Tips for tapering off Effexor and Effexor XR (venlafaxine)

[Vasherr]

Hi @Altostrata

 

Recently I've found a study where liquid solution was made from crushed extended release beads using Ora-Plus suspension vehicle (which can be bought on Amazon) 

 

https://pubmed.ncbi.nlm.nih.gov/23696051/

 

I am also using Ora-Plus to make a suspension from crushed extended release mini tablets and it seems to work fine I've found a pharmacy recipe for venlafaxine suspension which stated that both immediate and extended release venlafaxine can be used with this vehicle

 

https://www.uspharmacist.com/article/venlafaxine-hydrochloride-15-mg-ml#:~:text=Thoroughly pulverize the venlafaxine hydrochloride,final volume and mix well.

 

I don't know if it should be added to the first post of this thread, some countries don't have immediate release venlafaxine (like mine) so many people could benefit from the knowledge that they can switch to liquid for more accurate dosing and most notably for end game taper.

 

V.

[Altostrata]

On 5/5/2011 at 8:01 PM, Altostrata said:

At the end of the taper: Make a liquid from venlafaxine extended-release beads

If you have generic venlafaxine XR or Pfizer Effexor XR or Efexor XR in gelatin capsules filled with tiny beads, you probably will want to reduce by counting beads for most of your taper. But when you're down to 9 beads, how do you taper by 10%?

 

You can make a liquid with water from those beads. This has been proven to be stable (for 30 days) and effective: Rosa, N. F. D., & Sharley, N. A. (2008). Stability of Venlafaxine Hydrochloride Liquid Formulations Suitable for Administration via Enteral Feeding Tubes. Journal of Pharmacy Practice and Research, 38(3), 212–215. https://doi.org/10.1002/j.2055-2335.2008.tb00841.x

 

When the beads are dissolved in water or pharmacy liquid, the drug become immediate-release venlafaxine with a much shorter half-life. You may wish to take it 2 or 3 times a day (see the section above about immediate-release venlafaxine).

 

[Alfred1977]

On 9/16/2023 at 10:28 PM, Guest said:

While looking for a Venlafaxine XR/Effexor XR serotonin occupancy chart, I found it alongside ones for other drugs.
https://www.nature.com/articles/s41380-021-01285-w/figures/1

 

However, I'd like to see one for Effexor XR that is much more detailed for the range between 0mg and 5mg.

 

Can anyone provide a chart like this?

 

If I got this correctly you can find the related data points for the chart in the article on p. 196. Unfortunately there are only 14 data points for Venlafaxine and this is a rather small sample. At 5mg there is 40% +/-1 receptor occupancy and at 2.4mg there is 25% +/-13 (so i guess 2 data points at 2.4mg with 12% and 38% respectively).

 

I also think it would be interesting to know more about this. And 38% receptor occupancy at 2.4mg sounds terrifying to me. It looks like there is a lot of variation, which would help to explain why some people get off Venlafaxine more easily.

[Alfred1977]

Hello,

this is quite a lot of information and quitting seems to be a tight rope. Reading all this it seems that you have to be prepared to dose fractions of miligrams when trying to quit Venlafaxin (you might be lucky and manage otherwise but who knows), because receptor occupancy is already very high at tiny doses.

 

As mentioned here https://www.survivingantidepressants.org/forums/topic/1596-using-a-scale-to-weigh-and-measure-doses/

weighing is not really an option when it comes to such doses since affordable scales lack the required accuracy.

However weighing could be useful before for stashing and preparing higher doses, especially if it's possible to use empty gelatin (or vegetarian) capsules bought somewhere (as is suggested in the link above).

 

Sry if I missed the answers somewhere, but can you do this with Venlafaxin? Can you fill third party capsules with crushed immediate release tablets or with beads from the Effexor original brand? Would the original beads stay extended release?

 

When it comes to those very tiny doses, what is better, solving immediate release tablets in water or using the beads? Can you take the beads without capsule or would you have to put e.g. 5 beads back into a capsule?

 

If you solve a tablet in water, how long can you use the liquid? For one dose, two doses, three days, one week ...?

 

I think that dosing fractions of miligrams is a pretty tall order and I am pretty scared that the active ingredient won't get evenly distributed when I crush tablets or solve them in water.