Gloaming: Effexor withdrawal is ruining my life

[Gloaming]

Hi, all. I've been tapering off Effexor XR for the past month. My psychiatrist and I decided together that, after 12 years, Effexor was no longer working for me. She set me up on the following schedule, down from 150mg:

 

Start: 150

Week 1: 112.5

Week 2: 75

Week 3: 37.5

Week 4: Completely off

 

The taper hasn't been going well at all, so she decided to let me have two weeks between reductions. It's helping a little, but not much. After this last taper (to 37.5mg), it's been a nightmare. I can deal with the dizziness, brain zaps, and shakiness, but the constant mood swings are horrible. Mainly, everything (and I mean EVERYTHING) makes me cry. I'll cry for hours at a time. During this episodes, I feel intensely suicidal.

 

Unfortunately, the mental health care system in New Mexico sucks. If you go to the ER with suicidal ideation, they tell you you're not really suicidal and to call your doctor in the morning. The only way to get admitted is to actually make an attempt. Pretty stupid, eh? Calling my psychiatrist doesn't do much good either. I have to go through her medical assistant, and she's terrible at returning calls. Sometimes it takes a week to get back to me, and unless I make an appointment, I can't actually speak to my provider. Appointments are very difficult to get. 

 

I feel stuck. I can't drive because of the dizziness, I can barely eat because my stomach is constantly upset. My anxiety is off the charts. And then there's the crying. I wake up each morning terrified of having another crying jag. I don't think I can handle another one.

 

Has anyone else had this much trouble going off Effexor XR? I'd love to hear from you!

 

[Hudgens]

You're getting withdrawal symptoms because you're tapering way too fast. You should never drop more than 10% of you current dosage at a time. And you should always wait for any withdrawal to pass before the next drop.

What you're doing is no different from going cold turkey.

Small drops and waiting until you're body tells you to make the next drop reduces withdrawal symptoms to being at worst

very manageable, and it greatly lessens the chance of long term withdrawal after the taper. 

[scallywag]

Gloaming, -- Welcome to Surviving Antidepressants (SA)
 
I've moved your post to the Introductions Forum so that more people will see your question.

I hope you'll find the information in the SA forums enlightening and helpful for your taper.  I'm sorry that you are in the position that you need the information, but am glad that you found us.

 

This is a long post. Please read it all and have a look at the linked topics on our forums. SA is a do-it-yourself kind of place and it's important that you educate yourself.
 
Your doctor's recommended "taper" of Effexor is a virtual guarantee of withdrawal symptoms.  Are you tapering off Effexor in order to try something else?  If so, what is the plan? If not, you might consider updosing to one of the previous taper doses.
 
How did you feel at 112.5 mg?  Last week at 75?  You could increase your dose to one of those and it *should* help reduce your symptoms.

 

Getting support from your prescribing doctor on this will be important. Here are some useful discussions
How do you talk to your doctor about tapering and withdrawal

What to expect from your doctor about withdrawal symptoms
 
 I wonder if your psychiatrist has seen this research paper about the relationship between doses and SERT-occupancy (serotonin receptors)? One of the 5 drugs studied is Effexor.
Why taper paper: dose-occupancy curves

For more about withdrawal:

Introduction to antidepressant withdrawal syndrome

What is withdrawal syndrome
 
You may have read already that we recommend calculating next taper dose by cutting 10% from your *current* dose. For the rationale, please read
Why taper by 10% of my dosage?
 
This topic has information relevant to your situation:
Tips for tapering off Effexor (venlafaxine)


 
A request:  Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly? Any drugs prior to that can just be listed with start and stop years. Please put your withdrawal history in signature
 
A few administrative items to assist you:

• You may way want to follow this topic so that you get notifications when someone posts in your thread.  Click the gray "Follow this topic" button. A dialog box appears:  select one of the notify options, then click follow this topic in the dialog box.
   
• Setting this web page as a bookmark or favorite in your browser will help you navigate back to it.

This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.
 
