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

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@bdizjr

I am trying to stop taking effexor xr. I have been taking 150 mg for 20 years. I have slowly reduced 37 1/2 mg each month with no problems. Now that I am on the last 37 1/2 , I have tried to stop taking this last dose and I got the brain shivers and was violently sick. Per my docter I am now taking it every other day. Even then I am getting brain shivers and agitation after 36 or so hours. I really want off this medication. Any suggestions to help?

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I would not take the 37.5mg every other day–Effexor has a very short half-life in the body; ping-ponging on/off from one day to the next is putting you into withdrawal over and over. Going slooowww is your friend! Reduce by only 5-10%, or even less with each taper and stay at each tapered level for some weeks/months before tapering again. There's no point rushing the process if you ultimately can't get off Effexor because the withdrawals are too awful.

Your doctor can prescribe a different formulation–changing from extended-release capsules to regular-release tablets (I was on 25mg regular-release tablets that could be cut), or specifying a certain brand of capsules (@farm_mom found Teva had the most consistent size and number of beads within a capsule–helpful to those counting and throwing out beads to taper–see @sandij, or @doorman on how to do this). Or your doctor can write a prescription for a compounding pharmacy to make tapered doses for you (the extra cost may well be worth it because you can glide down in incremental amounts, rather than make rather large jagged drops).

Ask your doctor about a "Prozac bridge"–"The only way doctors know to soften the blow when withdrawing from short half-life drugs [Effexor is such] is to add 20mg fluoxetine (Prozac). The half-life of Effexor is 5 hours and 99% of it is out of your body in one day. Prozac's half-life is 4 to 6 days and it takes 25 days for 99% of it to be out of your body. Essentially, the Prozac cushions the effect of no Effexor and lets you "ride out" the withdrawal process.–https://natashatracy.com/treatment-issues/withdrawal/antidepressants-effexorpristiq-venlafaxinedesvenlafaxine/. See also https://www.depressionforums.org/forums/topic/107532-coming-off-of-effexor-with-prozac-bridge/.

Liked by Sherman, Leonard, doorman

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@texasduchess

I would not take the 37.5mg every other day–Effexor has a very short half-life in the body; ping-ponging on/off from one day to the next is putting you into withdrawal over and over. Going slooowww is your friend! Reduce by only 5-10%, or even less with each taper and stay at each tapered level for some weeks/months before tapering again. There's no point rushing the process if you ultimately can't get off Effexor because the withdrawals are too awful.

Your doctor can prescribe a different formulation–changing from extended-release capsules to regular-release tablets (I was on 25mg regular-release tablets that could be cut), or specifying a certain brand of capsules (@farm_mom found Teva had the most consistent size and number of beads within a capsule–helpful to those counting and throwing out beads to taper–see @sandij, or @doorman on how to do this). Or your doctor can write a prescription for a compounding pharmacy to make tapered doses for you (the extra cost may well be worth it because you can glide down in incremental amounts, rather than make rather large jagged drops).

Ask your doctor about a "Prozac bridge"–"The only way doctors know to soften the blow when withdrawing from short half-life drugs [Effexor is such] is to add 20mg fluoxetine (Prozac). The half-life of Effexor is 5 hours and 99% of it is out of your body in one day. Prozac's half-life is 4 to 6 days and it takes 25 days for 99% of it to be out of your body. Essentially, the Prozac cushions the effect of no Effexor and lets you "ride out" the withdrawal process.–https://natashatracy.com/treatment-issues/withdrawal/antidepressants-effexorpristiq-venlafaxinedesvenlafaxine/. See also https://www.depressionforums.org/forums/topic/107532-coming-off-of-effexor-with-prozac-bridge/.

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@bdizjr
P.S. You mentioned being on Effexor for 20 years. I tapered off slowly from just 25mg (taken for hot flashes for almost 18 years). I didn't have any withdrawal effects until 6.5 weeks after my last dose–that's when all the stored Effexor finally got used up. So be aware that it gets stored in body tissues when you've been on it for a long time.

