Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

Posted by richyrich @richyrich, Nov 2, 2016

I have been taking Effexor/Venlafaxine for years and tried to get off it a few times but each time I try to give up the chemical withdrawal symptoms are a horror story and I give up giving up. Anyone got any tips or tried and tested strategies? Thank you

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@simon007

NJOYS, Hi. Update & your above post. It took me 4 years to titrate down from 75mg Ven/Effexor XR, as you say , by progressively reducing down. By crushing 3 -2 - 1 capsule beads , diluting them & syringing down at small degradations, from a measuring pot.
Was on Ven / Effexor April 2017 to *Oct 2018, *when titration off started. Got 90% of side effects, titration did not reduce these in any way. 2 years after titration, I was still getting bleeding spots , headaches, anxiety, blurry vision, light sensitivity, dribbling etc, I can go on. BUT, in the past 2 months some of the more minor side effects have stopped. I gather from M. Horowitz & other Professionals / feedback , some years lie ahead before recovery . anxiety persists along with other major issues. CAUTION, weight gain from these meds can in turn, cause high levels of Glucose & possible pre-diabetes. Regards

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4 years? Something wrong with that. That would make it the worst drug in the world BY FAR!! You needed something to go along with your withdrawal process.. boy I am sorry!!! That's horrible!!! Iwas taking 150 mg for 12 years. In 2 weeks I went to 75 mg no problem. Then to 37.5, that's when the problems started. Stopped there and went back to 150. I needed to take something anyway
Now I've been switched to pristique 50 mg. Switch took 3 days and no withdrawal. Now coming off the pristique I don't know. But at least it's only 50 mg. We'll see maybe.

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I have been taking 60 mg in morning and 60 mg at night for probably 8 years. Recently, I saw a Mayo psychiatrist that realized I was on three of the same type of medicine class which can be very dangerous. He made recommendations for me to first come off of Cymbalta because I feel like it is no longer benefiting me in anyway. I am now working with a new home psychiatrist that is working off of the recommendations from the Mayo doctor. I have been weaning off of Cymbalta for several months now. We started with the night dosage because he said it could be causing some of my sleep issues. We went down 20 mg for a month, down another 20 mg for two weeks, and another 20 mg for two weeks. I’m completely off of the night dosage now and haven’t noticed any withdrawal symptoms others talk about. At 60 mg Cymbalta can help with pain and since I have a lot of pain does psychiatrist wanted me to monitor my pain for a month at 40 mg. That is where I’m at now for about two weeks and I can’t tell a difference in my pain level and still know withdrawal symptoms. So for me, taking it extra slow and being patient is working to come off of it.

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@rfinley2024

Yes, would like to hear more o. Your protocol for tapering off Venlafaxine with minimal side effects. Thanks

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I would like to hear your protocol

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@simon007

Frances 007, Hi. Regarding dropping down from 75mg EFFEXOR XR to 37.5 mg. This was done with ease * over 3 months or so. Compared with what was to follow. * I had no noticeable reactions, barring a short term (1 week) "step down" withdrawal jolts to my system, each time I dropped down to 37.5 . These reactions were short lived. The REAL issues, (as is commonly experienced by others), come when titrating down from 37.5 to zero. In fact, I was eventually **diluting individual beads from a 37.5 MG slow release capsule (3x beads in each) so, 3,2,1 beads. Then** syringing down in a diluted pot @ 10ml degradations , every 2 months 3,2,1 beads. This took 24 months. BUT, as someone else here has said. The withdrawal effects DO NOT STOP @ zero pill taking! No one knows , as it on a individual basis, as to how long the final , (after pill taking), withdrawal / side-effects issues will last. I have identified 3 to 5 years ! Also , the effects go away & come back over this period. Recent info I have secured , indicates about 50% of people have NO issues with EFFEXOR withdrawal and can even stop quite abruptly. But the rest are all over the place. Critically, as has been commented on here, it is the PACE of titration off that is key to mitigating these severe issues in the most sensitive of people. To stop @ 37.5 is not recommended.

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Why is stopping at 37.5 nor recommended?

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@mmsm

Why is stopping at 37.5 nor recommended?

