TaperShaperVXR: tapering off venlafaxine extended release

[TaperShaperVXR]

Hi All:

 

Thank you for this WONDERFUL resource! I am so excited to start my first post.

 

In 1994 or 1995 at about the age of 28 I started taking Venlafaxine for immense,  longstanding depression with concomitant anxiety. I can remember having severe and debilitating depression with concomitant anxiety since I was about 10 years of age.

 

Back to 1994/1995 (+/-). After taking Venlafaxine for a while, the depression abated and has never come back. Unfortunately, I never ceased taking the drug, even after I felt better. I have been on it for many many years.  You can do the math. Yikes!

 

Ultimately, after a 10 month up-titration to 75mg (maybe in 2015), I lost my libido. It was low but not lost. It has not come back. My poor wife. 

 

In 2017 and 2018 (I believe), on two separate occasions, I attempted to taper. Each time counting beads from the capsule over a 10 month period, but I went too fast.

 

As a result, I suffered bizarre, horrific and terrorizing anxiety and panic attacks, especially related to communicating with others. I would have this unreasonable idea that I offended someone, or that they misinterpreted something I said, or that they were mad at me, or that they thought I talked their ear off, etc. The emotional reaction I had was almost a sense of terror and panic. Very bizarre. I knew it was the withdraw. I had never ever been THIS crazy, even before starting the Venlafaxine.

 

Please note, when I tapered I also had all the other "fun" side effects - electric shocks, brain zaps, tinnitus, etc., etc. But the worst was the social paranoia, by far!

 

After these 2 unsuccessful tapers(2017 and 2018) things changed in my body/brain. I lost the periodic, positive feelings of excitement and joy, also I noticed I became flat (had almost no feelings of love, empathy, sympathy, or sadness, etc.). 

 

Thankfully I don't suffer from depression anymore. It stopped way back in 1995+/-. The depression didn't even come back during my tapers. Now I just suffer ftom moderate social anxiety, GAD, sexual disfunction, lack of excitement, and a feeling of "flatness."

 

In the past I was able to down-titrate to 18.75mg with "tolerable" discomfort; unfortunately, back then I didn't wait to stabilize before further down-titration. I tapered again before I felt better. This compounded my WD symptoms....And, I kept tapering and tapering, thereby compounding the WD symptoms more and more. I am now trying to taper once again. Its been 2 days.

 

This time I am titrating down to 18.75mg and holding there until I feel better, only then will I decrease very slightly and slowly (10% decrease per each down-titration). This time I am not drinking any alcohol or eating sugar. This time I am exercising much more. This time I am more strictly sticking to my whole food plant-based diet.  This time I am taking:

 

Multivitamin/multimineral

D3

B6

Magnesium

potassium 

Coq10 

Choline 

Inositol

Theanine 

Tryptophan 

Tyrosine

N-acetylcysteine (NAC)

Omega-3 

Probiotic 

 

One of my VERY FEW good qualities is that I have good logic skills and I am a good "researcher." I am intellectually curious. I have seen Medicating Normal (a movie about psych drugs, as most of you know). I have done tons of research of MANY scholarly articles (for many many years), and I am NOW ready to do the taper CORRECTLY this time. I have read many of Alto's articles and many SA posts. They are amazing and informative. 

 

Fyi, Venlafaxine Extended Release is my only "psych" drugs. No benzos. No other SNRI/SSRIs. No anti-psychotics. Nothing. I guess I am lucky for that at least.

 

I own and operate a successful business. I Have a beautiful family. I have great family relationships. I Have a 3-year post-graduate education. Don't know if anyone wanted to know all this, but I guess it adds some color to my situation.

 

OK. Enough about me. I want to give ALL of you a very very heart-felt thank you! I truly appreciate what Alto and the members have done by setting up, running and managing this forum. 

 

Thank you! Thank you! Thank you!

 

Hugs and love - The TaperShaperVXR

 

Pls forgive typos and bad grammar. I am writing this from my phone. 🙂

 

[Kiasofia]

Welcome @TaperShaperVXR

I'm glad you have found us and that you are doing lots of research. Hopefully this time the taper will succeed! Thank you for creating your signature.

 

What dose effexor were you taking before you reduced to 18.75mg? Please add this to your signature. What method are you using to taper?

Tips for tapering off venlafaxine (Effexor)

Why taper by 10% of my dosage?

 

This explains why it gets harder to taper at the lower doses:

Why taper? Importance of gradual change in plasma concentration

 

Make sure to hold the taper when withdrawal symptoms appear, this time.