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@bdizjr
Good morning & Happy Holidays,
I hope your fine this Christmas morning.
You were given some top notch advice by @texasduchess.
I want to alert you to only one other thing. You tapered at a set rate (37.5mg) per month. When you look at it from a percentage standpoint your taper wasn’t so slow or smooth. If my calculations are correct (And I wouldn’t bet money on them) you started with a 25% decrease then the next month decreased by 33% and then 50%, so it was anything but slow as you describe. It’s better to choose a particular percentage and stay there.
It is incomprehensible to me how someone can take a medication for 10, 20 or 30 years than expect to get off it in such a short time or worse stopping cold turkey. A lady here stopped cold turkey after 30 years and had a stroke.
Your best chance for a totally uneventful taper is to do it slowly. Oh yes, one more thing. Here is a link to micro-tapering at Cinderella therapeutics,
https://www.cinderella-tx.org/en/
Blessings,
Jake

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@jakedduck1

@bdizjr
Good morning & Happy Holidays,
I hope your fine this Christmas morning.
You were given some top notch advice by @texasduchess.
I want to alert you to only one other thing. You tapered at a set rate (37.5mg) per month. When you look at it from a percentage standpoint your taper wasn’t so slow or smooth. If my calculations are correct (And I wouldn’t bet money on them) you started with a 25% decrease then the next month decreased by 33% and then 50%, so it was anything but slow as you describe. It’s better to choose a particular percentage and stay there.
It is incomprehensible to me how someone can take a medication for 10, 20 or 30 years than expect to get off it in such a short time or worse stopping cold turkey. A lady here stopped cold turkey after 30 years and had a stroke.
Your best chance for a totally uneventful taper is to do it slowly. Oh yes, one more thing. Here is a link to micro-tapering at Cinderella therapeutics,
https://www.cinderella-tx.org/en/
Blessings,
Jake

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Hi Jake
We on Connect should be sending you- and I am- a huge thankyou for all your posts about tapering off meds
wisely! You may not be an official professional but you certainly are giving excellent suggestions to those of us
out in cyberspace who are struggling to move on without drugs and it is not easy so we need all the help we can get! So I hope you will stay with us!
To you and those on Connect who celebrate-Merry Christmas- and for you and those who do not-Happy
Holidays and to all my very best wishes! Thank goodness we are all here for each other!
Ainsleigh

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@texasduchess

I would not take the 37.5mg every other day–Effexor has a very short half-life in the body; ping-ponging on/off from one day to the next is putting you into withdrawal over and over. Going slooowww is your friend! Reduce by only 5-10%, or even less with each taper and stay at each tapered level for some weeks/months before tapering again. There's no point rushing the process if you ultimately can't get off Effexor because the withdrawals are too awful.

Your doctor can prescribe a different formulation–changing from extended-release capsules to regular-release tablets (I was on 25mg regular-release tablets that could be cut), or specifying a certain brand of capsules (@farm_mom found Teva had the most consistent size and number of beads within a capsule–helpful to those counting and throwing out beads to taper–see @sandij, or @doorman on how to do this). Or your doctor can write a prescription for a compounding pharmacy to make tapered doses for you (the extra cost may well be worth it because you can glide down in incremental amounts, rather than make rather large jagged drops).

Ask your doctor about a "Prozac bridge"–"The only way doctors know to soften the blow when withdrawing from short half-life drugs [Effexor is such] is to add 20mg fluoxetine (Prozac). The half-life of Effexor is 5 hours and 99% of it is out of your body in one day. Prozac's half-life is 4 to 6 days and it takes 25 days for 99% of it to be out of your body. Essentially, the Prozac cushions the effect of no Effexor and lets you "ride out" the withdrawal process.–https://natashatracy.com/treatment-issues/withdrawal/antidepressants-effexorpristiq-venlafaxinedesvenlafaxine/. See also https://www.depressionforums.org/forums/topic/107532-coming-off-of-effexor-with-prozac-bridge/.

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totally agree.. even my pharmacist gave me that advice.. i suppose it may work for some ppl.. but i know the way i get when i miss even ONE dose..