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I have previously researched & looked at feedback from multiple sources. It is clear people react very differently as individuals. Both in how high an mg dose of Anti-depressant they can tolerate. And , how quickly they can then titrate off of them. It seem that , as with me & effexor / Venlafaxine, dropping down from 75 mg to 37.5 mg can be done by many people in quite a short timeline. BUT, it is commonplace that then dropping down from 37.5 to 0, has to be done MUCH more slowly. I have seen many cases reported, where withdrawal symptoms get much more severe, post the 37.5 mg dose. Having said that, I am in the lowish % of people that are hyper sensitive to ANY Anti-depressant. So, the hyper slow dropping down from 37.5 took a long time to be able for me to cope with the withdrawal side effects, at each stage of reduction. At the extreme opposite, Some people can stop & start taking any Anti-depressants at will, with very little adverse effects.

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@simon007

I have previously researched & looked at feedback from multiple sources. It is clear people react very differently as individuals. Both in how high an mg dose of Anti-depressant they can tolerate. And , how quickly they can then titrate off of them. It seem that , as with me & effexor / Venlafaxine, dropping down from 75 mg to 37.5 mg can be done by many people in quite a short timeline. BUT, it is commonplace that then dropping down from 37.5 to 0, has to be done MUCH more slowly. I have seen many cases reported, where withdrawal symptoms get much more severe, post the 37.5 mg dose. Having said that, I am in the lowish % of people that are hyper sensitive to ANY Anti-depressant. So, the hyper slow dropping down from 37.5 took a long time to be able for me to cope with the withdrawal side effects, at each stage of reduction. At the extreme opposite, Some people can stop & start taking any Anti-depressants at will, with very little adverse effects.

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I want to be sure I understand, as it is my plan to drop VERY SLOWLY from 75 to 37.5 mg, then stop for a while. IF I want/need to completely get off the effexor, I will do it extremely slowly in the future. Does anyone know if protracted withdrawal can still happen if I'm on a small dose of the effexor? This is a big concern of mine, as I know I reduced dosages quite quickly, even though I suffered withdrawal during the process.
FYI - With guidance from my GP, I first dropped from 225 to 150 (33%), and ended up in the Psych ER. I then dropped by 37.5 mg to 112.5 (25%). This was more manageable. The next reduction was again 33% down to 75 mg. I have been at this level for two weeks so far, and continue to struggle a great deal. I plan on weighing the beads in the capsule to slowly drop to 37.5mg. The effexor has caused very concerning liver enzyme levels. While I want to protect my liver, I also want to protect my brain!

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@mmsm

I want to be sure I understand, as it is my plan to drop VERY SLOWLY from 75 to 37.5 mg, then stop for a while. IF I want/need to completely get off the effexor, I will do it extremely slowly in the future. Does anyone know if protracted withdrawal can still happen if I'm on a small dose of the effexor? This is a big concern of mine, as I know I reduced dosages quite quickly, even though I suffered withdrawal during the process.
FYI - With guidance from my GP, I first dropped from 225 to 150 (33%), and ended up in the Psych ER. I then dropped by 37.5 mg to 112.5 (25%). This was more manageable. The next reduction was again 33% down to 75 mg. I have been at this level for two weeks so far, and continue to struggle a great deal. I plan on weighing the beads in the capsule to slowly drop to 37.5mg. The effexor has caused very concerning liver enzyme levels. While I want to protect my liver, I also want to protect my brain!

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I have bought the book ‘ The Maudsley Deprescribing Guidelines’ by Mark Horowitz and David Taylor. It is not cheap; I paid
£ 40.00, but it is excellent, and worth every penny. It will tell you everything you need to know, and includes charts of decreasing doses and timelines, starting at various dosages. The Maudsley is a renowned hospital in London in the U.K., which specialises in mental health issues.

Before I bought this book, I had attempted to reduce from 300 mgs per day, having taken velafaxine, (effexor) for the previous 20 years+. I managed to lower my dose to 75 mgs per day. On reaching this level and having no smaller dosage tablet, I tried taking one 75 mg tablet on alternate days. This was it turned out, the worst thing I could have done. Instantly I was hit with appalling withdrawal effects. Unfortunately, my G.P. announced that she had no experience with this, and that I knew more than she did on this subject. Fortunately I discovered the Maudesley book. Nevertheless I ended up back on the full 300mgs of venlafaxine per day. Despite that I have had a severe skin problem over the entirety of my body, including for example, my ear canals. This was roughly one year ago. I have now, four weeks ago, started again to reduce my venlafaxine dosage. This time however using the guidance of the Maudsley book. The chart I am using is one which starts at
300 mgs daily. After my previous experience, I shall be deliberately taking the longest recommended times between doses. I do not want a repeat of what happened before. I will keep posting about this second experience as it continues. I hope it may help someone.

