![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 81. Go back in thread:
Posted by SLS on March 11, 2005, at 7:21:28
In reply to About the Effexor XR Withdrawal, posted by MoparFan91 on March 10, 2005, at 4:00:00
Here is a list of some of the more common withdrawal symptoms:"electric" shock-like sensations in the head or limbs
anxiety and/or agitation
bizarre dreams
confusion
diarrhea
dizziness or light headedness
fatigue
gait instability
gastrointestinal distress
headaches
insomnia
irritability
lethargy
nausea and/or vomiting
paresthesia
problems with concentration and memory
sweating
tingling (parasthesias)
tremors
vertigo
I don't think it is advisable to discontinue Effexor abruptly. For those who do, the withdrawal syndrome appears within 3 days, and is quite intense. This is also true for those whom do not optimize their taper schedule as they reduce dosage of Effexor over time. The intensity of the withdrawal symptoms do not necessarily lessen at lower dosages during an ineffective taper. There really is no dosage "threshold" for the precipitation of the withdrawal syndrome.Feel free to browse the board to discover the various strategies people have used to discontinue Effexor. The one that works for me is a flexible taper dosage schedule that involves taking progressively smaller amounts of Effexor three times a day. I have successfully discontinued Effexor several times from a dosage of 300mg. My strategy spared me almost entirely from inducing withdrawal symptoms.
Generally speaking, Effexor is more effective than the SSRI antidepressants (Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro). If you have failed two optimized trials of an SSRI, you might want to try Effexor. Personally, I would not allow the potential for a withdrawal syndrome prevent me from trying this drug. SSRIs produce their oen withdrawal syndromes.
I think the reason you see so many people here describing bad experiences with Effexor discontinuation is that it is only these people whom seek out information about withdrawal on the Internet and manage to find this site. In other words, I believe the percentage of people suffering from withdrawal syndromes on Psycho-Babble does not represent the general population and is skewed. The same can be said of the high percentage of people here whom are treatment-resistant to medication.
Some people do not suffer a withdrawal syndrome at all.
- Scott
Posted by zander on March 11, 2005, at 10:04:25
In reply to Re: About the Effexor XR Withdrawal, posted by SLS on March 11, 2005, at 7:21:28
This is a very succint and to the point response, and I very much appreciate what you say! Wish my mind was this organized! I appreciate your comments, Scott, as they always are informed and helpful. An important point you make, and I am glad you did ...
> I think the reason you see so many people here describing bad experiences with Effexor discontinuation is that it is only these people whom seek out information about withdrawal on the Internet and manage to find this site. In other words, I believe the percentage of people suffering from withdrawal syndromes on Psycho-Babble does not represent the general population and is skewed. The same can be said of the high percentage of people here whom are treatment-resistant to medication.
>I would also like to add that the list you have regarding Effexor side effects for withdrawal can also be experienced while taking Effexor. I had quite a few of these symptoms including black outs. Everyone's body chemistry is different and unfortunately, I appear to be a CDY2D6 poor metabolizer...a medical journal article I recently read recommended genotyping before taking certain meds (as opposed to the quinea pig approach). Wish this was more readily available so that the patient and doctor could make more substantive choices.
If one is to take Effexor, I would recommend starting on a low dose and gradually increasing (the effective dose level is different for everyone)... AND insist that the doctor prescribing the meds monitor you closely...in my experience, not even my blood pressure was ever taken!
Marie
Posted by Broken on March 11, 2005, at 11:25:21
In reply to Re: About the Effexor XR Withdrawal, posted by SLS on March 11, 2005, at 7:21:28
> I think the reason you see so many people here describing bad experiences with Effexor discontinuation is that it is only these people whom seek out information about withdrawal on the Internet and manage to find this site. In other words, I believe the percentage of people suffering from withdrawal syndromes on Psycho-Babble does not represent the general population and is skewed. The same can be said of the high percentage of people here whom are treatment-resistant to medication.
>
> Some people do not suffer a withdrawal syndrome at all.
>
>
> - Scott
>Very well put
Posted by winddancer on March 15, 2005, at 10:36:51
In reply to Re: About the Effexor XR Withdrawal, posted by SLS on March 11, 2005, at 7:21:28
Can you please tell me how you taper by taking 3X per day. Are you on the XR type? I am. Should I open the capsule and divide. Will that give me relatively equal amounts of the drug??
