I was on 75mg per day for hot flashes. It was not a problem for me to drop to 37.5mg per day. If you want to be cautious, I recommend a slow process, such as alternating capsules for a week to see how you respond on days of 37.5mg. If no reaction, then you should be okay to go to 37.5mg per day. On rare days that I forgot to take a pill, I would begin to feel nauseous--a reminder that I missed it--and take it immediately, and be ok. It is more difficult to discontinue the lowest dosage, in my experience. I weaned myself off by adding more hours between 37.5mg capsules, then a day between pills, until I was taking so few that I figured I could do without.
I've been off them for about two months, and am feeling extreme anxiety now, after feeling ok after stopping the drug. During withdrawal period, I had occasional nightmares (without realizing they were the result of withdrawal). I am no longer constipated and have less of an appetite for food, so I've lost weight since stopping the drug. With this degree of anxiety, I am not sure I can stay off the 37.5mg per day, but I am trying to alleviate the anxiety by other means--exercise, deep breathing, etc. My doctor suspects that I need the drug now to control anxiety; I would prefer to be off the drug, due to its side effects and difficulty of withdrawal. (No change in hot flashes; I still have them with and without Effexor. It was a mistake to prescribe this drug for hot flashes.)