What to bridge when tapering off effexor

I have read that Prozac is good for helping with avoiding withdrawal because it has a longer half life. I don't know if that is what is meant as a "bridge." And that may be true of Cymbalta. Does your doctor have a preference?

Personally I would prioritize minimizing withdrawal (having seen the effects in a family member) vs pain relief. Then dealing with pain after fully off. SSRI"s are supposed to help with pain receptors but not sure if that is true of Prozac (or Cymbalta) so maybe that is something to ask.

Gabapentin, in our experience, is good for neurological pain (if tolerated) and helps with anxiety.

Your doctor sounds like a good one !

@julishka
I'd be curious why the doctor wants to add medication when your trying to get off it unless he's trying to stop your effexor to quickly. I'm wondering if your doctor is not taking into account the length of time you've been on this medication. This isn’t a medication you should expect to get off of quickly. Although bridging may be necessary for some people personally I would never do it since I've always gone off medications extremely slowly. It's been my experience that doctors often try to reduce your medication at two quickly thereby causing withdrawal effects. I stopped some powerful medications and all without any withdrawals and and I credit doing it slowly. as the reason.
Take care,
Jake

@julishka and @jakeduck1 I assumed a long taper. @jakeduck1 you are right about what doctors tend to suggest: "Cut in half for a week and stop.'!

Even when on an SSRI for a much shorter time, my family member needed to taper down over months, using small dose reductions and then, when at the lowest amount (I think the lowest was using liquid) doing longer time intervals between doses.

I have read that switching from a short acting SSRI to a longer acting one like Prozac can help with this but I do not remember at one point that is suggested.

@ julishka I may be misunderstanding your use of the term "bridge." I am using it as a term for concurrent meds at one point, with Prozac intersecting with the med being withdrawn, and then the Prozac being tapered. Prozac is easier to taper due to its long half life. Just wanted to be clear.

Doctors use a "bridge" blood thinner while going off and on Coumadin for surgery. I used Pepcid as a "bridge" for getting off omeprazole. In the latter case, I slowly replaced omeprazole with Pepcid and then tapered the Pepcid because it is shorter acting.

Thank you for your reply. I am hesitant to do the Cymbalta because as an SNRI I feel it is more of the same and I agree prioritizing withdrawal is more important.

Yes and she has done this the previous two times I tried unsuccessfully so I insisted on slow this time (I will be reducing beads by 10% per month), but I think she wants to have something in our back pocket .

Yes the bridge being when I get down to the lower dose (by reducing by 10% by counting beads) having something that will overlap and then tapering off that.

Found this on ZocDoc:
"Tapering is something of a hot topic among psychiatrists, and prevailing opinion in the field is changing. For years, it’s been standard for doctors to recommend 2-4 week tapering regimens. But two psychiatric researchers recently published a paper recommending an “extended tapering regimen, reducing [a patient’s] dosage by smaller and smaller increments, down to one-fortieth of the original amount.” This method takes months or even years, but researchers say it accounts for how antidepressants change brain chemistry, while the old way does not."

I also saw reference to the fact that it can be harder to go from 2mg to 1mg than from 20mg to 10mg. In other words the end of the taper needs to go even more slowly and use a liquid.

One article mentioned that Prozac's half life is 2-4 days. Effexor is 5-10 hours. According t that article the shorter the half life, the longer the taper needs to be. One person mentioned being put on Prozac at the end of a taper of Zoloft but it wasn't clear what the timing of that was.

I am so glad to see so much more info on withdrawal online. When my family member was coming off, there wasn't much at all!

@julishka crossposted! Thanks for the info on how the bridge med intersects with the one you are tapering.

What do you recommend for someone who must taper rather quickly, due to the liver damage effexor is causing? Withdrawal symptoms are terrible currently.

With all sincerity and respect, I strongly feel that your question is best addressed by a trusted doctor who is respected by peers for his/her knowledge and effectiveness with patients. Your question will probably receive answers on thes site, and if so, please consider examine all you can about the drug/dose and possible contraindications with whatever else you take.

I am truly sorry that the Effexor has caused you liver damage. This is the first that I've heard of that awful drug creating that situation. What does the doctor who prescribed the Effexor have to say about the urgency to taper with immediacy?

You've been added to my prayers, and hope you recover from your serious ordeal. I was on Effexor XR for about 15 years, and while I went through hell with it --- literally and figuratively--- thank God that liver damage did not occur. I sought the help of a trusted neurologist for tapering and ceasing this devil drug because I had little trust in the doctor who has prescribed it.