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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@jakedduck1

@frances007
I’d never reduce a medication by 50%. My guess is you’re going to regret it. Especially when you’re in your last phase of discontinuing.
My brother stopped it within 1 week with no symptoms at all.
Your best option is a compounding pharmacy and at a much lower percentage. Isn’t it better to be safe than sorry?

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Hi Leonard, please see my reply to @ Frances 007, I re-iterate your advice based on my experiences.

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@frances007

in reply to @kmart720
I dropped down from 150mg venlafaxine to 75mg, and now want to taper to the 37.5mg capsules. My doctor has suggested I do this slowly, but how does one do this? Did dropping from 75mg to 37.5mg cause any awful problems? Initially, my doctor had me go from 150mg to 75mg capsules, but that was terrible. So, I went from 150mg caps to 75mg capsules, and I am now ready to taper further. Can you please tell me about your experience going from 75mg capsules to 37.5mg capsules?
Thank you

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I was on 75mg per day for hot flashes. It was not a problem for me to drop to 37.5mg per day. If you want to be cautious, I recommend a slow process, such as alternating capsules for a week to see how you respond on days of 37.5mg. If no reaction, then you should be okay to go to 37.5mg per day. On rare days that I forgot to take a pill, I would begin to feel nauseous–a reminder that I missed it–and take it immediately, and be ok. It is more difficult to discontinue the lowest dosage, in my experience. I weaned myself off by adding more hours between 37.5mg capsules, then a day between pills, until I was taking so few that I figured I could do without.
I've been off them for about two months, and am feeling extreme anxiety now, after feeling ok after stopping the drug. During withdrawal period, I had occasional nightmares (without realizing they were the result of withdrawal). I am no longer constipated and have less of an appetite for food, so I've lost weight since stopping the drug. With this degree of anxiety, I am not sure I can stay off the 37.5mg per day, but I am trying to alleviate the anxiety by other means–exercise, deep breathing, etc. My doctor suspects that I need the drug now to control anxiety; I would prefer to be off the drug, due to its side effects and difficulty of withdrawal. (No change in hot flashes; I still have them with and without Effexor. It was a mistake to prescribe this drug for hot flashes.)

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@simon007

Frances 007, Hi. Regarding dropping down from 75mg EFFEXOR XR to 37.5 mg. This was done with ease * over 3 months or so. Compared with what was to follow. * I had no noticeable reactions, barring a short term (1 week) "step down" withdrawal jolts to my system, each time I dropped down to 37.5 . These reactions were short lived. The REAL issues, (as is commonly experienced by others), come when titrating down from 37.5 to zero. In fact, I was eventually **diluting individual beads from a 37.5 MG slow release capsule (3x beads in each) so, 3,2,1 beads. Then** syringing down in a diluted pot @ 10ml degradations , every 2 months 3,2,1 beads. This took 24 months. BUT, as someone else here has said. The withdrawal effects DO NOT STOP @ zero pill taking! No one knows , as it on a individual basis, as to how long the final , (after pill taking), withdrawal / side-effects issues will last. I have identified 3 to 5 years ! Also , the effects go away & come back over this period. Recent info I have secured , indicates about 50% of people have NO issues with EFFEXOR withdrawal and can even stop quite abruptly. But the rest are all over the place. Critically, as has been commented on here, it is the PACE of titration off that is key to mitigating these severe issues in the most sensitive of people. To stop @ 37.5 is not recommended.

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@simon007
Yes, I understand some people can stop abruptly and do well. Some can titrate slowly and still have problems. My brother is one who stopped in a week without one withdrawal symptom. One person here decreased their medicine by such infinitesimally small amounts and still had withdrawals. One lady here abruptly stopped and had a stroke.
Studies show that stopping Effexor quickly the
symptoms are worse and last longer than in those who stop slowly. So, it seems more reasonable to me that when someone wants to discontinue Effexor it seems to me they may have a better chance of success to titrate a small amount from the start not wait until the end of the taper. Admittedly, this is not everyone's experience. I believe in safety first. Why not decrease the chance of withdrawals as much as possible?
Take care,
Jake

