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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@karathine99

Good morning: I am new to this group and looking for some help on how to manage my withdrawal side effects from Effexor. I have been on Effexor for 15 years and its time to wean off with my doctors help. I have tried weaning off many times over these years with no success. The dose I have been on was 150mg for 15 years. My doctor started tapering down to 75mg and now I am on 37.5. I am now taking 37.5 each night and then skipping a day. I have ten pills left. The side effect i find most difficult is the dizziness, nausea, euphoria and flu symptoms. Any suggestions on what I can do to alleviate these symptoms?
K.

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I agree with @jakedduck1 and @sears—your taper is very fast. The withdrawal effects are what keep folks on this medication; tapering off slowly minimizes them. The stories on this blog show that most tapers are TOO FAST–the drops are too steep and the wait before dropping again is too short. Skipping days puts you into withdrawal every other day. Note, too, that Effexor gets stored in body fat. For long-term users—you're not really off Effexor UNTIL that gets used up as well.

Effexor is a very powerful drug that affects your brain's neurotransmitter levels—it takes time for your head to recalibrate these without Effexor, or at lower levels of the drug … hence, the nausea, dizziness, insomnia, anxiety, etc.

OTC medications and supplements can help with some of the withdrawal symptoms. Ben*dryl, Bon*ine, or other seasickness remedies can reduce/minimize the dizziness/vertigo. Fish oil may be more helpful than krill oil for brain zaps. If by "euphoria" you mean agitation, or a mania in which you can't relax and feel you must move, I found supplementing with GABA calming. Taking L-tryptophan helped me as well, but you CANNOT take L-tryptophan (or 5-HTP) while still on Effexor. Here's a good article re how to mitigate withdrawal effects with supplements–https://www.4mind4life.com/effexor-withdrawal-symptoms.

* * * * *

You say your doctor is helping you to get off Effexor. Talk to him/her about your withdrawal effects. Ask for help with these. Will he prescribe a "Prozac bridge" to get you off Effexor at this point? (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/.) Your doctor can prescribe a different formulation of Effexor; I was on 25mg regular-release tablets that could be cut, or he could specify 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.

* * * * *

There's a lot of good information on this discussion board. I HIGHLY recommend that you start at the beginning, work your way through up to the present and READ it all.

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@karathine99

Good morning: I am new to this group and looking for some help on how to manage my withdrawal side effects from Effexor. I have been on Effexor for 15 years and its time to wean off with my doctors help. I have tried weaning off many times over these years with no success. The dose I have been on was 150mg for 15 years. My doctor started tapering down to 75mg and now I am on 37.5. I am now taking 37.5 each night and then skipping a day. I have ten pills left. The side effect i find most difficult is the dizziness, nausea, euphoria and flu symptoms. Any suggestions on what I can do to alleviate these symptoms?
K.

Jump to this post

Hi Karathine99. I’m glad you found this forum. It got me through my withdrawal and it will help you, too. First, I want to let you know that you will be ok and you will get through it.

Secondly, I don’t recommend ever skipping a day. If you are doing well on 37.5mg, hang out there for a while. Let your body get used to it. But take it everyday.

I was on Effexor for about 20 years. The highest dose I took was 75mg. I weaned off very slowly by opening up the capsules and slowly taking out more and more beads. How slowly? Well, let’s just say it took me 18 months to wean off the last 37.5mgs. I would remove 5 beads from each capsule of a months’ worth. Then the next month I’d take out ten beads from each capsule.

It was slow going but I had very little withdrawal symptoms.

So, my story is this, however... I was 6 months totally med-free but my old anxiety and depression crept back in... I am back on an antidepressant (zoloft) as well as a mood stabilizer (seroquel) and I feel great. Lowest dose of each and I even cut the seroquel in half. (I informed my doc and she is good with it)

So look. Life is short but plenty long enough to taper slowly. You don’t need to spend one miserable day! And just so you know, you can do it 🙂

I’ll be watching for your posts. Stay in touch! This is a great group.

👍

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@secretwhitepop

Hi Karathine99. I’m glad you found this forum. It got me through my withdrawal and it will help you, too. First, I want to let you know that you will be ok and you will get through it.

Secondly, I don’t recommend ever skipping a day. If you are doing well on 37.5mg, hang out there for a while. Let your body get used to it. But take it everyday.

