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Tips for tapering off Effexor and Effexor XR (venlafaxine)

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Hi Caro,

Your situation sounds very much like mine - I have been counting beads too. I am also in Australia and the only compounding phy that i found that would repackage the effexor into smalIer doses wanted to charge $50 on top of the prescription cost. So, i do it myself. I have a black velvet cloth, some empty gelatine capsules that i got from a phy and a sharp knife. I empty a line of beads and then separate them into lots of five to get how many I need then i scoop them up into an empty gelatine capsule and put in my pill container. I do the whole amount that i need for the reduction - when i was doing drops every 4 weeks i would do all 28 doses - that way i knew i wouldn't be tempted to go faster when i felt OK.

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Thank you guys for your replies. Your experiences and the ones I read here make me feel more comfortable to IGNORE my dr's advice.

 

How many times I have tried to wean using medical advice and where did it get me; rotton side-effects from this drug only to be told that I have a chemical imbalance ???? Not that their method of withdrawal is too harsh.

 

No thanks I'll count my beads and go down slowly.

 

Peggy, I got a quote from a pharmacy of $100 to compound a script - how rediculous.!! I am in Brisbane. Which city are you?

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I am in Sydney Caro

 

the quote i got was an 'around about $50'....

 

I like being more in charge of my medication anyway. It sends shivers down my spine when i was down to 15mg and saw how little it is - each tiny bead is .3mg... very poweful stuff

 

I wish you the best too

 

P

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Some compounding pharmacies will post meds to you, so it might be worthwhile making enquiries from further away. I get compounded thyroid meds from a compounding pharmacy and it comes with a stamp so I can claim from my private health insurance, so that might also be worth enquiring about if you have that. (I'm in Aus too.)

 

BTW I like the idea of doing a month at a time. Brilliant idea.

B

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Thanks Bubbles,

 

I will have a look at that although now that I've got my head around taking out the beads I feel happier as I am taking control and not spending any more money.!!

 

Whats really good is as my brain is foggy I know where Im at. July take out 20; so when August comes around - 30.

 

After years of trying "unsuccessfully" to tapper, the recomendations here of going slow is the way to go. After reading stories here about the horrible w/d folks are going thru - it brings back bad memories. So far for me so good. It will be interesting to see what happens when I get lower? but will worry about that when I get there.

 

Good luck with your w/d journey!

 

Caro

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Question: I know I shouldn't get ahead of myself but on my schedule July remov 20 beads (55mg); Aug remov 30 beads (45mg)

 

In sept can I get the Effexor-xr script for 37.5mg thereby not having to remove beads?

 

Then continue on 37.5mg script from October and again start removing 10 beads per month again making it 27.5mg ?? then 17.5 mg

 

Does that sound right?

 

Caro

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Question: I know I shouldn't get ahead of myself but on my schedule July remov 20 beads (55mg); Aug remov 30 beads (45mg)

 

In sept can I get the Effexor-xr script for 37.5mg thereby not having to remove beads?

 

Then continue on 37.5mg script from October and again start removing 10 beads per month again making it 27.5mg ?? then 17.5 mg

 

Does that sound right?

 

Caro

 

Makes sense to me.

 

The only thing I would add is, don't be too rigid about following a schedule. Our bodies don't really heal according to calendar schedules. Brains do heal and change, but it's not a fast process. You wouldn't expect a broken bone to heal exactly 10% every month, or a baby to grow precisely 5% a month. Living things are a little messier than that.

 

And never before in evolution have our brains encountered these powerful drugs that cause these bizarre changes to their chemistry, so the mechanisms they use to adapt and heal are imperfect and improvised. The kinds of changes in neurotransmitters that our brains do know how to work with are subtle and due to things like change in day length, hormonal changes of adolescence and pregnancy, normal aging, life stressors, stuff like that. So I think if we're going to manipulate our brain chemistry and ask it to adjust, we need to be gentle and subtle.

 

So pay close attention to your symptoms, and use your body's feedback as your primary indication of how fast to taper. It's always safer to go more slowly than to go faster. (Unless you're having a severe toxic reaction to the drug itself.)

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Caro, the other thing to remember is that as you go lower, those 10 beads constitute more of a % of your total dose..that is where i got into trouble.

Are you taking a generic effexor? I take the brand name and it has about 250 beads per 75mg. So each of my beads is around .3mg.

 

I found getting down to 37.5 mg quite easy and it was great just taking the capsule without having to count anything, but you need to go down slower after that, so from 37.5, you down 3.75mg to 33.75 then down 3.75 to 30 mg... etc.

 

I started doing 5% cuts every week and thought i was doing great, until i mistakenly took 2 10% cuts a week apart - from 18 down to 16.5 and then down to 15mg...my maths got a little screwed up for some reason, i thought i was doing great but i got hit with anxiety/obsessive thoughts and low mood again so went back up to 37.5mg about 5 days ago, still a little shaky and feeling defeated and angry with myself for yet again being too hasty.

