Crossover: tapering effexor

[Crossover]

Hello, I am hoping someone can help provide or advise me, this is my first time to request help in this type of forum.  I have been taking Venlafaxine 37.5mger for 13 yrs. for depression after my son's passing.  I had know idea once I started this drug it would be so difficult to get off of.  I am currently taking it every other day.  I want to continue to get off of it completely but read somewhere on this forum that you should not wean off of it after taking it every other day?  Can anyone advise how to proceed weaning at this state of the game?  Thank you, much appreciated!!

[ChessieCat]

Hi Crossover,

 

(Edit:  One of the mods has created you own Intro/Update topic for you)

 

Welcome to SA.  You've landed in the right place for support, encouragement and lots of helpful information.  You are not the only one who didn't realise how hard it would be to get off an AD.  But it is possible, although it will take time.

 

Are you currently getting any symptoms from being on the venlafaxine?  What type and brand of venlafaxine are you using?

 

Taking ADs on alternate days is not recommended here.  How long have you been taking it that way?  It will help if you could Please put your Withdrawal History in Signature.  Please include ALL drugs, dates, doses and how you decreased/increased.  Once we have these details we will be better able to make suggestions about your individual situation.  It is a good idea to update your signature each time you change your dose so it remains current and allows your history to be seen at a glance.

 

SA recommends tapering by 10% of the previous dose with a 4-6 week holding period to allow the brain to adapt to not getting as much of the drug.  The best thing to do is for you to start taking your V every day at about the same time.  It will depend on how long you have been alternating your dose whether you halve the amount or take more than half every day.  Once we have the details we will be able to offer a suggestion on the dose to take every day.

 

Here are some links for you to read:

 

Introduction to AD Withdrawal Syndrome

Why taper by 10% of my dosage?

 

Tips for tapering off Effexor (venlafaxine)

 

These couple of things helped me to understand why 10% tapering is recommended:

 

Brain Remodelling (Rhi's Description of Brain Healing)

Video:  Healing From Antidepressants - Patterns of Recovery

 

Many people become concerned about how their medical prescriber will react to their decision to taper.  The information in these topics can help with that:

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

There is lots of information there for you to check out.  It can feel a bit overwhelming when you first join here because there seems to be so much to learn.  Check them out and then please come back here to ask any questions in your Intro/Update topic and you can also journal your progress.  Click FOLLOW (top right) and you will be notified when someone responds.

 

Once you get stabilised and hold for a while on a daily dose you will then be able to start a safe taper following the 10% reduction method.

[KarenB]

Hello Crossover,

 

Just popping in to say hello as I am also tapering effexor.  Actually today and yesterday we've had quite a few effexor taperers arrive here.  CC gave you a great start, so I won't add any more to that.  It's true what she said about feeling better once you get your head around all the info and decisions.

 

Welcome to SA,

Karen

[Crossover]

Thanks ladies for your responses! You should know I am not a good "computer person" or computer literate and stunned to have found my way back to these responses.  Please bare with me!!  I have tried to update my med intake and will review the sites posted above from Silver star. Can I give you a brief history on this page about my experience over the last four years or can you direct me how or where to post that?  Sorry to be so uncertain, in all honesty, I'd prefer to just speak to each and every person personally via a phone call, but understand that's just not possible.  Thank you both again, C

[Crossover]

After reading learning more from Silver Star's above posts, I unfortunately realize in order to get off of this medication I will need to increase my intake. This worries me. If I have been taking the venlafaxine 37.5mg every other day, for several months how much should I increase it by to start the taper process?  

[Crossover]

Ok ChessieCat, I've been reading most of the day and into the evening.  I wish I could've found more info on this forum regarding hair loss and venlafaxine?  As you know by now, I've been taking this med every other day.  At first I thought I may need to increase my dosage before tapering?  But now, I wonder what you might think about me reducing one bead at a time while still continue to take every other day?  With the hair loss situation I continue to experience, the sooner I wean off completely (over much time, I realize) I hope will help save some of my hair?

 

I plan to pull apart one of my capsules tont to see if I can tell any difference between the beads?  From what I've read, that may not be the case. I'm planning to continue my learning on this powerful drug.  I can't believe it's taken me so long to understand it.  The past 4 to 5 yrs have been a struggle and I now finally realize it may be from trying to wean myself of this drug and not other health issues. So troubling in many ways. I will be anxiously awaiting your response. Thanks again and again!!!!

