Tips on minimising withdrawal symptoms from Effexor (aka Venlafaxine)

Posted by richyrich @richyrich, Nov 2, 2016

I have been taking Effexor/Venlafaxine for years and tried to get off it a few times but each time I try to give up the chemical withdrawal symptoms are a horror story and I give up giving up. Anyone got any tips or tried and tested strategies? Thank you

Good Morning All!
After reading all that everyone has gone through trying to come off Effexor, I wonder if the doctors really know and understand what a good schedule would be to taper off the drug.
I know 'one size does not fit all,' but it seems to me that we probably need to come off even slower than the recommendation.
I have at least one surgery (the next one in 2 weeks) to have done before I even attempt to taper off…..One thing at a time.
As I have mentioned before, my psychiatrist is leaving so I will be looking for another one to manage my meds.
I will listen to this new person but my PCP tried to get me weaned off years ago on a schedule that was not good for me.
I am at the point that I am willing to take as long as necessary in order to try to minimize the impact of this this drug.
FYI…..I take 150 mg in the am/pm. I have been on Effexor for many years and this top dose for about a year.
The way I see it, I've been on it for years, it may take me a year or more to get off it.
Anyway, I am NOT suggesting this to anyone, I am just thinking, out loud, that this might be a good way for me to taper off.

Here is to a good day…….
Ronnie (GRANDMAr)

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Good Morning All!
I received this article that I thought might be of interest.
I think this might be something that might help some of us as we try to taper off this drug.
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/pet-therapy/art-20046342/?utm_source=newsletter&utm_medium=email&utm_campaign=managing-depression
Ronnie (GRANDMAr)

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@youngsally

Ronnie – I think that docs didn't warn those of us who have been on Effexor for a long time – simply because there wasn't enough clinical data out there to show that there are problems. Prescribers (many of whom are PCPs as opposed to psychiatrists/psychopharms) found that the SNRI's worked well in patients who didn't respond to the SSRIs….but there wasn't enough experience in patients coming off the drugs.

I remember back in '03 or so, issues with the atypical antipsychotics (high cholesterol, weight gain, hypertension, diabetes) had on many patients started to come together. The atypical antipsychotics – the ones that we now see lots of advertisements for under the banner of "when your antidepressant isn't working – add XYZ" – are a huge improvement over older antipsychotics – but now doctors know that these drugs are not without their downsides.

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@youngsally
Good Morning!
I agree with you. I know that these doctors were not be malicious.
What amazes me, in general, is that the US takes so many years to approve drugs for use and yet they still approve drugs that can be dangerous and in some cases deadly.
I remember when I was pregnant over 40 years ago, they were giving moms-to-be drugs for morning sickness. They later found out that the children of these mothers were being born with all sorts of birth defects.
There has to be a better way to test drugs. I don't know what that would be, but there has to be.

Have a great day!
Ronnie

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@kbmayo

I am so sorry you've had such a horrible experience!! I've read (and my doctor confirmed) that because venlafaxine has such a very short half-life, trying to taper by using it only every other day is really hard on the body because it never has a chance to really get rid of the drug — sort of a yo-yo effect — you take it out, then you put it back in, so the body doesn't know what the heck is going on. I'm fortunate, I guess, because I had the XR capsules so I set up a taper schedule where I've gone down an additional 50 beads per week. It's maddening to open the capsules and count out the right number of beads, but so far it's made my taper much easier physically. None of those godawful zaps or dizziness or nausea, which I've had several times before when I didn't get my scrip refilled in time! A 50-bead reduction is not quite 15.5 mg, so it's been easier on my body. I have 2 and a half weeks left to go — 95 beads/day this week, 45 beads/day next week, then 30 for a day, then 25 for a day, then 20, then 10, then 5. (My doc said I can probably stop completely when I get to 45/day because that's less than 14 mg. I may try it; I'll see how brave I feel! The total tapering time for me will be about 3 months — I was on 150/day (486 beads), I started small with 10 beads/wk for 2 wks, then boosted it to 20 for 1 wk and decided to up it to 50 because I was doing ok. I'll be very interested to see what I experience when I take none at all. I'm so glad you're getting medical care and I really hope things will get much better for you very soon!!!

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Yes the “bead” protocol had been used successfully by some. I found it a very frustrating and difficult way to titrate off this medication. In addition, as soon as you pop open the capsule and you have just the beads separately, you lose the extended release nature of Effexor XL, which is the form of the medication that most people are on. I know it seems counterintuitive to use one medication to get off of another, but as I have mentioned before on this post, I strongly recommend you speak to your physician about doing a Prozac bridge, which in my opinion is the best way to get off this very difficult medication.

