Kris108 - Effexor/Venlafaxine IR, XR, conversions and related stuff

[Kris108]

Hello dear friends!

 

Let me introduce myself by saying I've been to hell and back a few times already due to inability to live with permanent post-surgical back pain and the resulting depression with more than a pinch of insomnia... 

 

I have a question about Venlafaxine/Effexor.

Does anyone know if it is possible to turn XR (extended release) capsules of Venlafaxine into an instant release version of the drug? By dissolving it in warm water, for example? Where I live, the only available version is XR, and it would be much easier to manage if I could first  begin to reduce my evening dosage, which would among other things improve my sleep. I don't want to add Mirtazapine/Seroquel/Amitr. into the mix because of their side effects, and Pregabalin that I also take is not strong enough to counter the insomnia of Venlafaxine (or earlier Duloxetine/Cymbalta)...

I hope this hasn't been too incoherent.

 

Thanks for any input

[nz11]

Welcome Kris

You might like to have a read of this thread

Tips for tapering off Effexor (venlafaxine)

 

nz11

[KarenB]

Hello Kris,

 

Effexor is a nasty drug isn't it?  Sorry you're having trouble with sleep.  I'm tapering Effexor, and I have trouble with sleep sometimes too (which is why I'm typing now at 4am NZ time).

 

NZ gave you a really good link to start with.  When you say that you'd like to start by reducing your evening dose, does that mean you take Effexor in two doses per day?  If so, it's important that they are each the same amount, otherwise you can destabilise your Central Nervous System.  

 

We don't recommend that you start any other drugs - this site is to support people who are getting off drugs.  Two supplements that can help during withdrawal are magnesium and fish-oil.  Magnesium is good before bed to help with sleep. 

 

I'm unsure about changing extended-release into regular.  If you want more control over doses, and to be able to reduce by smaller amounts, the usual way is to get micro-scales and weigh out the beads inside the capsules.  We recommend tapering by no more than 10% monthly. 

 

I hope that gives you some useful info.  Please feel free to come back to this thread, which can be your tapering journal, and ask any more questions. 

 

Welcome to s/a

Karen

[Shep]

Hi, Kris. 

 

Like Karen said, it's best not to add additional meds for sleep. Sometimes these meds turn paradoxical and you may not realize this until dependency has set in. I've experienced this and it's brutal to be trapped on a drug that's working against you. 

 

This is a really good thread with information about many non-drug ways of getting sleep during withdrawal:

 

http://survivingantidepressants.org/index.php?/topic/555-tips-to-help-sleep-so-many-of-us-have-withdrawal-insomnia/

 

There's tons of information and links, so you may wish to book mark it to read as you feel up to it. 

 

Welcome to the forum. You'll find a lot of information and support here. 

 

[AliG]

Hi Kris .   Effexor  X R   can not be made into a liquid , but as you get lower you could switch to regular Effexor in liquid form .

 

What is your dose , and also when do you take it  ?   Do you split the dose ?  it sounds like you do .  I t would be helpful if you could put a little more information , in your drug history signature.   That way everyone can see  what is going on , and offer more help . You are in  the right place for that support.

 

Ali

[Fresh]

Hi Kris , welcome to the site.

 

Ditto to AliG's post. When we have more information we can make some suggestions.

 

If you click FOLLOW at the top right , you'll receive an email each time someone posts here.

 

best wishes , Fresh

[Kris108]

Thank you.

I was in fact referring to a part of that thread, nz11, especially this part:

 

 

Convert from venlafaxine XL or Effexor XR to regular tablets

Especially in the last leg of your taper, when you might be down to a few beads of Effexor XR, you may wish to switch from an extended-release version to regular Effexor so you can make a liquid from it to make very small reductions.

 

Because of its short half-life, taking regular Effexor as a tablet or liquid necessitates taking the tablets every 12 hours.

 

If you are taking brand-name Effexor XR, use the bead-counting method until you get down to 37.5mg, then convert to regular Effexor and make a liquid from it to finish the taper, taking doses at least twice a day.

[Fresh]

Maybe try online Kris. Search "buy effexor slovenia".

 

See https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwi8qYvKjunLAhWEJ5QKHZFYA5IQFgghMAE&url=http%3A%2F%2Fwww.meds-easy.com%2Fbuy_online%2Fanti_depressant%2Feffexor-in-slovenia.html&usg=AFQjCNEUGuzkv-9ImpCI6_uJsGNJnShMqQ&sig2=MVWEmHrXppW7JTKEKuF3nQ

[SquirrellyGirl]

 

I have a question about Venlafaxine/Effexor.

Does anyone know if it is possible to turn XR (extended release) capsules of Venlafaxine into an instant release version of the drug? By dissolving it in warm water, for example? Where I live, the only available version is XR, and it would be much easier to manage if I could first  begin to reduce my evening dosage, which would among other things improve my sleep. 

 

Welcome Kris, 

 

Everyone else has answered the question about the XR, but I am curious if you are taking the XR twice a day.  My understanding of the XR version is that it allows once a day dosing, where with the immediate release, the half life is so short as to need 2 x day dosing.  Since Effexor is activating, and messes up sleep, it is best to take the XR in the morning.  Did your doctor set you up to take it in the PM?

