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Success with venlafaxine withdrawal

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oz82
oz82

Hi guys,

After 6 long years on venlafaxine, I have finally gotten off the drug. I don't know if this will be of any use to anyone, but I wanted to share some hopeful words and tips for anyone trying to come off of this nasty medication. I should clarify, however, that I am not angry for having been put on this medication, as I am sure it saved my life. That being said, 6 years, 225mg/day and an additional 20kg later (!!! just awful !!!) I am so glad to be Effexor free.

The details:

I was taking Effexor XR and had been on my maximum dose for 3.5 years. Prior to that I was on 150mg for about 2 years. I took 3 x 75mg capsules every morning as a once a day dose. Taking three tablets was initially to save money (for some reason it was cheaper here in Australia to do it that way) but it ended up having the extra bonus of making withdrawal easier.

What worked for me may not work for everyone, but this is the approach my GP and I came up with. Most was my own plan, based on what I found worked, but my GP gave me the initial "tablet dropping" idea and trusted me to take it slowly, listen to my body and see her as needed. It worked very, very well, with minimal side effects. If it helps even one of you it will be worth having posted this.

First things first:

1. Make sure you are taking care of yourself and are in a good place emotionally before even contemplating withdrawal.

2. You are going to need supportive people around you- I don't know if I could have done it without my boyfriend. Tell your family/friends AND DOCTOR what you are doing. This is crucial. You may also want to tell someone you trust at work what is going on, so they know why you may seem a little dazed every so often.

3. Make sure you are eating really well. I switched to a vegan diet about half way through and, although this is not for everyone, this made withdrawal so much easier. I am sure the huge amounts of vegetables made a difference. I especially noticed that days when I ate lots of sea vegetables I coped best with symptoms, so consider working them into your normal diet.

4. Take a multivitamin and drink lots of water. At least 2 litres a day. This will help minimise the horrible nausea you will probably experience.

5. Drink ginger tea/use ginger. This is also for the nausea and I found it was essential in the days after stopping completely. It really does help. I also wondered if some people might find a prescription for maxalon or stemetil helpful, as the nausea and dizziness was the worst for me.

6. Get lots of sleep. I mean heaps of it. Anyone who has withdrawn from this med (or even skipped a dose!) knows how tired you will get.

Now the tablet reduction:

I started by reducing my total weekly dose by 1 tablet per week (taking 2 tabs one day and 3 every other day) for a few weeks. This sounds like nothing, but even this produced quite bad side effects at first (teariness, exhaustion, dizziness and nausea). Only when I was comfortable (ie no side effects) with this dose regimen did I move on.

Then, I took 2 tabs instead of 3 on two days a week for a few weeks until I was comfortable (making sure to space the 2 tablet days out, eg Sat and Wed). Then I got into the habit of taking tablets as follows. I made sure to plan/write all of this down on our calender beforehand, to use as a guide and make sure I didn't mess it up:

3, 3, 2, 3, 3, 2, 3, 3, 2 etc for about 3 to 4 weeks

Then:

3, 3, 2, 3, 2, 2, 3, 3, 2, 3, 2, 2 etc for about another 3 weeks to month.

Then:

3, 2, 2, 3, 2, 2, 3, 2, 2, 3, 2, 2, etc for about a month. Then when I got to 2 tablets (150mg) a day on every day of the week I rested on that for quite a while (mostly as I was nervous about going too fast). Then, I did a pretty much similar thing to get down to one tablet a day. Then the same to get to 37.5 mg. I actually stopped pretty abruptly from the 37.5 mg stage, as I felt entirely ready. After that I had about 5 days of feeling pretty crappy, with symptoms as above, then I started getting better. Day 3 with no drugs was the worst for me.

So, in the end, it took me about 8 months to go from 225 to nothing. I know that seems an eternity, but I think that is why I coped so well. Five days after dropping from 37.5mg to nothing, I had almost no symptoms. Seven days later I had none. Even if you take nothing else from this, please know that it is possible to get off of this nasty drug BUT you must be careful, listen to your body, do it with support from those around you and in communication with your GP.

