my doc never warned me that suddenly stopping effexor could be a problem. i ran out for a week, and it took about 1/2 a day to start feeling horribly sick. i asked the pharmacist when i picked up the refill if withdrawal from effexor could be causing me to feel like i was dying, and he said, "absolutely not. no way."

assholes.

These are drugs designed to fundamentally change the chemistry of our brains, of course stopping -- either suddenly or gradually -- is going to be painful. Dropping off them for a week or two because you run out is a good way to seriously mess yourself up physically and mentally... If you want on these pills only do so with the help of a trained professional, and it's the same if you want off.

I'm sure GSK will claim there is no such thing as lamictal withdrawal...just your symptoms returning ;)

I take Lamictal also..250 mg and have been taking it for years. I guess I know what to look for if I ever go off of it. I read your blog everyday and find it very interesting.

Except for my frustration that my doc didn't tip me off that this might happen.

Are you actually surprised by this? Doctors DO NOT know about withdrawal. People DO NOT generally withdraw. It is in the doctors interest to keep people on drugs and usually because they withdraw people in the wrong way if they do choose to let someone try, they get a radical withdrawal effect that makes them think that the drug is needed. So they don't often even let people try to withdraw.

To make matters worse, there are a FEW people who have a very easy time of withdrawal so this makes it easier for the psychiatrist to believe that if someone had it easy then the 100 other people who have it hard must simply be relapsing.

This isn't written totally clearly--but I'm about to watch a movie...

Yes, effexor is a nasty one. Sometimes I'll get the brain shivers thing after missing only one dose.

But remember, these pills aren't "addictive" so you're not "really" going through "withdrawal," you're just experiencing "discontinuation syndrome." (yeah, whatever)

I would suggest reporting this withdrawal as an adverse effect because it is one. The reason there is so little documentation of withdrawal symptoms, is because most people do not report these to FDA-MedWatch Reporting by Consumers. Doctors are not required to do this, and some people just think they might have the flu, etc. and of course in general most people do not know about the FDA medwatch reporting system.

The more that is recorded as an adverse reaction, is how %% get into those prescribing packages that come with all medications.

Not only do most doctors not warn patients of withdrawal effects, most doctors do not explain the prescribing information in detail.

This is an important step everyone here who has suffered withdrawals[including myself removing Seroquel]should take, to get the "officials" hearing consumers loud and clear.

Most people, when we read anecdotal stories say the withdrawals worse than any other symptoms or adverse affects.

I also agree, that though feeling out of sorts in the withdrawal stage, the mood can feel fine.That right there befuddles most doctors.

Continued best wishes and give it time, and keep documenting here, it's going to help others.

Well you know I can't leave the fine print research alone if I wanted to.I have all of my Lamictal given to me via Pharma reps. I'm going to work on a post about this but will start here with the Pharma rep freebie insert that came w my 25mg. Lamictal package.

"If your doctor decides to stop your treatment, do not keep any leftover medicine unless your doctor tells you to.Throw away your medicine as instructed."

GSK-GlaxoSmithKline@August 2005."

So, did your doc tell you to throw it away? That is the only reference to stopping the medication listed in the GSK "Information for the Patient" paperwork that comes inside the samples given to psychiatrists.

All in all, I'm trying to remain positive about the whole experience. I mean, I've taken Lamictal for three years, so what did I expect?

That is a great point. Could you imagine what a bitch you would be right now if were trying to quit smoking?

Link to:
FDA-Med Watch Reporting for Consumers

Psychiatrists can't deal with side effects nor withdrawal syndromes as these problems are outside of their very limited frame of reference. Shrinks seem themselves as healers (I see them as drug reps, one step removed) and they're unable to deal with the mess that they make.

Effexor is an especially nasty one. My cousin is on a low dose and simply forgot to take it for a couple of days (she was moving). We ended up in the emergency room as she was dizzy, falling over, seeing blinking lights and had vision swim (that ghastly feeling when you swing your head but your vision can't make the transition for a couple of seconds).

As she's a brain cancer survivor, she quite reasonably thought she had another tumour. She was fine once she took her next dose. I can't believe this kind of information isn't put on those information slips you get from the pharmacy when you get a prescription.

