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Anjo: how to reinstate venlafaxine


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Hi! Would someone advise me how & when it would be best to reinstate Venlafaxine? I have reduced from 150mg Effexor XR to 75 mg of ordinary Venlafaxine tablets over 12 months. Have been on this for 4 weeks and feeling the effects of W/D. 

2002 Effexor XR 150 mg capsule

Mid 2019 Venlafaxine 150 mg XR tablet form

Late 2019 Venlafaxine 150mg IR tablets then stayed on IR Venlafaxine to taper
Mid Feb 2020 112mg. Mid May 103.12 mg

1st July 2020 93.78 mg. Early Oct 84.37 mg

Early Jan 2021 75mg (1 x 37.5mg am & 1 x37.5mg pm) IR Venlafaxine tablets.

 

 

 

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Also, my hay fever is so bad at the moment. Is that a result of Venlafaxine W/D? In my previous post I meant to say my W/D symptoms are just about bearable so should I just stay on this dose until I feel better. It’s the daily headaches which are making me feel horrible and slightly nauseous together with heavy feeling & pins & needles in my hands, arms & feet.

2002 Effexor XR 150 mg capsule

Mid 2019 Venlafaxine 150 mg XR tablet form

Late 2019 Venlafaxine 150mg IR tablets then stayed on IR Venlafaxine to taper
Mid Feb 2020 112mg. Mid May 103.12 mg

1st July 2020 93.78 mg. Early Oct 84.37 mg

Early Jan 2021 75mg (1 x 37.5mg am & 1 x37.5mg pm) IR Venlafaxine tablets.

 

 

 

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  • Moderator
getofflex
Posted (edited)

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  What are you withdrawal symptoms?   

 

 I'm not sure if hay fever can be a symptom of withdrawal from Venlafaxine.  It could be a coincidence - you could have recently developed allergies to pollen.  Is it spring where you are?

 

First of all, can you please give us specific information about your drug history?  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

This helps you understand what withdrawal syndrome is: 

 

What is Withdrawal Syndrome?

 

Here is some information about how these drugs actually work.  

 

How Psychiatric Drugs Remodel Your Brain

 

From reading the information in your profile, it looks like you tapered by 25% every 6 to 8 weeks.  Tapering is best done extremely slowly, and we taper by 10% of the current dose, so that the taper becomes exponentially smaller.  This is probably why you are having WD symptoms.  

 

 Why Taper by 10% of my Dosage  

 

Also, as we are tapering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

Windows and Waves Pattern of Stabilization

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

 

Magnesium

Omega 3 Fish Oil

 

Finally, increasing your dose, which we call reinstatement, is best done very carefully.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

Edited by getofflex

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08

Benadryl 50 mg, Ibuprofen 800 mg, or Tylenol 1000 mg

other meds: Levothyroxine 75 mg

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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Drug history. Effexor XR 150mg capsules Started 2003
                “       Venlafaxine tablets XR  150mg started February 2020 

          “.              Venlafaxine tablets 150mg started April 2020

                         — then reduced dose by cutting into quarters with 6/8 weeks in between each reduction. Until I reached 75mg. February 2021. 
 

I have decided to stay on this dose as experiencing W/D effects. I guess too late to reinstate a little higher.??? 
 

Any help from moderators appreciated.

Thanks
                          

                          

 

2002 Effexor XR 150 mg capsule

Mid 2019 Venlafaxine 150 mg XR tablet form

Late 2019 Venlafaxine 150mg IR tablets then stayed on IR Venlafaxine to taper
Mid Feb 2020 112mg. Mid May 103.12 mg

1st July 2020 93.78 mg. Early Oct 84.37 mg

Early Jan 2021 75mg (1 x 37.5mg am & 1 x37.5mg pm) IR Venlafaxine tablets.

 

 

 

Link to post
  • Moderator
getofflex
Posted (edited)

Hello Anjo.  Thank you for giving us more information about your drug history.  I will need more detailed information about your taper.  It would help if you could put this in your signature as instructed in the link I gave you previously. That way it will be included in each post, and not get lost in your intro thread.  Instead of saying "cutting into quarters", please state the date and the dosage in mg. for each dose reduction.  If you don't remember the day, say "early, middle or late April" for example. This will reduce confusion, and help us to give you accurate suggestions.   I don't know from the above post when you started your taper.  Thank you. 

