Hows day 2 on the new meds @Rekonum ?

@Steve1 few lightheaded, weak, and anxious spells but nothing like it was chest tightness wise

Just want to update everyone I’m doing lightyears better on my 37.5mg effexor and 0.5mg klonopin 2x a day

The chest tightness has went from 8/10 to 1/10

The only issues I’m having now is constipation (probably from starting effexor), heat intolerant to showers and hot weather still, and sometimes breathing feels off on klonopin (probably because I’m not panicking when taking it), but doctor wanted me to take it as a bridge exactly as he prescribed.. he thinks this will help calm this storm I been in and reset me and give the effexor time to take over..

Wish me luck.. Thanks guys

It would be irresponsible not to point you to accurate current reputable information.

Google search:

Yes, there is a substantial and growing body of evidence in highly reputable medical journals that addresses both the strict duration limits of benzodiazepines and the serious risks associated with using them as a "bridge" when starting SSRIs.

While older clinical practices historically utilized benzodiazepines for rapid anxiety relief, modern psychiatric literature heavily cautions against this approach due to the rapid onset of physiological dependence and long-term adverse outcomes.

1. The Dangers of Using Benzodiazepines Beyond One Week

While many international clinical guidelines traditionally capped benzodiazepine use at 2 to 4 weeks, recent landmark studies demonstrate that the risk of long-term dependence can begin after just 7 days of continuous use.

• The 7-Day Threshold: A major population-based cohort study published in PLOS Medicine (June 2026) by Dr. Nikki Bozinoff and colleagues tracked prescribing patterns and determined that initial benzodiazepine prescriptions spanning longer than 7 days were directly associated with prolonged, chronic use and a significantly lower likelihood of ever successfully discontinuing the drug.

• Rapid Dependence & BIND: According to literature in journals like Neurology International (2021) and the Cleveland Clinic Journal of Medicine (2026), physiological dependence can establish itself within weeks, and abrupt cessation can cause life-threatening withdrawal symptoms (including seizures). Furthermore, emerging research in a 2025 scoping review on Benzodiazepine Exposure in PMC highlights a condition known as Benzodiazepine-Induced Neurological Dysfunction (BIND), where severe, de novo neurological symptoms can persist for months or even years after stopping the medication.

2. Why the "SSRI Bridge" Strategy is Disfavored

The practice of co-prescribing a benzodiazepine to mask the temporary "activation anxiety" or insomnia that occurs when starting a Selective Serotonin Reuptake Inhibitor (SSRI) is increasingly scrutinized due to severe safety trade-offs.

• Doubled Overdose Risk: A study published in 2023 on PubMed examining Drug Overdose Risk with Benzodiazepines evaluated young adults initiating treatment for anxiety or depression. The data revealed that individuals who simultaneously initiated a benzodiazepine alongside an SSRI had nearly double the risk of a medically treated drug overdose (Adjusted Hazard Ratio of 1.99) compared to those who started on an SSRI alone.

• The "Accidental Polypharmacy" Trap: A primary reason medical literature warns against bridging is that the bridge rarely ends on time. A 2025 study on SSRI and Benzodiazepine Co-Prescription in PMC notes that individuals who are co-prescribed an SSRI/SNRI are uniquely vulnerable to much longer treatment durations and higher doses of benzodiazepines than intended, trapping patients in long-term dependency.

• Lack of Long-Term Benefit: In a comprehensive Cochrane Systematic Review looking at Antidepressants plus Benzodiazepines, researchers noted that while adding a benzo might provide mild, subjective anxiety relief in the first few weeks, it carries a high toxicity profile, risk of abuse, and yields no added antidepressant effect or long-term clinical benefit over taking an SSRI

by itself.

Source: National Institutes of Health (NIH) | (.gov) https://share.google/19B2j0UWPdrf6otpd

Experiences with benzodiazepine use, tapering, and discontinuation: an Internet survey - PMC https://share.google/Y6MYUxZFZXNhdtJwF

Source: Benzodiazepine Information Coalition https://share.google/oPWFJlAZwmFP3zE1e

I am very glad to hear that you are getting some relief. We would not deny that to anyone here.

