View Full Version : Venlafaxine cold turkey advice please
angels22165
03-12-15, 20:15
Hi
Just would like a bit of help please, was increased to Venlafaxine 225 a day last Friday from 150 from Monday had serious itching and eruptions GP told me to go back on normal 150 for next two days which is today to see if helped, it didn't he said I've had a allergic reaction to the medication and to stop it from today and then wait till Monday and commence Citalopram, I was shocked I said to the GP what just stop! He said yes you cannot take anymore due to the reaction, this has me very worried with going cold turkey, I know it won't help me worrying but heard so many horror stories of people just reducing this med not just stopping, he has given me diazepam to take twice a day to help.
Just would like any people's experience please - really unnerved me.
Thank-you Julie
Unless it's a medical emergency don't go cold turkey. Venlafaxine is difficult to withdraw from at the best of times. Your GP should know better but of course doesn't..
angels22165
03-12-15, 20:42
Thanks Pulisa for replying
Yea he said not to take anymore because of the allergic reaction, just hope the diazepam will help with the withdrawal symptoms until can commence Citalopram on Monday and they start working, just the thought of it makes me cringe but he was adamant on me not taking anymore :unsure:
The same thing happened to my daughter (different med) but she had to do exactly what you're doing. From what she said, she was feeling like crap anyway so it didn't matter. The new med works great for her.
Your doctor did right by you. Although going cold turkey is not recommended, you were having a serious reaction so you had to stop. As has been said, hopefully the chill pills will keep you in check until you can start the new med.
Positive thoughts
I would seriously get a second opinion on this. You could be lucky and get no withdrawal symptoms at all but in my opinion you'll need more than the odd dose of diazepam to cope with a drop from 225mg to zero-especially over the weekend when your surgery is closed.
I don't wish to scare you but it's not as simple as your GP is suggesting in the majority of cases
Have to agree with Pulisa on this one.
Of course the fact that you are having a reaction complicates matters a lot.
A second opinion would be useful.
angels22165
03-12-15, 22:00
Hi thanks for the replies it's hard to get a second opinion as there's only one GP at my doctors, maybe a pharmacist could advise me, will call my local one tomorrow and see, otherwise I'm going to have to believe in what my GP is saying and trust the direction he has given me, he said commencing another ssr whilst the ven is still in my system will make matters worse. That's why he says a full 3 days of nothing will be the best action and the diazepam should help me through - just praying it be like he says it is x
Hi thanks for the replies it's hard to get a second opinion as there's only one GP at my doctors, maybe a pharmacist could advise me, will call my local one tomorrow and see, otherwise I'm going to have to believe in what my GP is saying and trust the direction he has given me, he said commencing another ssr whilst the ven is still in my system will make matters worse. That's why he says a full 3 days of nothing will be the best action and the diazepam should help me through - just praying it be like he says it is x
That's exactly what my daughter's doctor said. She actually had to do that twice as the first two meds gave her a hard time. It's only a few days so you should be Ok.
Positive thoughts
angels22165
03-12-15, 22:24
Thanks Fishmanpa for your reply :)
MyNameIsTerry
03-12-15, 23:25
Cautious cross tapering is advised when switching between these two meds to avoid withdrawal syndrome and there is no need for a "wash out" period as your GP is advising:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=1651179592
Whilst skin rashes are part of possible allergic reaction do you have the other symptoms?
http://www.drugs.com/venlafaxine.html
Skin rashes are also mentioned in the Rare side effects category with some other skin problems mentioned in the Incidence Unknown section. More detailed information can be seen in the Dermatologic section:
http://www.drugs.com/sfx/venlafaxine-side-effects.html
Whilst your side effects are in the section informing patients to contact their doctors, the fact it is a listed side effect outside of allergic reaction raises an issue for me - why would you suddenly become allergic to a drug you have been taking for a while? Whilst the dosage had increased, the active ingredients have remained the same and you crossed into the med starting to work on dual neurotransmitters at 150mg. Reducing back isn't as simple as this, as can be seen in others who have taken longer to stabilise after a knock, and if you are on the XR version it may not have even reduced fully in your blood plasma yet which is something you can work out if you tell us which form you are on.
If you had just started Ven the question would still be whether this is a true allergic reaction or a side effect.
