Anxiety is often a withdrawal symptom. If your friend didn’t have to quit taking venlafaxine because it was causing other health issues, or he can no longer get/afford a prescription, posters to this thread have found that the quickest “fix” is to reinstate venlafaxine. Getting relief from withdrawal symptoms by reinstating will be dependent on how long your friend has been off this drug and if it will work for him again—he may need to take a higher dose than he used to and it may take weeks to kick in.

I did not try to reinstate. I didn’t have any withdrawal symptoms until 6.5 weeks after my last tapered dose (a tiny chip of a 25 mg regular-release tablet).

Hindsight is 20/20—if I had known all the problems I would have from quitting, the expense of the supplements I took to ease the withdrawal symptoms and ESPECIALLY how long it’s taken to get back to “normal,” I would DEFINITELY have just stayed on it. My prescription only cost $25 for a six-month supply and I never had any problems with this drug unless I forgot my daily pill (I’d get a very particular headache the next day)—I was only taking 25 mg venlafaxine for hot flashes and no longer needed them for that purpose.

Through trial-and-error and research, I came up with a number of OTC medications and supplements that helped me and have listed the supplements I took in previous posts (click on my name to go back through and read). The most helpful are l-tryptophan (it CANNOT be taken while still on venlafaxine) and GABA. I also now take Calm, a magnesium supplement drink mix.

If your friend tried a ketamine infusion, he probably has access to medical care. While it’s not a good idea to exchange one drug that can become problematic for another, he could ask his doctor about something to help in the SHORT term:

1) Some folks on this thread used a “Prozac bridge” to ease off venlafaxine. Essentially, the Prozac cushions the effect of no Effexor and lets you "ride out" the withdrawal process. Then, you taper off the Prozac.

2) While still on venlafaxine, my primary care doc had me take Xanax for a few days when I developed serotonin syndrome after he prescribed dextromethorphan for severe sinus congestion and it interacted with the venlafaxine.

3) Before I came up with an effective regimen of OTC medications and supplements, my akathisia and anxiety became overwhelming and I went to a walk-in healthcare clinic. The Care Now doctor was familiar (very unusual!) with venlafaxine withdrawal and had me stay home for three days and take 5 mgs Valium twice a day to “get ahead of the anxiety.”

4) My oncologist (who prescribed the venlafaxine for hot flashes resulting from my breast cancer treatment) followed up with a limited Valium prescription to take as needed when the akathisia and/or anxiety got too bad. (I took those Valium sparingly, seldom more than a 1/2 tablet and no longer than a day, or two.)

Self-care is also important—sunshine, fresh air, physical exercise (walking, yoga, running, etc.), hobbies/distractions and supportive friends/family are very helpful as is reducing stress and (for me) avoiding frenetic, violent, or disturbing music/TV/movies/books.

It took almost three years for my withdrawal symptoms to go away; they would ebb and flow with longer and longer periods in between. The stress of losing my job due to the pandemic and the isolation from friends/family for over a year because of Covid lockdown added at least a year to my recovery time.

I strongly recommend that your friend (and maybe, you as well) start at Page 1 of this thread and read ALL of it. There's a lot of good information on this discussion board. May your friend soon find ways to mitigate his anxiety.