Mimosa: looking for tapering advice from Venaflaxine 150mg XL capsules

June 7, 2021

Hello,

Hello I am new to this site. I would specifically like to connect to others tapering from Venaflaxine/ Effexor

I have been taking Venaflaxine XL 150mg for 12 years and have decided to start tapering my dose. From reading this site and some others, I've decided to start by tapering by 10% of the last dose that I have taken and hold on the new dose for a month. I am from London and am speaking to my GP who is my prescriber about this in a weeks time. I am sure that my GP does not have any knowledge of bead counting or weighing as I was originally advised to make much bigger cuts that 10% using what doses are available.

The brand of Veneflaxine that I am currently being prescribed is Venlaslov XL 150mg prolonged release capsules. They have 12 mini pills inside each capsule. Are these what you are referring to as beads?

When I pick up my prescription from the pharmacy I often am given a different brand name of capsules. From what I've been reading, its essential to have the same brand name all the way through a taper and to have the brand that has the largest amounts of beads in.

My plan is to reduce from 150mg - 135g hold for a month, then reduce to 121.5 for a month and so on. So tapering 10% of the last dose taken.

I can't make this up with my current brand as the beads are 12.5mg each so not small enough to even start to taper on. They also only come in 150mg and 75mg.

Questions -

Can someone advise me on the best capsule brand to use for tapering by counting beads?

Also is there anyone else on this site from the UK who gets their prescription through their GP that is tapering Veneflaxine/ Effexor in this way? I don't think its possible to specify what brand of capsules that you receive. It seems it changes according to what the Pharmacy has received?

Does anyone have any experience of this in the UK? Also I have not ever heard of a compounding Pharmacy? Are they something that exists in the UK?

Lastly what is the best literature or summary, that people have found to give to their prescribers in order to convince them to come on this journey with them, ie to believe in the tapering method at 10% from last dose and counting beads?

Many thanks in advance! I am so pleased I have found this site as before this I was totally in the dark about how to do this

Edited June 7, 2021 by Gridley

June 7, 2021

Welcome to SA, Mimosa.

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

Account Settings – Create or Edit a signature.

As you already know, we recommend tapering by no more than 10% of your current dose every four weeks. Using available doses to taper as suggested by your GP will result in much too fast a taper. The following link about the 10% method lists several authorities and groups that recommend this taper.

Why taper by 10% of my dosage?

8 hours ago, Mimosa said:

When I pick up my prescription from the pharmacy I often am given a different brand name of capsules. From what I've been reading, its essential to have the same brand name all the way through a taper

It would be great to get the same brand every time, but this isn't always possible. Many, if not most of us, myself included, have had to switch generics due to unavailability of the previous generic. So while it's helpful to do your entire taper with the same brand, it's not essential. The thing to remember is to save enough of your old brand to do a gradual crossover from old to new, using this schedule:

3/4 old brand, 1/4 new brand for 3 to 7 days

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

Do not taper while doing the crossover. Hold at your present dose.

8 hours ago, Mimosa said:

Venlaslov XL 150mg prolonged release capsules. They have 12 mini pills inside each capsule. Are these what you are referring to as beads?

The Venlaslov XL 150mg capsules you're taking don't contain beads but rather mini-tablets. The following excerpt about tapering mini-tablets is from the thread, which is worth reading in its entirety:

Tips for tapering off venlafaxine (Effexor)

Please read the excerpt carefully, as it gives very specific instructions about tapering off mini-tablets. One possibility it mentions is switching to the same dosage Venlafaxine but with the beads rather than mini-tablets. This switch might make tapering simpler.

Here's the excerpt. I address the rest of your post after the excerpt.

-----

Extended-release venlafaxine capsules: Open and count out mini-tablets

Some generic types of Effexor XR are gelatin capsules containing smaller tablets. Depending on the manufacturer and dosage, there may be 3-12 tablets in a capsule, for example Vanlalupen XL https://imedi.co.uk/vanlalupen-xl-75mg-prolonged-release-capsulesor http://www.mhra.gov.uk/home/groups/spcpil/documents/spcpil/con1438318470327.pdf (PDF) or Venlablue http://www.mhra.gov.uk/home/groups/par/documents/websiteresources/con062651.pdf(PDF).

In the UK, generic Vensir (similar to extended-release or ER) comes in 75mg, 150mg, and 225mg "modified release" capsules. About the 75mg capsules:

Quote

Prolonged release capsules, hard. The capsules are peach opaque / peach opaque size '1' hard gelatin capsules having thick and thin radial circular band on the body in red ink and thick and thin radial circular band on the cap in red ink. The capsule is filled with 6 white to off-white round biconvex film coated mini tablets of 12.5mg.

A gelatin capsule has no time-release effects. To make the drug extended-release, the modified-release ingredients such as povidone and microcrystalline cellulose are integrated into the core of each mini-tablet (not the tablet coatings).

(There are many such generic versions from many manufacturers in Europe, Asia, other parts of the world. Check with the manufacturer of your generic extended-release venlafaxine that the capsule is made of gelatin. If it is, the time-release quality is in the mini-tablets.)

