Proteus: stable on 37.5 mg effexor over 8 years, planning final taper

[Proteus]

I have been through a very stressful period of my life over the last few years and in recent months my life has stablised and I am starting to do well. For over 8 years I have been on a maintenance dose of efexor of 37.5 mg per day.

 

Over all the years of being on efexor I have been very careful not to take my daily dose outside of my regular time frame as I have been very scared of withdrawal effects which often start rapidly after the 24 hour dose has left my blood stream. This explains my resistance to the idea of weaning off finally. The symptoms I usually experience when coming off or forgetting to take my daily dose on time has been harsh. Brain zaps, vertigo, anxiety, disorientation, depression, and a sensation of popping in my brain. I have always thought of efexor as being particularly evil in that it keeps one enslaved to it while there appears to be no apparent dependence or need to stay on it until one tries to come down.

 

My questions is. Do you think I should consider starting to wean off completely and if I do, how should I go about it?

 

I know that I have been stable on this dose for many years, and also know that if I even want to consider starting to taper I have to be mentally and emotionally strong which I think that I am finally ready to do.

 

I successfully managed to stop smoking after smoking for 35 years about a year and a half ago so I think that I have the mental and emotional strength to tackle this challenge now.

[bubble]

Welcome Proteus!

 

Many of us here wish we had come across this forum before coming off our medication. So I can only say you are in a great situation to learn from the wealth of knowledge gathered here as well as benefit from amazing support BEFORE experiencing the agony of a fast taper (advised by doctors) as most of us here...

 

More experienced members and moderators will come with more advice but usually we start with links with extremely valuable tips on how to taper each particular drug.

 

Below is the link about Effexor. 

 

If you have any particular concerns or fears, please write freely about them and you will meet a lot of people with very similar experiences.

 

http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/

 

best,

bubble

[Proteus]

Thank you Bubble for your kind welcome and helpful reply 

[mammaP]

Hi Proteus, welcome to SA. It's great that you found us before starting your taper, most of us 

arrived here in withdrawal! 

 

You are right that effexor is a nasty drug to get off! I've been tapering for almost 2 years but getting there.

It takes time but is well worth the slow taper. I made the mistake of stopping too soon but the withdrawal

was horrific and had to reinstate. Just 5 beads, and I thought I would be ok to stop there! I don't know if

liquid is available where you are but it would be much easier for tapering at the lower doses.  We 

recommend no more than 10% reduction of the CURRENT dose every 4-6 weeks or so. 

 

 

Have a good look around, especially the tapering topics, there is a huge amount of information in there. 

http://survivingantidepressants.org/index.php?/forum/14-tapering/

[Proteus]

thanks mammaP

 

I am pleased to announce that it has been 4 days since I started my taper. I am removing 5 beads every day off my current capsule of 37,5 mg venlor (venlafaxine-generic effexor). So far no serious problems to date. I had a period of reactive anxiety last night after some tension with my partner, but it passed. I believe that I will make it. I will keep updating my progress here. I had feared the awful brain zaps and disorientation and vertigo associated with withdrawal from effexor, but thankfully none of that has happened.

 

And will under advisement from peers in the forum proceed to taper off another 5 beads after 4 to 6 weeks.

 

Its good to know I a not doing this alone like I did the first time.

 

And in fairness to my partner, if it was not for her I would never have been mentally and emotionally ready to start my final taper. She has been a pillar of support and belief in my ability to make it. But now I think I have to develop my own momentum with support gained in the forum, so that she does not feel burdened by my withdrawal and bears the brunt of support alone.

[mammaP]

Hi Proteus, thanks for updating us. I'm glad you have started your taper low and

it is going well for you.It is early days but stick at it and you will be fine. If you do

start to feel withdrawal, slow down a bit and you will soon start to see a pattern

emerging. It is usual to feel a little bit of change a few days after a cut but it quickly

settles as you have found.  If it persists then that drop was probably too big. 

5 beads is a small amount and you should be just fine but as you get lower down

you will need to reduce by less.  

 

Keep us posted won't you? 

