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jr1985

jr1985: Effexor / venlafaxine taper

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jr1985

Hello,

 

I've been on a few antidepressantsfiver the last 8 years. Paroxetine (Paxil), escitalopram (Lexapro) and finally Effexor.

 

I decided to come off 75mg Effexor last November by tapering over a month (on advice from dr). I had some withdrawals for the first few weeks, which was manageable until 5 weeks off, when I had massive anxiety, akathisia, tingling/burning nerves in arms and legs, diahorrea, crying spells, etc.

 

I felt absolutely terrible, so I reinstated 37.5 mg, which made me feel better after about 2 weeks. I then went back to my original dose of 75 mg for two weeks, but this made me feel worse, so I came back down to 37.5 mg again.

 

I'd also been taking Ritalin for ADHD, but since withdrawal, I've found it seems to destabilise me - causing really bad depression/anxiety. So I've stopped this for now.

 

I've read about the 10% taper every 3-6 weeks, but I've decided to play it safe by tapering 5%, as I know Effexor is really difficult to come off of and people seem to have a hard time getting off the lower doses.

 

After reinstating for about 12 weeks, I dropped 5% two weeks ago, and I'm only now beginning to feel the drop - slightly more anxiety, groggy, brain fog. So I plan to stay here until I feel stable again before dropping again.

 

I'm just really worried that I'll experience horrific w/d even tapering slowly, once I stop the drug completely...

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Skyler

I felt absolutely terrible, so I reinstated 37.5 mg, which made me feel better after about 2 weeks.

 

I'd also been taking Ritalin for ADHD, but since withdrawal, I've found it seems to destabilise me - causing really bad depression/anxiety. So I've stopped this for now.

 

I've read about the 10% taper every 3-6 weeks, but I've decided to play it safe by tapering 5%, as I know Effexor is really difficult to come off of and people seem to have a hard time getting off the lower doses.

 

After reinstating for about 12 weeks, I dropped 5% two weeks ago, and I'm only now beginning to feel the drop - slightly more anxiety, groggy, brain fog. So I plan to stay here until I feel stable again before dropping again.

 

I'm just really worried that I'll experience horrific w/d even tapering slowly, once I stop the drug completely...

 

Hi Jr.

 

Welcome!! You will find the Surviving crew well informed and overall, a good lot. Glad you made your way here.

 

 

I would not think you will return to where you were previously, given the response you had to Effexor within 2 weeks of reinstating at 37.5 mgs, and your cautious taper plan. I'm wondering though, given your response to Ritalin.. have you considered weaning off this med before continuing further? Usually Ritalin loses it's effectiveness over time, and given it's destabilizing effect, you might benefit from withdrawing this first. Usually drugs in this class are easier to taper (if using easy and taper in the same phrase is not an oxymoron), and you might be able to kick clear in a couple of months. Alto will be along shortly to give her most considered opinion.

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jr1985

 

I felt absolutely terrible, so I reinstated 37.5 mg, which made me feel better after about 2 weeks.

 

I'd also been taking Ritalin for ADHD, but since withdrawal, I've found it seems to destabilise me - causing really bad depression/anxiety. So I've stopped this for now.

 

I've read about the 10% taper every 3-6 weeks, but I've decided to play it safe by tapering 5%, as I know Effexor is really difficult to come off of and people seem to have a hard time getting off the lower doses.

 

After reinstating for about 12 weeks, I dropped 5% two weeks ago, and I'm only now beginning to feel the drop - slightly more anxiety, groggy, brain fog. So I plan to stay here until I feel stable again before dropping again.

 

I'm just really worried that I'll experience horrific w/d even tapering slowly, once I stop the drug completely...

 

Hi Jr.

 

Welcome!! You will find the Surviving crew well informed and overall, a good lot. Glad you made your way here.

 

 

I would not think you will return to where you were previously, given the response you had to Effexor within 2 weeks of reinstating at 37.5 mgs, and your cautious taper plan. I'm wondering though, given your response to Ritalin.. have you considered weaning off this med before continuing further? Usually Ritalin loses it's effectiveness over time, and given it's destabilizing effect, you might benefit from withdrawing this first. Usually drugs in this class are easier to taper (if using easy and taper in the same phrase is not an oxymoron), and you might be able to kick clear in a couple of months. Alto will be along shortly to give her most considered opinion.