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

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

The Windows and Waves Pattern of Stabilization  

 

Aside from a high quality fish oil and magnesium, be careful with supplements. The brain gets sensitized from tapering and can react unpredictably. Great that you are avoiding alcohol and sugar.

Important topics about tests, supplements, treatments, diet

 

Here is our symptoms and self care section, you may find some useful ideas to help manage symptoms. 

Symptoms and self care topics  

 

The search function on this site doesn't work very well. To find things on the forum I find the easiest is to type "survivingantidepressants.org + what you're searching for" into a search engine.

 

This is your Introductory topic, where you can ask questions and connect with other members.  If you need any advice specific to you and your situation, please ask it here. Otherwise, feel free to join discussions on other threads. To make sure I or someone sees your question, tag them by writing @ and then start typing their username. A drop down menu will appear. Click on their username and it will turn blue.

 

Please check into the forum and update while tapering and keep your signature up to date.

 

I’m glad you found us, we’re here to support you!

Edited December 18, 2021 by Kiasofia

[TaperShaperVXR]

Dear @kiasofia

 

Thank you VERY much for your response!! I see that you are in the middle of a taper too (I believe). Good luck with your endeavors!

 

To answer your questions:

 

2 hours ago, Kiasofia said:

What dose effexor were you taking before you reduced to 18.75mg? [...] What method are you using to taper?

 

• Dose - For all intents and purposes, over the  last 25+/- years, I have been on 37.5mg almost all of the time. There were a few short periods using 75mg (maybe 3, 10-month periods on 75mg). Also, there were the 2 periods where I attempted to taper below 37.5mg. These 2 down-titrations lasted about 10 months each too. Before I started this most recent taper, I had been on one of those aforementioned 75mg periods. I was on 75mg for about 10 months(3/2021 to 11/5/2021), followed by about a 6 week period (11/6/2021 to 12/14/20021) on 37.5mg. I have just moved down to 18.75mg on 12/15/2021 to present (12/18/21). So, from 11/15/21 to 12/15/2021 I  quickly reduced from 75mg to 37.5mg to 18.75mg. Been at 18.75 from  12/15/2021 to today (12/18/21).                                                

 

• Method - From 11/6/21 to 12/15/2021 I  quickly reduced from 75mg to 37.5mg to 18.75mg. Now, I am holding at 18.75mg until I feel very stable. Thereafter, I am planning on reducing each subsequent dose by 10% (of last dose), and holding there for as long as it takes to feel stable....and so on. Currently, I am at 18.75mg since 12/15/2021. Historically, I have been able to get down to 18.75mg quickly without too many unbearable side effects. But, historically, once I go lower than that, I would have horrifying  paranoia/anxiety/panic about any interpersonal interactions I would have with others. These thoughts were never-ending, obsessive and intrusive with corresponding exaggerated and horrific emotional responses of terror and paranoia and anxiety. I had thoughts that I had said or done something wrong or offensive when talking with others, and the emotional response to these unreasonable thoughts was completely unreasonable too. It was almost psychotic and dilutional! BIZARRE! The down-titration was too quick! Note: I had other horrifying side effects too, but these were the most outstanding for me. FYI, This time I am supplementing with neuro-supportive supplements. See supplement list in my last post. I am being cognizant about being too sensitized to supplements. So far so good.

 

• Currently (12/18/21), at 18.75mg, I am having no real side effects to speak of (yet), except minor neural and physical, i.e. brain zaps, dizziness and body shocks. But, I have only been at 18.75mg since 12/15/21 to today (12/18/21). So, we shall see.

 

Note: For all intents and purposes, over the  last 25+/- years, I have been on 37.5mg most of the time (except maybe 3, 10-month periods on 75mg; and maybe 2, 10-month periods attempting a down-titration/taper below 37.5mg).

 

@kiasofia - Thanks for all the time and advice. I TRULY appreciate all that you and the staff have done!!!  I will update my signature, as you suggested. Good luck on your taper.

 

VERY warm regards - TSVXR 🙂

 

 

[Kiasofia]

Reducing from 37.5mg to 18.75mg is a very big reduction, even if you have managed it before. Brain zaps, dizziness and body shocks are symptoms of too big a dose reduction. As it has only been three days, you may want to consider increasing to 33.75mg or at least a higher dose than you are now, and doing a proper 10% taper from there.