I'm down to 75mg one day and 37 1/2 the next. I don't see my dr till next week, but she knows that I'm weaning off it.
what kind of headachs to people experience. I have these one-sided headaches in the back of my head that over the counter pain relievers don't seem to eliminate. Even acupuncture doesn't eliminate them entirely. I also have tingly numb hands, but have been diagnosed with tendonitis in my hand and wrists, but I somehow suspect its all related to the meds.
I started noticing a lot of the side effects of effexor after I weaned myself off of a lot of other drugs I was taking for the anxiety and depression, like Remeron, Neurontin, Klonapin, Xanax - but I don't want to go back to those since my depression and panic has mostly lifted and is somewhat stabalized.
Anybody here ever taken Serzone? I was doing well on that for about 8 years and then had a panic attack about the time it was taken off the market and I was advised to switch to all the other stuff, which has had all these challenging side-effects. I didn't understand why all these things were happening until I surfed the web and started reading the posts here about the same symptoms as side effects for effexor.
I'm hoping to find out more about Serzone being removed from the market and if I need another med to perhaps see if I can get my dr to prescribe the generic Serzone. If anyone has any info -please share.
winddancer
Posted by SLS on March 15, 2005, at 14:37:03
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by winddancer on March 15, 2005, at 10:36:51
> Can you please tell me how you taper by taking 3X per day. Are you on the XR type? I am. Should I open the capsule and divide. Will that give me relatively equal amounts of the drug??
Yup. Despite its being an "extended release" Effexor XR still clears the system very quickly once it is completely absorbed. I was using 150mg XR capsules and just estimated. Precise measurements are not really necessary for a flexible dosing strategy. You basically take your next dose when you start feeling the withdrawal symptoms emerging. Anxiety and tremulousnes are the first things to appear for me. You may have other symptoms that you recognize as indicators. As you work with the drug, become familiar with what symptoms these are. If this strategy works for you, you will be one happy camper.
> I'm down to 75mg one day and 37 1/2 the next.
I really believe that it is best to take the same dosage of Effexor every day during the taper period. The half-life of Effexor is far too short to skip days or alternate dosages between days. It would be ideal to get a hold of the 25mg tablets to work with. Then you can divide them into quarters and work with 6.25mg at a time. Again, precision is not necessary. You end up using small doses of Effexor throughout the day as needed like a PRN.
How about dividing the 75mg capsule into quarters and take one quarter three times a day. When you see your doctor, you can ask him for a prescription for the 25mg tablet. You could then move to 12.5mg three times a day or as needed if withdrawal symptoms emerge. Once you are stabilized at 12.5mg 3 times a day, I would start using 6.25mg doses. You can probably handle 6.25mg four times a day at this point. Hopefully, you will be dosing every 6 hours without having symptoms develop. When you feel you are ready for the final taper, begin using the Effexor as a PRN. Wait until symptoms begin to appear before taking your next 6.25mg dose. You should find that you can go longer and longer between doses. You may find that you cannot get beyond dosing every 12 hours. At this point you can either move down further to 3.125mg dosing or stop taking it entirely. Hopefully, the withdrawal syndrome you experience will be mild and brief.
I never used the immediate release tablets. Using the pellets found in the capsules, I just estimated the amount of Effexor that I thought I would need to allow 6-8 hours to pass before the symptoms would emerge again. My dosing was very flexible, and I found that I needed less and less Effexor and that the amount of time between dosing increased.
This strategy works for me. I hope it does for you as well. It has been my experience that I can get from 300mg to 0mg in less than two weeks this way.
No one else here has dared to try this method yet. If you decide to go with it, please post your experiences with it. Perhaps you will need to use another strategy. You can try continuing along your present path. It might work for you. However, if you begin to experience escalating withdrawal symptoms, please don't allow yourself to suffer. Either restart Effexor and taper or use an alternate strategy like substituting Prozac for the Effexor and taper the Prozac. It's an easier ride. You already have the raw materials to try a flexible dosing taper. Maybe you can get started before you see your doctor next.
I'm too tired to proofread this. I hope I made sense.