By the way, I have nothing whatsoever to do with either the Maudsley hospital, the authors of the book, or anyone else. I am recommending the book purely in a personal capacity.

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@zainahelizabeth

I have bought the book ‘ The Maudsley Deprescribing Guidelines’ by Mark Horowitz and David Taylor. It is not cheap; I paid
£ 40.00, but it is excellent, and worth every penny. It will tell you everything you need to know, and includes charts of decreasing doses and timelines, starting at various dosages. The Maudsley is a renowned hospital in London in the U.K., which specialises in mental health issues.

Before I bought this book, I had attempted to reduce from 300 mgs per day, having taken velafaxine, (effexor) for the previous 20 years+. I managed to lower my dose to 75 mgs per day. On reaching this level and having no smaller dosage tablet, I tried taking one 75 mg tablet on alternate days. This was it turned out, the worst thing I could have done. Instantly I was hit with appalling withdrawal effects. Unfortunately, my G.P. announced that she had no experience with this, and that I knew more than she did on this subject. Fortunately I discovered the Maudesley book. Nevertheless I ended up back on the full 300mgs of venlafaxine per day. Despite that I have had a severe skin problem over the entirety of my body, including for example, my ear canals. This was roughly one year ago. I have now, four weeks ago, started again to reduce my venlafaxine dosage. This time however using the guidance of the Maudsley book. The chart I am using is one which starts at
300 mgs daily. After my previous experience, I shall be deliberately taking the longest recommended times between doses. I do not want a repeat of what happened before. I will keep posting about this second experience as it continues. I hope it may help someone.

By the way, I have nothing whatsoever to do with either the Maudsley hospital, the authors of the book, or anyone else. I am recommending the book purely in a personal capacity.

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Well done Keep up the effort
You can be prescribed m
Venlafaxine 37.5 mg tabs

When you need to go lower as per the Maudsley chart your GP should prescribe the liquid solution. That has 37.5 m /5ml I get mine from Boots on prescription

Buy syringes on line to be able to take decreasing doses
There is no shortcut Decrease very slowly
Best wishes

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@looplu79

Well done Keep up the effort
You can be prescribed m
Venlafaxine 37.5 mg tabs

When you need to go lower as per the Maudsley chart your GP should prescribe the liquid solution. That has 37.5 m /5ml I get mine from Boots on prescription

Buy syringes on line to be able to take decreasing doses
There is no shortcut Decrease very slowly
Best wishes

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Thank you for your message! In the book the amounts are so small that you have to dilute the venlafaxine for the last dosage . The smaller dose, the longer time in between dose changes. A copy of this book should be in every GP surgery. They happily prescribe these drugs, and yet it seems that many/most understand nothing about the safest way to deprescribe these medications. The thing that annoys me most, is not the fact that my doctor has no experience in this situation, but that she appears to have made no effort whatsoever, to educate herself about the subject in the past year! To say that I am disappointed in this is an understatement.

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@zainahelizabeth

Thank you for your message! In the book the amounts are so small that you have to dilute the venlafaxine for the last dosage . The smaller dose, the longer time in between dose changes. A copy of this book should be in every GP surgery. They happily prescribe these drugs, and yet it seems that many/most understand nothing about the safest way to deprescribe these medications. The thing that annoys me most, is not the fact that my doctor has no experience in this situation, but that she appears to have made no effort whatsoever, to educate herself about the subject in the past year! To say that I am disappointed in this is an understatement.

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When you get to very small doses you have to be most careful
Just missing one dose can leave you feeling horrible
Many GPs have no experience
A good service would refer you to mental
Health team dealing with drugs
There seems to be very few of those so we have to care for ourselves

My friend is married to a doctor and all her family are doctors but she tried to come off another antidepressant by alternating days and had dreadful side effects
I loaned her my copy of the book

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