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Kala208: Switching from Venlafaxine ER to Venlafaxine Immediate Release to begin tappering - help needed


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I've been on depression and anxiety medication for 20 years. I know I need to get off them. I currently take Effexor XR 150mg and Klonopin 1.5mg daily. I have tried to wean off before with no luck as I started to fear everything in life and started to have panic attacks so I went back to original dose of Effexor two months ago.  I recently told my Dr. I wanted to try again and wean off the Effexor first and she prescribed me 37.5mg tablets that are immediate release. I don't know how to divvy these up throughout the day as I am use to the extended release capsule once a day. I was thinking I would take two tablets (75mg) when I wake up, then take 37.5 tablet 4-6 hours later and then 18.75mg 4-6 after that for my first month of tapering. I am lookin for thoughts and suggestions.

  • Medication

          Venlafaxine XR 150mg - started approximately early June 2005 - failed attempt to wean off early April 2022; failed attempt to wean off Nov 30 2023 to 37.5mg; increased to current dose 150mg                early Feb 2024 - Dr switched me to immediate release 37.5mg up to four times a day April 23 2024 (have not started to taper, not sure how much to take throughout the day and what times)

          Clonazepam 1.5mg - stared approximately mid 2015 - failed attempt to wean off early Feb 2024 by 0.5mg; increased to 1.5mg end of Feb 2024.

 

  • Supplements

          Vitamin D, Vitamin C, Zinc, Magnesium, Iodine, Silver & Melatonin

 

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  • Moderator

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
  • An accurate history of recent drugs, taken in the last 12-24 months
  • Dates for recent should be written as 7 Oct 2023, or Oct 7 2023, or early Oct 2023, or mid Oct 2023
  • A history of drugs taken 24 months ago and beyond - if applicable
  • Dates for historical drugs can simply be listed as start and stop years
  • Please do not use 07/10/23 // 10/07/23 as this is intepreted differently around the world

 

  • Please leave out symptoms and diagnoses. See my signature for example of clear and concise information.

 

 

3 hours ago, kala208 said:

I have tried to wean off before with no luck as I started to fear everything in life and started to have panic attacks so I went back to original dose of Effexor two months ago.

How did you try to taper? I would suggest staying on the XR and reducing by 5% using the bead counting method.

 

Please read Tips for tapering off venlafaxine (Effexor)   in full.

 

Here are some more 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

Active Monday-Friday UK time

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021; 55mg - 23 Feb 2024; 60mg - 20 March 2024; Start tapering - 24 April 2024

Current dose: 57.93mg  (15 May 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

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  • Erimus changed the title to Kala208: Switching from Venlafaxine ER to Venlafaxine Immediate Release to begin tappering - help needed
  • Mentor

Hi Kala,

I am in a somewhat similar situation (I am no doctor and I am not giving medical advice). I am on Venlafaxine since 2005 and now I am trying to figure out how to get off of it. The last weeks and months I quit too fast and had a bad crash. Therefore I reinstated Venlafaxine about 4weeks ago.

 

It's important to taper in a speed that your body can handle. With respect to that there is no rule or tapering plan that applies to everybody. Therefore it is important that you observe yourself after a reduction and only proceed tapering after a couple of weeks (e.g. 3-6) if the last step went well. If your last step didn't go well and you experience anything worse than slight symptoms for a couple of days (e.g. 3-5) you should immediately go back to the last dose you felt stable on and proceed afterwards more slowly. It is not good to endure withdrawal since withdrawal can lead to a downward spiral of your condition and severe trauma. In this community people usually suggest that you start tapering carefully by reducing 10% of your last dose in each reduction step you do (this means there will be a lot more than 10 reduction steps). When you have gathered more experience about yourself and tapering you can adjust that pace to what suits your well being best - as long as you keep on being careful.

 

It is important to understand that antidepressants have a very strong effect on what seems to be a very low dose. For example 5mg Venlafaxine sounds like little, but in fact it's extremely potent and binds already about 40% of the serotonin reuptake receptors in your brain, whereas 75mg binds about 80% of receptors. This also explains why it's so hard to get off these drugs. The commercially available doses are in this sense massive and it is impossible with them to slowly fade out the receptor occupancy in your brain.

 

Therefore a major challenge when tapering is obtaining the drug in a form that can be dosed granuarly. Personally I will try to solve immediate release tablets in water (the only good thing I so far heard about venlafaxine is that it's (chemically) soluble in water). This sounds a lot easier than counting beads to me. And it probably is also more precise and accurate (affordable scales are not accurate enough to weigh fractions of mg). The downside with this is that you need to tolerate the immediate release version since you cannot solve xr in water (at least the xr effect gets lost) and you cannot prepare your doses time in advance. I will have to try, but I think the advantages outweigh the disadvantages. I already bought graduated cylinders in different sizes, dropping glasses and tinted glass medicine bottles (I will try to keep the solution for 2-3 days).

 

While you are on a higher dose, you might want to combine tablets and a liquid solution. Thus dosing is probably easier on high doses.

 

All the best

Earlier drug history:

Paroxetine  2001 until 2003, quit cold turkey, don't remember dose; Venlafaxine 2005 until Dez. 2023, mostly 75mg xr per day, for about 4 years 37.5mg xr; quite a lot of Antihistamines because of allergy; there were other drugs that I don't remember all, but nothing what I consistently took over a longer period of time, for example Lorazepam 0.5mg prn.

