Tapering off EffexorXR

June 18, 2005 12:29 PM

I've been taking Effexor for at least 5 years. Twice my doctor has tried to wean me off of it, but only horrible side effects happen- I cry, shiver, feel like I'm floating, become irritated, etc. The lowest dose is 37.5 mg. For about a month I was opening it up, dumping about half of the "sand" out, and swallowing the rest like my doctor suggested. I just got worse and worse. Has anyone successfully stopped taking Effexor?
posted by madmath to health & fitness (19 comments total)

Sure, but I was on it for only a year.
posted by five fresh fish at 12:47 PM on June 18, 2005

I haven't taken this drug before but I found this link to a forum that discusses Effexor withdrawal. I hope this helps some.
posted by alteredcarbon at 1:23 PM on June 18, 2005 [1 favorite]

I was on it for about a year, and also had horrible withdrawal symptoms (even when I would accidentally miss a dose). After trying to wean off several times, I finally just stopped cold turkey, had maybe a week and a half of constant sobbing, and then started to feel better. It was kind of dramatic, but I knew logically that the emotions because of the withdrawal and not "real". Good luck, madmath.
posted by emyd at 2:08 PM on June 18, 2005

You may have already tried this, but a lot of times, doctors will switch you to something that is longer acting (usually prozac) for tapering off drugs that have short half-lifes and/or aren't easily broken down (I was going to suggest switching to regular effexor, since I think it would be available in tablet form and much easier to cut into pieces, but it looks like effexor is only available in its XR form these days ??) I would taper off extremely slowly, though, regardless of what you choose to do.

You've probably already tried this but I found a bunch of stuff when I googled Effexor XR tapering (googling for withdrawl will just find forums where people are complaining about their symptoms, rather than offering good suggestions.) One forum that I found in particular has a post from a person who broke apart the 37.5 mg capsule and counted the granules (there are apparently 100 in each capsule) and took 10 less every three days. This seems easy enough--I'd try this if I were you--just take 5 less each week or something...I'd do it really slowly. You mentioned you took half of what was in the capsule and it got much worse--try going much slower in terms of how much less you take each week. It will make a difference.

When I was thinking about going ON medication, I did a ton of research and remember reading a woman's weblog where she tapered off of Celexa by crushing the tablets and mixing them with orange juice, and then just drinking less and less of the juice every week (she measured it, obviously.) When I started taking Celexa I had to taper on ridiculously slowly, so I'd imagine tapering off of any of these drugs would require the same patience...

Good luck! This doesn't sound fun...
posted by fabesfaves at 2:18 PM on June 18, 2005 [1 favorite]

Sure: I just quit this month. I was only on it for 8 months at the lowest dose though. FWIW, I too split the caps in half and did that for a week, and then went cold turkey.

I got all the stuff you read about when you type "Effexor Withdrawal" into Google, worse when I went cold turkey, and I treated them with mostly Benadryl, ibuprofen, wine and cigarettes. I took a few days off work at the start too. It's taken a full 3 weeks from cold turkey to feel 90% clean.

So from my personal experience, yea: it's gonna get worse before it gets better. But now that it's almost gone from my system, I've felt better than I've ever done before.

I should add that I coincided my withdrawal with getting a raise and new position at work. This may seem a bit of an odd idea, but all the chaos of the changes at work helped me keep my focus off myself which I think is key. It's like having a cold - it's better to be at work and occupied than lying at home in bed doing grating loops in your head about how awful you feel....
posted by forallmankind at 2:18 PM on June 18, 2005

I found a link that describes the orange juice tapering I mentioned.
posted by fabesfaves at 2:23 PM on June 18, 2005

I know exactly how you feel, and can totally sympathize. The withdrawal from Effexor is AWFUL (for some people, myself included).

I was on it for about a year and a half, up the highest dose, and would get the withdrawal symptoms even if i missed one day. One of the more frustrating parts was that Effexor withdrawal isn't really documented, and my doctor didn't seem to know anything about it. He had told me to just stop taking it when I was on the highest dose, and I had to explain to him that wasn't exactly such a good idea.

I eventually made my way down the lowest dose (after about 2 months of tapering), and then one day just took the plunge and stopped. I was a total mess for about 3 weeks, and the brain tingles (which I really can't explain unless you've experienced it) didn't stop for another 2 and a half months after my last dose.

