Avoiding discontinuation syndrome during removal of Venlafaxine XR

Hi @h8fxr, welcome to Connect.
Tapering off venflafaxine is an active topic here on Connect. I recommend reading this discussion:
- Tips on minimising withdrawal symptoms from Effexor (aka Venlafaxine) https://connect.mayoclinic.org/discussion/tips-on-minimising-withdrawal-symptoms-from-effexor-aka-venlafaxine/

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."

@texasduchess @maryathome also mention seeking advice from a compounding pharmacy.

For me my doctor reduced 225mg to 150mgs for 2 weeks, then to 75mg for 2 weeks, next week I will begin taking 75mgs every 2nd day for 2 weeks. This is my 4th week and Im experiencing headaches, tummy troubles, pain jabs here and there but all symptoms are the same I experienced when starting on them. The headaches were worse getting the drug into my system than they are getting them out of my system, so far that is. Immense sweating was an awful side effect of Venlafaxine, very stressful, that has stopped now, whew. When I have completed 6 weeks I will return to my Doctor for an update and further direction. I knew with all of me I was ready to go off this tablet. Other medications also I wanted out. including Zopiclone for sleep and Lorazepam for anxiety issues. I started with Zopiclone. After 3 weeks I was off them and could begin the antidepressant the following week. All these meds have served there purpose. I will keep on with Gabapentin. This drug changed my life. After 19 years with fibromyaIgia pain and chronic fatigue this drug rescued my nervous system and pain subsided causing chronic fatigue to subside too.. I anticipate Lorazepam to be the hardest give up
but then again maybe not. My reasoning power has returned so Im tackling this with a positive logical mind. Before I began this tapering off my meds I realized they had served there purpose. Why? Because there effect was dragging me down. When the pills had this opposite affect on me that they were supposed to I knew it was time to give them a miss. I was so ready to live better. Becoming unchained to the weakening effect of chronic trauma was my motivation. My quality of life had sucked for too long. I had to do my best better to withdraw from my drug dependencies now. I am succeeding. You cannot do this on your own. Professional direction from your doctor is a must. Anyway this is my take on my tapering. Wish me well, I've still a way to go.. On 12 November I sail into the last 2 weeks of round 1 before I see my Doctor to get round 2s instruction. I am totally awestruck at how easy it has been especially since I have been on various sorts of these meds for 19 years. We can and we will succeed friends. @-;-

Hi, @littlepaw - I don't believe I've gotten the chance to welcome you to Mayo Clinic Connect, so welcome. Hoping you are finding Connect a good place to talk. Sounds like you've hit a number of tough side effects with your taper off of the venlafaxine. I'd invite you to check out and participate in a very active current discussion on Connect, "Tips on minimising withdrawal symptoms from Effexor (aka Venlafaxine)," https://connect.mayoclinic.org/discussion/tips-on-minimising-withdrawal-symptoms-from-effexor-aka-venlafaxine/

❝ Capsules should never be split. Removal of beads from capsules to accomplish titration is not a recommended method of tapering. ❞

Fine, but there is no dose below 37.5mg for Venlafaxine XR ... How am I supposed to taper it off if I cannot take any of those beads off the capsule ?

You can request Venlafaxine in tablet form and then use a pill splitter.

And switching to non-XR to tapper off is recommended ?
Also, despite all the withdrawal symptomes, If I knew this is temporary and that the tapering off process will be successful in the end, I would be ready to endure it. Is it safe to simply endure it all and wait for them to subsidy on their own ?

Discl: please forgive my limited english, i'm french-native.

@h8fxr , I'm in the very same boat right-now, may I ask if you found an answer since ?
My 37.5mg venlafaxine XR have 3 of those mini tablets inside the capsule. (I bet those are 12.5mg).
But given @colleenyoung 's advice against taking those appart from the capsule, and the fact that i'm in canada as well (no instant release formula here), I'm left with no alternative than to go through the full dose (37.5mg) withdrawal symptoms until it subsidies.. I'm sweating, i'm dizzy, brain fog, and difficulty sleeping, but I guess it is safe to endure it all until it subsidies on it's own ?

Please talk to your doctor about it. My doctor was fine prescribing the tablet vs the capsule. I didn't notice a difference. I tapered very very slowly...took me a year. Even at 1/4 of the lowest dose tablet, the symptoms were rough. But I finally did it in January and have been fine since. I think I felt ill for about 3 weeks and then it finally lifted off of me: nausea, weird brain buzzing type feeling, fatigue, etc. I informed my husband what I was doing and slept ALOT. Golden milk helped me with the nausea. You can find recipes for it online. I hope that helps and best wishes with your tapering off.

What’s a person to do when the doctors don’t have a clue? This is why so many ask these tapering questions here.

Here’s the thing. Her doctor should have already switched her to the pill form. She should not have to be asking people on forums as to how to taper. If the doctors are going to prescribe these meds they need to know exactly what to do when it’s time to come off. This is a major major problem. Almost all suffer from their doctors lack of knowledge when it comes to physchiatric medication. These doctors can put us disastrous situations that affect us for years.