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Flats going off Effexor


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Hi. .This is my first post . I'm tapering off Venlafaxine after 12 years finishing at 150 mg , and introducing Mirtazapine. .

After reading the forums I realise I have tapered off ( mainly due to my doctors ignorance way to quickly)

As we speak I am currently taking half a generic 37.5 mg ( approx 20mg)Effexor am and 30 mg of mirtazapine in the evening.I am 3 days into this current dosage.

My doctor put me on the generic tablets at 75mg saying they would be easier to split ( for years I had been on 150 mg X slow release)...

On realising now , my too speedy tapering off, should I persevere on this current dose ( splitting a 37.5 generic tablet) or revert to bead counting, as I still have a supply of 150 mg XR.

Symptoms wise, I feel terrible, headache, zaps, judders , dizziness ..maybe some of these are caused by the introduction of mirtazapine ( I have been on 30 mg for 12 days now) although I suspect it's more like the effexor withdrawal. ..

Any help and advice is much appreciated , I'm just in a sort of mental limbo at the moment, not knowing what to do.....Many thanks

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  • Administrator

Welcome, Flats.


I moved your post to our Introductions forum to start your Introductions topic, where you can ask questions about your particular situation and track your progress. Please bookmark or follow this topic so you can find it again.


How did you reduce from 150mg Effexor XR? Is the generic 37.5mg tablet venlafaxine XR or immediate-release?


It sounds like you need some kind of updose. If I were you, I'd start taking the entire 37.5mg tablet in the morning for now, while we discuss your reduction from 150mg Effexor XR.


Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Drug Interaction Report


Drug interactions for the following 3 drug(s):


Unsaved Drug ListEmail | Print | Save | New listmirtazapinevenlafaxineVitamin B12 (cyanocobalamin)




Major Moderate MinorFood Therapeutic Duplication









Interactions between your selected drugs


Majorvenlafaxine  mirtazapine


Applies to: venlafaxine, mirtazapine


Using venlafaxine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. 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


No other interactions were found between your selected drugs.

Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.


Other drugs that your selected drugs interact withmirtazapine interacts with more than 300 other drugsvenlafaxine interacts with more than 500 other drugsVitamin B12 (cyanocobalamin) interacts with more than 10 other drugsInteractions between your selected drugs and food


Moderatevenlafaxine  food


Applies to: venlafaxine


Alcohol can increase the nervous system side effects of venlafaxine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with venlafaxine. Do not use more than the recommended dose of venlafaxine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.


Switch to professional interaction data


Moderatemirtazapine  food


Applies to: mirtazapine


Alcohol can increase the nervous system side effects of mirtazapine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with mirtazapine. Do not use more than the recommended dose of mirtazapine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.


Switch to professional interaction data


Therapeutic duplication warnings


Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.




Therapeutic duplication


The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:




Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed



Above is the drug interactions between the 2 ADS I currently take.

I am so grateful for your reply and discovering this site ...My GP is next to useless and I have basically been left to find help myself , especially the withdrawal symptoms of this evil drug..

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Sorry..to continue...

After 10 years of being on 150 mg of modified release XR, I felt the drug wasn't helping and I asked my GP for an alternative. .

1/1/16..dropped from 150 mg effexor to 75 and introduced 7.5 of mirtazapine.

22/1/16 ..another drop to approx 50 mg of Effexor ( instant release???) And an increase to 15 mg mirt in the evening.

4/2/16...drop to 37.5 effexor and 30 of mirtazapine.

15/2/16..drop to half a 37.5 of effexor plus 30 of mirtazapine. ...This is currently my dose..

The effexor is instant release after years of being on modified release???

Symptoms have ranged from extreme to bearable, the infamous head zaps , judders...headaches..anxiety.

It's as though my senses are hypersensitive to movement causing dizziness , nausea etc...

I'm an illustrator who specialises in wedding caricature ...its been tough doing that as it's all visual , with constant head movements throwing me off balance ( even though I'm seated) ..I've barely been able to get through a 2 hour gig and have had to excuse myself while I go to the toilet, breathe and collect myself...obviously the social setting just exacerbates the symptoms....I keep telling myself it's the withdrawal, you ain't going to collapse although that's how it feels...Computer work or too long on the phone again emphasise the head shocks and dizziness. ..scary stuff, and I'm not a wimp, I was a firefighter for 27 years before retiring early because of this illness....The drawing is now my livelihood but now I'm scared to even do that, but I have to...

After finding this wonderful forum, I realise I've tapered way too fast and need to find mental equilibrium again.....In anticipation, many thanks.

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  • Moderator Emeritus

Hi Flats,

Welcome, I'm glad you found us. You have been tapering Effexor much too fast. We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising. Please read through this which will explain why:


Why taper by 10% of my dosage?


As you are discovering, Mirtazapine does not stop Effexor withdrawal. If I were you, I would go back up to 37.5mg of effexor and hold there to see if your symptoms improve. When did you start experiencing symptoms?


Once you have become stable again, you could continue with a proper taper, see:    Tips for tapering off Effexor (venlafaxine)


It would be great if you would put your drug and withdrawal history in your signature. Doing this helps people understand your context, it appears below each of your posts. Here are instructions for how to do it:




You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want. Its a good idea to bookmark it or follow it, so its easy to find again. Please stay in touch and let us know what you decide.



I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?

VIDEO: How are psychiatric diagnoses made?

VIDEO: Why do psychiatric drugs have withdrawal syndromes?

VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes




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