And, FINALLY enough from me. Read, come back here and ask your questions.

[SquirrellyGirl]

Hello Gloaming, 

 

I'm sorry that you have been harmed by your p-doc's reckless tapering schedule.  Suicidal ideation is a serious matter and it is awful that the ER doesn't take it more seriously.  They are always so over-run with emergencies that they probably push those away who are physically intact out of lack of manpower.  Not a good excuse...

 

Well, scally, Hudgeons and myself are all experienced with Effexor, so you aren't alone.  I, myself, went through protracted WD though it presented differently from you in that I didn't have any wd up front - it came on a month or two later with mental confusion and memory problems and built from there.  Effexor is oh so special, being known as one of the worst to come off of.  

 

Though new members really are shocked to learn that they need to taper much slower than ever expected, it really is best, especially for those of us long time users, 12 years for me.

 

Again, I'm glad you found SA!

 

SG

[KerryMM]

OMG, I am so sorry to hear this,

I agree with the above feedback - your taper has been way too fast.

I was also on Effexor for a couple of years (I put on a beautiful 20kg and had other fantastic side effects) so decided I needed to come off.

But the withdrawals sucked so badly - 6 months later I still have nausea/vomiting - sort of motion sickness, even if there is no motion. I have to take motion sickness tablets every day and if I don't, I get nauseus and throw up. No matter what I am doing that day!

 

I am so sorry I cant be of any more help. But please know that you are not the only one. That poison has ruined the lives of so many other people too.

Lots of love and hugs to you xx

[mickt07967]

Hi 

 

I am currently trying to taper Effexor XR from 150mg and my first drop was 37.5mg. It was a horrible

experience and I ended up going back up to my original dose which helped get rid of the withdrawl.

From what I have read it is best to go very very slowly to not suffer from withdrawl.

 

Your taper sounds way to fast and that's why you are suffering so much.

 

My plan is to switch to the standard venlafaxine which you can cut and make very small adjustments

every say 4 weeks or so. 

[aberdeen]

Hello! I'm sorry to hear about your suffering. I have to jump in because i too was a victim of a very similar taper regime from Effexor...told to drop 37.5mg every 2 weeks. i was on 262.5mg at the time. I went all the way to zero in 3 months and paid dearly. I was disoriented, detached from reality, and the anxiety was indescribable, nothing Id ever experienced in my life before, and yes, the suicidal thoughts...I know how terrifying it is. I didnt know any better back then and allowed my Doctors to keep dumping new pills on me, for months, trying this one and the next. If i could go back and do it again i would have re-instated the Effexor a close to the original dose and began a very careful, slow taper. I hope this works for you. I am much better today than i was back then, far more functional and the hideous anxiety is over. I still have some issues as I  recently finished a 4 year taper off Paxil (which was the last drug they tried on me to "cure" Effexor wd). You can do it! I am so much better today than I was in those days. It wont last forever.

[dowdaller]

My taper took about 18 months from 300mg and that was too fast I am off everything 10 months and still have very rough days.The mods on this site are excellent and will give you good advice.

[Gloaming]

 

 

A request:  Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly? Any drugs prior to that can just be listed with start and stop years. Please put your withdrawal history in signature

 

A few administrative items to assist you:

• You may way want to follow this topic so that you get notifications when someone posts in your thread.  Click the gray "Follow this topic" button. A dialog box appears:  select one of the notify options, then click follow this topic in the dialog box.

   

• Setting this web page as a bookmark or favorite in your browser will help you navigate back to it.

This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.

 

And, FINALLY enough from me. Read, come back here and ask your questions.

Thanks for the welcome! I've tried talking to my prescriber about the horrible withdrawal side effects, and she just nods and says, "Effexor is very hard to get off. You should feel better soon." It's crazy. 

 

Oh, about the signature: I've been on dozens of meds/dosages in the past 18 months. It would make a huge list! Should I try to delve into the Walgreens system for everything I've taken, or is summarizing my conditions good enough? Thank you!