Good luck to all of you

xx

biggrin biggrin

17 likes, 204 replies

204 Replies

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  • linda73099
    linda73099 oz82

    Posted

    Hi Oz,

    Thanks I'm coming down from 450mg and have stumbled basically onto the same system. What are sea vegetables?? I have been craving and I mean craving nuts, cashews, and peanut butter and hazelnuts. Peanuts are a legume actually not a nut but it is peanut butter I want. Yes hydration I agree is vital. My major side effect has been brain zaps and being able to hear myself blink or turn my eyes. Not dizzy but falls are common.

    Well done. I've had set backs as most of my depression stems from my reactions to my bipolar daughter and her actions. So psychologist for some Cognitive Behavioural adjustments.

    My biggest hassle is awake at night sleep all day. Very handy when the world doesn't work that way.

    Linda

  • mystic63538
    mystic63538 oz82

    Posted

    Hi all-I would just like to state that I am off this drug for 3.5 weeks and I am so pleased. FINALLY my fatique is lifting. I had been on effexor for about 10 months (1 month or so @75mg 9 months @150mg). I went off on my own after reading all the clinical trials and case reports I could get my hands on (benefits of access to the med library). I decided to go cold turkey. And to be honest I'm glad I did. Effexor was simply making me too tired. I am trying to finish my PhD so it was hellish for me personally. I can tell you that the first week withdrawl was awful. I had little to no sleep, suffered body aches and cramps and generally felt that that I was experiencing what can only be described as near psychosis-like symptoms including cognitive distrubances and paranoia. The symptoms got worse or stayed the same for about 10 days until finally the brain zaps (as people describe them) began to calm down. They became fewer less intense gradually over the next 10 days. I was so relieved! For about a week now I've had almost no brain zaps, few cramps and more energy. I feel healthy and able to participate in my own life. The only advice I would give is to read the studies (perhaps not too many message boards -this thread excluded of course smile where the evidence is anecdotal and those who write in tend to be those most deeply affected) so that you know what to expect, of course talk to your doctor and treat yourself kindly and with compassion. I am not trying to take away from any other poster's experience but I would caution against dramatic diet changes (although I want to become vegan too), new exercise regimes or supplements at such a vulnerable time unless advised by your doc. St. John's Wort especially can cause some interactions for example. I just wanted to put this out there so that people know it is possible to survive the withdrawl. Best of luck to everyone!!
    • betsy0603
      betsy0603 mystic63538

      Posted

      Hi mystic, 

      Congratulations on coming off!  You sound very in control of your destiny, very healthy-minded!  Why did you go on ven to begin with, may I ask?

      Hopefully you were on ven a short enough time to not have the major physiolgical changes that lead to protracted withdrawal  Have you read any accounts of this?  From my own experience and what I have learned from others who have been in the pits with coming off ven is that up front you will have the physical symptoms that you experienced.  Then , a window, followed by the surprise around 5 or 6 months out - brain fog, anxiety, depression and insomnia the likes of which you have never experienced before!

      I just wanted to give you a head's up since it is still rather early days for you.  Not trying to be negative as I truly hope you are done, but dang, it really nocks people for a loop when it happens, and now you will know what's up if it happens to you :-)  See, when this happens so far out, the doctors and patients alike think that they have relapsed and MUST be on teh medication because they are still "mentally ill."  But it is entirely a drug-caused phenomenon.  It's not caused by the drug iteself but what the drug did to the nervous system while it was around, causing remodeling and such.  

      Good luck and I hope you truly do get through unscathed cheesygrin

    • jeannine41171
      jeannine41171 betsy0603

      Posted

      Hi Betsy, I am in my second week of tapering down on Venlafaxine while ti starting up on Pristiq. My taper started at 225 mgs of Venlafaxine. My doctor dropped the dosage 75 mgs to start with while starting with 50 mgs of Pristiq. The second week I dropped 75 mgs leaving my dosage at 75 mgs of Venlafaxine anfpd 50 mgs of Pristiq. I am to drop to 37.5 for 1 week then go off Venlafaxine. This med was beginning to work well for me but I began to feel itchy and my skin has been very sensitive for the last two months. As far as withdrawal effects; this week I am very sleepy, nauseous off and on and feel a little off. I don't have brain zaps but an unusual crawly feeling in my head. I feel a little better than yesterday. Transitioning with psychoactive meds is not easy. I think this change has been the hardest. Wishing all of you the best.