Given your GP's strange decisions, a second opinion is wise. Despite what FMP has said about those 3 days (which is a possibility) I think we need to remember that this is one of the two worst to come off as recognised by NICE and pulisa has experience of withdrawing from this med so I agree with her. Abrupt withdrawal is to avoided. Had your GP stopped it initially I would think slightly differently but reducing a dose to an allergic reaction seems odd as normally elimination is the way.
Another strategy is to taper down first to reduce the drop. This is why they crows taper between those two meds because the Citalopram going in at lower dosage will prevent you hitting zero.
I think if this was me I would asking myself whether this is a truly dangerous allergic reaction or a low level one - even if it is one, which seems dubious. If it's not a dangerous one, which I would think given your GP kept you in it, then a cross taper is possible.
Hello, angels22165,
Having "accidentally withdrawn" from venlaxafine by dint of forgetting to take it one morning, I can assure you that by bedtime I was in no shape to be able to go out if I needed to. My symptoms included intense ringing in the ears, extreme dizziness and difficulty walking. I had a lot of trouble hearing clearly and thinking/speaking as well. There is absolutely no way I would have been able to drive, nor to navigate walking out of doors. It was frightening and disconcerting, and was getting steadily worse. This was after about 12 hours from the time that I missed my dose. It took awhile for it to dawn on me that this is what was wrong. (I took my missed dose then, and felt better after a couple of hours, and have stuck with bedtime dosing since.)
I say this not to scare, but to prepare you. Please consider a backup plan of going to hospital for observation and treatment of your symptoms if necessary. You won't be able to drive after a bit, trust me. You will need to have someone around helping or checking on you over the weekend, and they (or you) may find medical supervision to be necessary if the tranquilizers don't take care of everything.
(Sorry, but I have to agree that this is one med that cannot be stopped cold turkey, and only experience with it will tell. Same with titrating up by 75 mg at a time, inside of a month. I think every doctor who prescribes antidepressants needs more in-depth training on their effects. IMO, yours should be first in line...)
nicola1980
04-12-15, 06:21
How long had you been on 150mg? I find it strange that an allergic reaction can occur suddenly when and if you've been taking it for a while already? Could it possibly have been a reaction to anything else? I'm also against you going cold turkey, I lowered my dose by just 37.5mg and 15 hours later it hit me and I had to reinstate again, you need to taper off ven very slowly or bridge it with another AD to avoid nasty withdrawal even bridging it with another med like cit will give you withdrawal but hopefully not as bad. Please get another opinion XX
MyNameIsTerry
04-12-15, 07:14
I think "just in case" is important here based on what pulisa, Marie & Nicola have said (not forgetting Elen too). It's very convenient for your GP to choose the weekend for this to take place, the one time he won't be around to help if something does happen, and I think this is very poor. This seems to be a lack of consideration on his part and shows his ignorance. But if you choose to go ahead with this, I would suggest you follow Marie's advice on having some help through this and would say it would be a very good idea to ensure you/they have contact numbers to hand for your out of hours GP service and your local Crisis Team (if they accept calls direct). It may not be needed but it's best to be prepared.
Paroxetine is the other med considered the hardest to withdraw from. However, I have seen people say they have come off it no problem as well as those who have struggled terribly. I don't know if Ven is the same in this respect but they are both considered the hardest to come off and by come off, I mean withdraw in a controlled fashion and not cold turkey style. To me, unless you are under medical supervision I would be concerned about this method and if your allergy is not even serious, I can't see why you couldn't at least taper off and make the drop more gentle when it comes.
Given you were fine on Ven <150mg, when it was only acting on Serotonin, it makes sense Citalopram may not aggravate this issue from a Serotonin perspective but from an active metabolite point of view I would need to see if they are the same and to be honest, I doubt GP's have that level of knowledge to make such a decision so unless he was in a book looking it up, it may not be something he understands.
3 days inbetween may ensure Ven is <5% in your blood plasma (this means it's clinically insignificant) although it takes 7 half lives of drug to be fully eliminated based on the standard pharmacokinetic calculation. It's 5 half lives to get to <5%. It's 5 to stabilise when you start taking it too but Ven has been shown to stabilise (reaches "steady state", the same amount going in as coming out) at 3 half lives. I'm unclear on whether quicker stabilisation like that also means quicker elimination (removal by your liver) because it would seem thats more about the liver but you would need a professional here to be sure. If you are on XR, that half life is a lot longer at 21 hours and that 2 days your GP left to get you back to 150mg wouldn't have even been enough as even if Ven is eliminated quicker than the standard calculation (3 instead of 5 half lives) it wouldn't have been enough time in 2 days. This is another alarm bell for me on this GP's knowledge.