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@njoys

I was on 75mg per day for hot flashes. It was not a problem for me to drop to 37.5mg per day. If you want to be cautious, I recommend a slow process, such as alternating capsules for a week to see how you respond on days of 37.5mg. If no reaction, then you should be okay to go to 37.5mg per day. On rare days that I forgot to take a pill, I would begin to feel nauseous–a reminder that I missed it–and take it immediately, and be ok. It is more difficult to discontinue the lowest dosage, in my experience. I weaned myself off by adding more hours between 37.5mg capsules, then a day between pills, until I was taking so few that I figured I could do without.
I've been off them for about two months, and am feeling extreme anxiety now, after feeling ok after stopping the drug. During withdrawal period, I had occasional nightmares (without realizing they were the result of withdrawal). I am no longer constipated and have less of an appetite for food, so I've lost weight since stopping the drug. With this degree of anxiety, I am not sure I can stay off the 37.5mg per day, but I am trying to alleviate the anxiety by other means–exercise, deep breathing, etc. My doctor suspects that I need the drug now to control anxiety; I would prefer to be off the drug, due to its side effects and difficulty of withdrawal. (No change in hot flashes; I still have them with and without Effexor. It was a mistake to prescribe this drug for hot flashes.)

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in reply to @njoys Thank you very much! I did take a 37.5 mg capsule this morning and will see how it works out. I appreciate this helpful information.

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@jakedduck1

@frances007
I’d never reduce a medication by 50%. My guess is you’re going to regret it. Especially when you’re in your last phase of discontinuing.
My brother stopped it within 1 week with no symptoms at all.
Your best option is a compounding pharmacy and at a much lower percentage. Isn’t it better to be safe than sorry?

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in reply to @jakedduck1 Thank you very much. I understand your point, however, I am in the Medicare Donut Hole in terms of my prescription drugs, and I would imagine that using a compounding pharmacy would be too costly for me. I fell into the hole after filling some new migraine medication twice, until my copay went up 300 percent. Luckily, I have a good doctor who gives me sample when I need them and until I can afford the $150 copay.

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@frances007

in reply to @jakedduck1 Thank you very much. I understand your point, however, I am in the Medicare Donut Hole in terms of my prescription drugs, and I would imagine that using a compounding pharmacy would be too costly for me. I fell into the hole after filling some new migraine medication twice, until my copay went up 300 percent. Luckily, I have a good doctor who gives me sample when I need them and until I can afford the $150 copay.

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@ francis007
Perhaps you could contact the manufacturer and see if you qualify for more affordable medication.
There is a seizure medicine that costs about $32,000 a year but some receive it for $20.00 or so a month.
Your copay is outrageous.
I hope something works out for you. Medicare has a plan called “The Extra Help program.” It helps with medication, copays and deductibles. However, that program doesn't help with compounded drugs as I understand it.
Take care,
Jake

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@andrewnielsen

That advice is no good. The withdrawal is from the last little bit of the Efexor being metabolised really quickly. So, tapering will not help. Instead, overlap your last three Efexor tablets (37.5 or 75 mg, which ever is the lowest you tolerate) And then stop them both, or stay on the Prozac if you prefer. No more withdrawal symptoms at al. The Prozac inhibits the metabolism of the Effexor, you see.

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Hi Andrew,
I'm desperate to come off Effexor having tried (including counting the beads in the capsules) unsuccessfully several times with the withdrawals symptoms being crippling. Can you please advise what dose prozac to take during the three days overlap. I would be so grateful to know. Is it the same dose of prozac whether you are on the 75mg or 37.5mg capsules of Effexor?

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@jakedduck1

@simon007
Yes, I understand some people can stop abruptly and do well. Some can titrate slowly and still have problems. My brother is one who stopped in a week without one withdrawal symptom. One person here decreased their medicine by such infinitesimally small amounts and still had withdrawals. One lady here abruptly stopped and had a stroke.
Studies show that stopping Effexor quickly the
symptoms are worse and last longer than in those who stop slowly. So, it seems more reasonable to me that when someone wants to discontinue Effexor it seems to me they may have a better chance of success to titrate a small amount from the start not wait until the end of the taper. Admittedly, this is not everyone's experience. I believe in safety first. Why not decrease the chance of withdrawals as much as possible?
Take care,
Jake

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Jake, thanks. You seem to have monitored this issue on this site longer than me ! My burning question is – how long do the side – effects / withdrawal effects last after a long titration ? = with a complete cessation of pill intake? Have you seen timeline evidence of how long people experience these "legacy" issues? thanks.