 

I know it can seem like the road to 0 will be so much further away, but in the end it might bring you to the finishing line faster. Powering through these withdrawal symptoms is not good for your brain and can make it even more sensitive to further reductions.

 

This post explains why small reductions are important the whole way:

How Psychiatric Drugs Remodel Your Brain  

 

[TaperShaperVXR]

Hi @Kiasofia!

 

Thx for your advice. It is cherished and very welcomed. I agee with you. I know the data supports what you have suggested 

 

Actually (brace yourself), I went down from 75mg to 37.5 to 18.75 in about 6 weeks. [Fyi, this last 75mg stint was one of only 3 times I was up that high.] I Was On 75mg From 3/2021- 11/5/2021, then went to 37.5mg for 6 weeks (11/6/21-12/14/21), and now I am at  18.75mg as of 12/15/21.

 

The down-titration from 75 to 37.5 was almost completely uneventful. Thankfully! I heald at 37.5mg for 6 weeks to make sure the change was tolerated. I Felt fine. Only Then did I titrate down from 37.5 to 18.75.  I have been at 18.75mg for 3 days. It has come with mild and infrequent brain zaps, electric shocks and dizziness....And, no other symptoms. Historicly, this has been my experience at 18.75mg; but, I am VERY aware that it is early in the process (3 days) and things could go downhill, fast.

 

Accordingly, I will monitor very closely.  if things get worse, I will QUICKLY titrate to 33.75mg, as you suggested. If I have symptoms, I know an immediate up-titration is preferred, as delays in doing so may leave one with more longer-term issues to deal with.

 

I hope you are doing well.

 

Thanks for your help, time and concern 

 

TSVXR 🙂

[TaperShaperVXR]

Hi @Kiasofia

 

I am just checking in with you. I hope you are doing well. Wanted to give you an update.

 

I just read @Altostrata's post: The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable. It was an awesome post. @Altostrata is a blessing! 

 

I know I broke the 10% reduction "rule" on my initial reductions. I dropped from 75 to 37.5 to 18.75 in just 6 weeks. But thankfully I am feeling fine...right now.

 

It is day 6 at 18.75mg effexor. I am feeling fine. I was at 37.5mg for 6 weeks prior. I had no real side effects at 37.5mg. I was on 75mg for the 8 months prior to that. Currently, I am holding at 18.75mg for a very long time. At this time, I have very mild brain zaps and very mild dizziness, but otherwise I feel "fine." This has been my experience in the past when I have tapered to 18.75mg. Historicly, 18.75mg is fine, but the "fun" starts when I go lower than 18.75mg and too quickly. I think I just need to hold at 18.75mg for a VERY long time. I am in NO rush. Hopefully nothing gets worse. I will monitor. Promise.

 

The supplements (mentioned in my first post) were added relatively slowly (ROUGHLY, one new supplement added every few days over about 6 weeks). It allowed me to monitor any changes each supplement may have. None caused a negative response....yet. Thankfully, I had positive or innocuous responses to them.

 

I am vigilant.

 

Hope you are well!

 

TaperShaperVXR 

 

PS I did not realize that you are a Norwegian Viking. My wife is a school teacher. She and I are impressed with your impecable English. It is perfect. Better than ours! Let me know how you are doing...if you wish.

 

 

[Kiasofia]

I hope your long hold at 18.75 goes well and that symptoms settle down. Great that you added in supplements gradually! I grew up bilingual due to having American family so I'm more fluent than the average Norwegian, though they too can be quite impressive. I'm ok. Going through the "windows and waves" pattern of stabilization after too fast a taper...Hoping to one day be drug free, but those plans are on hold for now. Helping out on the forum in the meantime, so I can put my experience to some use and continue learning more!

[TaperShaperVXR]

@Kiasofia Tusen takk! for your thoughts. So far, so good.

 

Based on my research, you WILL stabilize and feel better. It just takes time. I know that when I tapered too fast I was extremely uncomfortable - OCD, panic, paranoid, anxious, etc. Had I been as strong as you I might have been able to stick with my last taper but it was too difficult for me. Had I stuck with it I am sure I would have stabilized by now. You will too.

 

Stick with it! It will get better!

 

Ha en vidunderlig dag!

 

TaperShaperVXR 

 

[Kiasofia]

Tusen takk😊

[TaperShaperVXR]

Muscle Tightness Question

 

Hi All!

 

Forgive me if this is the wrong place to ask this question. I am a novice at message/internet forums.

