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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@danalee5

@youngsally
When I was ready to go down from 37.5 my PC doctor told me to divide the capsules in half but the psychiatrist she referred me to for the withdrawal process (his main field is psychopharmacology) disagreed and said that not all the beads were the same and that it was not a good idea to do that. So he prescribed some 25 mg tablets so that I could split them as needed.

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Interesting -- I haven't broken open a capsule -- but there may be different coatings on different beads and they may be the same color.

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@grandmar

@youngsally
Good Morning!
I was on XR for years but after having weight loss surgery 2 years ago, I had to change to immediate release. After weight loss surgery, the body does not adsorb the way it used to. At that point, my psychiatrist did not know how I would adjust to the change. No problem.
Yes, I take 150 mg, twice a day.
Thank you for sharing your plan. I am worried that would be a little too quick for me. I actually take 2-75mg in the am/pm. I was thinking about cutting the evening 75mg in half for a week (or 2 depending on how I feel), thendoing the same with the am dose next.
I know I cannot do this without the guidance of a psychiatrist.
I don't know if you read, but my psychiatrist left so I have to find a new one, which I am working on. I actually think I found one, will call today.
Anyway, thanks again for all your sharing.
Have a great weekend!
Ronnie

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I recall you mentioning that you were looking for a new psychiatrist. I was concerned that you might be racing to get this done before you found someone. It won't hurt if you stay on a certain lowered dose for awhile. I have been at 37.5mg for 2 weeks - originally it was only supposed to be a week -- but my joyful (and hopefully brief) excursion into what menopause might have been like had I had any symptoms - was enough to get me to hit the pause button for a week. And if the titration down to zero is too weird - I might do every other day for a couple of weeks.

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@mrhappy

I did read this somewhere and felt that it was unusual also. I read that the physical container for all the little capsules had the time release properties not the individual capsules themself. If someone on this forum would provide accurate information that would be great!

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There is a comment somewhere on this thread where a patient says they were told that all the beads are not the same -- I haven't looked it up yet -- but it would throw the whole bead counting thing as an accurate titration method - out the window -- unless there are so many different types of beads that it doesn't really matter. But then I have to pull out a statistics book to figure that.

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@terri672

I suppose it would have to be both the capsule and the beads. The capsule has to dissolve before the beads can. If you are tapering off, you can always buy the gel capsules empty and put the beads in them if you can't change the mg..

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The capsules dissolve almost immediately. They are simply gelatin....they will even begin to dissolve it they get a little too wet. The technology is likely entirely in the beads.

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@susanarm

Thank you! I take 75mg capsules, ER. I try to skip a day, but if I skip 2 I feel so sick! It actually takes a full day to recover from that. I’m struggling because I’m getting ready to start a new job, ugh! I’m going to ask my doctor to send me to a specialist.

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You can always slow or delay the taper...new jobs are stressful enough -- titrating and being sick is no way to start.

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@susanarm

I am a 55 year old female who started taking Effexor for my hot flashes about two years ago. I take 75mg daily. I’ve tried to quit but my symptoms are so severe, I can’t get off. My ears feel really full making me dizzy, light-headed and nauseous, and I am physically ill. Any suggestions?

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See if you can get a scrip for 37.5mg (assuming you are taking the XR capsules not the immediate release)...titrate down to 37.5 first. I didn't get any symptoms until last week when I had two days of what you are feeling - plus my first experience with hot flashes -- 3 years after hitting menopause without symptoms....all because my dosage masked the symptoms.

If you are taking immediate release I think the options are different. Just speak with the doctor to say that titrating off is difficult. Also know that some of your hot flashes might come back while you are titrating down - or afterwards....but hopefully they will be less severe/frequent.

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@youngsally

We'll see what happens. Although I did learn one benefit of Effexor -- apparently it tamps down menopause symptoms...I hit menopause 3 years ago - no symptoms whatsoever....when I spoke to my therapist about how crappy I felt on Wednesday and how I slept with ice packs for a couple of nights -- she said that I was probably experiencing hot flashes....mine were more like heat waves.

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Today has been the worst day yet with withdrawal symptoms. Headache, sweats and throwing up. I've been sick all week but today it was just sever throwing up. My throat is killing me, headache probably from the vomiting and the sweating!! My poor fiance is freezing and I'm laying under air vent with a big fan blowing on me. Even taking cool showers. I bet it's your withdrawal and not hot flashes.

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@grandmar

@youngsally
Good Morning,
Thank you very much for the information, I had no idea.
Guess I need to research more before I shoot off my mouth.
Thanks again,
Ronnie

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Ronnie -- I've covered the healthcare industry for 20+ years (including pharmaceuticals)...it gives me an historical context/perspective that I wouldn't expect most people to have....

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@texasduchess

@youngsally
Whether the extended nature of the drug is in the gelatin capsule, or in the beads within--
Saw this at drugs.com re how to take Effexor XR capsules--"Swallow whole. Do not chew, break, or crush. You may sprinkle contents of long-acting product on spoonful of applesauce. Do not chew. Swallow the mixture right away. Do not store for use at a later time." This sounds to me as though the capsule is not important; what is important is that you let the beads dissolve in your digestive system.

Re bead-counting and why it is not a reliable tapering method and difficult to do--
From a Reddit post by u/tacomaprime and 37.5mg capsules--"I emptied the beads out of 7 capsules, 1 at a time and counted them. They were between 93 and 106 beads in each capsule." And this on survivingantidepressants.org by FeralUrban--"Effexor capsules do not contain the same amount of medication by weight in each capsule. The beads are all different sizes, as noted by others on this site and therefore inherently impossible to accurately reduce by 10% since you could be removing a bead that weighs three times as much as another bead, etc. [The] Pfizer Medication Help line [told him,] 'The capsules are filled by weight, not by volume. Ranges are validated with in an allowable variance.' The actual weight variability of each 37.5mg dosage of brand name Effexor is at least 3.5%, meaning if you take out 10% you could actually be taking out 13.5% or 6.5% and be bouncing your dose all over the place."

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That makes perfect sense. I haven't watched these things be manufactured - so I don't know the bead making process....but clearly there is an allowed variance (even in capsule weight)...which also makes sense because people have such different reactions to changes in generic versions/vendors.

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@haleysmom

Today has been the worst day yet with withdrawal symptoms. Headache, sweats and throwing up. I've been sick all week but today it was just sever throwing up. My throat is killing me, headache probably from the vomiting and the sweating!! My poor fiance is freezing and I'm laying under air vent with a big fan blowing on me. Even taking cool showers. I bet it's your withdrawal and not hot flashes.

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It could be both. I haven't had any symptoms today...and in many ways, the hot flashes are related to the withdrawal...and can persist in post-menopausal women. Effexor and other SSRIs/SNRIs are shown at low doses to decrease hot flashes. Using that as a starting point, had I not been on Effexor, I might have experienced hot flashes going into menopause...and after. They are related to withdrawal - because I am going off something that may have been masking them...although they may also be related to it. It's the dreaded correlation/causation conundrum. 🙂

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