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Author Topic: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?  (Read 46468 times)

Alex 2024

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #45 on: April 12, 2024, 07:33:41 PM »

Sorry to be the bearer of more confusion  ;D but re
 Medichecks .com offers an 'Advanced Thyroid' panel test which includes a bunch of other things which are good to test (B12, D3, ferritin etc). It includes all the thyroid tests except rT3, but is a great place to start....

Yep! I'm very confused!  :o
I'm on a very limited budget so medichecks sounds good but.... I'll have to wait and see what the doc says in a couple of weeks
Thanks for updating me though :)
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Alex 2024

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #46 on: April 17, 2024, 08:29:12 AM »

Hi Everyone,

I've got another, interesting update on this - especially for those who were thinking they might take a gene test.

I had a text chat with some friends in the states and they said they'd help me try and take the Genesite test. It is just not as easy as I thought. You'd need to be over there but also you would need to register with a pyschiatrist service, a Genesite provider and liase with them. The fees for this seem to be between $300 and $450. It also wouldn't be easy to organise, as I contacted a few providers by email and they all want to speak to you by phone. So actually I think it would be more difficult than doing a test here and would also cost more or the same.

If anyone else tries this or gets further than I have then I'd be grateful if you could update this thread with the info.

On the plus side... I finally got hold of my psychiatrist and he said he would support me with doing the myogenes test. There was a caveat though: he has done this for other people and he said it may not be as useful as I think as it's not as "cut and dried" with answers as I might think. He makes a good point.

And how am I doing right now........? Terrible this morning.... I think I'm really struggling with cutting my dose of Venlafaxine. The Mirtazapine does seem to be doing something to help me feel more optimistic but I started feeling VERY tense on Sunday. On Monday I woke up with very bad face excema again (I've managed to control this, phew!). Tuesday I didn't feel so bad but today, Wednesday morning, I am so tense and ratcheted up I cannot concentrate... I feel like I could easily snap at someone. I have a dry mouth too. I've been two weeks now on cutting down from 112.5 to 75mg, I think I'm going to "power through" for another two weeks, but of course the option is to go back up to 112.5mg. This is what the psychiatrist recommended. Does anyone else have something to help me on this....?

It's fine if you'd prefer to DM me with your experiences/advice.

Thanks everyone - just trying to take one step at a time today and get through my day's committments x
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CLKD

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #47 on: April 17, 2024, 11:50:33 AM »

It's the Trial and Error that is so tiring  :'(

it’s just your symptoms coming back.  it's known as 'bounce back' in that the symptoms that the drug/s were prescribed for and which subdued any sensations etc., come back without the drug imput.  It took me 9 weeks of weaning to get off one AD can't remember which one: each time I dropped the dose the effects would return so my head went into 'what if I can't stop', 'what if I have to go back on it', 'what if the new regime doesn't work'  :-\ :'(.  It took me 10 days to realise that after each 'drop' those awful feelings didn't become worse; so I persevered.  I had support from my GP at the end of each week as well as a DH.

If people don't get that support and reassurance then it must be so hard to ditch any drug that may be prescribed.

Me: I want a cure and I want it yesterday  :-\  ::)

I'm feeling vulnerable for the last 2.5 weeks, due to a problem with eating  :'(

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Alex 2024

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #48 on: April 19, 2024, 08:12:04 AM »

It's the Trial and Error that is so tiring  :'(

It is - and to be perfectly honest it's wrecked my life - I feel like I've spent the last year "on hold" because of medication that was supposed to help but actually just made things worse..... hence why I'm so keen on the gene test rather than more trial and error .... just how much hell can one person take...?

it’s just your symptoms coming back.  it's known as 'bounce back' in that the symptoms that the drug/s were prescribed for and which subdued any sensations etc., come back without the drug imput.  It took me 9 weeks of weaning to get off one AD can't remember which one:

From what I've been reading this week you did very well to get off an AD in 9 weeks. This forum suggests 10% drop every 4 weeks: https://www.survivingantidepressants.org/forums/topic/300-important-topics-in-the-tapering-forum-and-faq/

So when I was advised to go from 112 to 75 it was a 30% drop...! - that's a massive drop for me!! - no wonder I felt awful after two weeks!!

If people don't get that support and reassurance then it must be so hard to ditch any drug that may be prescribed.  - yep! absolutely!!

Me: I want a cure and I want it yesterday  :-\  ::)

I'm feeling vulnerable for the last 2.5 weeks, due to a problem with eating  :'(

Yes - me too.... so sorry to hear you've got eating problems atm, anything we can do to help......?  xx
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Hollyboll

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #49 on: April 19, 2024, 06:07:30 PM »

Thanks for the interesting updates Alex, and we're all wishing you improvement soon.

Hope it's helpful to paste here some info I put in another thread about withdrawals.  It's not to replace anythign your specialst recommended but you might find it helpful to discuss with them in trying to understand their recommendtions ...

Experiences of this are massively individual - depends on metabolism (and presumably gene things they don't understand yet!), the drug, how long one's been on it, other health and meds etc etc.  Some people sail off without many probs, but for many it's much much harder. 