[KarenB]

Hello Crossover, 

 

Thanks for filling out your signature.  Would you be able to add in which month you started taking your dose every second day?

 

I can answer some of your questions, and CC will probably be along at some point too.  It's really good you've been reading, cause understanding this stuff will make a big difference to your approach to the whole experience. 

 

You can write your history on this page, just press 'reply' at the bottom of the thread.

 

But now, I wonder what you might think about me reducing one bead at a time while still continue to take every other day? 

Taking your dose every day is important, otherwise your Central Nervous System just won't stabilise properly - and you need that to happen before you begin tapering.  They say skipping doses is like playing ping-pong with your brain.  It makes such a difference to how your taper will go if you can start from a strong place. 

 

So for now we just need to know how long you've been skipping doses for so we can figure out at what level you should start the daily doses.  (ie it's not a given that you'll need to increase).  I'm probably sounding a bit pedantic, but we need to know what 'several months' is, as to some people it's 2 months, and to others it's 6. 

 

I hope some of that is helpful.  Please keep coming back to discuss things further - we really want you to be sure about what you're doing. 

 

Best wishes,

Karen

[Crossover]

Thank you Karen for your willingness to help, I am truly grateful. I apologize for my late reply.  I spent most of my day calling my prescribing doctors to figure out dates and meds so that I can provide the most accurate account as possible.  Honestly, what I've realized in the last two days have been disturbing.  This is the new med schedule & I will again revise my signature:

 

I started regular brand Effexor XR 75mg from 2002 to 2011, 9 yrs.  I never had any issues on this and infact it helped me get through a very difficult sad time in my life.

In June of 2012 I thought I was ready to wean and shared this with my doctor and she switched me to the Effexor XR 37.5mg extended release. No mention of any withdrawal issues were shared with me. Then in June 2013 for some reason was put on the generic brand Venlafaxine caps 37.5mg extended release?  May have been done for insurance purposes, I really don't know or recall why?  I can tell you, that I thought nothing of it at the time, generic brands are more affordable and I've never had issues with them before.  Again, no one ever explained to me this could or would change the way I felt on this drug. Never a word and I was clueless and very trusting of both my doctor & pharmacists. 

 

I've just begun to put the puzzle pieces together since finding this forum. It was sometime between 2012 & 2013 I started experiencing what I thought was hormonal issues (going thru menopause) or thyroid issues (I have Hashimoto's thyroiditis)  plus turning 50 so basic "older age" problems. It wasn't until I noticed my hair falling out that I knew I had to find some help. 

 

After jumping around from doctor to doctor over a period of about 2 to 3 yrs, I finally went to Houston in September 2015 to meet with a Homeopathic clinic.  They provided me with a hormone treatment and vitamin/mineral supplementation and increased my thyroid medicine. Also, I dropped all gluten in my diet and started eating healthier.  They also suggested I get off of the Venlafaxine, but only once I felt better. They told me to meet with my prescribing doctor before doing so. After these changes I started to feel much better, plus, my hair stopped falling out for a while and began to look a bit better. I was thrilled, so much so, after 3 months I met on Dec 7, 2015 with my prescribing doctor to begin the process of weaning.  I let her know I was already taking the venlafaxine every other day. This was fine for me unless I forgot to take it within the designated hour for the next dose.  Then the withdrawal would start reminding me that I hadn't taken the next dose so I'd run for it. She (my doctor) told me to increase it by two days, then three days, then four days and once I hit the 5th day mark without taking the med I wouldn't need to take it anymore.  I started or tried to wean by hours, so if I was taking it every other day at 7am, the next time I'd hold out to 8am, 9am or 10am depending on how bad the withdrawal was. I suffered up & down through this until Feb 9th where I jumped back on it daily. This went on until I could wean back down to every other day again and as of March 15^th  I've been there ever since. I'm still experiencing many withdrawal issues, all of them bad, but most disturbing is my hair loss.

