Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

My doctor and I discussed getting off Effexor after being on it for 20 years. Before that, I had tried Paxil, Zoloft and Prozac. My dosage is light...37.5, but I am very sensitive to it, as has been the case with all antidepressants I’ve tried. Case in point, 5 mg of Paxil put me in the hospital. I’m getting off Effexor with the help of Wellbutrin (doctor prescribed). I’ve continued Effexor with 50mg of Wellbutrin but now take 100mg of Wellbutrin daily and Effexor every other day. I’ve had some of the brain swishiness (zaps) but nothing unbearable. Today is the first day I’ve gone beyond the every other day regimen with Effexor, and the withdrawal symptoms are no worse. My mood is still ok and I’ll see how it goes. If nothing changes today, I’ll try another day tomorrow without Effexor. I’ll continue with the 100 mg of Wellbutrin, which clearly has helped reduce Effexor withdrawal. By the way, sexual dysfunction has also been reduced over the past several days.

I'm really lost and trying to get myself off venlafaxine. My psychiatrist did not care about me at all - he worried about me getting addicted to 0.5mg of loratadine and then prescribed me venlafaxine! With zero mention of how addictive it is. For other reasons, I fired him a little while ago. A few weeks or like 2 months. I'm not very good with time.

How can I get myself off it? My PCP is ignoring the pharmacy (for over a week) and all I have is about 60 of 75mg tablets. I'm lying in bed now, dizzy and feel horrible. I was on a dose of 150+37.5 when I stopped seeing my psychiatrist. Currently, I'm down to 75mg a day, last taken a bit less than 24 hours ago. I have to do this on my own because my doctor doesn't care either. I'm one of thousands of people who use the health care center and I'm not worth the time apparently. My doc didn't even bother to follow up on diarrhea that left me seriously dehydrated - just tried to pin it on depression instead of treating me. Ordered tests and then no one gave me instructions and didn't do all the tests. Never did find out what caused it and thankfully after nearly a month straight and some antibiotics 'just in case', it went away. Of course, they did have time to file the paperwork to bill me for it.

I would get a new doctor but I can't even pay the bills I owe - $150 per appt to not help me.

I live alone and have no family. I have to do everything myself and there's no one to rescue me from being homeless again. I'm a transsexual so my options for any medical care (or employment, housing, people treating me like a human being) are very very limited, and I've been in treatment for over a decade despite not turning 30 yet. But I get told I'm too young to possibly be depressed, until the assumer asks me about my past and then I always get the same shocked look.

Does anyone have any advice on how I can stop feeling so horrible? I can't get a new rx, I have no support except my cat, and I just don't see any point in trying anymore but I am not quite ready to completely give up. If I was, I'd not be writing this. I have a degree in psychology (not that it's helped me any) so I can understand technical advice.

Hi, @notaround, and welcome to Mayo Clinic Connect. If you've not had the opportunity to do so, reading through some of the past posts in this discussion about going off of venlafaxine may be insightful.

Just wanted to learn a little more. I believe you are saying that ideally, rather than go off of venlafaxine, you'd like to stay on the medication, and that you are trying to see if your primary care provider would take over this prescription that was formerly managed by the psychiatrist? If so, does he or she require a visit for an assessment of your current status prior to him or her taking on the prescription and calling it in for you to the pharmacy?

@lisalucier No, I want off venlafaxine. It hasn't worked for my depression for a long time and for the past year I've been taking it only to avoid the withdrawal. The side effects aren't immediately serious but I recently realized that the persistent extreme fatigue and sleepiness I've been trying to get my doctor and psychiatrist to address for over a year might be caused by the med - it's on the label even but no one said it's possible as a cause. I don't trust doctors anymore. I've been burned too many times now. It feels like all mine do is bill me and tell me I have depression. I know that! I want to actually live instead of struggling through every hour of every day.

It's just worse because I'm tapering very fast since I can't seem to get refills, rather than by choice. I haven't heard anything from my PCP. No response in almost two weeks.

I'm scared because twice now I've had severe problems with withdrawal. Once I stayed at a friend's house for a holiday for 2 days and after 48 hours, I started to go into medical shock and was pretty sure I was dying (nothing at all like a panic attack). Recently, I had a small seizure and smell hallucinations. The recent event was from stepping down to 75mg suddenly from 150mg. I don't want to lose what little dignity I have.

I have read several pages of this thread (the oldest ten or so and the most recent 5 or so). It seems like the people who succeeded all had a cooperative doctor (and the financial ability to see them) and support, usually from a spouse. I want to know if I can do this without having those. Or maybe I'm doomed to fail.

