give it a week before going back to my GP. I will no doubt be admonished (quite rightly) for unilaterally stopping the venlafaxine.
Many thanks for your help
Right. Well it's good that you are open-minded to stufy findings and hopefully you will allow yourself to be reassured that Effexor is not harmful long term. And can be very helpful when taken as prescribed and augmented if required.
So glad that you are going in to see your doctor again. No offense, but mine would just bounce me if I didn't see him about any med changes beforehand. A lecture is a small price to endure if he's going to help you!
As for the impulses to use/drink, if you used to drink heavily/smoke you will get these from time to time anyway, but fewer and further between. I speak from experience. To this day if I'm really upset, I will get a craving for a cigarette (which goes unanswered, btw), and it's been 18 years since I quit. 19 years and counting for alcohol. 12 months is not a long time in the scheme of things, and your addiction will try all sorts of tricks to get you back drinking. Including to get you messing with your mind meds. It will stop at nothing. You need to recognize when this is happening, the denial, the little "ideas" you get that are better than the doctors', the cravings, all of it. You will get to know when it's the disease talking, and you really need to tell it to eff off. As often as necessary.
Hang in there, keep turning toward the light! Drag yourself up by the bootstraps and give that combo a full-on try. :yesyes: It's tailor-made for problems just like yours! It is working so well for aprilmoon. I'm surprised you haven't seen her post? She's taking just the effexor and mirt. Was on effexor first, then the doctor added mirt.
Marie
I think the chronic alcohol abuse is the root of all my health anxiety. I was drinking heavily from age 16 to 38. The amount I used to drink still shocks and scares me. When I go into a panic mode and start googling symptoms and conditions the increased risk factor posed by chronic alcohol intake is truly terrifying. I'm never going to get that peace of mind from any test or scope result (regardless of the many I've already had) because there simply isnt a test that can negate the effect of 20 years hard drinking or predict any future implications.
The prospect of spending the rest of my life worrying about every ache and pain is depressing. My psychologist is talking about having regular blood/liver etc tests to try and keep it under control. The trouble with this strategy is that these regular screenings will only be another source of regulated anxiety. I started smoking again this week after 5 weeks of quitting. If my stomach ends up being okay this will be the next pointless worry in the pipeline. I definitely need to quit again (I've quit smoking for over 3 weeks 5 times this last year) but cannot deal with acute anxiety episodes without a cigarette. The ridiculous that I cope with worry about my health by smoking is not lost on me. Do you think regularised blood tests are a good way of handling health anxiety?
Sigh. Here's where I have to say I don't have experience with health anxiety. Depression is my thing. Had it my whole entire life, since childhood. Am really determined to get on top of it now that I have an understanding doctor, support, and modern medicine to try.
From everything I've read on here though, it seems your gut instinct/experience is right. All the testing in the world isn't going to convince you (or most others) that there isn't anything wrong since the test was taken, what, a week before? Or that something that wasn't tested for is ticking away ...
I guess that's why we had the google free Friday last week. You are not alone, and it is fully accepted by those who are feeling better, that googling symptoms and looking for trouble is NOT the answer.
My advice would be to go ahead with the tests you've been offered, and then do whatever you have to do to stay off google. Your friends on here can help with that. Yes your liver is indeed something to check out, but when they tell you you blessedly haven't tanked it, believe them! Talk to your doctor about becoming a non-smoker. Second to last time I quit, I used the patch, stepped down gradually. I had a whole year smoke-free ... until (are you listening my friend?) ... I let that voice in my head convince me that my anxiety was to the point that I had to have a cigarette to calm myself. Do not fall for this, it is the addiction talking, and physiologically speaking, of course, it's b******t, we all know that. Your heart races, your mind shuts down and can't think properly because of reduced oxygen, you feel dizzy and sick and your anxiety actually gets worse. I ended up smoking a friend's half pack before bed and woke up in the morning with my mind already racing about where I was going to get more. Then this other voice in my head said "You are a non-smoker, you just had a relapse. You can choose to stay a non-smoker from this moment on." I liked that voice much better, and cold-turkeyed. Of course three weeks later I went through the withdrawals again but I toughed it out. Being sober, you will be able to hear this stuff coming and, as I said, tell it to eff off.
If no one has explained it to you before, there's a reason the 3 week timeline makes perfect sense. Nicotine is stored in your fat cells. After you quit, at precisely the 3 week point, the last of the nicotine leaves these cells and this causes major cravings, which will be accompanied by these "impulses" which you feel as terrible anxiety. Yes, you are anxious, you are having withdrawal pangs. That's what it feels like. And the thinking is part and parcel of it. You can tough them out, that's how people quit. There is help to get you through the worst of it. Talk to your doctor (but I wouldn't go down the route of benzodiazapenes. For you, it's the same woods as the booze, different path in.)
For more help with your health anxiety, I encourage you to start another post that doesn't pertain to a symptom, but the condition itself. This is what you need help with.
Good luck, hang in,
Marie :)
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