Liked by texasduchess

REPLY
@jakedduck1

@bdizjr
Good morning & Happy Holidays,
I hope your fine this Christmas morning.
You were given some top notch advice by @texasduchess.
I want to alert you to only one other thing. You tapered at a set rate (37.5mg) per month. When you look at it from a percentage standpoint your taper wasn’t so slow or smooth. If my calculations are correct (And I wouldn’t bet money on them) you started with a 25% decrease then the next month decreased by 33% and then 50%, so it was anything but slow as you describe. It’s better to choose a particular percentage and stay there.
It is incomprehensible to me how someone can take a medication for 10, 20 or 30 years than expect to get off it in such a short time or worse stopping cold turkey. A lady here stopped cold turkey after 30 years and had a stroke.
Your best chance for a totally uneventful taper is to do it slowly. Oh yes, one more thing. Here is a link to micro-tapering at Cinderella therapeutics,
https://www.cinderella-tx.org/en/
Blessings,
Jake

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thanks Jake, you are right. i recently went from 150 to 75 (went fine) then to 37.5 (50% cut) went through hell.. now i'm a little more stable.. but still "stress fragile".. i'll call it..your percentage comparison opened my eyes to how aggressive i actually was.. going to go off 37.5 measuring the beads and taking slow

Liked by texasduchess

REPLY

I have been Effexor for maybe a year, following a previous two-year depression relapse from hell. Before the relapse I had been on Paxil very succesfully for probably eight years. I sucessfully weaned off of Paxil (boy I wish I had never done that) for maybe four months when the depression came back with a vengence. I could not tolerate Paxil anymore and after two years of hell and I managed to tolerate Effexor. But, it was never a happy relationship. I've been in therapy and the psychiatrist encouraged me to wean off Effexor. Some severe stress triggers are gone now. The doc simply advised me to take it "slowly." I can't even remember what doses I took when… I was at … 225? I reduced in 37.5 increments over the past several months with no problems. If anything I just felt better. Last night I went down to 37.5 and I felt fine today. Perhaps a little lucid! I stopped for dinner with friends (despite the recent excessive holiday season) and drank wine. I really shouldn't have done that. When I got home this evening I found that my cat pooped on my bed (rnot an unknown, but rather random act) and barfed (I guess he's not feeling well) and I just became super agitated. I mean really agitated, for me anyways. This is how my last relapse started. Agitation. So, I'm scared. I hate Effexor. I want off, but I'm so afraid of a relapse. I'm single and I don't think I can endure that again. I have gained a ton of weight on Effexor. More than I've ever weighed. I drink more. I have stopped going to the gym. Arghhhhhh. I'm so frustrated. I see the doctor Friday, but I'm venting. I want my life back.

Liked by texasduchess

REPLY

I tried Tintellix after a long relationship with Paxil, among others. Trintillix was a completely horrible experience for me. After a few frightening months, my psychiatrist changed me over to Prozac, a completely different generation from Trintillix, and that was 10 months ago. I also take Clonazepam, and have taken a therapeutic dose of 1mg twice daily. I have dysthymia, so depression is a constant background, but I function normally, or at least more normally. Sadly, medication is a roll of the dice. Make eye contact with your doctor. Put your cards face up on the table. Your doctor is on your payroll..

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@shermananski

I have been Effexor for maybe a year, following a previous two-year depression relapse from hell. Before the relapse I had been on Paxil very succesfully for probably eight years. I sucessfully weaned off of Paxil (boy I wish I had never done that) for maybe four months when the depression came back with a vengence. I could not tolerate Paxil anymore and after two years of hell and I managed to tolerate Effexor. But, it was never a happy relationship. I've been in therapy and the psychiatrist encouraged me to wean off Effexor. Some severe stress triggers are gone now. The doc simply advised me to take it "slowly." I can't even remember what doses I took when… I was at … 225? I reduced in 37.5 increments over the past several months with no problems. If anything I just felt better. Last night I went down to 37.5 and I felt fine today. Perhaps a little lucid! I stopped for dinner with friends (despite the recent excessive holiday season) and drank wine. I really shouldn't have done that. When I got home this evening I found that my cat pooped on my bed (rnot an unknown, but rather random act) and barfed (I guess he's not feeling well) and I just became super agitated. I mean really agitated, for me anyways. This is how my last relapse started. Agitation. So, I'm scared. I hate Effexor. I want off, but I'm so afraid of a relapse. I'm single and I don't think I can endure that again. I have gained a ton of weight on Effexor. More than I've ever weighed. I drink more. I have stopped going to the gym. Arghhhhhh. I'm so frustrated. I see the doctor Friday, but I'm venting. I want my life back.

