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

Most of my sugar comes from coke. Then I eat a dessert nightly. I guess I could slowly switch to Diet Coke.

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@babydoll

Most of my sugar comes from coke. Then I eat a dessert nightly. I guess I could slowly switch to Diet Coke.

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@babydoll
Switch to Diet Coke? That's crazy!

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@falon

@jakedduck1 I don't have access to a compounding pharmacist. I was originally on 2 mg clonazepam. Tapered for the last 6 weeks by .125mg weekly. That is 1/4 of one tablet (0.5mg tablets). I am currently also on 150mg of Effexor that comes in a capsule the smallest of which is 37.5mg. Am not doing any tapering with the Effexor until after the clonazepam is done and I feel well enough. Thanks for your interest.

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@falon
Good morning,
So now the question is have you contacted your insurance to see if they would pay for a compounding pharmacy to provide medication currently unavailable by the manufacturers? The compounding pharmacy I use is 430 miles away. It really is the best way to go when tapering provided your willing to invest the time necessary to hopefully have an uneventful taper. Just think of the potential withdrawal effects versus a little time to come of it safely and probably side effect free. I’d think it would be a NO-BRAINER to go SLOW, VERY SLOW and I’m not talking just slow, I’m talking SLLLOOOOOOOOWWW!!
Snail pace slow,
Many people may consider it pain stakinglee SLOW and so they speed up the process which they never fail to regret. Of course you could spend 10-20 thousand dollars and go to a rehab It’s amazing some take it for 10, 20, 30 years and they think nothing of it but suggest they spend a year or two getting off it and many people come unglued. I cannot comprehend what the hurry is to be miserable although that appears to be the most popular choice. The proof is in the thousands of posts. By going too fast your probably in for nothing but agonizing withdrawal symptoms and virtually guaranteeing defeat.
Please people, slow down, way down!!!
Wishing you all the best,
Jake

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@texasduchess

@babydoll
Switch to Diet Coke? That's crazy!

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I know! Right!

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@texasduchess

@babydoll
Switch to Diet Coke? That's crazy!

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It actually is crazy. Aspartame. Hey guys, just because something is legal and passed by the FDA, doesn’t mean it doesn’t have major side effects on our brains and livers. I used to drink Diet Coke in college until I learned about n a neurology class what it does to your brain. Stopped cold turkey. That was over 30 years ago!

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I couldn’t do diet anyway, can’t stand the taste. I’d rather do water.

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I got a question. I was off the effexor for a week and half how long should it take to get back into my system? I've been back on it for a week. Thankyou

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@farmboy

I got a question. I was off the effexor for a week and half how long should it take to get back into my system? I've been back on it for a week. Thankyou

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@farmboy
I think you're really asking when you can expect the Effexor to be at a steady state.

Pfizer (mfr of Effexor) says of Effexor XR, "Dose increases should be in increments of up to 75 mg per day, as needed, and should be made at intervals of not less than 4 days, since steady-state plasma levels of venlafaxine and its major metabolites are achieved in most patients by day 4."
https://www.rxlist.com/effexor-xr-drug.htm#clinpharm–
"Steady-state concentrations of venlafaxine and ODV (its major active metabolite) in plasma are attained within 3 days of oral multiple-dose therapy. …When equal daily doses of venlafaxine were administered as either an immediate-release tablet, or the extended-release capsule, the exposure to both venlafaxine and ODV was similar for the two treatments, and the fluctuation in plasma concentrations was slightly lower with the Effexor XR capsule. Therefore, Effexor XR provides a slower rate of absorption, but the same extent of absorption compared with the immediate-release tablet."
https://www.mayoclinicproceedings.org/article/S0025-6196(11)62919-4/pdf–
"The ideal antidepressant should have a half-life consistent with once-a-day dosing or a half-life of about 24 hours. The shorter half-life drug reaches steady state sooner than the longer half-life compound and also is eliminated quicker.

A pharmacokinetic rule of thumb is that it takes about 4 to 5 times the elimination half-life with a constant dosing interval to achieve steady-state levels. With a drug that has a half-life of 1 day, this steady state is reached after 4 to 5 days. For a drug with the elimination half-life of 4 days, the time to steady state with once-a-day dosing is 16 to 20 days.

Additionally, the phenomenon of cumulation, or accumulation occurs when a drug is given at an interval shorter than 4 to 5 times its half-life. In this case, the blood level at steady state is much higher than that after the first dose. This is because the drug is given at an interval that is shorter than the time necessary for the body to eliminate most of the previous dose.

Another pharmacokinetic rule of thumb based on the elimination half-life is that it takes about 4 to 5 times the elimination half-life to have more than 90% of the drug eliminated from the body after the medication is discontinued. Thus, a drug with an intermediate half-life shortens the time to steady state and shortens the time for elimination.

This knowledge is important when therapy is initiated, when dosages are adjusted, when a medication is discontinued because of an adverse effect, or when one drug is discontinued before another drug is initiated that might cause a drug interaction.

