Tusco: just started tapering venlafaxine / Effexor

[Tusco]

Hi everybody,

I am in my mid 40s and I have had dysthymia and recurrent major depression episodes since I was 16. Needless to say that I have been on lots of antidepressants over the years for short and long periods. I have had also periods without medication.

Now I am on venlafaxne (AKA effexor) 150mg/day. I think that I started taking it in 2014 but I can't remember for sure.

Now I feel that after these years its benefits have decreased, it has pooped out basically and, what's worse, it has slowly, very slowly making worse my sex life. I din't realize at first but my libido has gone down and down and unfortunately it has made for me very difficult to get an orgasm. Further, I believe that has de-sensitized  my penis, not completely but I am sure it has because I feel so much less when I touch myself or have sex.

I hope that these problems are reversible but I have read of PSSD, so I am worried.

I have just started tapering venlafaxine today, I am cutting the 150 mg tablet of 1/4, it's not a very precise thing unfortunately, the tablets are not made for being cut. Anyway I am thinking to stay on this dosage of about 112,5 mg for about 10 days before going on 75 mg for further ten days, then I would go on 37,5 for ten days and eventually I would stop. Is this schedule too ambitious? I need your advice please.

Thanks for reading this

[Shep]

Hi, Tusco.

 

Welcome to Surviving Antidepressants.

 

On 5/19/2019 at 12:50 PM, Tusco said:

I have just started tapering venlafaxine today, I am cutting the 150 mg tablet of 1/4, it's not a very precise thing unfortunately, the tablets are not made for being cut. Anyway I am thinking to stay on this dosage of about 112,5 mg for about 10 days before going on 75 mg for further ten days, then I would go on 37,5 for ten days and eventually I would stop. Is this schedule too ambitious?

 

I'm glad you found this site because this is far too rapid a taper plan. Please see:

 

Why taper by 10% of my dosage?

 

The 10% taper method recommends a 10% dosage reduction every 4 weeks, with the 10% calculated on the last dosage. The amount of decrease is proportionate to the last dosage (not the original prescription) and keeps getting smaller.

 

If you've already started your taper, please updose back to 150 mg and let us know how you're feeling. Antidepressants are notorious for a delayed withdrawal phenomenon, so this drastic a reduction may not show symptoms for a number of days or even months. So it's best to start out with the 10% taper. 

 

For information on how to taper venlafaxine:

 

Tips for tapering off Effexor (venlafaxine)

 

Since you mention being on tablets, you are taking the regular venlafaxine (not the extended-release version). If you scroll down toward the end of the first post in that thread, you'll find the instructions for tapering off the tablets. There are several options, including:

 

1. Venlafaxine tablets are water soluble, so you can make your own liquid to titrate.

 

How to make a liquid from tablets or capsules 

 

Questions and answers about liquid medications

 

2. Use a scale:

 

Using a digital scale to measure doses

 

3. Use a compounding pharmacy to make up your doses:

 

Compounding pharmacies (US, UK, and elsewhere)

 

Please note that venlafaxine has a short half-life of 15 hours, so you may want to split the dose and take it twice a day before you begin tapering. We recommend moving the dose by an hour a day, as this gradual change is the easiest on your nervous system. Please post if you have any questions about this.

 

Some more links about withdrawal:

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

PSSD is common with these drugs, although technically, what you're experiencing is sexual dysfunction due to being on the drug (i.e. a side effect). PSSD happens after you come off the drug. So you may recover from this simply by removing the offending drug. For more on PSSD, please see:

 

PSSD Post-SSRI sexual dysfunction

 

Are you having any other symptoms? 

 

You may find some helpful information to handle your symptoms here: 

 

 Non-drug techniques to cope with emotional symptoms

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

 King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

Are you currently taking any supplements? If so, please add them to your signature.

 

Please continue to use this thread to document your taper and to ask questions. 

 

[Tusco]

Hi Shep,

Thanks for your reply. Much appreciated.

I started today before getting this, I went down from my ordinary 150 to 112,5 mg of venlafaxine extended release. 

I understand what you say about being too fast but I don't know how scaling of 10% only. I think I read somewhere on here that I should open the capsules and assess the ratio of bead/mg and refill with 90%.

