Accidental Cold-Turkey SNRI Detox: A cautionary tale
Okay, so this has been a fun (!!!!) little weekend excursion I feel compelled to tell people about, because Loki knows I couldn't find flippin' ANY helpful resources about it since my fate was sealed by 5:30 p.m. Wednesday. Let's hope nobody needs this ramble, but I'm a huge fan of JIC since the off-chance usually kicks me square in the ass at every opportunity.
I swear I didn't do this to myself on purpose. Due to a (holiday-fuelled?) clerical oversight, my next 3 mos of Desvenlafaxine prescriptions were not released to my pharmacy. After a week of daily "Oh, we'll fix that, sorry!" phone calls with no follow-through, I ran out. The day before Thanksgiving. Oh. Holy. SHITWEASELS.
[Do not, Dear Reader, ever take yourself off of psych meds with anything resembling abruptness. Cold turkey is fantastic for sandwiches but is the exact opposite for medication. Always use medical advice and oversight. This is not a DIY guide. This is for the unfortunate soul who is left with an inappropriately cheerful voicemail apologizing for any inconvenience in one hand, an empty bottle of happy pills in the other, and no idea what's about to happen to them.]
Day 1: Normal "Whoops, forgot my dose!" Shenanigans. For 100-150 mgs, symptoms may include the sensation of planetary tilting, forgetfulness, increased appreciation for pretty colors and/or light, and mildly impacted spatial awareness.
This will be the only time for about the next week that you'll be able to safely operate a motor vehicle, so plan accordingly.
Day 2: Everything Is Terrible. The brain zaps will commence as the first 24 hours comes to a close. Sometimes the zaps are accompanied by the perception of flashing light and/or extremely inconsiderate VROOSH sound effects. Mild to moderate dizziness and disorientation, derealization, and more forgetfulness will occur.
You may find yourself unable to sleep for more than two hours at a time. Frequent catnaps are your best bet. Oh, and fair warning: if you thought your dreams were vivid before, you're about to discover new realms. Upon waking, take time to reorient yourself. It is evidently not uncommon for SNRI detox dreams to be so sensory-laden as to feel entirely real. I genuinely feared I was suffering a psychotic episode. If face-melting unreality persists beyond 30 minutes after waking, seek medical help.
The nausea will also start today. I recommend thin soups, the BRAT diet, and Gatorade. Especially for my fellow hypoglycemics and our good friends the diabetics, I strongly suggest you keep some good crash foods on hand. You are not gonna have custody of those calories for very long.
Oh, and PS: to add insult to injury, you're gonna sweat. A lot.
Day 3: What Did I Do To Deserve This? If you have the ability, I strongly suggest barricading yourself in a dark room and listening to podcasts, or reading, or just any escapism. This is the worst day.
Brain zaps will increase in frequency and intensity. More with the derealization and disorientation. I found wall-leaning to be the most effective means of locomotion, because the dizziness is just horrid.
Hydration is key, because you're going to be in the bathroom for a good 40-60% of your waking hours. The next 48 hours will be a colon cleanse composed of hate and digestive betrayal. Expect intestinal rebellion 20 minutes after any type of food intake.
Today will also be emotionally turbulent. Have friends, family, pets, whatever on standby. There is a silver lining in that the artificial intensity means you'll have an easier time directing your feelings than during an ordinary (ha!) depressive episode; escapism is your best friend. Today is the day to sob violently over an episode of Archer or Pawn Stars. Do not, for the love of god, consume any media that contain genuine feels.
You have reached the peak of Mt. Shitstorm. Gradually things become easier from here.
Day 4: Time Dilation, and Do I Actually Need Skin? Having now been emotionally exhausted by gastric terrorism and the tragic character of Woodhouse, we leave the period of catharsis for a marginally more real world. While derealization and disorientation are still very much sidelining conscious thought, today should be somewhat better than yesterday.
Your perception of time should be returning, albeit in a strangely philosophic fashion. Minutes may pass quite quickly, but hours may take days. The strategic use of a timer may be necessary for something as simple as making tea.
Disorientation and confusion will lessen from "alternate reality in a yawning void from which there is no escape" to "sort of cute from an external perspective." You will no longer frighten your loved ones, but you will bemuse them.
But of course we can't see improvement without the addition of a New Hateful Symptom: itching. If you have one, it will itch. A lot. And it's entirely psychosomatic. Take advantage of your altered state by fooling yourself with a skin care routine. If you believe in the lotion or bath oils, they'll work.
Day 5: I Can See the Light, So Could You Just Stop Already?! With some small exceptions, your rational mind should now be more or less functional. Time has regained meaning. The corners of the world are still soupy, RealLife isn't exactly urgent, and if you turn around too quickly the world keeps moving without your permission--but it beats the hell out of Day 3. I still wouldn't recommend attempting to crouch, though; I fell down trying to pick up a potato I dropped on the floor earlier.
While still a gurgling, resentful mess, your gut should be in the process of negotiating a cease-fire. Brain zaps will gradually downgrade from Murder Lightning to Really Really Super Irritating.
You should now be somewhat more self-sufficient; e.g., using a cheese grater without maiming yourself, not falling down in the shower, etc. Driving a car is still right the hell out.
Day 6: THE END IS NIGH. TAKE THAT, IDIOT BRAIN!! Brain zaps are down to a minimum, which is great, but do expect to be annoyed by everything. Just everything. If you've never experienced PMS-related grouchiness, today's your lucky day!
Anticipate the return of your motivation coupled with a frustrating lack of ability. Vacuuming the floor without getting a severe case of the spins is a possibility, but the conclusion of your Sisyphean task will be accompanied by the sensation of continued movement. All repetitive motion is a carnival ride... but only after you stop.
Mental accuity is nearing normal levels, which is why your mouth's inability to convey adult speech without sounding drunk will make you want to smash adorable bunny rabbits into the drywall. (Be sure to Pin it if you do. #Rustic!)
Stomach upset is still fighting a flagging guerilla campaign, but now should be at mere irritant levels. Sources are murky on whether drug interactions are still risky at this point, so Pepto and mint tea are probably your only friends.
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