Tips for tapering off Effexor and Effexor XR (venlafaxine)

[H8FXR]

@Altostrata @brassmonkey @ChessieCat

 

I need to get something off my mind.  Recently I've really been on a research kick and pouring over the patents for Effexor XR. An issue I can't seem to resolve is whether or not each bead has the same mgai.

 

I weighed until 25mgai/83mgpw, and I have realized that what I have been doing is inaccurate. The reason I believe this to be so is because the beads vary in size, small, medium, large. If they spill out randomly into the scale it will be a different number of beads every time. I see no evidence to believe that bigger beads have more AI. In fact, it seems more likely (from reading the patents) that all the beads start out as "core" or "active" beads (a mix of venlafaxine and methyl cellulose) and then are subsequently receive an XR coat or two (ethyl cellulose and hypermellose). That would suggest they all have the same amount of API regardless of size.

 

So its seems that counting IN beads is the way to go. Taking the same number each day. But I think pharmacokinetics have also to be considered. Since the capsules are filled with an assortment of bead sizes to achieve the proper dissolution rate over 24 hours, I feel the ratio needs to be respected as the dose is reduced. Perhaps there is good reason to sort the beads in the capsule according to size and take a certain number of small, medium and large in the ratio in which they are found in the full capsules. 

 

One of my main concerns is that as one takes fewer and fewer beads the pharmacokinetics are thrown way off. After all the medication wasn't designed to be taken that way. I see a lot of members struggling when they are down to just a few beads and I don't think it's just to to larger drops in sert occupancy. 

 

Would anyone care to comment on this, enquiring minds would like to know?

 

Cheers,

 

H8

 

Effexor XR patent: 

 

https://patents.google.com/patent/US6274171B1/en

 

 

 

 

[OzAnnie]

Hi there H8FXR

I'm really impressed that you've done this research into properties of the beads. It is really interesting!

I have been meaning to post on this site as a few months ago I successfully came off Effexor completely. I wanted to share this so that people struggling to do the same know that it is possible.

Like you, I counted out beads, but I never bothered to weigh them. Towards the end of each drop in dose, I would eyeball the beads and pick out the smaller ones, assuming that the dose in these was less. Perhaps I didn't need to do this after all.

 

As an overall summary of my tapering experience, it took me 2 years to get off 37.5mg. I was tempted towards the end to rush the very small doses, but I committed to the "program" and relaxed into staying on very very small doses for at least 2 weeks before dropping down by 1 bead. My family thought I was nuts, but it worked. 

 

I've been free since Oct 2021. I can be a bit wobbly emotionally sometimes, but I'm pretty sure that's just life's ups and downs. I'm happy to share the minute details of my "detox" if anyone wants that level of detail.

 

I'm grateful for the information and support of this website. I would still be a slave to an unwarranted medication if I hadn't found this site.

 

Good luck

 

37.5 effexor XR commenced approx 2004

Commenced taper October 2019 (counting beads to reduce by 10% per month)

Successfully off effexor Oct 2021

[Altostrata]

Thanks for your research, @H8FXR In bead-counting to taper, we're just doing the best we can. We know it's not perfect. Weighing the beads might also be approximate in terms of active ingredient, but it's a good way to manage the taper because the selection of beads for each dose in random in size.

 

It appears that most people can tolerate the small dosage variations in these measurement approximations. Given half-life of the XR formulations, on the average, the variations might not be of practical consequence.

 

The tiny minority who can detect the difference in active ingredient between one random selection of 10 beads and another probably would be better served by having immediate-release venlafaxine (or pure venlafaxine ingredient) compounded into capsules or made into a liquid to dose more than once a day.

 

However, even for this group, simply pausing the taper and allowing the nervous system to get accustomed to the current level of drug probably will reduce this sensitivity to minute dosage variation.

[rmce72a]

I am beginning my Effexor withdrawal journey and would like to hear from others about their success (or failures) with removing beads to taper off this evil medicine.

[Altostrata]

@rmce72a see above. Others might add to this topic as well.

[rmce72a]

Bead counting question

 

I, am having trouble with bead counting and looking for some guidance. I am tapering Effexor 75 XR name brand. I count every bead in every capsule and divide 75 by the # of beads to get the aprox dose per bead. Example: 255 beads would be .294 per bead. I am trying to hold at 72.9. So in this case I would remove 7 beads (X.294) = 72.9 dose. But tomorrow's capsule is 275 beads (.272/bead) so I need 8 beads which is 72.8. This makes taking the same dose while holding difficult. I am very sensitive to meds and find I am having withdrawals some days because I go from 72.9 to 73. to 72.8 because of the variations in the number of beads.

