Cold Turkey

Never quit medication cold turkey. It will shock your body and will do a lot of harm. If you want to come off them, tell your doctor and they will advise you on how to come off them gradually. As you said you will get withdrawl and this is NEVER a good thing. Calling a suicide hotline is NEVER a waste of their time either. If it stops you doing something silly, then they've done their job.

So in short, do not go cold turkey, and talk to you doctor about it. In the mean time, phone those hotlines to keep yourself calm. Don't make decisions like this for yourself because you won't know what the outcome is likely to be, always voice your concerns to someone who knows what they're doing and they'll change your medication for you.

 

I also started taking Effexor a couple of weeks ago, and I too feel pretty bad (always tired, suicidal, no desire to communicate/hang out with friends). I've heard that it is one of the hardest antidepressants to stop taking, because the withdrawal symptoms are pretty severe. Either talk to your doctor (recommended) or very slowly taper your dose. Like if you're taking 150 mg, reduce it to 75mg over the course of 1-2 weeks, and then to 0 mg over the course of 1-2 more weeks. It's sucks, but I've read that if you quit it cold turkey, the physical withdrawal symptoms resemble those of the flu (accompanied by more anxiety and depression).

Personally, cannabis is the only thing that helps with my depression and anxiety. It chills me out and gives me an optimistic life perspective. I keep trying to tell everyone this but no one thinks that it is an acceptable way to deal with my problems. Maybe I'm just psychologically addicted to it, but it's one of the only things that truly makes me see things in a positive light anymore. Too bad it's still illegal...

Hang in there, message me if you want to talk

 

As someone interested in psychiatry and psychology, do you mind me asking why you're on antidepressants in the first place? (I volunteer in a local psychiatric clinic.) And had you thought about killing yourself before you went on Effexor?

In our clinic, the psychiatrists don't generally prescribe SSRIs for depression with known causes i.e. are you depressed about being LGBT? The clinical trials for SSRIs aren't as clear cut as the drug companies want you to believe, and sometimes are only marginally better than placebos.

I'm not a psychiatrist (yet) so take what I say with a grain of salt, but I can read research published by psychiatrists. The most interesting is a meta-analysis (a technique for combining the results of a number of studies) done in 2005 by Joanna Moncrieff and Irving Kirsh, a British psychiatrist and psychologist respectively, which showed that SSRIs have no clinically meaningful advantage over placebo tablets. They similarly found little evidence in support of the claim that these drugs are effective in more severe types of depression. Findings that appear to show a positive effect for antidepressant medication when compared with a placebo are probably therefore the result of methodological defects in the research.

Supporting these arguments, Canadian psychiatrist Corrado Barbui made an analysis of unpublished as well as published research, and concluded that SSRI antidepressant medication is not superior to placebos (Barbui et al., 2008).

Analysis by Irish psychiatrist and researcher David Healy and colleagues in 2006 has also linked modern antidepressant use to increases in violent behaviours (Healy et al., 2006).

But, whatever you do: talk to your doctor and inform them of what you are doing. Is it a primary-care physician/general practitioner that you are seeing or a psychiatrist?

Have you thought about seeing a clinical psychologist instead? I think it will be more beneficial, and you should enquire about cognitive behavioral therapy.

 

I've gone Cold Turkey off anti-depressants before, but not Effexor. Honestly, I wouldn't recommend it based on my experience.

I had to keep going off of them due to the side-effects, though they didn't make me feel suicidal. Thankfully, my side-effects were just sexual (anorgasmia) and feeling very lethargic, both of which are pretty common when taking anti-depressants.

I decided I couldn't take the sexual side effects, so I decided to go off them cold turkey. The first one I went off was Paxil. HUGE MISTAKE. For like an entire month I was filled with pretty much uncontrollable rage. Any little thing would set me off, and there were times when I struggled to contain myself or I'd become violent.

I remember a situation when I was having dinner with my parents. All my mother asked was if I wanted something, she was offering to pass me the bowl. I remember grabbing the sides of the table and just trembling with anger and rage. Had I not grabbed the table, I'm pretty sure I would have physically attacked her - for no reason. Keep in mind, that this is no where NEAR my normal personality. I'm pretty much the polar opposite.

Honestly, I think I could easily envision myself committing murder when I was going through that. It was crazy.