Personally I would try and not increase the Venlafaxine if it is working okay at this dose. A sensitised nervous system often cannot tolerate so called "therapuetic" doses. 37.5mg might be the same as 300mg for your nervous system in terms of potency. As the old saying goes, if it ain't broken, don't fix it. That is, don't increase just for the sake of it if you are feeling okay. And remember that the higher the dose, the longer to get off in future if you want or need to.

Regarding Klonopin: you need to have a conversation with your prescriber and ask pointedly what the long term plan for this medication is. In addition to what @LostinCanada has said, there is some data that suggest daily use of benzodiazepines can cause cognitive impairment whilst taking them, and possibly be a risk factor for dementia. This isn't an absolute, but something to consider.

16 hours ago, Rekonum said:

Just want to update everyone I’m doing lightyears better

Glad you are doing better, it is great to hear. I suspect this is the Benzo that is helping you for the minute. Wishing you well @Rekonum.

Are things still going well @Rekonum

@Steve1

Not as good as first 3-4 days.. a little chest tightness here and there and still very very heat intolerant.. I get lightheaded and doom feeling in the heat.. other than that I’m okay

Also am pretty severely constipated since starting the effexor and klonopin regularly (I dont drink a lot of water though)

I have an upper endoscopy done tomorrow to see if I have some GI issues going on related to the chest

Edited October 6Oct 6 by Rekonum

2 hours ago, Rekonum said:

Also am pretty severely constipated since starting the effexor

The constipation is definitely the Effexor. I was on 37.5mg for 3 weeks at one point and the constipation was severe. Went away within 2 days of stopping it. It is unlikely to improve with time, at least, it tends not to for my patients who get that side effect. Many end up relying on laxatives to stay on the Effexor.

Let us know what the endoscopy shows. My prediction is that it will be normal. Your symptoms so far seem very consistent with Withdrawal.

I will admit that I am worried for you @Rekonum. I see someone who was suffering immensely and in desperation went back on an antidepressant and a benzodiazepine. But I begin to suspect this hasn't had the sustained benefit you hoped for. And now I worry that you will end up stuck on a strong SNRI and a benzo, still feeling quite unwell and now needing to taper these too. Have you had a think about how you are going to approach things if you don't continue to improve and/or go backwards in terms of symptoms?

5 hours ago, Sminismoni said:

begin to suspect this hasn't had the sustained benefit you hoped for. And now I worry that you will end up stuck on a strong SNRI and a benzo, still feeling quite unwell and now needing to taper these too

I agree with @Sminismoni

Because you haven't been on Effexor long, it is worth considering stopping.

It is well documented how the placebo effect can make us think they are helping when indeed they are not. We just want relief and a solution so bad that initially this is what happens.

Please analyze your situation carefully.

❤️🙏

But what should @Rekonum take if he stops. Just the benzo and gradually taper off?

3 hours ago, Steve1 said:

But what should @Rekonum take if he stops. Just the benzo and gradually taper off?

There doesn't need to be a replacement for a drug that hasn't caused dependency.

Edited October 6Oct 6 by LostinCanada

@Sminismoni @Chippy @LostinCanada

So what are your suggestions for what I should do if things don’t get better?

Come off Effexor quickly since it’s been a week and don’t reinstate lexapro either? What about the klonopin I’ve been taking?

I’ll add I have ED now I guess that’s from the combo of klonopin and effexor

7 minutes ago, Rekonum said:

Come off Effexor quickly

You are safe to do so but if you decide, don't hesitate...each day on it works towards dependency.

8 minutes ago, Rekonum said:

What about the klonopin I’ve been taking?

You are dependent on that and need a slow careful taper once stable

9 minutes ago, Rekonum said:

don’t reinstate lexapro either?

That will depend on symptoms showing up.

10 minutes ago, Rekonum said:

add I have ED now

You central nervous system has taken a beating. This can be from the lexapro CT.

Sorry to hear.

Thoughts @Chippy @SarahMc

hey @Rekonum haven't read all of your story but I had chest tightness and had an endoscopy and they prescribed amitryptiline for "esophageal spasms". Luckily I only took it for a day. Anyway I figured out the tightness was caused by my Adderal. I still get the tightness occasionally during times of stress but it's not even really an issue anymore.

@Rekonum Im with Lic, if you want to stop Effexor, do it now before you are depedant on yet another drug.

