Venlafaxing withdrawal - chest pain!

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Hello, I've been slowly reducing my venlafaxing over the past year. Following a few months where i stayed at the same dose i started reducing again about three weeks ago. My chest is feeling really tight, which i have never had before. Has anyone else had this?!

Thanks,

Lucy

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  • Posted

    Hi Lucy, 

    I am also taperng Effexor after a failed attempt a year ago.  Didn't know about the very slow taper.  So, may I ask, how long were you on Effexor, what was your highest dose, what is your taper schedule, and what dose are you on now?

    I never had tightness in the chest though I have seen it listed as a WD symptom.  If you are under 37.5 mg, that may be part of why you are running into WD with this cut.  At 37.5 mg, receptors are still occupied at 80%, with about 92% being the maximum no matter how high you go in dosage.  What happens as you go below this dosage is that receptors begin to free up precipitously with small cuts, which means instability and symptoms.  It is even more important to go very slow at this point in the taper.  The nervous system has a lot of adapting to do to less of the drug, so small cuts and at least 4 weeks in between is needed.  Going faster means your nervous system won't be able to keep up and you will either experience more severe WD with each cut, or once off it will all catch up to you and you will still have protracted WD regardless of the slow taper.

    I am counting AND weighing beads, and creeping off.  I'd been on for 12 years and my failed attempt was proof that my nervous system had become very dependent on the action of the drug to operate "normally."  Also, I am tapering off mirtazapine, focusing on it due to the weight gain.  

    Betsy

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    • Posted

      Hi Betsy,

      Thanks for that info - i had no idea about the 37.5 80% occupancy of receptors thing - really interesting!! 

      This is about my third attempt and am tapering very slowly - weighing out the beads. I was on 150mg and have reduced to 102mg over the past year. I don't have a schedule per se - i am reducing by about 1.5mg per reduction. at the moment i reduce every week but i slow down when i have a lot of work on as i get really tired etc... and can't focus properly.

      I was on effexor for about seven years and it was really helpful when i needed it - but is now a massive pain to get off!!

      What is your tapering schedule? How much do you reduce by each time? I hope it's going well smile

      Lucy

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    • Posted

      Hi Lucy, 

      Sounds like you are doing a fine job of tapering. 

      Right now I am tapering mirtazapine and following the 10% per month rule of thumb.  I weigh my doses out every two weeks so I don't have to think about it every day, and I weigh my Effexor dosages at the same time.  Every other week, I reduce my Effexor by 1 mg gross weight, which is 0.375 mg.  It is not adviseable to take off 10% of two meds at once, so I'm sneaking up on the Effexor with micro-tapering.  That is fine, though, because my nervous system was hooked on it for 12 years as I said, and it is slow to adjust.

      When I was in protracted withdrawal from Effexor, I reinstated at 37.5 mg, which with my brand weighs 100 mg gross, so I am now at 70% of that starting point.  Those tiny cuts have been easy peasy, but when I get down to 20 mg gross, I will have to slow it way down because at that point my 2 mg/mo will aomunt to 10%.  Right now my 2 mg/mo equals only 2.8% off.

      Ultimately, you have to listen to your body and slow down if you are having WD.  The idea is to stay comfortable and functional in the process.  It is agonizingly slow, though.  Better than the withdrawal I experienced before, though!

      If you did 10% that would be taking off 10.2 mg on your next cut and then holding for four weeks.  Or you could take off 5 mg, hold for two weeks, and then take another 5 off.  Then calculate the next cut based on 92 mg.  Gotta be a math whiz doing this tapering business!

       

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    • Posted

      Hi Betsy,

      Thanks so much for your reply - it sounds like you are making amazing progress even if it does involve a lot of maths and fairly slow progress. I campletely agree with you though that it is better to taper really slowly then face the hellish withdrawals of a fast reduction!!

      I think i will start useing the % reduction method once i get down to 37.5mg as that seems to be when people find it the hardest to cut down. 

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