Posted by SLS on March 11, 2006, at 12:44:25
In reply to Effexor withdrawal crisis and anafrinil issues, posted by bigcat on March 8, 2006, at 21:06:00
Hi.
I don't think very much is understood about the phenomenology of the discontinuation syndrome of drugs like Effexor. All I can say is that it has been my experience that a taper that is gradual enough to prevent withdrawal symptoms from appearing is preferable to a rapid taper or abrupt discontinuation.
It is difficult to say whether your depression is the result of a withdrawal rebound or is actually a return to a baseline state that you haven't fully appreciated. Maybe the Effexor was helping you more than you realize. I'm sure it was still inadequate, though.
Just an idea I came up with:
I have had success discontinuing Effexor 300mg within 2 weeks using what I like to call a flexible-dosing strategy. It generally requires that you take 3 or more doses a day. You take a very small dose as soon as you begin to feel the withdrawal effects reappear. I like to take just enough medication to last 6-8 hours, at which point I take another dose. It doesn't work if you take so much at any one time that it lasts 24 hours. Ideally, what happens is that you need smaller and smaller doses to last the 6-8 hours. Eventually, you will reach a point where no further dosage reductions are possible. Your current dosage will last 8 or more hours, but any further reduction will not allow for more than 4 hours. At this point, you can try to discontinue the drug entirely.
I find that it is not necessary to be precise. I have learned to do it by "feel". However, some people will actually count the pellets contained in the capsule and reduce the dosage based on the number of pellets ingested. I have just sort of "eyeballed" the amount taken. I have also used the 25mg tablets, biting off smaller and smaller pieces during the taper. I feel it is essential to wait and allow for the withdrawal symptoms to reappear before taking the next dose. It optimizes the time it takes to taper and might force the system to reregulate itself faster.
This has been a pretty weak explanation - sorry. You can find more stuff in the archives by using the search function. You can try using the keywords "flexible" and "SLS".
Do you have any questions that I could perhaps answer now regarding the flexible-dose strategy?
You know, if you are to go to another serotonergic drug next, you might see the withdrawal symptoms of Effexor disappear almost immediately upon starting it. Anafranil would qualify.
- Scott
poster:SLS
thread:618788
URL: http://www.dr-bob.org/babble/wdrawl/20060228/msgs/618860.html