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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@brightwings

Wow, well, first of all welcome. You have not had an easy time of it have you.
I took antidepressants for 33 years. I needed them too.
I had a tough childhood too.
My last dose of effexor 150mg was January, 2018.
I worked long and hard to give myself endorphins to make up for the medications.
Crying, yes I know it.
Age???
Have you called your local health food store and gone in there to try natural teas like chamomile or others?
Age of your child?

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I am 20. I was really hoping to hear that haha! I keep telling myself that my brain is just trying to readjust, but it begins to feel like an excuse after a while.. I have tried all the tea. I have tried vitamins and exercise, yoga, etc… I just want to be normal. I don't want that dependency.. I have no children. I got married in March last year. These should be the best times of my life, which they really feel like the worst…

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@shermananski

The only thing worse than Effexor is depression. I'm down to 37.5 mg and feeling MUCH better. I tried 0 mg a few weeks ago and the darkness came over me, so I'm back to 37.5 mg. Several very stressful situations have been resolved and so my depression is in general much better. But, clearly I'm still depressed. I work with a psychiatrist in therapy and if you're still struggling without medicine, you should get into therapy. I've been going for months and I have months to go. I had thought my childhood traumas were way behind me, but like my general practitioner warned me 20 years ago, those traumas do not just go away. I've got me some learnin' to do. Find a good psychiatrist for medication management to get you through it and a therapist to help with your depression. Easier said then done, I know. Good luck.

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Thank you for your comment… I have had so many doctors, and I've been on almost every antidepressant you can think of. It feel like a lab rat. Different doses, different doctors… YEARS of psychotherapy and all different kinds of counseling. It feels so pointless.

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@evamaree

I am 20. I was really hoping to hear that haha! I keep telling myself that my brain is just trying to readjust, but it begins to feel like an excuse after a while.. I have tried all the tea. I have tried vitamins and exercise, yoga, etc… I just want to be normal. I don't want that dependency.. I have no children. I got married in March last year. These should be the best times of my life, which they really feel like the worst…

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What state?

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@evamaree

I am 20. I was really hoping to hear that haha! I keep telling myself that my brain is just trying to readjust, but it begins to feel like an excuse after a while.. I have tried all the tea. I have tried vitamins and exercise, yoga, etc… I just want to be normal. I don't want that dependency.. I have no children. I got married in March last year. These should be the best times of my life, which they really feel like the worst…

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Maybe you could ask your doctor for a bridge like zoloft or Paxil. When I finally got myself completely off Effexor, I stuck it out for 6 months. After which I was just crying too much and too agitated. I’m on seroquel at night and after a week of that am on zoloft during the day. I’m trying to ween off seroquel but I feel some anxiety creeping back. (So I’m going to stick with the 25 mgs).

I had been in Effexor for over 20 years and did quite well, but since I’m through menopause I though well, maybe I’ll be ok without. 🙂

You’re only 20. Take a bit more time weening if you’re able. No need for you or your new husband to add stress and depression to your union!

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@evamaree I have gone through what you have gone through most of my life. Starting as a child and going into my 60s I have had severe depression. About a year and a half ago my doctor finally found the cure. I went back on the same antidpressant I had found worked the longest for me and then the doctor kept increasing the dosage. I had to go to a very high dosage. It is now working. I am finally able to enjoy life. If your doctor cannot find an answer, try another one that will keep with you until you do.

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@evamaree

Thank you for your comment… I have had so many doctors, and I've been on almost every antidepressant you can think of. It feel like a lab rat. Different doses, different doctors… YEARS of psychotherapy and all different kinds of counseling. It feels so pointless.

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That was very presumptuous of me to think you hadn't! I'm sorry. For what it's worth I never had a psychiatrist until now and it's made a world of difference when it comes to meds. A young resident with a medical university with access to highly trained doctors. I've never had real good success with meds, but this clinic helped me sort through the whole med fiasco and what I should be working towards.

And I hear you on the therapy… what a load of crap! Until now. I'm really getting something out of it. Meditation app. Reading. I don't know, I think I'm on the right track with this one doctor. He's leaving in June. 🙁 He's supposed to help me find a therapist outside this clinic. I'd really like to find a super talented one! I recently read "Maybe you should talk to someone." It was very good. I hope you find a good professional support to help you get through this.

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@johnhans

@evamaree I have gone through what you have gone through most of my life. Starting as a child and going into my 60s I have had severe depression. About a year and a half ago my doctor finally found the cure. I went back on the same antidpressant I had found worked the longest for me and then the doctor kept increasing the dosage. I had to go to a very high dosage. It is now working. I am finally able to enjoy life. If your doctor cannot find an answer, try another one that will keep with you until you do.

