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mickt07967: Venlafaxine XR


mickt07967

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Hi

 

I am currently on Venlafaxine XR ( 150 mg ) and have decided to reduce my dose

as feel in a stable place to try. Me and my doctor decided to taper down using 37.5 mg

XL tablets as this is the smallest dose they do. Anyway I had very bad withdrawl symptoms

which began after about 1.5 days after dropping the dos by 37.5 mg 

 

After about 9 weeks and still suffering from withdrawls I went back up to my normal 150 mg XL

dose which helped. My question is how do I withdraw any less that 37.5 mg as this is the

smallest tablet and I believe you are not able to cut the XR version of venlafaxine XR.

 

Thanks 

Edited by brassmonkey
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brassmonkey

Hi Mick-- welcome to the group, I'm so glad you found us.  There are several techniques for tapering small amounts of a drug at a time and we have a lot of information on each one of them.  Before we jump into tapering there is some more information we need to know. Primarily, how long has it been since you reinstated to your full dose?  I edited your post to call attention to the important information so it will be easier for the other mods to find. If you would please add a signature block with all your drug information that would really help.

 

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

Here are some other links that will get you started:

 

Why taper by 10% of my dosage?

 

Tips for tapering off Effexor (venlafaxine)

 

Those will get you started, give them a read and then ask us a kit if questions.

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.

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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SquirrellyGirl

Welcome to SA, Mick!  I am glad you have found us!

 

It would help everyone if you could fill out your signature block with your med and withdrawal history:  Please put your withdrawal history in your signature.  This allows everyone to get an idea of your history at a glance, since it appears below each of your posts.

 

It helps to understand a bit more about what causes withdrawal syndrome to see why tapering more slowly is so important.  Your doctor had you tapering very fast, and though it went okay for the first part, when you got to 37.5 mg, your system was really quite upset about doing with so much less of the drug.

 

Introduction to AD Withdrawal Syndrome

About reinstating and stabilizing to reduce withdrawal symptoms

Why taper by 10% of my dosage?

 

In the reinstatement link, you will see that we often recommend much smaller up-doses to remedy withdrawal symptoms.  People often are able to drop down by larger amounts from the higher doses, but when they reach the Effective Minimum Dose (or in Effexor's case, 37.5 mg), it becomes more difficult because you are really starting to cut into the receptor occupancy (freeing up receptors that had been blocked by the drug).  Couple that with down-regulation due to oppositional tolerance, and things start to get rough!

 

This paper explains why it is so important to go slowly:  http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

See the graphs on page 4 - I believe venlafaxine is the last set of curves.  At 37.5 mg your receptors are still blocked by nearly 80%, and that is just for serotonin.  With Effexor also blocking norepinephrine at higher dosages, you may have been experiencing withdrawal due to those receptors freeing up as well.

 

Now that your system has experienced destabilization, you may be more sensitive to dosage changes in the future, so you may have to go slower below 150 mg this time.  We dont' recommend reducing by more than10% per month, but if you do, you should hold longer between cuts to allow your nervous system to catch up with healing.

 

Here's info about tapering Effexor:  Tips for tapering off Effexor (venlafaxine)

 

 

If yours are the extended release tablets that cannot be broken, they see if your doctor can prescribe the XR capsules with little beads inside.  This allows for reducing by counting beads.  Many of us also weigh the beads to be even more precise in our dosing.  Using a digital scale to measure doses

 

If your doctor can't prescribe you the XR, then the next best bet would be to be prescribed the IR version, which unfortunately then would have to be taken at least twice a day due to the short half life of Effexor.  Any time you do a switch between forms or brands, you should NOT also reduce since simply switching could cause symptoms to arise due to different rates of absorption.

 

This should help with getting you ready to taper:  Preparing to taper

 

If you only recently reinstated, you will want to give yourself at least a month to get good and stable before challenging your system with tapering.

 

Meanwhile, click Follow above to be notified of responses in your thread.  This is your place to document your journey and ask questions. Once you have read the iinks, come back with your questions!

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

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

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Effexor is a nightmare to come off, take it slow small tapers the withdrawals are rough.

I am off all meds 16 months I had been on olanzapine, Effexor zanex and assorted sleeping meds for approx 2 years.

Weaned off 375 mg effexor over two years, I had previously come off xanax, rivotrill and olazapine. Reinstated 75mg of effexor on the 22/12/16

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  • Moderator Emeritus

Hi Mick,  I tapered effexor and it is difficult with XR tablets but as SG says there are XR capsules that can be opened and then count or weigh the beads.  We recommend no ore that 10% drops with at least 4 weeks between . At lower doses you might have to slow down or make smaller cuts. 

 

In the UK you can also get effexor liquid if your doctor will prescribe it for you. I asked the chemist if it was available and they gave me a note with the brand and dosage ml per mg. Unfortunately I had an allergic reaction to something in the liquid and had to go back to beads. You can also make your own liquid from the immediate release tablets and dose 2 or 3 times a day. Instructions can be found in tapering venlafaxine (effexor) topic, SG has provided the link for you.

 

You need to wait for several weeks to be sure you are stable before starting another taper, prepare carefully and you can get off with little discomfort.  :)

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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blazesboylan

Hi Mick,

 

First of all welcome. There was a point when I was on 300 mg Effexor. However, I have managed to taper down as far as 80 mg. My advice to you also would be to take it slowly.

 

Back in September I foolishly reinstated from 75 mg to 150 mg on my doctor's advice. I was having a bit of a crisis at the time. I should have reinstated by a much smaller amount. So, it was a step backwards.

 

My experience with Effexor is that the withdrawal symptoms can be intense at times. If 10% cuts are too much you could always make 5% cuts or 10 % every 6 weeks or so.

 

On my current Effexor taper I am thinking that the fact that I am taking mirtazapine and olanzapine may be making the withdrawal symptoms less severe. However, I am not sure if that is actually true. It's just a gut feeling.

 

I take fish oil and magnesium supplements also. I wish you the best of luck  :)

Previously - zopiclone, risperidone, lyrica (pregabalin), ativan (lorezapam)
 
01/Aug/2016 -  65mg effexor, 4.5mg olanzapine, 15mg mirtazpine
12/Aug/2016 -  75mg effexor, 4.5mg olanzapine, 15mg mirtazpine
03/Oct/2016 -  70mg effexor, 4.5mg olanzapine, 15mg mirtazpine
29/Oct/2016 -  65mg effexor, 4.5mg olanzapine, 15mg mirtazpine
25/Nov/2016 -  65mg effexor, 4mg olanzapine, 15mg mirtazpine
25/Dec/2016 -  60mg effexor, 3.6mg olanzapine, 15mg mirtazpine
18/Jan/2017 -  60mg effexor, 5.25mg olanzapine, 15mg mirtazpine
27/Mar/2017 -  54mg effexor, 5.25mg olanzapine, 15mg mirtazpine
23/Apr/2017 -  54mg effexor, 7.5mg olanzapine, 15mg mirtazpine
09/May/2017 -  75mg effexor, 7.5mg olanzapine, 15mg mirtazpine
08/Jun/2017 -  75mg effexor, 6.75mg olanzapine, 15mg mirtazpine
18/Jul/2017 -  75mg effexor, 6mg olanzapine, 15mg mirtazpine
 
Sometimes valium. Not daily. Supplements - Sterols and Stanols.
 
Note : I would really hope that nobody uses my tapering history as a guideline. It might not work well for somebody else tapering similar medications.

 

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