RayGirl: Trying to quit Pristiq - by switching to venlafaxine?

[RayGirl]

I've been taking Pristiq 100mg (plus 5mg Somit to sleep and 100mg Activigil to wake up) for the past 3 years more or less. I've been trying to quit Pristiq for many months due to HORRIBLE withdrawals whenever I forgot even one pill. I got to down the dose to Pristiq 50mg after enduring two weeks of those horrible withrawals and then they were gone, luckily.

Now I'm trying to figure out my next step. There's no Pristiq 25mg where I am from. My psych told me to switch to venlafaxine 75mg three days ago, not the XR, the regular. It has such a short half life that I'm having horrible symptoms as well, even though I'm taking 37,5mg in the morning and 37,5mg in the afternoon. I'm trying to figure out if this is the best way to quit Pristiq. She says I should stay with venlafaxine and taper down from it. I'm worried about feeling awful. I can't function. Should I stay with the venlafaxine or switch back to Pristiq 50mg and figure out something else? Should I bridge with Prozac form Pristiq? Should I stay with venlafaxine and THEN bridge with Prozac? Should I just taper down from venlafaxine?

 

By the way, thank you all for describing so accurately all the discontinuations sympotms of the Pristq- the brain zaps, the headaches, the dizziness, the confusion. What has this done to us? I want out. 

[Altostrata]

Welcome, RayGirl.

 

We would call Somit zolpidem, the sleep drug, and Activigil modafinil.

 

How long were you taking 50mg Pristiq?

 

Since you've made the switch to venlafaxine, what are your symptoms? Do they follow any daily pattern?  Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

As you've already made this change, I would stick with venlafaxine for now. We may be able to adjust it, the dosage might be too low or too high to substitute for 50mg Pristiq. See these topics for background

 

Tips for tapering off Pristiq (desvenlafaxine)

 

Tips for tapering off Effexor (venlafaxine)

 

I would make another switch to Prozac only if we find the Effexor is not going to work.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature

[RayGirl]

Thank you so much for your reply Altostrata!

 

I added my signature, hope it helps. I took 100mg Pristiq for about two years and a half, and then 50mg Pristiq for 3 months. 

Don't know if it helps but I'm an almost 27 year old female.

 

Right now I'm in my 9th day having switched from 50mg Pristiq to 75mg venlafaxine (brand Elafax) (regular release, NOT xr), and I feel really bad. What happens is: I wake up with chills or tingling and feeling like I can't move, I take 1/2 a pill (so 37,5mg), and wait for a while and I'm ok. Then after midday I start feeling bad again, and I take another 1/2 pill. But if I wait a bit I start having chills and feeling bad and just down, lacking motivation, very tired, and unfocused. I feel better when I take the 2nd half but then at nighttime I have all the symptoms again.

TODAY was the first day that I tried something different: I took 1/2 in the morning, and then after midday I took 1/4, and early evening I took another 1/4, hoping to distribute the drug. But it doesn't seem to be working. 

 

I hate the way I lack strenght when I wake up (i loved working in the mornings), the lack of motivation, the chills, the unfocused feeling. I want to know if there's something I can do. Should i go back to pristiq and try something else? should i try something else with venlafaxine? should i switch to prozac? Idk. Help

 

Thank you so so so much again for your kindness.

 

 

[Altostrata]

You will need to take the immediate-release Effexor 12 hours apart.

 

It could be that 75mg per day is not enough to compensate for 50mg Pristiq. Can you take 112.5mg total per day in two doses per day?

[RayGirl]

1 hour ago, Altostrata said:

You will need to take the immediate-release Effexor 12 hours apart.

 

You mean taking 37.5mg in the morning 8am And then 37.5 mg at 8pm? What about the chills and the tiredness and weird syndromes that will happen after midday? Around 7 hours after the first dose.

I’ll try taking it as you say, but am wondering what’s gonna happen in the middle.

