Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

So, I just finished this process with Zoloft (sertraline) and here are some things that worked for me. Your mileage may vary, but hopefully these are low risk for you to try.

1) You may need to ask your doctor for a slower tapering program than other patients. Some people are just more sensitive to dosage changes. Be aware that symptoms will get better, then may reappear each time you taper. AAFMA (practice group of family physicians) says that the symptoms typically last 1-2 weeks and as long as 4 weeks, so I just kept reminding myself that it was temporary.
2) Be watchful for things that make your symptoms worse. For example, caffeine seems to trigger the brain zaps for me (still, even after being off for several weeks), so I cut back my caffeine intake. I didn't give it up completely (because I still need to function), but cut back on how much real coffee I was drinking, mixed decaf with regular, and switched to tea sometimes. In the end, I probably cut my daily caffeine intake in half, and it did help quite a lot.
3) Ibuprofen or other pain reliever can help with the flu-like body aches.
4) Benadryl helped with the brain zaps.
5) Exercise helped with both. Even if I wasn't up to a run, a few blocks of walking would settle down the symptoms for a while at least. (Then, when they come back, just take another walk. We took a lot of walks for a while there).
6) Get enough sleep. As I came down off the meds, my normal sleeping patterns returned, which was great, but it did mean that I needed to plan time to let my body rest.
7) Pay attention to your diet. Your brain uses carbs to make seratonin, so now is not the time to go on the Atkins diet. Eat well and make sure you're getting enough healthy carbs. You may crave sweets; I certainly did. I tried to counteract this by having bananas, graham crackers, and other healthy things I could snack on instead of sticking my head in a birthday cake like I seemed to want.

No lie - it's a painful process, but this did really help make it easier. Also, at a certain point, when I was down the below the normal starter dose, I just ripped off the bandaid and went to zero. At that point, it felt like each taper was just prolonging the suffering. Don't just go cold turkey from your current dose, though, as that can be dangerous. Also, don't add any supplements or substitutes for the SSRI without talking to your doctor first (also dangerous).

And of course, watch for the return of depression / anxiety type symptoms. For a while it was hard to tell whether I was tired because of the change in meds or because my depression was returning. I figured as long as I felt okay enough to function and wasn't thinking about being harmful to myself or anyone else, I could play it out and see. It turned out to be the meds and on the other side, I can see that I was more worried about it than I needed to be.

I wish you the best of luck and a healthy life.

Mardee

I have been taking venlafaxine HCL ER Cap 37.5 mg since 2017. recently I felt they were making me nausea. I have decided to get off of them. I take capsules therefore, I would break them open and count the little pebbles and took like this,. The first week I took 1/2 of capsule pebbles daily, next week 1/3 capsule pebbles daily, then this last week 1/4 of capsule pebbles. Today is friday 3-5 and I am now off the pills totally. I don't feel depressed at all. Symptoms are bad nausea, sweats, feeling cold, vivid dreams. The nausea is the worse, I ve tried everything to help rid me of the nausea, nothing works. I am in hopes that I am doing the weaning the proper way. My dr. suggested for two weeks take1 pill every other day. I didn't feel that would be good so I did not follow her instructions. Is there someone at Mayo Clinic Connect who can suggest something for the nausea. Thank you

Withdrawal symptoms are the big tip off that you are tapering too fast; tapering off slowly minimizes them. You and your doctor (if it's his/her tapering plan) might want to reconsider the speed at which you are tapering and the amount you are dropping with each taper.

You can click on my name and read my previous posts. 9/26/2020 has links to articles about helpful supplements and ways your doctor can mitigate/ease withdrawal.

@cp6401 used the term "stress fragile" to describe how so many of us are during the process of getting off/reducing Effexor and even, afterwards. I certainly recognize your need to run and pace—it's a fight, or flight reaction. Distraction helps—reading, hobbies, work, chores, gardening, exercise, etc. I was mindful of what I watched (nothing frenetic, violent, or disturbing), read (cozy mysteries, or romances were good), or listened to (no atonal, or dissonant music)–some things were just too agitating. Getting natural light to my eyes was extremely beneficial for lifting my mood and calming me ... not sunbathing, but getting out and seeing daylight–take a walk, or at least, get out of your house for 5–10 minutes, even if it's just stepping out onto a patio.

