Tips on minimizing 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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@texasduchess

Tapering off 37.5 mg in just 20 days is a very fast taper. If you start experiencing withdrawal symptoms you can't tolerate, people here have found relief by going back to a dosage where they weren't having symptoms, staying there until they stabilize (may take weeks) and dropping by a smaller amount at the next taper. Generally, commenters on this forum have found a gradual taper (dropping only 5–10%) over a longer period of time is a more successful strategy and is much less stressful.

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@rosa66
I wanted to suggest you perhaps speak to your doctor regarding taking a medication with a longer half-life and see if s/he would recommend a longer half-life. Supposedly they make withdrawal symptoms easier.
Here are some half-life times for you.

Serotonin reuptake inhibitors

DRUG……….HALF-LIFE
Paxil………24 hours hours
Lexapro..27 to 32 hours
Celexa…..36 hours
Prozac……..4-6 days

Serotonin and norepinephrine reuptake inhibitors

Effexor……..3-5 hours
Cymbalta….12 hours
Pristiq………..12 hours

Dopamine and norepinephrine reuptake inhibitor

Wellbutrin……21 hours

The problem, I believe is that people have a different idea of what slow is and don't take into account their dose, age, sex, time on the drug etc.
I also think exercise and a healthy diet are important.

Best of luck,
Jake

REPLY

Thank you for your thoughtful reply.
Since Paxil worked so well for so long for me, could a different SSRI work?
The SNRI’s add another component, rather than just the serotonin….what if don’t need the norepinephrine and how do I know

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@jakedduck1

@rosa66
I wanted to suggest you perhaps speak to your doctor regarding taking a medication with a longer half-life and see if s/he would recommend a longer half-life. Supposedly they make withdrawal symptoms easier.
Here are some half-life times for you.

Serotonin reuptake inhibitors

DRUG……….HALF-LIFE
Paxil………24 hours hours
Lexapro..27 to 32 hours
Celexa…..36 hours
Prozac……..4-6 days

Serotonin and norepinephrine reuptake inhibitors

Effexor……..3-5 hours
Cymbalta….12 hours
Pristiq………..12 hours

Dopamine and norepinephrine reuptake inhibitor

Wellbutrin……21 hours

The problem, I believe is that people have a different idea of what slow is and don't take into account their dose, age, sex, time on the drug etc.
I also think exercise and a healthy diet are important.

Best of luck,
Jake

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Wow….so shorter half lives are harder to taper off….Effexor would be worse than Paxil!
Since Paxil worked so well for so long for me, could a different SSRI work?
The SNRI’s add another component, rather than just the serotonin….what if don’t need the norepinephrine and how do I know

REPLY

Thx for your thoughtful reply.
Since Paxil worked so well for so long for me, could a different SSRI work?
The SNRI’s add another component, rather than just the serotonin….what if don’t need the norepinephrine and how do I know

REPLY
@rosa66

Wow….so shorter half lives are harder to taper off….Effexor would be worse than Paxil!
Since Paxil worked so well for so long for me, could a different SSRI work?
The SNRI’s add another component, rather than just the serotonin….what if don’t need the norepinephrine and how do I know

Jump to this post

@rosa66
You have asked many questions that most if not all on this site are not able to answer.
You need to ask your questions to a physician or two who you trust or perhaps a medical library could assist you. But at some point, you're going to have to decide to try another medication, risks and all or decide to do without. There are no guarantees. People have said what helped them so why not ask your doctor if one could be helpful to you. Currently, you seem to be going around in a circle here and prolonging the care you need.
Best of luck,
Jake

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@texasduchess

You acknowledge that you need to replace the Paxil you were taking for depression and anxiety—but right now it seems you're "putting the cart before the horse" and mostly worrying about how to get off whichever you try IF it DOESN'T help you.