 

I have reduced my venlafaxine xr to 18.75mg for the last 6 weeks. Doing well. 

 

I am athletic, but I am finding that after the down-titration I am now prone to calf injury during running (and even walking). It seems that since I reduced my dose of venlafaxine my calves are tight and prone to injury.

 

Has anyone suffered from muscle tightness after reducing AD dosage? What is the cause, lower serotonin in the nerves in the muscles? How long does this muscle stiffness last?

 

Fyi, I did/do have some generalized, non-specific, flu-like muscle aches in other body parts. All due to down-titration. Probably related to calf tightness.

 

A Little info: I lift weights and run. I Take supplements (listed above in my original post). I eat a plat-based/vegan diet. I go to a massotherapist (I have had him massage calves...didn't help)

 

Any thoughts would be GREAT! 

 

Big hugs to all.

 

TaperShaperVXR 

[ChessieCat]

#56 on the withdrawal symptoms list:

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

There are many existing topics on SA.  You can use the site search function or use an internet search engine and add site:survivingantidepresssants.org to the search term.

 

muscle-and-joint-stiffness-aches-pain-or-weakness

 

[TaperShaperVXR]

37 minutes ago, ChessieCat said:

#56 on the withdrawal symptoms list:

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

There are many existing topics on SA.  You can use the site search function or use an internet search engine and add site:survivingantidepresssants.org to the search term.

 

muscle-and-joint-stiffness-aches-pain-or-weakness

 

 

Dear @ChessieCat

 

Thank you VERY much! I did a quick review of the info you sent. It looks spot-on. I will review in more detail.

 

I have searched AD for related subjects. None were as on target as what you sent.

 

Thank you and big hugs!

 

TaperShaperVXR 

[TaperShaperVXR]

Dear All:

 

Hope everyone is well!

 

It has been a longtime. I just wanted to post an update on my Effexor XR (Venlafaxine XR) journey.

 

Since I started this most recent (third) Effexor XR (Venlafaxine XR) taper on 12/15/21, I have had success with my taper for the first time! This time about 3 weeks after each down-titration I get horrible OCD, paranoia, and anxiety, but these feeling are intermittent and only last one to two weeks. Thereafter, the aforementioned negative feeling are fluid - they come and go - and only last for a short time. Then, they finally stop. I hold at my current dose well after the negative feeling stop. At some point I taper down again. This protocol has worked...so far...this time.

 

I am not sure why this time my taper is successful. I do not believe I am doing much differently than the last two tapers. If one reviews my initial post, I list supplements that I have been taking. I was not taking these on my last two tapers. Anecdotally, maybe they are mitigating the withdrawal symptoms? But I do not know.

 

I am struggling. I need a little help. Please provide any thoughts. Two issues:

 

1. As I mentioned, my current (third) taper is going well. However,  In the past I have attempted to taper 2 other times. It caused severe mental/emotional issues, some of which are still lingering, I think. For example, after my second taper I lost the high, joyous, and upbeat feelings I once had. They have not returned. Will they return?
2. A couple times in my past, I increased my dose to 75MG. Once i increased to 75MG, It killed my libido and it has not come back, even after tapering down to my current dose of 4.68MG. Will it return?

 

Big Hugs - TaperShaperVXR

 

 

[TaperShaperVXR]

Dear All:

 

Happy New Year! I hope everyone is well and on the road to recovery!

 

I am so thankful to @Altostrata for this GREAT resource. This resource TRULY saved my life. Thank you @Altostrata!! Super Big Hugs to you!

 

I thought I would post an update on my status for "record keeping purposes."

 

As of 11/28/22 I have decreased my dose of Venlafaxine XR (Effexor XR) to 2.34mg. My taper has been VERY difficult at times. There have been a myriad of HORRIFIC side-effects (mental, emotional and physical, etc.). However, after each dose decrease, it seems that at the 4 month mark my symptoms become more manageable and I am able to reduce the dose once again.

 

I am looking for guidance on 2 issues (please):

 

1. As I mentioned in my prior posts, this current taper is going "well." However, In the past I have attempted to taper 2 other times. These tapers caused SEVERE mental/emotional side-effects, some of which are still lingering, I think. For example, after my second taper (the taper before this current "successful" taper) I lost the high, joyous, and upbeat feelings I once had. They have not returned, even after tapering down to my current dose of 2.34mg. I believe this is called anhedonia. Fyi, I had moderate anhedonia while on the full dose of Venlafaxine (37.5mg), but the anhedonia became horrible after my second to last taper and has not corrected even during this most recent taper. Have others experienced anhedonia? Did the pleasure and upbeat feelings return? What was the time-frame?

