Withdrawal help - due to upset stomach

[Gardenlover]

Hi - My name is Angela and this is my first post. Apologies if this has been addressed before - I couldn't see anything but due to my mental state at the moment might have missed.

I've been on venlafaxine for about 20 years. This was for perimenopausal symptoms of terrifying anxiety after HRT didn't work (or didn't work quickly enough).
Venlafaxine has been a miracle drug for me over that time.
The only problems I encounter is when I get an upset stomach. In October I had that when my dog died. Suddenly all the venlafaxine was out of my system. So now I'm trying to deal with a bereavement and drug withdrawal. Managed to get some diazepam from the Dr same day.

I had another upset stomach two days ago. I suspect it is hormone related and I have an appointment in 2 weeks to see the Dr about a newer type of HRT.

My question is - how do other people manage short term with the distressing mental symptoms of sudden unexpected withdrawal until the drug builds up in your system again? I've got a few diazepam left from October but is there anything better? I had some propranolol once but it gave me diarrhoea so now I'm terrified of that too or anything like it.

Symptoms are mental - waves of total fear - separation anxiety - don't want to be left in a room on my own (no reason) - fear of dark etc. .

Thank you for any help or advice.

Edited to add..

I'm on venlafaxine 75XL at breakfast and 37.5XL at bedtime (extra dose was to ensure there was always something in my system apparently).

I know some people hate venlafaxine. Please no horror stories - I'm feeling fragile.

[panic_down_under]

to NMP, Angela

I've been on venlafaxine for about 20 years.

...The only problems I encounter is when I get an upset stomach. In October I had that when my dog died. Suddenly all the venlafaxine was out of my system.

I don't understand what you mean by all the venlafaxine was "out of my system". Do you mean it stopped working suddenly that day, or that you stopped taking it?

So now I'm trying to deal with a bereavement and drug withdrawal.

If you're having withdrawal symptoms I assume you stopped taking it. If so this is not a good idea.

Managed to get some diazepam from the Dr same day.

And apart from prescribing some diazepam what, if anything, did your doctor recommend as the way forward?

My question is - how do other people manage short term with the distressing mental symptoms of sudden unexpected withdrawal until the drug builds up in your system again?

This isn't how antidepressants (ADs) work. I think you're confusing loss of effectiveness with withdrawal. They are not the same. If you are still taking venlafaxine at the same long-term dose then you are not in withdrawal.

ADs don't work directly in the immediate way that aspirin works for a headache, or diazepam does for anxiety. Antidepressants stimulate the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels (PDF). The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly.

I've got a few diazepam left from October but is there anything better?

The benzodiazepines are not good long term anti anxiety meds as they have the same deleterious effect on the hippocampus as stress hormones do when they are taken regularly. Pregabalin (Lyrica) might help. It has similar effects on the brain as the benzodiazepines, but achieves it by a different route and has a neutral to positive effect on hippocampal neurogenesis. However, dependency is an issue with it too so it should only be a temporary solution. The sedative mirtazapine is another option.

Symptoms are mental - waves of total fear - separation anxiety - don't want to be left in a room on my own (no reason) - fear of dark etc. .

...I'm on venlafaxine 75XL at breakfast and 37.5XL at bedtime (extra dose was to ensure there was always something in my system apparently).

I suspect venlafaxine actually stopped being effective some time ago and it just needed a trigger to expose it.

Seems to me you have 2 choices, increase the venlafaxine dose and hope this restores order, or switch to another AD. If it was me I'd switch to fluoxetine (Prozac). As you may be aware, venlafaxine can be a very difficult AD to quit because of its very short half-life. Rather than weaning of it the far better option is to switch to the very long half-life fluoxetine and wean off it if the plan is to be med free. It is also the best option, imo, for switching to another med if venlafaxine no longer works.

[Gardenlover]

Thanks for your reply.

I don't understand what you mean by all the venlafaxine was "out of my system". Do you mean it stopped working suddenly that day, or that you stopped taking it?

I have not missed a dose. I understood that the individual pellets within the capsule were absorbed in the bowel. These would have passed through quicker than normal so I had less drug in my system.

And apart from prescribing some diazepam what, if anything, did your doctor recommend as the way forward.

Nothing. They told me that this was temporary and within a few days venlafaxine will have built back up in my system. The diazepam was just to try to help me through that. Within a few days I was 100% back to normal.

Thanks for your suggestions.

[panic_down_under]

Within a few days I was 100% back to normal.

Cool!