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Rhi - agreed. I have to be careful. So far so good. Its makes me feel better to think I have some control; but unless I monitor where I'm at and miss it (thru denial) I will end up getting "caught" ending up with horrendous w/d.- been there often enough!!

 

Peggy - I cant take generic effexor (enlafax) - I am too sensitive. Enlafax tablets not small beads inside and is still supposed to be slow release.

 

You are right that question was in the back of my mind about the dosage as I get lower. It gets confusing. My brain is foggy without dealing with maths. I read in the Tapper section re Effexor-xr that there were 75 beads in a 75mg capsule, so essentially approximately 1mg per bead? but not necessarily? but that a jewlers scale that can measure small increments would be more accurate. So I guess I will have to get one.

 

My thought was once I get to 37.5 mg was to stay there for a couple of months to make double sure that my body adjusts and that no issues. Although it might be the issues come as the increments get smaller. I will wait and see.

 

I found Hymalayan Sea Salt helps me sleep; it has lots of minerals in it and is gentle. I have been waking in middle of night and last night took some and slept really well after it.

 

Caro

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Watch out, there are different numbers and sizes of beads in 75mg capsules vs 37.5mg, and they vary by manufacturer, too.

 

Listen to your body, if you get withdrawal symptoms, you're taking out too many beads.

 

Another reason to create your own custom capsules -- you can change the dosage if you need to.

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if you are taking brand name effexor in Aus - then there are around 250 beads in a 75mg capsule - open one and count them all. I like that there are lots, even though it gets hard to count - it means that you can really tailor your decrease.

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Peggy,

 

Yep I am using the brand name in Aus. I should have counted them. I didnt. So if there are 250 beads in a 75mg capsule what does that mean in terms of dosage?

 

So some beads drug; some beads filler I presume. I will go and reread the tapper info.

 

Caro

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i think all the beads must drug - I think i would have become unstuck much earlier if some were filler.

 

there is .3mg per bead.

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Peggy, well then potentially I should have taken out 25 beads in the first month and then seen how I reacted; only taking out 20 atm.

 

Back to the drawing board. My foggy brain- I read the tapper section but somehow misunderstood and didn't follow through!!!!!

 

oh well a lesson out there for anyone reading this.

 

Also means I will have to start removing 25 beads and monitor how I go.

 

Thanks. Will go and count them now like I should have before!.

Caro

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Hi Everyone,

 

Would it be helpful with Effexor-xr (slow release beads) to take 1/2 dose in am and then balance in the pm.

 

An example 75mg = 250 beads. 10% reduction take out 25 beads

 

So am take 112 bead; pm take 113 beads.

 

Then 20% -50 beads thats for straight reduction or reducing balance (maths does my head in at the best of times :unsure: )

 

250 - 50 = 200 so 100 am and 100 pm. (This straight reduction may harsh??)

 

or 225 x 10% = 22.50 = 225 - 22.50 = 202.50 (10% per reducing balance)

 

With the reducing balance it will not be even ??

 

The thoght process is that with a half life this could help lessen the "withdraw" effects.??

 

Any thoughts or am I trying to complicate things ??

 

Caro

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Hi Caro!

i think that is complicating things - the XR formulation is good for once a day dosing. If you were to crush the beads and destroy the coating then you would need to split the dose - but that shouldn't be necessary.

If you have the brand name effexor (i think you said you did), then take out 25 beads and dose once a day. It is so much easier to do it all in one go so you don't have to be counting every day - measure out a month's worth in one go and then you can relax for the rest of the month!

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Thanks Peggy,

 

I understand you cant split the beads. My idea was that Effexor-xr has 1/2 life than instead of taking the whole dose and wating till the next day take half the dose in the morning than another half dose in the evening etc. The idea being that there was no significant drops ? :unsure:

 

On another topic - If 1 bead = 3.33 (ie 250 beads devide 75mg) then how does it work when the 10% tapper gets down (do you know what I mean?)

 

37.5mg has 125 beads (?)

 

What do you do when your % requires a .5mg ??

 

Well by the end of this my maths may improve :blink:

 

Although there is a saying about "keeping it simple silly"

 

There is an underlying fear because I have been down the road of withdrawal symptoms and I know there are no guarantees about tappering other than slow and steady.

 

How does it work for Effexor when you get down to the 1 bead?

 

Caro

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Hi again Caro,

i bead isn't 3.33... it is actually .3, so about 3 beads per mg.

