Hi @samrichardson, welcome. I can see that you are doing your research and are concerned about how to taper down from 37.5mg venlafaxine XR. Your pharmacist has suggested to count the beads to smaller doses. Several members in this community have made the same suggestion and had success with this method. Others have split tablets and others have reported finding help at compounding pharmacies.

Because there were different approaches, I sought the advice of a Mayo Clinic pharmacist and this is what she had to say:

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FROM MAYO PHARMACIST
"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.&#34"
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This is in direct conflict with the advice you received from your pharmacist. As a fellow patient, I can only pass along this information. I cannot tell you what is right for you. I might suggest you talk with your prescribing doctor and/or take your concerns to the pharmacist for a discussion. Equipped with that knowledge, you can have confidence in your choice.

je vous souhaite bonne chance et bien du succès.

I'm no expert, just a person who went through the ordeal of tapering off Effexor; I trial-and-errored the methods and followed the advice/suggestions of others who quit Effexor.

Removing beads from the capsules to taper may not be recommended by the manufacturer, but frankly, folks trying to get off this drug don't have a lot of options.

Folks who took beads out of their venlafaxine capsules had capsules that contained many, many teeny beads (I was on a solid tablet and never took capsules, but imagined the beads to be similar to the nonpareils on chocolates, or mint candies). You're the first person who has described a capsule with just three "mini tablets" inside. Your pharmacist (I would consider such a person an expert) said you could open your capsules and take the mini beads out. I would only suggest that you further split the mini beads to make additional steps between 37.5, 25 and 12.5 mg—a more gradual taper is usually more successful.