 

I hope between you and CC y'all can & will guide me with instruction on how to proceed.  I recently picked up the book The Antidepressant Solution, a guide to safely overcoming antidepressant withdrawal, dependence and "addiction" by Joseph Glenmullen, M.D.  Although, I have not found or come across in the book how to deal with weaning from taking venlafaxine extended release every other day? Your thoughts on increasing up or decreasing down from here - this is the main question for now. Thanks, CO

[KarenB]

I agree with you - disturbing is the right word to describe the mess the drug companies get people in to.  And doctors are also of little help.  You've got a great book there.  Another one is Anatomy of an Epidemic by Robert Whitaker.

 

Okay, so you were skipping doses from Dec 7th till Feb 9th, then on a daily dose from Feb 9th till March 15th, then back skipping doses from March 15 till now - roughly 6 weeks. 

 

I think the reason you got worse hair loss when you went from skipping doses back to a daily dose, was that you kept the dosage amount the same, but your body had probably adjusted to having a lower amount in it's system.  Also, the frequent changes were starting to take more of a toll on you.

 

The nasty thing about w/d is that it the damage cumulative.  So each time you go up or down in dose, or change drugs, it brings even more destabilisation than the previous time.  You know that game jenga?  Once things are already unstable at the bottom of the tower, each new move makes it even more wobbly. 

 

Your full dose was 37.5mg, and taking it every second day would equal out to 18.75 daily.  It could be good to try 18.75 daily to see if you can stabilise there.  Give it at least four days to a week to properly settle in, and keep symptom notes (it really helps with decision making).  

 

I also wanted to mention supplements - many are very activating, especially multivitamins and B vitamins.  We've got a thread here:  http://survivingantidepressants.org/index.php?/topic/2836-supplements-what-helps-what-doesnt/ which elaborates.

 

What do you think about that dosing idea?  I'm also going to get some other mods to look at this as I'm one of the newer ones, and more brains are better than one .

 

Karen

[ChessieCat]

Hi Crossover,

 

The most important thing at this time is to start taking your drug DAILY at approximately this same TIME.  KarenB has suggested a dose above.

 

This link has members discussing Hair Problems.

[Petunia]

Hi Crossover,

Welcome to the site. I really can't improve on the great help you have been getting from CC and Karen. I agree with Karen's suggestion of now trying to stabilize on 18.75 daily.

 

I suggest your read through this topic again:  Tips for tapering off Effexor (venlafaxine)

 

Pay special attention to the section on how to taper generic Effexor (venlafaxine) XR. It talks about how to make smaller doses from the beads or mini-pills inside the capsules. One thing to be aware of is if you are breaking the mini-pills, you may be losing the XR effect, meaning the drug dose will need to be divided and taken 2 or three times a day. If this is going to be an issue, and you have more questions, please ask here in your thread.

 

Others have have more personal experience than me with tapering effexor and will be able to help.

 

 I see Chessie has kindly just posted a link to our topic on hair loss, I hope you find some reassurance there.

 

My own experience with hair loss is that it was falling out like crazy when I was in acute withdrawal, for over a year. It was frightening, each time I brushed or washed my hair, hand-fulls would come out. My scalp was visible in places and I was sure I was going to lose it all. My hair has never been very thick to begin with, so this was very difficult to watch. I was also losing a lot of weight without trying, that was scary too.

 

As my nervous system started to settle down, the hair loss slowed and then hair started to grow back. I think its almost back to how it was before now, I'm no longer concerned about it anyway. I hope that puts your mind at ease.

 

Petunia.

[Crossover]

Ladies, I can't begin to tell you what a relief it's been to read your messages! To finally have this kind of exchange with supportive input has brought reprieve for the first time in 3 long years, so THANK Y'ALL!!!!

 

First, I wanted to let you know that my vitamin intake has been monitored. Since Sept. 2015- April 2016, I've had four separate occasions to have blood work done and all has been reading in the normal range and looking good.  I will continue to have this done, while I try to wean as well.

 

Second, I have a phone call set for next Monday, 5/1, to speak to a doctor that specializes in Functional Medicine and has experience with patients trying to wean off of antidepressants. Plus, I have a meeting set up with a compounding pharmacists to discuss dropping to the suggested 18.75mg and helping to make that happen.