As CLKD says, because sometimes withdrawal symptoms are not dissimilar to originals, medics often miss and muddle them. 
Her experience - of it taking a couple of months and stabilsing after 10 days each time - sounds exhausting and challenging but many do have much longer and tougher times ... I say this not to frighten you, as you may not, but because when my GP put me into withdrawal nightmare by advising very poorly on withdrawals from drugs onto which he should never have put me to start with, but he either didn't know about or didn't believe in hormones, I had to find this all out for myself, and really wished I'd known when I started.  I was by then desperate to get off them, but realised the only way I'd have any chance of doing that sustainably was to do it really slowly and gradually - I'm NOT a patient person!!!

Anyway - here's the info from the other thread:

Specialist advice generally is that even the Royal College of Psychs revised guidelines are too fast - unfortunately psychiatrists are people who prescribe drugs.

For anyone trying to taper, I'd recommend looking at Critical Psychiatry / survingantidepressants.org / the work of Mark Horowitz / David Healy (sp Healey?) - lots around including on youtube.

Idea generally is to reduce by 10% not more than every month or so - your CNS needs time to catch up and stabilise.  That means the reductions get very (VERY) small as you get to lower doses.  So it's easier with liquid although there are other options - lots of info on survingantidepressants.org ... Alex venlaflaxine liquid is available, have you tried that for smaller decrements?

There's also a pharmacy that does 'tapering strips' - you need a doctor to order them - and has some very helpful info on the different meds and suggested decrements (including the graph thing I try badly to explain below).  www.taperingstrips.nl - search under 'antidepressives'.

What most GPs don't know or understand is that the 'effective mechanism' of all these drugs is on a graph like a hockey stick.  So the difference between 0 and a teeny tiny amount or a teeny tiny amount and a tiny amount is massive (a vertical slope up) compared to say between (say) 112.5 to 75 of effexor (brand name for venlaflaxine, nicknamed by medics as side-effexor) - at those greater doses the 'effective mechanism' slope is almost horizontal.  THe side effects may reduce as dose reduces, but it's at the lower levels (starting when you get 'down' to what medics often quote as the minimum therapeutic doses) that reductions often cause huge withdrawal issues ... so advice is to take them very slowly and gradually.
'Effective mechanism' is something to do with occupancy/binding or receptors, but way above my head!

Some people are fine doing halving and quicker etc but a lot of people have problems - hence even the RCS updated its guidelines and the Critical Psychiatry movement (all of whom, like Horowitz and Healey are psychiatrists).
 
The effective half-lifes can vary from hours to days - or even longer for some (and some have complicated functions that mean they get even further extended ... fluoxetine is one which is why sometimes people are bridged from shorter half-lives onto fluoxetine for the later reductions) .. and as always different people react/metabolise differently.  Best practice isn't to shorten the hold just because something has a short half-life - but to give yourself proper chance to stabilise after each decrement; it's just that a longer half-life might give you a less bumpy ride / side-effects ... and for those with particularly long half-lives (eg fluoxetine) any effects might only emerge a lot later.

I'm not a doctor - simply sharing some general principles I learned the hard way.  But they are very general principles and everyone is different.  If I ever again was facing coming off ADs , I'd only consider doing so with some specialist input - and if a specialist wasn't familiar with Healy/Horowitz/Ashton-Manual/taperingstrips.nl, I'd find another specialist - I'd not expect them to agree with everything, but i'd want to know they were aware of the principles/discussions! 

HTH and good luck to all
xx

« Last Edit: April 19, 2024, 09:47:04 PM by Hollyboll »
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Alex 2024

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #50 on: April 23, 2024, 07:40:17 AM »

Hi Holllybol,
Thanks so much for your detailed reply - that's really helpful, I really appreciate the time you're taking trying to help me.
The reason I haven't replied earlier is because I feel absolutely terrible..... every hour of every day is a challenge. I feel frightened/fearful to face even simple taks and those that I do manage are taking forever :(
This isn't funny - I'm trying to function, get my life back on track  and look after my child at the same time.
My sleep is great - but too much, still struggling to get up and wake up. When I'm awake I click into "highly tense" mode with shaking hands and hot cheeks, chattering teeth, feeling very thirsty and holding tension in my gut which aggravates my IBS. This lasts all day unless I am with an adult and doing something simple and enjoyable, but I only have this for a few hours each week.
I'm 26 days into cutting Venlafaxine and starting Mirtazapine although I cut back to the very small dose of 7.5mg of Mirtazapine after 11 days because I was such a zombie.
I'm just putting up with feeling terrible in the hope that things will get better. I'm keeping a diary and I've just written in it that I shouldn't change Venlafax until 6th May and Mirtaz until 15th May...... but I have a very important event on 2nd May and I know I'll feel absolutely terrible and I'm so worried about how I will cope. And the idea of not feeling any better when I reach either of those milestones (I honestly don't think I will) is just so horrible to contemplate. These milestones are just dates when I should consider making changes for the better that will take 4 weeks or so to kick in............

Does all that make sense and do you have any further advice for me as someone who seems to react in a very similar way to me and has been through this hell before me?