You can taper by removing these mini-tablets:

Ascertain how many mini-tablets are in each of your capsules. Open a few and count the mini-tablets.
Divide the dosage of each capsule by the number of mini-tablets in each capsule. That is the dosage of the mini-tablet.

(For example, every dosage of Venlablue contains some number of 12.5mg mini-tablets; 37.5mg contains 3 12.5mg mini-tablets while 150mg contains 12 12.5mg mini-tablets.)

Calculate the amount of your decrease, such as 10%, on your current daily dosage.

If necessary, you may split a mini-tablet into smaller doses. For more precise dosing when splitting mini-tablets, see Using a digital scale to measure doses

The venlafaxine in a mini-tablet fragment may become immediate-release venlafaxine as it can be absorbed easier. Remember that doses in immediate-release tablet form have much shorter half-lives than those made from extended-release venlafaxine.

You cannot make a liquid from these mini-tablets, they contain a glue that will create a gel in liquid.

Taper with extended-release venlafaxine tablets

If the extended-release tablets are cut, the extended-release quality is compromised. It is likely the tablet pieces will be quickly absorbed as immediate-release venlafaxine. If you are accustomed to extended-release venlafaxine, you may experience this as uncomfortable "dosage dumping" or a significant adverse reaction.

If you're taking extended-release venlafaxine tablets, you might switch to the same dosage in the capsules containing tiny beads, if available, and use the bead-counting method, or switch to the same dosage in immediate-release tablets, if available, and follow the tips above for tapering with immediate-release venlafaxine.

If you have no choice but to taper by cutting up extended-release tablets, you may wish to convert your dosage into the smaller 37.5mg XR tablets, and taper by splitting only one of the smaller tablets. The combination may cushion the effects of a more immediate release of the drug. Note that doses in immediate-release tablet form have much shorter half-lives than those made from extended-release venlafaxine and may need to be spread out over the day.

For example, if you're taking 150mg XR per day, request that your prescription be filled with one 75mg XR tablet and two 37.5mg tablets per day (for insurance coverage, your doctor probably will have to write the prescription as a spilt dosage of 112.5mg in the a.m. and 37.5mg in the p.m.). You can then take your daily dose as 112.5mg XR in the morning and start tapering by cutting the 37.5mg tablet for a smaller dose later in the day.

For more precise dosing when splitting tablets, use a digital scale to weigh tablet pieces.

-----

8 hours ago, Mimosa said:

Lastly what is the best literature or summary, that people have found to give to their prescribers in order to convince them to come on this journey with them, ie to believe in the tapering method at 10% from last dose and counting beads?

I can't answer your first three questions about brands available in the U.K. Regarding literature supporting the 10% taper and Venlafaxine, I'm not aware of anything specifically about Venlafaxine. Regarding the advisability of tapering by 10%, take a look at the authorities listed in the link. The reason to taper by 10% is to avoid or minimize withdrawal. To get your doctor on board, you may want to print this article out from the following link. It's from the Royal College of Psychiatry (RCP), the official psychiatric organization in the U.K., which in 2019 at long last reversed its previous position (which was to the effect that withdrawal was "mild and transitory") to admitting the severity of withdrawal.

Stopping antidepressants

And here's an article with leaders in the RCP explaining why they wrote that.

Psychiatry’s Top Experts Acknowledge Lasting Harms of Antidepressant Withdrawal

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker

Omega-3 fatty acids (fish oil)

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members. We're glad you found your way here.

June 8, 2021

Hi Gridley,

Thank you so much for getting back to me. I have read the specific information re tapering from Effexor? Venaflaxine which is very useful and I am thinking that switching to a capsule that has beads instead of mini tablets would make it much easier to taper by 10%. I spoke to my pharmacist who said he can try to order specific capsules for me but can't guarantee. We are feeling the brunt of Brexit in the UK now and he has said he's finding it really difficult to get all medication. It seems that I could end up sometimes getting capsules that I could do the counting bead method and then sometimes get the mini tablets. I think this would make things really difficult to manage and am wondering whether there are any other people finding this in the UK and who have found a solution?

I have been reading about tapering strips from the Netherlands https://www.taperingstrip.com but Im not sure they do a 10% taper one. 'm going to look into this further as it may solve the issue of having to keep changing from Beads and mini pills.

Does anyone have any experience of using tapering strips for Venaflaxine?

Thank you for the links that I can send to my GP. I don't have much faith she will support me but will do my best and if not I will be looking for another prescriber that will work in partnership with me before I start tapering.

All the Best

June 8, 2021

25 minutes ago, Mimosa said:

I have been reading about tapering strips from the Netherlands https://www.taperingstrip.com but Im not sure they do a 10% taper one.

From my understanding, they will do the tapering strips with any percent dosage reduction that your prescription calls for. Given the situation you describe that you're facing in the U.K., this might be an excellent way to taper. I don't know the NHS policy on Netherlands tapering strips.