 

Having the weekend will allow me to continue to process all this new and recent information and most importantly to "own it", accept it for what it is and move forward!! I have no other choice, I want off.  I don't like what's happened, but in a small way it's been comforting to know I'm not the only one to go through it.  It will be slow & difficult progression to wean and I may need to decrease it even less than the 18.75??  I want to do this as slowly as possible??  My greatest worry is continued and increased shedding even more than what I'm experiencing now, which is alot! The same as what Petuna described above has been happening to me over the past few years!

 

After my conversations on Monday, I will post here again to inform Y'ALL what I learned and ask for your additional advice!  I will not move forward until hearing back from you. Together, I feel confident that I might possibly be able to do this.  Karen, you mentioned above that you were going to inquire with a few other "mods"? More brains, for input.  This put a smile on my face and I'll take any and all advice I can get, so please continue to share what you learn!!

 

Thanks again, I am so appreciative and happy to have found SA!!!  

[ChessieCat]

"After my conversations on Monday, I will post here again to inform Y'ALL what I learned and ask for your additional advice!  I will not move forward until hearing back from you."

 

Excellent idea!!!  You might find some tips in these links:

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

Good idea to chat with the compounding pharmacy.  But be aware that (at least in Australia) the prices can vary dramatically so you might want to consider getting a few quotes before going ahead.

[KarenB]

Yes, I did confer with some other mods, and they agree about starting at 18.75.  You'll get through this crossover, you have a great attitude towards it all and that makes a big difference.  It's hard and slow, but do-able.  I am hoping that the hair loss will ease once you have been stable for a while, but as usual there's no guarantees. 

[Crossover]

Alright, I've read both response's (CC & KarenB) AGAIN, the input I needed!!  I do have questions after reading the attachments CC suggested:

 

1) Do you know if Venlafaxine is prescribed in liquid form?  If you don't know, I can check with the compounding pharmacists on Monday, 5/1.

2) If I wanted to decrease from venlafaxine even less (slower) than the 18.75mg, what would you suggest?  I can NOT afford to lose any more hair.

3) I read that increased water intake and exercise is helpful during weaning.  Have either of you found this to be true in your cases? I choked down 1qt or 18.7 fl oz yesterday and starting another today, it's not easy. I googled how much water someone should drink in a day & found 2 qts is the desirable amount - that will be a challenge! But will do anything to help ease this upcoming withdrawal I'm bracing for - any advice that seemed to work for y'all is welcomed.

4) I'm a coffee drinker too, only 1 stout cupful in the mornings.  Will I need to stop that during my wean? I really rely on that cup to get me up and going in the mornings. If so, I'll probably have to wean off the caffeine before my venlafaxine wean!! 

5) Karen, you mentioned "been stable for a while", have you known of others on venlafaxine that have made it through a wean and still experienced hair loss?? 

 

Ok, these were my questions after reading your last posts.  Please continue to help provide your most wonderful and needed guidance! Y'all are truly a blessing! It's been really amazing to know I've found help from across the world, Australia and New Zealand - Wow!! Thank you!!

[KarenB]

Okay - here goes:

 

1.  I haven't heard of liquid Venlafaxine, but sometimes different countries have different options - maybe do check with the compounders.

 

2.  The idea with the 18.75 is that it's pretty much as close as we can get to what we think you are currently taking, only put into daily form rather than spread out.  So it's not decreasing yet, it's just trying to stabilise you on a daily amount.  Then when stable, you can taper as slowly as you like. 

 

3.  Drinking plenty of water is very helpful, though I'd ignore any general specified amount.  Your body size and functions are individual and I think it's better to really tune in and pay attention to what your body tells you it needs.  Since being in w/d, I keep a bottle by my bed so I can easily keep hydrated through the night and also when I wake, if I'm too tired to get out of bed. 

 

3b.  Exercise is great, but keep it gentle.  Too much/too active and it can ramp up your symptoms.  I do gentle goga, walking, and riding my electric bike. 

 

4.  Most people find caffeine too activating during withdrawal.  I had been a 1-cup-a-day girl for years, but in w/d it made me feel so awful I had to stop it.  I had 4 days of caffeine w/d headaches and then I was home-free.  Well, apart from the Effexor w/d...

