maxfly: trying to go off Effexor XR

[maxfly]

Hi There,

 

I took reluctantly took 150mg of Effexor XR for about 8 months to recover from a work related break down that resulted in high anxiety.  My doctor assured me I had nothing to lose by trying Effexor.  After 8 months passed, and work settled down, I decided to stop taking Effexor.  I tapered to 37.5mg quite easily.  I've spent the last 5 months trying to get past 37.5 - using bead counting reductions.  Every attempt has been the same.  I am fine for about 7 days and then on day 8, I crash with extreme flu symptoms.

 

My last attempt I tried crossing over to Prozac.  I took 20mg of Prozac for a week and then started taking out 5 beads (~5%) from my Effexor capsules.  After week 2 I started to have trouble sleeping - I assume from the Prozac building up.  Towards the end of week 3 I started to feel really strong withdrawal from the Effexor - headaches, diarrahea and nausea.  I was a complete mess so I bailed and took 75 mg of Effexor - the flu symtoms went away the next day.  I stopped the Prozac and I am now sleeping okay just taking 37.5 mg of Effexor.

 

I'm really not sure what to try next.  I've been taking 37.5 mg of Effexor for 5 months and I'm not sure if this dose helps or hurts or does nothing.  Failed tapers are very stressfull so I want to be conservative.    A couple of questions:

 

1) Why do my withdrawal symptoms take 8 days to appear and why are they 'all or nothing'?  Any insight into what's happening over the 8 days?

3) What should I try next?  A two bead taper seems like the only option - but it will take me 5 years to get off the drug.

3) Could it be that opening and reassembling the capsule reduces the effectiveness of the drug?

 

Thoughts?

[Altostrata]

Welcome, maxfly.

 

I've moved your post to the Introductions forum, to start your Intro topic, where you can track your tapering progress.

 

When did you try Prozac? Since you gave up on that, have you been taking 37.5mg Effexor XR regularly, at the same time each day, or have you tried to reduce your dosage again?

[brassmonkey]

Hi Maxfly-- welcome to the group.  I'm sorry to hear that you've had such a frustrating time with your taper.  Hopefully the five month hold has settled things down a lot.  Delayed symptoms are one of the real frustrations of tapering.  Any dose change, either up or down, takes at least four days to become steady state in the blood, after that the symptoms take their own good time in showing up.  Anywhere from a few days to a few weeks.  This is why we recommend for people to wait 4-6 weeks between drops, to let the symptoms sort themselves out and settle.

 

Opening, sorting beads and reclosing a capsule does nothing to change the effectiveness of the medication.  In fact it is a standard way to taper Effexor.

 

Effexor has a bad habit of sensitizing its users if they make several changes up and down.  With all the manipulations you've done over the past year or so I suspect that is the case for you, so you'll have to be very gentle with any changes you make.  Dropping by two beads sounds like a good place to start.  Yes it will take a long time, but the object is to get off with the least pain possible, not the quickest way.  I'm starting into my fifth year of tapering paxil, and should be jumping off some time this summer.  I can't believe how fast the taper has gone, it really doesn't seem like five years.  When I compare my experience with other members (something we really shouldn't do) I have been relatively pain free compared to the ones who CTed or fast tapered.

[KarenB]

Hello Maxfly,

 

Just chiming in to say I'm also tapering Effexor.  The only way I seem to be able to do it is very slowly - a 10% reduction caused me two months of horrible w/d symptoms, then a 1.3% cut meant I wasn't functional for a month.  Currently I am making 4 weekly 0.4% cuts then holding for a month.  As I am currently on 133mg, it will take years.  At some point I may try slightly larger cuts, as I sense my CNS is stabilising more and more. 

 

Right now though, I need to be a functional mum so this is the way for me.  You can experiment with those small cuts of, say, two beads and see how it goes.  Eventually you will find your tapering sweet-spot. 

 

There are some things you can do to ease your way through this in the Symptoms and Self-care forum.  Many people find fish-oil and magnesium very beneficial.  And here is the link for tapering Effexor:  http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/

 

Would you be able to fill out a signature so we can see your med and tapering details easily whenever you post? 