With your other drugs, its the same as before. Hold the Benzo till stable and then taper off. With Lexapro you could RI a low dose and sit on that and hope it props up SSRI WD. Maybe 0.5mg to start and updose from there. Your body has been through so much. At some point you need to stop and just wait for things to settle.

@Chippy

I have my endoscopy in 2 hours

After I guess I’ll talk to my doctor on the phone tell him to switch me back to lexapro and maybe even tell him to specifically call in the liquid version if he will..

Me and him had a pretty fiesty conversation when he switched me to venlaflaxine.. he thinks I’m being extremely hardheaded and I’m worried for how it could go when I tell him I’m tapping out on effexor after a week..

So hold 1mg klonopin a day and reinstate at 0.5mg of lex ?

1 minute ago, Rekonum said:

I have my endoscopy in 2 hours

Good luck let us know how that goes,

1 minute ago, Rekonum said:

After I guess I’ll talk to my doctor on the phone tell him to switch me back to lexapro and maybe even tell him to specifically call in the liquid version if he will..

Id be tempted to stick the tablets and if you choose to RI lexapro at 0.5mg we can help you do this making your own liquid, Just need some syringes. 10ml and 1ml same brand would do the job.

3 minutes ago, Rekonum said:

Me and him had a pretty fiesty conversation when he switched me to venlaflaxine.. he thinks I’m being extremely hardheaded and I’m worried for how it could go when I tell him I’m tapping out on effexor after a week..

He won't understand low dose RI at all.

4 minutes ago, Rekonum said:

So hold 1mg klonopin a day and reinstate at 0.5mg of lex ?

Would be my thoughts. @LostinCanada ?

@Chippy

Man I’m crying right now just scared.. How sure are you guys this is what’s going on with me because I’m not going to lie since switching to effexor I’ve been thinking you guys are fear mongerers, but maybe I’m just in denial..

I’m just tired of feeling bad and want to be normal and feel good again.. I mean did this kindling effect that happened at the July reinstatement mess me up for good and the benzo even complicate it even more? I mean if I don’t take this benzo and only took the 0.5mg lexapro I’d be at the ER everyday with all kind of weird scary symptoms …

Thanks in advance and I’ll let yall know about how the endoscopy goes.. already worried about taking sedation after taking klonopin since klonopin suppresses my breathing some

Goals: Not have chest tightness, not fear going out and dying, being able to take hot showers and enjoy them again instead of feeling BP drop, not have GI issues, be able to tolerate hot weather, etc

^ will these ever fix

Also am adding I think the Josef Witt Doerring guy is full of shi.. his clinic costs an entire salary for a year and I’ve heard people didn’t even get help.. if this is what I’m going through how am I gonna get through this when all the psychiatrists that preach it sell themselves out for money as well

Edited October 7Oct 7 by Rekonum

How are you getting on with Effexor @Rekonum . Are you getting worse every day?

Realistically your doctor will say your symptons are "normal" as side effects are to be expected.

I'm not trying to influence your decision, but best to be prepared with an answer if you do want to come off Effexor.

3 minutes ago, Rekonum said:

@Chippy

Man I’m crying right now just scared.. How sure are you guys this is what’s going on with me because I’m not going to lie since switching to effexor I’ve been thinking you guys are fear mongerers, but maybe I’m just in denial..

Im so sorry. This must be terrifying for you. We all understand. I trusted the doctors for such a long time. I found SA and honestly, I thought it was a bunch of people complaining about their weird symptoms and they must all be mad or neurotic or something. Better trust the professionals. Until they dropped me like a bad smell when they had nothing else to suggest. It was at that moment I realised I was on my own and what had happened to me.

I don't want to cause you any fear. Quite the opposite I want you to feel advocated for. That is what we are trying to do here. Support, not scare. If we scare you or you think this isn't a safe place then please don't come here. That isn't something we want to achieve.

We don't know what is your right move, or how long things take to settle. As you are no doubt starting to appreciate, there is no research and little support in the US for WD beyond 8 weeks or so. So we are just a bunch of harmed folk helping each other out. In the UK and worldwide as a whole, this bunch of halmed folk are the data that is driving changes within the health services. So we might be just some people on the internet but in reality this community (Not just this website) is making some serious moves (not serious enough) in the medical world.

We can only tell you what we have seen in others. You have to decide what is wrong with you based on your own research.