[Proteus]

yes I will keep you posted

 

I will especially await your feedback should I make any further adjustments

[Proteus]

Dear all

 

I thought that it my be helpful to share more about my life. I had a breakdown at 35, 15 years go. I was in a very stressful job situation and my personal situation was very challenging. Some months after starting to see a psychiatrist and going on meds, I cracked up completely, and went into free-fall. I was put into early retirement by my employers as a result.

 

A year or two later I was doing a course in social work and then worked in a part time job at an NGO. After a year I resigned after a conflict of interest arose between me and my employers, and then for many years until recently was an activist for human rights for people with mental disabilities. Eventually I ended up in a senior position in an international organisation and spent many years being active in it which resulted in travelling frequently, and getting to see the world.

 

All the time I was in a marriage with a wife who was very abusive and controlling, and I accepted my abuse on an emotional and sometimes even physical level because of my kids. I divorced a few years ago and am now with a loving partner who is very supportive and caring. The challenge with many people  is on the social and psychological level to get out of the mental conditioning which society places on most of us as being disabled and no use for life. This is by far the experience of most people on the planet who have experiences like ours, and I think that the middle classed and comfortable people like ourselves who have time to engage in bourgeois forums like this is not representative of the experiences of most of our peers who are grey little people which society have jettisoned and pushed aside.

 

Be that as it may, I am slowly starting to try to instead of being a political and social activist and commentator to start dealing with my personal subjective experiences and I find this forum very very helpful to help me to reach into the deeper recesses of my psyche and to make sense of it and to start in a self help with support way, to break those social and psychological chains which were placed on me my a system which left me on the margins of mainstream society.

 

Getting divorced was an important first step in my reinventing. Now I am at 50  in a new and loving relationship and also starting to see myself as a normal non disabled person who can and must like everyone else work and be social and live a fulfilled life like everyone else.

 

My challenge is that I was married for 26 years and even before while courting I was not allowed by a very jealous and insecure partner who controlled me so that I never developed adult social networks and experiences, and that even while running organisations my ex wife violently (verbally and sometimes physically) would push away all the people I was engaged with.

 

Now I am with my new partner who is the best thing that ever happened to me and some of that bad conditioning is starting to stifle her and make her feel overcrowded. for years I was made to believe that doting attention was my role in the world and that it was bad to be expanding my social network, Now my partner expects that and my conditioning is that I have to devote my time and energy to being mostly with her to show my loyalty and devotion.

 

On another level, my withdrawal continues with no serious challenges as yet but I wonder if the intensity in my relationship now is not also as a result of the tapering, as I am tending to be more sensitive and overreact to small things which normally I would overlook.

[Proteus]

Quick update:

 

After just over two weeks of a reduction of 5 beads per day off my 37, 5 mg venlor, all is well. No serious issues as yet. I had one or two episodes of brief downers where I felt slightly depressed, also once felt brain twinges, probably because I took my daily dose a bit later than usual.

 

On the personal side I would like to share that about a year and a half ago I stopped smoking after having been a smoker for 35 years. I stopped smoking prior to my having to have chemotherapy. I had to undergo two cycles of BPE chemotherapy after routine blood test showed an increase in my blood tumour markers. Two years ago I had testicular cancer and had to undergo surgery to have the cancerous ******** removed. So fat I am doing well and am recovering on all fronts.

[bubble]

This looks like a very nice and patient story of a veteran in tapering

 

It's amazing how you managed to take charge of your own 'treatment' and intuitively found a way of coming off of so many drugs before they caused too many problems.

 

It's also great that you have developed those insights regarding the need for you personal growth and changing patterns.

 

best of luck on your journey!

 

bubble

[Altostrata]

Welcome back, Proteus. Good to hear you're doing well.

 

You may wish to slow down now on reducing Effexor. Please read http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/

[Proteus]

I am doing fine with my tapering so far

 

Initially on Feb 14 I went down 5 beads, stayed at this strength for 4 weeks. Then decided to test the upper limits of my taper and went down another 10 beads this time. I experienced no withdrawal problems apart from my normal periodic fragile period which happens to me once a month for a day or two.