 

SG

[Kris108]

No, just once a day in the morning, but I could reduce the dosage and improve my sleep at the same time, if I could take a quarter of the instant release dose in the morning, and a quarter in the afternoon (and then nothing at night). Quitting altogether is not a realistic option for me as my depression isn't entirely curable since I live with incurable post-surgical back pain (6 years ago) that worsens if I don't take any drug that increases norepinephrine and at least a little bit of serotonin (bupropion made me feel angry)... 

 

I apologize for not being very clear.

 

Another option that I could explore would be a higher dosage of St-John's wort since permanently trying to buy prescription medication from abroad (IR of Venlafaxine) isn't a realistic option...

[Kris108]

Thanks, Fresh. Is the pharmacy you linked to - meds-easy - reliable? And is the stated generic Effexor an instant release version? I usually check for dosing info (3-times a day vs once) to know, but can't find the info in that website...

[Fresh]

I'm in Australia Kris and I don't use a Slovenian pharmacy ... it was a suggestion you may wish to investigate.

I googled "slovenia effexor buy online"

[nz11]

Another option that I could explore would be a higher dosage of St-John's wort

Are you implying that you are currently taking Ven and SJW together. and now you are going to up the SJW further?

 

Its recommended that you dont take these together. It could possibly lead to a rare but serious condition called serotonin syndrome.

 

If all you currently have available is XR ven. I assume they are the beads right?  Then in the meantime you could taper by counting the beads. Many people are tapering by removing beads.

 

No, just once a day in the morning, but I could reduce the dosage and improve my sleep at the same time, if I could take a quarter of the instant release dose in the morning, and a quarter in the afternoon (and then nothing at night).

That sounds like a 50% reduction and that is not recommended here. sa rec a 10% per month of previous dose reduction.

 

Quitting altogether is not a realistic option for me as my depression isn't entirely curable since I live with incurable post-surgical back pain (6 years ago) that worsens if I don't take any drug that increases norepinephrine and at least a little bit of serotonin (bupropion made me feel angry)...

I am sorry you have to live with pain.

Did you know that long term use of these drugs actually can cause depression. You may think that your depression is incurable when in fact you have simply confused withdrawal from a too fast taper or CT with depression (drug induced wdl depression is one of many  classic wdl symptoms and it can go on for many many months) and then tried to relieve it with yet another drug.

Are there other relief options for pain you could consider other than psychotropic drugs?

If making 50 % cuts has been the norm in the past then no wonder you have had trouble withdrawing from these drugs.

[Kris108]

No - St.John's Wort as a substitute for pharmaceutical antidepressants, not as an add-on.

 

No, I have never made 50 percent cuts overnight, the idea was to get there gradually (not 10 percent monthly, though,more like 20 percent - sorry, but some of us don'tneed it that slow, at least in this case when it's mostly related to pain)

 

I did explore more than 15 options of pain management and possible cure during the first 4 years after the surgery, but I had a slightly botched surgery and my pain is the result of too much cutting (to put it simply) and now not a single therapist admits a possibility of much improvement.

I exercise daily - especially strengthening the muscles that support the spine - and that reduces the depression by a tiny bit as well, but I'm always going to need drugs, it's just a matter of which and how much. You see, I have joint AND muscle pain from morning to night 365 days a year, and any worsening of mood makes the pain feel worse, which then further worsens the mood etc... Some people DO need antidepressants their whole lives. Not many, but there are cases such as mine, and it's important to say it, because you get morons all over the internet, who say that no one should use them.

 

As a note - I've never in my life abused any drugs, and the strongest substance I was addicted to before the back pain was milk tea. I had tried a life without painkillers and ADs for sometime after the surgery, but was not able to work as a result (not a taper - I'm talking more than one year of complete abstinence).

[nz11]

Thanks for the clarification

 

.. the idea was to get there gradually (not 10 percent monthly, though,more like 20 percent - sorry, but some of us don't need it that slow, at least in this case when it's mostly related to pain)

 

Kris i would like to push back on this viewpoint. I totally understand how and why one would think this; its being used off-label so i dont need to worry about the withdrawal effects.

 

I would like to tell you that SSRI/SNRIs are no respecter off reasons for prescribing, and after what appears to be  6 yrs? of cumulative psychotropic drug use you will need to taper slowly and i would guess at the 10% rate. Especially if the aim of the game is to keep your mood stable. Believe me you do not want to trigger full blown withdrawal symptoms.

 

I believe that with longer term use and switchings it slowly becomes more difficult to get off these drugs. So what i am saying is because you may have got off easily in the past the game can now subsequently change.

i might have missed it but i cant seem to see what dose you are on? 37.5mg?

[Fresh]

If you plan to stay on a small dose of effexor , than you don't need the instant release.

Why not just taper down on the extended release and go as low as you feel comfortable with.

 

"No, just once a day in the morning, but I could reduce the dosage and improve my sleep at the same time, if I could take a quarter of the instant release dose in the morning, and a quarter in the afternoon (and then nothing at night). "

It shouldn't make a difference Kris.

You might try melatonin if you need help with sleep , or explore some non-drug methods of intervention.

See our sleep threads here

http://survivingantidepressants.org/index.php?/topic/555-tips-to-help-sleep-so-many-of-us-have-withdrawal-insomnia/

http://survivingantidepressants.org/index.php?/topic/53-sleep-problems-that-awful-withdrawal-insomnia/

http://survivingantidepressants.org/index.php?/topic/6122-guided-meditations-calming-videos-sleep-hypnosis/

 

bw , Fresh