I think Angie brings up a good point, about what I think could be how we all have a "vice". When I reduced Seroquel, I had to have junk food that I had given up. By the end of the day it was Doritos and a diet coke, which I had also given up. Then I made sure to watch the junk food intake because I was glad to be rid of it. When life pressures increased[finances,hospitals, work and lack of it]I started needing PRNs.[in other words, I didnt use doritos and diet coke I went for xanax]You mention you took an Ativan to help ride out the Lamictal removal. You most likely do not want or plan to stop smoking cigs or cigars and I wonder if that has increased, meaning what if---we can use psych drugs as vices the same as alcohol,food,tobacco,sex, etc.
So, in fact maybe it's okay to remain on some Lamictal, [just thinking outloud in general terms here]instead of having that extra Ativan, smoke,booze,food or sex[whatever applies].
I don't think I know any one who doesn't have something we use to get through the day, even if it's a coffee and donut, soda and chips, booze, etc. I wonder if situational stuff is more of a culprit than we all think, and maybe Lamictal is like a bag of chips.Either way a person looks at it, what's the difference if it's chips or Lamictal, we all use. I bet there isn't one person reading this that doesn't have a vice.So in a way what does it matter which one it is. And prescription drugs are "safe" compared to alcohol and tobacco right? or transfat?

I wonder if there have been studies done comparing the saftey of lamictal to alcohol, tobacco, or even transfat. It's an anticonvulsant that no one knows that much about but probably in the end causes worse side effects than alcohol, tobacco or transfats. I've read that people who are manic can benefit from marijuana but unfortunately, it's illegal.

I can't help but think ... before you file a report, have you ever considered that this might be closer to WHO you really are? And that you're feeling it in fully personified force? You said:

"I hadn't mentioned the irritability yesterday. A few weeks ago when I got into the 50 mgs. a day range, I noticed that I'd begun getting very snappy with my friends."

I mention this because today, I went off in the parking lot of Wally World, the snappiness culminated by two Latinos discussing a plight with WW's bank, and yes unintentional eavesdropping I was...once again I heard of 2 MORE people getting ripped off royally and yes, quite snappy was my sudden motive of operation, and they weren't even friends. So I righteously shifted the snap, and explained to them how they were being victimized, then suggested a solution and word-a-mouth snap to-it message: "tell all amigos!"

See, I am not biased, and I hekyll-jyde any moment when our "locals" -- the political commentators and commerce giants, exploit people, any people, and where I live, many of those people are Latinos. I get f-ing snappy, too, and I'm withdrawing only from biz-as-usual and SOP.

Then I waited around to see if I needed to go to customer no-service to ombuds a few English and well-understood words on the couples' behalf.

(om being much better but less effective at WW)

All is well. Problem solved. And I'm not on meds.

Sometimes it is not bad to feel 'bad' or 'snappy' things, it just takes getting used to...

Namaste, all is well, PD, you are fantastic!

I read a quote once and rather liked it.

"The more you become like yourself the odder you become."

My self can't stand a ripoff. And if I'm odd, then so be it.

So, as you say, "...I've taken Lamictal for three years, so what did I expect?"...

Then my response is expect a wake-up call. If it solves problems while it happens, the problemos may be justified after all. ;-)

I was being sarcastic about prescription drugs being "safe" because they are prescribed by doctors, approved by the FDA, yet all of the other things like alcohol,tobacco,transfat get bad press. All of it does something to the body and some of those so called "safe meds" ruin livers more than drinking booze. I guess what I meant to say is in the end we "choose our poison" and hope to come out of it intact and happy.

Stephany, I realize I'm preaching to the choir, but this is the thing, when someone takes a drink or eats an onion ring (my favored poison) they already know the dangers and are choosing to indulge anyway. "Patients" are tricked into taking psych meds, lied to about their benefits and side effects, and such. I'm reminded of the ads in magazines in the first half of the 20th century that touted the health benefits of tobacco, completely false and completely believed until somehow the public caught on. (Disclosure: I'm a reformed tobacco smoker. I don't smoke marijuana).