I was on Effexor for about 20 years. The highest dose I took was 75mg. I weaned off very slowly by opening up the capsules and slowly taking out more and more beads. How slowly? Well, let’s just say it took me 18 months to wean off the last 37.5mgs. I would remove 5 beads from each capsule of a months’ worth. Then the next month I’d take out ten beads from each capsule.

It was slow going but I had very little withdrawal symptoms.

So, my story is this, however... I was 6 months totally med-free but my old anxiety and depression crept back in... I am back on an antidepressant (zoloft) as well as a mood stabilizer (seroquel) and I feel great. Lowest dose of each and I even cut the seroquel in half. (I informed my doc and she is good with it)

So look. Life is short but plenty long enough to taper slowly. You don’t need to spend one miserable day! And just so you know, you can do it 🙂

I’ll be watching for your posts. Stay in touch! This is a great group.

👍

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Hi Secretwhitepop:
I really wish doctors had better training when it comes to this but then again I dont feel the pharmaceutical companies strategize on how best to come off of these meds either.
I never thought of removing the beads from my pills. I have to agree that skipping a day has not served me well. I am going to try this.
Thanks
Katharine

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@karathine99

Hi Secretwhitepop:
I really wish doctors had better training when it comes to this but then again I dont feel the pharmaceutical companies strategize on how best to come off of these meds either.
I never thought of removing the beads from my pills. I have to agree that skipping a day has not served me well. I am going to try this.
Thanks
Katharine

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I agree! Some docs are aware of withdrawal issues, but too many aren’t. Since the half life of Effexor is so short, you should start feeling better once you get a steady (albeit smaller) dose back in your system.

I think I was fortunate. My doc (nurse practitioner) had me set appointments for her regularly once I explained that I was weaning off. (My weaning happened “between” doctors due to a family move. I think the former doc didn’t understand as much as my current doc)

Anyhow, take it slow and stead and make sure you ask family or a close friend if they are noticing anything awry. I put my family through a lot... lots of crying jags. It was awful!

Thankfully better now!

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Counting beads from capsules and splitting pills are regularly talked about in this discussion. We took the question of cutting pills to a Mayo Clinic pharmacist and this is what she had to say:

"Each patient should consult their clinician for individualized recommendations for tapering off antidepressant medications. Tapers should be individualized with consideration for the specific medication to be tapered, current dose, how long they have been taking the medication and other factors based on the clinicians expertise.
In some cases tablets may be split. Capsules should never be split. Removal of beads from capsules to accomplish titration is not a recommended method of tapering. Taper schedules can extend for several weeks if the patient's situation requires a slower taper. Tapers are sometimes shortened in the case of adverse effects or other patient factors. You can read more about antidepressant withdrawal here https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133."

I agree with the experiences shared by many members on this forum. Take the time to taper slowly. Advocate for this need with your physician. To support your discussion with your doctor, you may find the points made in this discussion and New York Times article helpful:
- Patients are teaching doctors online about antidepressants https://connect.mayoclinic.org/discussion/patients-are-teaching-doctors-online-about-antidepressants/

REPLY

Hi Colleen:
Thankyou for your reply.
I am definitely taking all suggestions into consideration. I really find physicians dont know much more about tapering off than the patient. This has been my experience. I will be going back to my doctor for a follow. Thankyou for the article.
Katharine

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@colleenyoung

Counting beads from capsules and splitting pills are regularly talked about in this discussion. We took the question of cutting pills to a Mayo Clinic pharmacist and this is what she had to say:

"Each patient should consult their clinician for individualized recommendations for tapering off antidepressant medications. Tapers should be individualized with consideration for the specific medication to be tapered, current dose, how long they have been taking the medication and other factors based on the clinicians expertise.
In some cases tablets may be split. Capsules should never be split. Removal of beads from capsules to accomplish titration is not a recommended method of tapering. Taper schedules can extend for several weeks if the patient's situation requires a slower taper. Tapers are sometimes shortened in the case of adverse effects or other patient factors. You can read more about antidepressant withdrawal here https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133."