June 8, 2021

Unfortunately the NHS does not prescribe the tapering strips there is a campaign to get them to do so. They can deliver internationally but there is a cost, another thing I'm looking into. The only worry I have about tapering strips is that if a taper is not going well and I start to experience withdrawal symptoms for more than a few days, I can't tweet the dose and slow the taper. I'm not sure what I'd do in that situation. I can see there are pros and cons of the different methods and am quite nervous about starting to taper with all these uncertainties. I have been on some type of psychiatric drug for more than 30 years without success of coming off any of them.

June 9, 2021

Hello all,

I'm 56 years old a mother of a 14year old, live in London, UK and I have been taking Venaflxine 150mg capsules for 12 years.

The brand name of the capsules I'm presently being prescribed is Venlaslov XL 150mg Prolonged- Release Capsules. It is a capsule with 12 mini tablets inside

In order to start tapering I need to ask my pharmacist to order a different brand of capsule that has a large amount of beads inside rather than just 12 mini tablets.

Is there anyone here in the UK who is tapering Venaflaxine/Effexor 150mg XL using the bead counting method? If so, can you let me know the brand name of your

Venaflaxine/ Effexor capsules?

I would also like to connect with anyone who is reducing or has completed reducing Venaflaxine.

I'm wondering if anyone in the UK knows of any in- person support groups for withdrawing from antidepressants and/or particularly Venaflaxine/ Effexor?

I am also interested in hearing from anyone who may have used tapering strips to reduce/ withdraw from Venaflaxine. What was your experience? Would you recommend it?

Thank you and thank goodness for this site!

Mimosa

June 10, 2021

@Mimosa please put questions about your personal taper here, in your Introductions topic. Do not start additional topics in Introductions, there's only one Introduction to a member.

Did you read Tips for tapering off venlafaxine (Effexor)

You can taper with the mini-tablets inside your capsule, or you can ask your pharmacist for a brand that contains tiny beads.

If you want to ask about what's available from the NHS, you could ask in this topic or

or, you could ask the NHS and share the information in the Tips for tapering off venlafaxine (Effexor) topic.

If you want tapering strips, your NHS doctor can write the prescription, but you might have to pay for it out of pocket.

June 10, 2021

Hi Altostrata,

Yes I've read the Tips for tapering Effexor. The mini tablets in my capsule are so small that it wouldn't be possible to shave off 2.5mg from a 12.5mg for instance which is what I'd need to do for the first 10% reduction, so I think that bead counting may be better. My pharmacist doesn't know which brand name of capsules contain beads and which contain mini pills, so he's asked me to find out which is why I was asking people what brand name they were using for bead counting on here.

I'm sorry for posting in the wrong place, this is the first time Ive used one of these forums/websites. I don't even use facebook!

So just to confirm if I want to post something like questions to everyone, I should post here? So should I paste my other post to here?

September 17, 2021

Hello looking for some advice

I started my taper from 150mg Venaflaxine 2 months ago using the Brassmonkey method ie reducing 2.5% a week for 4 weeks and then holding the last dose for 2 weeks. I chose this because I have been on medication for 30 years and after reading a lot on this website, thought this may suit me as it was a bit more gentle than a 10% drop in one go every month.

Although early days, what I have found is that the weeks I am dropping a dose( although only 2.5% of the last dose) I am having sleep problems,( sleeping v lightly and waking up v early) feeling agitated in the day time, its a physical feeling like I've had loads of coffee. I'm experimenting taking magnesium but haven't found right dose yet. I took 120mg capsules to start off with and they made me feel really groggy and didn't give me better sleep so I'm now trying 50mg in morn and 50mg at night.

The lack of sleep is really affecting me so I'm thinking I may have to taper even slower. Also I'm 57 and most of menopausal symptoms had gone but they have now come back ( mainly hot flushes -day and night). Wondering if this could be anything to do with tapering?

I'm just surprised and that I'm having these symptoms with such small drops in dose. Do you think I should carry on with the same schedule and see if things get better and the magnesium works? I was also thinking of trying melatonin which I haven't used before. Do you think that's a good idea?

Any advice welcome!

Mimosa

March 10, 2022

I don't know if You are still visiting the forum but from what I've gathered reading many introduction topics, any drop in dosage can generate withdrawal symptoms, the objective of slow gradual taper is for the symptoms to be bearable and don't incapacitate a person.

November 8, 2022

Hi Everyone,

@Vaherr thanks for your response to my last post. I haven't visited the site for a while.

I have been tapering using the taper strips from the Netherlands successfully for the past 15 months and have tapered from 150mg Venaflaxine to 82.5mg. The Taper which is 5% Taper a month and then a 2 week hold went well with few withdrawal effects until I got to about 90mg then I started experiencing problems, with disturbed sleep, crazy dreams, waking up very early, brain fog, dizziness, anxiety. So I am now holding at 82.5mg for a while, whilst I work out my next steps.

I'm thinking of of switching to Veneflaxine Liquid so I can be more precise in the measurements. Are there any UK members that know of where to get Venaflaxine liquid from? and is there anyone in general who is tapering using Venaflaxine Liquid at the moment who may have some advice?