 

Hi Schuyler,

 

Thanks for your response!

 

I've actually just stopped taking the Ritalin. I've technically been on it for a year, but it wasn't regularly. I've been able to stop before without any difficulties, mabe feeling tired and unfocused for a few days. I really don't want to start taking it again to taper slowly because it makes me feel awful.

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Karma

Hi JR and welcome to the forum.

 

I am also coming off of Effexor. I've been tapering extremely slowly since about 2007 and have not really had any withdrawals until last fall. I was decrementing by 6.25 mg every two weeks and didn't catch that I was having withdrawals - if I had noticed, I would have held my dosage longer and then continued my taper - that would have minimized the withdrawals.

 

I recommend that you log and rate your symptoms daily so that you can catch symptoms early and simply hold your dosage http://survivingantidepressants.org/index.php?/topic/1779-rate-symptoms-daily-to-catch-withdrawal-early/. After I up-dosed in the fall I waited 9 weeks before I tried to decrement again and I still felt the decrement ... not nearly as bad as what I experienced in the fall, but I did notice the symptoms.

 

Your plan of dropping 5% and holding until you feel stable is a good plan. Alto suggests starting with holding for 4 weeks and the decrementing again. If that goes well you can try 3 weeks ... and if that goes well you can go to 2 weeks.

 

You should not experience the horrific withdrawals again if you taper very slowly and monitor your system for symptoms.

 

Glad you found us.

 

Love and Light,

Karma

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Altostrata

Welcome, jr.

 

I agree with Karma. Listen to your body -- as you're doing -- and it will help you decide your taper rate.

 

Your cautious 5% plan is a good one. It takes about 4 days for your system to register the full extent of changes. If you feel the dosage change for only a few days, your system is adjusting properly. The rest of the time holding on a dosage enables it to stabilize.

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jr1985

It took two weeks from I dropped 5% before I felt anything, now I've felt mild (compared to previous taper) symptoms for a few days. If they last longer than 4 days does it mean I'm tapering too much?

 

Is there any risk from tapering too slowly? Poop-out?

 

Thanks for replies so far :)

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Altostrata

No, you can't get poop-out from tapering too slowly. The worst that can happen is you get bored and frustrated.

 

If the symptoms get worse over 4 days, that may mean you're tapering too fast.

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Shanti

Hi JR. Welcome to the group. I'm sorry you had this experience too. 5% taper should be as safe as you can be. I'm going to do a micro-taper like that when I start my Xanax taper. I'm glad you found us. This is such a helpful, supportive group.

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Rhiannon

It took two weeks from I dropped 5% before I felt anything, now I've felt mild (compared to previous taper) symptoms for a few days. If they last longer than 4 days does it mean I'm tapering too much?

 

Is there any risk from tapering too slowly? Poop-out?

 

Thanks for replies so far :)

 

Welcome JR!

 

Your taper plan sounds safe and realistic to me. I really don't think you're going to crash into those intense withdrawal symptoms like you did before. Just pay attention to your body and learn as you go. Sounds like you have a sensible and realistic approach, I think you'll do fine.

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jr1985

Thanks for the encouragement.

 

I'm on Effexor XR, so I've been weighing the beads with a jewellers scale, they all look roughly the same size.

 

When I reinstated Effexor, I noticed I had more side effects this time - teeth chattering, feeling more stimulated (it used to make me drowsy!), etc. The side effects got too much at 75 mg, which is why I dropped to 37.5mg. I felt more or less stable mentally, but it wasn't the same as it used to be. But I'm wondering if I should have really stayed on 75mg for my nervous system to fully recover, since that was my original dose? Could the drop from 75mg eventually catch up with me?