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@grandmar

Good Morning All!
After reading all that everyone has gone through trying to come off Effexor, I wonder if the doctors really know and understand what a good schedule would be to taper off the drug.
I know 'one size does not fit all,' but it seems to me that we probably need to come off even slower than the recommendation.
I have at least one surgery (the next one in 2 weeks) to have done before I even attempt to taper off…..One thing at a time.
As I have mentioned before, my psychiatrist is leaving so I will be looking for another one to manage my meds.
I will listen to this new person but my PCP tried to get me weaned off years ago on a schedule that was not good for me.
I am at the point that I am willing to take as long as necessary in order to try to minimize the impact of this this drug.
FYI…..I take 150 mg in the am/pm. I have been on Effexor for many years and this top dose for about a year.
The way I see it, I've been on it for years, it may take me a year or more to get off it.
Anyway, I am NOT suggesting this to anyone, I am just thinking, out loud, that this might be a good way for me to taper off.

Here is to a good day…….
Ronnie (GRANDMAr)

Jump to this post

Ronnie – are you taking immediate release – or XR? Also you are taking 150mg BID (2x day?).

As a starting point here's been mine: and I was taking 150mg of Effexor XR once a day for about 15 years.

Week 1: 112.5mg side effects – none.
Week 2: 75mg side effects – 1 day with facial numbing (fleeting)
Week 3: 37.5mg side effects – one night of crazy dreams – really draggy for a day.
Week 4: 37.5mg side effects – one day with nausea, dizziness and headaches for a few hours. However, may have been heat and/or allergies and that I hadn't slept the night before – so had about 90min of sleep in 24 hours (which was yesterday)

I am going to titrate down to zero on Monday or Tuesday and see how things go. I rescheduled my psychiatrist appointment today because I still have a lingering headache and didn't want to take the 90 minute commute in the heat both ways….also had spent hour on phone arguing minor legal process details with the person unlucky enough to have gotten my call – but who deserved it for hanging up on me last month 🙂 Actually – it made me feel better.

REPLY
@grandmar

@youngsally
Good Morning!
I agree with you. I know that these doctors were not be malicious.
What amazes me, in general, is that the US takes so many years to approve drugs for use and yet they still approve drugs that can be dangerous and in some cases deadly.
I remember when I was pregnant over 40 years ago, they were giving moms-to-be drugs for morning sickness. They later found out that the children of these mothers were being born with all sorts of birth defects.
There has to be a better way to test drugs. I don't know what that would be, but there has to be.

Have a great day!
Ronnie

Jump to this post

Ronnie — It is the nature of clinical research. Even with our exhaustive drug approval process in the US – these drugs are generally still only being tested on a group of individuals in a controlled situation by physicians who are very familiar with the NDE (new drug entity)…and for a decidedly limited time (which varies by indication).

Side effects start to show themselves in aftermarket studies (phase 4 clinical trials) which are longer in duration….but then datapoints and trends show up once any physician can write a scrip for the drug….the drugs are taken by a wider variety of people in terms of age, health, gender, racial, ethnic factors and lifestyle differences. It can take a number of years before there's enough data (assuming it's reported back to the FDA or the drug company) indicating that there may be a problem…..and then if the problem is considered significant – there is a process to put warnings on the labeling for these drugs….but then that requires more testing.

In general, withdrawal from SSRIs/SNRIs by individuals without any significant comorbidities is safe – even if someone decides to go cold turkey (which isn't saying it's a good idea) — but withdrawal can be unpleasant. Getting on these drugs can be pretty damn unpleasant as well….but that is a factor with many drugs.

REPLY
@mrhappy

Yes the “bead” protocol had been used successfully by some. I found it a very frustrating and difficult way to titrate off this medication. In addition, as soon as you pop open the capsule and you have just the beads separately, you lose the extended release nature of Effexor XL, which is the form of the medication that most people are on. I know it seems counterintuitive to use one medication to get off of another, but as I have mentioned before on this post, I strongly recommend you speak to your physician about doing a Prozac bridge, which in my opinion is the best way to get off this very difficult medication.

Jump to this post

I'm wondering where you found the information on the "change the extended nature" of the XR when the capsule is opened. In capsule forms the extended release is usually built into the bead coating — the capsule disintegrates quickly. In tablets, where the extended release is built as a combination of coating and/or structures to the tablet (laser drilled holes or a gel matrix) – then one definitely changes the absorption rate if the tablet is broken in half or crushed. It's one of the reasons why there has been such a push to make opioids "tamper proof" – can't crush em and smoke/snort or inject them.

It's a minor point – and I agree that a bridge is an option for people…and bead counting is tedious – and difficult to do correctly every time.

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@youngsally

Ronnie – are you taking immediate release – or XR? Also you are taking 150mg BID (2x day?).

As a starting point here's been mine: and I was taking 150mg of Effexor XR once a day for about 15 years.

Week 1: 112.5mg side effects – none.
Week 2: 75mg side effects – 1 day with facial numbing (fleeting)
Week 3: 37.5mg side effects – one night of crazy dreams – really draggy for a day.
Week 4: 37.5mg side effects – one day with nausea, dizziness and headaches for a few hours. However, may have been heat and/or allergies and that I hadn't slept the night before – so had about 90min of sleep in 24 hours (which was yesterday)

I am going to titrate down to zero on Monday or Tuesday and see how things go. I rescheduled my psychiatrist appointment today because I still have a lingering headache and didn't want to take the 90 minute commute in the heat both ways….also had spent hour on phone arguing minor legal process details with the person unlucky enough to have gotten my call – but who deserved it for hanging up on me last month 🙂 Actually – it made me feel better.