If anyone is interested in the Taper Strips here is their website. https://www.taperingstrip.com

You can customise your own strips using your own tapering schedule which is what I did using the @Brassmonkey Scale.

If anyone has any questions about the Taper Strips or the process of getting them, please ask!

Mimosa

April 17, 2023

Hello @Altostrata @brassmonkey and all,

I am looking for some advice from switching from Veneflaxine slow release tablets and capsules ( I'm taking both) to Venaflaxine Liquid.

I have been tapering using the Taper Strips from the Netherlands since July 2021. I have been using the Brassmonkey scale reducing 5% a month. I have reduced from 150mg to 82.5mg. I am not able to carry on reducing using the taper strips as the lowest dose they do is 0.5mg. (I am not crushing splitting or counting beads as it is too complicated since I have a combination of capsules and tablets) The drops have become to crude by rounding up or down, which started causing side effects that meant I have been holding on the same dose for the last 6 months.

I have just been to my GP who has said that she will prescribe me the liquid form if I can come back and let her know that I will be able to find a pipette that will allow me to measure out the very small amounts. The smallest dose Liquid form she can get here in the UK is 37.5mg.

So I am looking for some advice!!

Please can you/ anyone advise a micropippe that other people have found to work well at very small doses. I think I will I will need to be able to measure out as small as 0.005ml

Also I have seen somewhere on this site but I haven't been able to re find them -

1)a conversion table to help work out the amount in liquid form that is equivalent to the mg amount in a tablet/ capsule form,

2) advice about how to gradually transfer from tablets/ capsules to a liquid form

Please can you/ anyone pass these on to me!

I would really appreciate this as I am at point where I'm stuck and am unable to move on to the next stage of tapering.

Many thanks!!

April 18, 2023

I can’t answer your questions, but I wanted to caution you when using liquid Venlafaxine. The liquid will most-likely be immediate release, not extended release, which means half your intended daily dose will need to be taken twice a day. If they tell you it is extended release, make sure you double and triple check with the pharmacy. I have yet to see any liquid Venlafaxine that is truly extended release. It can cause a big increase in daily withdrawal symptoms if you use it as ER when it is IR. Some pharmacists have even mislabeled the dosage instructions, not being aware that it is immediate release.

Edited April 18, 2023 by FindRest

April 18, 2023

There is no way for a liquid venlafaxine formulation to be extended release, at least not to the extent that the capsules are, and even dosing two times a day can be a problem, I had to change to immediate release and am dosing 3 times a day and I haven't stabilised since over a year ago, no amount of holding changes that, so in my experience I wouldn't recommend changing to immediate release.

But my case is bad even in our community of bad cases, so take my account with a grain of salt and search other peoples threads for info about this, I remember reading one users thread with liquid venlafaxine being taken.

And crossover would also be tricky, as You would have to take something like 3/4 current capsule 1x times a day + 1/8 liquid x2 times a day (or 1/12 3x times a day) for a week then 1/2 current capsule x1 + 1/4 liquid x2 or 1/6 x3 for a week and 1/4 capsule + 3/8 liquid x2 or 1/4 x3 for a week and after that full dose in liquid.

But alas I am not a moderator so wait for someone more experienced in the art of crossover.

Wishing You a lifelong window!

V.

April 18, 2023

On 4/17/2023 at 12:57 PM, Mimosa said:

I have reduced from 150mg to 82.5mg. I am not able to carry on reducing using the taper strips as the lowest dose they do is 0.5mg.

I don't understand why you cannot proceed with tapering strips. A 5% reduction of 82.5mg would result in a dose of 74.25mg. When an odd amount, we advise rounding up, to 74.5mg. This would be slightly less than a 5% reduction.

Why are you tapering by 5% per month? Did you have difficulty with a 10% per month taper?

As @FindRest and @Vasherr said, you would need to take a liquid form of venlafaxine, which would be immediate-release, twice a day, and crossover from pill to liquid can be bumpy.

On 4/17/2023 at 12:57 PM, Mimosa said:

1)a conversion table to help work out the amount in liquid form that is equivalent to the mg amount in a tablet/ capsule form,

Your pharmacist should be able to calculate this. It depends on the strength of the liquid.

Veterinarians and compounding pharmacies carry tiny oral syringes for the purpose of customized drug dosing.

April 18, 2023

Hey there Mimosa. And first congratulations for getting from 150 mg VenlafaxineXL(extended) to 82.5 mg.

I'm in agreement there with Altostrata, and wondering too, why not proceed tapering further with extended release tapering strips.

I am coming up with your next 5% drop from 82.5 mg present extended release venlafaxine to be 79 mg

And then one more 5% calculated from the 79 mg would get you to 75 mg

That would mean getting to 75 mg with present extended release, once a day dosing and then........trying to cross on over to liquid immediate release venlafaxine, split into at least 2 doses to get your total daily amount in mg or dose.

And this is where then we might have to get creative.

We've got about 12 weeks though to figure this all out, which is nice if you begin to taper again doing 5% and extending an extra 2 weeks.