      ;

    • betsy0603
      betsy0603 jeannine41171

      Posted

      Thanks for sharing your story on this, Jeannine.  It helps to go into this eyes wide open so that you can make sense of what you are experiencing.  ADs do also block the histamine site, especially mirtazapine, and when that block is removed, it can cause itching and allergy-like symptoms, even sensitivity to high-histamine foods.  Pristiq is an SNRI like ven, so hopefully the cross-over won't be too difficult.
    • jeannine41171
      jeannine41171 betsy0603

      Posted

      Thanks, Betsy. Venlafaxine is really the sister to Pristiq so I am hoping that the itching and skin sensitivity does not cross over to Pristiq. If so, I may be looking at the U.S. Drug called Fetzima another SNRI. I was on Cymbalta for 10 years but as life issues built up Cymbalta did not hold me back from depression and anxiety. Cymbalta was a good drug for a long time. Good luck to all of you.
    • betsy0603
      betsy0603 jeannine41171

      Posted

      It's important to recognize that with long term use we can develop tolerance withdrawal, the symptoms of which can be depression and anxiety! Feels like relapse, the result being the same, but for reasons other than your original condition arising. I had this happen with Ven, and thought I was just a depressive type that would always have to be on drugs.  Now I recognize that I was in withdrawal from cutting doses, and the likely in tolerance withdrawal when I held at 75 for long time.
    • shelbytrev
      shelbytrev mystic63538

      Posted

      How are you doing ? My withdrawal story is somewhat similar to yours but it started while I was still on my regular dose. Anywhow, I was just wondering if you were still feeling good? People keep scaring me telling me to be careful because I could all of a sudden have all these bad withdrawals come up in the next couple of months. But I went through so many already for like 4 months. I don't thing the Effexor was working anymore ( I was out on for anxiety) and my brain was trying to normalize but couldn't cause I just kept taking the effexor. I started working out really hard and I think it brought on worse withdrawal even while still on my daily dose 75mg. I wasn't going up so I came off. Trying to get on other drugs for 2 months because the withdrawal was so bad I thought I couldn't live without meds. So I went on Prozac and tried that for a month. Didn't like it. Now it's been almost a month with nothing. I will admit I did take some benzos while trying other meds and to get some sleep. But I haven't needed those either. Knock on wood.
    • angela64068
      angela64068 shelbytrev

      Posted

      I been trying to wing myself off venlafaxine for bout a month now. Did u feel like u were messing things up and not realizing it. The last 3 days at work iv been short 100 dollars I have no ideal how or why it makes no sense but I'm starting to wonarrow if my brain is just under a fog so bad that I'm making mistakes and don't relize it. I normally now when I mess something up. But now I feel like I'm loosing my mind and people are thinking I'm a thief which I'm not but I have nothing to explain it at all.

    • emma27188
      emma27188 betsy0603

      Posted

      Hi Betsy

      I realise it's been a while since your last post but I was wondering how you were getting on? 

      I'm 2 months off Ven & going downhill fast with depression symptoms kicking in  as well as anxiety (which I didn't suffer from pre Ven) 

      Just wondered if there's light at the end of the tunnel. 

      Thanks

      Emma

  • elizabeth41242
    elizabeth41242 oz82

    Posted

    Hi there. Congratulations! I took my last 2 mgs of Effexor a week ago. I tapered off fro 100 mgs breaking open a capsule and counting the beads, then going down by 2 beads a week. I was feeling pretty good but the past few days I have had mild nausea and an upset stomach -- both symptoms I experienced when I was on 100 mgs. I had been feeling pretty good before this. Wondering how long I will be feeling this way?
    • betsy0603
      betsy0603 elizabeth41242

      Posted

      How many mgs are there per bead?  That's your pill dosage divided by the number of beads per capsule.  

      At 75 mg, your serotonin receptors are occupied by about 85%, but as you drop below that, the occupancy really starts to free up precipitously, especially between 37.5 mg and 0.  That is why the last bit is the hardest, because small drops free up relatively large amounts of receptors which means imbalance and symptoms.

      You might reinstate the 2 mg and hang out there for a month, let your nervous system get caught up.  It depends on how badly you feel and whether you feel you can ride out the symptoms, but if the beads were large in dosage, it may be you were pushing your taper too fast and there is relatively still a lot of remodeling for your nervous system to do.