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Can I ask what you mean by lucid?

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@shermananski

I have been Effexor for maybe a year, following a previous two-year depression relapse from hell. Before the relapse I had been on Paxil very succesfully for probably eight years. I sucessfully weaned off of Paxil (boy I wish I had never done that) for maybe four months when the depression came back with a vengence. I could not tolerate Paxil anymore and after two years of hell and I managed to tolerate Effexor. But, it was never a happy relationship. I've been in therapy and the psychiatrist encouraged me to wean off Effexor. Some severe stress triggers are gone now. The doc simply advised me to take it "slowly." I can't even remember what doses I took when… I was at … 225? I reduced in 37.5 increments over the past several months with no problems. If anything I just felt better. Last night I went down to 37.5 and I felt fine today. Perhaps a little lucid! I stopped for dinner with friends (despite the recent excessive holiday season) and drank wine. I really shouldn't have done that. When I got home this evening I found that my cat pooped on my bed (rnot an unknown, but rather random act) and barfed (I guess he's not feeling well) and I just became super agitated. I mean really agitated, for me anyways. This is how my last relapse started. Agitation. So, I'm scared. I hate Effexor. I want off, but I'm so afraid of a relapse. I'm single and I don't think I can endure that again. I have gained a ton of weight on Effexor. More than I've ever weighed. I drink more. I have stopped going to the gym. Arghhhhhh. I'm so frustrated. I see the doctor Friday, but I'm venting. I want my life back.

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@shermananski
Having to clean up cat poop and barf upon arrival home last night would have upset most of us. @cp6401 used "stress fragile" in the post above yours–that's how so many of us are during this process of getting off/reducing Effexor and even, afterwards.

To go from 225 to 37.5 "over the past several months" is pretty fast. Many here have found that going sloooowww works best, especially as you get down to lower dosages. Dropping to just 37.5 already might be too soon. If your agitation persists and/or increases, consider reinstating to your previous dosage, stabilize there and wait weeks, or even months before reducing again (but reduce by only 5-10%, or less). Rushing the process may mean you ultimately can't get off Effexor because the withdrawals are too awful.

Eighteen months out, I am still mindful of what I watch (nothing frenetic, violent, or disturbing), read (cozy mysteries, or romances are okay), or listen to (no atonal, or dissonant music)–some things are just too agitating. However, life doesn't always cooperate; I have cats, too and that homecoming would have set me off as well. I find it helpful to distract myself when I become agitated–I take a walk, put on a comedy, or look at YouTube videos (I like the TooCute cat/dog shows and the English Heritage How to Victorian Cooking shows–Mrs. Crocombe is wonderful and the comments crack me up).

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@elwooodsdad

I tried Tintellix after a long relationship with Paxil, among others. Trintillix was a completely horrible experience for me. After a few frightening months, my psychiatrist changed me over to Prozac, a completely different generation from Trintillix, and that was 10 months ago. I also take Clonazepam, and have taken a therapeutic dose of 1mg twice daily. I have dysthymia, so depression is a constant background, but I function normally, or at least more normally. Sadly, medication is a roll of the dice. Make eye contact with your doctor. Put your cards face up on the table. Your doctor is on your payroll..

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Trintillix was bad juju for me, too.

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@texasduchess

@shermananski
Having to clean up cat poop and barf upon arrival home last night would have upset most of us. @cp6401 used "stress fragile" in the post above yours–that's how so many of us are during this process of getting off/reducing Effexor and even, afterwards.

To go from 225 to 37.5 "over the past several months" is pretty fast. Many here have found that going sloooowww works best, especially as you get down to lower dosages. Dropping to just 37.5 already might be too soon. If your agitation persists and/or increases, consider reinstating to your previous dosage, stabilize there and wait weeks, or even months before reducing again (but reduce by only 5-10%, or less). Rushing the process may mean you ultimately can't get off Effexor because the withdrawals are too awful.