 

 

1 hour ago, Altostrata said:

t could be that 75mg per day is not enough to compensate for 50mg Pristiq. Can you take 112.5mg total per day in two doses per day?

 

Yea, I thought about maybe it not being enough, but given that I’m about to enter my 10th day with it, shouldnt I take it as a reduction or somethingg? So i wont hve to taper Effexor from larger doses?

 

Or mYbe I could try to take 112.5 in two doses per day. 

 

In any case What i want is to be able to feel well at night or when i wake up and not get withdrawals in the middle of the day or morning, as if all effects from the drugs were gone.

 

so my two options would be:

1) to take 37.7mg 8am + 37,7mg 8pm (75mg total)

or

2) to take 112.5mg total divided in two.

 

which one is better? Which one will fix the fact that five-six hours aftar i take a dose i feel withdrawals?

 

thank you again!!! You have no idea how important it is to be able to think this with someoen else. Thank you for your kindness in this dispair

[RayGirl]

Ok so I took 37.5mg at 7.30am and it’s currently 5.30pm and so far so good. I’ll wait till 7.30pm to take the other 37.5. Let’s hope I stay this stable tomorrow as well! 

[RayGirl]

Hello. I managed to get as low as 75mg of venlafaxine about two years ago. And I've been in that dose ever since (taking 37,5mg in the morning, and 37,5mg at night). But I really really really want off, I clinically don't need them anymore, I haven't for a long long time, the only reason I'm taking them is because of the AWFUL withdrawals.

So- talking with my psychiatrist we arranged I'd send the 75mg pills to the lab to compound into doses of 28mg so I'd take 28mg in the morning and 28mg at night, lowering my total dose by 25% - (total 56mg)

I took my first 28mg last night, and then my first morning 28mg today. I already have symptoms: body tremors, a bit of headache, and slightly unfocused vision. It is a very different feeling from two years ago when I had to switch medications and lower my dose by 50% and I had brain zaps and IDK it was totally awful. Luckily last time those awful symptoms went away after 10 days or so and then it was all normal for 2 years. Until now that I decided to start tapering off again, of course.

But still- it has not been a full day and I already have these tremors and unfocused vision and headache, I can manage to go about my day although a bit slower and not totally focused, and because of all I read here I'm so scared that those symptoms may mean I'm doing something too aggressive for my nervous system, and I read that the ideal lowering would be by 10%. 

My questions: 

Do you think those symptoms are enough to be scared that lowering 25% may do damage medium-long term?

Should I keep trying with this dose a couple more days before OR should I go right back to 37,5mg per take (total 75mg) and then send again to lab to compound to lower my dose by 10 or 15%?

Or maybe these are mild symptoms that won't damage too much if I wait for them to go away in a week? (I'm guessing they will go away in a week-10 days or so because of all the other medications I quit before). 

Or do you think lowering from total 75mg to 56mg is not that bad?

 

Anyway, I know this questions may not have an absolute answer, but I want to know if I should continue with this dose or change back or what to do. I've been feeling so well this past two years and I want to take care of myself and quit this awful thing! It's truly the worst.

 

Thank you everyone! Reading this forum back then and now has been life saving.

 

 

[RayGirl]

Hello. I managed to get as low as 75mg of venlafaxine about two years ago. And I've been in that dose ever since (taking 37,5mg in the morning, and 37,5mg at night). But I really really really want off, I clinically don't need them anymore, I haven't for a long long time, the only reason I'm taking them is because of the AWFUL withdrawals.

So- talking with my psychiatrist we arranged I'd send the 75mg pills to the lab to compound into doses of 28mg so I'd take 28mg in the morning and 28mg at night, lowering my total dose by 25% - (total 56mg)

I took my first 28mg last night, and then my first morning 28mg today. I already have symptoms: body tremors, a bit of headache, and slightly unfocused vision. It is a very different feeling from two years ago when I had to switch medications and lower my dose by 50% and I had brain zaps and IDK it was totally awful. Luckily last time those awful symptoms went away after 10 days or so and then it was all normal for 2 years. Until now that I decided to start tapering off again, of course.