 

It's good to have you here.  Getting through this isn't easy, but it is do-able when you have the right info.  So have a read around the site, and then come back to this thread to ask any questions you may have.  This will be your journal for your healing progress.

 

Best wishes,

KarenB

[SquirrellyGirl]

Hi There,

 

I took reluctantly took 150mg of Effexor XR for about 8 months to recover from a work related break down that resulted in high anxiety.  My doctor assured me I had nothing to lose by trying Effexor.  After 8 months passed, and work settled down, I decided to stop taking Effexor.  I tapered to 37.5mg quite easily.  I've spent the last 5 months trying to get past 37.5 - using bead counting reductions.  Every attempt has been the same.  I am fine for about 7 days and then on day 8, I crash with extreme flu symptoms.

 

Hi maxfly, 

 

I am also tapering Effexor, though I am focusing on my Remeron (mirtazapine) taper first and gently nudging the Effexor down as I go.

 

You mentioned you used bead counting, but you didn't say how many beads, or what percentage, you were cutting.  It sounds like it was too much, but more details would be helpful so that we can determine if you were in fact doing a reasonable taper schedule but are just super-sensitized.

 

I count AND weigh beads.  I have found with the Teva brand that I have mostly large beads that weigh about 2.6 mg each, along with some medium sized beads and some extra small ones.  I got sloppy once and scooped up a bunch to get the weight I was aiming for and ended up with WD symptoms, probably because I got too  many little ones in the capsules compared to my usual method of aiming for the large beads.  The volume to surface area of coating changes with size.  Smaller beads mean more surface area to volume than larger beads.  Messed me up.  So, I have to be just that careful.  My p-doc calls it OCD!

 

As I said, I am doing the Remeron 10% per month, doing a weighing session every two weeks.  That means I prepare all my dosages for the next two weeks, putting them in gel capsules I got off Amazon.  I will drop my Effexor by 1-2 mg gross weight each time I do a weigh session.

 

Anyway, we will get you straightened out and on your way!

 

SG

[maxfly]

Thank you all for you responses.  I tried the Prozac bridge at the suggestion of my Doctor and after reading that it was a fast way to get off Effexor.  I tried between Nov 23th and December 12th 2015.  Since December 12th I've been taking 37.5 mg of Effexor every morning and have stabilized.  

 

The 37.5mg capsules I'm taking have 115 beads.  Sounds like I need to start will a very slow taper.  I think I will try a 2 bead taper and see how that goes.  It's a little discouraging to think I could be tapering for a couple of years but there doesn't seem to be another option.

[Altostrata]

It probably would be a good idea to postpone dosage changes until after the holidays. Give your nervous system a chance to rest up.

[SquirrellyGirl]

Great advice, Alto!  Maxfly, you could actually do 10% per month, which would be about 103 beads to start with.  If that seems like too much, then 5% or about 110 beads.  Have you counted several capsules to see if they are fairly consistent? 

 

Of course, taking out two beads per taper is a nice slow, steady taper that should minimize symptoms.  When you think about the fact that many people have failed tapers and erroneously believe they will have to be on the drugs indefinitely, taking a couple of years to come off doesn't sound as bad as that!

 

I am glad you were able to get stable on 37.5 mg.  Slow and steady wins the race!

 

SG

[KarenB]

Thanks for filling in the signature.  I hope you take Alto's advise to wait till after Christmas before starting to taper as it's not long since your last changes. 

 

You might also like to buy a micro-scale as the contents of the capsules vary a lot.  If you weigh them yourself then you can keep things more accurate, and it's easier than counting lots of beads.  Starting low is a good idea.  If you discover there are no issues, then you can try increased cuts, but just be careful not to go over the 10%.  The last thing you want is w/d to catch up with you sometime down the track. 

 

KarenB

[alenka9]

I tried the Prozac bridge at the suggestion of my Doctor and after reading that it was a fast way to get off Effexor. 

 

What happened when you tried the Prozac bridge? What made you think it was not working? I'm also on Effexor and I'm thinking about doing the Prozac bridge. I would be very grateful if you could tell me about your experience.