From a theoretical standpoint, the compounds with a half-life between about 17 and 36 hours can be given once per day to maintain good steady-state levels. Drugs with lesser half-lives must be given more frequently, and those with greater half-lives can be given less often than once per day, although this approach is generally not used. …An extended-release form of venlafaxine allows once-daily dosing."

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@farmboy

Fallon,do you have trouble with anxiety/panic attacks?

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Speaking of anxiety, when does this go away?! I have good days, then all of a sudden, I have anxiety and don’t want to do anything or talk to anyone! I want it to stop. I can be somewhere feeling fine, then anxiety hits me and I’m ready to go home and be by myself. I can’t have this in my work life or personal life for that matter. I do not want to go back on Ativan or klonopin.

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Hey everyone. I'm familiar with tapering from effexor. I went from 225mg to 112.5mg about 4 years ago, it took about a year to taper down. I spent forever separating the little balls insides the capsule. Now I'm hoping to taper more to get off of it someday in the future. I went down by about 10% one day last week and it was instant flu symptoms and some brain zaps and vertigo. I reassessed and went down by only a few milligrams to be about 3%. I am at about 107% now so a 5% decrease in about 2 weeks. I'm staying at the same level for the better part of a week before I decrease the dosage by another few milligrams. I know it will take me over a year and a half to taper off this completely. I'm looking for some tips and help with how to alleviate the anxiety and depression I'm feeling and the symptoms that come with getting off these strong meds.

I currently separate each days meds by separating the tiny balls inside the capsule with a knife to take away a few milligrams. I've heard people getting small jewelry scales to measure the pills instead of doing it by eye, but I have't had any good luck looking online for a microbalance or a jewelry scale that measures milligrams accurately for less than a few hundred dollars. Does anyone have any good recommendations on scales to use? Also, I've heard about CBD, but have never used it. Would it be useful to use during my tapering or would my cannabis use be more or just as effective? Should I be taking Tylenol everyday or just days when I feel those flu like symptoms arise? Has anyone had any results using acupuncture to alleviate symptoms? Or what about people who are severely sensitive to these meds like I am where a 10% reduction isn't possible and slower tapering is necessary-any advice on how to do this in a manageable way that won't make me want to jump off a cliff because it's taking so long, but also a way to make it go as fast as possible while still enjoying my daily life?

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@babydoll

Speaking of anxiety, when does this go away?! I have good days, then all of a sudden, I have anxiety and don’t want to do anything or talk to anyone! I want it to stop. I can be somewhere feeling fine, then anxiety hits me and I’m ready to go home and be by myself. I can’t have this in my work life or personal life for that matter. I do not want to go back on Ativan or klonopin.

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@babydoll
Effexor affects brain chemistry–particularly the amount of serotonin available. Serotonin in the brain is thought to regulate anxiety, happiness, and mood. Now that you're off Effexor, it is no longer boosting the amount of serotonin available. I remember that you asked your doctor for Prozac after a week, or so off Effexor. Prozac can also modulate serotonin, but has a longer-half life than Effexor and takes longer to work, so yours is another steady state question.
https://www.justanswer.com/mental-health/53wzh-long-does-one-dosage-prozac.html–
"Prozac has a half-life of 4-6 days. That means one pill taken today will be 50% washed out of the body in 4-6 days. So each pill taken between now and then adds to the blood plasma level.

In Prozac, for example, fluoxetine has the 4-6 day half-life, but its metabolite norfluoxetine has a 9.3 day half-life. So it can take longer to reach plasma levels for that chemical, so that would mean 18 days to reach steady state.

Just because you reach steady state doesn't mean you have reached full potential, or full reaction from a medication. Psychiatric medications are typically given 2-4 weeks before adjustments are made to allow for steady state to be reached, but also to allow the body to adjust to the chemical changes in the brain, and to allow the short-term negative side-effects to pass.

If your body processes medications at different than average, such as kidney or liver damage which may allow the medication to hang around longer than the expected half-life, [it can take a] longer time to reach steady state and a higher steady state amount in the body.

One other note, not all generics work the same, nor do generics always work as well as brand name. If you feel like the same dose is not working as well as a previous trial on the same medication, be sure to check that they were manufactured by the same company. The same medication may not give you the same reactions twice, because your body doesn't find it to be the same novel, unique, or intense change that it may have taken the medication to be previously. Kind of like the first bites of a cake taste sweeter than the following bites."

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@babydoll

Speaking of anxiety, when does this go away?! I have good days, then all of a sudden, I have anxiety and don’t want to do anything or talk to anyone! I want it to stop. I can be somewhere feeling fine, then anxiety hits me and I’m ready to go home and be by myself. I can’t have this in my work life or personal life for that matter. I do not want to go back on Ativan or klonopin.

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I had anxiety and panic attacks almost all the time when I tried quitting effexor. You will probably have to have some sort of med to help you through the anxiety attacks and go really really slow coming off of effexor.

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