 

2. Approximately three times in my past (many years ago), I temporarily increased my dose to 75MG (from 37.5mg) for only about 10 months each time. Once I increased to 75MG, It KILLED my libido and it has not come back. I have ZERO libido since going up to 75mg for only a brief period of time and from many years ago. It has not returned, even after I returned to 37.5mg (my usual dose) for many years AND even after tapering down to my current dose of 2.34MG. "Everything" works (sorry. TMI). I have read that increasing or decreasing dosage can cause libido issues. Have others experienced loss of libido when increasing and/or decreasing their dose? My complete loss of libido seems to have started after a brief dose increase to 75mg (from 37.5mg) many years ago. Even after returning to 37.5mg for many years and even after this current taper to 2.34mg, my libido has not returned. Has anyone experienced complete loss of libido? Did the libido  return? What was the time-frame? I have heard Stuart Shipko, MD state that loss of libido may be permanent. YIKES!

 

I don't want to make this all about me. If I am able, I am ALWAYS happy to help or advise anyone in our SA family. Feel free to reach out. If I am able to help, I will.

 

Big hugs to ALL!

 

TaperShaper
 

 

 

 

 

[Altostrata]

You're welcome! Good to hear from you, @TaperShaperVXR

 

It looks like you are reducing by 50% every 4 months. As you know, we advise a taper of only 10% per month, calculated on the last dose (amount of reduction keeps getting smaller). You might find this smaller reduction per more tolerable than the relatively large jumps you're making every 4 months. It's best to minimize those periods of withdrawal symptoms.

 

See Why taper by 10% of my dosage?

 

Tips for tapering off venlafaxine (Effexor)
 

As this discussion shows, when you're down to a low dose, it's even more important to taper very gradually:

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

Discussion of a scientific journal article with data supporting a very gradual taper. 

Various kinds of antidepressant-induced sexual dysfunction are common, affecting half of more of people who take them. 10 months on 75mg  Effexor is not a short amount of time, and 37.5mg Effexor (or less) can also cause sexual dysfunction. If you've been taking antidepressants a long time, such as since 1995, your sexual functioning may or may not recover as you lower the dose or even when you go off. Recovery from post-antidepressant sexual dysfunction (PSSD) is very gradual and can take a long time.

 

Please do check in from time to time and let us know how you're doing.
 

 

[TaperShaperVXR]

Hi All:

 

I just wanted to log another down-titration.

 

As of 7/22/2023, I have decreased my dose of Venlafaxine XR (Effexor XR) to ~1.17mg. I taper and then hold steady until I "stabilize." 

 

My taper has been VERY difficult much of the time, but especially as I approached the lower doses. There have been a myriad of HORRIFIC side effects (mental, emotional, physical, etc.). I have had some periods of relief. A stereotypical Windows and Waves scenario.

 

I have 2 questions:

1.  Anhedonia -  I lost the periodic high, joyous, and upbeat feelings I once had. I believe this is called anhedonia. Although I had many negative feelings, I would sometimes have a few periodic feelings of joy, excitement, and motivation. I do not have those anymore and they have not returned, even after tapering down.  Have others experienced anhedonia? Did the pleasure and upbeat feelings return? What was the time frame?
2. Libido - I have a complete loss of libido. It seems to have started after a brief dose increase to 75mg many years ago. Even after tapering my libido has not returned. Has anyone experienced a complete loss of libido? Did the libido return? What was the time frame? I have heard Stuart Shipko, MD state that loss of libido may be permanent. YIKES!

Any thoughts would be greatly appreciated

 

Big Hugs to all

[Altostrata]

The anhedonia and sexual dysfunction you describe are common effects of long-term psychotropics that should very slowly fade over months after you go off venlafaxine.

 

Apathy, anhedonia, emotional numbness, emotional anesthesia 

 

SSRI-induced sexual  dysfunction as an adverse effect

[TaperShaperVXR]

1 hour ago, Altostrata said:

The anhedonia and sexual dysfunction you describe are common effects of long-term psychotropics that should very slowly fade over months after you go off venlafaxine.

 

Apathy, anhedonia, emotional numbness, emotional anesthesia 

 

SSRI-induced sexual  dysfunction as an adverse effect

 

@Altostrata thank you! I appreciate everything you have done for those of us who are surviving antidepressants.