I know this isn't exactly a reassuring story, but it CAN be done, you just have to commit to it and know that it does and will pass. Good Luck!
posted by ilovebicuspids at 2:23 PM on June 18, 2005

Yes, I've been completely off of it for about a month now. My withdrawal effects sucked (anxiety, brain shocks, 30 pound weight gain in a month, vivid dreams, night sweats, etc.), but weren't brutal like the horror stories my Google searches have led me to. My doctor had me go on the 37.5/day for a while, then one of those every other day for a couple weeks, then I was done.

I've documented all of my side effects and withdrawal symptoms and I'm going to give that to my doctor when I go next. Does anyone know of anywhere else we could submit such experiences, given that the company seems to think that going off of it is a piece of cake?
posted by heatherann at 2:49 PM on June 18, 2005

Effexor withdrawal. Hell on earth. I tried it a couple of months ago and just couldn't do it. I've managed to go from 300mg a day to just 150 now. I tried to stop cold turkey but I had to give up. I couldn't speak, move, eat for about a week.

I have heard that the ONLY way to come off effexor is to taper it very slowly. Like taking one tablet a day, then one every other day, then one every few days, etc etc. I know exactly the side-effects you mean, and it's just not documented in the literature. Only on discussion boards on the internet etc. The main problem is that it messes with your blood pressure (hence why you're not supposed to give blood while taking over a certain dose). Maybe that's something you could ask your doctor about?

Good luck. I wish you all the best. My next strategy is to take three weeks off work and do it that way. But you MUST have someone to look after you when you do it. To make sure you eat, drink, get out of bed once in a while. It might also be an idea to request some help from your Dr - maybe go into hospital for a few weeks to get them from your system. In extreme cases, when no other withdrawal method works, then this has been done.

Best of luck x
posted by lemonpillows at 3:11 PM on June 18, 2005

I've been tapering off gradually over the past couple months. I only take it when I start to get dizzy from withdrawal- initially, it was every other day, but now it's about every 4.

Effexor is a great drug- but going off it is horrible. Hope you feel better soon!!!
posted by elisabeth r at 3:17 PM on June 18, 2005

My understanding was that you shouldn't open up capsules of extended or sustained release (XR or SR) drugs because the packaging is (at least) part of what makes the release slow, and you may end up getting, for a while at least, more of the drug in your system. Instead of 37.5 mg (or whatever) trickling into your system over the course of several hours you get 18.75 mg (or however many grains you've left in the capsule) dumped into your system at once. Can anyone confirm or deny this?

(My own experience with Effexor is that I didn't respond to it at all but thankfully, based on what I've heard here and elsewhere, didn't experience any especially unpleasant side-effects when I went off. I wish you well.)
posted by TimeFactor at 3:23 PM on June 18, 2005 [1 favorite]

No, you can crack open capsules -- you don't want to crush them, but the direction specifically state that it is acceptable to open the capsule, dump it on something like applesauce, and eat that, if you can't handle the capsules -- the 150mg XR caps are pretty large.

As to getting off Effexor. I just went cold turkey, felt fluish for a couple of days, but then I was fine. I was on a low dose, and I react weird to lots of things, so I'm most certainly not the best example in the world. There are certainly people who have horrible problems with it.

I did have the brain tingly thing once. I went "What the fuck? This isn't right. Oh, wait, this must be that brain tingly thing people warned me about. Ok." Just knowing what it was and why it was occurring turned it from really scary to just another thing.
posted by eriko at 4:08 PM on June 18, 2005

Yes, I got off it by tapering off over a couple months. Like ilovebicuspids, I would feel symptoms if I missed even one day when I was still on it, so getting off it entirely was awful. Ditto googling effexor withdrawl, that's basically where I was. It took several weeks before I felt physically normal and it took longer than that to control my emotions.

If you can, I'd suggest that you talk to the people who are close to you so they can understand what's going on and not come to weird conclusions about you based on fits of weepiness or whatever you end up dealing with. I emailed a couple people, it was too weird to talk about in person, but I was glad I did simply because of one person who took it seriously and helped me deal with some of the stress and reminded me (pretty much constantly, heh) that a lot of the things I was feeling were because of the withdrawal.