I really would consider asking that pharmacist about this. I've been in my chemist across from my GP's surgery and seen them refusing to dispense meds because the GP has failed to spot interactions and I've always been told that pharmacists have a greater working knowledge of these meds anyway. I understand about the one GP practice issue, my GP has one like that and says he is pretty uselss but other than change what can she do.
---------- Post added at 07:14 ---------- Previous post was at 06:30 ----------
The same thing happened to my daughter (different med) but she had to do exactly what you're doing. From what she said, she was feeling like crap anyway so it didn't matter. The new med works great for her.
Your doctor did right by you. Although going cold turkey is not recommended, you were having a serious reaction so you had to stop. As has been said, hopefully the chill pills will keep you in check until you can start the new med.
Positive thoughts
That's exactly what my daughter's doctor said. She actually had to do that twice as the first two meds gave her a hard time. It's only a few days so you should be Ok.
Positive thoughts
FMP,
For the benefit of the OP, can you clarify a bit more about what your daughter went through? The reason I ask is the OP has been told she is having an allergic reaction, not a bad reaction to the med hence needing to switch. These are two very different scenarios and in the case of the latter it would be upon starting the med hence it is nice & safe to stop them as you've only been on them a very short amount of time.
With you saying your daughter went through this twice I wondering whether this is the more common issue of meds being too harsh for some people hence needing a switch because it seems strange to have an allergic reaction to too different meds.
According to drugs.com on both Ven and Citalopram it has the same allergic reaction warning so I'm guessing it will be a standard one and it fits the obvious serious allergic reaction symptoms we tend to associate:
Get emergency medical help if you have any of these signs of an allergic reaction to citalopram: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
The things is, both skin rashes & difficulty breathing are listed as side effects for Citalopram. They are in the "contact your doctor immediately" section but that doesn't mean they are an emergency unlike the ones listed above. If you look at Ven, you can see the same and Ven also has side effects for difficulty swallowing and that is not in the "contact your doctor immediately". With a serious reaction you wouldn't want to wait as you need potentially urgent care and so contacting your GP would seem less urgent, although still important & required.
What I am concerned about here is whether a GP knows all the side effects for ALL antidepressants. I know mine hardly knew any. So, if I saw him looking them up in a medical manual it would give me more confidence but to just reel them off the top of his head would make me skeptical.
What do you think?
Terry, you posted the pertinent link in another ven thread recently, which I read tonight.
I think I've figured out why on earth Julie's GP would do this. I believe he made two concurrent mistakes when reading, in haste, from the nhs directions for venlaxafine cessation. Where he ought to have been reading left to right VEN to SSRI, he instead read from the first paragraph in the chart (SSRI to VEN) without realizing he had things the wrong way round. (Maybe exhausted, and his native language reads right to left??)
Secondly, he somehow failed to drop down one line to the directive for switching even those two (SSRI to ven), and read straight across instead. I know it boggles the mind, but ... In this way he ordered his patient to withdraw ven and commence alternative. (SSRI)
If he is not, say, new to the country from Asia AND also somehow unable to follow a chart ... then, he just pulled this idea out of his ass. :mad:
Chart:
From To Comments
SSRI SSRI Withdraw and then commence alternative
/ Venlafaxine Cross taper doses cautiously, commence venlafaxine at 37.5mg
and increase slowly. Increase more slowly if swapping from
fluoxetine
Mirtazapine Cross taper doses cautiously
TCA Cross taper doses cautiously, commence low dose TCA. If
swapping from fluoxetine, wait 4-7 days before commencing
TCA and monitor for 4 wks
Mirtazapine SSRIs Cross taper doses cautiously
Venlafaxine Cross taper doses cautiously
TCA Withdraw and commence TCA
Venlafaxine SSRIs Cross taper doses cautiously, commence SSRI at low dose
Mirtazapine Cross taper doses cautiously
TCA Cross taper doses cautiously, commence TCA at low dose
TCA SSRIs Halve dose, add SSRI and withdraw slowly
Venlafaxine Cross taper doses cautiously, commence venlafaxine at 37.5mg
Mirtazapine Cross taper doses cautiously
TCA Cross taper doses cautiously
Bolded, is what he ought to have read. One hell of a mistake.
