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Detoxing

I used some of my sick days to sample a cross section of literature differing from my usual reading fare. I began reading Valley of the Dolls, doubting the relevance a 1966 Sex and the City-esque book would have some 50 years later. I was caught off guard when I saw a little of myself in each of the main characters. I identified with Anne, as naivete and blind faith led her into lackluster relationships. Neely’s lofty career aspirations led her to accept the unreasonable demands placed upon her. Jennifer sought to win the approval of her overly critical mother and used pharmaceuticals pacify her inner turmoil. I devoured the book in a single day and downloaded the movie as a follow-up. Spoiler alert: Neely ends up in a psych ward, Jennifer commits suicide and Anne continues to down “dolls” (read: sedatives) to remain complacent enough to tolerate her husband’s infidelity and her own unfulfilled dreams. It’s crazy to think that after all of this time, I’m still medicating myself to ensure a certain docility in work and relationships.

This book convinced me to come off of my psychotropic meds for good. First, let’s be clear: I don’t have an indication for any of them. An unfortunate series of events precipitated a depressive episode some 3 years ago and I was prescribed Effexor. Instead of reevaluating the need for the drug after the initial storm had passed, I continued taking it prophylactically. I assured myself that a low dose of Effexor (venlafaxine 37.5 mg) was hardly sufficient to have profound impacts on my mood or behavior. Yet if I ever missed a dose, I’d experience dissociation and brain zaps that sent me running back to the medicine cabinet post-haste. Eventually I began experiencing withdrawal even while on Effexor. Perhaps after 3 years, my body was adapting and required a higher dose to maintain the baseline. So while my fear of withdrawal had prevented me from discontinuing Effexor in the past, here I was experiencing withdrawal whilst taking it. I decided that enough was enough and I would come off cold turkey.

The first few weeks were rough. I was weepy and a sappy commercial was enough to induce a flood of tears. My brain zaps made it hard to concentrate or even function, and I spent all day in bed. I avoided driving and was perpetually irritable and averaged 4 hours of sleep per night. Online searches for managing Effexor withdrawal brought up a Medscape article featuring case studies where patients were simply restarted on Effexor to avoid withdrawal or online psychiatry forums where patients shared coping strategies. Since “online psychiatry forum” ranks somewhere in between “magic 8-ball” and “tarot card reader” on the credibility scale, I knew I was on my own with this one. What little research exists states that “venlafaxine-withdrawal symptoms are more likely to be caused by a lack of noradrenergic than of serotonergic action, contrary to the commonly accepted theory.” So easy peasy, right? I just needed to increase the noradrenaline in my brain with an ADHD med like Dexedrine (which I also have a prescription for) to ward off the withdrawal symptoms from Effexor, but I will eventually taper off both. Certainly the Dexedrine bridge, when I get to it, will be wrought with many of it’s own challenges.

So why does any of this matter? I know better than anyone the number of people who stay on their antidepressants indefinitely. Why not subjugate our feelings and continue taking “mother’s little helper” to cope with our ills? Personally, the times in my life when I was most depressed coincided with unhealthy external circumstances. I was either in a relationship where I was being terribly mistreated or I was working a toxic dead end job or I was enduring chronic back pain that required treatment. Medicating away the sadness would prevent me from taking steps to actually correct the situation. Perhaps if I’d continuously taken antidepressants since high school, I’d have been content to work my minimum wage job in a grocery store pharmacy indefinitely. Maybe I’d have settled down with a womanizing cad who’d expect me to support him. Or maybe I’d still be living with excruciating back pain that limited every aspect of my life. Despite the withdrawal, I couldn’t be happier being antidepressant-free. For the first time in a long time, I feel like a participant (vs. observer) in my own life.

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