Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

@youngsally
Yes, this is why I was prescribed Effexor--for hot flashes. I developed breast cancer in 2000 and was pre-menopausal. The cancer was hormone-driven and I was put on Tamoxifen after a lumpectomy, chemo and radiation. The Tamoxifen binds with estrogen and after about 10 weeks on it, I began having hot flashes because I was going into a chemically-induced menopause. It is very common for breast cancer patients who can't have hormones to be put on Effexor to control hot flashes (well-known off-label use). It worked like a charm and I was on 25mg for 18 years. I was going to quit it about four years ago, but developed breast cancer again. This time I was facing double mastectomy, several reconstruction surgeries and 16 rounds of chemo and my doctor said let's put that on the back burner. I had no idea when I started Effexor that it was such a powerful drug, that it affected your brain neurotransmitters and was difficult to quit. I don't think my oncologist knew this either and he has been surprised by my continuing issues despite tapering off quite slowly. It has been my experience, however, that if there is a weird, or uncommon side effect to something, I'll get it.

I'd say that 18 years ago, it was still an underrecognized side effect...Keep working at the taper- there's certainly a lot of resources here to help with ideas. Are you taking an AI now? I understand that the mood swings on those have prescribers adding an antidepressant to the mix as standard after therapy.

@youngsally
I only ever took an antidepressant (Effexor) for hot flashes and that was why it was specifically prescribed. In the oncology world (especially those working with women breast cancer patients), its side effect of stopping/controlling hot flashes was well-known. At the time (year 2000), my oncologist didn't even hesitate, or have to do some research on how to help me with the hot flashes. Except during active cancer treatment, Effexor was my only prescribed drug.

The akathisia is not all the time and started six weeks after I slowly tapered off and (I figure) all the Effexor was completely gone from even body tissues. It comes over me like someone's dumped cold water on me--starts at the top and I feel it travel down my body to my feet. I feel fear (sometimes downright terror), anxiety, restlessness and agitation and must pace, rock and hug myself. I know there's nothing to be frightened of, but it doesn't matter. Taking l-tryptophan and B6 has helped tremendously in reducing, or stopping these episodes and on occasion, I'll take a prescribed half to a whole 5mg Valium. I am taking 10 capsules of various supplements plus 5 B6 tablets at least four times a day (about 5 hours apart). That's a whole lot of pills and I don't know how long it will take for my brain to balance itself. I will taper off of these over some months. I am still trying to find a referral to someone who knows how this drug works, what it does to the brain and how to recover from being on it.

It sounds like your experience with your oncologist is not unusual...one really has to be willing to advocate. I know someone who is having a terrible time with her AI....but in her case - she won't even bring it up with the MD...her husband finally called to see if the oncologist would bring up the subject. Alas, she won't consider ANY sort of medication to help her symptoms - even aspirin for joint pain. As the old saying goes - you can lead a horse to water.....

@youngsally
I never had mood problems with Tamoxifen, or Aromasin--just physical ones. After three years on Tamoxifen, I did get a blood clot (known possible side effect) in my right calf and spent 8.5 days in the hospital and had to be on Warfarin for a year. While in the hospital that 8.5 days, they noticed I had anemia and I said not too surprising as my periods have gotten so heavy and hardly ever stop. Well, that led to a diagnosis of Tamoxifen-induced uterine cell changes (uterine cancer--another known possible side effect), so I had a hysterectomy. Then, I was on Aromasin for six plus years ('cause now menopausal for real) and from the very first pill, went "urp" all night long once I went to bed.

Here's a story of one woman's difficulty with aromatase inhibitors including mood swings, depression and joint pain; she weighed her cancer risks and the unpleasant side effects from the AIs she tried and quit it--https://www.curetoday.com/community/bonnie-annis/2017/08/the-choice-to-walk-away-from-aromatase-inhibitors.