 

Sometimes I doubt whether I should come off Effexor at all - I want to quit, but I'm afraid I won't be able to cope without it. I have Aspergers Syndrome/ADHD, depression and anxiety. I was put on AD's because I was severely depressed and had social anxiety (I was bullied at school). I've had recurring bouts of depression but the social anxiety was treated pretty well with CBT. The reason I decided to quit Effexor was because I think it may make my memory/cognition worse, and SSRI are known to exacerbate ADHD due to the decrease in dopamine. It also makes me emotionally flat, so while I'm not depressed, I'm not particularly happy either, everything is just meh. I had severe anxiety, even while on AD's, while at university, which eventually made me quit. So clearly it's not doing me that much good. I'm hoping more CBT will hep me cope with any depression/anxiety without AD's, but I still worry about it.

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Nikki

Hi & Welcome...

 

Glad you found the site. It's a marvelous support network. Going back in the post, what Alto said holds true for me about feeling symptoms from a drop within a 4 day range.

 

Axiety is symptom #1 followed by sadness, some insomnia. I basically feel like the wires in my head are unplugged, and there is despair.

 

With a small enough drops in dose this can lift after a week. It's a process. From reading other posts here and on other sites, it seems that those who make the smallest cuts in dose and wait a month of so in between drops have less trouble after being off the drug entirely.

 

Best regards

Nikki

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Altostrata

jr, your nervous system has changed since you were stable on 75mg. The stress of withdrawal has made it more sensitive to neuroactive drugs. Effexor will never have the same effect on you it had before.

 

From your experience before, it seems taking 75mg again is not an option for you.

 

Effexor is a noradrenergic, this can cause jitteriness, anxiety, and sleeplessness.

 

It seems you have stabilized on 37.5mg. Tapering carefully from there may be the best solution, it's been working so far.

 

It may take a while for your nervous system overall to feel "normal." It's undergone a lot of stress.

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Shanti

JR, there are so many alternatives to helping things like Social Anxiety and Depression that is non-toxic and doesn't harm your nervous system. My daughter effectively treats her Social Anxiety with Valerian Herb and Gelsemium Homeopathy. You can work with a Naturepath or Homeopath to get specific with your symptoms. It does work.

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jr1985

My nervous system has definitely changed since w/d. Ritalin used to make me calm and focused, but since w/d it just makes me depressed and anxious.

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jr1985

Well I'm feeling better w/d-wise - less anxiety, etc. I'm going to hold for another week (4 in total) before dropping again, as Alto and others have suggested.

 

I've noticed the teeth chattering, arm/ leg sensations seem less since dropping and stabilising. I suspect it's either because of the drop in dose or because I quit the Ritalin.

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Altostrata

Very good news.

 

No need to rush, you may wish to hold even longer until all the symptoms fade.

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jr1985

Well I may have spoken too soon. Although my anxiety has improved, I now feel more irritable (getting angry easily, etc). It doesn't feel too bad tbh, but I'll still wait another week or so before thinking about dropping again.

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jr1985

It's been just over 3 weeks since I made my first 5% cut, and I'm feeling.... strange. I'm not sure how to describe it but I think it could be my emotions coming back to full strength?

 

I suspect the irritability I've been feeling is really my normal pre-AD level of irritability, only I'm not used to feeling that intense, which makes it seem worse than it is.

 

I've also had some anxious thoughts, but so far I've been able to counter them, rather than falling into despair like I usually do. Could AD's actually make it more difficult to deal with anxiety?

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Altostrata

Anxiety can be a side effect of ADs. Effexor is noradrenergic, which may activate feelings of anxiety.

 

You might wish to keep notes about the pattern of symptoms you feel after every cut.

 

Let's hope they're temporary and your nervous system will quickly adjust to the decrease.

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jr1985

Well the teeth chattering/arm tingling seems to have come back today. Is it possible for side effects (NOT w/d) to get better after a drop, then return once stabilized?

 

PS. Can exercise make your hypersensitive nervous system worse?

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Altostrata

Side effects generally decrease as dosage decreases.

 

Over-exercising can definitely cause a surge of symptoms.

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EffexorMeNoMore

 

 

Effexor is a noradrenergic, this can cause jitteriness, anxiety, and sleeplessness.

 

 

I'm starting my own taper on Monday, but I'm wondering if it would be possible to counter bouts of sleeplessness with Benadryl? Benadryl is commonly used to treat insomnia.