Eighteen months out, I am still mindful of what I watch (nothing frenetic, violent, or disturbing), read (cozy mysteries, or romances are okay), or listen to (no atonal, or dissonant music)–some things are just too agitating. However, life doesn't always cooperate; I have cats, too and that homecoming would have set me off as well. I find it helpful to distract myself when I become agitated–I take a walk, put on a comedy, or look at YouTube videos (I like the TooCute cat/dog shows and the English Heritage How to Victorian Cooking shows–Mrs. Crocombe is wonderful and the comments crack me up).

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I was stomping around the house, shouting, slamming doors, throwing a ball point pen at the wall (see you in hell ballpoint pen). Wow. Then I feel bad, guilty, etc. My doctor will say feel it and own it. I stuff feelings deep. Cats are a pain in the arse. Just saying. I've bent over backwards over the years appeasing and caring for very difficult cats. This one is 25 pounds and has PTSD (I assume). Cheap cat litter. Seriously. I think it makes him sick to his stomach. The poop? I was out of town for a few days and then was gone all day at work. He misses me. Poor baby. My head is spinning.

Anyways, you're right about finding alternative outlets. I was tired, so I turned on a Headspace sleep story, The Laundromat, and got my head in a different place and fell asleep. It's damaging, I think, to get so worked up and angry. Maybe not. Maybe it's feeling so guilty and bad about feeling angry. That's the theory I'm working on…

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@cp6401

Can I ask what you mean by lucid?

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Good question. Lucid: expressed clearly; easy to understand. I usually get so bogged down in brain fog. Everything seems so heavy and hard. I'm constantly looking for distracting, simple tasks to take me away from more demanding work. When I'm lucid I jump right in and take charge.

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@shermananski

Good question. Lucid: expressed clearly; easy to understand. I usually get so bogged down in brain fog. Everything seems so heavy and hard. I'm constantly looking for distracting, simple tasks to take me away from more demanding work. When I'm lucid I jump right in and take charge.

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Ok yes, I can relate to that. It’s kind of inline with self confidence. When I get to work I’m confronted with a dilemma.. how do I feel.. confident? If so I use the main door and walk by everyone and say hi etc, expect they come to me with technical problems.. if I don’t feel confident or I’m fragile, I slip in the side door where no one sees me.. ultimately they see you at your desk but there’s a grace period… just a little game I play I noticed…

When you said lucid, I thought perhaps you meant in relation to derealization.. which I feel less now that Im only in 37.5, but still kinda present nonetheless. Scary

Liked by Sherman

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@shermananski

I was stomping around the house, shouting, slamming doors, throwing a ball point pen at the wall (see you in hell ballpoint pen). Wow. Then I feel bad, guilty, etc. My doctor will say feel it and own it. I stuff feelings deep. Cats are a pain in the arse. Just saying. I've bent over backwards over the years appeasing and caring for very difficult cats. This one is 25 pounds and has PTSD (I assume). Cheap cat litter. Seriously. I think it makes him sick to his stomach. The poop? I was out of town for a few days and then was gone all day at work. He misses me. Poor baby. My head is spinning.

Anyways, you're right about finding alternative outlets. I was tired, so I turned on a Headspace sleep story, The Laundromat, and got my head in a different place and fell asleep. It's damaging, I think, to get so worked up and angry. Maybe not. Maybe it's feeling so guilty and bad about feeling angry. That's the theory I'm working on…

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Effexor messes with your serotonin and norepinephrine levels (neurotransmitters in the brain). I have a temper, but I knew I was experiencing Effexor withdrawal symptoms when I would go from mildly annoyed/irritated to I-want-to-throttle-you/homicidal maniac in the blink of an eye. While reducing and after getting off Effexor, it takes your brain a while to figure out how to rebalance serotonin and norepinephrine.

P.S. You were out of town for a few days? Could have been a revenge poop and barf! But cats can be very finicky about litter and whether, or not the catbox is "clean" enough. Hairballs seem related to age–our cats seem to start having these after years four to six.

On the other hand, our pets are often very empathetic–your cat may be mirroring the distress/stress you're feeling right now as you're reducing Effexor.

Liked by Sherman

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