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@simon007
I’m sorry I can't answer your question because of how differently people react.
I took over 2 years to taper my Klonopin. My taper was uneventful exexpt very slight symptoms when I finished my taper. I immediately chipped off an extremely tiny piece which quickly eliminated my symptom/s and never had another symptom.
If I was having withdrawal symptoms I would increase the dose until the symptoms go away, then possibly increase the length of time between cuts (I cut my dose usually every 2-4 weeks) and not skip days. I would taper down from day one until I was finished. Some people cut their dose by 50% in the beginning which usually is asking for trouble.
One lady was tapering 1/2 of one percent (I believe) anyway an infinitesimally small amount and she still suffered withdrawals. So tapering isn't a guarantee to prevent withdrawals but tapering slowly enough provides the best chance to prevent them.
Best of luck,
Jake

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@careth2

Hi there! I am new to Connect, but hopefully can offer some insight. I DID go off 150 Effexor XR (name brand) COLD TURKEY on January 2016. I survived it, but will never in my life EVER go off ANY antidepressant cold turkey. I had taken Effexor for at least 8 years, Zoloft prior to that and and Imipramine (sp?) as the first antidepressant (in all 25+ years on antidepressants.) It all started with running out of meds over a long weekend and deciding it was time to try to get off antidepressants to see how I would do. Since I had recently retired from teaching, thought this would be an ideal time to give it a go. In addition, Effexor just wasn’t helping all that much anymore (I thought.) The first 3 days I felt like I was going to die! When I realized that I wasn’t dying, decided to keep going to get it all over with. In addition to the symptoms you have heard about, I had deep bone/joint pain that felt like I was being pinched with clamps. Also had skin sensations and peeling, and noticed a strange smell on my skin. Each day got a little better and by the 3rd week started to function a bit more normally. I was very emotional, however, which caused my family great concern. Well, to make a long story short, the depression crept back in full and I am still trying to get my life back. I did everything I could to stay stable, including herbal supplements and took a vacation where I hiked 6 miles daily for 9 days on hilly, rocky terrain. I finally had to accept that I’m a person who will need antidepressants for the rest of my life. With the help of a PCP and counselor, I am on my 3rd antidepressant & may need to resort to going back on Effexor, because nothing seems to be working. All in all, in my opinion, the chronic depression is worse than the withdrawal symptoms that do eventually end. If you are a person with situational depression, you may be successful weaning off Effexor gradually. If I were to do it again, that’s what I would do (while replacing Effexor with something else.) Here are the things that helped me with the physical withdrawal symptoms:
1. Get plenty of sleep/rest.
2. Eat a very well-balanced diet (this is not the time to worry about your weight.) Lots of soup & easy to digest foods the 1st few days.
3. Drink plenty of water, including coconut water.
4. Have a glass of wine in the evening (if advisable.)
5. Get outside and walk or other excersize (the warm sunshine will feel good!)
6. Hot yoga 3-4 times per week. Stay in class even if you feel nauseous & can only do a few postures.
7. Soak in a hot tub (with bath salts if available.)
8. Use a good moisturizer on face & body several times per day.
9. Get several professional massages.
10. Take Tylenol for muscle pain, if OK on your stomach.
11. A heating pad is also helpful at bedtime or during naps.
12. If you are single & live alone, make sure a few trusted friends/family members know what you are doing.
13. In general, be kind & gentle to yourself.
14. NEVER give up! Keep going, even when you don’t feel like it (which will be often.) YOU ARE WORTH IT!!!

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Hi I’m on day 4 cold turkey 🙈! I went on Effexor 225mg then to 75mg over 9 mths and now cold turkey . I only went on it for a relationship break up . I’m feeling it is now time to get off it. I feel nauseous that’s all atm. I know I shouldn’t go cold turkey but I’m pushing through it. I’m hoping it will be better after a week or so! It’s not my mental emotions , I just feel rather shit atm 😂!

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