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Wow. You are really going fast young sally. I wish you all the best. I will be off soon too. Monday I will be down to 12mg for a week, then down to 0. I got very sick with nausea and insominia when I tried to go from 37.5 to 0. I am still waking up with an occasional headache lasting no longer than an hour. It will be so nice to get this monkey off my back.

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@youngsally
When I was ready to go down from 37.5 my PC doctor told me to divide the capsules in half but the psychiatrist she referred me to for the withdrawal process (his main field is psychopharmacology) disagreed and said that not all the beads were the same and that it was not a good idea to do that. So he prescribed some 25 mg tablets so that I could split them as needed.

REPLY
@youngsally

Ronnie — It is the nature of clinical research. Even with our exhaustive drug approval process in the US – these drugs are generally still only being tested on a group of individuals in a controlled situation by physicians who are very familiar with the NDE (new drug entity)…and for a decidedly limited time (which varies by indication).

Side effects start to show themselves in aftermarket studies (phase 4 clinical trials) which are longer in duration….but then datapoints and trends show up once any physician can write a scrip for the drug….the drugs are taken by a wider variety of people in terms of age, health, gender, racial, ethnic factors and lifestyle differences. It can take a number of years before there's enough data (assuming it's reported back to the FDA or the drug company) indicating that there may be a problem…..and then if the problem is considered significant – there is a process to put warnings on the labeling for these drugs….but then that requires more testing.

In general, withdrawal from SSRIs/SNRIs by individuals without any significant comorbidities is safe – even if someone decides to go cold turkey (which isn't saying it's a good idea) — but withdrawal can be unpleasant. Getting on these drugs can be pretty damn unpleasant as well….but that is a factor with many drugs.

Jump to this post

@youngsally
Good Morning,
Thank you very much for the information, I had no idea.
Guess I need to research more before I shoot off my mouth.
Thanks again,
Ronnie

REPLY
@youngsally

Ronnie – are you taking immediate release – or XR? Also you are taking 150mg BID (2x day?).

As a starting point here's been mine: and I was taking 150mg of Effexor XR once a day for about 15 years.

Week 1: 112.5mg side effects – none.
Week 2: 75mg side effects – 1 day with facial numbing (fleeting)
Week 3: 37.5mg side effects – one night of crazy dreams – really draggy for a day.
Week 4: 37.5mg side effects – one day with nausea, dizziness and headaches for a few hours. However, may have been heat and/or allergies and that I hadn't slept the night before – so had about 90min of sleep in 24 hours (which was yesterday)

I am going to titrate down to zero on Monday or Tuesday and see how things go. I rescheduled my psychiatrist appointment today because I still have a lingering headache and didn't want to take the 90 minute commute in the heat both ways….also had spent hour on phone arguing minor legal process details with the person unlucky enough to have gotten my call – but who deserved it for hanging up on me last month 🙂 Actually – it made me feel better.

Jump to this post

@youngsally
Good Morning!
I was on XR for years but after having weight loss surgery 2 years ago, I had to change to immediate release. After weight loss surgery, the body does not adsorb the way it used to. At that point, my psychiatrist did not know how I would adjust to the change. No problem.
Yes, I take 150 mg, twice a day.
Thank you for sharing your plan. I am worried that would be a little too quick for me. I actually take 2-75mg in the am/pm. I was thinking about cutting the evening 75mg in half for a week (or 2 depending on how I feel), thendoing the same with the am dose next.
I know I cannot do this without the guidance of a psychiatrist.
I don't know if you read, but my psychiatrist left so I have to find a new one, which I am working on. I actually think I found one, will call today.
Anyway, thanks again for all your sharing.
Have a great weekend!
Ronnie

REPLY
@youngsally

Ronnie – are you taking immediate release – or XR? Also you are taking 150mg BID (2x day?).

As a starting point here's been mine: and I was taking 150mg of Effexor XR once a day for about 15 years.

Week 1: 112.5mg side effects – none.
Week 2: 75mg side effects – 1 day with facial numbing (fleeting)
Week 3: 37.5mg side effects – one night of crazy dreams – really draggy for a day.
Week 4: 37.5mg side effects – one day with nausea, dizziness and headaches for a few hours. However, may have been heat and/or allergies and that I hadn't slept the night before – so had about 90min of sleep in 24 hours (which was yesterday)

I am going to titrate down to zero on Monday or Tuesday and see how things go. I rescheduled my psychiatrist appointment today because I still have a lingering headache and didn't want to take the 90 minute commute in the heat both ways….also had spent hour on phone arguing minor legal process details with the person unlucky enough to have gotten my call – but who deserved it for hanging up on me last month 🙂 Actually – it made me feel better.

Jump to this post

Please consider remaining on the 37.5 mg dose for another two weeks. I would then recommend 10 mg of Prozac for five days and then stop everything.

My experience and the experience of some others going from 37.5 mg of Effexor to nothing can be quite a shock to the system especially if you have been on it for a while. Everyone is different though as we know! Good luck!

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