[Gloaming]

I'm so frustrated with my psychiatrist. I left a message with her med assistant yesterday requesting that she prescribe the immediate release Effexor tablets so that I can do a slower taper. Her med assistant called back and claimed that no insurance company will cover it. She also told me that I can't open the ER capsules and remove some of the contents (honestly, how does SHE know???). So I called my insurance company, and they DO cover the immediate release version. Left another message for the med assistant. Nothing back so far. I just don't know what to do anymore. It would be nice to see someone who actually knows about withdrawal. Unfortunately, it takes several months in NM to find another psychiatrist, and of course there's no guarantee that he/she would be any better.

 

I see my therapist this morning. Hopefully she'll have some ideas of how to approach this with my psychiatrist (they work in the same office).

[PatriciaVP]

Hello Gloaming,

 

I am so very sorry to hear about your awful experience with this kamikaze taper your doctor has released on you. It's simply criminal how little these professionals seem to understand about how these drugs effect the brain and how much less they know about tapering.

 

My doctor actually wanted me to stop two meds at the same time cold turkey! Yeah, thanks doc for throwing my brain off a cliff! And I pay you for this?!! Fortunately, I had already found SA and knew what a bad idea this was. I was able to force him into a much slower taper.

 

Anyway you've come to the right place.

 

Just hold on, dear Gloamer. It will get better. Keep telling yourself this during the dark hours. You are not alone.

 

Peace, love and healing.

[scallywag]

Gloaming -- Oh the adventures with doctors and their assistants!

 

I had a similar conversation about opening the XR capsules and removing beads when I called Wyeth 12 years ago.  The Wyeth dude on the other end told me "You can't do that." I replied, "Well, as a matter of fact, I am capable of doing it and have been doing so for the last week."

 

Your signature is good. One small edit would make it better for future reference -- put in the date you started the doctor recommended (?!?!?) 4 week rapid-taper. 

[Gloaming]

I talked to my therapist yesterday, and she didn't believe Effexor causes withdrawal. Then again, she's not a physician. It was just disheartening. It's been three days since I started leaving messages for my doctor with no call back.  Three 37.5mg capsules left. Looks like I won't get to taper down from there. I'm so scared. Last time I tapered off Effexor, the jump from 37.5 to nothing landed me in the hospital. I don't know what to do.

[scallywag]

Gloaming, keep insisting on getting a prescription renewal from your doctor either for 37.5 mg/day or 75 mg/day.  If need be insist on an appointment to tell the doc you want to go slower -- that the symptoms -- list and/or describe them to the doc -- are affecting your functioning in your life.

 

I know nothing about medical offices in NM. My experience is that many doctors' offices here (Ontario, Canada) still have fax machines. I have had good response to sending a fax. Because it's usually used for communicating between doctor's offices and from medical labs, the admin staff deals with these promptly. In addition to calling, a one-page fax -- if you have access to sending one --  would emphasize the urgency of this request for you.  If need be, send one twice a day.

 

Another thought: Does the office have an nurse-practitioner who might be able to prescribe for you?

 

For now, don't worry about switching to immediate release. Let's make sure that you've got a supply to hold where you are with XR.

[Gloaming]

Gloaming, keep insisting on getting a prescription renewal from your doctor either for 37.5 mg/day or 75 mg/day.  If need be insist on an appointment to tell the doc you want to go slower -- that the symptoms -- list and/or describe them to the doc -- are affecting your functioning in your life.

 

I know nothing about medical offices in NM. My experience is that many doctors' offices here (Ontario, Canada) still have fax machines. I have had good response to sending a fax. Because it's usually used for communicating between doctor's offices and from medical labs, the admin staff deals with these promptly. In addition to calling, a one-page fax -- if you have access to sending one --  would emphasize the urgency of this request for you.  If need be, send one twice a day.

 

Another thought: Does the office have an nurse-practitioner who might be able to prescribe for you?

 

For now, don't worry about switching to immediate release. Let's make sure that you've got a supply to hold where you are with XR.

