Altostrata

Tips for tapering off Effexor and Effexor XR (venlafaxine)

180 posts in this topic

Thanks for your reply, Peggy.

 

To clarify, are you recommending staying at 3 week reduction intervals?

 

Or that one should do three complete intervals before reducing to a shorter interval time (i.e., my partner should consider doing 3 rounds of two week reduction intervals before dropping down to one-week reduction intervals)?

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Peggy is right Poppy, we do not recommend reducing the time between cuts. I did just fine with my tapering of effexor but it caught up with me because I went too fast. I also had bad withdrawal and it took a long time to stabilise properly again.  No more than 10% cuts of the current dose with at LEAST 3 weeks between cuts. Any withdrawal symptoms that pop up are a sign that he is going too fast and needs to slow down. 

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Generally, we advise reductions at intervals of a month. This is very conservative and accommodates most people except those at the extreme edge of the curve representing sensitivity to dosage reductions.

 

On the other hand, by listening to their bodies, many people might be able to taper faster. LovingSupport's partner is following a reasonable schedule adapted to a higher tolerance for dosage reductions.

 

However, even if you're highly tolerant of dosage cuts, I would not reduce any faster than every 2 weeks, to give your nervous system and the rest of your body a chance to adapt to the new drug levels.

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Thank you, Altostrata, MammaP, and Peggy for your thoughtful consideration. We are going to stick with the current 2-week reduction schedule (10% of current dose, each time), based on your input.

 

If someone is going to have withdrawal issues while following the protocol, is s/he more likely to experience it down at the lower end of the titration process? (ie, when down to 25% of original dose rather than at 75%). If yes, as my partner gets down to lower dosages, we may consider going back up to 3 week intervals (he's at about 70mg of Effexor XR, down from 150mg).

 

Thank in advance for your help on this!

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Yes, it seems the last leg of the taper can be more difficult.

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We just did the math looking at the Dose Weights calculation chart from the SA site. At a two-week interval reduction schedule, it will be longer than a year to get down to 1.5mg of Effexor XR from today's 64.6 mg  downward. My partner has already be reducing for the last four months, so this whole schedule might take a full year and a half.

 

The emotional disappointment is strong realizing this.  We talked about working down slowly to 10 day intervals, so that the "jump off" point is not soooo far away (assuming all goes smoothly). Another full year feels like a very long time, considering he was on the AD for 13 1/2 months before starting titration--less time than the titration will potentially take.  

 

Any and all advice, wisdom, experience is greatly appreciated.

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well, from my past experience one and a half years is not long!  I used to think the same thing and would speed up (as i was feeling fine with no apparent withdrawal symptoms) until i went too far and got slammed with anxiety and depression.  Then i would have to updose and stabilise for a few months and then begin the process again - so i am now 3 years since i found this site and still almost back where i started - if i had stuck with a 10% plan i could be off now.  

 

As your partner reduces the side effects of the medication will also reduce; if you can go slow and avoid any potential problems a year and a half out of your life is nothing!

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People vary in their tolerance for tapering. Some need to go slower and others can go faster.

 

Here's the thing: You cannot tell which you'll be, and once you develop withdrawal symptoms, it can be too late for an easy correction.

 

That is why we recommend these slow tapers, to stay out of trouble. Speeding up a taper is entirely at your own risk.

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I know how you are feeling....I was only on effexor for 7-9 weeks egrb I cut my dose in half. I've been decreasing since jan 2013. You can risk getting wds. If he is tolerating the tapering at the rate this forum suggests, then he has a better chance of getting half as bad as some of us here are. May I suggest setting mini goals?

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Oops sorry typing from my phone and my vision is not as good as before effexor.

I meant if he following this forum's tapering advice then he will not be half as bad as some of us here are.

Good luck!

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Advice heeded. "Slow and steady wins the race", so to speak. Love the idea of "mini goals"; good reminder for us all to celebrate the micro-gains.

 

Thanks, everybody.

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My partner is on the "slow titration train" off of Effexor XR. He started at 150 mg, is now down to 27.8mg. At what mg amount might you recommend him migrating to either non-XR to make liquid form for more precise measuring? Or would you suggest staying as long a possible on the XR scale measuring? We weighed out what 1.5 mg would be, and it seems to be about 4 beads of the Effexor XR brand he is taking. (We have been ordering the same brand at an independent pharmacy from near the beginning of the titration, to stay consistent.)