 

Do you have any suggestions?  Thank you

 

Edited June 29, 2022 by ChessieCat
added topic title before merging with existing topic

[ChessieCat]

30 minutes ago, rmce72a said:

Bead counting question

 

I, am having trouble with bead counting and looking for some guidance. I am tapering Effexor 75 XR name brand. I count every bead in every capsule and divide 75 by the # of beads to get the aprox dose per bead. Example: 255 beads would be .294 per bead. I am trying to hold at 72.9. So in this case I would remove 7 beads (X.294) = 72.9 dose. But tomorrow's capsule is 275 beads (.272/bead) so I need 8 beads which is 72.8. This makes taking the same dose while holding difficult. I am very sensitive to meds and find I am having withdrawals some days because I go from 72.9 to 73. to 72.8 because of the variations in the number of beads.

 

Do you have any suggestions?  Thank you

 

 

There is also this topic.

 

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

 

[JC1957]

Hi all -- I am doing the 10% monthly taper off Effexor.  My reasons are crazy side effects including dry mouth, which is keeping me up at night.  Now, I am feeling awful and wondering whether it's worth it.

If any of you can offer feedback as to 1) is it worth it? and/or 2) did anything like a Prozac bridge help?

Many thanks in advance!

[OzAnnie]

5 hours ago, JC1957 said:

Hi all -- I am doing the 10% monthly taper off Effexor.  My reasons are crazy side effects including dry mouth, which is keeping me up at night.  Now, I am feeling awful and wondering whether it's worth it.

If any of you can offer feedback as to 1) is it worth it? and/or 2) did anything like a Prozac bridge help?

Many thanks in advance!

Hi there JC

Sounds pretty awful! I wonder if you're cutting down too fast. There's no race to the end with this so if you're suffering with withdrawal, go slower.

Good questions: is it worth doing??? Depends how much you hate being stuck on effexor. I have ended up on another drug, Valdoxen, but I'm soooo pleased to be free of effexor. I couldn't even be 2 hours late taking it without experiencing withdrawal. 

I tried a prozac bridge for a couple of days, but I was so out of it, I didn't pursue that line of attack.

Hang in there and good luck

[Rosabell]

7 hours ago, JC1957 said:

Hi all -- I am doing the 10% monthly taper off Effexor.  My reasons are crazy side effects including dry mouth, which is keeping me up at night.  Now, I am feeling awful and wondering whether it's worth it.

If any of you can offer feedback as to 1) is it worth it? and/or 2) did anything like a Prozac bridge help?

Many thanks in advance!

Hi JC,

so sorry to hear you’re not feeling so great. I’m currently doing my second effexor taper. The first time was WAY too fast. From 75mg to zero in two months! Things went completely sideways 6 weeks later and I ended up going all the way back up to 75mg before I felt any better.

It has been just over a year since we started my second taper and I am now down to 32mg. I went faster at the beginning, the symptoms didn’t seem to really hit me at all. But as I get lower, I am only doing 5% cuts, and holding for at least a month, sometimes longer if there is anything I definitely don’t want to have any trouble with, such as vacations etc. This has worked amazingly for me so far, I haven’t had any unbearable symptoms at all.

One thing that recently struck me, is that what some people might think of as withdrawal, might not actually be withdrawals, but just actual emotions able to be felt after years of numbing them! I am feeling so so much more now, and it was a bit scary at first, I forgot about having real emotions!!
Keep going, as slow or as fast as YOUR body and health can handle. It can be done, it’s when we get impatient with our progress that things can take a turn for the worse!

[KayC]

On 1/4/2012 at 10:06 AM, Altostrata said:

If it's the regular form of venlafaxine, and not extended-release, you can cut the tablets up to make smaller doses.

I take the instance release tabs and was cutting/shaving them for awhile to achieve my desired taper weight. Unfortunately, with the inactive ingredients also present, it's hard to get the proper amt of active ingredient in each dose to not throw myself into withdrawals even while holding! I noticed that by grinding my tabs up into a fine powder and using empty gelatin capsules, my withdrawal symptoms were reduced significantly! I just tare the scale with an empty gelatin capsule, and then fill the capsule with powder until I get the correct weight. It takes a bit of practice to get right, but is so worth it!

 

[JC1957]

Thanks, ladies, for all of this wonderful advice.  Tried going with a 5% reduction this very day (I have the caps, not tablet) and am feeling tons better.   Appreciate your insight and kindness.  jc

[gogetter2014]

I think I'm finally at a point where I want to start tapering Effexor XR.  I used to take a 75 mg capsule and a 37.5 mg capsule once a day (112.5 mg/day).  A few months ago, my doctor asked if I wanted to take three 37.5 mg capsules instead so I didn't have two prescriptions and therefore two co-pays.  I switched to three 37.5 mg capsules.  I do have concerns about side effects while tapering and plan to do the 10% reduction of beads every month. 

Seems like it would be easier to begin tapering from a 75 mg capsule instead of a 37.5 mg capsule and later another 37.5 mg capsule.

Any thoughts?

Thank you

[Altostrata]

Hello, @gogetter2014 It's just as easy to taper from a 37.5mg capsule. In fact, you'll want to keep the capsule dosage and manufacturer consistent throughout your taper.

[gogetter2014]

Ok thank you very much Altostrata.