The only meds that I know of that have extremely well "anecdotally" published discontinuation effects are Paxil and Effexor. Regardless, unless you're having some ugly side effects and you just can't handle it, a slow taper is best to err on the side of caution--just to let your brain adapt.

And a trick for Effexor? Once you get down to a low enough dose, take a tiny (i.e. initial dose) of Prozac for just a few days. It tricks your brain into thinking it's still soaking in enough Serotonin. I've done this before and it helps. I've never been on Paxil but since it's an SSRI, I don't know if it would work in the same way (Effexor is in a different class.)

I haven't had any problems going off any of my meds when needed--and my GP who was treating me at the time for most of them usually yanked me off them fairly quickly.

I actually yanked myself off of Lamictal as I broke out in a rash and it was unbearable--my entire body. I didn't have any other "get yer ass to the hospital" symptoms...fever is a big one. I was on a fairly low dose though. It was ruled a viral exanthema and I was put back on the med. It was a weekend so I just doped myself up on Benadryl and that seemed to help for the most part.

But I haven't found any discontinuation issues in the literature either for any of the ACs. Mostly it's got more to do with people that have seizure disorders--not for Bipolar.

PA--I had a recent rash on Lamictal and it was full blown welts not even hives. I was feverish and loaded up on Benadryl per it being a holiday and it was gone after a few days. I never stopped the Lamictal, I figured SJS wouldn't kill me overnight. I guess we play with fire on these meds.

My husband was, I suspect, incorrectly prescribed Lamictal after SSRIs did not aleviate his anxiety-induced depression. Effexor also did not work and was a nightmare to get off of. But Lamictal has proved impossible. When he tried to titrate down slowly (from 150 mg. over several months) he developed burning sensations in his skin. At 50 mg. he ended up in the ER with heart attack symptoms and was told it was from going off Lamictal. It was recommended that he go back up to 150, which he did. He's still in bad shape. He's lost his appetite and about 15 lbs. He has terrible headaches, dizziness, difficulty focusing, exhaustion, and anhedonia. He says he feels worse than he ever did before the psych med nightmare began 6 years ago. Apparently Lamictal withdrawal syndrome is rare, but he's having it. Even after he's gone back on it. Has anyone heard of any experience this severe with Lamictal?

One thing I really wonder about is that, after several ill considered withdrawals from psych drugs, is it possible that it just catches up with you and no matter what drug you're on you finally have some awful reaction? I wish someone out there was studying the cumulative effects of going off psych drugs one after another and especially going off them too fast. I do think there are probably some lasting effects that are not understood I'm sorry to say.

Sara,
I think you are correct.The long lasting effects, from too many meds and withdrawals from them. I'm like a broken record here, but considering the boatloads of meds my daughter has taken over 8 years, and how she has never recovered from 2yrs. ago summertime withdrawals from Depakote,Lithobid and Zyprexa; makes me wonder about all of this quite a lot.
Cumulative effects are often considered for allergic reactions for medication, such as codeine for example. It's not the dose or how or when a person might react, it's an individual's cumulative result of the use of the medication. That is unpredictable, and thus the beginning of the question of long-term effects of psychiatric medications starts. I feel the body often responds especially in withdrawals as if it is having an allergic reaction.Which takes people by surprise, because most people do not think about how bodies react to removing a chemical.
It can often be a negative response[I know I had one coming off of Seroquel, swollen face, brain zaps, the fatigue, it was horrible] and Benadryl helped, which is a curious thought as to "why?"

I feel, that some people may in fact not need the medications they started on, but in fact may have long term damage, and when I say damage I mean psychiatric symptoms as damage: such as permanent psychosis, that often is just written off by doctors as "the illness", when in fact is an unprovable injury caused by the medication use.

Regarding the post written by jk above: the withdrawals could be from the Effexor, depending on when that was removed, there could still be withdrawals happening from it.