This is so frustrating! I have a 75mg refill left, so I should be able to fill that. That will give me some breathing room. I'm looking into changing providers and was told I could get an appointment at this other office in a couple weeks. Hopefully this new doc will be more responsive. This whole thing is really hard to deal with when my emotions are all over the place. I've been crying half the morning just because I can't get a call back. Not like me at all. I miss me!

 

I'll give the fax a try, too. Thanks for your advice!

[Gloaming]

A brief update: my doctor's med assistant finally called me back, and I have an appointment scheduled for tomorrow. She doesn't believe Effexor has bad withdrawal, so I'm not quite sure what to say to her. 

 

I went to another practice today for an intake appointment. They said they could get me with a provider within two weeks. Yay! Except the yay went away just now. They called and said they can't see me at all because of my multiple diagnoses. Also tried the largest psychiatry group in Albuquerque, and they're not accepting new patients. 

[scallywag]

Gloaming:
 
You may want to read and then print out the following research study to take to your doctor's appointment

Why taper paper: dose-occupancy curves

The paper is linked in that thread to download and the first few posts discuss what it means. One of the drugs studied was venlafaxine, aka Effexor.

Have a read of these two threads:

How do you talk to your doctor about tapering and withdrawal

What to expect from your doctor about withdrawal symptoms

 

I had another thought after I clicked post: An American psychiatrist, Peter Breggin, has published a book that recommends a much slower taper that what your doctor advised. His recommendation is to cut 10% of current dose to calculate the next dose.  There's a topic on our forums here about the book:

Peter Breggin in Your Drug May Be Your Problem

[Brandy]

Forgive me if you've already addressed this and I missed it, but it sounds like the prescribing doctor is your psychiatrist. Have you discussed your need to taper more slowly with your regular doctor (PCP, family practice doctor, whatever)?

 

Any doctor can prescribe these meds. They don't need to be psychiatrists. The key would be finding one who will take seriously your symptoms and concern that you would be better off tapering very slowly. If necessary, it might be easier right now to find a PCP/general medicine doc who would be willing to help you with this, than to find another psychiatrist.

 

Just a couple of things to bear in mind -- Be careful to be tactful and not step on any doctors' toes until you find one you feel confident will work with you on your taper in a way you feel comfortable with. Most important thing is not to get cut off of getting your med prescribed since worst thing would be to have to cold-turkey. Frankly, I've found many doctors are very uptight if you see another doctor about anything and then will refuse to see you. But seeing your own (or a new) primary care physician would not be a problem if your prescribing doc is a psychiatrist. No conflict of interest (egos!) there! Then if a PCP will work with you, you can stop seeing your present psychiatrist without risking having your med prescribed. Just be tactful when you talk to the PCP (docs often know each other!). Don't criticize your psychiatrist; just talk to the PCP about how you feel your system is very sensitive to tapering and see if they will prescribe or support you in doing a slower taper.

[Gloaming]

Forgive me if you've already addressed this and I missed it, but it sounds like the prescribing doctor is your psychiatrist. Have you discussed your need to taper more slowly with your regular doctor (PCP, family practice doctor, whatever)?

 

Any doctor can prescribe these meds. They don't need to be psychiatrists. The key would be finding one who will take seriously your symptoms and concern that you would be better off tapering very slowly. If necessary, it might be easier right now to find a PCP/general medicine doc who would be willing to help you with this, than to find another psychiatrist.

 

Just a couple of things to bear in mind -- Be careful to be tactful and not step on any doctors' toes until you find one you feel confident will work with you on your taper in a way you feel comfortable with. Most important thing is not to get cut off of getting your med prescribed since worst thing would be to have to cold-turkey. Frankly, I've found many doctors are very uptight if you see another doctor about anything and then will refuse to see you. But seeing your own (or a new) primary care physician would not be a problem if your prescribing doc is a psychiatrist. No conflict of interest (egos!) there! Then if a PCP will work with you, you can stop seeing your present psychiatrist without risking having your med prescribed. Just be tactful when you talk to the PCP (docs often know each other!). Don't criticize your psychiatrist; just talk to the PCP about how you feel your system is very sensitive to tapering and see if they will prescribe or support you in doing a slower taper.

