Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

Please start at Page 1 of this thread and read ALL of it. There's a lot of good information on this discussion board; I hope you'll start at the beginning and work your way through up to the present. You will note that the recurring recommendation is to taper off Effexor (venlafaxine) slowly—drop to a lower dosage that is no more than 5–10% less and stay at the new level for weeks (even months) AND stabilize before dropping again. Withdrawal symptoms (brain zaps, anxiety, hopelessness, rage, etc.) are the big tipoff that a taper is being done too aggressively.

You say that no doctor has been able to help. Sadly, the NORM is that often doctors don't know how to get someone off antidepressants; as @jakedduck1 said, "If there is an expert on getting off Effexor, they are hiding very well." You can help yourself—read this thread, do some online research, print out articles to give your doctor. Here are some articles about the difficulty of getting off psychiatric drugs, tapering off and the importance of tapering slowly—
https://www.rnz.co.nz/national/programmes/ninetonoon/audio/2018703293/going-off-antidepressants-take-time-to-quit
https://www.theguardian.com/commentisfree/2019/may/30/antidepressant-withdrawal-symptoms-doctors-side-effects
https://natashatracy.com/treatment-issues/withdrawal/stop-antidepressants-minimize-withdrawal/
https://natashatracy.com/treatment-issues/withdrawal/antidepressants-effexorpristiq-venlafaxinedesvenlafaxine/
https://www.benzoinfo.com/benzodiazepine-tapering-strategies/

Once your doctor is up to speed re discontinuing psychiatric drugs, you can ask your doctor to prescribe a different formulation of Effexor—changing from extended-release capsules to regular-release tablets (I was on 25mg regular-release tablets that could be cut), or to 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). You can also ask your doctor about a "Prozac bridge"—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/
https://www.depressionforums.org/forums/topic/107532-coming-off-of-effexor-with-prozac-bridge/

Even with a slow taper, you can experience withdrawal symptoms until you stabilize at the new lower level; OTC medications and supplements can help with some of the withdrawal symptoms (you can click on my name and go back through my past comments to see the supplements I used). Ben*dryl, Bon*ine, or other seasickness remedies can reduce/minimize the dizziness/vertigo. Sucking on Pepto Bism*l lozenges and eating dry saltine crackers can help with nausea. Folks who experienced "brain zaps" found relief by taking fish oil capsules. Do NOT take l-tryptophan, or 5-HTP while still on Effexor (can trigger serotonin syndrome). Here's a good article re how to mitigate withdrawal effects with supplements—
https://www.4mind4life.com/effexor-withdrawal-symptoms

Distraction during the weaning process helps—reading, hobbies, work, chores, gardening, exercise, etc. But some things can just be too agitating, so be mindful of what TV and movies you watch, or any video games you play—nothing frenetic, violent, or disturbing. Same for what you read, or listen to (no atonal, or dissonant music).

There is quite a benefit to getting your hands in dirt. There's a microbiome in it that acts as a natural anti-depressant. Even if you aren't up to a lot of gardening (or that interested), a houseplant, or an outdoor potted plant can lift your spirits and give you something beautiful to look at and/or smell.

Getting natural light to your eyes is extremely beneficial for lifting your mood and is calming … sunbathing isn't required, 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.

Effexor is a very powerful antidepressant that affects your brain's neurotransmitters–serotonin and norepinephrine. While reducing, or after getting off Effexor, it takes your brain a while to figure out how to rebalance serotonin and norepinephrine. Each of us is our own guinea pig; we're all just guessing here on what tapering schedule's going to work for us. Only you know how you feel; don't let anyone rush you. Make it easy on yourself—take as much time to taper off as you need to.

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@texasduchess
I'd love to know your take on @colleenyoung 's advising against taking those beads out the capsule ?
What I've read from you makes me more trustful than pretty much any "specialist" I've met on the subject so far..