I hope this isn't true. He's gone off Serzone, which was easy. Some other SSRIs that I can't remember the name of (because I'm so worried about him) were a piece of cake next to Effexor. But this Lamictal is way more painful to get off of. It's interfering with his ability to get up in the morning, do his work, he's so miserable he can't "stand being" as he says. One of the worst symptoms for him is dizziness, because he can't drive, do his work, or anything else. He has both sleep disruption and sleepiness during the day when he wants to work. The burning skin sensation is also hell for him. My concern especially is the lackadaisical attitude of his prescribing psychiatrist ("If you just quit your job you'd be fine").
Well, that's not going to happen unless he ends up on disability because the psych meds have made him totally dysfuntional.
His primary care physician is a useless nimrod, too. He's the one who started this whole cycle.

jk:

Google "effexor withdrawal venlafaxine" and read this medscape article titled "Venlafaxine, Withdrawals, warning to drivers". [I can't get the link to work]

" ..withdrawal symptoms as "serious": agitation, anorexia, anxiety, confusion, impaired coordination, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting."

Though this article is in discussion regarding Effexor, I believe [and this is just an opinion, based on my own experience withdrawing from Prozac and Seroquel, which are 2 different medication classes. I experienced the same withdrawal symptoms, and it took 6 or more months for the withdrawals to stop.

I would take a look at the timeline of when the Effexor was removed, how fast, and was it administered while on Lamictal. Some people report in that it can take months, and years to recover from medication withdrawals.[which come in the form of physical and disabling symptoms]. Most general doctors[PCPs]do not understand the medication they prescribe or how to advise a patient to remove it. Same for the psychiatrist that thinks quitting work will help.

Here is a series of posts I wrote during my removal of Seroquel[antipsychotic] and once again I need to say the symptoms were about the same coming off of Prozac.[antidepressant]In my opinion, withdrawals can happen on any one of these psych meds, even Lamictal.

My Seroquel Withdrawal Experience

Also, the author of this blog Bipolar Blast is writing in detail her experience withdrawing from psych medications and Lamictal is one of them.

Stephany and Sara,
Thank you so much for this information - so helpful. I will check out these links and show them to my husband, along with these posts. It's so helpful to have some support - I've really been struggling with this on my own for a long time.

A positive development: even though we've told his doctors and the numerous pharmacists I've spoken with about the dizziness problem, a solution did not present itself until last night.

I'm very persistant and continually research and call around for information and help. Last night a young pharmacy intern at an all night pharmacy recommended trying dramamine for the dizziness. I immediately went and got some.

Since my husband started the dramamine (1 last night, 1 today) his dizziness and headaches are gone. He almost sounded like his old self today. He's so super sensitive now to everything, that we're lucky he didn't have a bad reaction to it.

This gives me hope that one by one, we can beat these symptoms and the evil drugs.

Does anyone have a suggestion for dealing with his burning skin sensations? It feels to him like bad sunburn, even occuring at night. He uses a lot of aloe, which helps a bit. It isn't visible, so I don't think it's The Rash (plus he had a liver test at the ER two weeks ago).

It's also very helpful to hear that there may be continuing problems for a while even after he's off the Lamictal. I'm sure the MDs will say "Oh, his depression is coming back", but this time we won't succumb to these medieval, chemical sledge hammers.

I think he got off Effexor (this is worse than heroin) two years ago. I can't believe the parade of psych meds his poor brain has had to endure.

I also want to add in response to Stephany's comments on coping, that my vice is classical music. It provides total escape for me, especially if it's vocal. The more detailed, the better. I'd be a goner with out it. And food's not so bad either....

Again, many, many thanks.
jk

I plan to try Benadryl tonight - thanks for all the input. If that doesn't work, I'll get Dramamine. I have been on Effexor for several years - up to 150 mg. I started feeling like it wasn't working a few months ago so my doctor very slowly cut me down to 37.5 mg 1x per day. A couple of weeks ago I was dianosed with bipolar disorder and the psych doctor put me on a schedule to up the Lamactil as I was reducing the Effexor. I thought I was going to die. My head was spinning, I became sick with a bad cold - feeling somewhat better today - I felt out of control and I still have a lot of dizziness and the feeling that when I turn my head, my brain doesn't turn at the same speed. I kind of feel like I'm in some time warp or I've had way to much to drink!! I am having hot flashes all during the day and night. I even have a fan blowing directly on me at night. I wake up several times during the night feeling like I'm in an oven then I break into a heavy sweat which leaves me wet and freezing. I feel like a drug addict trying to come clean!