Honestly it sounds very cumbersome and elsewhere on the web I read of docs criticizing this practice saying that not all the beads have the same size and effect, hence caps should not be open.

Anyway you guys let me know what you think. After reading on here I thought of altering my tapering schedule keeping each lower dose up to a month instead of only ten days.

[Shep]

Many of us came into this forum already severely destabilized from coming off psych drugs too fast and would give anything to turn back time and do a safe taper.  You'll have to decide if the 10% taper method is right for you. All we can do is offer you the harm-reduction method, which is 10% a month or less reduction. If you crash your nervous system from doing a rapid taper, it may take years for you to recover. 

 

Please read: 

 

CT and Fast Tapers

 

How psychiatric drugs remodel your brain

 

You are correct that not all beads are the same size. As Alto wrote in her first post in the "Tips for tapering off Effexor" thread, there are things you can do to be as precise as possible: 

 

On 5/5/2011 at 11:01 PM, Altostrata said:

You have to count the beads in the capsules of the type you have, and go by your own average. Someone else's bead count might be of a different brand or dosage.

• The size of beads in a capsule varies slightly from bead to bead.
• The number of beads in a capsule of a specific dosage varies among manufacturers, e.g., not all 150mg venlafaxine XL capsules from different manufacturers contain the same number of beads. If your prescription gets filled with venlafaxine ER capsules from a different manufacturer, counting out the same number of beads may give you a different dosage.
• Even from the same manufacturer, the number of beads in a capsule of a specific dosage varies, e.g. not all 150mg Effexor XR capsules from Pfizer contain the same number of beads.
• The number of beads in a capsule varies from dosage to dosage, e.g. the number of beads in 75mg Effexor XR capsules from Pfizer is NOT half the number of beads in 150mg Effexor XR capsules from Pfizer.

The number of beads in capsules may vary because the manufacturer, particularly generic manufacturers, have sloppy quality control and the capsules vary in weight (this may be illegal and worthy of a complaint to the government drug regulatory agency).

 

Use the same dosage and same manufacturer of Effexor XR throughout your taper.

 

This isn't a perfect science, but the small difference in bead size is negligible compared to the 25% reduction you just made.

 

I would updose back to 150 mg and taper no faster than 10%. Antidepressants are notorious for delayed withdrawal, so you may not feel this reduction for several weeks or longer and by then, you'll have made more reductions. At some point, this may catch up to you. We don't know who is dependent on these drugs and who isn't. There's no warning light to to caution you that something is wrong. 

 

It's much better to go slowly and remain functional than to go fast and end up unable to work, care for family, or even to care for yourself. 

 

 

[Shep]

19 hours ago, Tusco said:

I went down from my ordinary 150 to 112,5 mg of venlafaxine extended release. 

 

Please clarify if you changed from regular immediate release venlafaxine to extended release. I'm unsure what you mean by "ordinary". 

 

You mention being on tablets in your first post but in your latest post, you mention capsules, so it looks like you made a switch in formula from immediate release to XR. 

 

[Tusco]

No I didn't switch from immediate to extended release.

I was on tables extended release but here in Norway they are available only in the 75 and 150mg formats and you can't break them so I switched to capsules extended release because they also come in 37,5mg and because I thought that if worst come the worst I could open them and reduce them, particularly in the final phase of tapering when I thought that going from 37,5 to 0 could be tough.

[Tusco]

22 hours ago, Shep said:

 

Please clarify if you changed from regular immediate release venlafaxine to extended release. I'm unsure what you mean by "ordinary". 

 

You mention being on tablets in your first post but in your latest post, you mention capsules, so it looks like you made a switch in formula from immediate release to 

Further update:

I have tried to open the 37,5mg ER and count the beads but they are many, difficult to handle, jumpy and very small, I believe they have less than 1mm diameter. I started and restarted the count several times until I gave up and I roughly cut them in two equal groups hopefully both of them of 18,75 mg and I used one of the two groups to make a capsule in order to take it with one of 75 and one of 37,5. That makes a daily dose of 131,25 mg roughly. I don't think that I can do much better honestly.  That would be about 12,5% reduction to the original 150 mg intake.

[ChessieCat]

Hi Tusco and welcome from me too,

 

counting-beads-in-a-capsule-versus-weighing