https://lifestyle.walsallhealthcare.nhs.uk/media/188674/depression%20in%20adults.pdf
MyNameIsTerry
04-12-15, 07:44
Hi Marie,
There are no fixed switching methods from what I have read (in the UK) but there are several identified and one of the common ones you see are the Maudsley ones. I have looked at switching methods in probably 10+ local NHS trust papers on the subject and they quote these plus give additional (and very useful) information to help their doctors. If it comes from the local trust, doctors in that area are supposed to follow it. The NHS isn't actually national, despite the press, it's a load of trusts & CCG's and some lesser recognised bodies, but they should be saying the same things to their NHS staff and NHS partners (GP surgeries are going to be these as not directly employed) so given they seem to quote the Maudsley ones despite there being no agreed protocol it seems NHS trusts have decided which they pefer and that is the one you are quoting.
Another way they can do it as seen in that NHS doc is:
Some cross tapering may not be considered necessary e.g. when switching from one SSRI to another their effects are so similar that administration of the second drug is likely to ameoiorate withdrawal effects of the first
However, when you do that you can't use a "wash out" period as you are depending on some reduced amount of the first SSRI to still be in your system when you start the next one. So, typically you stop one day and start the other the next so their is overall.
The ones that need "wash outs" are the long half life drugs like Fluoxetine as otherwise you would be piling a shorter half life drug on top of it. I know that New Zealand do have a no cross taper policy other than with one med.
http://www.gpnotebook.co.uk/simplepage.cfm?ID=1651179592
There are several sources in that one and they are all professional ones. The NHS trusts, like the one you posted, seem to conform to this. The doc states that local forumulary advice should be followed and this is where the local trusts come into play as their docus would represent this.
The only other thing I can think of is that this GP is treating it solely as an allergic reaction to any medication so the usual thing to do is stop someone taking it. However, if that was the case, why on earth try to re-establish the previous settled dosage? Can you even become allergic to something you have been taking with no problems? I didn't think that was the case with things like Pencillin as they always ask about that one and me replying "I'm not allergic" would mean nothing if it could change anyway???
Please be careful, Julie. You really need a second opinion. I urge you not to go cold turkey. Venlafaxine is a very powerful drug and a GP shouldn't be feeding you misinformation.
I would rather stab myself in the eye ball than go cold turkey on a med,I was taken off Citalopram and quetiapine cold turkey and it nearly finished me off
As Pulisa says get a second opinion,its your health thats at stake look after it
angels22165
04-12-15, 11:15
Hi Guys
Thanks for all your replies, I contacted a pharmacist who said you have to follow what the GP is telling you that is why he issued the diazepam to help with the withdrawel, 2mg twice a day. I last took a venlafaxine yesterday at 7am and feel not to bad just a bit shaky, palapatations and head dizzy, Im at work so think that helping me a bit to focus.
Thanks for all your advice, just seeing how I go from hour to hour and if feeling worse by tea time will contact the GP before he finishes for the weekend x
---------- Post added at 11:15 ---------- Previous post was at 11:14 ----------
How long had you been on 150mg? I find it strange that an allergic reaction can occur suddenly when and if you've been taking it for a while already? Could it possibly have been a reaction to anything else? I'm also against you going cold turkey, I lowered my dose by just 37.5mg and 15 hours later it hit me and I had to reinstate again, you need to taper off ven very slowly or bridge it with another AD to avoid nasty withdrawal even bridging it with another med like cit will give you withdrawal but hopefully not as bad. Please get another opinion XX
Hi Nicola
Been on the 150 for about 3 months now x
So after being on the drug for 3 months you develop an allergic reaction to it?
MyNameIsTerry
04-12-15, 14:50
So after being on the drug for 3 months you develop an allergic reaction to it?