The biggest help in getting through it was realizing what triggered emotional fits and trying to head them off before I let my thoughts get stuck in a depressed cycle (still haven't perfected this of course). I also would advise discussing things with other people before making any major life decisions during the withdrawl period, because I was just not myself.

The only thing that I found helped at all with the dizziness was lying in one place and eating fairly often, which I can probably not recommend in good conscience. I gained a lot of weight and it didn't help that much. To be perfectly frank and potentially inappropriate, I also found self-gratification to be a help as I had spent a year unable to complete that act while medicated, and experiencing the feeling again was a relief.

Two years later and I feel fine. I did have brain shivers when I was on Effexor and while I was getting off it, but I don't anymore. I don't even think about it anymore. It was an awful time, but I've come out of it and I was able to regain some of the progress I'd made in dealing with my anxiety while I had been on it. Good luck, whatever you decide.
posted by jheiz at 6:06 PM on June 18, 2005

I feel lucky reading these responses that my experience with going off Effexor was painless.

I would recommend trying to get the non-ER tabs if you can. I know that they're still marketed in Europe, but I'm getting the impression that they're no longer available in the US. These are much easier to cut and you don't have the drug in your system for such a long period of time.

I also second the recommendation for going on something like Prozac while you come down from Effexor. Prozac is pretty easy to go off of from a low dose, so when you're done with the withdrawals, you should be able to go off from that as well.

Good luck!
posted by grapefruitmoon at 6:14 PM on June 18, 2005 [1 favorite]

I tried Prozac and it didn't work. I don't really know what I'm going to do; but it will be necessary to take time off work.
posted by madmath at 7:19 PM on June 18, 2005

The only way I got off it was having my doctor switch me to zoloft. I felt slightly odd for a week or so, but nothing even remotely like straight-up effexxor withdrawal. So maybe you could take a short course of something else before stopping altogether.
posted by mookieproof at 9:35 PM on June 18, 2005

madmath--

I feel your pain. I went through Effexor withdrawal back when Wyeth was insisting that there were no withdrawal effects. My doctors thought I had multiple sclerosis it was so terrible. I did have to take an extensive medical leave and only my wicked stubborness kept me out of the hospital.

A lot of Ativan and benadryl kept me going through withdrawal and some withdrawal effects lasted up to two years for me (the memory problems, etc.) However, I am ridiculously sensitive to meds. I've since read the recommendations to overlap withdrawal with an SSRI (Prozac, Zoloft) and this certainly seems worth a try...just remember to allow time for the SSRI to work. It was better for me have someone around during the day for the withdrawal period (perhaps a friend or family member could come stay with you?), to indulge in massages and healthy food, and to try to limit any other sources of stress. Dr. Bob's is a helpful forum for support. Know that it won't last forever. Take good care...
posted by jeanmari at 7:47 AM on June 19, 2005

They do still make the non-extended release tabs in the US. My shrink is tapering me off slowly (now down to a 25MG 2x/day). One thing that she mentioned when we began the process is that because I was on the XR before that we had to do this tapering differently -- the XR ones sort of give you a "boost" about half way through the day (which is why it's extended release). This is what has necessitated me taking the second pill each day -- over the whole day its a lower dose than the last phase, but dividing it between noon & night has helped.

It's only helped the nausea and dizziness sideeffects of this withdrawal process, though. I'm still crazy, gaining weight, brain shivering, etc. yada, blah. But I was having panic attacks and suicidal thoughts while on the higher and extended release dose and so we're trying to step me off of this evil evil pill before we on to something else.

It's also a lot harder to come off of it when you've been on it a long time. It's not a drug meant to be on for longer than a year or 2. I've been on it 7, which is why it's a huge bitch for me, and I wager the length of time that you've been on it is also a factor. Best of luck, and I hope this helps.
posted by macadamiaranch at 8:42 AM on June 19, 2005 [1 favorite]

I weaned myself off the tablets about 8 years ago (after taking them about a year). I'd just split them and take 3/4 for a week or so, then 1/2, then 1/4, etc. I couldn't skip a day or the world would go spinny and the ground would rush up to meet my face (wierd, dizzy sick feeling where I lost all sense of balance).

Good luck!
posted by belladonna at 5:18 PM on June 19, 2005 [1 favorite]