      The idea is for the taper to be slow enough that the nervous system can respond and up-regulate in response to small dosage changes, and that most of the recovery is done by the time you drop off your last bit.  But, if the taper was too fast and too steep, then when you jump off there is still a lot of up-regulating yet to be done since the nervous system couldn't keep up with the rate of taper.  You are still "growing a new brain."  This means wd symptoms AFTER you come off.  

      The 10% taper method is a harm reduction approach geared towards keeping the most people comfortable and functional while coming off.  Some can go faster while others must go slower.  Hopefully, the nervous system is healing at a rate that keeps up with this schedule.

      So, if the symptoms pick up steam, reinstate that small amount.  It takes four days for a dosage to reach a steady state, and a few more days to determine if an up-dose is helping, so give it a week.

      Good luck!

  • elizabeth41242
    elizabeth41242 oz82

    Posted

    Hi there.I took my last dose of Ven about a month ago..Over the past 2 weeks I have been feeling VERY rough -- upset stomach and more recently, very bad depression. Wonder if taking a small dose of oxazapam (tranq) would help me -- seem to be unable to focus enough to read or watch TV. Feel like it would help if I could just sleep all the time. Interested to know what you think.
    • betsy0603
      betsy0603 elizabeth41242

      Posted

      The only thing that can help you with severe withdrawal is the drug you are withdrawing from.  You likely tapered too fast (most do).  If you had the Effexor with little beads, you could reinstate maybe a few mg worth (divide the dosage of the capsule by the number of beads inside to get the mg/bead).  It takes four days for a reinstatement to reach a steady state in the blood so you may not know if that amount will help enough until five days or so.  It may not be enough but you don't want to reinstate too much and have that much farther to come off again.  If the reinstatement does alleviate symptoms enough, then sit tight on that until you finally feel ok before resuming a super slow taper off that tiny amount.

      Benzos might help with the anxiety but you'll find yourself wanting to take them regularly and then you have a new addiction and must taper.  It takes two weeks of regular use of benzos to become hooked, and they poop out causing rebound anxiety and insomnia worse than before. 

      BTW, withdrawal recovery happens in windows and waves, where you might begin to feel better, but then feel bad again, on again off again.  This is normal as the nervous system tries to rebuild itself with the drug out of the equation. It takes time.

      Good luck :-)

    • elizabeth41242
      elizabeth41242 betsy0603

      Posted

      Thank you so much. I thought tapering off by 2mgs a week was very slow but I guess not. I am seeing my ex-shrink tomorrow and will discuss this with him. I expect you are right about the benzos although I took 10 mgs of oxazepam this afternoon and was able to sleep for a while and that helped. Cheers!
    • betsy0603
      betsy0603 elizabeth41242

      Posted

      Unfortunately the nervous system takes as long as it takes to recover and restore itself.  One can taper off fast but pay the piper with protracted withdrawal that can last months (or even longer for those who have been on it for years), or taper very slowly and get the healing done while in progress, such that when they do come off, most of it's done and any residual recovery shouldn't mean bad withdrawal.

      There's a research article that shows the receptor occupancy rates at different dosages for several SSRIs and venlafaxine.  Granted, this was a study for 12 weeks, and things are different when you've been on the drug for years, in that there's been lots of down-regulation, the body putting the brake down to the drug's stepping on the accelerator, in an effort to regain homeostasis.  Anyway, at 37.5 mg Ven, your receptors are occupied by about 75-80%!  And that's the dose doctors have people jump off from much of the time!  That's a huge freeing up of receptors which means all you are left with are the compensatory changes left unopposed.  Big swings!  Essentially a cold turkey coming off that dosage.

