Delayed onset of withdrawal symptoms from Effexor XR

Posted by harrison1775 @harrison1775, Nov 15, 2023

I've been trying to ween off of Effexor XR for most of the year now after taking it for over 10 years. I started back in February going from 150mg to 75mg. Didn't have any withdrawal symptoms until almost a month afterwards. One night I experienced increased anxiety with hypnic jerks or fear every time I would be at the point of falling asleep. Went to the ER after almost 48hrs of no sleep. I was instructed to go back to 150mg and was given Seroquel 100mg to help me sleep. I started to feel better once my usual dose was back in my system and reduced Seroquel to 50mgs before bed. After several months of being stable I decided to try to ween off again but this time more slowly by reducing the amount 37.5 monthly instead of 75. September 150mg, October 21 112.5mg and November 24 75 mg. Around the beginning of Nov I started experiencing chronic aches and pains which was kinda expected as a withdrawal symptom. At least from what I was reading. The night of the 13th I started having increased anxiety especially before bed with an increase in heart rate but was able to eventually fall asleep. Last night I was having the same before bed but this time I started experiencing the hypnic jerks and fear right before I'd fall asleep. Its 712am and Ive yet to sleep. I did take another 75mg so I will be back up to 150mg again. Sigh!!!! It appears I'm having some delayed onset of withdrawals symptoms again. Seems like its around the same duration as the last time I went down to 75mg.

Has anyone experienced the same with weening off of Effexor? Reason I'm wanting to ween off is I'm feeling great. Doc is wanting me to go to Lexapro but I cant even get to 37.5 of Effexor and start taking Lexapro. If anyone has any info OMG please I could use the help and support. Jason

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Sorry my weening off period started September 20th 112.5mg, October 21st 75mg with the first day of severe withdrawal/anxiety Nov 15th.


Sorry my weening off period started September 20th 112.5mg, October 21st 75mg with the first day of severe withdrawal/anxiety Nov 15th.

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Harrison 1775 , Hi . I wondered what this was (Hypnic jerk). I get them as a result of VEN / EFFEXOR . And still get them & I stopped titration @ end Oct 2022 !
I was only ever on 75mg. Cut down to 37.5 in a matter of months. BUT, thereafter took nearly 2 years to titrate off completely. My guess is, (& having read this elsewhere from feedback), you can drop @ first , fairly rapidly , (to circa 37.5). BUT, thereafter , go really slow & extend timeline of titration steps down. This is the only way to mitigate the withdrawal / side effects "kick back". I get narcoplexy , even 1 year after stopping - so have no problem "dropping off". Hope this helps.


Years ago I weaned someone off of many years of high dose Effexor. This is a long term project as in many months and even years to get off of this medication.
With this slow incremental method, there were small side effects felt but minor compared to what happens We kept notes on an index card. Its imperative. I will share what we did but consult with your doctor about how you should approach this.

Example: Currently on 75mg dosage and a goal of getting to 37.5 over a period of several months.
1) Open 75mg capsule and count how many total little dots/spansules are inside. (the number and size of spansules vary pill to pill so it is a rough estimate) Write number down on an index card. If long term goal is to half the amount of spansules then write this half number down also. Draw a line underneath. Below the line is to document the dates of changes and how many total spansules are removed.
2) Open 2 week pill organizer and one at a time open 75mg capsule and remove 2 white dots/spansules. Reclose securely the capsule. I did this over a dark bowl so I could catch any spills and see easily. Close the capsule back securely and place in each daily slot. Use pill organizer to take daily pill for the next 2 weeks.
3) Document on index card the date and how many spansules were removed. Eg. July 2, 2022 Minus 2 spansules
4) If in 2 weeks you are feeling stable and feeling no or little side effects you can reduce the dose by 1 or 2 more spansules for the next 2 weeks. If you're not feeling great stay at same dose another week or two. This is not a race. This is letting body adjust to slow small reductions and reduce the side effects.
4) Be sure when you do decide to reduce that you document how many spansules are taken out total. So in example, July 16 you decide you are feeling good and will reduce by another 2 spansules, you write down minus 4 next to that date. Then open up 14 capsules and remove a total of 4 spansules from each, close and put in organizer.
5) You can opt to reduce by 1 spansule a week, 1 spansule every 2 weeks, 1 spansule every month. The amount and frequency you go down is based on how you're feeling. There were a few times when we went a full month without reducing any further because side effects were present and body wasn't ready for another change. When in doubt keep the same dose. Better to err on smaller changes less frequently than to feel awful and have to back up.
6) When you get to the half number of spansules that you wrote down on top of your card. You will be ready to for a new dose prescription from your doctor and you plan to stay on that dose for several months before attempting any further dose reductions.

Manufacurers only make certain dosages and therefore doctors can only order certain doses of this medicine. The drug company advises not to break or open capsules. So it is up to the individual patient to advocate and do what each needs to do for themselves along with guidance from their doctor. Let your doctor know you're going to slowly wean and how. Communicate with doctor as you go along as there may be other changes beyond side effects to be considered.

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