But still- it has not been a full day and I already have these tremors and unfocused vision and headache, I can manage to go about my day although a bit slower and not totally focused, and because of all I read here I'm so scared that those symptoms may mean I'm doing something too aggressive for my nervous system, and I read that the ideal lowering would be by 10%. 

My questions: 

Do you think those symptoms are enough to be scared that lowering 25% may do damage medium-long term?

Should I keep trying with this dose a couple more days before OR should I go right back to 37,5mg per take (total 75mg) and then send again to lab to compound to lower my dose by 10 or 15%?

Or maybe these are mild symptoms that won't damage too much if I wait for them to go away in a week? (I'm guessing they will go away in a week-10 days or so because of all the other medications I quit before). 

Or do you think lowering from total 75mg to 56mg is not that bad?

 

Anyway, I know this questions may not have an absolute answer, but I want to know if I should continue with this dose or change back or what to do. I've been feeling so well this past two years and I want to take care of myself and quit this awful thing! It's truly the worst.

 

Thank you everyone! Reading this forum back then and now has been life saving

[Altostrata]

@RayGirl, I moved your new posts here.

 

As you know from Tips for tapering off Effexor (venlafaxine), we do not recommend decreases as large as 25%, especially if you've had difficulty with withdrawal before.

 

I am sorry you did not share this information with your psychiatrist. You have made too big a decrease and brought about withdrawal symptoms again. If I were you, I'd go back to 37.5mg twice a day and let the symptoms settle down.

 

When you are free of withdrawal symptoms, you might try taking 37.5mg in the morning and 28mg in the evening, that would be a daily dosage decrease of 12.5% -- but that might be too much, because you've already upset your nervous system. You might have to reduce by even less than 10%, such as 5% per month.

 

Please note we are peer counselors, and monitoring your taper is what you pay your psychiatrist for. Now that I've given you this information, I highly recommend you explain it to your psychiatrist. We don't get paid for this.

[RayGirl]

Thank you SO much for your reply again.

I told my psychiatrist all about the info of this forum which is why I sent the pills to the lab to compound (she didn't have that in mind as a thing before, it's not common in my country). She wanted me to take the pills one day on, one day off, and I remembered what I read here to NEVER do that, so I told her NO. And then she wanted me to cut to half but we compromised on sending it to compound lowering the dose 25%. I let myself be convinced by her that it was the right dose  

I think I will have to change psychiatrist. I don't know if in my country there is someone else who knows about WD and tapering, but I'll search. 

 

Anyway. I had this symptoms after taking only a night and a morning dose of the 25% lowered. So it was literally only for a day that I lowered it.

If I go back to my full dose now, maybe I can wait a couple weeks and then lower the dose by 10%? 

 

I know this is not official medical advice but it literally saved my life before and it allows me to go to my psychiatrist with more information and it allows me to say no to bad practices. 

[Altostrata]

Thanks for your kind words.

 

51 minutes ago, RayGirl said:

If I go back to my full dose now, maybe I can wait a couple weeks and then lower the dose by 10%? 

 

 

It probably will take more than a couple of weeks for you to stabilize, perhaps more than a couple of months. Please let us know how you're doing.

 

You might work with the same psychiatrist, who seems willing to write prescriptions for compounded drugs. You should let her know you got severe withdrawal symptoms following her advice.

[RayGirl]

Moved from tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine topic

 

Hello everyone. I’ve been successfully tapering venlafaxine by the 10% method a couple of months now. The first few months it was 2% and 5% and 7% just to try it out and then the rest of the months it was 10%. The method I’m using is sending the pill to a lab to compound to the amount I need every 4 weeks.

