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Going from 150 mg capsule to 75 tablet.

Posted , 6 users are following.

janine52278
janine52278

Going on a lower dose. Do I need do it slowly . As I have gone from 150 to 75 in one day. And I have felt weird today. My doctor never said how I should it. Any one help

0 likes, 10 replies

10 Replies

  • betsy0603
    betsy0603 janine52278

    Posted

    Yes, my dear, you need to do it slowly :-)  I'm sorry that your provider has not given you guidance, but I am glad you asked here.  I have been through it, came off too fast and suffered hugely at the hands of Effexor withdrawal, reinstated, and am now doing a slow taper.

    Are you taking the one with the beads inside, the extended release?

    That fact that you are feeling weird already at one day means you have cut too steeply. Go back to 150 and get balanced again, and then start a proper taper.  You can't go wrong using the 10% taper method referenced on this page:

    https://patient.info/forums/discuss/depression-resources-298570

    This method is a harm reduction method geared at keeping most people comfortable and functional as they taper.  It is very conservative, more so than most doctors would have you do.   Some people may find they can go a little faster while others feel withdrawal even at 10% and need to go slower still.  You won't know until you do the first month's cut.  For you that would be 150-15=135 mg.  Keep notes on paper with dates so that you can see how many days after the cut you feel any symptoms, what they are, how long before they go away, etc.  Give it a month at that dosage.

    Once you know if you are going to feel anything odd from that cut, when they comes up and when they go away, you could cut perhaps more often, every 3 weeks if the symptoms came up at day 5, lasted 5 days, and then you felt totally fine for the remainder.  It would be good to have a solid 10 days of feeling fine before the next cut.

    I hope this was helpful.

  • Purpledobermann
    Purpledobermann janine52278

    Posted

    I would also add that just before reducing a dose my doctor first used to split dosage in half and had me take half in the morning and half at noon to prepare the brain for the changes for about a week. So from 150 xr he put me on one 75 XR in the morning and one 75 XR at noon for a week, before reducing by no more than 37.5. So after a week of 2x75 i was taking 75 in the morning and 37.5 at noon. The new dosage was then maintained until i was entirely symptom-free for 3 months ideally. I had the time and patience to go slow so this depends on your tolerance and circumstances of course. His method really worked for me where other methods attempted a coupel of times before were not pretty. All the best.
    • janine52278
      janine52278 Purpledobermann

      Posted

      Hi thanks for your reply. I have been feeling OK but the last few days I have had tummy pains and needing go toilet. Which is the usual thing I do when I forget my tablet. I have been thinking cause I have been on holiday had couple of drinks. Think I will be phoning doctor and ask.
  • j17344
    j17344 janine52278

    Posted

    Hi Janine,

    I've read that simply changing from the capsules to the tablets can cause withdrawal symptoms. Good luck!

    Jessica

    • janine52278
      janine52278 j17344

      Posted

      Well the last couple of days I have felt ok but keep having tummy pain and going the loo. Don't know if it's withdrawal or that I have had couple of drinks with been on holiday.
    • j17344
      j17344 janine52278

      Posted

      I'm glad you're not having too much trouble. Hang in there!
  • a-jay
    a-jay janine52278

    Posted

    I would strongly suggets doing it slowly.

    Various people have suggested doing it by dropping 10% over a number of weeks.  From someone who has come down too quickly I wish I could go back and do it this way.  Please don't end up like me!

    I went from 75 to a week of 37.5 then two days of 25mg.  I've been off them 5 weeks and still struggling with a host of symptoms that weren't there before.  

    • betsy0603
      betsy0603 a-jay

      Posted

      :-(

      a-jay, it isn't too late for you to back up and do it right.  You can reinstate a small dose. Were you on the extended release with beads?  If you came off 25, and have been off for five weeks, you could reinstate enough beads to be about 10 mg and see if that brings you some relief.  The withdrawal forum recommends reinstating even just 2 mg, because they want to know if it will trigger an adverse reaction.  If it doesn't, then you can updose a bit more.  Each drug change takes four days to come to a steady state, so you'd want to wait a week to see what that reinstatement does before more changes.

      Though it may feel like a failing, to go back on, if it brings you stability and gives you your life back somewhat, then you can begin the 10% taper off the rest after allowing yourself to stabilize over one to two months.  The reason for that much time is because your nervous system is still working on upregulating to the first big cuts you made - beginning the slow taper when your system hasn't caught up, yet, will destabilize you too much. 

      Anyway, food for thought.

      This is what I did.  I came off 75 mg much too fast and went through 10 months of protracted withdrawal before reinstating 37.5 mg.  I didn't know about any of this stuff and my doctor wasn't doing it as a reinstatement per se but because I had "tolerated" Effexor in the past.  It fixed me within an hour.  Had I known what I know now, I might have reinstated a much smaller amount and worked up, because now I've got a lot further to come off than I might have.

    • a-jay
      a-jay betsy0603

      Posted

      That's incredibly helpful, thank you.

      It's not a perception of failure I have it's concern that I'd just have to go through all this again and it would end up adding more and more time to it.

      I was on Bluefish XL which is like the Effecros but it's not beads, it's three tablets of 12.5mg inside a capsule.  I was prescribed two a day (i.e. 2x3x12.5=75mg).

      I have to admit, many years ago when I was on Effexor the extended release did not agree with me.  I can't recall exactly why but I remember having to go back to the doctor.  I know others have said you can't taper properly with the extended release though I can't find a de3tailed enough explanation of why.

      I am seeing a gradual improvement in my condition as I track all symptoms in a spreadsheet each day.  It's a long and bumpy road, I won't lie but the gradual improvement is why I don't feel inclined to go back on them.

    • betsy0603
      betsy0603 a-jay

      Posted

      That is fine, a-jay, and I hope it just gets easier and easier.  That is inconvenient that you seem to have the larger time-released mini-tablet things I've heard of but never seen.  There is something about the coating on the extended release that isn't to be violated.  It's meant to slowly release as it travels down your GI tract, and if the coating is disrupted, it would all release up front which I guess is a bad thing.  When it comes the way yours does, makes it impossible to do the smaller increments.  Just means you have more post-taper adaptations to make than if you were able to taper down to a lower amount.

      My Effexor beads are about 1 mg each, so I can go down by smaller increments and get down to the last mg (or less with the smaller beads - they vary).

      So, to ride this out, just know that it is Normal for there to be windows and waves of symptoms, windows where you feel great and think you are done followed by waves where you feel so bad, you wonder, how could it possible get worse over time, not better?  And it is normal for emotional symptoms such as anxiety and depression to come on, especially around month 7 for some, worse than you've ever known.  Everyone thinks relapse at that point, but the wave will pass if you just hang in there and practice some self care and don't allow yourself to get freaked out over it . It's hard, when you are in it, to believe that, but at least you will have the benefit of knowing why it is happening.  I didn't know that when it happened to me and just thought I was going insane!  

      From seeing the same story play out over and over with people in withdrawal, I have learned the many faces of withdrawal, that it can sometimes be quite protracted, though the docs will never admit and it and declare that your "disease" has come back. 

      Stay strong, my friend!

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