- Scott
Posted by winddancer on March 15, 2005, at 15:31:23
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 15, 2005, at 14:37:03
Thanks Scott, that,s what I needed to know. I had to go out this morning before breakfast, when i usually take the med and started feeling really yuky - hard to explain - headache, upset stomach, etc - didn't know if it was from withdrawal or from not eating b-fast until later and then later coming home and taking the meds (plus supplements) That was an hour ago adn I still have the headache.
Why is benedryl useful with withdrawal? I need to get some I guess. Did you use any other supplements when you went off? I'm thinking of working with my naturopath to do Sam-E or 5HTP or St.JohnsWort or something like that if I have recurring depression. I'm a little anxious but theres a lot going on with my life right now - the pain and headaches don't help - and I need to get back to finding some more temp or permanent work and don't feel like I present a best picture of my abilities when I'm like this, but I need to find some income and insurance to cover med insurance soon. Yikes, life is a challenge right now. No partner/etc for help with decisions is a challenge when I'm not feeling up to par.
Thanks for you reply.
Winddancer
Posted by SLS on March 15, 2005, at 19:53:44
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by winddancer on March 15, 2005, at 15:31:23
> Thanks Scott, that,s what I needed to know. I had to go out this morning before breakfast, when i usually take the med and started feeling really yuky - hard to explain - headache, upset stomach, etc - didn't know if it was from withdrawal or from not eating b-fast until later and then later coming home and taking the meds (plus supplements) That was an hour ago adn I still have the headache.
Do you mind being a guinea pig?
When I use the flexible dose taper method, I try not to allow the withdrawal symptoms to persist any longer than 1/2 - 1 hour. As soon as you are convinced you are beginning to enter the withdrawal syndrome, that is when it is time to take your next dose. There is no reason why you should have to suffer unnecessarily. Don't be afraid of Effexor. It is still your friend. Effexor will help you get off of Effexor if you use it the right way.
I would be interested to see how you would do taking 1/4 of the 75mg capsule (18.75mg) once every eight hours (56.25mg per day). If you find the results to be satisfactory, I would then have your doctor prescribe 25mg tablets to work with. Then you can give 12.5mg once every 8 hours or until withdrawal symptoms appear. When you are stabilized at 12.5mg once every 8 hours, you could try something pretty cool. Use 6.25mg on an as needed basis. Wait until the withdrawal symptoms just begin to appear, and then take your next dose. Towards the end of the taper, I would simply nibble a very small piece off of the tablet whenever I needed it. I believe it is important to allow the withdrawal symptoms to appear first, so that the amount of drug in the system is always kept toward the threshold of insufficiency. In this way, it forces the brain to adjust to the reduced exposure to the drug without being traumatized and producing an intense episode of withdrawal. The less time spent in the withdrawal zone, the sooner the withdrawal symptoms will disappear after the drug is completely discontinued, and the more mild will be the withdrawal syndrome.
You have nothing to lose by trying a flexible dosing schedule. I would be quite excited to see you try it. NO GUARANTEES! - Of course. But I like the odds.
Good luck!
- Scott
Posted by winddancer on March 15, 2005, at 20:36:02
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 15, 2005, at 19:53:44
Yes, this way of tapering makes the most sense to me. I'm willing to try it starting tomorrow since I took 75mg this late am. Only trouble is that I feel like the effexor itself is causing some uncomfortable symptoms like the body ache and insomnia but maybe by doing this I can better tell what is caused by the drug and what is withdrawal. I just saw my counselor and she concurs with this method of weaning and also is more inclined than my dr to believe that my symptoms are caused by the effexor and that I should be deligent to get off it.
Have you had any experience using herbal or alternative therapies for depression/anxiety? If so what? I want to be more educated about that although I will work with a naturopathic doctor to manage how much and what I can take. (If I need it!)
winddancer
Posted by SLS on March 16, 2005, at 6:06:44
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by winddancer on March 15, 2005, at 20:36:02
> Yes, this way of tapering makes the most sense to me. I'm willing to try it starting tomorrow since I took 75mg this late am. Only trouble is that I feel like the effexor itself is causing some uncomfortable symptoms like the body ache and insomnia but maybe by doing this I can better tell what is caused by the drug and what is withdrawal. I just saw my counselor and she concurs with this method of weaning and also is more inclined than my dr to believe that my symptoms are caused by the effexor and that I should be deligent to get off it.
>
> Have you had any experience using herbal or alternative therapies for depression/anxiety?I've tried a few things over the years without success. However, there are still some things talked about on the Alternative board that I have not. You might want to snoop around over there and see what you come up with. Anything that reduces anxiety should be helpful.