I think thats just the 150mg too as I'm sure Julie was talking about increasnig her Ven and had support on the Ven board with the side effects. (if I'm remembering rightly)
This is my issue with this. How can you be allergic to certain dosages but not the active ingredients. This and the fact some of these side effects are actually documented as not allergic reactions and the GP's bizarre strategy to reduce it back and not even allow enough time for a dosage stabilisation.
nicola1980
04-12-15, 15:37
I could be wrong but I would've thought if you were going to get an allergic reaction from the med it would happen immediately not after being on it 3 months? I'm glad your not too bad today but I would still be very cautious. 2 x 2mg Diaz is a tiny dose, I was on more than that starting and increasing the ven so please seek medical help over the weekend if your symptoms become unmanageable XX
angels22165
04-12-15, 17:06
I know was thinking the same too if been on the meds for a few months at 150 then surely a reaction would of been then, must just be the increase which kicked it off, I'm waiting for a call back from the GP as the head zaps and starting to feel pretty crap once the diazepam starts wearing off, like you say Nicola 2mg am and pm is such a small dose and around 3 hours after taking one can feel the anxiety big time xxx
To be honest the diazepam dose is farcical as is the advice given by your GP.
nicola1980
04-12-15, 19:34
Have you heard back from your gp? Yes the Diazepan dose is very low, people are given more than that to get on a plane with a flying phobia!! XX
angels22165
04-12-15, 20:37
Yes he said to start the Citalopram straight away instead of waiting till Monday alongside the diazepam, so have taken one this evening and then start taking them in the morning one a day - he said they work with the same receptors in the brain as the ven so the withdrawals should ease, must say I do feel slightly better now than I did this afternoon head zap wise, just have banging head and feel really sick, so fingers crossed I may be other the worst xx
nicola1980
04-12-15, 21:32
Keep us posted how you are doing XX
MyNameIsTerry
04-12-15, 22:39
Please be careful over this, that's not a cautious cross taper. There is a risk of Serotonin Syndrome with even a cross taper let alone starting so quickly. In the cross taper you would reduce one whilst starting on a small dose of the new.
Your GP is ignoring all accepted advice from the NHS here.
What dose of Citalopram have you started on?
And he is still wrong because Ven is a different class of drug. Citalopram doesn't work on norepinephrine. Since you were on the 150mg & above threshold that med had been influencing your adrenaline levels and reducing their receptor sites and now they will re adjust so some level of withdrawal is to be expected hence why you always taper off. If you were switching to a drug in the same class it would be a different matter.
angels22165
05-12-15, 08:29
Hi Terry
I'm on 20mg Citalopram he said to commence yesterday evening then one again this morning which should ease the withdrawels from the ven alongside the diazepam, it's only two days earlier than he first said so I'm sure it be fine - I just need to try and remain positive and trust his advice that this is for the best.
If I start thinking otherwise it makes me anxious even more, thanks for taking time to reply :)
MyNameIsTerry
05-12-15, 08:43
Hi Julie,
Everyone here will support you no matter what happens.
Just keep an eye on your symptoms. If things don't feel right, please contact somebody. If there is anyone at home who can help you keep on eye on this, it would be useful.
We only want the best for you hence what has been discussed but I'm sure everyone will agree that if this is making you anxious, we will just keep talking and leave the other stuff behind for now until you need to discuss it further.
I remember how getting the pills home and reading the side effects worried me.
angels22165
05-12-15, 09:01
Thanks Terry
Yeah just a lot of what if thinking - I'm I doing right now and commencing the Citalopram two days earlier than what the GP originally said, but he must know and think that starting the Citalopram must help the withdrawels with less risk of side effects otherwise he would of been forceful and said no you will have to wait till Monday. You think you have a problem with GAD then to top it off with med changes how do we cope we must be the strongest people to exist :)
just keep going Julie you will get through this bad stage and come out the end of it ok,we always find a way of pushing through the hard times
Julie, we just needed to draw your attention to the fact that coming off venlafaxine overnight is not to be recommended. I know you need to trust your GP but this drug is not one to be taken lightly and should be treated with the utmost caution.
I really hope that things go to plan but ,as the others have said, please seek help over the weekend if you begin to feel unwell. This isn't a matter of a straightforward swapover of meds.
angels22165
05-12-15, 09:30
Since I woke I've been itching again! What is going on, brain zap wise eased - maybe not taking another Citalopram till Monday was good advice and let the ven get more out of my system as maybe clashing with the ven, will see how I go today and not take another Citalopram, see if the itching stops. Just feel can't win, but trying to keep positive x
MyNameIsTerry
05-12-15, 09:37
These meds are a pain, Julie. If you broke your nose and went to A&E you wouldn't expect the doctor to say "yes, I can help you but first let me punch you on the nose" but thats how it feels with the whole "it gets worse before it gets better" with antidepressants.
