Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

I’ve been diagnosed with something called PPPD. And I want to say Mayo Clinic is studying it as well. Unfortunately I’m at work (with kids) and can’t remember what PPPD stands for... but the last work is dizziness.

Vertigo stinks! And anxiety plays a role.

Persistent postural-perceptual dizziness

I am trying to stop taking effexor xr. I have been taking 150 mg for 20 years. I have slowly reduced 37 1/2 mg each month with no problems. Now that I am on the last 37 1/2 , I have tried to stop taking this last dose and I got the brain shivers and was violently sick. Per my docter I am now taking it every other day. Even then I am getting brain shivers and agitation after 36 or so hours. I really want off this medication. Any suggestions to help?

I would not take the 37.5mg every other day–Effexor has a very short half-life in the body; ping-ponging on/off from one day to the next is putting you into withdrawal over and over. Going slooowww is your friend! Reduce by only 5-10%, or even less with each taper and stay at each tapered level for some weeks/months before tapering again. There's no point rushing the process if you ultimately can't get off Effexor because the withdrawals are too awful.

Your doctor can prescribe a different formulation–changing from extended-release capsules to regular-release tablets (I was on 25mg regular-release tablets that could be cut), or specifying a certain brand of capsules (@farm_mom found Teva had the most consistent size and number of beads within a capsule–helpful to those counting and throwing out beads to taper--see @sandij, or @doorman on how to do this). Or your doctor can write a prescription for a compounding pharmacy to make tapered doses for you (the extra cost may well be worth it because you can glide down in incremental amounts, rather than make rather large jagged drops).

Ask your doctor about a "Prozac bridge"–"The only way doctors know to soften the blow when withdrawing from short half-life drugs [Effexor is such] is to add 20mg fluoxetine (Prozac). The half-life of Effexor is 5 hours and 99% of it is out of your body in one day. Prozac's half-life is 4 to 6 days and it takes 25 days for 99% of it to be out of your body. Essentially, the Prozac cushions the effect of no Effexor and lets you "ride out" the withdrawal process.–https://natashatracy.com/treatment-issues/withdrawal/antidepressants-effexorpristiq-venlafaxinedesvenlafaxine/. See also https://www.depressionforums.org/forums/topic/107532-coming-off-of-effexor-with-prozac-bridge/.

@bdizjr
P.S. You mentioned being on Effexor for 20 years. I tapered off slowly from just 25mg (taken for hot flashes for almost 18 years). I didn't have any withdrawal effects until 6.5 weeks after my last dose--that's when all the stored Effexor finally got used up. So be aware that it gets stored in body tissues when you've been on it for a long time.

@bdizjr
Good morning & Happy Holidays,
I hope your fine this Christmas morning.
You were given some top notch advice by @texasduchess.
I want to alert you to only one other thing. You tapered at a set rate (37.5mg) per month. When you look at it from a percentage standpoint your taper wasn’t so slow or smooth. If my calculations are correct (And I wouldn’t bet money on them) you started with a 25% decrease then the next month decreased by 33% and then 50%, so it was anything but slow as you describe. It’s better to choose a particular percentage and stay there.
It is incomprehensible to me how someone can take a medication for 10, 20 or 30 years than expect to get off it in such a short time or worse stopping cold turkey. A lady here stopped cold turkey after 30 years and had a stroke.
Your best chance for a totally uneventful taper is to do it slowly. Oh yes, one more thing. Here is a link to micro-tapering at Cinderella therapeutics,
https://www.cinderella-tx.org/en/
Blessings,
Jake

Hi Jake
We on Connect should be sending you- and I am- a huge thankyou for all your posts about tapering off meds
wisely! You may not be an official professional but you certainly are giving excellent suggestions to those of us
out in cyberspace who are struggling to move on without drugs and it is not easy so we need all the help we can get! So I hope you will stay with us!
To you and those on Connect who celebrate-Merry Christmas- and for you and those who do not-Happy
Holidays and to all my very best wishes! Thank goodness we are all here for each other!
Ainsleigh

totally agree.. even my pharmacist gave me that advice.. i suppose it may work for some ppl.. but i know the way i get when i miss even ONE dose..

thanks Jake, you are right. i recently went from 150 to 75 (went fine) then to 37.5 (50% cut) went through hell.. now i'm a little more stable.. but still "stress fragile".. i'll call it..your percentage comparison opened my eyes to how aggressive i actually was.. going to go off 37.5 measuring the beads and taking slow

I have been Effexor for maybe a year, following a previous two-year depression relapse from hell. Before the relapse I had been on Paxil very succesfully for probably eight years. I sucessfully weaned off of Paxil (boy I wish I had never done that) for maybe four months when the depression came back with a vengence. I could not tolerate Paxil anymore and after two years of hell and I managed to tolerate Effexor. But, it was never a happy relationship. I've been in therapy and the psychiatrist encouraged me to wean off Effexor. Some severe stress triggers are gone now. The doc simply advised me to take it "slowly." I can't even remember what doses I took when... I was at ... 225? I reduced in 37.5 increments over the past several months with no problems. If anything I just felt better. Last night I went down to 37.5 and I felt fine today. Perhaps a little lucid! I stopped for dinner with friends (despite the recent excessive holiday season) and drank wine. I really shouldn't have done that. When I got home this evening I found that my cat pooped on my bed (rnot an unknown, but rather random act) and barfed (I guess he's not feeling well) and I just became super agitated. I mean really agitated, for me anyways. This is how my last relapse started. Agitation. So, I'm scared. I hate Effexor. I want off, but I'm so afraid of a relapse. I'm single and I don't think I can endure that again. I have gained a ton of weight on Effexor. More than I've ever weighed. I drink more. I have stopped going to the gym. Arghhhhhh. I'm so frustrated. I see the doctor Friday, but I'm venting. I want my life back.