So taper 1......6 weeks

Taper 2........6 weeks

I am finding a 75 mg in 5 mL of immediate release liquid that I think is available in the UK. The 37.5 mg would then be in 2.5 mL of liquid.

And then that comes out to be 1 mg in every 0.06 mL of liquid.

And then, Mimosa.......the liquid could be even further diluted with water, or partial amounts from the bottle to enable a higher mL volume for each milligram or mg of dose strength.

See what you can find out Mimosa. What you would be getting when you went to immediate release venlafaxine liquid. And if you'd be getting help at that point from the tapering strip people? or pharmacy people?

I don't think we do have a spread sheet where one can fill in the millimeters(mL volume) to milligrams(mg dose strength) but I could be wrong.

We can help with that if and when that time comes.

Crossing over from tapering strips used once a day to immediate release liquid twice a day...........well we will have to get creative.

I do see the venlafaxine tapering topic above and then this is the usual format for crossing over.........yet your case will get complicated by the fact that you'd be also shifting to immediate release(as all liquid is when it comes to venlafaxine) and having to adjust also to a new dosing schedule.

On 6/7/2021 at 3:20 PM, Gridley said:

3/4 old brand, 1/4 new brand for 3 to 7 days

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

Do not taper while doing the crossover. Hold at your present dose.

Syringes can be found on Amazon of varying sizes. Syringes are the equivalent of what you call a pipette for the most part. I'd go with one for oral use only, and with a plunger inside the body of the syringe. I can give you the topic so you can see some, and then with the 1 mL syringe you'd be able to get down to .01 or .02 of a mL.

Using an oral syringe and other tapering techniques

For right now. Give us an idea of where you are at. Why you paused tapering 6 months ago?

How you are doing overall?

Maybe even.......going to bead counting from a 75 mg extended release capsule filled with little beads might be the way to go once you get to 75 mg.

Okay. Best. Love, peace, healing, and growth,

mmt

Edited April 18, 2023 by manymoretodays
Tis complicated

April 19, 2023

Thank you @FindRest @Altostrata @Vasherr @manymoretodays for your replies. I really appreciate it!

I suspected what you have confirmed- that switching from extended release tablets/ capsules to immediate release liquid is not easy and of course I don't want to risk things getting too bumpy.

I am reducing only 5% as I found 10% too much, I was getting bad insomnia and couldn't work. 5% tapering using the brassmonkey scale was fine until I got too my present dose when I began to get nightmares and very intense dreams and agitation in the day with extreme tiredness. I thought these affects were because I wasn't able to taper by measuring the smaller doses. Having been on the same dose for the last 6 months, I still get the dreams but not as intense or frightening and am able to recover and function fine in the day. I had thought that to be more exact using a liquid might be a smoother ride but from what you've said this isn't necessarily the case.

I feel ready to carry on tapering now and may just try with the taper strips at least to get down to 75mg and then think again as you say @manymoretodays

I would have counted beads but since Brexit, pharmacies here can't guarantee I will get the same brand from my prescription. This means I could potentially get a different brand of Venaflaxine every 2 months and have to change to a new counting regime, each time that happened, which would be really confusing.

Thank you also for the conversion tables and advice about syringes.

I will have a good think about everything. Thanks everyone for your encouragement and support.

April 23, 2023

Hello again @manymoretodays @Altostrata and all. I have been thinking about a possible couple of options for my next stage of tapering after reading your posts and would welcome your advice!

I could get down to from 82.5mg 75mg by continuing the Extended release Veneflaxine Taper strips as you say @manymoretodays that would take me approx 12 weeks( in fact 10 I have worked out) using the Brassmonkey scale that have been using so far reducing 5% a month with a two week hold.

Then I could switch from extended release to immediate release by going back to getting my medication prescribed by my GP and ask for two immediate release 37.5mg tablets or capsules to take twice a day to get used to taking immediate release.

Once I was used to the switch from extended to immediate release tablets at the dose of 75mg, I could then continue my taper by crushing one of the tablets into powder and weighing using a digital scale and putting back into empty capsules to take?

(Even though it maybe easier to count beads the brand of Veneflaxine XR I was receiving often had mini tablets in the capsule which would need to be crushed anyway and would end up being immediate release anyway. I can't guarantee I will ever receive the same brand. Sometimes I may get the ones with mini tablets sometimes with beads it would become so complicated.)

So do you think the above is a good plan?

I have one more question. When I switch from one 75mg ER tablet tote immediate release 37mg tablets twice a day, should I do the crossover schedule you have quoted in your post. I'm thinking not, as this would mean I would be taking a mixture of extended release and immediate release at the same time?

Its so complicated!

Thank you! Look forward to your advice,

Mimosa

April 24, 2023

First, if you have been tapering every 2 weeks since July 2021, it could be that you would benefit from a vacation from tapering substantially longer than 2 weeks, to let your nervous system rest from dosage changes.

On 4/18/2023 at 8:00 PM, manymoretodays said:

I am coming up with your next 5% drop from 82.5 mg present extended release venlafaxine to be 79 mg

And then one more 5% calculated from the 79 mg would get you to 75 mg

If you are taking 82.5mg venlafaxine ER, why not get your less expensive normal prescription filled with 75mg ER and make a liquid from 25mg IR tablets for the 4mg? Can you get immediate-release venlafaxine tablets?