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Started catching up with posts after 2 weeks in hospital due to effexor withdrawal. That was horrible, both feeling that bad and being in a very grim suicide watch ward with no windows, no shower or bath and sporadic toilet paper. Down to one capsule and using seroquel and escitalopram to help take the edge off. So far this is working and when I drop the last 37.5 the seroquel will let me sleep the bad day or two off.
Im in Canada and finding a dr who will work with you is a challenge. In 2 weeks in hosp I have seen 4 different psychiatrists and one resident psychiatrist. They have all had a different approach and different understandings of what’s going on, what needs to happen. I will be put on a list for next psychiatrist with an opening once I’m discharged and it wont be any I have seen in hosp.
Reading about people who have fought depression since they were a child is making me see that has been my world also.
Arent you afraid being on a high dosage will eventually turn and stop working? Probably worth the risk though to have time feeling better. Depression requires bravery at a level most will never understand.

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@secretwhitepop

Maybe you could ask your doctor for a bridge like zoloft or Paxil. When I finally got myself completely off Effexor, I stuck it out for 6 months. After which I was just crying too much and too agitated. I’m on seroquel at night and after a week of that am on zoloft during the day. I’m trying to ween off seroquel but I feel some anxiety creeping back. (So I’m going to stick with the 25 mgs).

I had been in Effexor for over 20 years and did quite well, but since I’m through menopause I though well, maybe I’ll be ok without. 🙂

You’re only 20. Take a bit more time weening if you’re able. No need for you or your new husband to add stress and depression to your union!

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Why are you stopping the seroquel? Especially if its working? What about seroquel should we worry about?

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@ksad

Why are you stopping the seroquel? Especially if its working? What about seroquel should we worry about?

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I’m just trying to be med-free. And, apparently, I’m a much more “normal” member of society while on both meds… but I don’t believe there’s anything wrong with it. Might have heard some rumors about the possibility of cataracts, but that’s all.

My mom has dementia and I’m concerned about the connection between anti anxiety and anti depressants and dementia.

However, we all live in the now, without any idea of what the future holds… so let’s be happy in the now 🙂

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@lisalucier

Hi all, There has been a lot of discussion in this thread about tapering off and stopping Effexor and other antidepressants. We sought the input of a Mayo Clinic pharmacist and here what she had to say:

“Most antidepressants should be tapered before discontinuing. Patients should check with their healthcare provider for discontinuation recommendations. Taper directions can depend on the reason for discontinuation, the particular antidepressant being discontinued, the current dose and other patient-specific factors. Abrupt discontinuation of venlafaxine is more likely to cause withdrawal symptoms and relapse than many other antidepressants because of its short half-life. Likewise, strategies for switching between antidepressants require similar consideration from a care provider. Here at Mayo Clinic, we pharmacists work together with physicians to help determine the best strategies for each patient.

Patients may decide to discontinue their antidepressants for a variety of reasons. Some people feel better after taking an antidepressant and may feel they don’t need it anymore. The course of antidepressant therapy varies. Some people have lifelong mood symptoms that can be alleviated with antidepressants. Others may have difficult times in their lives where treatment is required while they work through the situation and/or find other mechanisms to alleviate symptoms. A clinician can help patients determine the appropriate treatment course based on patient history, symptom severity and other patient-specific factors.

Some patients may experience side effects. Management of side effects depends on their severity, expected duration, other options and patient-specific factors. For example, many patients experience stomach upset when starting antidepressants, but this is usually short-lived, and the benefits of continuing treatment usually outweigh the risk of stopping the antidepressant or having the same effects with another anti-depressant.

“Cold turkey” discontinuation of venlafaxine can cause agitation, sweating, fatigue, nausea, restlessness, tremor and relapse of depression. A slow taper is recommended, and tapering may need to be adjusted based on patient-specific factors listed above and for patient response to the taper.

Genetics play a major role in our response to venlafaxine. People with poor 2D6 metabolizer status may not respond to venlafaxine and thus may not be subject to the same withdrawal symptoms as those who were metabolizing the drug properly. Routine genotype testing is not routinely recommended but could explain lack of response to venlafaxine and certain other medications. Mayo Clinic offers this type of pharmacogenetics testing that can be ordered by our providers. For more information see: http://mayoresearch.mayo.edu/center-for-individualized-medicine/

The most important thing to remember is that each patient is different and may respond differently to the same treatment. We have to communicate openly with our healthcare providers to get the most from our medications. Sometimes this entails some trial and error, but it is worth getting the right therapy in the end.