I think by the time you get that low you can just drop :)

I didn't notice any significant problems with the daily dosing even when i got down to 15mg - except that i crashed and had to go back to 37.5mg :(

Once i start to taper again, i will go at 10% every one month to 6 weeks and NO faster - in the past i have picke up momentum as i get lower and always reduce the period between reductions - it's funny because for me there are either no symptoms or lots of symptoms - no gray area in between where i can think - oops, i better slow down.

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Well that makes sense .3 NOT 3.333 (honestly) !!!!! :lol::lol::lol:

 

Will stick to the "keep it simple"

 

Thanks again Peggy!!

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I wouldn't split the dose if you don't have to, such as getting withdrawal symptoms in the afternoon. You can see how confusing it is.

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Trying to wean off effexor, are all the beads in the capsule the same ingredient?

Does measuring contents of a pill help accuratley cut the dose without changing chemical makeup ?

 

I am currently taking effexor xr 75 mg. In each extended release capsule there are tiny beads . Some people count the beads but I find they are different sizes. The reason for opening them up is to have the least amount of withdrawal due to weaning off this drug. I'm wondering if it would be more accurate to weigh the beads? I guess my other question would also be is that how they make sure how much to put in the capsule when making the pills? I'm thinking what if there are x amount of one type of ingredient bead and x amount of another? Or are they all the same ?

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The beads vary in size from manufacturer to manufacturer and from dosage to dosage.

 

Some of the beads contain more filler than others.

 

When you're down to, say, 10 beads or less, weighing beads won't give you consistent amounts of the active ingredient, either.

 

This isn't a perfect method, but it's the best we can do with tapering Effexor XR.

 

The alternative is to switch to regular Effexor, take twice a day, and make a liquid of it.

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Hi shelby,

I think that all the beads are the same ingredient, but just maybe some bigger than others. I am also on the brand name effexor. I am in austtralia and we can't get regular effexor tablets here - i would switch to the tablets once i get down to about 18.75mg if I could - but i am just going to keep plugging on with the beads. I worked out that each of my little beads has 0.3mg effexor.

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Hi Shelby,

I spent most of my 13 years on 150mg, reduced down to 75mg last year and am now down to 25mg - i have had to updose several times because i went too far too fast. I was put on for depression - but anxiety was a pretty close companion. Try not to worry about the differences in the size of the beads - if you are on brand name effexor there are about 250 beads in each capsule, so you can probably tolerate the difference in size until you get down much lower

 

Edited to add that this method works really well for me.

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Note:

 

Tapering by removing beads from Effexor XR can be tricky. See http://survivingantidepressants.org/index.php?/topic/3471-effexor-xr-counting-beads/

  • The size of beads in a capsule varies slightly from bead to bead.

  • The number of beads in a capsule of a specific dosage varies among manufacturers, e.g., not all 150mg venlafaxine XL capsules from different manufacturers contain the same number of beads. If your prescription gets filled venlafaxine XL capsules from a different manufacturer, counting out the same number of beads may give you a different dosage.

  • Even from the same manufacturer, the number of beads in a capsule of a specific dosage varies, e.g. not all 150mg Effexor XL capsules from Pfizer contain the same number of beads.

  • The number of beads in a capsule varies from dosage to dosage, e.g. the number of beads in 75mg Effexor XL capsules from Pfizer is NOT half the number of beads in 150mg Effexor XL capsules from Pfizer.

  • The number of beads in capsules may vary because the manufacturer, particularly generic manufacturers, have sloppy quality control and the capsules vary in weight (this may be illegal and worthy of a complaint to the government drug regulatory agency).
If you are tapering Effexor XR and are very sensitive to dosage variations, you may wish to weight the beads with a digital scale to get precise dosages.

 

Or, you may wish to switch to regular Effexor so you can make a liquid from it. Switching also carries risks to people who are very sensitive.

Edited by Altostrata
updated

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I have been tapering off effexor for about a year now. It has been a wild ride. After a shakey start I did maintain the 10 percent of current dosage drop about every 4 weeks. I started at 150 mg per day and am down to 9 mg daily. Overall I am doing ok but it is difficult to separate the medication related effects versus my own body chemistry and issues. I have a very stressful job and we are in the midst of the winter doldrums in New England. I do not feel any brain zaps or physical effects I have experienced before but am generally a bit depressed and lack optimism and joy in my life. This may just be who I am. My question is do I need to maintain the 10 percent of my current dose drop at this point or is there some way to get more quickly through the last 9 mg? I am at 6 percent of my original dose and don't know what effects this small dose would have on my nervous system, but I recognize that it has some affect. If I go with the recommended taper, I could take another year to get off this medication. And as the reduction is asymptotic, I will never reach zero. Is there any reasonable modification I can make to the taper to give me a realistic elimination of this small dose without jeopardizing my nervous system or the progress I have made? Any advice or experience would be appreciated.

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There's no secret formula for speeding up going off the last bit.