       

    • betsy0603
      betsy0603

      Posted

      2 mg a week is a very slow taper by most standards.  What dosage did you jump from?
    • lesley96722
      lesley96722 betsy0603

      Posted

      Betsy, I am trying to come off Effexor. I have 12 beads in each capsul and have reduced 1 bead every 12 days. It has not been easy I am now down to 1 a day and life is hell, I have every wd symptom on the list. I have read your wonderful words of wisdom and tonight I am upping the dose to 3 beads, if I feel better, then I will stay at that dose for a much longer time, then try again. I have not seen a doctor since starting this and I now have an appointment. Thank you so much for your good advise. I just wish there was another medication on the market for anxiety and deppression. I would like to see these drugs banned. I forgot to mention that I have been taking them for around 20 years! 
    • elizabeth41242
      elizabeth41242 lesley96722

      Posted

      Hi Lesley. You have my profound sympathy. I am having terrible stomach upset, having come off Effexor a month ago, after a very slow taper. The only thing that seems to help is a tranq, oxazepam, but I havebeen warned that it is addictive. Feeling v sorry for myself!
    • lesley96722
      lesley96722 elizabeth41242

      Posted

       Reciprocated I sure. It's comforting to know others are going trough this hellish time, is it possible to ever be totally free of them and lead a normal happy life, do you think?

    • sara20313
      sara20313 lesley96722

      Posted

      It's certainly comforting to know you arnt alone and we can share our misery ...

      Venlafaxine took me to a better place but to get your life back again by coming off is the worst! I'm absolutely exhausted all of the time.

      Sleep is all I want right now

      X

    • betsy0603
      betsy0603 lesley96722

      Posted

      I would updose a bit if it is that much hell, Lesley.  You aren't doing your self any favors.  The first few cuts weren't  bad since they were 10% or less of the previous dose, but you cut too frequently.  It is best to allow a few weeks between cuts so that your nervous system has a chance to adapt and heal in between.  The cuts there-on out became larger and larger relative to the previous dose:  11, 12.5, 14.3, 17.6, 20, 25, 33, 50%.  With the Effexor, gradually smaller cuts still lead to greater amounts of receptors freeing up, causing instability.    So, cuts should get progressively smaller while yours became progressively larger and you were likely cutting while becoming symptomatic at the rate you were going.  Things caught up with you in a big way.

      Your best bet is to up-dose perhaps even just one bead and give it at least four days to reach a steady state and hopefully alleviate symptoms.  If that does enough to make you feel tolerable, then hang out there a good long time, could be a couple of months, to let your nervous system get really stable and caught up.  Then you'll need to look into a way to do micro-tapering, perhaps switching to the immediate release version to make your own liquid, or getting the liquid from your doc if possible.  This allows for tirating down by smaller amounts using an oral syringe.

      I know, it sucks to have to go to such trouble, but protracted withdrawal can go on for months or longer, in a windows and waves pattern of feeling better followed by feeling worse, over and over.  It isn't linear, and can be very hard on people.  That is why so many end up back on the drug, thinking they've relapsed, because the later waves are very emotional in nature.  And people get diagnosed as bi-polar and put on antipsychotics due to the windows and waves making docs think they are cycling.  Well, they are, but due to withdrawal, not an actual mental disorder!  So, be careful my dear!

      If you have patience and take this as slow as it needs to be, you will be free of Effexor without all the suffering.  It just takes time :-)

    • lesley96722
      lesley96722 betsy0603

      Posted

      Thank you so much for your very helpful reply. I'm feeling so much better today having uped my dose again and yes, it's just like bi polar! I'm 64 years old and just want to be drug free before I die...

    • betsy0603
      betsy0603 lesley96722

      Posted

      You wil get there, Leslie, but you need to have patience about coming off.  Once people decide they want to be done they want it to happen NOW, but when you've been on the drug for many years, the nervous system takes a very long time to come back to working properly on it's own without the drug.  I'd been on for 20 years, had a protracged withdrawal experience after coming off Effexor too fast, went back on after 10 months, and am starting over with a slow taper . Had I known what I know now when I first tried to come off, I'd be much further along now!  Slow and steady wins the race!

    • lesley96722
      lesley96722 betsy0603

      Posted

      I'm giving in, I can't stand it any more, it's a living nightmare! I feel cheated, my dr promised me it wasn't addictive. I think it is probably as bad as coming off heroin, if not worse! Sorry to rant, but I'm so disappointed.....

    • lesley96722
      lesley96722

      Posted

      re the above, just having a really bad day with it all, I will continue the increase until I feel stable, then take your advise and be patient ...
    • sara20313
      sara20313 lesley96722

      Posted

      Ah Leslie.

      It's not giving in Hun. It's a coping strategy.