In theory, it's a great idea, but the practice I go to also has PCPs. And mine is one of them. They aren't allowed to deal with the psych end of things. But thanks for the idea!

[Gloaming]

Gloaming:

 

You may want to read and then print out the following research study to take to your doctor's appointment

 

Why taper paper: dose-occupancy curves

 

The paper is linked in that thread to download and the first few posts discuss what it means. One of the drugs studied was venlafaxine, aka Effexor.

Have a read of these two threads:

 

How do you talk to your doctor about tapering and withdrawal

 

What to expect from your doctor about withdrawal symptoms

 

I had another thought after I clicked post: An American psychiatrist, Peter Breggin, has published a book that recommends a much slower taper that what your doctor advised. His recommendation is to cut 10% of current dose to calculate the next dose.  There's a topic on our forums here about the book:

Peter Breggin in Your Drug May Be Your Problem

Thanks! It was very helpful. 

[MostlyAlive]

Hi. I Just went through this for about a month. Horrible. Horrible. Horrible. And I have a reasonable Dr. Thank god you have the 75s.

I got down below 37.5 and crashed in May. Went back up to 75 basically and am taking olazapine to help me sleep. Hopefully this is only for the short term. I think its worse than Effexor but it help me survive. Keep in touch.

[Gloaming]

Just a quick update: My doctor gave me another month of the 37.5 mg capsules. She's still not addressing the taper, though. She said she doesn't understand why I'm having a hard time. Luckily I feel more acclimatized to this low dose now. I might start opening up the capsules and tapering that way. She still expects me to go off the 37.5 mg all at once, which makes me really nervous. Thank you to everyone for all your support!

[scallywag]

Gloaming, I'm glad you've got 37.5 mg XR capsules now.

Give yourself at least a month if not two so that your CNS (central nervous system) can catch up to the dose changes you've made so far.

Then if your symptoms have resolved or stabilized to a WD-normal, you can look at tapering. To taper from 37.5 mg, people either

• count beads or
   
• switch to IR (immediate release) and either weigh doses or make liquids.

 

For your reference:

 

Counting beads in a capsule versus weighing

Using a digital scale to measure doses

Making a liquid from a tablet or capsules

[SquirrellyGirl]

Just a quick update: My doctor gave me another month of the 37.5 mg capsules. She's still not addressing the taper, though. She said she doesn't understand why I'm having a hard time. Luckily I feel more acclimatized to this low dose now. I might start opening up the capsules and tapering that way. She still expects me to go off the 37.5 mg all at once, which makes me really nervous. Thank you to everyone for all your support!

 

You might print off this article and show it to her the next time you go in.

 

http://ils.unc.edu/bmh/neoref/this.dir.unneeded/schizophrenia/review/tmp/352.pdf

 

See page 6 for the graph for Ven.  Note that at about 37.5 mg occupancy is about 75%.  That means going from 37.5 to 0 means freeing up 75% of your serotonin receptors all at once.  You don't even have to have a discussion with her about it.  Highlight the section of the graph that is between 0 and 37.5 on the x axis and 0 and 75% on the Y and write:  this is why it is so hard to come off the minimum dose underneath.  Ok, maybe that won't get you anywhere but it's fun to fantasize about the doctor seeing that and having a d'oh! moment!

 

;-}

 

SG

[scallywag]

Hi Gloaming. How are things going for you?

[primekittycat]

Totally feeling you Gloaming, read my signature for my horribly fast Effexor XR taper and withdrawal experience. It is very hard to find a p-doc or even a therapist that knows about these withdrawal symptoms. Thankfully my p-doc is open to it and has been willing to prescribe me the 37.5mg doses now that I am below half of my original dose. I weigh my beads using the recommended scale in the links given above. It is worth it to reinstate and then take it slow. I noticed it is getting harder now that I'm below 37.5mg - the graphs SquirrellyGirl posted are my truth right now!