I went through a very difficult time starting my current med, easily the worst 10 days of my life. I didn't realise how bad it was until I spoke to others on here. I just held the thought that tomorrow it could ease off. It was horrible to wake up for it to still be there but a fair relief when day 11 came.
Just keep in mind that you will soon be stabilised on a new med and can get back on with your recovery.
The "what if" are a natural part of fight or flight. Fight them off with "positive what ifs" so you spin it around. For example:
Negative
"What if I have withdrawal problems"
Positive
"What if I don't have withdrawal problems"
"What if I quickly adjust to my new med"
"What if my new med helps me more than my old one".
Distraction can help too in times like this and just having the support of others to pull you through.
I don't have any advice to add to what the others have said but just wanted to show my support to you.
Keep posting here if it helps as I know that everyone wants to know how you are coping.
Elen
Way to put the fear of God into the poor girl people! Sheesh!
I know many of you have had bad experiences with meds and GPs, but not every GP is a novice when it comes to psych meds and not every GP is irresponsible in their diagnosis and advice. And how many of you do things that go against what Dr Google and the guidelines say or been told by your GP it's Ok? Heck, there are people on the boards as I write this weaning themselves off of meds without a doctors advice or supervision! Yes, coming of SSRIs cold turkey is not recommended BUT the OP was having severe reactions. Severe itching AND skin eruptions. The GP felt this warranted the action taken. A pharmacist affirmed to follow the GPs advice as well. My daughter had a similar reaction to one of the meds they tried and was told the same thing. And yes, she was fine for a couple of weeks and the reaction occurred when they ramped up the dose. Yeah, it sucked for her for a week or so until the new meds kicked in but she needed to stop the current med cold turkey due to the reaction. They had her wait a few days before starting the next med. And allergies can start out of the blue too! My wife never suffered from allergies until two years ago. Now she has to take an allergy pill. She drank milk her whole life and now she can't as it makes her sick. We use almond milk now... so it happens.
I understand your concern and wanting to help but this thread went a bit far in a negative direction IMO.
Angels... I'm glad you spoke with your GP and it sounds like you both have things under control. Hope the side effects are waning and you're beginning to feel better.
Positive thoughts
angels22165
05-12-15, 15:23
Thanks Fishmanpa for your message. When the GP said yesterday commence the Citalopram early because of the withdrawel I felt slightly relieved but on waking this morning the itching was back so I held off taking a Citalopram today, not sure why on a new med that it started up again, thinking that why the GP must of said wait until Monday so that's what I'm doing, will try again Monday and if itching still present will just ask for his advice again.
I would say feeling just OK - head zaps back and slight disorientation but the GP must of known that with the itching give a good few days break between meds for it to calm and for the ven to be less in my system. Just taking one day at a time and not thinking how will feel tomorrow.
Thanks again Julie X
Has your daughter ever withdrawn overnight from venlafaxine, FMP? Not other SSRIs
---------- Post added at 17:56 ---------- Previous post was at 17:52 ----------
Julie, if you're fine that's all well and good and every good wish for the new regime. Several of us weren't and your GP's advice was flawed. Be that as it may, we couldn't ignore your request for information and a weekend is a long time when you're in mental distress
angels22165
05-12-15, 18:04
Thanks Pulisa for messaging, I really appreciate how many people have taken time to reply and I'm very grateful, it's so nice knowing that your never alone and can share with people who suffer from anxiety conditions too who understand xx
You can choose what information to act on and in an ideal world of course you should trust your GP's advice but I wanted to respond to your thread with information taken from personal experience and others have too. I don't think it's been an overreaction-more a desire to keep you well and to alert you to a potential genuine and well-documented health concern. If we have acted out of line then please forgive us?