Thanks, @kbmayo! I appreciate the encouragement. I'm aware that I've come off the drug much faster than I should have. But I can't imagine having to go through these symptoms over months. Going from 75mg to 37.5mg was extremely painful! I'd rather rip off the band-aid and get it done.

I'm finding that I'm doing better today though! It has been 6 days since I last took 37.5mg of Effexor. I'm still feeling perpetually anxious, which is certainly unpleasant. But I haven't had any brain zaps this morning (or few, I just got one while re-reading this post). I did some weight-lifting this morning and a bit of cardio, which I think may have helped.

I'm also cleaning up my diet and I've been eating way too much sugar which just aggravates the anxiety - and the anger. And drinking tea and going to bed an hour earlier than usual.

Here is the fascinating part - I'm finding that because I'm in a constant state of exhibiting the physical symptoms of anxiety and rage (elevated heart rate, sweating, shaking, difficulty concentrating), my brain cannot properly interpret how I am actually feeling. Am I ACTUALLY anxious or angry or is it just withdrawal? My husband and I were talking about how working on self-regulating in such a heightened physical state is extremely difficult (almost impossible) but also great practice for when the physical symptoms abate and I'm back to normal. I'm not sure that I'm expressing this well...

On the one hand, I can't trust my own understanding of how I'm feeling right now because I'm so out of whack. On the other hand, I really have to flex my self-regulatory muscles to get through it with any dignity, which I think might make me "stronger" or rather better equipped to manage my emotions when I'm through. At the very least, I'm trying to frame the experience in that more positive and productive light while I'm in the thick of it. 🙂

One weird thing that I wanted to mention to see if anyone else experienced this: I developed a boil on my inner thigh and there is another one forming on the inside of my upper arm. At first, I thought I had skin cancer! Has anyone else experienced this as a possible symptom of weaning from Effexor? I ask because I have never had a boil before in my life until weaning - and now I have two! I also have psoriasis which seems to be a risk factor. I'm really hoping this is just another symptom that will disappear as I get through this.

Oh! And last question, does anyone have any strategies for minimizing the organ squishing feeling? I feel like my stomach/spleen/gallbladder(?) are periodically spasming and it hurts. Not for long, quite literally like someone is giving it a quick squeeze. It's on the right side primarily. Any advice would be appreciated.

For context, I'm taking Vitamin D3 x 1000mg a day, a tsp of fish oils, a whole food diet of mainly vegetables, fruit, kefir and whole grains, meat twice a week. I walk to and from work (30 minutes each way) and I'm now incorporating in some strength training. I'm a runner as well, but I hurt my knee running a half marathon at the end September and haven't fully recovered, so I haven't been running. As a consequence, I have put on 10 lbs. I'm 5"6 and 140 lbs.

Thanks!

@proserpine OMG--I, too, have had a sore on the top of my left thigh for some months now. At first, I thought it was an ingrown hair and it felt as though something was below the skin, but nothing could be expressed out. It keeps trying to heal over, but the area is now about the size of a pencil eraser across and the new skin is very thin and breaks when I change the dressing. I haven't had it checked by a doctor 'cause dealing with the Effexor withdrawal symptoms has been my priority. I've been taking ashwagandha for my anxiety symptoms and thought it might have something to do with this sore as ashwagandha reactions include skin rashes, itchiness and inflammation.

Many posters on here (including me) have anxiety and rage--often flash rage. I do have a temper, but didn't use to go from mildly annoyed to I-want-to-throttle-you in seconds. Effexor messes with your serotonin and norepinephrine; while reducing and after getting off Effexor, it takes your brain a while to figure out how to rebalance serotonin and norepinephrine. Serotonin is an important chemical and neurotransmitter in the human body that is believed to help regulate mood and social behavior, appetite and digestion, sleep, memory, and sexual desire and function. Serotonin deficiency is associated with several psychological symptoms, such as: anxiety, depressed mood, aggression, insomnia, irritability, low energy, low self-esteem and low sex drive. Norepinephrine is a naturally occurring chemical in the body that acts as both a stress hormone and neurotransmitter that's released into the blood when the brain perceives that a stressful event has occurred.

@notaround — your situation is certainly not an easy one. However, you know from personal experience that tapering slowly is necessary to get off this drug successfully with the fewest side effects. Venlafaxine withdrawal symptoms — even with a slow taper — can prove challenging. As you underlined, finances are your primary barrier to finding a doctor to prescribe medication and guide you respectfully through the taper process. So tough!