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Altostrata

People often use Benadryl for sleep when withdrawing. The only problem is the effect can wear off and go paradoxical -- the Benadryl will keep you awake instead. So use it sparingly if you can.

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jr1985

If your nervous system is sensitized after a too fast taper, and continues to be sensitive after reinstatement, can it settle down during a slow taper?

 

Or would you have to stay at the same dose for a long time for it to settle?

 

Would each 5% drop re-sensitize it?

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Altostrata

I think you need to move very, very carefully not to rock the boat in that situation.

 

How are you managing a 5% taper? Are you using a digital scale?

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jr1985

I think you need to move very, very carefully not to rock the boat in that situation.

 

How are you managing a 5% taper? Are you using a digital scale?

 

Funny you should mention rocking the boat - yesterday I switched from taking my dose in the morning to the evening AND I made another 5% cut. I switched times because I was feeling drowsy during the day and thought it might be a side effect (it used to make me drowsy before w/d). But I'm thinking dropping 5% at the same time was a bad idea, so I was going to go back up 5% and hold for another 2 weeks (6 weeks in total), just to give my body time to adjust to the new timing and to get a better idea of how each cut effects me.

 

My first 5% cut wasn't terrible but I have noticed some anxiety/depression, although mild compared with my fast taper. It's hard to say whether it's w/d or just me, as I've obviously had depression/anxiety in the past.

 

Yes, I'm using a digital scale to weigh the beads.

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Altostrata

Sounds like you've got a handle on your taper, jr.

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jr1985

I hope you're right, Alto!

 

This whole experience has been an eye opener. I mean first the drug that is supposed to help you actually makes things worse. Then you find out doctors, who are supposed to be experts, are absolutely clueless, and you have to get your advice from people on the internet! It's just crazy!

 

Also, this whole w/d thing is just so complicated. I mean, if you have w/d you would expect to reverse it just by going back on the drug? Not so, somethimes it doesn't work or makes things worse. I got new side effects (jaw tremor, arm/leg burning/tingling) after I reinstated. You would also expect to get better gradually, yet people actually experience "waves" of symptoms.

 

There have been some positives in all of this. It has forced me to look for non-drug strategies to help me cope with depression/anxiety. I've been reading Claire Weekes' books, which have been excellent in helping me cope. I've also been practicing mindfulness based stress reduction, CBT and I've been exercising more. Although I've discovered too much exercise makes me worse, so I can really only manage to walk, but it's better than nothing. I'm going to try "forest bathing" today to see if that helps too.

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Altostrata

You are so right, jr.

 

How about starting a topic in Symptoms about Claire Weeks's books? I'm sure a lot of people would be interested.

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jr1985

I'm stressed out at the minute, between studying, working part-time and dealing with w/d. I'm usually quite vulnerable to stress, but I'm feeling extra-vulnerable since w/d, even after reinstatement. I'm thinking maybe I should give up studying for now, at least until I finish tapering/recover. The problem is I've deferred so many times before (due to anxiety/depression), I don't know if I'll go back if I defer again. Not sure what is best.

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Altostrata

Is there a way you can slow down just a bit, with everything you're doing?

 

Make more time for you to recharge yourself.

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jr1985

Well I'm studying part-time and doing the bare minimum you can do. I could always refuse to do overtime at work, but I hate saying no and always manage to get coerced into doing it.

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Altostrata

You need to take care of yourself, especially if you're feeling vulnerable to stress.

 

Think hard about what you can trim back on, and make time for activities that are soothing or relaxing rather than stressful.

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jr1985

I had a complete meltdown last night :(

 

Depression, anxiety, crying, suicidal thoughts, feeling rage, etc. So much for 5% being tolerable :(

 

This is exactly what happened during my fast taper (although maybe not just as bad) - felt mild w/d, followed by feeling great, then w/d symptoms exploded 5 weeks later.

 

Not sure if I should ride it out and hope I stabilise, or try updosing by 2.5% or back to original dose?

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Altostrata

How are you feeling now?

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jr1985

Well I felt like I had the flu earlier, and my nerves feel electrified, but I feel a little better emotionally.

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