Dramamine was mentioned by my psychiatrist for any dizziness coming off
Effexor, however I was only mildly dizzy for a day. My daughter used Dramamine for dizziness post Effexor and it worked.
I have not looked for any forums where people are happy with the results of using mood altering prescription drugs but Prozac and Celexa really saved my life in years past. I think the spectrum of what is called "mental illness" has broadened to the point where many people are being treated for "depression", but it is the kind of depression that results from a state of severe exhaustion.
I am 60 and remember movies where people took "rest cures." (One of my favorites is NOW VOYAGER.)
However, some people, and I include myself in this category, have life threatening depression and mania. To give me a psych med might then have a very different effect than on someone who is desperately run down, defeated by life in a sick culture, under too much pressure, lacking fresh foods and little exercise.
I compare it to giving insulin to a non-diabetic. Does that make sense to anyone?
The rise in the use of anti-depressants is correlated to the inability to take time off without losing one's home, health insurance, etc. The pills keep people functioning, but prevents people from coming to grips with an unnatural life. No escape! It is common sense that to sleep too little, work excessive hours, eat fatty chemically altered food, and be consumed with worry would result in despair. The symptom indicates the anti-dote.
Also there was a reference to Marijuana as a good herbal treatment for mania, except for it's legal status. When I was young I smoked it and found instant relief from mania and extended rages - again, however, I did not get "high" like people who were not bi-polar, I went to sleep. Same with alcohol, I have never gotten a buzz, only sick from having a drink.
There was a reference to people "facing themselves" coming off mood altering medications, the crabby words, generally anger. I think there is some truth to that, but only the individual would know how to evaluate erupting emotions. No one complains about love erupting out of our mouths, and why does that not seem to happen?
What makes it always anger? I found this site helpful in that regard www.gocure.com ...
I wish you all well, this blog is delightful, so many intelligent writers, such specific information.
I am almost off Lamictal and found the debilitating feelings went away after reading the posts yesterday, it is the fear of symptoms that intensifies them for me. Now when I start to feel odd I tell myself, "Oh, my brain is adjusting. I will let it rest then." Within a short time the aggravating symptom has passed. In 2 weeks I will be off all medications, and time will tell.
As for supplements...enough B vitamins, zinc, magnesium...there are many sites with specific recommendations for those who use these medicines.

Hi there,
Question for one and all. I was taking over 150 mgs. of effexor when I went totally manic. Got off the effexor and started ramping up to 500 mgs. of Lamictal plus 2.5 mg of zyprexa. Have since weaned myself off the zyprexa (40 pounds later). I have also reduced the Lamictal to 200 mg -- as I was having so many language and memory problems that I was unable to function. I still have lots of memory, concentration and language problems (major issue as I am an actor). I would like to try weaning myself off the lamictal altogether. My hope is that the mania was triggered by the previously large doses of effexor. These postings have really offered great insight and encouragement to be Lamictal-free. But I live in terror that I will become manic again once I get off the Lamictal. Manic episodes have essentially ruined by personal and professional life irreparably. Are any of you worried about returning mania?

I'm not a doctor and though I've been labeled bipolar NOS, I don't really get the manic thing as I've never experienced it, still from what I know about effexor, I'd say as long as you stay away from it, it's likely you'll be mania free. Having been accused of mania, I've found journaling helpful. Keep a daily record of your energy level, pulse, bp, take a photo if you have a digital camera, weigh yourself, talk to friends, anything you can to self monitor in case you find yourself in a place you consider manic so that you will be able to decide how to handle the mania. Good luck!

Are there any cases of people who have gone off Lamictal and Effexor without the bad side effects? I recently (3 days ago) stopped both of these. 100mg Lamictal and 75mg Effexor. I wonder if I am setting myself up for a bad experience, or if others have been able to stop at these levels without problems.

dave, the best answer i can give you is that there are always cases of people who've managed to withdraw from those doses without problems. but as far as effexor goes, i've never met or spoken with one. i'm not experienced with effexor withdrawal myself, so hopefully some other readers will chime in here. as for lamictal, i can tell you that you are rolling the dice going cold turkey from that level. it might work, might not. i wish you much luck.