Are there any community services in your area that you may be able to appeal to? Might you be able to extend your prescription by going to the closest ER? That might give you time to find a provider who can help.

I did reach out to my medical center's complaint department. They understand the problem with sudden withdrawal from meds and are going to help thankfully.

(My medical center IS the community resource. The fundamental problem is that they serve a major metro and not enough providers for all the patients.)

Just need to get through each minute of each hour of the day. Funny how this makes time feel excessive. I've been trying to keep working through this but having to leave early when I just can't keep going anymore. Thankfully my job has been understanding about the weird schedule. Don't need to be fired on top of being short on rent.

I'm really sorry to hear about your ordeal @notaround. I'm lucky to live in Canada with universal healthcare and a drug plan at work. I have friend in the US who is very sick right now and they are barely scraping by as a consequence. He has benefits that are helping but there are a family of four. It's ridiculous.

I came off Effexor quick, as you are likely aware from my posts above. I'm a stubborn person and when I get a thought in my head...anyway, I wouldn't suggest doing what I did. I'm certainly not through it yet, though I am feeling better overall. Framing helps somewhat - trying to put things into perspective. My husband's dad got hit by a car on Saturday, so I've been alone with a five year old the last few days. And my boss is very stressed, which means a stressful work environment. I'm trying to remember that being a good mom is more important to me than getting to work on time. That I'm adult, and I get my work done and that all this anxiety and rage will pass. It is a constant battle, I find, re-framing things positively when I feel so crappy - but it really is helping.

It's great that your medical centre has recognized the need to support you through this. Know that we're here for you too if you need to talk over your experience. Effexor is brutal. No one should have to do that alone.

Thanks, @kbmayo! I appreciate the encouragement. I'm aware that I've come off the drug much faster than I should have. But I can't imagine having to go through these symptoms over months. Going from 75mg to 37.5mg was extremely painful! I'd rather rip off the band-aid and get it done.

I'm finding that I'm doing better today though! It has been 6 days since I last took 37.5mg of Effexor. I'm still feeling perpetually anxious, which is certainly unpleasant. But I haven't had any brain zaps this morning (or few, I just got one while re-reading this post). I did some weight-lifting this morning and a bit of cardio, which I think may have helped.

I'm also cleaning up my diet and I've been eating way too much sugar which just aggravates the anxiety - and the anger. And drinking tea and going to bed an hour earlier than usual.

Here is the fascinating part - I'm finding that because I'm in a constant state of exhibiting the physical symptoms of anxiety and rage (elevated heart rate, sweating, shaking, difficulty concentrating), my brain cannot properly interpret how I am actually feeling. Am I ACTUALLY anxious or angry or is it just withdrawal? My husband and I were talking about how working on self-regulating in such a heightened physical state is extremely difficult (almost impossible) but also great practice for when the physical symptoms abate and I'm back to normal. I'm not sure that I'm expressing this well...

On the one hand, I can't trust my own understanding of how I'm feeling right now because I'm so out of whack. On the other hand, I really have to flex my self-regulatory muscles to get through it with any dignity, which I think might make me "stronger" or rather better equipped to manage my emotions when I'm through. At the very least, I'm trying to frame the experience in that more positive and productive light while I'm in the thick of it. 🙂

One weird thing that I wanted to mention to see if anyone else experienced this: I developed a boil on my inner thigh and there is another one forming on the inside of my upper arm. At first, I thought I had skin cancer! Has anyone else experienced this as a possible symptom of weaning from Effexor? I ask because I have never had a boil before in my life until weaning - and now I have two! I also have psoriasis which seems to be a risk factor. I'm really hoping this is just another symptom that will disappear as I get through this.

Oh! And last question, does anyone have any strategies for minimizing the organ squishing feeling? I feel like my stomach/spleen/gallbladder(?) are periodically spasming and it hurts. Not for long, quite literally like someone is giving it a quick squeeze. It's on the right side primarily. Any advice would be appreciated.

For context, I'm taking Vitamin D3 x 1000mg a day, a tsp of fish oils, a whole food diet of mainly vegetables, fruit, kefir and whole grains, meat twice a week. I walk to and from work (30 minutes each way) and I'm now incorporating in some strength training. I'm a runner as well, but I hurt my knee running a half marathon at the end September and haven't fully recovered, so I haven't been running. As a consequence, I have put on 10 lbs. I'm 5"6 and 140 lbs.

Thanks!