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Jen 1698: Effexor XR withdrawal help


Jen1698

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My husband was advised by his pdoc to discontinue Effexor XR at 37.5 mg approx 9 days ago. He is having severe side effects from this that don't seem to be letting up. My question is would it be advised at this point for him to start taking some amount of Effexor again?

My husband has dealt with mood issues his entire life, never significant enough to diagnose until recent.

Had been prescribed Ativan since 2011, up to 2 mgs 4x daily when he went to detox to get off it in October 2015.

Started on Effexor XR in 2013 after a spinal fusion surgery that resulted in debilitating depression/anxiety.

Prior to Effexor tried approx 10 anti depressants, nothing really ever worked.

Started Effexor taper 11/1/15 during inpatient stay in mood disorders unit at mayo clinic.

He is currently taking 200 mg lamictal, 600 mg lithium, 1800 mg gabapentin.

11/1/15 inpatient doc at mayo clinic dropped him down to 75 mg with no major reaction.

12/1/15 home psych. dropped him down to 37.5 mg with no major reaction.

1/2/16 home psych told him to discontinue completely and he is having MAJOR issues. Mixed state mania, crying, brain zaps, horribly vivid nightmares, etc.

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  • Moderator Emeritus

Hi Jen,

 

Welcome to SA.  It's unfortunate that your husband's doctor (like many doctors) has advised him to cold turkey his Effexor.  It would be helpful if you could complete a signature block listing all medicines your husband has been on (drug, date, and how stopped).  Also it would be helpful if you could tell us why the doc advised him to go off and also what his current symptoms are.  Thanks.

 

This site recommends a slow taper of 10% of the previous dose with a 4-6 week holding time to stabilise before the next drop.  Reinstatement is an option, however, after 9 days of being off, he might be better to take a smaller dose.  Please read the following links which will help you to understand why.  Also, I suggest you wait until one of the more knowledgeable members drops by who will be better able to advise what dose he might reinstate.

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Why taper by 10% of my dosage?

 

Tips for Tapering Effexor

 

Video: Healing from Antidepressants: Patterns of Recovery

 

Brain Remodelling

 

I'm very pleased that you've found this site.  There is a vast amount of excellent information here and the members are very supportive and encouraging.

 

CC

 MISSION ACCOMPLISHED:    13 November 2021 -  0mg Pristiq      

Woohoo!!!  Finally off Pristiq   

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full tapering program     My Intro (goes to my tapering graph)    My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.  I do not provide tapering advice via PM.  Please post questions in your Introduction topic.  Please do not tag me for any reason.  I am an unpaid volunteer and assist members if I am able to and when I have the time.  Thank you for your understanding.

Mid Nov 2021 changed to low carb diet due to diabetes & cholesterol.  Lost 1/16 body weight, BP has reduced a lot. 

Links to my exercises and weights.  I also do 3 x 5.5 min with HIIT on exercise bike with 20 secs/min as fast as I can cycle.

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  • Moderator

Hi Jen--welcome to the group.  I'm sorry to hear about what is happening to DH, it's a pretty scary feeling. He is feeling the results of tapering much too fast last fall.  WD symptoms can be delayed for several months before they hit.  I see from your signature that he is on quite a mix of other drugs, which could be a big part of the problem and has a bearing on how much he should reinstate if any.  Please enter all of his current drugs into the interaction checker then copy and paste the results back here.

 

Drug Interactions Checker -- use it to reduce your drug burden

 

Thank you for adding a signature block it really helps to make things clear.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Interactions between your selected drugs

Moderate lithium  gabapentin

Applies to: Lithium Carbonate ER (lithium), gabapentin

Using lithium together with gabapentin may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate lithium  lamotrigine

Applies to: Lithium Carbonate ER (lithium), Lamictal (lamotrigine)

Using lithium together with lamoTRIgine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Minor gabapentin  lamotrigine

Applies to: gabapentin, Lamictal (lamotrigine)

My husband has dealt with mood issues his entire life, never significant enough to diagnose until recent.

Had been prescribed Ativan since 2011, up to 2 mgs 4x daily when he went to detox to get off it in October 2015.

Started on Effexor XR in 2013 after a spinal fusion surgery that resulted in debilitating depression/anxiety.

Prior to Effexor tried approx 10 anti depressants, nothing really ever worked.

Started Effexor taper 11/1/15 during inpatient stay in mood disorders unit at mayo clinic.

He is currently taking 200 mg lamictal, 600 mg lithium, 1800 mg gabapentin.

11/1/15 inpatient doc at mayo clinic dropped him down to 75 mg with no major reaction.

12/1/15 home psych. dropped him down to 37.5 mg with no major reaction.

1/2/16 home psych told him to discontinue completely and he is having MAJOR issues. Mixed state mania, crying, brain zaps, horribly vivid nightmares, etc.

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I must say that he didn't notice any of these issues until approximately 7 days ago.  He is also an intermediate metabolizer of most medications so it seems to make sense (to me anyway!)  that the side effects started when they did.

My husband has dealt with mood issues his entire life, never significant enough to diagnose until recent.

Had been prescribed Ativan since 2011, up to 2 mgs 4x daily when he went to detox to get off it in October 2015.

Started on Effexor XR in 2013 after a spinal fusion surgery that resulted in debilitating depression/anxiety.

Prior to Effexor tried approx 10 anti depressants, nothing really ever worked.

Started Effexor taper 11/1/15 during inpatient stay in mood disorders unit at mayo clinic.