 

Right now I’m at 33,6mg per day (I started at 75mg). In the last few months my symptoms are only dizziness, fatigue and slight chills the first three days of lowering the dose and then back to normal for the rest of the 4 weeks. 

Because of this I was thinking of maybe trying to lower a higher % each month. Such as 12 or even 15%. Does anyone have any experience reducing a bit more than 10% a month? 15%? What do you recommend?

 

(I also take high quality Omega-3, have massages every two weeks specifically to have my body ready for tapering, I’m doing lots of therapy and energy therapy which helps in many ways, and recently I’m trying to add exercise)

Thanks!

 

Edited April 28, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

The aim is tapering is to get off the drug with minimal withdrawal symptoms and be able to live your life as normally as possible.

 

There are members of SA who have tried to go faster and it has ended up taking them longer.  Some have ended up changing drugs (which does not always work) and some have ended up on an additional drug, which also then needs to be tapered.

 

Some members have ended up making too large reduction/s and ended up becoming destabilised.  Once this happens there is a possibility that you might not return to the pre-destabilised state, even with a long hold, because there has been trauma to the nervous system.  Also the effect of psychiatric drugs is cumulative.  You have a history of various drugs and have experienced (very) bad withdrawal symptoms in the past.  Just because you have managed to get of some of your drugs with no issues, does not mean that this will be true for other drugs in the future.

 

Every reduction you make, however small, is heading in the right direction of you getting off the drug.

 

When I got impatient to get off my Pristiq I would remind myself of how much I had already reduced, not how much further I still had to go.

[ChessieCat]

Many members find that the lower their dose gets the slower they need to go, reducing less and/or holding longer.

 

This member gives a fairly simple explanation of SERT occupancy and provides the link to SA topic Why taper paper: dose-occupancy curves

  

7 hours ago, Scrountz said:

Even low doses of SSRIs can have a pretty potent effect on the nervous system. A lot of doctors don't appreciate that the minimal dose of an antidepressant medication is still really strong. This link here illustrates this. If you don't have a science background it can be a bit hard to understand, but basically even the lowest dose of an antidepressant still fills about 80% of the receptor sites that its supposed to. Increasing the dose of medication does not increase its effectiveness proportionately.

 

.

[RayGirl]

Thank you ChessieCat!

I think what I also found that made each taper better than the one before in my case was all the preparation and taking care of my nervous system. From regularly taking Omega-3 to regularly going to all those alternative therapies and massages with the intention to prep my body for the tapering, and it made it so much better. I'm also sure to regularly be in nature and not go a lot to the city centre and to places with too much traffic and smoke and noises. Of course I can do that due to my specific circumnstances and the fact I work from home, I know is not the case for everyone. But I wanted to say all this anyway in case anyone reads it and needs reassurance that everything you do around the tapering helps so much.

 

And because I managed to sustain the 10% taper at such good rate and feeling better the lower I went, I was hoping that maybe a 12% or 15% would be ok for me to try someday, as I read some people managed ok with that right? But I get we never know really what happens. I just want off it so bad. But I also want to take care of myself as I've been doing.

[RayGirl]

On 8/5/2011 at 5:43 PM, Altostrata said:

Those finding the 10% hyperbolic reduction method too slow can speed up by making 10% (or less) reductions more often. Making smaller changes more often is less likely to perturb your nervous system than larger changes less often.

 

After many attempts and failures over the years, I've been very succesfully tapering Effexor for over a year. I started at 75mg and am now at 19,6mg daily, tapering 10% every 4 weeks, aprox. (My first tapers were of less than 10% just in case, but then I saw I could manage and started tapering 10% nonstop). I only have some symptoms the first three days of each taper, which are managable (mostly fatigue and I have to sleep a lot, some emotional sensitivity, dizziness). They then disappear completely and I get another great 3 weeks until the following taper. I have lots of coping skills, take Omega 3, have massages, go to therapy, spend time in nature, etc.