I really wish I hadn't cut the Venlafaxine at all (just following advice of psych)  and I wish I'd gone back up to my original dose of 112.5mg when the psych suggested I should 7 days ago, but there's no point in changing now though I suppose, so I'm on 94mg at the moment.
 
Thanks for the links to tapering off slowly - I'd found them just before I saw your post - that's VERY interesting and I wish my GP and Psychiatrist knew about these but my GP definitely doesn't and it's v early days with my psychiatrist. I think I understand about the hockey stick, but my brain is so mashed at the moment I don't really understand about half lives and how this affects me and both of these medications.

I'll send you a direct message in a minute.

CKLD: are you still reading this and are you ok.....? - your last message wasn't great so I really hope you are, just message if you need suppport and you're welcome to direct message me too

Thanks everyone xx



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CLKD

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #51 on: April 23, 2024, 08:27:57 AM »

Tnx - replied to your PM

I have an eating disorder from age 3.  My weak spot is below my belly button on the right.  I don't recognise hunger so if I don't eat little and often my body lacks energy = nausea.  Last Tuesday I had a light-bulb moment: we have been going to bed later, sleeping heavily until 9.03-10.00 a.m. so I'm missing an eating opportunity. Now we set the alarm for 7.45 [that's almost 7.30  :o] and I get breakfast at the proper time I am beginning to feel more human with less nausea = anxiety.

Your 'highly tense' feelings may ease if you eat every 3 hours, 24/7.  Takes practice I can tell you. The National Association for Pre-menstrual Syndrome [NAPS] gave me that advice in the 1990s, to stop the body losing energy.  Once the body becomes depleted those awful feelings may take over, it can take 8-10 days to regain levels. 

Take care of you.  R U able to not attend the event on the 2nd?  I've backed out of many things, even funerals, due to not wanting to upset others if I have to run for cover.  Anticipatory anxiety is the PITS! but I am unable to counteract it, I have an emergency tablet to take when necessary.  Until recently I hadn't required it for 4 years. 

MayB weaning off is something to ring your psychiatrist about this week?  Make a list of your queries so that you don't miss anything that you need to discuss.  My GP knew about tapering so I had support.   For me it was the physicality that was difficult, the 'what ifs' followed .......

Do U have help with child care?  It's scary feeling scared!   :foryou:
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Alex 2024

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #52 on: April 23, 2024, 09:18:14 AM »

Hi CLKD,
Thanks for your reply... that's really interesting about eating every 3 hours I can keep a snack to try and do that.

However.... I've done 24 hour fasting in the past (find it very difficult!!) and that has always helped me with sugar cravings and to reset to have a better diet... which is the opposite of what you're suggesting....... so I'm confused  (nothing new there!)

I'm sure most of my current anxiety is because the meds I'm on are not right for me in the current dosage or not right for me at all... I just don't know.

I can't get any help with child care unfortunately - and tbh it's being with him that's sort of keeping me going at the moment. I have to go on May 2nd... I'll just have to make the most of it.

I agreed with a close friend a couple of weeks ago that I'm a mentally strong person who's mental strength is being tested to the limit at the moment... it really really is, I can cope with anything but when you have to do it day after day, and those days turn into 13 months.... it's just too much...

Can I ask which emergency med you take to get through situations?

Thanks for your support and the lovely emoticon - that's very cute!!

xx
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CLKD

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Re: Severe Anxiety - is it wrong hrt meds or wrong anti depressants?
« Reply #53 on: April 23, 2024, 11:21:17 AM »

Fasting update: in the Sat papers it was suggested that fasting has no impact on over all gut health unless 1 is dieting; because the person continues to eat exactly the same processed foods in the same amounts  ::).  Of course I've binned the article  >:(.  We do fast over night so why bother at other times?  Me, if I went without breakfast by 11.00 I would be on the floor  :o- not a pretty sight  ::)

Although as hunter gatherers we would binge/starve as we have evolved socially it's obvious that people in the 1st World sit down to eat at specific times.  For convenience; i.e. breakfast, lunch, evening meal ; as well as when eating out with friends. 

Many years ago I read about eating 'correctly', the thought being at that time that we should take small amounts off the fork and chew slowly B4 adding more food.  Who has time  :D.  Another thought was to leave the table a little bit hungry.  I have found that not having pudding immediately allows my digestive process to work, after 20 mins I probably don't want pudding 'cos I feel full.  That doesn't stop me reaching for a bowl of ice cream at around 7.30 ;-).

I will have to search for the packet to find the name of the emergency drug.  Could you ask for 5mg of Valium to take the evening B4 the Event?  I used that successfully for many years, knowning that I could take another 5mg the next afternoon which I never required. 

Sugar cravings - r these cyclical?   Since eating less processed foods I feel less likely to reach for the sugar hit, other than a stick of 'twirl' chocolate as pudding.  There's a lot of recent research about how commercial foods 'feed' the bodies requirement for sugar  :(. [Chris Van Tulekan: it was too involved for me but DH is a scientist so would read out bits of interest that I was able to understand]

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