Tapering off of Venlafaxine after just 4 weeks of use

@meingan Welcome to Mayo Clinic Connect and to this support group.

I will share my experience with anxiety and antidepressant medication but first I would to ask if you've discussed you lack of response and plans to wean off Venlafaxine with your prescribing physician? When I'd had little to no response to antidepressants in the past I worked with my doctor to find medication that worked for me. For instance, I knew that others in my family had responded to Celexa so I was prescribed that medication for awhile. It worked OK but when another family member was prescribed Cymbalta I asked my doctor about switching to that medication. Cymbalta (I take duloxetine which is the generic) worked very well for me and I've been on it for more than 10 years now.

I've had some form of anxiety disorder since my early teens. I had a major depressive episode with anxiety in my mid-20's but that was long before there was any effective antidepressant medication available. Since that time I've had relapses of depression/anxiety but I could always trace it to a significant event in my life. Now I know what to watch for so that if the anxiety rears up again I can use my coping skills to manage the anxiety.

Are you working with a mental health therapist who specializes in anxiety? If not, I'd recommend asking your friends or checking in your community to see if there is a therapist available for you. The coping skills I mentioned were learned through therapy and a lot of practice on my own.

Three months seems like a long time to wait for a medication to work for anxiety. Benzodiazepines like the clonazepam you are prescribed work for anxiety but meant to be used in the short term. I hope you will work with your doctor and a therapist to figure out what works best for you.

Thank you for your thoughtful response.

I was on Effexor for lifelong depression (I eventually received a bipolar 2 diagnosis that I feel is accurate), and I can tell you that stopping it after being on it long term was miserable for me. So I would suggest speaking with your provider or even getting a second opinion about whether it's a good choice for you and what to expect if you find, as I did, that you need to pull off of it.

I was never informed of the withdrawal hardships, and if you weren't, or even if you were, I’d say definitely seek a second opinion to be sure the benefits are going to outweigh any possible negatives (not everyone gets them, many receive tremendous help from Effexor, but some don’t, and some experience severe difficulties quitting it; there are numerous posts and threads on this site discussing the topic).

As I was dealing with the aftermath of quitting the drug, I changed my primary provider for a number of reasons. One of them was that the original one had never talked with me about the possible downsides of Effexor. He just prescribed it. Meanwhile, I made the mistake of not looking into it for myself (I do studiously stick to credible sources like Mayo for information, not social media and such, and strongly advise you do likewise; there is too much disinformation out there). On the other hand, I shouldn't have had to do that legwork when I finally sensed what was driving the problem. My doctor and pharmacist should have better prepared me for possible ill effects and let me know that getting off the drug could be an ordeal. I would have made a more informed decision.

My previous doctor was about my age, so in his late forties when he prescribed it, and late fifties when I realized I needed off of it. He didn't seem to understand my plight. After a number of years of successful use, Effexor had amplified my depression to a dangerous level and I was hospitalized, a rare but known response. I was the one who discovered what was going on with the medication, not him or the psychiatrist. She’s also my age, I began seeing after getting out of the hospital, and still do see as she recognized what had happened to me and adjusted her treatment accordingly.

The clinic I now attend is owned and operated by former military M.D.s, all of them reasonably young and, owing to the recent wars, well acquainted with mental health issues. When I discussed what had happened to me with my new provider, who is young enough to be my kid, he knew exactly what I was talking about and told me that if he prescribes psychotropic drugs, he requires the patient to make routine visits, as frequent as once a month, so he can monitor how they are doing on the medicine.

I think that after years of dolling out antidepressants and the like somewhat willy-nilly, the downsides – including but not limited to severe withdrawal effects and possible mental health backfires, both of which I had – are now being recognized. Younger doctors, P.A.s, nurse practitioners and other medical providers are, I suspect, learning this in medical school. Older doctors, in my experience, aren't really up to date on it. So if you decide to get a second opinion, you might want to seek out someone on the young side.

I would also strongly advocate for finding a good counselor. I've worked with two since my hospitalization (the first was married to a soldier and had to leave when he was transferred, the second has been equally helpful if not more so). Talking has done me far more good than medicine. Although I am on a different class of drug that isn't an antidepressant and is absolutely helpful.