I agree with the experiences shared by many members on this forum. Take the time to taper slowly. Advocate for this need with your physician. To support your discussion with your doctor, you may find the points made in this discussion and New York Times article helpful:
- Patients are teaching doctors online about antidepressants https://connect.mayoclinic.org/discussion/patients-are-teaching-doctors-online-about-antidepressants/

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@colleenyoung
Hello Colleen,
I believe your pharmacist needs to check into hotel reality.
Her opinion is fine provided we lived in a perfect world with perfect doctors with excellent advice who cared about patients suffering but unfortunately that’s not the case.
Bottom line is that the manufacturer doesn't know proper taper schedules and neither do many doctors. Patients shouldn't have to cut pills, remove beads or make suspensions. But what choice do patients really have? The doctors don't follow proper depression system guidelines when prescribing these medications. The pharmacist the doctors the nurses all medical professionals need to look at this issue through the patients eyes but they don't. As I write this reply I am in the emergency room waiting to see the doctor to get some seizure medication which I forgot this morning and I am spending some time over here on the California coast celebrating my cousins birthday. The problem is they are trying to give me generic seizure medication which lowers my seizure threshold. They claim the medicine is the same but it's not, the bioavailability of the drug is different. They’re trying to tell me I won’t have a seizure and that really infuriates me. I told each one of them there statements are irresponsible and I told each one that none of you can predict a seizure but it just goes to show the mentality of some of the medical professionals that we patients run into every single day. They’re not the ones that may have a seizure that could be fatal or suffer withdrawal effects coming off various types of medications.
I apologize for the rant but I know what happens to me and what has happened to many other people at the hands of doctors. I am lucky to be alive today because of the irresponsible prescribing actions of some medical professionals.
Although I have a lot of respect for most medical professionals, I have none for those who are incompetent?
Sorry again for getting carried away,
Jake

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@jakedduck1

@colleenyoung
Hello Colleen,
I believe your pharmacist needs to check into hotel reality.
Her opinion is fine provided we lived in a perfect world with perfect doctors with excellent advice who cared about patients suffering but unfortunately that’s not the case.
Bottom line is that the manufacturer doesn't know proper taper schedules and neither do many doctors. Patients shouldn't have to cut pills, remove beads or make suspensions. But what choice do patients really have? The doctors don't follow proper depression system guidelines when prescribing these medications. The pharmacist the doctors the nurses all medical professionals need to look at this issue through the patients eyes but they don't. As I write this reply I am in the emergency room waiting to see the doctor to get some seizure medication which I forgot this morning and I am spending some time over here on the California coast celebrating my cousins birthday. The problem is they are trying to give me generic seizure medication which lowers my seizure threshold. They claim the medicine is the same but it's not, the bioavailability of the drug is different. They’re trying to tell me I won’t have a seizure and that really infuriates me. I told each one of them there statements are irresponsible and I told each one that none of you can predict a seizure but it just goes to show the mentality of some of the medical professionals that we patients run into every single day. They’re not the ones that may have a seizure that could be fatal or suffer withdrawal effects coming off various types of medications.
I apologize for the rant but I know what happens to me and what has happened to many other people at the hands of doctors. I am lucky to be alive today because of the irresponsible prescribing actions of some medical professionals.
Although I have a lot of respect for most medical professionals, I have none for those who are incompetent?
Sorry again for getting carried away,
Jake

Jump to this post

Please excuse me for introducing a new symptom (and health issue) (for me) and diagnosis of osteitis pubis. The pubis bones are at the end of the hip where it is closest to the spine. I guess this would be under bone health. This is an inflammation of the bone in a specific area. But this could be within any other bone in our bodies. The pain is in the top ten and no help with pain pills. Takes many, many months to hopefully heal with complete rest. This is since July 2020. This happened with me when I fell on my right side. So naturally it is my right side pubis bone that is affected. Wanted to die because I did think I was dying with the pain. It has calmed somewhat but not enough yet. Hanging in there, praying and suffering completely helpless. I am presenting this for all to be aware as this can be a killer. Peach (Pain, pain, pain.) love to all