Otherwise, cannot see why you cannot continue with tapering strips.

June 23, 2023

On 11/8/2022 at 8:03 PM, Mimosa said:

If anyone is interested in the Taper Strips here is their website. https://www.taperingstrip.com

You can customise your own strips using your own tapering schedule which is what I did using the @Brassmonkey Scale.

If anyone has any questions about the Taper Strips or the process of getting them, please ask!

Mimosa

Hi there Mimosa I’m new to this site since watching the panorama doc and I’ve just read this thread re: venaflaxine taper. Im 28F from the uk and I’ve been taking this wretched drug for nearly 6 years. I suffer from awful side effects even if I miss 1 dose let alone tapering off so I’ve been so so scared to do so however reading your thread and others on here I finally have some hope. My question is how did you manage to get the taper strips delivered? Did you have to get your GP to sign it? If so, how did you broach that conversation?

I take 300mg of venaflaxine this year I seem to be having awful trouble getting a consistent brand of drugs - in fact I’m struggling to get any at all! I’ve been left with nothing 3 times this year due to supply problem and I’ve been so ill from withdrawal so I’m thinking the strips would be a safer way to go

many thanks in advance

September 16, 2023

Hello @Ifeelnothing

Sorry for late reply, I didn't see your message

Re the Taper strips yes you need to get your GP to sign your order form for the taper strips. I spoke to my GP and sent her some articles that are on this website about safe tapering. I will try and find them and send you. Also I'm the same if I miss one dose I suffer from bad side effects. Before I started Tapering I could also not get the same brand each prescription from the GP which makes it impossible to do the bead counting method. The Taper strips have worked for me so far. The only thing is that since Brexit the import tax has gone up which makes it more expensive.

Also, now that the panorama doc is out you can also tell your GP about that.

Mimosa

September 16, 2023

@Ifeelnothing here is a link to one of the articles that would be useful to pass on to your GP

September 16, 2023

@Ifeelnothing

Here are two more links that would be useful for your GP

Stopping antidepressants

Psychiatry’s Top Experts Acknowledge Lasting Harms of Antidepressant Withdrawal

January 25

Hi all,

Can anyone tapering venlafaxine/Effexor give me any advice re excessive dreaming whilst tapering. My dreams are so vivid feel like they are all night long and I'm waking up exhausted. Sometimes they are distressing and I wake up with my heart beating fast. I know this is one of the withdraws effects of tapering Venaflaxine - just wondering if anyone has had any experience of what to do to calm the dreams down. I've tried writing them down but isn't making any difference. Also wondering how long they will go on for? I have worked out that if I continue tapering at the rate I am it's still going to be 7 years before I am off the drug! I'm thinking of trying acupuncture maybe. Any advice is welcomed!

January 25

Hi,

I don't think that there is anything that can be done to stave off this part of withdrawal other than doing a break in tapering, are You taking Your dose in the morning or in the afternoon?

Maybe moving the dosing hour could change something but its rather hit or miss, its possible that it will make problem worse...

January 25

Hi @Vasherr

Thanks for your reply. I take a dose in the morning and one in the evening as I've now switched to immediate release.

How is your taper of venlaflaxine going? How are you doing your taper? Are you doing 10% reductions?

April 16

Hello all,

Is there anyone on this site who is from the UK and tapering Venaflaxine/ Effexor? I would love to connect with you if so!

I'm finding that the gemini 20 digital scale can't cope with the small amounts that I'm measuring. I have to split my daily dose in half as Im on immediate release venaflxine. So I crush the pills and fill 2 capsules for each day.

It would have been easier to stay on XL and take beads out of a capsule - but the capsules I was receiving from the NHS were not filled with beads but mini tablets.

I'm wondering how others in the UK are tapering Venaflaxine ( Effexor )??

Thanks!

April 16

I'm making suspension with OraPlus suspending liquid from US Amazon.

April 17

@brassmonkey I have been following your scale in my Venlafaxine (Effexor) taper

Please could I check something with you??

At the moment I am tapering by crushing Venlafaxine IR tablets into power, weighing using a digital scale and putting into capsules.

I am reducing by 7% every month then a 2-week hold.

I am suddenly panicking that I may have done my calculations wrong as Maths really isn’t my strong point!

Please could you check that the below is correct?

· One 75mg tablet of Venlafaxine Torrent weighs 315.0mg. (i.e. with filler)

· 1 mg (with filler) is 315.0mg divided by 75 = 4.2mg

· Therefore, 1 mg of venlafaxine Torrent weighs 4.2mg (with filler)

· Therefore, X the amount of mg dose to take each week by 4.2mg to get the correct dose. (which includes filler)

Is the above, correct??

I am using one of the excel sheets on this site to work out my weekly doses.

My calculations are in the table below. I take 2 doses a day. I convert the mg dose in grams as my scale doesn’t weigh in mgs.

Also how do I change the title of my post, from the original title when I joined SA?

