Tips on minimizing withdrawal symptoms from Effexor (aka Venlafaxine)

Effexor and cymbalta have been recommended to me for depression and anxiety, 8 months after a horrendous withdrawal from 25 years on Paxil (which worked great all those years until depression crept in)
My depression and anxiety are through the roof and all I can do is obsess over these two drugs.
What if it doesn’t work? Side effects? Trying to go off???
Which one has worked better for you?

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.

@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

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

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.

@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.

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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?