 

5.  I don't know of any specific examples.  Symptoms in general are pretty random, but do seem to be better the slower you taper.  Which is why I'm now tapering at about 1.2% per month, although I'm in the middle of a long hold atm.

[Crossover]

KarenB, I guess I didn't realize you were weaning off of Effexor too?  I will go back and read through your blog.  From just glancing at it briefly, you're a eloquent writer.  Hopefully, later today I can spend more time on it.  I just wanted to say good luck with your continued weaning, you know & understand the drill, that's a huge advantage. Plus, you've been so helpful to many, I hope that brings you some kind of peace? 

 

I appreciate the answers above and completely understand the input.  I am hoping after speaking with the doctor & compounding pharmacist today, and they agree with your insightful suggestion to drop to the 18.75mg daily, I'd like to get started weaning.  I will most likely post again today, so SA is informed along with you and CC, about what I learned.  It's interesting, I've been rushing to my computer first thing in the mornings to look for & read Y'alls responses!!!  It's been my glimmer of hope!

[Crossover]

Ok, I'm back, it's now 8:15pm here.

 

I had better luck today with my pharmacist then the doctor visit.  The doctor did a lot of talking about re-balancing the brain chemicals, suppressed germs and germ toxins etc. He did sound like he'd like to help me, but wanted to conduct several tests before addressing the weaning. I don't have time for that. The pharmacist on the other hand was willing to weigh out my meds to 18.75mg and took enough to help me make it through the next 5wks.  I can pick them up on Wed. 5/3 and that will be my start date for stabilizing. I take my last 37.5mg tomorrow morning, usually around 7amish & the 18.75mg starting Wed. evening at 9pm. I am ready to give this a try and go from there.  Posting all the while with your guidance.  I will need y'all to be my allies!!  I am nervous, but know it's what must be done. I have faith that stabilization will go fine, it's the next 10% drop that may cause more issues???  What the heck do I know! 

 

KarenB, I signed up for your blog updates.  I haven't had much opportunity to read many of your posts, but plan to read more tonight.  I did read one that mentioned taking cod-liver oil, vitamin E, a dose of apple cider vinegar and eating raw, along with natural yoghurt to help with potential weaning problems. I plan to get them and add to my ever growing list of needs to try as well.  Any tid-bit like these to help ease the pain --  I find so beneficial! Thank you!

 

Do either of you or anyone really, have suggestions for Green Tea? Did you find it helpful?

 

Last question, I'm considering signing up for a weekly bikram yoga class or HOT yoga.  Are you familiar with this? Apparently it's touted most often as detoxification, heavy sweating to help flush toxins. I know to go slow & listen to my body.  What do y'all think about it? I do speed walk/slow jog, throughout the week around my neighborhood, it's not pretty, but I'm not starting from zero (like everything else) when it comes to moderate exercise. 

 

Y'all must think I am crazy?  I'm putting on my armor and ready for battle!

[KarenB]

I like working for SA because every time we are able to point someone in the right direction and minimise their w/d troubles it feels like a massive achievement.  I really like knowing that someone's life will be easier because this site is here. 

 

Awesome about getting the pharmacist and pills sorted.  5 weeks sounds like good length of time for allowing some stabilisation. 

 

Ha, you've picked up a mistake I made - it should be fish oil, not cod-liver oil.  Must fix that one... for many months I thought they were the same thing but then another mod on here picked up on my misunderstanding. 

 

Green Tea - yuck .  But here's a link:  http://survivingantidepressants.org/index.php?/topic/1032-l-theanine-for-anxiety-insomnia/?p=193667 

Some people find it too activating due to it's caffeine content.

 

This is a good thread on yoga, and the last post in it addresses hot yoga in specific.  Gentle exercise is best in order to not ramp up your symptoms.  Trial and error will let you know what your body can handle. 

 

You're going to get through this Crossover; it can be slow and a bit bumpy at times, but you've got some good knowledge now and support too. 

[Crossover]

KB, l love the links you share, they always give me something more to think about yet add more questions too. I will add the L-theanine to my arsenal, along with Fish oil, instead of the green tea for now and see how it goes. Plus, sounds like I'll need to have a heart to heart with the yoga instructor. May need to hold off on the bikram yoga and start even slower than I thought. I certainly don't want more complication!!