Since I'm doing so well I was thinking what could I do to speed up a little, with care, without it being too much or damaging. I was thinking of going up to 11% or 12% or slightly more in some taper, but I'm still to find someone who went through that experience, so I keep searching.

And now I find this quote. Do you think that in my situation it may be better to taper 10% in my 3rd week instead of the 4th? Or to taper 11-12% in my 4th week?

 

Thanks!

[ChessieCat]

Many members find that the lower their dose gets the slower they need to go, reducing less and/or holding for longer.

 

 

 

Getting off psychiatric drugs has nothing to do with how strong or determined we are as a person, it is to do with how the brain adapts to not getting as much of the drug.

 

Please note that if you do decide to go faster than 10% and you bring of withdrawal symptoms, you will be the one to suffer and have to cope with the fall out.  There is generally no quick fix.  Personally I do not think it is worth the risk of trying to go faster.  The aim of tapering is to get off your drug with minimal discomfort and be able to live your life as normally as possible whilst doing so. 

 

I have been a member here for nearly 7 years.  During that time I have seen SA members who have tried to get off their drug faster and in the end it has taken them longer than if they had done a nice and steady taper at a rate that keeps their withdrawal symptoms to a minimum.  Some of them have ended up switching drugs (which doesn't always work because you can get withdrawal from the first drug and/or side effects/adverse reaction to the second drug and it can be difficult to know what is causing any issues) and some have ended up on an additional drug which also needs to be tapered.

 

I have also seen SA members who have not heeded the suggestions to slow down and have later on regretted not going slower and wishing that they had listened.

[FindRest]

I agree with everything ChessieCat said. Venlafaxine is notorious for causing intense withdrawal issues, especially at lower doses. Each mg reduction, especially from 37.5 downward, reduces the serotonin occupancy in our brains at a faster rate than previous reductions. In other words, the risk of withdrawal symptoms and their intensity INCREASES the lower we go. Many make the mistake of thinking that once we get low in dose, things get easier because there’s less in our systems. That’s a false assumption. 

This link explains why tapering slowly on those lower doses is even more important.  The study it refers to included Effexor as well. The video clip would be very well worth your time to watch. It’s eye-opening.

 

Edited October 3, 2022 by FindRest

[Altostrata]

On 10/3/2022 at 7:17 AM, RayGirl said:

I only have some symptoms the first three days of each taper, which are managable (mostly fatigue and I have to sleep a lot, some emotional sensitivity, dizziness). They then disappear completely and I get another great 3 weeks until the following taper.

 

It appears you've found a good rate of taper. If I were you, I would not try to improve on it.

[LostInCanada]

I've been noticing this cycle of several weeks going great and several weeks with the anxiety and sadness baseline, and I was wondering if there can be another explanation or my take on life or circumnstances.

@RayGirl I have read your thread and question about waves and windows. It sounds to me that you are experiencing a new set of WD symptoms which is not unusual. 

I have read parts of the Maudsley Guide by Horowitz. The SERT tapering model is a bit more aggressive than the 10% and can cause symptoms. The book recommends going slowly if that is what your body is saying. If it were me, I would hold a month to see if the pattern still occurs without a drop in dose. If it doesn't I would personally take that as an indicator to slow the rate of taper a bit. 

Waves and windows are more random as to when and for how long they last. Hope this helps. Caution is always wise as you get lower in your dose. ❤️🙏

[RayGirl]

I’m sorry to write again, I need help-

i’m in vacation for a couple of days so the system i use to know if i took the dose changed. I cant seem to remember if i took my morning half-dose (I take 1.8mg in total daily, 0.9 in morning and 0.9 at night). 
 

I am getting very scared because i dont know how to figure out if i did take it or not, and am feeling weird but idk if its because i didnt take it or because im scared, since i dont have debilitating physical symptoms in general.

 

my partner says he thinks i didnt take it but we cant know for sure because i may have done it automatically when i woke up without him. Although i’m feeling light headed but it may be from the scare and i’m getting very very anxious, which may be from either the scare or not having taken it.