You can read more about Pharmacogenomics in this article https://www.seattletimes.com/life/wellness/depressed-genetics-affect-how-drugs-work/.”

Has anyone had genetic testing that altered their treatment plan or improved their condition?

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This response is 3 years after the initial question "Has anyone had genetic testing that altered their treatment plan or improved their condition?" but the answer is 'yes, I have'. If it is still of interest I can give more details.

Liked by Sherman

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I’d be interested

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@flind

This response is 3 years after the initial question "Has anyone had genetic testing that altered their treatment plan or improved their condition?" but the answer is 'yes, I have'. If it is still of interest I can give more details.

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Hi, @flind, and welcome to Mayo Clinic Connect. I'm guessing you were on venlafaxine (Effexor) at some point and tapered off? How did that go?

How did you happen to have the genetic testing that provided some direction for your treatment plan (I'm presuming for depression)? What did you learn from the results?

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@coloradogirl

So, I just finished this process with Zoloft (sertraline) and here are some things that worked for me. Your mileage may vary, but hopefully these are low risk for you to try.

1) You may need to ask your doctor for a slower tapering program than other patients. Some people are just more sensitive to dosage changes. Be aware that symptoms will get better, then may reappear each time you taper. AAFMA (practice group of family physicians) says that the symptoms typically last 1-2 weeks and as long as 4 weeks, so I just kept reminding myself that it was temporary.
2) Be watchful for things that make your symptoms worse. For example, caffeine seems to trigger the brain zaps for me (still, even after being off for several weeks), so I cut back my caffeine intake. I didn’t give it up completely (because I still need to function), but cut back on how much real coffee I was drinking, mixed decaf with regular, and switched to tea sometimes. In the end, I probably cut my daily caffeine intake in half, and it did help quite a lot.
3) Ibuprofen or other pain reliever can help with the flu-like body aches.
4) Benadryl helped with the brain zaps.
5) Exercise helped with both. Even if I wasn’t up to a run, a few blocks of walking would settle down the symptoms for a while at least. (Then, when they come back, just take another walk. We took a lot of walks for a while there).
6) Get enough sleep. As I came down off the meds, my normal sleeping patterns returned, which was great, but it did mean that I needed to plan time to let my body rest.
7) Pay attention to your diet. Your brain uses carbs to make seratonin, so now is not the time to go on the Atkins diet. Eat well and make sure you’re getting enough healthy carbs. You may crave sweets; I certainly did. I tried to counteract this by having bananas, graham crackers, and other healthy things I could snack on instead of sticking my head in a birthday cake like I seemed to want.

No lie – it’s a painful process, but this did really help make it easier. Also, at a certain point, when I was down the below the normal starter dose, I just ripped off the bandaid and went to zero. At that point, it felt like each taper was just prolonging the suffering. Don’t just go cold turkey from your current dose, though, as that can be dangerous. Also, don’t add any supplements or substitutes for the SSRI without talking to your doctor first (also dangerous).

And of course, watch for the return of depression / anxiety type symptoms. For a while it was hard to tell whether I was tired because of the change in meds or because my depression was returning. I figured as long as I felt okay enough to function and wasn’t thinking about being harmful to myself or anyone else, I could play it out and see. It turned out to be the meds and on the other side, I can see that I was more worried about it than I needed to be.

I wish you the best of luck and a healthy life.

Mardee

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I have to tell you….I literally signed up for an account just so I could comment and let you know how much this post made me laugh. In such a good way. I am in the thick of the withdrawal myself and I look forward to trying your advise. Thank you sooooo much for this!

Liked by Sherman, mariah1981

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Hi all,

Just wanted to fill everyone in, I’m down to 12.5 mg and plan on taking my last dose of it on Thursday night!
My withdrawal has been ok. I feel it’s been most difficult going from 25mg to 12.5mg for some reason. I really hope going from 12.5mg to 0 isn’t a disaster.
Definitely still like the way I feel when withdrawal is at its lowest. So I still know I’m on the right track.
Eating is still a struggle, eating tons of carbs and sugar 🤦🏼‍♀️. Trying not to be so tough on myself.

I’ll keep you posted!

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@flind

This response is 3 years after the initial question "Has anyone had genetic testing that altered their treatment plan or improved their condition?" but the answer is 'yes, I have'. If it is still of interest I can give more details.

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I’d be interested.

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