Three after the last taper I went down another 5 beads, held there for another 3 weeks and then went down another 5 beads. This brings me to the current stage of my withdrawal and I am now in my second weeks of going down at the current level of a total of 25 beads per day.

I plan to hold here for another 2 weeks then will take out another 5 beads per day from my capsule. I have bean saving the beads that I am removing for the time when I will be on very low doses. So in summary I have reduced my daily does by a total of 20% after starting my taper on Feb 14.

 

I hope to be totally drug free one day,but am not planning to rush things. I am just blessed to have found a safe and supportive situation in my life where I felt enough courage to tackle this final challenge of after many years to come off psych meds completely.  I am not a great writer in this forum, but I keep one eye out on following safe withdrawal as advised here. I have however over the years already did extensive reading on how to withdraw, but the forum has the most careful and meticulous approach to this I have ever come across.

[Proteus]

I dont know what happened but I made some errors in my update above. Here is the corrected text copied and pasted below.

 

I am doing fine with my tapering so far.

 

Initially on Feb 14 I went down 5 beads, stayed at this strength for 4 weeks. I then decided to test the upper limits of my taper and went down another 10 beads this time. I experienced no withdrawal problems apart from my normal periodic fragile period which happens to me once a month for a day or two.

Three weeks later I went down another 5 beads, held there for another 3 weeks and then went down another 5 beads. This brings me to the current stage of my withdrawal and I am now in my second weeks of going down at the current level, i.e. removing 25 beads per day from my capsule of 120 beads (a 37.5 mg dose of venlor, the generic of effexor contains 120 beads).

I plan to hold here for another 2 weeks then will take out another 5 beads from my capsule. I have been saving the beads that I am removing for the time when I will be on very low doses. So in summary I have reduced my daily dose by a total of 20% after starting my taper on Feb 14.

 

I hope to be totally drug free one day,but am not planning to rush things. I am just blessed to have found a safe and supportive situation in my life where I felt enough courage to tackle this final challenge of after many years to come off psych meds completely.  I am not a great writer in this forum, but I keep one eye out on following safe withdrawal as advised here. I have however over the years already did extensive reading on how to withdraw, but the forum has the most careful and meticulous approach to this I have ever come across.

 

Just some further sharing I would like to do at the moment. And hopefully I will get some feedback which could help me make sense of myself. I haven't worked full-time since my breakdown in 1999. As a former teacher I used to be a person who did head-work but for years find head-work hard and I tend to become quickly muddled and incoherent, making many mistakes and typos when I try to write anything. I do however find that I have better focus when I do physical work as opposed to head-work, especially if the work is repetitive and does not require too much cognitive input.

 

I am a lost cause? Any suggestions on what I could do. I like to think of myself as a person who trained and worked professionally using my head. Is there anyone in the forum who can share with me some insights on this topic. Are the changes which result from a emotional breakdown or burnout or whatever it is called, similar to brain damage, and is this damage permanent?

[Proteus]

A case in point: I again made a mistake even after re-reading . I'm not in withdrawal. On the contrary, I have no symptoms whatsoever. I meant to say that brings me to the current stage of my TAPER not withdrawal 

 

maybe the mush in my head is a withdrawal symptom? But I've been like this for many years now...

[Altostrata]

That's excellent news, Proteus. Carry on!

 

Could you find some part-time work that would keep you physically active but allow you to use your head? Perhaps start as a volunteer, for example, putting books back on shelves at the library, work up to a real part-time job, then a full-time job?

 

Do not worry about being perfect or demonstrating how knowledgeable you are. Let that come naturally. You will find your niche.

[Proteus]

Thanks Alto

 

This encouragement means a lot to me. For 10 years I had been a volunteer, and became a leader in an international NGO, but all that has been too much. I just want to settle down still using my intellect but mostly doing things which make me feel valued and having a purpose in this world.

 

I was just becoming a bit downhearted, but I know that I have a lot to offer still.

 

I am just so lucky having met a wonderful new partner in my life who has made such difference to me. Now I just want to show her what I can do, for her and my own sake.

[Altostrata]

Just start with what you think you can do and would enjoy. Do you like animals? You could help at an animal shelter, or walk dogs in your neighborhood as an odd job.