He is currently taking 200 mg lamictal, 600 mg lithium, 1800 mg gabapentin.

11/1/15 inpatient doc at mayo clinic dropped him down to 75 mg with no major reaction.

12/1/15 home psych. dropped him down to 37.5 mg with no major reaction.

1/2/16 home psych told him to discontinue completely and he is having MAJOR issues. Mixed state mania, crying, brain zaps, horribly vivid nightmares, etc.

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  • Moderator Emeritus

Hi Jen , welcome to the site.

The only way to stop his withdrawal getting worse is to reinstate some effexor.

Going back on 37.5 mg may be too much for him and it would be safer for him to start with half or a quarter of that dose.

He should get some symptom relief quite quickly.

 

This is a time to get him stable as soon as possible. The interactions can be addressed later. Each of the medications will need to be tapered , one at a time. Unfortunately there's no quick fix by changing any of them at the moment.

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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ok so would it be safe to just remove half of the beads since we only have capsules? 

 

Thanks so much for everyone's quick replies....we're definitely in crisis management mode and its much appreciated to have somewhere like this to turn to.

My husband has dealt with mood issues his entire life, never significant enough to diagnose until recent.

Had been prescribed Ativan since 2011, up to 2 mgs 4x daily when he went to detox to get off it in October 2015.

Started on Effexor XR in 2013 after a spinal fusion surgery that resulted in debilitating depression/anxiety.

Prior to Effexor tried approx 10 anti depressants, nothing really ever worked.

Started Effexor taper 11/1/15 during inpatient stay in mood disorders unit at mayo clinic.

He is currently taking 200 mg lamictal, 600 mg lithium, 1800 mg gabapentin.

11/1/15 inpatient doc at mayo clinic dropped him down to 75 mg with no major reaction.

12/1/15 home psych. dropped him down to 37.5 mg with no major reaction.

1/2/16 home psych told him to discontinue completely and he is having MAJOR issues. Mixed state mania, crying, brain zaps, horribly vivid nightmares, etc.

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  • Moderator Emeritus

Yes , tip out the contents of a capsule and split them into 2 piles (or 4 if you want 1/4).

It takes 4 days to reach a steady-state in the bloodstream , so stay on the starter dose and reassess after 4 days.

 

Let us know how you go.

 

:)

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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Hi Jen,

I just read your thread and am wondering how it is going. Venlafaxine is an awful drug and apparently one of the hard ones to get off. I do hope that everything is going well.

Best wishes,

Seeker

8 years on venlafaxine (generic name Altven). Various doses then 3 years on 75mg. Tapered off too quickly with very bad withdrawals. Put back on at higher dose of 150mg to stabilise. Been at 150mg for a year. Stable and ready to taper slowly.

Dosage 150mg. Average beads in each capsule 543

January 2016. Start tapering. Also taking fish oil, vit e daily and magnesium as required.

08/01 started with 5% taper, held for 2 weeks the. Another 5% and held for a month.

3rd March another 10% cut, now taking out 102 beads. Hold for a month then assess.

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It's going pretty well.....we noticed a difference pretty quickly and would say he stabilized after 3 days or so. He is taking 10 micro beads a day for now and we'll just taper as recommended from here on out! He's still feeling a bit down but NOTHING like the symptoms that were happening before!!!! Thanks for asking!

My husband has dealt with mood issues his entire life, never significant enough to diagnose until recent.

Had been prescribed Ativan since 2011, up to 2 mgs 4x daily when he went to detox to get off it in October 2015.

Started on Effexor XR in 2013 after a spinal fusion surgery that resulted in debilitating depression/anxiety.

Prior to Effexor tried approx 10 anti depressants, nothing really ever worked.

Started Effexor taper 11/1/15 during inpatient stay in mood disorders unit at mayo clinic.

He is currently taking 200 mg lamictal, 600 mg lithium, 1800 mg gabapentin.

11/1/15 inpatient doc at mayo clinic dropped him down to 75 mg with no major reaction.

12/1/15 home psych. dropped him down to 37.5 mg with no major reaction.

1/2/16 home psych told him to discontinue completely and he is having MAJOR issues. Mixed state mania, crying, brain zaps, horribly vivid nightmares, etc.

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  • Moderator Emeritus

Hello Jen,

 

So glad to hear your husband has had some relief from the symptoms.  It would be a good idea to stay at that dose for at least a month in order to stabilise a bit before resuming the taper.  Keeping daily symptom notes on paper can help you work out when to make changes.

 

I'm on venlafaxine too, so just wanted to say hi and wish you both well,

Karen

2010  Fluoxetine 20mg.  2011  Escitalopram 20mg.  2013 Tapered badly and destabilised CNS.  Effexor 150mg. 

2015 Begin using info at SurvivingAntidepressants.  Cut 10% - bad w/d 2 months, held 1 month. 

Micro-tapering: four weekly 0.4% cuts, hold 4 weeks (struggling with symptoms).

8 month hold.

2017 Micro-tapering: four weekly 1% cuts, hold 4 weeks (symptoms almost non-existent).

2020 Still micro-tapering. Just over 2/3 of the way off effexor. Minimal symptoms, - and sleeping well.
Supplements: Fish oil, vitamin C, iron, oat-straw tea, nettle tea.

My story of healing:ContinuedHealing

***I am not a doctor; please do your own research and be able to take responsibility for decisions you make.*** 

           'The possibility of renewal exists so long as life exists.'  Dr Gabor Mate.

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