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Good to hear, LovingSupport.

 

Is your husband tapering by 1.5mg at a time?

 

At 27.8mg, a 10% reduction would be 2.78mg (you calculate the 10% based on the last dosage, not the initial dosage). A reduction of 1.5mg would be even more gradual -- that's fine.

 

Hi Altostrata, thanks for responding.

 

No, he is tapering at the 10% of last dosage each time, as SA recommends. The 1.5 mg is the lowest amount listed on the Excel spreadsheet y'all graciously provided on this site, called "Dose_weights_SA.xls".

 

(Side note to those who have not found/used this spreadsheet yet--it's amazing and will save you a big headache trying to calculate each reduction on your own).

 

I'm trying to assess whether he should simply stay on the scale method all the way down to the last 1.5mg dosage weight listed, or make the transitional switch to liquid at a higher weight to stay more exact. He's free of withdrawal symptoms at this rate, and I want to keep it that way as the reductions continue when possible.

 

I know that as the dosages get lower, the accuracy range of the scale's range of variance will get proportionally less accurate. (for example, a .001g or .skipping around a 003g variance in weight is more significant when one is measuring a total weight of .007g).

 

 

Thanks in advance for your input.

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Hi LovingSupport--  Just because 1.5mg is the lowest dose on the spreadsheet doesn't make it the best place to jump off, it is still quite high.  If you haven't read this thread I would recommend that you do;

 

Tapering to zero -- when do you just drop off? 

 

It is very disheartening to have done a great taper and have it all go wrong at the very end.

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To taper further from 1.5mg, one might switch to making Effexor liquid from immediate-release Effexor and take a dose as beads plus liquid, such as 3 beads plus the remainder in liquid.

 

I would taper as long as feasible.

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Has anyone had any withdrawal symptoms occur when your Effexor XR generic manufacturer is changed, even though you're taking the same dose? My pharmacy keeps going back and forth between Teva and Wyeth, and I'm finding myself having some (manageable) symptoms 2.5 weeks after a 5% cut for which I hardly had any symptoms days after.

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Some people do have trouble switching between generics, but it usually shows up in a day or two.  If you aren't getting symptoms for two and a half weeks after a drop it is more than likely just regular old WD and not the change in brand.  Are you keeping records as to what brand you are using for which dose reduction and when the symptoms hit?

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Does anybody know if Im likely to experience withdrawal effects after only being on 75mg for 11 days? I absolutely hate feeling so drugged and want to stop asap but wondering whether I will still need to taper off? Has anyone else stopped suddenly after this time period and any effects?

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Hi NotANutter-- welcome to the group.  You'll get a lot more responses if you start a thread in the Introduction forum.  That is the best place for asking questions and keeping a journal. 

 

If there are no other factors involved, like other drugs, then just stop.  With only being on it for 11 days you shouldn't have too much trouble.  Effexor is a very powerful drug and because you are already feeling some side effects you will probably feel some when you stop.  They shouldn't last very long and should be pretty mild, nothing like you may read about on some of the other threads.  Don't let them panic you, they will pass.

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Hello all!

 

Does anyone know if it is possible to turn XR (extended release) capsules of Venlafaxine into an instant release version of the drug. By dissolving it in warm water, for example? Where I live, the only available version is XR, and it would be much easier to manage if I could begin to reduce my evening dosage, which would among other things improve my sleep.

 

Thanks

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Hi Kris , please start a thread for yourself in the Introductions forum.

 

Thanks , Fresh

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Hello all!

 

Does anyone know if it is possible to turn XR (extended release) capsules of Venlafaxine into an instant release version of the drug. By dissolving it in warm water, for example? Where I live, the only available version is XR, and it would be much easier to manage if I could begin to reduce my evening dosage, which would among other things improve my sleep.

 

Thanks

 

I was unable to do it - maybe a compounding pharmacy might be able to crush them and mix with a solubiliser - we only have the XR version available here too

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Kris, please read post #1 in this topic carefully.

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Note for member  'Crossover' I moved your post to the introductions forum where you will get more replies and more people will see it. You can add to it there and ask questions about your taper. This forum is about general info on effexor tapering. Here is a link to your new thread. 

 

http://survivingantidepressants.org/index.php?/topic/11964-crossover-tapering-effexor/

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The venlafaxine in a mini-tablet fragment may be released more quickly as it can be absorbed easier. If you take your venlafaxine in the morning, you may wish to take the mini-tablet fragment in the afternoon to avoid too much release of the drug at once.

