Posted by SLS on March 28, 2005, at 6:53:39
In reply to Re: About the Effexor XR Withdrawal, posted by Detroit on March 27, 2005, at 23:56:56
Hi Detroit.
I think you are the second person here to use a flexible dosing strategy to discontinue Effexor. The most difficult period for most people seems to be making it past 37.5 - 75.0mg. Flexible dosing becomes more and more necessary the closer one comes to 0.0mg.
I used a flexible strategy beginning at the higher dosages. I was able to discontinue 300mg of Effexor twice in 10 days without suffering a single withdrawal episode. Upon complete discontinuation, the withdrawal symptoms were mild and lasted for about a day or two. I'll be very curious to see what your experience is.
I think it makes sense to wait for the withdrawal syndrome to appear before taking the next dose, albeit not allowing it to last for more than a 1/2 hour. It guarantees that you are decreasing the dosage as quickly as the body and mind can handle comfortably. You are thereby optimizing your rate of taper. My schedule was to take as much Effexor as would allow me to remain symptom free for 6-8 hours. The first time, I used the tablets and simply bit off very small amounts towards the end of the taper. Precision is not really necessary. The second time, I used the granules contained in the 150mg capsules. Perhaps you will find a schedule or dosing method that works better for you.
Although I haven't set out to determine a biological mechanism yet, intuitively, I think it might be desirable to allow the system to reach the threshold of withdrawal syndrome purposely. It might help to provoke the system into making the adjustments necessary to allow for the complete discontinuation of the drug by providing it with a periodic gentle nudge. Pharmacologically speaking, this might act as a stimulant for the neurons and neural pathways to re-regulate themselves toward their original genetically defined state. This is a just an idea of mine that may or may not reflect what is really going on, but I think altering gene expression is essential. It is ironic that it might be the allowance of an unmitigated withdrawal state to continue that sets up for a protracted withdrawal syndrome long after the drug is discontinued. I believe this phenomenon represents the consequences of kindling.
> Overall, I feel better than I have in more than two years!!! So much of what I've felt in the past few years I now believe to be "minor" withdrawals from the Effexor XR brought on by the 24 hrs between doses.
That is an excellent observation and deduction. I never gave it much thought regarding Effexor. You might be absolutely right. What an important insight this! I used to experience the same thing using Halcion or Ativan for sleep, so I am quite sure it is possible.
I make a habit of dividing my doses of most medications, despite the once-a-day prescribing habits of most doctors. I always divided my Effexor dosage by taking it twice a day. Even with drugs that have a 24 hour half-life, I like to do this. I feel it is desirable in most cases to provide as steady a blood level as is possible. Consequently, I can't speak from experience the results of a once-a-day dosing schedule for Effexor. However, it does seem reasonable that it would set up for a chronic withdrawal state.
> Like others here, I have very mixed feelings about this medicine now. It definitely helped me more than some other meds I tried (Imipramine, Prozac, Wellbutrin), but is clearly not without its own problems
Of course, this is true of so many drugs.
The other potent serotonergic drugs are capable of producing discontinuation syndromes despite their longer half-lives. Effexor is the most notorious, but is not without company.
> the biggest being withdrawal related to its incredibly short half life - even in the XR version.
This is why I am so interested in investigating methods of discontinuation that work and no longer makes the fear of withdrawal be the reason people are disuaded from using particularly effective treatment.
Best wishes for your health and happiness.
- Scott
poster:SLS
thread:469497
URL: http://www.dr-bob.org/babble/wdrawl/20050323/msgs/476639.html