If you do experience an extended withdrawal period, you can try using Benadryl. It has a good track record for mitigating symptoms. However, more recently, people have reported good results using Claritin D. I would be inclined to try the Claritin D because it is far less sedating than Benadryl. Both of these drugs are antihistamines, although I don't know if this is the property that is responsible for their beneficial effects. Hopefully, the last step of the taper to discontinue Effexor will leave you with a short and tolerable withdrawal.
- Scott
Posted by winddancer on March 16, 2005, at 9:55:39
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 16, 2005, at 6:06:44
Thanks for your answers. I did go to the alternative board. I also find that I need to not spend too much of my day focussing on my feelings as "what we focus on increases" but it is good to find some discussion about how to be proactive in our emotional healing. Right now I'm not working and it is easy to hang out at the computer following links but I need to get on with daily activities and evaluate how well I deal with life's little challenges as I wean off the meds. Getting busy with other things provides its own healing and I want to get to the gym or otherwise do some aerobics, which is a neccessary activity to accomplish true healing IMHO.
I don't see many posts that people are just as serious about keeping up with daily aerobic exercise while dealing with their situation. Many chats about being in bed all day. It's been proven that exercise is critical in recovering from depression/anxiety.
Wish me luck. I'm going to open the Effexor capsule - 75mg and split it up for the first day of the trial on tapering.
Winddancer
Posted by SLS on March 16, 2005, at 14:53:44
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by winddancer on March 16, 2005, at 9:55:39
GOOD LUCK !!!
You are to be a pioneer!
- Scott
Posted by VV on March 18, 2005, at 23:48:23
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 15, 2005, at 14:37:03
Hi Scott,
This is my first visit to Dr. Bob's, and fortunately for me, yours is the first thread I chose to read. I am withdrawing from Effexor and reached 150 mg./day (down from 300/day), doing well until BAM --two days ago I was hit with the nausea, flu-like symptoms, anxiety and severely depressed mood. I knew what had happened as I had experienced these symptoms once before when I went out of town and forgot my meds. That's why I decided to wean the drug--I didn't want to go through that every time I missed a couple of doses. My MD and I worked out a 5 week schedule which now seems a bit aggressive. Your divided dose method makes a great deal of sense to me and I believe I'll give it a try. I'll also try the Claritin and keep up the exercise. Thanks to all for your suggestions.
Posted by SLS on March 19, 2005, at 6:48:52
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 16, 2005, at 14:53:44
> Dr. Bob is away for a week and has left others in charge. It will be interesting to see if this gets redirected there. Fondly, Phillipa
I think it would be better to continue this on the Withdrawal board.
WindDancer, I really would like to see you get the tablets to work with. Once you get toward the end of the taper - which you are approaching - you might actually want to allow for the very beginnings of withdrawal symptoms to appear before dosing again. At this point, it is ideal that you get the medication into your blood stream as soon as possible. In my experience, it only takes 15 minutes to 1/2 hour for the symptoms to subside. I don't know if the yogurt thing will work well to accomplish this.
On an empty stomach, you can simply swallow your doses. If necessary, the pieces that you split off the 25mg tablets will dissolve in your mouth (bucally or sublingually). You can wash down what hasn't dissolved with water. It is somewhat bitter, but very tolerable. Towards the end of my tapers, I simply nibble small amounts off the tablet and wait until withdrawals appear and then nibble off a little more. You might be able to get the stuff to dissolve in water. I don't really know. I estimate that I bite off 4mg. That equals 1/3 of the 12.5mg halves of the 25mg scored tablet.
Too many words?
Let's see how things go.
- Scott
Posted by winddancer on March 19, 2005, at 10:02:57
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 19, 2005, at 6:48:52
Good, thanks for the info. I'll try to get the 25mg tabs - it does seem much simpler.
What were the main symptoms of withdrawal that you expereinced?
How often did you take the Benedryl? What symptoms does it alleviate mostly? I finally got some and took 2 tabs before bed last night and slept pretty well - (I still wake up with my SI joint pain when I try to turn over - so I'm trying to separate that from insomnia caused by Effexor)
Thanks again. I'll keep you posted of my progress.
winddancer
Posted by SLS on March 19, 2005, at 10:14:51
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by winddancer on March 19, 2005, at 10:02:57
Hi WD.
