Coming off Venlafaxine. FAIL

Hi Damian

First of all I wanted to say well done for reducing your dose from 375mg to 225mg. That's a whopping 150mg drop.

That may well have been the hardest part in all of this. And you must be commended.

I have reduced venlafaxine from 150mg to 50mg over 6 months or so. The initial drop was the worst. I went through a real horrible episode of not only crying feeling sick to my stomach but a deep feeling of anger.

I can now say I've reached a good place.

I reduced 150 to 75 ( which in hindsight was too big a drop) but went on GP advice. I then decided to do the rest on my own without taking advice because I know my body better than anyone.

I then reduced in increments of 12mg by removing one tiny bead from the capsule. Any more then that I'd be on the floor.

I continued that way up until only a fortnight ago.

Ran out of 75mg so because I had some 150mg left from previous (there are 3 large beads in each capsule) 50-50-50. I just took the 50mg. And I'm feeling ok. Just starting to regain clarity. No fogginess in my brain. A first for many many years.

I think slow is the key. I had to tell myself 'what's the rush?!'

So that's where I'm at. Also if it wasn't for this forum learning and listening to others I don't know where I'd be. For that I will always be grateful.

With love X

Hi damian.

Quite a rough experience. But a great learning curve too.

Just wanted to give you a different perspective based on what you wrote.

You actually came successfully off ven, albeit too fast. You did not have protracted withdrawal. What happenned to you was a relapse and every relapse is several fold tougher than the initial problem - feels much worse and is notably harder to reign in.

The reason why diazepam did not help is because it cannot help at that point.

Citalopram could not make a difference because your brain was in need of a SNRI thanks to high doses of ven you were previously on.

Going back on ven was the best thing you could do given the deal. 

Dependence does not play a part in this unless this is how you choose to look at it. You can and will withdraw from this just fine under the correct circumstances!

One way to go about it is: once you are stable and you experience a withdrawal of most (ideally all) your presenting symptoms you would need to endure maintenance therapy on the dose that brought relief. Maintenance should last no less than a year. Ideally two. Then you should try slowly tapering to 150 (lowest dose at which SNRI effect is available). Maintain 150 for (if i am not mistaken - your psychiatrist should confirm - but GP won't know any better so hope you have a psychiatrist) at least another year after adjustment symptoms ease up. If no disturbances crop up, you can consider tapering  by another 37.5. If, after 2-3 weeks at a below therapeutic dose (SSRI without notable SNRI action) you manage to even out and feel good - you are ready to taper down.

I took at least 3 months between each drop (and making sure i count from the point my adjustment issues ease off) -this was my holy grail. I never looked back. 4 years now. After a total of 13 years of therapy.

I went through several very stressful situations, am living in a very stressful environment and have a demanding job. I should have caved several times but did not.

Wish you the same and better!

when i was last tappering down i was given this advice from betsy0603.

Your nervous system doesn't notice 50% cuts as much when you are at the higher dosages, but at the lower dosages, your system really notices a 50% cut!  This is because at the minimum effective dose of 37.5 mg, your neuron receptor blockage is still 80%!  It's complicated, but to try to regain balance, our systems actually ADD receptors, so that is why we tend to have to keep raising the dose, an arms race of sorts.  SSRIs work by occupying the neuron receptors to prevent the neurons from resorbing serotonin, making it hang around in the gap longer.  

So, when you make cuts that start bringing you below 80%, your system starts to really notice the imbalance the cut creates.  This means we have to make cuts smaller the lower we go in dose.

It may be possible for you to get a liquid version of ven, which would make it easier to cut smaller than what is convenient with the tablets.  Some, myself included, go as far as to buy a jeweler's mg scale and weigh out our doses.  Ven withdrawal is one of the worst, so it is actually recommended to make 10% cuts of the previous dosage every 3 to 4 weeks.  It is important to feel stable before making the next cut.