The second one I went off of cold turkey (yeah I didn't learn much from my first experience), was Prozac I think. I'm not 100% sure, it's been a long time ago. The side effects were pretty much the polar opposite of what Paxil did to me. I went emotionally numb. I felt nothing. You could have murdered my entire family right in front of me, and I would have felt nothing. I wouldn't have even shed a tear. Emotionally, I was "dead" - I felt no joy, no sadness, no happiness, no motivation, not even a cold indifference. I felt nothing.

It lasted for longer than a month, but I can't remember how long. I think both of them also screwed a bit with my memory.

My mother is still telling me stories of what I was like when I went off Paxil, and half of it I don't even remember.

I don't recommend it. I have no idea how it'll impact you, as I think everyone is a little different. You really should inform your doctor as to why you're going off of them. From what I hear suicidal thoughts is actually not that uncommon when taking these types of drugs. It doesn't necessarily mean he's going to have you committed; I believe that he can only do that if you're actively planning to commit suicide. Having the thoughts alone, I don't believe, are not enough to have you institutionalized.

At a minimum, you need to inform your mother or someone who can keep an eye on you and look for changes in your behavior and personality.

Also, speaking to your doctor about this is important, because I think there might be a possibility that those feelings you're experiencing could get WORSE by going off the medication cold turkey. Not better, worse.

Your doctor is the best person who can inform you on that, but you really should also inform someone who can keep an eye on you and look for changes in your personality and behavior.

 

First off, you need a hug (*hug*)

I don't think a big debate on the efficacy of antidepressants is what is really needed right now :eusa_naug I also would be steering clear of cannabis...

I really think you need someone to talk to - call that hotline and have a chat if you need to. Also, Efexor takes about 6-8 weeks before it reaches it's maximal effects... which is probably why your doctor wants to review your situation again in a month (it coincides roughly with this date). However, you should have told him that your were having thoughts about suicuide - I imagine his plan of action may have changed (if you want to get the most out of your doctor - there needs to be no barriers - be completely honest, remember, everything is confidential). Efexor is *not* a first-line therapy for adolescents & youth because it has an increased risk of suicidal idealisation when compared to other antidepressants in this age group. I was actually wondering why you were prescribed it until I read your paragraph about your mother's experience with SSRIs. Personally I would go for an SSRI first and stay away from the Efexor, especially since you are having the suicidal idealations.

I don't agree with going cold turkey - I still think it would best to wean yourself off with your doctor's supervision. One possible way is a 10-15% reduction every 4 days (this might require a prescription for the 37.5mg strength of capsules though). The manufacturers recommend a gradual taper over two weeks. Withdrawal effects are not pleasant (e.g. dizziness,sweating, agitation & anxiety), but can be minimised or eliminated through gradual tapering. It would again be best to discuss this with your doctor! I would call your doctor again and be completely honest with him - your doctor is there to help you.

When it comes to feeling isolated an alone I think everyone's been there (well I have been at least... and I'm still there :tears I think you need to make new friends and put yourself out there (this of course, isn't easy!). An appointment with a counsellor or psychologist might be a good idea... they can be someone you can talk to, and they can help you to make positive changes in your life.

 

I can't really help with advice about your meds, but I think you ought to see a clinical mental health psychologist. I know that my mother (who is one) has a lot of info and resources on both drugs (legal or not) and depression/suicide. I also recommend talking to the hotline.
And, most importantly, I think you need some hugs:
(*hug*)(*hug*)(*hug*)(*hug*)

 

Omg my doctor prescribed effexor for me last week..I took it three times before I felt like complete shit and stopped...it's sounds like a demon drug! Exercise helps me more than that shit did!

 

I definitely think you need to go off the drug due to the effects its having on you. My only fear is that those feelings could potentially intensify if you go off it cold turkey, and you may actually go through with them as a result.

I don't think you really have to worry about being institutionalized unless you're actively planning suicide. If you watch virtually every anti-depressant commercial they all talk about the risk of having suicidal thoughts, which leads me to believe that it is a fairly common side effect. Since anti-depressants are so widely prescribed, and we don't see or hear about lots of people being institutionalized, my guess is that you're pretty safe on that end.

