mamoebobo: Venlafaxine Cross Taper to Desvenlafaxine

[mamoebobo]

Hi all,

I am new to this site.  A little background info.  I have been on Venlafaxine for the past 8 or so years.  I got off of the medication 5 years ago (somewhat abruptly) and had terrible withdrawl symptoms.  I stayed off of the medication for four months before I finally reinstated, along with 7.5 mg of remeron and 1 mg of Klonopin.  I was on the klonopin for a year and tapered off the mg over the span of a year.  I had been on 150 mg of Venlafaxine.  I sucessfuly tapered down to 112.5 over the span of six months.  I did so well on this that my wife and I decided we would do a 3 month taper for the second quarter.  I did okay on this and was on 75 mg for two weeks.  Then I started having really bad anxiety/ocd/insomnia.  We quickly reinstated to 112.5 mg which is what I have been on the past three months.  I was also prescribed klonopin, again, as needed.  I am taking .5 mg of klonopin four nights a week to help sleep.  I have been having muscle spasms, increased ocd symptoms, GI symptoms, and more muscular pain which seems to only get worse the longer I am on the Effexor.  

 

I did a DNA Test and it turns out I am a poor metabolizer of CYP2D6-which is the enzyme used in metabolizing Venlafaxine and a lot of other SSRI/SNRI's.  Desvenlafaxine is one SNRI that is not metabolized by CYP2D6.  I am wondering if anybody has sucessfuly cross tapered from Venlafaxine to Desfenlafaxine.  

 

Any advice/suggestions would be greatly appreciated!

 

 

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

Your first task is to create a drug signature, with the following:

 

• All current medication you take, the dose you take, when you started the drug, and when you made dose changes
• All current supplements you take
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• Dates for recent should be written as 7 Oct 2023, or Oct 7 2023, or early Oct 2023, or mid Oct 2023
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• Please do not use 07/10/23 // 10/07/23 as this is intepreted differently around the world

 

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• Click this link to edit your signature: Edit your signature here.

 

 

This topic is for anything relating to you, and any questions you have. Please do not start another topic.

 

We recommend tapering by no more than 10% of your CURRENT dose each month, to limit withdrawal symptoms. E.g. 10mg --> 9mg --> 8.1mg --> 7.29mg

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

 

Here are a few of the most useful links:

 

Important topics in the Tapering forum and FAQ

 

Micro tapering

 

Why taper by 10% of my dosage?

 

Taking multiple psych drugs? Which drug to taper first?

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

 

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

[Erimus]

22 hours ago, mamoebobo said:

I did a DNA Test and it turns out I am a poor metabolizer of CYP2D6-which is the enzyme used in metabolizing Venlafaxine and a lot of other SSRI/SNRI's.  Desvenlafaxine is one SNRI that is not metabolized by CYP2D6.  I am wondering if anybody has sucessfuly cross tapered from Venlafaxine to Desfenlafaxine.

I wouldn't put too much weight into the results that these genetic tests provide. The fact is your brain and nervous system is used to taking venlafaxine. Cross tapers are very unpredictable, so it's best to continue with the drug your brain is already adapted to.

 

22 hours ago, mamoebobo said:

I have been having muscle spasms, increased ocd symptoms, GI symptoms, and more muscular pain which seems to only get worse the longer I am on the Effexor. 

To me it sounds like you're still experiencing withdrawal symptoms from the reduction you made 3 months ago. Taking klonopin/clonazepam sporadically could also be creating problems, due to interdose withdrawal. I am not familiar with benzos but I think what you need to do is move to a consistent daily dose. What this amount is I am unsure of. Once you are taking a consistent dose of klonopin, it might be easier to assess what could be producing problems.

 

We need a comprehensive drug history in your signature, but if I assume that you've been taking the benzo for 3 months then you are already dependent on it. The 2mg of klonopin you're taking weekly translates to 0.286mg/day. This might be a sensible starting point for a daily dose.

 

Please see the following topics:

 

Benzo Forum

 

Tips for tapering off venlafaxine (Effexor)

 

Tips for tapering off mirtazapine (Remeron)

 

About going off mirtazapine plus venlafaxine (Effexor) aka "California rocket fuel"

 

 

Edited April 3 by Erimus

[FindRest]

I would strongly recommend not crossing over to desvenlafaxine. It is even more difficult to taper than venlafaxine, and for me and many others, the side effects were much worse. I agree with what Erimus said above. 
 

Once you create your signature, we can help you navigate this. Meanwhile, I’d recommend doing a site search for the word “desvenlafaxine” and you can read about the experiences others are having trying to taper it. Venlafaxine is also very hard to taper, but if you get the kind with many small beads in the capsule, the process is much smoother. Are you currently taking tablets or capsules? If capsules, do they contain many beads or just a few? If tablets, are they XR or IR. This information would be very important going forward.

[mamoebobo]

Erimus, Thanks for the insights!  I have tried several times to add in Fish oil, but cannot handle the GI issues that come with it.  I have tried liquid drops at the smallest dose and frozen capsels with no luck.  I will look into Magnesium.  I did blood work recently, and everything came back normal, besides a slightly elevated Homocysteine level.  I am familiar with micro tapering as my wife and I have done this with effexor and klonopin.  The muscle pain has been issue since I started with Effexor, but it has only gotten worse with time.  When I reinstated back to 112.5 mg in January my muscle pain spiked greatly, which is why I assume that it is casued my the effexor.  I think I need to wait a while to let my nervous system reset and maybe start an even slower taper after that.  I will look into taking a more normal dose of the klonopin.  It mainly helps me with sleep, which as you know is so important!

 

FindRest, Thanks for your thoughts!  I am very familiar, unfortunately lol, with the bead counting. I am currently on 112.5 mg Extended Release. My wife helps out with this a lot.  I got down to 75 mg for two weeks and felt ok.  Then withdrawl seemed to set in really bad.  I reinstated to 112.5 and my muscle pain was almost unbearable.  It's like my body does not want the effexor in it any more.    

 

 

[FindRest]

Several of us outside of SA who are tapering off Effexor were just talking about the physical pain we are ALL dealing with. All of us are well below 37.5mg and most are below 10mg. You’ll read plenty of examples here, not just from those tapering Effexor but those on other AD’s as well. This can’t be a coincidence. Recent studies have shown that mice have increased pain and major debilitating fatigue from SSRI’s. I believe both the presence of the drugs and the subsequent absence of them set us up for this. It’s hard figuring out whether what you are going through is an adverse reaction or withdrawals or from the large recent updose. Maybe one of the moderators will be able to give you more clarity on this now that you’ve completed your signature, or maybe it’s all too intertwined to be able to pinpoint.
 

Or, perhaps the clonazepam is a big part of the issue. Benzo withdrawal is known to cause significant muscle pains, and interdose withdrawals can as well. Your irregular dosing of clonazepam can be compounding the pain. BTW, .5mg is not a small dose, as you probably already know from other reading. K is very potent. I like Erimus’ suggestion above regarding how to possibly take it on a daily basis.

 

16 hours ago, mamoebobo said:

I think I need to wait a while to let my nervous system reset and maybe start an even slower taper after that.

I think this is a good idea regarding the Effexor. You’ll know more once you start taking the Klonopin on a daily basis and see how much that helps you, if that is the route you choose to go. 
 

I am not a moderator but wanted to share my thoughts. I’m sure one of them or an admin will be along shortly. Thanks for filling out your signature. 
 

As someone who is also dealing with both of these drugs and who came from a very bad place prior to arriving here, I will tell you things do get much better.

Edited April 5 by FindRest