Your friend's irritability and mood changes could be from menopause. My hot flashes were weird--I'd be so cold my teeth would chatter and the next minute, OMG, I'd be boiling; then, freezing; then, hot, etc. Continuing in that manner would have driven me crazy. I knew one woman whose hot flashes made her a prisoner in her own home--she never knew when one would hit and when it did, she would literally be soaking wet from the skin out (including her hair). Everyone is different--my mother had no problems; an 85-year-old friend said she never had any issues, but her mother, sister and a daughter did. If you have them, these menopausal effects are miserable and no, when you're standing there so soaking wet that you're making a puddle on the floor, it's not "all in your head." There are natural products and activities that she might benefit from as well as dietary changes that can help (eating some things and avoiding others)--https://draxe.com/5-natural-remedies-menopause-relief/, https://www.healthline.com/nutrition/11-natural-menopause-tips and https://www.healthline.com/health/menopause/alternative-treatment.

There's no reason for your friend to be uncomfortable (nor those around her), but she needs to accept she's having some problems and get some help. You don't need a drug, or treatment for every little thing, but ignoring some big issues is not helping her and those she interacts with.

Thanks for the info -- my friend is 60 -- so she's been in menopause for awhile -- but the AI may be making it worse....alas - she also is high maintenance. It's sad - she's been this way for awhile - but it's been worse since the med switch...but her daughter just graduated college and her son is in HS...and she has been a stay at home mom (by choice)...so maybe it is a combination of things.

Your case is basically my case. I was diagnosed with breast cancer in April 2016 and elected to go ahead and have the bilateral Mastectomy. I didn't have to have radiation or chemo (Thank God!), but I was put on the 37.5mg of Venlafaxine. I am now at 75mg and then I found out what a horrible drug it is. I missed my pill for three days due to a conflict at my pharmacy, and I had begun to have brain zaps, nausea, and upset stomach. I want to be off this drug and hopefully be put on something else for hot flashes if possible. My oncologist office says we can try tapering back down to the 37.5mg and see how that goes. Had I known this drug was so bad, I would have said no to being put on it, but I was never told about the side effects of coming off of it.

Well tomorrow will be my first day of week 4 without any Effexor and I’m still blown away by the amount of brain zaps I’m having and how there is no rhyme or reason for them. I had been taking 25 mg for almost a year for hot flashes and seems that it wasn’t doing a great job and am scheduled to try a different method if I can get my head straight. I am not driving and having problems staying focused and in task when on my computer. Watching TV is bothersome and reading books is worse! I had to walk down stairs on an escalator that wasn’t working. The lines of the steps began to run together and I had my first real panic attack. I had to hold on to my daughters shoulders in front of me and not look down at all. It was horrible!!
I have had a few (3) days where I felt clearer but not so much that I could drive I would get hopeful and the wake the next morning with the dizziness all that vet again. My family is going on holiday next week and will be on a boat for 5 days. Right this minute, it seems like it will be torture. Only 7 more days to get my head screwed on straight. Ugh.

After warning down over 10 weeks I am completely off now for 11 days . I went to stomach pain that sent me to hospital, in 60 years I never threw up as much as I did in 1 week, had trouble swallowing good and sent for a scope and colonoscopy, all came back fine. Thank god ! I took was never told about the side affects of this horrific drug . I rather suffer with hot flashes any day of the week . When I got down to 37.5 I took that for 2 weeks and then started to take a pellet out every night 1 then 2 then 3 dr. Said that was worse because they are time release . Get yourself back down to 37.5 for two weeks and stop . Deal with it once and for all . It’s hard but worth it. As for the hot flashes put your head in freezer because anything is better then this. I heard it’s hatder to get off this then heroin . Good luck . Ian now 11 days with nothing a feeling pretty good . I got to the point I will never take even a tylonal anymore without reading the side effects . I wish you well and good luck .

Thank you so much for your response! I hope everything continues to go well for you.