 

If my switch to Prozac is unsuccessful, I will micro taper.

 

Alenka

[maxfly]

I've slowly tapered from 150mg to 100mg with the following dosage drops roughly every 6 weeks (142.5, 132.5, 122.5, 112.5, 110, 105, 100)

 

The main side effect is fatigue.  Anyone else feel extremely tired when tapering?  I can basically fall asleep when ever I sit down on the couch.  Need to keep myself active and stimulated. 

 

The issue is that the fatigue is strongest in weeks 4-6 after the dosage drop.  It makes it difficult to taper because I need to wait 6+ weeks for my energy to return.  Any suggestions / thought on how to deal with the fatigue?  Why is it the worst in weeks 5 and 6?

 

I know the answer may be that "that's just how it is for me" and my taper will be very slow and prolonged but wondering if anyone has had experience with drawn out fatigue.  @Altostrata - would love your guidance on this.  thanks, maxfly

[Altostrata]

max, I moved your post here to update your topic.

 

Congratulations on getting down to 100mg Effexor.

 

What happens in weeks 1-3 after a dosage drop? Why did you decide to taper at 6-week intervals?

[maxfly]

Hi @Altostrata,  Just realized this post got moved to my intro topic.  The strange this about my taper (~5% every 6 weeks) is that I really don't notice any withdrawal effects in weeks 1-3.  I think everything's fine and then on about day 18 or 19 I get headaches and fatigue.  I wait a couple weeks to feel better and then taper again.  Hence the 6 week tapers.

 

Is it unusual for withdrawal effects to take 2 weeks to appear?

[ChessieCat]

Putting this here for your history:

  

36 minutes ago, maxfly said:

Anyone have experience switching Effexor brands?  Did you notice any difference on the new brand?

 

The brand I've been taking for 4 years, Teva, suddenly stopped making Effexor XR.  I switched to a brand called APO.  I chose this brand because it has 450 beads in a 75mg capsule and should be good for tapering.  I've noticed my sleep has been shallow and interrupted and I have mild headaches.  It's been 3 weeks.  Could this be due to my system getting used to the new brand?

 

Thoughts?

 

  

Just now, ChessieCat said:

Generally when switching drug manufacturer we suggest doing a cross over because it is gentler on your system, each combo for 3-7 days (longer if needed):  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.  No reduction at the same time.  Good information to have if needed down the track.  Also a good idea not to leave getting the next prescription filled at the last moment.

 

However this obviously cannot be done if you haven't planned for it and they switch brands.  Very frustrating.

 

Yes, some members do notice a worsening of symptoms when changing.  Some even when doing cross over.

 

change-in-drug-manufacturer-or-generic-substituted-for-brand-name-drug

 

It's best to hold on the current dose until stable:

 

Stability

 

WDnormal
 

 

[ChessieCat]

7 minutes ago, maxfly said:

The strange this about my taper (~5% every 6 weeks) is that I really don't notice any withdrawal effects in weeks 1-3.  I think everything's fine and then on about day 18 or 19 I get headaches and fatigue.

 

Quote from post about changing brands:

 

37 minutes ago, maxfly said:

I've noticed my sleep has been shallow and interrupted and I have mild headaches.  It's been 3 weeks. 

 

Q:  Did you make a reduction at the same time as changing brands?

 

If you did then, because you made 2 changes at the same time, it is difficult to know the cause.

[maxfly]

I held the dose at 85mg for the brand switch to APO.  I'll wait 2 more weeks (4 in total since I switched) and see how I feel.  If my sleep is better I'll start my slow taper again.  Will try 2.5mg every 4 weeks and see how that goes.

[ChessieCat]

Just responding to your question from the PM.

 

Have you checked out the Brass Monkey Slide

 

You can choose what percentage you reduce by.  You might find that you can reduce by more than 3% per month.

 

And the only supplements which SA recommends are magnesium and omega 3.

 

There are topics about those.

 

It's best to try one at a time and start with a small amount.

 

And it's better to take things as a single thing, not a complex.  Be aware that some members find B vitamins activating especially B6. 

 

To search for them use a search engine and add site:survivingantidepressants.org to the search term.