[Lexy]

Proteus

How are you doing currently?

I'm also trying to taper off effexor. Removing only 1 or 2 beads brings wds. Are you taking any supplements?

[Proteus]

Proteus

How are you doing currently?

I'm also trying to taper off effexor. Removing only 1 or 2 beads brings wds. Are you taking any supplements?

Hello Lexi

 

So far so good. I am currently on a 37,5 mg capsule of venlor and have removed 30 beads so far. going down 5 beads at a time. No noticeable withdrawal symptoms since  I started tapering on 14 Feb. I have decided to go down another 5 beads tomorrow after just two weeks at the current level.

 

I am confident that I will do fine. I will hold for two weeks and then go down another 5 beads.

 

Wishing you all the best. Hold as long as you need to before attempting further tapering if you still experience withdrawal effects. That would be the safest.approach

[Lexy]

Thanks

Let me me know how it goes.

I understand ghr lower the dose the slower it he taper...but I am already going so slow.

[Proteus]

UPDATE: Long overdue!

 

Over the last months I have been coming down at the slow rate of 5 beads every two weeks. A month ago I felt some anxiety which was unlike my normal states so I decided to slow down my taper rate. I held for a week longer this time and finally have come down to 63 beads per day, which is exactly half my original dose which I started on back in February. I also plan to switch from the venlor capsules to the generic tablet,which is easily snapped into two. I plan to hold here for some months, and then make a solution of the tablets and start on liquid doses when I resume my tapering.

 

I guess that my recent wobbly with anxiety and other mild but worrying withdrawal symptoms, are indicating that I am nearing the OH NO POINT, so it would be prudent to for the meantime hold for long in order for my brain to adjust.

 

I am struggling to update my signature. Can anyone help me?

[mammaP]

Hi Proteus, glad that you are doing ok. You are right to hold for a while and I would

hold for at least another month before attempting another cut. In my experience

it is the lower doses that cause more problems and need longer holds. It's a

good idea to dissolve the tablets to make a liquid, it is much more accurate than 

counting beads because the beads vary in size and I can feel it if my little beads

are too big or too small! 

 

Changing your signature........I'll just have a play with mine because I've forgotten! 

Click your name at the top of the page....click settings, then signature on the left.

 

Your signature appears at the top of the page with a box underneath to make changes.

Click save changes when you have finished. 

[Proteus]

UPDATE:

 

Dear all

 

Since my last update I have been on a year long hold from September 2014 until September 2015. In the meantime lots of things happened in my life, Very positive but quite demanding and stressful. I moved to a foreign country and started teaching at a primary school at the start of May this year. I live alone without my wife but I am now economically empowered and have already gone home to spend time with her during the summer in August. Next we will be together during my winter break for a few weeks.

 

In September I started my next phase of tapering. For two weeks I adapted to making liquid solutions of my tablet. I diluted one 37.5 mg tablet in 37.5 ml of water, and then got used to taking two daily doses of 9.375 mg (9.375 ml per dose), which means 18, 75 mg per day. After two weeks I started my first cut going down to 9 mg per dose. Since then my routine has been coming down every two weeks by 5 mg per dose. Last week I went down to my current level of 7 mg per dose. I am able to get 5 doses from one tablet now. I have not had much problems since I started my current taper. Last week however I experienced the occasional low and also anxiety which makes me feel unable to function until it passes thankfully within the hour. So I have decided now to hold for an extra week. So I will hold at the current level of 7 mg per dose for the next two weeks, when I will continue with my taper and will go down to 6.5 mg per dose. Its been 16 years since I have been on psych meds and its been about a decade that I started coming off meds.

 

For me its been characterised my slow and careful tapers with holds of years in between until I felt mentally, physically and emotionally ready to continue to my next target.

 

Not sure when I will finally be medication free. But the end is now in sight.

[Proteus]

Appears I wrote the wrong amount in my update above. My cuts every two weeks are to come down by 0.5 mg per dose and not 5 mg.

[AliG]

Hi Proteus,

It sounds like you are doing very well. You have tapered in an extremely slow and steady fashion, with long holds in between. This method, not surprisingly has worked for you. It's encouraging that even with the stress of your life changes, you are managing so well. I hope your recovery continues on a smooth path . Thank you for the update. 