I'm now on 175 mg of Venlafaxine gelatine capsules - one 150 mg capsule and two 12,5 mg mini-tablets.

Do you recommend me taking the capsule in the morning and the mini-tablets in the afternoon?

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Cicci's latest post promts a hopefully useful note at this point:

 

The Swedish pharma company BLUeFISH make "Venlablue XL 37.5mg prolonged release capsules, hard"

containing 3 hard mini pills of 12.5mg each.

 

These were the form of 37.5mg dose I got as prescribed here in the UK (Scotland).

They have proved most useful in tapering.  A lot better than all that counting beads palaver.

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Yes, it's really handy peng! They also come in 75 mg and 150 mg capsules with the same mini-tablets inside (12,5 mg).

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The venlafaxine in a mini-tablet fragment may be released more quickly as it can be absorbed easier. If you take your venlafaxine in the morning, you may wish to take the mini-tablet fragment in the afternoon to avoid too much release of the drug at once.

I'm now on 175 mg of Venlafaxine gelatine capsules - one 150 mg capsule and two 12,5 mg mini-tablets.

Do you recommend me taking the capsule in the morning and the mini-tablets in the afternoon?

 

 

Cicci, a whole mini-tablet, intact, will not have the extended-release properties. When you cut up a mini-tablet, the extended-release quality may be destroyed.

 

Your mini-tablet can be taken at the same time you take the capsule.

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I successfully went from venlafaxine 150mg to 75mg by eye-balling a 10% taper - worth trying if you're unwilling to count hundreds of beads every day.

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Hi everyone,

My husband is on 150mg of venlafaxine (regular tablets not slower release capsules). He split the time for his dose going from 150mg in the morning now to 75mg (AM) and then 75 mg (PM) - about a week ago - with the aim of tapering according to the schedule we found here. Alas, he has already started to experience withdrawal symptoms. I'm wondering if this could be because of the difference between tablets and capsules? We were told making this change should really not change anything as he's still getting the same dose per day (no actual drop) but obviously that's not the case. I should add that he is also currently taking 15mg of mertazapine and 10mg of temazepam as well, right before bed.

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Can anyone tell me what the actual weight of a brand name Effexor XR 75mg pill is?

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A YouTube video from our friend Mixter showing his method for reducing Effexor XR (the number of beads in his 150mg Wyeth Effexor XR capsule may be different than the number of beads in yours):

 

How to remove 30 mg in pellets off 150 mg Effexor XR Wyeth, to get the desired dose 120 mg the fastest way for my taper! Remember 1 pellet equals 0.2757mg! One 150 mg Effexor Wyeth contains average of 544 pellets! So we get 109 pellets by calculating 30 divided with 0.2757! This is my 5 bunch 5 group method!

 

I'm very thankful my effexor beads are less tiny. 

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DOSE - Effexor 150mg XL  -  

1 X 150mg capsule, or 2 X 75mg (XL).

 

Thanks to you guys, I am down to the magic, round number of 150mg/day.  Not been that low (??!) for 3 years.

 

I have plenty of 75mg.  In your personal opinions, mods, will taking two of them at once in the evening be OK, or is there not much to choose between that and one 150mg at that time, please?

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DOSE - Effexor 150mg XL  -  

1 X 150mg capsule, or 2 X 75mg (XL).

 

Thanks to you guys, I am down to the magic, round number of 150mg/day.  Not been that low (??!) for 3 years.

 

I have plenty of 75mg.  In your personal opinions, mods, will taking two of them at once in the evening be OK, or is there not much to choose between that and one 150mg at that time, please?

 

Yes, you can take two 75mg capsules or tablets rather than one 150mg for your dose.

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Thanks Altostrata!

 

A couple of days ago, now down to 125mg, thanks to ideas offered on your fine site.

 

(75mg capsule + 4 X the extremely useful 12.5mg minitablets in the Swedish "BLUeFISH Venlablue XL prolonged release capsules, hard - Venlafaxine" prescribed by our health centre here.)  

 

Generic versions of Effexor liable to change at any time, here, though, depending on cost to the local county Health Trust.

One of our GPs told me a few years ago that the drugs bill is so immense that they employed a person specially to examine current costs of all medications so that they could opt quickly for the most cost effective brand at any time.

 

Also, personally, I have not been aware of any markedly differing symptoms when changing from one version of Effexor to another as some people report.

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