I'm going to keep my fingers crossed for you.
The first time I tried to come off Effexor, I experienced most of what others have described. In particular, I remember nervousness, nausea, brain-zaps, tremulouness, and confusion. It was pretty intense.
I have since been on and off Effexor a number of times using the flexible dosing strategy that has worked so well for me. I don't know what it's like to go through Effexor withdrawal anymore.
This is a good thing.
:-)
- Scott
Posted by tkmphd on March 21, 2005, at 11:58:46
In reply to Re: About the Effexor XR Withdrawal » winddancer, posted by SLS on March 15, 2005, at 19:53:44
thanks scott. i'm going to print this out and file it away for the day i may want to get off of effexor.
someone i know used extra blood pressure medication in getting off of effexor. not sure about the clinical mumbo-jumbo, but it worked for him.
Posted by SLS on March 24, 2005, at 11:25:50
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by winddancer on March 19, 2005, at 10:02:57
How's it going?
I'm hoping that the flexible dosing strategy I outlined has worked magic for you. I'm a bit concerned that you are having a bad time of things, though, as you haven't been posting. If my strategy is a failure, move on to something else like using Prozac as a surrogate to ease the withdrawal syndrome. I'm still looking at anticonvulsants to use during the taper period to prevent the withdrawal syndrome from kindling its own intensity and persistence. However, this hypothesis is still very preliminary, although there are a few people here whose experiences with tapering Effexor while taking anticonvulsants might be evidence of its validity.
Good luck.
- Scott
Posted by winddancer on March 24, 2005, at 11:40:02
In reply to Re: About the Effexor XR Withdrawal, posted by tkmphd on March 21, 2005, at 11:58:46
Things are going pretty well. I just saw my dr and got the script for 25mg tabs. I've had a little bit of anxiety when I've left home and then got back later than I wanted to take the next dose. But I've managed it pretty well with deep breathing and conscious relaxation tape. I still have trouble with tingly fingers, but I'm not now sure what to attribute it to. I am now seeing a chiropracter for some SI joint pain and a life-long problem of a bit of scoliosis which he says may be pinching some place in my back causing a little numbness in my hand. It's all so complicated to sort everything out from the other and identify what's causing what.
What's an example of an anti-convulsant? I have taken benedryl a few times - especially at night but I still don't get a solid nights sleep. How does the benedryl work to alleviate symptoms? I don't quite understand that.
Thanks for checking in. I've just been busy with other things and I guess that's a good sign.
winddancer
Posted by gardenia girl on March 24, 2005, at 21:28:01
In reply to Re: About the Effexor XR Withdrawal » tkmphd, posted by winddancer on March 24, 2005, at 11:40:02
I am new to this site, have spent most of the evening reading postings, and am very interested in knowing how Benedryl (mentioned above and in other postings) might help with the nightmare of Effexor withdrawal that is my life right now.
I was a reasonably healthy, sane, calm person until several events beginning 6 years ago helped to create a lot of anxiety - more than I could effectively deal with. FP prescribed 37.5 Effexor XR four years ago. Start up side effects were tolerable. As months/years grew, issues began to surface. Things like more migraines, massive weight gain (50 lbs over 4 years), skin abnormalities, liver problems, other challenges with no clear source. I tried cold-turkey. Living Hell. Most of my problems are the same as I have seen listed on this site in various postings.
FP and I worked out a progressive withdrawal plan (every two days for a month, then every three days, four days, etc.) Still had symptoms but they either lessened in severity or I just became more tolerant. Last week I decided I was tired of feeling OK for a few days, feeling like dog do-do, feeling OK, dog do-do, ok, dog do-do. I finally came to a place where I just can't bear the thought of having to go through the roller-coaster any more.
I took the last capsule last Friday. Six days ago. Six days may not be a lot to some folks, but it is a long, long time when you are vacationing in hell. I am looking for methods to mask / lessen the severity of the withdrawal effects without becoming dependent on another drug with more withdrawal effects. I took a Benedryl about two hours ago. What does it normally do to help? What is the suggested dosage / interval? Can someone who has successfully withdrawn from Effexor XR tell me how long (estimate only - I know it depends on individuals)best case / worst case before I start feeling human again? Will I ever feel like the B-E me again?