 

I am so thankful for this site, SA.  But, honestly, for you mostly, you've already made such a difference and I haven't even started my weaning!!  I know your story and I'm so sorry, what an amazing women you are to be able to share it. Your experiences and knowledge have actually given me hope, which I haven't had in a long time.  You fueled my enthusiasm to move forward and possibly succeed.  The support, advice and comfort you've given me, I have no words for.  I'm certainly not the beautiful articulate writer like you, but you've made a difference and you need to know it! I will always be grateful, in fact, if you were here right now - I'd have to give you a giant hug!! Thanks for everything and I'll keep you posted.

[KarenB]

You don't know how much it means to me to hear that Crossover.  I'm so happy you are feeling hopeful again - that's the basis of some really good healing.  Hugs to you too,

 

Karen

x

[Crossover]

5/4/16, 9:05pm, just took my first 18.75mg of venlafaxine and so it begins...

[Crossover]

Hey friends, just an update, as of yesterday it's been a full week of taking the venlafaxine 18.75mg, nightly. All seems to be going well.  I do think I've notice a slight increase of hair loss, unfortunately.  Only slight, but worrisome due to the extreme thinning over time.  Otherwise, things seem to be going well or I guess I should say tolerable.  I plan to re-evaluate at 4wks, if all remains the same, I might decrease 10% then instead of going the 5wks as previously stated? As usual, I won't do anything without consulting y'all first.  I'll repost briefly on a weekly basis, to keep you updated.  Thanks, for hanging in there with me. Take care!!

[AliG]

Crossover.  I hope it all goes well . How are your other symptoms?  Are they improving at all ?  You mention - tolerable . What does that consist of ?

Please keep us updated and ask any questions , along the way . 

Ali

[Crossover]

AliG, I shouldn't have even mentioned it," tolerable", I mean.  I've had a few waves of lightheadedness (is that a word) and some fatigue. But for the most part, it's been going well. My hair loss continues to be the big issue. I pray once I am off this drug it will correct itself?????

[KarenB]

What we see on this site is that things do gradually correct themselves again.  The healing starts when we begin to lessen the drugs in our system, and continues for some time after we are drug-free.  Nature is generally very good at restoring itself - picture forests after fires etc. 

[Crossover]

Boy KarenB, I really needed to hear that this morning!!  Perfect timing, the push I needed THANK YOU! 

[Crossover]

Today will be 2 full wks of 18.75mg nightly. I must say for the most part I am doing well enough. With that said, I must also mention the dreaded continuation of my hairloss.  It has increased and I just don't understand it? What is it with this drug & my head of hair? To see the heightened amount of loss has begun to cause additional stress.  Which of course I understand is not helpful in my case.  I am doing my best to hold on to the fact that once I'm done with venlafaxine things may return to normal???  In the meantime, it's not a pretty site!

[AliG]

Crossover. How are you feeling apart from that ?  Symptoms ?

[Crossover]

Hello out there, for those of you interested, I've made it down to 15.mgs as of 6/3/16 of venlafaxine.  I have definitely been experiencing head issue's. My neck seems to feel warm and with every step I take, my head feels as if it's cracking (not sure how else to explain it)?  I'm pushing forward and trying to ignore it as much as possible, hoping it will go away.  I will not give in to this and will succeed!  Unfortunately, I realize it won't get any better soon. I have my low moments and allow it to happen, for short times before redirecting my attention. I know it's withdrawal. For the past few nights, I've been waking up around 2:30am and finding it hard to fall back to sleep for a few hours.  I guess that's part of the withdrawal too?  If all goes well, I plan to finish with the 15.mgs on July 1st at which point  I drop to 11.25mgs.  Wrapping this wean up by the end of Sept?  Sure, easy to say now, right? I'll continue to post throughout, thanks for reading!! 

[KarenB]

Hey Crossover,

 

It sounds like your plan for 1 July may be a bit fast, especially considering you are a little pushed with the symptoms you are having now.  Your last cut was also more than 10%.  Gentler cuts would be less rough on your CNS.  It's always so tempting to go faster, but it usually backfires so I hope you'll consider slowing things a little. 

 

I am glad to hear how well you are managing things though.

 

Karen