In fact, someone in my extended family attempted to commit suicide several months ago. He was addicted to pain killers, and could no longer get prescriptions for them. He blatantly begged the doctors to help him, and told them if they didn't send him somewhere for help that he was going to kill himself. He went to three different doctors and told them this, and none of them institutionalized him. He then tried to shoot himself, but thankfully he only shot himself in the shoulder. After that they DID institutionalize him, but only for like three days.

So, it seems that - at least down here in Virginia - it's pretty hard for them to lock you up. I have that same fear as you, which is why when I was suicidal (non-drug related), and had even attempted suicide, I didn't tell the doctors. I was afraid of being locked up. I was seventeen, about to turn eighteen at the time. In fact, it was after my last suicide attempt that I went to seek help. That's when I got prescribed the Paxil.

 

I think it is perfectly reasonable given that it is something Cynicite has thought about before. Clearly she is not benefiting from Effexor, and suicidal ideation is something, in our clinic anyway, that without doubt outweighs the so-called benefit-risk balance i.e. there is high risk and seemingly no benefit of Effexor for Cynicite.

The lead-in time for Effexor is four weeks maximum, and if we get a positive response from Effexor (actually quite rarely; we only prescribe it for the blackest of depressions and not in cases like this in any circumstances), it has almost always been by the third week. So Cynicite should be seeing the benefits, if any at all, by around now. Six to eight weeks is not the correct lead-in time.

But note, that while I do not think SSRIs are the answer for you, I DO NOT advocate going cold turkey either. You have to ween yourself off slowly. Maybe you don't have to go the 37.5 mg route — that could take ages to do (but I will admit that this is what is recommended). Still, you have to take note, once again, of the benefit-risk balance. Suicide ideation is probably one of the worst side effects and it does justify a quicker discontinuation of the drug. In a sense, it's kind of an "emergency", especially if you feel like you're going to do something. But take two to three weeks and gradually reduce your dose. If your doctor is a staunch advocate of SSRIs and does not like your plan, I suggest you ask to be referred to a psychiatrist or another primary care doctor who will assist you with it.

And, for the love of God, go and see a clinical psychologist. I think you need to talk through your issues.

 

I knew you were a guy! That must have been a typo XD.

Well, yes, I presume that you can look up clinical psychologists in the phone book. But if your doctor is someone you trust, often he will be the person to refer you to one. At least ask him for a few recommendations. Some clinical psychologists don't like taking consultations over the phone, but you should at least try to get a chance to speak with them somehow before your first session. Choosing any kind of a therapist, no matter what their training, is a very personal kind of thing. Just because someone has a PhD doesn't mean you will work with them well. Essentially, a therapist should be like a good friend who you can trust. But there is also a strong correlation between a high level of expertise and experience, so definitely take this into account. A clinical psychologist should have a PhD or, in the the U.S., a PsyD.

But there are a number of questions you can ask:

• Ask them how long they had been a practicing clinical psychologist.
• Tell them the exact problems you are having.
• Explain that you are looking at the benefits of Cognitive Behavioural Therapy (C.B.T.) as a sole treatment initially, and that you would like to see if it could be beneficial without medication. Tell him that you tried Effexor and that it made your problems worse and that you experienced suicide ideation.
• Ask them what experience they have in dealing with your kind of problems.
• Ask them if C.B.T. is a treatment they believe in for your kind of problems.

(If they sound a bit hesitant, move on! Research has shown that how much a therapist believes in the treatment has a demonstrable effect on the efficacy of the treatment. But also note that research has shown C.B.T. to be over twice as effective as a similar period on SSRIs. i.e. if you were to spend either sixteen weeks doing C.B.T. or sixteen weeks on SSRIs and then stop both treatments, C.B.T. will be noted to be twice as effective for moderate to severe types of depression. This is optimal given that no-one wants to be in treatment, either in therapy or on medication, for the rest of their life. In fact, in the study I'm referring to, to achieve the same benefit as the C.B.T. patients, those in the medication group had to stay on the drug indefinitely. If you're interested, I'm talking about a study done in 2005 by DeRubeis et al.)​

• Ask them their areas of expertise. i.e. do they deal with adolescents often?
• Then you need to deal with the financials i.e. fees, insurance and anything else.

And then, once you do have your first session, you should make sure that you both have clearly defined goals of treatment. Establish what you both want to achieve and how quickly you want to achieve it. I would think that four months should be the minimum amount of treatment.