mickt07967: Venlafaxine XR

[mickt07967]

Hi

 

I am currently on Venlafaxine XR ( 150 mg ) and have decided to reduce my dose

as feel in a stable place to try. Me and my doctor decided to taper down using 37.5 mg

XL tablets as this is the smallest dose they do. Anyway I had very bad withdrawl symptoms

which began after about 1.5 days after dropping the dos by 37.5 mg 

 

After about 9 weeks and still suffering from withdrawls I went back up to my normal 150 mg XL

dose which helped. My question is how do I withdraw any less that 37.5 mg as this is the

smallest tablet and I believe you are not able to cut the XR version of venlafaxine XR.

 

Thanks 

Edited June 27, 2016 by brassmonkey
Highlighted important information

[brassmonkey]

Hi Mick-- welcome to the group, I'm so glad you found us.  There are several techniques for tapering small amounts of a drug at a time and we have a lot of information on each one of them.  Before we jump into tapering there is some more information we need to know. Primarily, how long has it been since you reinstated to your full dose?  I edited your post to call attention to the important information so it will be easier for the other mods to find. If you would please add a signature block with all your drug information that would really help.

 

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

Here are some other links that will get you started:

 

Why taper by 10% of my dosage?

 

Tips for tapering off Effexor (venlafaxine)

 

Those will get you started, give them a read and then ask us a kit if questions.

[SquirrellyGirl]

Welcome to SA, Mick!  I am glad you have found us!

 

It would help everyone if you could fill out your signature block with your med and withdrawal history:  Please put your withdrawal history in your signature.  This allows everyone to get an idea of your history at a glance, since it appears below each of your posts.

 

It helps to understand a bit more about what causes withdrawal syndrome to see why tapering more slowly is so important.  Your doctor had you tapering very fast, and though it went okay for the first part, when you got to 37.5 mg, your system was really quite upset about doing with so much less of the drug.

 

Introduction to AD Withdrawal Syndrome

About reinstating and stabilizing to reduce withdrawal symptoms

Why taper by 10% of my dosage?

 

In the reinstatement link, you will see that we often recommend much smaller up-doses to remedy withdrawal symptoms.  People often are able to drop down by larger amounts from the higher doses, but when they reach the Effective Minimum Dose (or in Effexor's case, 37.5 mg), it becomes more difficult because you are really starting to cut into the receptor occupancy (freeing up receptors that had been blocked by the drug).  Couple that with down-regulation due to oppositional tolerance, and things start to get rough!

 

This paper explains why it is so important to go slowly:  http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

See the graphs on page 4 - I believe venlafaxine is the last set of curves.  At 37.5 mg your receptors are still blocked by nearly 80%, and that is just for serotonin.  With Effexor also blocking norepinephrine at higher dosages, you may have been experiencing withdrawal due to those receptors freeing up as well.

 

Now that your system has experienced destabilization, you may be more sensitive to dosage changes in the future, so you may have to go slower below 150 mg this time.  We dont' recommend reducing by more than10% per month, but if you do, you should hold longer between cuts to allow your nervous system to catch up with healing.

 

Here's info about tapering Effexor:  Tips for tapering off Effexor (venlafaxine)

 

 

If yours are the extended release tablets that cannot be broken, they see if your doctor can prescribe the XR capsules with little beads inside.  This allows for reducing by counting beads.  Many of us also weigh the beads to be even more precise in our dosing.  Using a digital scale to measure doses

 

If your doctor can't prescribe you the XR, then the next best bet would be to be prescribed the IR version, which unfortunately then would have to be taken at least twice a day due to the short half life of Effexor.  Any time you do a switch between forms or brands, you should NOT also reduce since simply switching could cause symptoms to arise due to different rates of absorption.

 

This should help with getting you ready to taper:  Preparing to taper

 

If you only recently reinstated, you will want to give yourself at least a month to get good and stable before challenging your system with tapering.

 

Meanwhile, click Follow above to be notified of responses in your thread.  This is your place to document your journey and ask questions. Once you have read the iinks, come back with your questions!

 

SG

[dowdaller]

Effexor is a nightmare to come off, take it slow small tapers the withdrawals are rough.

[mammaP]

Hi Mick,  I tapered effexor and it is difficult with XR tablets but as SG says there are XR capsules that can be opened and then count or weigh the beads.  We recommend no ore that 10% drops with at least 4 weeks between . At lower doses you might have to slow down or make smaller cuts. 

 

In the UK you can also get effexor liquid if your doctor will prescribe it for you. I asked the chemist if it was available and they gave me a note with the brand and dosage ml per mg. Unfortunately I had an allergic reaction to something in the liquid and had to go back to beads. You can also make your own liquid from the immediate release tablets and dose 2 or 3 times a day. Instructions can be found in tapering venlafaxine (effexor) topic, SG has provided the link for you.

 

You need to wait for several weeks to be sure you are stable before starting another taper, prepare carefully and you can get off with little discomfort. 

[blazesboylan]

Hi Mick,

 

First of all welcome. There was a point when I was on 300 mg Effexor. However, I have managed to taper down as far as 80 mg. My advice to you also would be to take it slowly.

 

Back in September I foolishly reinstated from 75 mg to 150 mg on my doctor's advice. I was having a bit of a crisis at the time. I should have reinstated by a much smaller amount. So, it was a step backwards.

 

My experience with Effexor is that the withdrawal symptoms can be intense at times. If 10% cuts are too much you could always make 5% cuts or 10 % every 6 weeks or so.

 

On my current Effexor taper I am thinking that the fact that I am taking mirtazapine and olanzapine may be making the withdrawal symptoms less severe. However, I am not sure if that is actually true. It's just a gut feeling.

 

I take fish oil and magnesium supplements also. I wish you the best of luck