 

what would happen if i take an extra half-dose and what would happen if i miss half-dose? How long would any disregulation be? Maybe i can take my evining half dose earlier today? 
 

im scheduled to make my next taper in 11 days (i need to scheduled far in advance because of the pharmacy). Will i be fine then?

[LostInCanada]

@RayGirl is there anyway you can count out the doses? Are they pill packets? Do you know how many you brought? 

I see this drug has a very short half life. 

Have you ever missed a dose before and if so what happened? Have you ever double dosed and if so what happened?

What time in the day do you usually take them?

[RayGirl]

I just grabbed a bunch of pills to take on my vacation, I wished I had counted how many of them. Now I know what to do next time.

 

In over two and a half years of tapering I have never missed a dose or double take a dose, that’s why I’m having such anxiety. 
 

I do feel what could be “symptoms”, but they are also things I feel when I have deep anxiety or am scared, such as light headed, and maybe even a bit of chills (which I would also feel on my tapers) but not a lot. I have been able to go about my day normally (at least on the outside, physically).

 

Usually when I make a taper I start feeling bad when it’s time for the next dose, so about 10-12 hours after I change the dose. In this case it would already be time for my next dose anyway.

 

I usually take 0.9mg of venlafaxine in the morning (between 8-10am) and 0.9mg in the evening (between 9-11pm). 
 

right now its 2pm where I am. 

I don’t know how to discern if i took it or not. An option would be to take the evening dose a bit earlier. 

 

do you know how many days will I be affected if i happened to miss one dose? (Which is half a dose, not my full dose)

 

would i be able to keep with my scheduled taper in 11 days?

 

i heard its less bad to miss a dose than to double a dose, is that so?

[LostInCanada]

2 minutes ago, RayGirl said:

do you know how many days will I be affected

It's so individual

2 minutes ago, RayGirl said:

right now its 2pm where I am. 

Did your time zone change on vacation?

[RayGirl]

No, I’m still in my country, same time zone, same everything

[LostInCanada]

@RayGirl so you are already 4-5 hours off. I would probably just take my normal evening dose a couple hours early and make sure I take my morning dose an hour earlier and fall back on the regular schedule after that. Hopefully nothing will spike. You probably took the dose automatically. I have done the same thing. Try not to overthink it. ❤️

[RayGirl]

18 hours ago, LostInCanada said:

@RayGirl so you are already 4-5 hours off. I would probably just take my normal evening dose a couple hours early and make sure I take my morning dose an hour earlier and fall back on the regular schedule after that. Hopefully nothing will spike. You probably took the dose automatically. I have done the same thing. Try not to overthink it. ❤️

 

Thank you so much for your words. I felt perfect physically all day yestarday (did a lot of hiking, didn't need nap, etc.). Then I took my evening dose and today morning I took my morning dose. I feel a tiny bit as if I had withdrawals, idk, like when I feel inside my body something is happening which usually happens around 12 hours after I make my tapers. I'm confused as to what is truly withdrawal and what is just anxiety and fear. So I don't know. 

 

I'm glad I'm back on my regular doses, now my only worry is that I make my next taper in 10 days (the pharmacy makes my pills that's why it's all planned so in advance), and I just want to know what you guys think if in 10 days time I'll be alright to make a taper. I guess from what I'm reading around people miss or double dose more often than I thought and they regulate immediately. Given all this experience, will it catch up to me in my next taper or in 10 days I'll be good enough? (I still have no idea if I actually missed the dose or not, but let's think I did).

 

Thank you again for your time and words, they really helped me go through the day yesterday.

[LostInCanada]

2 hours ago, RayGirl said:

what you guys think if in 10 days time I'll be alright to make a taper.

It is always best to err on the side of caution. I would just wait another month to continue the taper. Then if anything is an issue it will have resolved. 😊