Thank you!

Week		Full weight of whole dose mg	2 doses in mg am/ pm	2 doses in gms
1	73.69mg x 4.2mg	309.489	154.749	0.154
2	72.40 x 4.2	304.080	152.040	0.152
3	71.13 x 4.2	289.746	149.363	0.149
4	69.89 x 4.2	293.538	146.769	0.146
5	Hold	293.538	146.769	0.146
6	Hold	293.538	146.769	0.146
1	68.66 x 4.2	288.372	144.186	0.144
2	67.46 x 4.2	283.332	141.666	0.141
3	66.28 x 4.2	278.376	139.188	0.139
4	65.12 x 4.2	273.504	136.752	0.136
5	Hold	Hold	Hold	0.136
6	Hold	Hold	Hold	0.136

1	63.98 X 4.2	268.716	134.358	0.134
2	62.86 X 4.2	264.012	132.006	0.132
3	61.76 X 4.2	259.392	129.696	0.129
4	60.68 X 4.2	254.856	127.428	0.127
5	Hold	Hold	Hold	0.127
6	Hold	Hold	Hold	0.127
1.	59.62 x 4.2	250.404	125.202	0.125 here now.
2	58.57 x 4.2	245.994	122.997	0.122
3.	57.55 X 4.2	241.710	120.855	0.120
4.	56.54 x 4.2	237.438	118.719	0.118
5.	Hold	Hold	Hold	0.118
6.	Hold	Hold	Hold	0.118

April 17

Yes, that is correct.

April 18

@brassmonkey I have been following your scale in my Venlafaxine (Effexor) taper

Please could I check something with you??

At the moment I am tapering by crushing Venlafaxine IR tablets into power, weighing using a digital scale and putting into capsules.

I am reducing by 7% every month then a 2-week hold.

I am suddenly panicking that I may have done my calculations wrong as Maths really isn’t my strong point!

Please could you check that the below is correct?

· One 75mg tablet of Venlafaxine Torrent weighs 315.0mg. (i.e. with filler)

· 1 mg (with filler) is 315.0mg divided by 75 = 4.2mg

· Therefore, 1 mg of venlafaxine Torrent weighs 4.2mg (with filler)

· Therefore, X the amount of mg dose to take each week by 4.2mg to get the correct dose. (which includes filler)

Is the above, correct??

I am using one of the excel sheets on this site to work out my weekly doses.

My calculations are in the table below. I take 2 doses a day. I convert the mg dose in grams as my scale doesn’t weigh in mgs.

Also how do I change the title of my post, from the original title when I joined SA?

Thank you!

Week		Full weight of whole dose mg	2 doses in mg am/ pm	2 doses in gms
1	73.69mg x 4.2mg	309.489	154.749	0.154
2	72.40 x 4.2	304.080	152.040	0.152
3	71.13 x 4.2	289.746	149.363	0.149
4	69.89 x 4.2	293.538	146.769	0.146
5	Hold	293.538	146.769	0.146
6	Hold	293.538	146.769	0.146
1	68.66 x 4.2	288.372	144.186	0.144
2	67.46 x 4.2	283.332	141.666	0.141
3	66.28 x 4.2	278.376	139.188	0.139
4	65.12 x 4.2	273.504	136.752	0.136
5	Hold	Hold	Hold	0.136
6	Hold	Hold	Hold	0.136

1	63.98 X 4.2	268.716	134.358	0.134
2	62.86 X 4.2	264.012	132.006	0.132
3	61.76 X 4.2	259.392	129.696	0.129
4	60.68 X 4.2	254.856	127.428	0.127
5	Hold	Hold	Hold	0.127
6	Hold	Hold	Hold	0.127
1.	59.62 x 4.2	250.404	125.202	0.125 here now.
2	58.57 x 4.2	245.994	122.997	0.122
3.	57.55 X 4.2	241.710	120.855	0.120
4.	56.54 x 4.2	237.438	118.719	0.118
5.	Hold	Hold	Hold	0.118
6.	Hold	Hold	Hold	0.118

April 18

Thank you @brassmonkey!

April 18

Hi Mimosa,

I am not from the UK (Germany) but I would also like to connect with people tapering/having difficulties with Venlafaxine.

Right now I am trying to cope with a failed taper that has been/is pretty rough. I didn't know about SA and all this until recently. So there are a lot of questions and thoughts in my head right now.

I also wonder what is the best way to handle Venla. The original brand with beads is extremely expensive here and bead counting sounds tedious. So from what I read here on SA there are supposed to be only 3 options for me:

1) crushing and weighing immediate release tablets

2) solving immediate release tablets in water

3) switching to another AD which is easier to taper

I tend to prefer 2) over 1) but have no personal experience so far. What I read about 3) here left matters open to me. On the one hand Venlafaxine is supposed to be particularly difficult to taper and on the other hand switching ADs is supposed to be risky.

Did your switch to immediate release go smoothly (I am on XR)? How do you split up your daily doses, 50%-50%?

How is your experience with the slow taper so far (you said you have issues with dreaming)?