      There's little else you can do right now.. Rebalance. I'm with you and I'm struggling too Big hug xxx

    • elizabeth41242
      elizabeth41242 lesley96722

      Posted

      Hang in there. I am also having a bad day but not going back on that drug. Going to kick this thing!
    • lesley96722
      lesley96722 sara20313

      Posted

      Thank you Sara I'm just feeling absolutely desperate but a big hug helps so a big one back to you xxx

    • lesley96722
      lesley96722 sara20313

      Posted

      thankyou sara just feeling a bit desperate at the moment but your big hug helped, sending one back to you xxx
    • sara20313
      sara20313 lesley96722

      Posted

      I know. And my heart goes out to you. It's almost like being totally alone. That's why it's so nice to have each other for reassurance and any guidance no matter how small.

      I'm feeling so nauseous every single day. My head isn't right I'm all over the place. But like you said in an earlier post we are side by side. ??

    • betsy0603
      betsy0603 lesley96722

      Posted

      I'm sorry you were put in this situation.  I know the anger and disappointment.  Many coke and heroin addicts have remarked that it IS harder to come off ADs!  Don't feel bad that you didn't forge ahead.  You are doing yourself a kindness to reinstate and then go slow off once you are stable.  Protracted withdrawal syndrome is hell on earth and I've known many who many months later wished they had reinstated and tapered because it was just unrelenting.  For those who stick it out, there are windows and waves, so it isn't 24/7 torture forever, but when the waves hit, we tend to feel as if it has been constant.  We forget feeling good.

      If I'm doing the math right, you were tapering for 120 days?  What dose did you reinstate?  How are you feeling now?

    • lesley96722
      lesley96722 betsy0603

      Posted

      I have gone back to 4 beads a day, will see if I feel better by Sunday if not will keep adding until I feel stable thanks again
    • elizabeth41242
      elizabeth41242 lesley96722

      Posted

      Hope that helps.Keep us posted. I find it really useful to hear how others are doing!
    • betsy0603
      betsy0603 lesley96722

      Posted

      Just keep the four days in mind that it takes four days for a dosage change to become steady state, so allow that much time before making another change.  Don't want to blow yourself out of the water increasing too much!  The nervous system becomes very sensitized once it has gone into withdrawal.

    • lesley96722
      lesley96722 betsy0603

      Posted

      I am feeling so much better on four beads a day, not  feeling psychotic any more. Having said that I still keep feeling faint, having to lie down in the floor sometimes until the wanting to vomit and hot flush goes away! I am drinking plenty and take max dose fish oil. For the  the first time in my life I have lost my appetites, which is not a bad thing as I am a comfort eater, but I'm gaining wait, I think this could be fluid retention? My worry is I might be doing some cardiac damage. Any thoughts please? 

    • sara20313
      sara20313 lesley96722

      Posted

      Hi Lesley

      Some good news for you which is nice to hear. The weight thing is something you can work on soon. I put on weight that I find hard to shift but can only concentrate on one thing at a time. My head is all over the place and the nausea is horrible. A cold flannel helps a lot!

      Big hug 😊

    • sara20313
      sara20313 lesley96722

      Posted

      I'm also going to get some omega fish oils. I've heard they work wonders. There's also an alternative for vegans or for ethical reasons too.

    • betsy0603
      betsy0603 lesley96722

      Posted

      Lots of people have withdrawal affect blood pressure, so you might want to take yours and see where you are at.  When I was in PAWS, my BP went up 15 points on top, and my pulse increased.  Now that I am tapering, I have the opposite:  top number has gone down nearly 15 points from my norm of 120.  Serotonin affects the smooth muscles of the cardiovascular system, not to mention the digestive system.

      I'm glad you are feeling better!  It maybe be that the RI is still low compared to your level of healing and so there's still a little WD.  If it is all tolerable, I'd stay put and get nice and stable rather than dink around trying to titrate up perfectly.

    • lesley96722
      lesley96722 betsy0603

      Posted

      Thank you I really do value your very knowledgeable advice, without it I don't know where I would be now. Will stay on this dose for a few weeks maybe months intill I am certain I can tolerate a tiny reduction, I really couldn't go through that again. I will keep in touch as and when I start the next phase of wd ....

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