nicola1980
05-12-15, 19:41
We have responded out of concern for Julie, the majority of us have either gone thro or witnessed ven withdrawal and believe me it isn't pleasant. We all understand how you must be feeling Julie and how frightening it is we just didn't want you to suffer unnecessarily when there is other ways to safely withdraw. I hope you haven't been offended by us, the last thing I'm sure any of us wanted to do was scare you, it was pure concern XX
angels22165
05-12-15, 20:36
Thanks Nicola I'm not offended in the slightest and really appreciate everyone's concern xx I'm not feeling to bad when the diazepam is working but about 5-6 hours after can feel such anxiety till I take the night one and the itching is still there, which is kinda odd xx
Maybe the itching is caused by something else ,have you changed your washing powder or soap
Hang in there things will get easier once the meds have settled
angels22165
05-12-15, 21:15
Was thinking to Mr Andy the itching could be caused by something else, just unsure what at the moment, nothing changed with washing powders or scents. Thanks I Am hanging in the best I can and keeping positive X
How much benzos have you got left ,just take two tablets instead of one
angels22165
05-12-15, 22:35
I have 8 left been taking 1 am and pm since Thursday
I went from 225mg to nothing straight away. It was unpleasant but I was fine after 3 or 4 days
MyNameIsTerry
06-12-15, 05:30
Yes, coming of SSRIs cold turkey is not recommended BUT the OP was having severe reactions. Severe itching AND skin eruptions. The GP felt this warranted the action taken. A pharmacist affirmed to follow the GPs advice as well.
No, she didn't actually say that. She said serious NOT severe. There could be a difference there so lets not change the wording to make it sound worse. :winks:
The pharmacist just stayed out of it in my opinion. I don't see how they really confirmed it the right thing to do.
The reason we are concerned is that the allergic reaction the OP mentions is actually documented as a side effect on Drugs.com. So, it possible to experience it when starting or increasing but it will go away as side effects do. The GP has been taking some conflicting actions as can be evidenced in this thread and has not followed the guidelines given to him by his own local trust which he is supposed to follow to the letter. A GP, that is someone not even trained in mental health or the meds, breaking away from guidance issued to the whole countries doctors by specialists in the NHS, is a red flag to me. We are talking rare side effects here so this only increases the possibility as you would expect them to have a good command of the common ones.
We all know that this is possibly not even an allergic reaction and unless it is seen as an emergency, there is an argument for a slower taper to allow for a cautious cross taper. Thats how they do it with Ven to Citalopram. The warning for allergic reaction is to contact emergency medical help and this to me sounds closer to needing a trip to A&E NOT waiting to see a GP.
No one wants to scare Julie, far from it, but we do need to be realistic. Some people start meds and have no side effects at all (jammy so & so's!) but the majority have difficulty and thats the reason why guidelines tell GP's to be monitoring for certain things and to be open with patients about what they could experience. The thing is FMP, if you want to argue we are being over the top, we could argue you are being dismissive. I don't believe you are, hence why I asked if you could add some detail to give a bit more confidence in what you were saying, but none of us now how this experience will be for Julie and that absolutely includes her GP. He really should have scheduled this for when he was around and this is one of the failings that other doctors (in places like A&E) are annoyed about as they have to intervene at a greater cost to their emergency resources.
Julie - your GP did say that he thought not having a "wash out" period would mean the allergic reaction would continue. I would debate this because they are different drugs and we are not talking lactose like FMP has given an example of because you can live without lactose, you can't live without Serotonin! If you are allergic to the active ingredient of Ven, then if that active ingredient isn't even in Citalopram, I would think it very questionable that Citalopram could make it continue. But something to consider is that in a cautious cross taper you would not be starting on 20mg of Citalopram so maybe if this is more a side effect, it is being aggravated? It seems strange though because you were maxed out on the Serotonon element of Ven and increasing the Norepinephrine element.
---------- Post added at 05:30 ---------- Previous post was at 05:25 ----------
I went from 225mg to nothing straight away. It was unpleasant but I was fine after 3 or 4 days
I think you were very lucky, Dan. There are people the complete opposite and there is clinical evidence that this is one of the 2 worst so we need to be realistic here just like how we have to assume starting a med means side effects yet some people have none at all...the rarer people.
How are you making out, honey? :) Has the itching let up, and are you managing okay so far on the new med?
angels22165
08-12-15, 22:25
Hi
Contacted GP yesterday and he told me not to take anymore Citalopram after the itching started again on Saturday, he said it works the same way as Ven which seemed to cause me to itch too.
He was unsure which med to try which won't cause me to itch, so he put me on 50mg Amitriptyline took the first one last night was a bit groggy today but still managed work okay, just hoping these will work for the GAD and pure o, not sure on the waiting time for these to become actively working, had a bit of an evening with irrational thoughts and anxiety but haven't taken a diazepam now since yesterday am so think the ven withdrawels must be over and hardly any head zaps today which is good.
Thanks for asking SADnomore xx
Good luck, all the best! xx
Marie ;)
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