Thank you so much for you reply! Yes, I have been trying to keep my body moving as much as I can but sometimes I feel completely frozen from muscle tightness. My Psychiatrists office messes up my tapering - cut me down from 175 to 37.5 overnight. By the time it was realized I was knee deep in some of the worst physical and mental distress I have ever felt - including my so-called first "manic" episode (I often doubt my bipolar diagnosis). The decision was made to keep me on the 37.5 and ride it out. I started doing every other day last week and it has just been too much. I am back to taking it every day, but switched it up from PM to AM. I hate this drug and what it is doing to me. It saddens me deeply to read all of your stories but makes me feel like I am not crazy, lazy, or weak. I have excellent support and an amazing therapist who is helping me with relaxation tools and support but had to stop doing EMDR because it was too over stimulating. I can't do anything it seems that causes too much because my head goes in a spinning motion. The sun is out today though and that is very helpful. I just want one day when I am not feeling complete rage or utter sadness. I would also love to stop stuttering. It frightens my daughter. I have to stop myself and pick another word to start the sentence. I also touch something cold to give the brain a tap in another direction. I am trying to give this time instead of rushing it, but it feels like a poison I just want to rid myself of.

I have been taking venlafaxine HCL ER Cap 37.5 mg since 2017. recently I felt they were making me nausea. I have decided to get off of them. I take capsules therefore, I would break them open and count the little pebbles and took like this,. The first week I took 1/2 of capsule pebbles daily, next week 1/3 capsule pebbles daily, then this last week 1/4 of capsule pebbles. Today is friday 3-5 and I am now off the pills totally. I don't feel depressed at all. Symptoms are bad nausea, sweats, feeling cold, vivid dreams. The nausea is the worse, I ve tried everything to help rid me of the nausea, nothing works. I am in hopes that I am doing the weaning the proper way. My dr. suggested for two weeks take1 pill every other day. I didn't feel that would be good so I did not follow her instructions. Is there someone at Mayo Clinic Connect who can suggest something for the nausea. Thank you

Have you and your doctor explored and ruled out other causes for your nausea (pregnancy, inner ear/balance issues, etc.)?

Your taper was pretty fast, but your doctor's every-other-day suggestion would have put you into withdrawal every other day. Withdrawal symptoms (headache, anxiety, digestive issues, brain zaps, dizziness, nausea, etc.) are the big tipoff that a taper is being done too aggressively. Often, folks get relief from withdrawal symptoms by reinstating the Effexor: going back to a dose where they didn't have any WD symptoms (sometimes, even upping the dose a bit) and staying there for some weeks to stabilize before attempting ANY more tapering. When they began tapering again, they only reduced 5–10% (or even less) and waited weeks before reducing again.

OTC medications and supplements can help with some of the withdrawal symptoms. I didn't have nausea very often, but when I did, I found sucking on Pepto Bism*l lozenges and eating dry saltine crackers helpful. You may be experiencing dizziness/vertigo; Ben*dryl, Bon*ine, or other seasickness remedies (wrist bands) can reduce/minimize those symptoms.

@marylcamp67 ,
I too have had lots of nausea related to tapering. There are lots of meds of which I've tried many. OTC remedies have at times worked just about as well as Rx meds. Ginger chews, ginger tea, or ginger liquid dissolved in water all work pretty well. Another is Nauzene, which is a chewable tab and you can use up to 24 tabs/24hours, if needed, hopefully not. If you need names of Rx meds, I've got lots you could choose from, but that's just adding another medicine. I would try the ORTs first. I feel your frustration. Stay in touch.

@marylcamp67 ,
I too have had lots of nausea related to tapering. There are lots of meds of which I've tried many. OTC remedies have at times worked just about as well as Rx meds. Ginger chews, ginger tea, or ginger liquid dissolved in water all work pretty well. Another is Nauzene, which is a chewable tab and you can use up to 24 tabs/24hours, if needed, hopefully not. If you need names of Rx meds, I've got lots you could choose from, but that's just adding another medicine. I would try the ORTs first. I feel your frustration. Stay in touch.

"Messing up my tapering" is understating it—going to 37.5 mg from 175 mg overnight is like being pushed off a cliff.

"The decision was made to keep me on the 37.5 and ride it out." Again, wow! Only you know how you feel. Many times doctors are more optimistic than their patients find comfortable regarding how quickly you drop and how steep the drops should be.

Skipping days puts you into withdrawal every other day.

Getting off Effexor is a marathon, not a sprint. You may want to consider going back to a dose where you didn't have any WD symptoms, staying there until stabilized before attempting ANY more tapering and when you do taper again, note that folks are usually more successful dropping no more than 5–10% at a time and staying at the new level for weeks (even months) AND stabilizing before dropping again.