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@jakedduck1

@colleenyoung
Hello Colleen,
I believe your pharmacist needs to check into hotel reality.
Her opinion is fine provided we lived in a perfect world with perfect doctors with excellent advice who cared about patients suffering but unfortunately that’s not the case.
Bottom line is that the manufacturer doesn't know proper taper schedules and neither do many doctors. Patients shouldn't have to cut pills, remove beads or make suspensions. But what choice do patients really have? The doctors don't follow proper depression system guidelines when prescribing these medications. The pharmacist the doctors the nurses all medical professionals need to look at this issue through the patients eyes but they don't. As I write this reply I am in the emergency room waiting to see the doctor to get some seizure medication which I forgot this morning and I am spending some time over here on the California coast celebrating my cousins birthday. The problem is they are trying to give me generic seizure medication which lowers my seizure threshold. They claim the medicine is the same but it's not, the bioavailability of the drug is different. They’re trying to tell me I won’t have a seizure and that really infuriates me. I told each one of them there statements are irresponsible and I told each one that none of you can predict a seizure but it just goes to show the mentality of some of the medical professionals that we patients run into every single day. They’re not the ones that may have a seizure that could be fatal or suffer withdrawal effects coming off various types of medications.
I apologize for the rant but I know what happens to me and what has happened to many other people at the hands of doctors. I am lucky to be alive today because of the irresponsible prescribing actions of some medical professionals.
Although I have a lot of respect for most medical professionals, I have none for those who are incompetent?
Sorry again for getting carried away,
Jake

Jump to this post

Well stated. Thanks for providing the pharmacist’s input but I totally agree with Jake. He’s spot on. The doctors and pharmacists are trying to put too much into the patients’ hands. I’m tapering from Xanax to Valium at this time. Myself and my doctor decided to put my taper on hold for a bit due to my extreme anxiety about Covid and my sister’s cancer diagnosis. I’m using both Xanax and diazepam at this time. Xanax in the morning, Diazepam in the evening. I’m sick of being looked at like a drug addict when I pick up my scripts. Also tired of answering the same question to the same pharmacist as to why I’m taking two different Benzos. I politely answer everytime she asks and explain about the taper. She acts all confused as though she never even heard of tapering. Tired of being treated like this. I’ve switched pharmacies. Same thing at everyone. Are pharmacists really that ignorant about tapering benzos? They should be our friends not our foes as we go through the ordeal of tapering. It was a doctor of 30 years who got me in this benzo mess. And now I’m treated like a drug addict. Makes me want to forget this whole taper and just cold turkey. I’ll be 68. Whatever happens, happens. I’m too old for all this scrutiny. It was very difficult finding a new doctor that believes in very very slow tapers and now I’m dealing with pharmacists. Too much for me. I’m about done.

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@jakedduck1

@colleenyoung
Hello Colleen,
I believe your pharmacist needs to check into hotel reality.
Her opinion is fine provided we lived in a perfect world with perfect doctors with excellent advice who cared about patients suffering but unfortunately that’s not the case.
Bottom line is that the manufacturer doesn't know proper taper schedules and neither do many doctors. Patients shouldn't have to cut pills, remove beads or make suspensions. But what choice do patients really have? The doctors don't follow proper depression system guidelines when prescribing these medications. The pharmacist the doctors the nurses all medical professionals need to look at this issue through the patients eyes but they don't. As I write this reply I am in the emergency room waiting to see the doctor to get some seizure medication which I forgot this morning and I am spending some time over here on the California coast celebrating my cousins birthday. The problem is they are trying to give me generic seizure medication which lowers my seizure threshold. They claim the medicine is the same but it's not, the bioavailability of the drug is different. They’re trying to tell me I won’t have a seizure and that really infuriates me. I told each one of them there statements are irresponsible and I told each one that none of you can predict a seizure but it just goes to show the mentality of some of the medical professionals that we patients run into every single day. They’re not the ones that may have a seizure that could be fatal or suffer withdrawal effects coming off various types of medications.
I apologize for the rant but I know what happens to me and what has happened to many other people at the hands of doctors. I am lucky to be alive today because of the irresponsible prescribing actions of some medical professionals.
Although I have a lot of respect for most medical professionals, I have none for those who are incompetent?
Sorry again for getting carried away,
Jake

Jump to this post

@jakedduck1, I agree. Medicine should be practiced in partnership with the patient. I acknowledge that the information supplied by the pharmacist assumes that the patient has a good working relationship with a knowledgeable and compassionate health care provider. And that they have access to medication and refills as needed to taper slowly and safely on a schedule that is individualized to their medical needs - I stress individualize taper schedules, as everyone is different. System and medication guidelines are just that - guidelines. Individual factors should also be considered.

This is not always the case as demonstrated in the many storied and experiences (and sometimes rants 🙂 ) shared here on Mayo Clinic Connect. However, there are many good mental health professionals who do understand tapering and medications. That is why your relentless self-advocacy serves as an example for patients. We have to ask questions and keep asking questions. Share our knowledge about ourselves and find providers who will respect that we have expertise through experience which is a valid contributor to medical decisions.

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