10 minutes ago, Rekonum said:

I’m just tired of feeling bad and want to be normal and feel good again.. I mean did this kindling effect that happened at the July reinstatement mess me up for good and the benzo even complicate it even more? I mean if I don’t take this benzo and only took the 0.5mg lexapro I’d be at the ER everyday with all kind of weird scary symptoms …

It all likley started, stopping the SSRI too quickly. This made your nervous system sensitive, then adding in the RI at the full dose made things worse. It is hard to know if the big cuts also upset things. It's possible, however as we said, staying at that dose (10mg) wouldn't have likley have helped in the long run and may make things worse. Now you have switched drugs which is another bunch of changes, it's all possibly making things worse. Is my guess. The Benzo is acting as brake and keeping things easier for you.

You will almost certainly not want to stop the benzo now, youll need to taper off that 100%

The new drug is giving you some nasty side effects by the looks of things. Stopping that before you are more stuck on it makes sense.

RI a small dose of Lexapro hopefully will act as crutch to help the WD from it without the reaction of a higher dose.

We can't really suggest anything better than that I am afraid.

Other then lots of time and patience and no further changes whilst things settle down for you.

16 minutes ago, Rekonum said:

Goals: Not have chest tightness, not fear going out and dying, being able to take hot showers and enjoy them again instead of feeling BP drop, not have GI issues, be able to tolerate hot weather, etc

^ will these ever fix

We can't tell you anything concrete. I would say it is very very very likley you will (like others have) improve over time when the body is left to heal.

How did you get on @Rekonum ?

@Chippy

Endoscopy showed nothing besides mild irritation in the stomach and he said chest tightness could be esophageal spasms that he’s giving peppermint oil for…

Sending this to my doc.. I will take the effexor until he replies tho.. (I’m 7 days in)

should get a response within a day or 2

Hopefully the 2 more days of effexor isnt gonna affect me that much.. dont want to do something stupid without doctor’s say so

sent this to doc:

“Having a rougher time on Effexor…

Severe constipation, erectile dysfunction which I didn’t have on lexapro and way more heat intolerant than lexapro. I’d rather just try the lexapro again honestly before the effexor is too much in my system; it’s miserable right now. Klonopin helps with the chest tightness some but fades..I think the klonopin is helping calm the storm where I don’t have to feel the need to rush to ER with whatever I feel.

 

Unless you think I should stay on it and not switch.. the ED and constipation is very very bothersome if it doesn’t subside.

 

Truthfully I think the klonopin is the only thing that is currently helping me and the other meds are just causing issues.”

15 minutes ago, Rekonum said:

@Chippy

Endoscopy showed nothing besides mild irritation in the stomach and he said chest tightness could be esophageal spasms that he’s giving peppermint oil for…

Sending this to my doc.. I will take the effexor until he replies tho.. (I’m 7 days in)

should get a response within a day or 2

Hopefully the 2 more days of effexor isnt gonna affect me that much.. dont want to do something stupid without doctor’s say so

sent this to doc:

“Having a rougher time on Effexor…

Severe constipation, erectile dysfunction which I didn’t have on lexapro and way more heat intolerant than lexapro. I’d rather just try the lexapro again honestly before the effexor is too much in my system; it’s miserable right now. Klonopin helps with the chest tightness some but fades..I think the klonopin is helping calm the storm where I don’t have to feel the need to rush to ER with whatever I feel.

 

Unless you think I should stay on it and not switch.. the ED and constipation is very very bothersome if it doesn’t subside.

 

Truthfully I think the klonopin is the only thing that is currently helping me and the other meds are just causing issues.”

That sounds good!

6 hours ago, Chippy said:

Would be my thoughts. @LostinCanada ?

Yes, stick with the Klonopin and 0.5 mg lexapro.

If your old prescription had repeats, it will still be fillable at the pharmacy. At least it is in Canada.

28 minutes ago, Rekonum said:

Having a rougher time on Effexor…

Severe constipation, erectile dysfunction which I didn’t have on lexapro and way more heat intolerant than lexapro. I’d rather just try the lexapro again honestly before the effexor is too much in my system; it’s miserable right now. Klonopin helps with the chest tightness some but fades..I think the klonopin is helping calm the storm where I don’t have to feel the need to rush to ER with whatever I feel.

You did good. Most of us have found that we can't be completely forthcoming with our doctors since they really don't understand the power in these small amounts.