(Sorry if tagging onto someone else's post is not appropriate, but I really don't have the patience or mental health to figure out how to do otherwise at the moment. I'll try to do better next time)
Posted by winddancer on March 24, 2005, at 22:31:12
In reply to Re: About the Effexor XR Withdrawal, posted by gardenia girl on March 24, 2005, at 21:28:01
Jumping into the discussion is the best way to go, I think. "Scott" seems to know a lot about how the benedryl and other things work to help with withdrawal. I'm waiting for a reply from him for the same question.
I'm down to about 3/4 of a 75mg per day and have been breaking the capsules and dividing out into 4 piles and taking them at intervals as Scott suggested.
Do you have any tingling/numbness in your tongue/fingers/etc? Anybody?? Could it be the anxiety reemerging or is it a side effect of the drug or withdrawing from the drug.
Food doesn't have much taste. For the first time ever I'm having a difficult time maintaining my weight and I am suspecting the Effexor is the culprit - I am maintaining at about 10+ lbs over what my ideal weight is, and I feel that my activity level is about the same. At first I was experiencing constipation but am taking some Chinese herbs to combat that and taking some Mg supplement which helps also.
winddancer
Posted by SLS on March 25, 2005, at 7:02:47
In reply to Re: About the Effexor XR Withdrawal » tkmphd, posted by winddancer on March 24, 2005, at 11:40:02
Hi WindDancer.
How many days have you been tapering at this point?> Things are going pretty well. I just saw my dr and got the script for 25mg tabs.
Don't forget to fill it. :-)
> I've had a little bit of anxiety when I've left home and then got back later than I wanted to take the next dose.
when you leave home?> But I've managed it pretty well with deep breathing and conscious relaxation tape.
If the anxiety is being produced as a withdrawal symptom, it might not be necessary for you to experience it at all. The same could be said about the paresthesia if it too is a withdrawal symptom. Paresthesia is one of the more common ones.
> What's an example of an anti-convulsant?
Tegretol
Trileptal
Depakote
NeurontinThese are the ones that interest me so far.
> I have taken benedryl a few times - especially at night but I still don't get a solid nights sleep.Be sure to get the preparation of Benadryl that does not contain the decongestant.
> How does the benedryl work to alleviate symptoms? I don't quite understand that.
I don't either. I'm not sure whether to attribute its effectiveness to histamine receptor blockade or its strong anticholinergic effects.
I'm still confused as to extent to which you have been flexible with your dosing. I'm not sure how to interpret your statement at the top of this post. It sounds like you grasped the idea well enough, but just in case...
You should be able to take small amounts of Effexor as soon as you begin to feel withdrawal, but NOT before. This is why it is important to become familiar with how the withdrawal effects manifest for you as an individual. For now, don't worry too much about your total intake of Effexor for the day. The amount taken should become less and less naturally. Use Effexor sort of like aspirin. When the headache returns, take enough for it to go away. If you can estimate, try to take enough to last 6-8 hours but NOT longer. Carry Effexor with you wherever you go.
Effexor is your friend. Don't be afraid to continue to use it in a way that minimizes your suffering. It is a tool for you to work with. It might not be necessary for you to "go through withdrawal" the way most of the other people here do.
What are the signs and symptoms that alert you to when you are beginning to experience withdrawal effects? Does the paresthesia come and go with the other symptoms?
Do you have any questions? I am not sure I am expressing myself well enough.
I'm really rooting for you.
:-)
I would love to see the flexible dosing work for you. No guarantees, of course. If it becomes evident that you are getting nowhere, you can then go to a more rigid taper schedule and try to manage the withdrawal symptoms as they occur. Benadryl is one method. Others have claimed Claritin, another over-the-counter antihistamine, works as well. You can always cross-over to Prozac and allow its long half-life act as a gradual taper. I would point out that the flexible dosing of Effexor very much approximates the Prozac strategy.
You are a bit of a guinea pig at the moment. :-)
One step at a time.
* For anyone else reading this, flexible dosing is probably best used towards the end of the taper period when you get down to dosages of 75mg and less. It is still smart to take doses of Effexor more than once every day. 25mg x 3 times is better than 75mg x 1. Do not skip days. The extremely short half-life or Effexor or Effexor XR makes this practice imprudent for people vulnerable to withdrawal syndrome.
