PeaceLily: tapering off Effexor 75mg

[PeaceLily]

I've been on antidepressants for 18+ years and am at a point where I feel the need to come off them. I've been on Paxil, Lexapro, and recently switched to Effexor, which I understand is more difficult to stop taking. 
I'm on Effexor XR 75 mg. 
Without knowing a lot about it, in December I began reducing the number of balls in my daily dosage by 2. (There are roughly 100 balls in each capsule.) Then moved to 4, then 6, 8, and now 12. I'm having some symptoms that I think are from withdrawal... irritability, crying at the drop of a hat, brain fog, fatigue, and some sadness. However, it could also be due to life circumstances and hormones, and I'm scheduled for a partial hysterectomy within the next few months, so I definitely don't want to do too much at once or go too fast in tapering. 

I'm not so concerned about how fast I come off the Effexor, just that I'm making progress and doing it right. I understand that being on antidepressants for so long will naturally require a good deal of healing and time to adjust. I do take a good brand of Cod Liver Oil and Magnesium daily. 

I'm also taking Halcion to sleep at night, but think it might be wise to go off the antidepressant first before tackling that. 

I want to understand more how to correctly measure my dosage so that I'm tapering accurately. 

[ChessieCat]

Hi PeaceLily and welcome to SA,

 

SA recommends tapering by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When we take away some of the drug we can experience withdrawal symptoms.  The tapering protocol we recommend aims to do this slowly enough so that withdrawal symptoms are kept to a minimum.  Dr Joseph Glenmullen's Withdrawal Symptoms

 

You are correct is thinking that it is better to taper the AD first.  See:

 

Taking multiple psych drugs? Which drug to taper first?
If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug).

 

This topic explains how to get the dose you need:

 

Tips for tapering off Effexor (venlafaxine)

 

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

This is your own introductions topic where your can ask questions about your own situation and journal your progress.

 

 

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

We strongly encourage members to learn and use non drug coping techniques to help get through discomfort and tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[PeaceLily]

Thank you so much! I've read books by Claire Weeks and they were good, but I need to re-read them. 
This morning I counted the balls in my Effexor capsule and there were 119. I'm afraid it's going to be confusing to know how much to remove from each dosage if the number of balls vary. 

[ChessieCat]

You are very welcome.

 

I suggest you read through Tips for Tapering Effexor.  You could also see which members have posted in that topic and visit their Introduction topics and see how they are managing and ask them questions.

[Alanmane]

6 hours ago, PeaceLily said:

Muchas gracias! He leído libros de Claire Weeks y eran buenos, pero necesito releerlos. 
Esta mañana conté las bolas en mi cápsula de Effexor y había 119. Me temo que será confuso saber cuánto eliminar de cada dosis si el número de bolas varía. 

Hello friend, I am just like you, reducing effexor. I make the average pearls in my capsules which is 150 pearls, they vary between 145 and 155. It will never be exact but it is the best there is, a scale not being very precise will also give margin of error ...

[PeaceLily]

Thank you both very much! 

 

[PeaceLily]

How do you tell your doctor you want to begin tapering off your medicine? I'm not sure he's going to think it's a great idea, and I don't want to alarm him, but I'll need his help in the process. 

[ChessieCat]

I've merged the new Intro topic you created with your original Intro topic.  SA works differently to many other forums.  Each member has only 1 Intro topic where they can ask questions about their own situation and journal their progress.  This keeps there history in one place.  Please do not create another Intro topic.  Thank you.

 

You might find it helpful to write a script and rehearse what you are going to say.  Be calm, gentle but assertive.  You are the customer, it is your body.  Use words like I'd like to try this, or I'd prefer to do it this way.  If a suggestion is made that you don't want to follow, say I'd like to think about it before making a decision.

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

[PeaceLily]

This may be covered elsewhere, but I couldn't find it by doing a search. 

Since I only switched from Lexapro to Effexor 4 months ago, and Effexor seems to be such a brutal drug to withdraw from, is it feasible or desirable to switch back to Lexapro and taper from there? Which antidepressant seems to be the easiest to wean from? 

 

[Carmie]

Hi Peacelily, 

 

Firstly I wanted to welcome you to SA.

 

It’s not a good idea to keep changing meds as it usually takes a lot longer to stabilise if we continue to cause upheaval to our systems. Four months is already a long time since you’ve been on Effexor. 

 

Why do you feel Lexapro isn’t as hard to get off as Effexor? People on here have really struggled coming off both of them. Press on the tags that say Lexapro and Effexor and you’ll find others tapering off both these meds. 

 

Wishing you all the best in your recovery💚

 

 

 

 

[PeaceLily]

Thank you! And thanks to everyone for the welcome. 
I'd just read that Effexor was the most difficult to withdraw from, and since I've only been on it a few months, didn't know if it was feasible to switch to another AD that would be easier to withdraw from. 

I'm thankful to find this group! 



 

[ChessieCat]

Changing drugs is generally not recommended.  You can get withdrawal symptoms from drug A and start up / side effects / adverse reaction from drug B.  You won't know what is causing any issues.

 

It is possible to make regular Effexor into a liquid.

 

 

[PeaceLily]

Thanks so much, ChessieCat! 

[PeaceLily]

Can someone help me with the math on tapering? I'm terrible at math and don't want to mess this up.
I started tapering Effexor 75 mg. There are approx 100 balls in each dosage. 
I've taken 12 balls out so far and stayed there for some time. 
So now I'm taking 88 balls per day. 
So, 88% of 75 mg is 66 mg. ??
I am taking 66 mg currently?

To reduce by another 10%, I'd take another 6 balls out?  Is that correct? 

I've used the tapering calculator, but get confused when it comes to how many balls to reduce my dosage by. Any help will be greatly appreciated! 

[PeaceLily]

I tried to edit my above post but can't figure out how to do that. 
I think I'm understanding this better. 
To reduce the number of balls each time, I multiply the number of balls by 90% and take that many? 

 

[ChessieCat]

4 hours ago, PeaceLily said:

So now I'm taking 88 balls per day. 

 

The easiest was to calculate the new dose for a 10% reduction is to multiply the current dose by 0.9

 

If you wanted to make a 5% reduction you would multiply by 0.95

 

You will see that:

 

10% + 0.9 (or 90%) = 100%

 

5% + 0.95 (or 95%) = 100%

 

 

88 balls x 0.9 = 79.2 balls

 

Always round up so that the reduction is less than 10%.

 

Next reduction would be 80 balls x 0.9 = 72 balls

[PeaceLily]

Thank you so much!