To make it short, I'm trying to taper off 37.5mg venlafaxine XR, and my pharmacist told me to open the capsule and take those beads seperately, but I keep reading that those capsule should not be open at all.. Don't know what to think.
My 37.5mg capsules contains 3 beads(mini tablets) (I assume those are 12.5mg).
My plan was to go this way: 37.5>25>12.5>0… but 👇

❝ Capsules should never be split. Removal of beads from capsules to accomplish titration is not a recommended method of tapering. ❞
src: Colleen Young, Mayo Clinic Connect Director | @colleenyoung | Oct 14, 2018 | connect_mayoclinic_org/comment/220253/

Please let me know if my plan is safe or not. Thanks !
*please forgive my limited english, i'm french-native*

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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:

++++
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"
+++

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.

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❝ Capsules should never be split. Removal of beads from capsules to accomplish titration is not a recommended method of tapering. ❞
src: Colleen Young, Mayo Clinic Connect Director | @colleenyoung | Oct 14, 2018 | connect_mayoclinic_org/comment/220253/

I'm not sure how we're supposed to taper off this crap if we can't even take those beads out, though. Your message is 4 years old, how have you been since ?

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@texasduchess
I'd love to know your take on @colleenyoung 's advising against taking those beads out the capsule ?
What I've read from you makes me more trustful than pretty much any "specialist" I've met on the subject so far..

To make it short, I'm trying to taper off 37.5mg venlafaxine XR, and my pharmacist told me to open the capsule and take those beads seperately, but I keep reading that those capsule should not be open at all.. Don't know what to think.
My 37.5mg capsules contains 3 beads(mini tablets) (I assume those are 12.5mg).
My plan was to go this way: 37.5>25>12.5>0… but 👇

❝ Capsules should never be split. Removal of beads from capsules to accomplish titration is not a recommended method of tapering. ❞
src: Colleen Young, Mayo Clinic Connect Director | @colleenyoung | Oct 14, 2018 | connect_mayoclinic_org/comment/220253/

Please let me know if my plan is safe or not. Thanks !
*please forgive my limited english, i'm french-native*

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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.

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Everything was fine for a while, but I'd forgotten that venlafaxine also stopped my panic attacks as well as alleviating depression. The panic attacks returned and they were horrendous. I refused to go back on venlafaxine, but I knew I needed something. I've ended up taking duloxetine (generic Cymbalta) 60 mg/day. I started with 20 mg, then went to 40 mg and now to 60 mg for almost a year. I was sorry to have to use a drug again, but the panic attacks were debilitating and really limited my life. If my body chemistry needs some help, then so be it. (And, FWIW, if I hadn't been able to split capsules, I'd never have been able to get off the damn stuff.) Best of luck to you!

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Tablets are IR? Did you cut them? My prescription is for XR which is beads in capsules….. sounds like tabs would be much easier

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I was prescribed 25 mg, immediate-release Effexor (venlafaxine) in 2001 to control the hot flashes I developed while on Tamoxifen (binds to estrogen) to treat hormone-driven breast cancer. My last dose was 4/14/18. All those years, my medication was in tablet form—at first, it was an uncoated, very small, flat, five-sided, light pink tablet. Then it came as an oval and later, a round—always flat and uncoated; sometimes pink, sometimes yellow. The only difficulty with any of the tablets was that because they were very small (slightly less than a quarter of an inch across), flat and uncoated, they would easily get stuck at the back of the throat (they were quite bitter and tasted horrible). Mind you, I can literally take a whole handful of supplements (various sizes of tablets and capsules) with just one sip of water, but not the Effexor!

All of the 25 mg tablets I took would have been very easy to cut. When I tapered off in 2018, my tablets were round ones that even had a score down the middle. I cut these into halves, quarters and even smaller. I put the pieces into empty gelatin capsules (available at Vit*min Shoppe and online) to be sure I actually got the teeny dose swallowed.

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