Venlafaxine withdrawal - emotional detatchment

Hi Lucy, 

Yes, such swings happened to me when I dropped dosages, but I wasn't really aware that it was withdrawal.  I would have issues with anger, poor concentration, extreme defensiveness and extreme reactions to conflicts with others that normally wouldn't have been such a big deal.  I lost friendships during those times.

Now I understand that tapering this and other ADs must be done more slowly to avoid such destabilization!  Your cut from 63 to 50 was about 20%, much too big, so from here on out, try not to do more than 10% of the previous dose per month.  You're in a big brain bounce at the moment.  Only ever cut when you feel you are stable.  See, your nervous system adapted to life with the drug built into the workings, and when you make a cut, the nervous system has to adapt to that much less drug in the works by remodeling to make up for it.  You are essentially building a new brain each and every time you make a cut!  This takes time, especially if you were on the drug for many years.  Allowing a month between cuts gives your nervous system time to make that adjustment.  Sometimes more time is needed if you feel symptoms bigger.

Given a 20% cut, I would hold there for a couple of months if you can stand it, before resuming at no more than 10%.  Are you dropping beads?  Having awareness to the fact that these strong emotions are caused by the cutting can help you navigate relationships; this is withdrawal, not me.  Mindfulness meditation can help, as well as telling yourself "this is withdrawal, a sign that I am healing, and I can take one moment at a time" or something along those lines.

If the WD is too difficult to tolerate, you could updose by a bit.  Since you are six weeks out, your system is in the process of remodeling to adapt, so you don't want to exceed that by updosing by too much.  A couple of mgs might make you feel a little better.  

My situation was that I'd been on Ven for 12 years, having gone up high and then dropped back down over the years.  I think I was on 75 mg when I decided I didn't want it in my life anymore, too many ways it was impacting me negatively.  So, I fast tapered off.  Like you, some physical started first, hot flashes/burning skin sensation, cognitive issues.  But then the emotional stuff hit hard about five months out, severe depression/anxiety/doom/insomnia like I'd never known before.  I didn't connect the dots that I was in withdrawal, but also knew this wasn't me, since I'd never had such problems before going on the meds.  I ended up on mirtazapine to help me sleep and eat, but the despondency was still severe so I ended up back on 37.5 mg Effexor, ten months later, and within one hour I began to feel completely better!  Whoah!  It was then that I realized that it was withdrawal all along and I knew I didn't want to be on drugs that could cause this to happen by their absence!  I learned a lot about the harm of long term AD use and so once stable, began a slow taper of both drugs.  Since I am tapering both, I do each less than 10% per month.  

Sometimes my cuts have triggered mild withdrawal.  Right now I am at about 12 mg Effexor, and my recent small cuts have triggered tearfulness, mild waves of body anxiety, and hot flashes at night with burning skin sensations.  My biggest issues over the whole tapering process have been low energy and motivation, poor memory and anhedonia.  But all are at a level that are tolerable.

How long were you on and what made you decide to come off?  What was the highest dose?  You have done very well taking it slow so far, two years!  I'll have been tapering from 37.5 mg for two years as of June.  It is not a speed event!

Hi Lucy159!

Coming off Venlafaxine can really make a play on your emotions. I think it's like your brain is trying to operate on a lesser dose while at the same time compensate and even go into protection mode...I don't know. What I do know is that it helps to remind your partner that you're titrating and if possible to talk as much as possible about how you're feeling to him. However, this isn't always helpful because aside from trying to be patient and understanding with you, he's got his own emotions and issues to deal with whether as a result from work, family etc or from your relationship. He's only human too after all and unless he's been through it, he can't really know how you feel or what's best for you. My advice is, get a qualified, experienced therapist to help you through this period. I cannot emphasise enough how important proper psychiatric care is - and not just a GP. I've had to sacrifice financially to get a private psychotherapist because of the long waiting times to get one on the NHS.. There are many who charge reasonable hourly rates... Not only are they great listeners but they can offer great techniques and advice on how to cope through the transition.