Please remember that—
1) NOT everyone has difficulty getting off a drug; this site is for folks who ARE having, or DID have problems, so of course, it seems that quitting Effexor/venlafaxine is a nightmare. For some it is, but mostly because they're going too fast; quite a few here found "slow and steady" a successful strategy.
2) You learned something about tapering through your own experience getting off Paxil—that going too fast put you into a tailspin. Again, this reinforces the "slow and steady" approach to tapering if discontinuing a drug is needed.
3) You may learn very quickly that your post-Paxil choice IS, or ISN'T working. Usually, it is long-time use (or high dosages) that make discontinuing a drug difficult.
4) What drug will work for you is solely dependent on YOUR body—no one else's physiology, mental/medical issues, or past treatments are going to be like yours, so their experiences good, or bad aren't a prediction of yours.

You will set yourself up for success by reading up on how these possible next drugs work and for what conditions/issues they work best and having an in-depth talk with your prescriber. Good luck and much success going forward.

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Thank you.

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@samrichardson, thank you so much for sharing what you learned from your pharmacist and the approach you are taking to taper. You've also received first-hand knowledge and guidance from fellow members @jakedduck1 @rosa66 @kbmayo @sears @texasduchess and others have said. Tapering off venlafaxine is different for everyone. It's not easy.

++++
The Mayo pharmacist did some more digging and contacted the manufacturer as well. Here's what she writes:

"Recommendations from the manufacturer and compendia suggest discontinuation after tapering to the venlafaxine er 37.5 mg for a period of time in the same manner that someone would be initiated on that dose (and not ramped up by counting beads to start). I reached out to the manufacturer Viatris to see if they had information about opening Effexor XR capsules and dosing based on bead counting. The manufacturer stated they did not have any data on opening the capsules and could not provide recommendations about that. They defer to the discretion of a prescriber.

Generally, venlafaxine can be tapered by 37.5 mg intervals over several weeks. Some patients may have more trouble with tapering and require a longer taper or change to another medication, such as fluoxetine, for a period of time before tapering off that. It could be that patient specific factors lead the prescriber to conclude that counting pills was the best option, even if information regarding this approach is lacking.

The danger is that if the beads are not standardized the dosing by bead counting would be variable. The manufacturer offers no indication that there is any particular amount of drug per bead, and release from the beads themselves could vary from the drug delivery from the bead and capsule since they are not designed to be taken that way. In practice across several states over 15 years I have not encountered prescriptions describing this method of administration for tapering.

You can read more about antidepressant withdrawal here:
– Antidepressant withdrawal: Is there such a thing? https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133
It’s important that you are reaching out for advice to help manage symptoms. It can also be important to involve your care provider to ensure there is a plan in case depressive symptoms worsen on tapering. "

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Sam, I agree with you and others who have stated that the manufacturers and "monography alone never provide the reason why they advice not to split/crush/break their original form." How is your tapering going? Is the guidance from your pharmacist helping you?

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@colleenyoung

@samrichardson, thank you so much for sharing what you learned from your pharmacist and the approach you are taking to taper. You've also received first-hand knowledge and guidance from fellow members @jakedduck1 @rosa66 @kbmayo @sears @texasduchess and others have said. Tapering off venlafaxine is different for everyone. It's not easy.

++++
The Mayo pharmacist did some more digging and contacted the manufacturer as well. Here's what she writes:

"Recommendations from the manufacturer and compendia suggest discontinuation after tapering to the venlafaxine er 37.5 mg for a period of time in the same manner that someone would be initiated on that dose (and not ramped up by counting beads to start). I reached out to the manufacturer Viatris to see if they had information about opening Effexor XR capsules and dosing based on bead counting. The manufacturer stated they did not have any data on opening the capsules and could not provide recommendations about that. They defer to the discretion of a prescriber.

Generally, venlafaxine can be tapered by 37.5 mg intervals over several weeks. Some patients may have more trouble with tapering and require a longer taper or change to another medication, such as fluoxetine, for a period of time before tapering off that. It could be that patient specific factors lead the prescriber to conclude that counting pills was the best option, even if information regarding this approach is lacking.