[Gloaming]

Hi Gloaming. How are things going for you?

 

NOW, I'm doing ok. Friday was a nightmare. My doc prescribed me Pristiq, swearing that because it's close to Effexor, I wouldn't go through withdrawal. Boy, was she wrong! By Friday I was a total wreck. She told me to go off the Pristiq and go to urgent care ASAP. I put myself back on the 37.5 dose again and was fine a few hours later. Next week is foot surgery, so I don't want to make any med changes for a while. Thanks for asking!

[Gloaming]

Totally feeling you Gloaming, read my signature for my horribly fast Effexor XR taper and withdrawal experience. It is very hard to find a p-doc or even a therapist that knows about these withdrawal symptoms. Thankfully my p-doc is open to it and has been willing to prescribe me the 37.5mg doses now that I am below half of my original dose. I weigh my beads using the recommended scale in the links given above. It is worth it to reinstate and then take it slow. I noticed it is getting harder now that I'm below 37.5mg - the graphs SquirrellyGirl posted are my truth right now!

 

Yeah, it's AWFUL. Does your p-doc support weighing the beads? I want to do that, but I'm afraid to tell her!

[scallywag]

OMG the last thing you need is to switch drugs.  I'm glad you had the sense to stay with Effexor. The game and the goal now is stability.  Then once you've stabilized, you can start to slowly reduce the dose.

[primekittycat]

 

Totally feeling you Gloaming, read my signature for my horribly fast Effexor XR taper and withdrawal experience. It is very hard to find a p-doc or even a therapist that knows about these withdrawal symptoms. Thankfully my p-doc is open to it and has been willing to prescribe me the 37.5mg doses now that I am below half of my original dose. I weigh my beads using the recommended scale in the links given above. It is worth it to reinstate and then take it slow. I noticed it is getting harder now that I'm below 37.5mg - the graphs SquirrellyGirl posted are my truth right now!

 

Yeah, it's AWFUL. Does your p-doc support weighing the beads? I want to do that, but I'm afraid to tell her!

 

 

She was iffy about it because it would be very easy to make a mathematical mistake and it's also very time consuming. I told her that I don't mind doing it because it means I won't feel like crap. She is also worried that I'll spend so much time tapering (it's already been a year and have maybe 1.5 more to go), what if when I come off, I have to go back on. The goal is to not ever go back on!

[SquirrellyGirl]

The alternative to the very long taper isn't pretty!  After 10 months of PAWS (protracted antidepressant withdrawal syndrome), I reinstated and fortunately it worked.  I wish I'd known about the slow taper back then.  It's a tough pill to swallow, I know.  I'd been on Effexor for 12 years and others for 8 prior to that, so in the scheme of things it just is what it is.  I have to remind myself that every month that I am on less of the drug is better than staying on the higher dose for the rest of my life or getting caught up in the medi-go-round because of poop out and docs switching or adding more drugs to deal with the poop out and side effects.  Way better.

 

When I reinstated at 37.5 mg and everything became right as rain, my p-doc automatically, without question as to whether the current dose was adequate, raised me to 75 mg, and said that other meds might need to be added ( I complained of sexual side effects which plagued me all those years).  I guess he thought there was something that could be added to address that.  Now I know that was a load of bull!  I learned about PAWS and this site three days in to 75 mg and immediately went back to 37.5 mg with the intent to get off these meds!  There was no asking him if he thought that would be ok.  I just DID it.  I got a scale and started weighing beads.

 

My doc knows I am coming off and is ok with it, but thinks I'm OCD for doing it so slow and weighing dosages!  He thinks anything past 6 weeks off is "something else."  So, I use him.  When I go for med checks, I tell him everything is fine, knowing that if I tell him anything about wavy symptoms he'll want to throw a drug at it rather than admit it could be withdrawal.  So it goes.

 

SG