Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

@samrichardson, thank you so much for sharing what you learned from your pharmacist and the approach you are taking to taper. You've also received first-hand knowledge and guidance from fellow members @jakedduck1 @rosa66 @kbmayo @sears @texasduchess and others have said. Tapering off venlafaxine is different for everyone. It's not easy.

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The Mayo pharmacist did some more digging and contacted the manufacturer as well. Here's what she writes:

"Recommendations from the manufacturer and compendia suggest discontinuation after tapering to the venlafaxine er 37.5 mg for a period of time in the same manner that someone would be initiated on that dose (and not ramped up by counting beads to start). I reached out to the manufacturer Viatris to see if they had information about opening Effexor XR capsules and dosing based on bead counting. The manufacturer stated they did not have any data on opening the capsules and could not provide recommendations about that. They defer to the discretion of a prescriber.

Generally, venlafaxine can be tapered by 37.5 mg intervals over several weeks. Some patients may have more trouble with tapering and require a longer taper or change to another medication, such as fluoxetine, for a period of time before tapering off that. It could be that patient specific factors lead the prescriber to conclude that counting pills was the best option, even if information regarding this approach is lacking.

The danger is that if the beads are not standardized the dosing by bead counting would be variable. The manufacturer offers no indication that there is any particular amount of drug per bead, and release from the beads themselves could vary from the drug delivery from the bead and capsule since they are not designed to be taken that way. In practice across several states over 15 years I have not encountered prescriptions describing this method of administration for tapering.

You can read more about antidepressant withdrawal here:
- Antidepressant withdrawal: Is there such a thing? https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133
It’s important that you are reaching out for advice to help manage symptoms. It can also be important to involve your care provider to ensure there is a plan in case depressive symptoms worsen on tapering. "

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Sam, I agree with you and others who have stated that the manufacturers and "monography alone never provide the reason why they advice not to split/crush/break their original form." How is your tapering going? Is the guidance from your pharmacist helping you?

As I peruse the feedback I am noticing many differing many different comments and experiences. Goes to show we are not all wired the same when it comes to medication. One size does not fit all.

Totally, every human has different chemistry. All wired differently. That's why any doctors ideas around how to work with medications go out the window. Only thing I've found that they know is NOT to go off "cold turkey" which I so agree, because too hard on our system. All the doctors I've been to had zero idea about Effexor withdrawal, even my Top Rated Colorado psychiatrist, MD. However thankfully I recently found a nurse practitioner who does.
I was on Effexor XR- 75 MG for 20 years. I've recently Tapered along with a low dose of 20 mg Prozac, per my doctor. Went down to 17 mg then went off cold turkey from 15mg and I've been sick for 5 weeks now. Some days are OK, but most days nausea and a bit of vertigo. Holy shit Effexor XR I learned has Class Action Law Suits currently; one for pregnant women that have led to birth defects while taking it. There should be a Class Action for the insane withdrawal symtoms as well.

Totally, every human has different chemistry. All wired differently. That's why any doctors ideas around how to work with medications go out the window. Only thing I've found that they know is NOT to go off "cold turkey" which I so agree, because too hard on our system. All the doctors I've been to had zero idea about Effexor withdrawal, even my Top Rated Colorado psychiatrist, MD. However thankfully I recently found a nurse practitioner who does.
I was on Effexor XR- 75 MG for 20 years. I've recently Tapered along with a low dose of 20 mg Prozac, per my doctor. Went down to 17 mg then went off cold turkey from 15mg and I've been sick for 5 weeks now. Some days are OK, but most days nausea and a bit of vertigo. Holy shit Effexor XR I learned has Class Action Law Suits currently; one for pregnant women that have led to birth defects while taking it. There should be a Class Action for the insane withdrawal symtoms as well.

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

Hello, I want to start tapering off my venlafaxine 37.5 capsules, but I'm not sure how to do it. Can someone please advise the safest way?

Hello, I want to start tapering off my venlafaxine 37.5 capsules, but I'm not sure how to do it. Can someone please advise the safest way?