The danger is that if the beads are not standardized the dosing by bead counting would be variable. The manufacturer offers no indication that there is any particular amount of drug per bead, and release from the beads themselves could vary from the drug delivery from the bead and capsule since they are not designed to be taken that way. In practice across several states over 15 years I have not encountered prescriptions describing this method of administration for tapering.

You can read more about antidepressant withdrawal here:
– Antidepressant withdrawal: Is there such a thing? https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressant-withdrawal/faq-20058133
It’s important that you are reaching out for advice to help manage symptoms. It can also be important to involve your care provider to ensure there is a plan in case depressive symptoms worsen on tapering. "

++++
Sam, I agree with you and others who have stated that the manufacturers and "monography alone never provide the reason why they advice not to split/crush/break their original form." How is your tapering going? Is the guidance from your pharmacist helping you?

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Thanks for the inquiries you've made, this is appreciated.
All withdrawal symptoms (swetting, chills, brain zap, dizzyness) went away the same day I switched from 0mg back to 25mg (2 beads from a 37.5mg capsule). I'm starting 12.5mg (1 beads) next week for ~2 weeks, then 0mg if everything goes well.

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I would simply add, hydrate yourself throughout the process and continue hydrating yourself thereafter.

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@parus

As I peruse the feedback I am noticing many differing many different comments and experiences. Goes to show we are not all wired the same when it comes to medication. One size does not fit all.

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Totally, every human has different chemistry. All wired differently. That's why any doctors ideas around how to work with medications go out the window. Only thing I've found that they know is NOT to go off "cold turkey" which I so agree, because too hard on our system. All the doctors I've been to had zero idea about Effexor withdrawal, even my Top Rated Colorado psychiatrist, MD. However thankfully I recently found a nurse practitioner who does.
I was on Effexor XR- 75 MG for 20 years. I've recently Tapered along with a low dose of 20 mg Prozac, per my doctor. Went down to 17 mg then went off cold turkey from 15mg and I've been sick for 5 weeks now. Some days are OK, but most days nausea and a bit of vertigo. Holy shit Effexor XR I learned has Class Action Law Suits currently; one for pregnant women that have led to birth defects while taking it. There should be a Class Action for the insane withdrawal symtoms as well.

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@kikinordy

Totally, every human has different chemistry. All wired differently. That's why any doctors ideas around how to work with medications go out the window. Only thing I've found that they know is NOT to go off "cold turkey" which I so agree, because too hard on our system. All the doctors I've been to had zero idea about Effexor withdrawal, even my Top Rated Colorado psychiatrist, MD. However thankfully I recently found a nurse practitioner who does.
I was on Effexor XR- 75 MG for 20 years. I've recently Tapered along with a low dose of 20 mg Prozac, per my doctor. Went down to 17 mg then went off cold turkey from 15mg and I've been sick for 5 weeks now. Some days are OK, but most days nausea and a bit of vertigo. Holy shit Effexor XR I learned has Class Action Law Suits currently; one for pregnant women that have led to birth defects while taking it. There should be a Class Action for the insane withdrawal symtoms as well.

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May I Sk what state you r in? I need such a professional to help me. Would you plz your NP for a Detroit area recommendation! Thank you!

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@kikinordy

Totally, every human has different chemistry. All wired differently. That's why any doctors ideas around how to work with medications go out the window. Only thing I've found that they know is NOT to go off "cold turkey" which I so agree, because too hard on our system. All the doctors I've been to had zero idea about Effexor withdrawal, even my Top Rated Colorado psychiatrist, MD. However thankfully I recently found a nurse practitioner who does.
I was on Effexor XR- 75 MG for 20 years. I've recently Tapered along with a low dose of 20 mg Prozac, per my doctor. Went down to 17 mg then went off cold turkey from 15mg and I've been sick for 5 weeks now. Some days are OK, but most days nausea and a bit of vertigo. Holy shit Effexor XR I learned has Class Action Law Suits currently; one for pregnant women that have led to birth defects while taking it. There should be a Class Action for the insane withdrawal symtoms as well.

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For anyone reading this. Jumping off 15 mgs. Prozac was not a good idea. Always try to taper to 0.

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