April 18

P.S.: Did you switch from tapering strips to crushing and weighing tablets? Are tapering strips expensive?

I also get huge problems if I miss Venla only shortly. It's like day1 I am feeling strange, day 2 I begin to feel ill and day 3 I can't do anything anymore.

April 20

Hi @Alfred1977

Thanks for your message.

I did go from Tapering strips from the Netherlands to crushing tablets. Tapering strips were great when I was at a higher dose and I used them to get from 150mg XL to 75XL. I am doing the Brassmonkey scale of Tapering and reducing by 7% a month followed by a 2 week hold. The doses that the Taper Strip.people do will only do a full number and a half number - so for example 80mg , 80.5, 81, 81.5.82, 82,5. (I was rounding the numbers up or down)

So as the doses on my taper got lower, would need say 81.6 or 81.7 etc. I thought it would be too crude to go down in the larger increments so decided to move to crushing the immediate release tablets and weighing to get the doses more exact.

And yes, my switch to Venaflaxine IR from XL went ok. I did it when I was at 75mg and so I went from one 75mg XL capsule a day to two 37.5mg IR tablets a day - one on the morn and one in the eve (about 12 hours apart.) I held at this dose for quite a while on the IR to get used to the change. (I think for about a month to 6 weeks)

I'm now taking 2 equal doses a day of crushed Veneflaxine IR. The dreaming I mentioned has got more intense and excessive since being on the IR Venaflaxine and I do wake up with complete brain fog and a fuzzy/ dizzy head which last around 3 hours before it clears and am often exhausted by the dreams. Sometimes my sleep is bad and I have physically totally awake feeling in the middle of the night. However I can cope with it and I haven't crashed or had to updose yet, but I have had a couple of periods of spiralling into a depression but they have only lasted around 48 hours each and I've just ridden them out. I do get stressed about doing the measuring and crushing myself and was much calmer when I had the taper strips made to the right doses, and I just needed to take them.

What doses of Venaflaxine are you on at the moment? and how much per month are you planning to taper by? I"m happy to give you any advice that I can from my experience so far.

I wouldn't necessarily move over to IR. It does mean you have to take them twice a day and maybe 3 times a day as they have such a short half life. You could us the Taper strips and stay on XL.

There is definitely no perfect way and I'm now thinking I want to be back on the extended release! - as maybe I'd get less withdrawn symptoms

(I am presently looking for a compounding pharmacist in the UK to see if they can make up extended release in the doses I need- but I dont know if its possible and it's likely to be really expensive - so I may have to carry on the way I'm doing it now.)

And yes the same as you - If I miss a dose by accident I feel terrible and it's hard to function the next day. I've always found that even before I was tapering.

Hope the above is helpful in some way. Its a hard and slow journey but I'm sure it will be worth it in the end!

With Best wishes

Mimosa

April 20

Hey Mimosa,

tank you very much for you answer. I appreciate this very much. I am now on 25mg xr capsules. I reinstated after an uninformed, much too fast, psychiatrist led taper the last weeks. Right now I am waiting to feel better. No idea how long it's going to take, but in the end I want to get rid of this drug.

I have read a lot the last days here and I don't know if I remember everything correctly. What I found interesting or helpful:

Rhiannon said in some thread that it's more important to dose precisely than to dose accurately. This is supposed to mean that your way of dosing should repeatedly produce the exact same amount of the drug (precision) and that it is not so important to measure/know exactly how much that is (accuracy) - I guess at least as long as it is somewhat accurate and not totally off. But I think this makes sense. Particularly since they are also saying that it's more important to listen to your body when tapering instead of strictly adhering to some plan. This might also be a reason why it could be better to dose yourself and not buy custom dosages in a pharmacy because it might turn out that you cannot tolerate the custom dosage yet and want to adjust swiftly.

We will probably have to be able to dose a fraction of a miligram in the end because e.g. 2mg of Venlafaxine can still be very potent. As far as I read here affordable scales cannot do this. They are not accurate enough. I don't know much about bead counting yet. But I watched 2 interviews with Altostrato and Dr. Horowitz and I think both would rather not switch the AD and instead try tapering the one you already got.

So if I had to decide now, I probably would go with solving Venlafaxine in water. Venlafaxine hydrochloride is supposed to be soluble in water and this is the first good news I heard since I started to learn about this drug. Supposedly this only works with beads or Venlafaxine immediate release tablets and the liquid itself will be "immediate release". But this is the best chance I have heard about so far to be able to dose really small amounts. There was an interesting thread about this somewhere here, but I can't find it right now.

Last December I thought I can quit in 3 months and got pretty roughly punished for it. When I started reading here I thought about tapering for a year. Now I think it will be at least 2 years not considering the time I will need to recover from now. Maybe I try reductions of 10-14% every 3-4 weeks. This could get me somewhere to 0.5mg within 2 years.

It's good to talk to people like you. I often feel terribly lonely in this whole situation. It's difficult to explain to others and I still haven't found a psychiatrist or physician who understands and believes.

All the best

Alfred

Mimosa: looking for tapering advice from Venaflaxine 150mg XL capsules

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