In talking with both counselors, as well as several people I know in the field, and a couple of mental health professionals I've met along the way, I've found them better equipped than doctors at guiding clients through depression and other mental health difficulties because they spend more time talking about underlying issues and finding coping strategies. You don't get a hurried appointment and handed drugs, you get personal attention tailored specifically to your needs. They are trained to help with the day-to-day processes of coping with mental health problems and crises. What they provide is every bit as important as medical assistance.

And my observation is there appears to be better knowledge among counselors about how these drugs can sometimes go wrong, and how to help people through it if it does. They see in their first hand their practice the results if those drugs fail to help, and can do so in ways doctors can’t. Often because doctors are less cognizant of this and/or don't have the time to look for such results. Counselors seem to know the warning signs. I can't stress enough the value of finding a good counselor.

Sorry to go at such length, but these have been my discoveries after a severe breakdown that was driven by Effexor and nearly cost me my life (I’m not saying this will happen to you). Fortunately I found my way out of it and have been broadly depression-free for over a year-and-a-half. I hope this helps, and that you achieve similar success with what you are working to overcome.

Thank you so much for taking the time to provide all this info. I am 67 yrs, and have had depression most of my life but never to the point of needing medical treatment. I think I was just a melancholy person placing pressures on myself due to high expectations (retired architect). I am no longer depressed (~10 years) due to my own talk therapy with the help of friends, healing my gut (with the GAPS protocol) which I believe is key and turned my life by being grateful for all that I have (and returning to God). I learned that there is a bacteria in our gut that can lead to depression.
So my problem is an intense uncontrollable intense anxiety that suddenly happened 2 months ago. I have never suffered anxiety before and it is distinctly different than depression.
I learned that low estrogen can be a culprit here. I had 15 years of hot flashes, a sign of low estrogen, so maybe it has caught up to me.
I’m going to consider low dose transdermal HRT.
Someone’s posted here that they were on HRT to deal with premenopausal depression and anxiety and as soon as she stopped, the anxiety came rushing back.

Thanks again. So happy to know you made it. I feel for you.

@naturegirl5 I was given Effexor long time ago. It worked really well for me for about a year. I slept good, more energy, and just a better mood. But then my ears starting ringing so I looked up side effects and doing research it could be a side effect. My physician said it wasn’t. I went home and decided to taper off myself and finally was no longer taking it and my ears completely stopped ringing. I have never taken it again. I have taken other medications but none have been as good as Effexor was. I now just take 10mg of Lexapro. I have found for me to just work with my depression as I can. I have found too many of the medications had side effects I didn’t like.

glad you didnt have issues coming off it. I have been on it a few years and tried getting off WOW the side effects were nasty, so I feel like Im stuck on it.

@tisme The side effects will become worse the longer you are on it. I had looked up the side effects before I started taping it. If you what off of it I would definitely recommend working with your physician. I am glad I chose to discontinue it before staying on it any longer.

I’m in the process of weaning off of it after being on it for 2 years. It’s only been 2 days without it. The worst thing seems to be not being able to sleep. I was on 75mg +37.5 mg. I was told to stop taking the 37.5 mg and just take the 75 mg for a month. I’m too reduce to 37.5 mg once a day for another ninth and then stop. Does this sound logical? I’d appreciate any input.

@bern7475
I think you are wise to taper slowly. Although I heard it should only be 5-10% less at each stage which can take a long time. I’m glad to hear your 1st 2 days is just not being able to sleep. I had been on Venlafaxine (up to 76mg for 3 weeks) for just under 4 weeks total and decided to stop it because of the horror stories. I stopped cold turkey taking the chance that because it was such a short time, it shouldn’t be too difficult. I’m on my 7th day. I’m also taking some supplements that I heard would help during withdrawal. Magnesium L-Threonate, L-theanine and lithium orotate. Had a few days feeling dizzy; the 7th day was bad- very anxious. I typically take a very low dose (0.25 mg - 0.5 mg of clonazepam to help calm me. )
Wishing you well.

@bern7475 There is a tremendous amount of information on this site regarding tapering Effexor, and I would suggest you research it. As meingan mentions, a 5-10% reduction is recommended, and yours is much greater than that.