 

You could possibly try a reinstatement.  One of us moderators will suggest a reinstatement dose when we see more details about your taper.  

Edited by getofflex

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08

Benadryl 50 mg, Ibuprofen 800 mg, or Tylenol 1000 mg

other meds: Levothyroxine 75 mg

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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  • 1 month later...

Hello,

Would a Moderator please advise me if it is wise to reinstate just a few mg until I feel able to cope better. I have now put my drug history on Signature. I am feeling I can’t go on with all the withdrawal symptoms I am experiencing. I spoke to my GP a few weeks ago - I live in England - and she said to reinstate a little until I feel better but not to go back up to 150mg.When I tried this I didn’t feel any better and I didn’t get any advice on how much to increase by, how long to wait between each raised dose etc We thought by going from Effexor XR capsules down to Venlafaxine slow release tablets, then to IR tablets before I started to taper would be a good idea. Having read up on how to taper on here & other people’s experiences I realise this was probably not a good way to taper, even though I did this over a period of 12 months. Please would you advise me on whether it would help if to stay on 75 mg ir tablets & try to increase gradually or go from taking 75mg IR tablets to 75mg Slow release tablets or Effexor 75 mg capsules. My symptoms are fatigue, tiredness, fitful sleep, headaches, numbness in hands, dropping things, manual dexterity is terrible, body feels leaden, aches & pains, upset bowels, lack of motivation, brain fog, not able to concentrate. ( I don’t think I should be driving the way I am). 
I would be so grateful for any advice or help.

Thank you

 

2002 Effexor XR 150 mg capsule

Mid 2019 Venlafaxine 150 mg XR tablet form

Late 2019 Venlafaxine 150mg IR tablets then stayed on IR Venlafaxine to taper
Mid Feb 2020 112mg. Mid May 103.12 mg

1st July 2020 93.78 mg. Early Oct 84.37 mg

Early Jan 2021 75mg (1 x 37.5mg am & 1 x37.5mg pm) IR Venlafaxine tablets.

 

 

 

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FindRest

Sorry you are struggling. I am not a moderator, but wanted to point out something important in case you don’t already know. Due to it’s extremely short half-life, Effexor IR needs to be taken twice a day (half your dose 12 hours apart). XR only needs to be taken once per day. If you have not been dividing your dose up and taking it twice a day, that could explain many of your withdrawal symptoms.

1988-1996  Various AD’s, all classifications.  

1996-2019  Effexor XR 37.5mg to 150mg. Jan 2017 onward, 37.5 mg.

2019  Apr 11: Latuda 20mg added to Effexor.  Apr 22: L to 40mg.  May 14: L to 20mg.  May 27: L to 10 mg for 3 days then ct (dr’s orders). Continue Effexor 37.5.  Jun 10: Rexulti .5 mg added. Incr to 1mg.  Jun 15: Rex to .5mg.  Jul 1-24: taper Rex to .25mg over couple of weeks then off.  Jul 24: CT Effexor (per dr’s orders)  Sep 9-19: Viibryd (low dose, not sure mg), CT (dr’s orders).  Sep 23-27: Trintellix (low dose). CT (dr’s orders).  Sep 28:  Prozac 10mg.  Oct 24:  Began rapid taper off Prozac (every other day for wk) began Pristiq 25mg for 10 days, then 50mg after that.  Dec 31-Jan 31, 2020:  Pristiq 25mg. 

2020  Feb 1: CT Pristiq due to serious side effects incl high BP w pre-existing heart condition.   Feb 1: Effexor XR (10 large beads from 37.5 capsule).  Feb 3: 14 L beads.  Feb 15: 14 L beads+2 med beads.  Feb 17: 15L + 5M beads (25mgbw or 7.56mgai).