- Scott
Posted by gardenia girl on March 25, 2005, at 9:22:50
In reply to Re: About the Effexor XR Withdrawal » miracles, posted by SLS on March 25, 2005, at 7:37:53
Thanks to all for comments.
Scott - RE: I hope we can gather more anecdotes on this board to try and establish the efficacy of various methods of withdrawing from the SRIs.
My info:
Currently taking Claritin (allergies) – still having serious withdrawal
Common ingredients of Benedryl and Claritin must not be the key for my particular chemistryTook Benedryl last night, did sleep better.
Took Benedryl about an hour ago. Didn't go to work. Still experiencing vertigo issues, tightness in neck muscles, feeling of band around my head, confusion, and ears ringing. I AM NOT feeling the intense nausea, irritability, zapping noises in my head every time I move or look in a different direction, GI cramps, adrenaline rushes. Only some of these - some of the time - and certainly not to the degree of suffering over the last few days. Is it the Benedryl or the expected decline of symptoms on the seventh day of withdrawal?
Never took more than the 37.5 mg of E-XR, but took it for four years. I do know that I am the type (don't know if there is a technical or clinical name for it) of person that only needs half the recommended adult dosage of any drug to feel the results. Does that have anything to do with my having intense withdrawal symptoms?
Is there any documentation regarding possible permanent changes to the way our brains will function in relationship to chemistry production / non-production due to use of this type of drug? I used to work for the manufacturer of E-XR and I do still believe that it has tremendous beneficial value. I just want to know what to expect, how to manage my body for the rest of my life...
I guess my biggest question / fear is once these withdrawal symptoms go away, then what? Will I be the same person I was before E-XR?
Data:
Age 51, female, 37.5 mg for four years, highly susceptible to chemicals, tried cold turkey last fall - lasted four days - went back on same dosage, started weaning in November
1 month every other day - no symptoms, 1 month every third day - mild symptoms at end of second day. 1 month every fourth day - mild symptoms at beginning of third day getting progressively worse until next dosage. 3 weeks @ every fifth day - mild symptoms at end of third day getting progressively worse until next dosage
last dose seven days ago - don't want to take any more, don't want the roller coaster, am willing to lash myself to a post and ride out the hurricaneDon't have the same stress factors (1995 got divorced; son went away to college; 1998 company closed the division I worked in; transferred me to another state; 1999 sold home; built another in new state; 1999 mother, brother & father died within a year/I settled all their estates; 2000 trained for new responsibilities at work; 2000 remarried; 2002 got laid off; went back to school for IT cert; 2004 got new job) as when I started the drug and I want it out of my body. I want to have genuine emotions again. I want to laugh and cry, feel joy, sadness, all those things that make humans – human. Found other coping methods (exercise, hobbies, bio-feedback...) for dealing with stress.
Trying to find the most expedient method of withdrawal, with minimal symptoms (temporary masking is OK, so long as mask does not have withdrawal also). My husband is very supportive, loving, intelligent, rational… He and I both deserve better than what I have been able to give lately. I appreciate any suggestions you might have to help with my restoration mission. I will win. Its just discouraging to not know what is happening to my body, how long it will continue, what to do to get relief without using the same drug. It is very encouraging to know that I am not alone – others have been successful in the same quest, and that there is that proverbial light at the end of the tunnel.
Sorry for the long post. I guess there was much needing to be released. Onward and upward!
Posted by SLS on March 25, 2005, at 9:57:16
In reply to Re: About the Effexor XR Withdrawal, posted by gardenia girl on March 25, 2005, at 9:22:50
Hi GG.
I'm glad you posted.
> Sorry for the long post. I guess there was much needing to be released. Onward and upward!
As I have detailed in other posts, skipping days seems to be counterproductive with Effexor. If you feel you are headed in a positive direction despite skipping days, I guess it doesn't make sense to try anything different. Note that 3 days is the magic number for the onset of withdrawal syndrome. Your experience gives further evidence of this.
If it were me, I'd get the 25mg tablets to work with. Until then, you can use the 37.5 tablets effectively by dividing them into quarters. Try taking 1 quarter three times a day. See what happens. If you become stable at that dosage and can avoid the serious withdrawal effects that are keeping you from working, then the next step might be to take either 1 quarter of the 37.5 twice a day or 1 quarter of a 25mg tablet three times a day (preferable). I don't think you will be able to go further than one quarter of 25mg twice a day. Perhaps you will. That would be convenient. If twice a day is your limit to avoid constant withdrawal symptoms, then wait until you are stable and prepare for moving to complete discontinuation as your next step. Any residual withdrawal symptoms should be mild to moderate and will perhaps be amenable to palliative treatment with Benadryl.