Recent developments:

Dez 2023 - 03/13/2024 quitting Venlafaxine 75mg (skipping doses); 04/07/2024 reinstating Venlafaxine 12,5mg; 04/17/2024 Venlafaxine 25mg; 4/29/24 until 5/4/24 Trimipramine, 5mg going down to zero over 5 days

Drugs right now:

Venlafaxine 25mg; supplements: 500mg magnesium, 100mg aspirin and melatonin spray

 

I am no medical expert. I am dependent on Venlafaxine, trying to find and give peer support in this community and simply giving my opinion. Double check any information before you take action, for example with your doctor.

 

First they sell addictive drugs as harmless and then they leave you alone dosing fractions of a mg correctly or plunging into the abyss.

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  • Mentor

P.S.: To the best of my knowledge with immediate release your daily dose is divided up equally into 2 or 3 doses of the same amount. So basically you reduce your daily dose by 5% or 10% and then divide it up into 2 or 3 partial doses, try how that works for about a month and then plan your next step. I probably will try 2 daily doses (morning and evening) since that is less trouble. I also think about taking slightly less in the evening since I don't sleep well and Venlafaxin is known for being activating and causing tension and insomnia.

As far as I read here on SA it is generally a good idea to first taper venla and afterwards the benzo (and not both at the same time).

Earlier drug history:

Paroxetine  2001 until 2003, quit cold turkey, don't remember dose; Venlafaxine 2005 until Dez. 2023, mostly 75mg xr per day, for about 4 years 37.5mg xr; quite a lot of Antihistamines because of allergy; there were other drugs that I don't remember all, but nothing what I consistently took over a longer period of time, for example Lorazepam 0.5mg prn.

Recent developments:

Dez 2023 - 03/13/2024 quitting Venlafaxine 75mg (skipping doses); 04/07/2024 reinstating Venlafaxine 12,5mg; 04/17/2024 Venlafaxine 25mg; 4/29/24 until 5/4/24 Trimipramine, 5mg going down to zero over 5 days

Drugs right now:

Venlafaxine 25mg; supplements: 500mg magnesium, 100mg aspirin and melatonin spray

 

I am no medical expert. I am dependent on Venlafaxine, trying to find and give peer support in this community and simply giving my opinion. Double check any information before you take action, for example with your doctor.

 

First they sell addictive drugs as harmless and then they leave you alone dosing fractions of a mg correctly or plunging into the abyss.

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Thank you both for sharing with me as I really appreciate it. I appreciate this website and am thankful for it and the people as I was losing hope. I am going to try tapering with the bead method as I was not aware of this until now and think it would be best for me as my body is use to the extended release and it will only be once a day. I am going to start tapering by 10% and start in a couple of days as I will need time to prepare the beads. 

  • Medication

          Venlafaxine XR 150mg - started approximately early June 2005 - failed attempt to wean off early April 2022; failed attempt to wean off Nov 30 2023 to 37.5mg; increased to current dose 150mg                early Feb 2024 - Dr switched me to immediate release 37.5mg up to four times a day April 23 2024 (have not started to taper, not sure how much to take throughout the day and what times)

          Clonazepam 1.5mg - stared approximately mid 2015 - failed attempt to wean off early Feb 2024 by 0.5mg; increased to 1.5mg end of Feb 2024.

 

  • Supplements

          Vitamin D, Vitamin C, Zinc, Magnesium, Iodine, Silver & Melatonin

 

Link to comment
  • Moderator
Posted (edited)
5 hours ago, kala208 said:

Thank you both for sharing with me as I really appreciate it. I appreciate this website and am thankful for it and the people as I was losing hope. I am going to try tapering with the bead method as I was not aware of this until now and think it would be best for me as my body is use to the extended release and it will only be once a day. I am going to start tapering by 10% and start in a couple of days as I will need time to prepare the beads. 

I would suggest starting with a more conservative cut of 5%, given the length of time you have been on the drug, and your past attempts to taper.

Edited by Erimus

Active Monday-Friday UK time

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021; 55mg - 23 Feb 2024; 60mg - 20 March 2024; Start tapering - 24 April 2024

Current dose: 57.93mg  (15 May 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

Link to comment
  • Mentor

Could you share with us the details about your "beads method" and how it works out for you? I would be very interested since it is always good to have/consider alternative ways.

 

All the best

Earlier drug history:

Paroxetine  2001 until 2003, quit cold turkey, don't remember dose; Venlafaxine 2005 until Dez. 2023, mostly 75mg xr per day, for about 4 years 37.5mg xr; quite a lot of Antihistamines because of allergy; there were other drugs that I don't remember all, but nothing what I consistently took over a longer period of time, for example Lorazepam 0.5mg prn.

Recent developments:

Dez 2023 - 03/13/2024 quitting Venlafaxine 75mg (skipping doses); 04/07/2024 reinstating Venlafaxine 12,5mg; 04/17/2024 Venlafaxine 25mg; 4/29/24 until 5/4/24 Trimipramine, 5mg going down to zero over 5 days

Drugs right now:

Venlafaxine 25mg; supplements: 500mg magnesium, 100mg aspirin and melatonin spray

 

I am no medical expert. I am dependent on Venlafaxine, trying to find and give peer support in this community and simply giving my opinion. Double check any information before you take action, for example with your doctor.

 

First they sell addictive drugs as harmless and then they leave you alone dosing fractions of a mg correctly or plunging into the abyss.

Link to comment
  • Moderator
On 5/4/2024 at 8:12 AM, Alfred1977 said:

Could you share with us the details about your "beads method" and how it works out for you? I would be very interested since it is always good to have/consider alternative ways.

 

All the best

See:

 

Tips for tapering off venlafaxine (Effexor)

 

Counting beads in a capsule versus weighing

Active Monday-Friday UK time

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021; 55mg - 23 Feb 2024; 60mg - 20 March 2024; Start tapering - 24 April 2024

Current dose: 57.93mg  (15 May 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

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