Current: Mar 1, 2020: Effexor XR (15 large beads + 7 medium beads, 30mgbw or 9.072mgai)

 

Other current meds: Ambien 10mg nightly (2012), clonazepam .125mg nightly (May, 2019), omeprazole 20mg (alt w famotidine 20mg, since Oct 2019), Synthroid 125 mcg (1985), Premarin .625mg (2002), Miralax capful/day (2014), fluticasone nasal once/day (mid-2018), cetirizine 10mg nightly (late-2018) .  Supplements: D3 25mcg, probiotic

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  • Moderator
getofflex

Thank you for putting detailed drug history information in your signature.  It really helps.  

 

@FindRestis correct.  Immediate release venlafaxine is normally taken 2-3 times per day.  How many times a day are you taking it? If you are only taking it once a day, are the symptoms worse at any particular time of the day?  What time of the day do you take the venlafaxine? You could be having interdose withdrawal effects if you only take it once a day.  

 

I'm assuming the 75 mg is the total amount you are taking each day. If my assumption is correct, and if you are already taking it 2-3 times per day, then try increasing your dose from 75 mg up to 80 mg.  Please carefully read About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

Also read carefully  Tips for Dosing and Tapering Venlafaxine

 

If you feel significantly worse after updosing, then drop back down to the 75 mg.  Please keep us posted on how you are feeling.  

 

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08

Benadryl 50 mg, Ibuprofen 800 mg, or Tylenol 1000 mg

other meds: Levothyroxine 75 mg

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

Link to post

FIND REST.  Thank you but I do take 75mg in divided doses twice a day. I just omitted to put it in signature. Silly me.

2002 Effexor XR 150 mg capsule

Mid 2019 Venlafaxine 150 mg XR tablet form

Late 2019 Venlafaxine 150mg IR tablets then stayed on IR Venlafaxine to taper
Mid Feb 2020 112mg. Mid May 103.12 mg

1st July 2020 93.78 mg. Early Oct 84.37 mg

Early Jan 2021 75mg (1 x 37.5mg am & 1 x37.5mg pm) IR Venlafaxine tablets.

 

 

 

Link to post

Hi!

I have been having long periods of no energy, fatigue & low motivation. Also, last night I woke up at 4am with horrible face pain, headache & deafness in my left ear. I just felt I wanted to have some heat on my face. I took 2 paracetamol and went back to sleep. I have had deafness all day and rang my GP surgery where a nurse said it was sinusitis and has given me steroid nose spray. I went shopping for an hour or two yesterday & today I feel so fatigued with no energy. I managed a short slow walk in the sunshine this afternoon but didn’t feel any better. I am 69 and have always been fairly fit and take exercise every day but I worry now as I find I can’t most days. I worry that I will never feel well again. Is it good to take exercise or should I rest when feeling awful? Can I blame most of my ills on Venlafaxine withdrawal? Or maybe it’s just getting older! Another problem I have, is tingling in my arms & hand, aching legs & back pain, frequent migraine headaches with seeing zig-zag lines & bright lights. I’ve gone through having nausea, vomiting & haven’t experience this since starting W/d a year ago. I did have surgery to remove a tumour from my spinal cord in 2020 and was put on Effexor to help with pain & odd sensations in my limbs & hands. Maybe taking Effexor has masked a lot of these symptoms & now I am withdrawing they are coming back. I was hoping after all these years I would have healed by now! I am wondering if I will ever feel well again. 

 


 

2002 Effexor XR 150 mg capsule

Mid 2019 Venlafaxine 150 mg XR tablet form

Late 2019 Venlafaxine 150mg IR tablets then stayed on IR Venlafaxine to taper
Mid Feb 2020 112mg. Mid May 103.12 mg

1st July 2020 93.78 mg. Early Oct 84.37 mg

Early Jan 2021 75mg (1 x 37.5mg am & 1 x37.5mg pm) IR Venlafaxine tablets.

 

 

 

Link to post
  • Moderator
getofflex

Good to hear.  Let us know how the reinstatement works out.  Remember to revert back to your previous dose if the reinstatement makes you feel worse. 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08

Benadryl 50 mg, Ibuprofen 800 mg, or Tylenol 1000 mg

other meds: Levothyroxine 75 mg

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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