 

If you haven't had any symptoms, you might reduce the interval of the taper, for example, drop 10% every 3 weeks; if that goes well, drop 10% every 2 weeks, etc.

 

HOWEVER, many people find decreasing gets more difficult at the end, so don't be hasty.

 

Your feeling of being a bit depressed and lacking optimism and joy in life sounds like the emotional anesthesia that is a legacy of the antidepressant. Over time, this will very gradually lift.

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Hello there,

 

Whilst on Effexor aside from side effects I craved anything sweet: Has anyone experienced this?

 

I have been tapering off Effexor for two months. have now stopped it all together.

I have been along side the Effexor taking Serdep50mg...

 

Have felt anxious and apprehensive, I was told to stop Serdep50mg yesterday and see what happens

Has any one gone through:

 

Intense body heat and then chills

No desire for any thing sweet

Absolute frustration

Shaking and trembling

headackes

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I have just been to the pharmacy and asked if I can get liquid made up for my taper

because I aren't sure I can make it correctly. She said it is licensed in the uk but I 

will need a prescription and may have to pay for it. (NHS prescriptions are free to

everyone here in Scotland).  She didn't know this without having to contact the supplier

and said the doctor wouldn't have known either. She also said it's absolutely the right thing to do

titrating slowly.  I wasn't sure where to put this so Alto can move it to the right place if needed,

I thought it was worth sharing. 

 

2.5ml = 37.5mg.  

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Sorry I didn't make that very clear, it is already available as a liquid. 

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After several unsuccessful attempts to get off Pristiq, I was able to switch to Effexor XR. The plan was 2 weeks of EffexorXR 75mg(2 capsules) a day and then 2 weeks at EffexorXR 37.5mg and then stop. First 2 weeks were fine except for a suspicious daily low grade afternoon migraine. Second 2 weeks also fine with continued low grade afternoon migraine. On the second day after stopping completely(week5), I starting having Brain Zaps, Vertigo and mood swings.

I restarted EffexorXR 37.5mg a day and will now start counting beads to slowly taper off. Is it worth trying to switch to Prozac? Seems people can have side effects getting off of any of these medications.

 

 

You cut down very fast. It seems most likely to me that it was the rapid reduction that has caused your symptoms, and probably changing to a different drug will not be especially helpful. I would recommend that you not taper any more for four to six weeks until your symptoms settle down, then begin a slow (10%) taper off the 37.5 mg.

 

It seems like everyone hopes to be an exception to the need to taper slowly, and some people are, but you don't know in advance if you will be, and from the symptoms you're getting it doesn't sound like you are. Please be cautious and take care of yourself.

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Has anyone on our site actually made their own liquid Effexor solution?  Does it work ok with water or does one have to find the suspension solution that compounding pharmacies use?

 

I've been getting compounded solution from a compounding pharmacy and it has been working great for me, but due to recently advertised changes in my company's health insurance, cost may become an issue and I need to determine what my options are.

 

Thanks

Karma

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What are people's experiences with duration of withdrawal symptoms. I was on the lowest dose of XR (37.5 I think it is) and went every-other-day for about 2 weeks then quit altogether. My withdrawal symptoms haven't been as bad as I expected, but I'm having something that I refer to as lightheadedness, but I'm not sure that description is completely accurate. I feel almost like I'm having a bunch of mini absence seizures or something. Any time I turn my head kind of quickly or sometimes even being unexpectedly touched seems to really trigger them, but I feel a bit "otherworldly" most of the time.

 

Has anyone else experienced something like this? How long did it last? :blink:

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Those sound like mild brain zaps.

 

Alternating doses is a very good way to trigger withdrawal symptoms. Withdrawal symptoms can last from a few weeks to years.

 

If you've gone off too fast, you can protect your nervous system by reinstating a partial dose, e.g. 15mg, stabilize, and taper from there.

 

Please start a topic for yourself in the Introductions forum.

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Is there brand name effexor immediate release? I feel being on the generic brand is the reason I can't stabilize. I understand that when I cut my dose by 50% that was HUGE. However it's been 15months and have been micro tapering for a year. I was only on 150mg for 6 weeks.

Yes, I believe there is.

 

Does stabilizing mean not having any symptoms at all? Or does it mean that you can function with some daily symptoms. I guess I am somewhere in between.

Stabilizing means having predictable, manageable symptoms.

 

I am wondering if my age (19yrs) or low immune system (as a child pediatrician said I had low immune because of my tonsils) have anything to do with it.

"Low immune system" doesn't mean anything, especially now that you're a grown-up. Do what you can to keep yourself in good health -- that's your immune system.

 

Also does anyone know if switching to liquid suspension made by a pharmacy be immediate release or timed release?

And what would be a better choice for me?

Timed-release medications cannot be made into liquids. A liquid would need to be made from immediate-release drugs.

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