I'd like to mention that those people who reported success using Claritin actually used the "Claritin D" preparation.
- Scott
Posted by gardenia girl on March 25, 2005, at 11:25:34
In reply to Re: About the Effexor XR Withdrawal » gardenia girl, posted by SLS on March 25, 2005, at 9:57:16
What I have read about skipping days being counterproductive does sound sensible to me. Unfortunately, that information has come to me after I have invested six months in this process. It appears that I have lost 30% of three months to "bad days", gaining nothing toward my goal. My FP did not offer any other help, except Welbutrin.
Are you saying that you think it is necessary to re-start E in the taper-off method before any significant improvement is realized?
Because I have already invested so much time, I am inclined to continue with the path I am on, elect not to put any more E into my body. I just cannot stand the thought that especially these last six days have not put me closer to complete discontinuance. What can I expect on days 8, 9, 10…? Have you collected any info on the various phases/timelines without returning the E the system? If, at day 15, my condition has not significantly improved and I decide to try the taper vs. skip method – can I break open the 37.5 capsules, divide the granules, and then take only a portion of them? Are all the granules equal, or are there some with more strength than others to facilitate the XR (timed release) property of the drug?
Posted by SLS on March 25, 2005, at 12:54:50
In reply to Re: About the Effexor XR Withdrawal » SLS, posted by gardenia girl on March 25, 2005, at 11:25:34
> Are you saying that you think it is necessary to re-start E in the taper-off method before any significant improvement is realized?
Have you already discontinued Effexor entirely? If not, what are you currently taking?
> Because I have already invested so much time, I am inclined to continue with the path I am on
That's why I made the remark that, "If you feel you are headed in a positive direction despite skipping days, I guess it doesn't make sense to try anything different."
> I just cannot stand the thought that especially these last six days have not put me closer to complete discontinuance.
Although only a theory of mine, I think the withdrawal syndrome gets worse and lasts longer the more time you allow it to persist.
> What can I expect on days 8, 9, 10…?
I guess we will both have to find out once you get there. Perhaps you will be lucky and not have to suffer beyond the two week mark.
> Have you collected any info on the various phases/timelines without returning the E the system?
No. However, there are many people here who describe a persistence of withdrawal effects well beyond two weeks. In fact, some people claim that they persist for months. This description seems to be particularly common with people who go off "cold turkey".
> If, at day 15, my condition has not significantly improved and I decide to try the taper vs. skip method – can I break open the 37.5 capsules,
It is my experience that yes you can.
> divide the granules, and then take only a portion of them?
Yes.
> Are all the granules equal, or are there some with more strength than others to facilitate the XR (timed release) property of the drug?
Good thinking. I don't recall whether the granules are the same or different. However, I can't see what difference it makes since they are distributed randomly. I would recommend getting the 25mg tablets to work with.
I can appreciate your desire to not add any more Effexor into your system. If you are currently taking 37.5mg every three days, that averages out to 12.5mg per day. That obviously isn't enough. If it were me, I would get the 25mg tablets and divide them into quarters, each being 6.25mg. I would then "restart" daily dosing at 6.25mg three times a day = 18.75mg. When you are ready, go twice a day = 12.5mg. In the meantime, you can break open the 37.5mg capsules and divide the granules roughly into quarters and take 1 quarter three times a day. You don't have to be precise in your measurements. I believe more frequent dosing is important. It smooths out the peaks and troughs of Effexor blood levels.
You really wouldn't be adding very much Effexor back into your system; 12.5mg a day versus 18.75mg a day. You can decide how rapidly to taper from there. If you are in no rush, you can spend a week at each dosage. If you are in a rush, you can probably spend 3 days at each dosage. Once you get down to 6.25mg, you might no longer be able to stave off withdrawal symptoms. That's when you discontinue it entirely. Hopefully, your withdrawal will be mild by comparison to what you have already experienced and last no longer than a week or two. For me, it was a day or two, but I used a flexible-dosing strategy to taper.
Good luck.
:-)
- Scott
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