 

Ali

[bubble]

It's nice to hear from you Proteus and especially to hear that you are doing so well.

 

We don't often hear that people do such a slow and controlled taper so it's great to see that patience pays out and rewards us with so few symptoms and an improved quality of life.

 

Can you please update your signature to reflect the changes over the past year? Just keep it slow and let us know how you are doing. 

 

We need more stories like this. 

[Proteus]

I am making this update after a very long time. I have been coming off very slowly ever since. My current dosage is 9.2 mg per day, which I take in two doses (morning and evening) in liquid suspension of the tablets.

I received new packets of the XR version and in capsule form.

 

I probably could count the beads or try dissolving the beads for 24 hours.

 

What would be the best to do under the circumstances?

[Proteus]

I just checked the capsules

They have three mini tablets inside each of them which means that each mini tablet is 12. 5 mg.

 

That leaves me with a challenge to get to my current liquid dose of 4.6 mg in the morning and 4.6 mg at night.

 

It could however work if I dissolve 1 tablet in 12.5 mg of water.

 

Will the mini-tablets dissolve?

[scallywag]

Were you taking the brand name Effexor XR previously? 

How have you been creating your 9.2 mg doses?

 

The capsules with "mini-pills" are from a generic manufacturer.  Sometimes prescription drug insurance will only cover a prescription if a low(er) cost generic is substituted for the brand name drug. Under certain policies, the insurer will cover the brand name if the doctor specifies it on the prescription.

Edited July 16, 2017 by scallywag
deleted incorrect statements

[Proteus]

Thank you very much scallywag for taking the time to reply.

 

When I started tapering I had Effexor XR capsules with many beads which I gradually removed. When I reached half of the beads I switched to the immediate release and started taking half of the tablet by dissolving it in water. I used dilution of a 37.5 mg immediate release tablet to taper from 19 mg to 9.2 mg. At that time I was in Europe and they had immediate release tablets.

 

In January I ran out of immediate release tablets and my GP in South Africa couldn't find any immediate release Effexor available on the market in South Africa. What I got where XR capsules with 2 small tablets inside.

 

I dissolved those small tablets in water and started taking my dose as before measuring 9.2 ml out of 37.5 mg capsule dissolved in 37.5 ml of water.  

 

I switched from dissolved immediate release tablets to dissolved XR tablets from a capsule on 11 February (12 days ago) and haven't noticed any change in my symptoms: I remain to be symptom free. On 20 February I made my regular monthly reduction from 9.2 mg to 8.8. mg and I don't have any symptoms.

 

I read on the thread about tapering Effexor that XR cannot be made into a liquid but unfortunately I couldn't find an explanation why. Did you mean to say that Effexor XR shouldn't be dissolved in water?

 

I'm quite anxious of what is going to happen and whether this will ruin my so far smooth tapering but I had no choice: I couldn't get hold of immediate release tablets and there is no other way I can get my current dose of 9.2 my of active ingredient from 3 small pills inside a 37.5 mg XR capsule.

 

I will keep you updated.

Edited July 16, 2017 by scallywag
deleted quote of immediately previous post for readability

[scallywag]

Okay, I've refreshed my information and memory. Dissolving Effexor XR in water removes the time release coating and makes it immediate release.  [statement is incorrect]

Correction: The time release coating is affected by liquid but is not removed. When the beads come in contact with liquid the coating becomes permeable. The active ingredient, venlafaxine, can now gradually diffuse out of the bead(s) as the beads move through the digestive tract.

 

Immediate release venlafaxine is usually prescribed to be taken twice a day because of its very short half-life of 4 hours.

 

The safest way would be to continue with the liquid dosing. If you haven't had any problems so far, GREAT! 

 

If you do run into interdose withdrawal symptoms, then consider splitting your dose in two and taking ½ at the time you take it now and the other ½ approximately 12 hours later. When reducing with a split dose, you could reduce each ½ dose by 10% to get the total 10% reduction in daily dose.

Edited July 16, 2017 by scallywag
corrected statement about extended release coating