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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Lstevens29 on May 4, 2005, at 10:08:24
Hi - I have been on effexor for about 5 years after many years of trying almost all the other anti-depressants without relief)- GREAT success.... for me except for sleepiness and a bit of blurred vision.... NO side effects... even increased libido.
I've been through extensive therapy (Almost 10 years)and feel that many of the outside factors are "fixed".... and want to try and try and manage my own moods now... I have been trying to get off of Effexor for about 2 months now.... I was going very slowly reducing my dosage gradually.... I am down to 75 mg (XR) but have noticed NO libido, Increased irritability.... I feel like I am crawling out of my skin.... Huge body aches, headaches and a low grade fever.
I don't believe my Dr. has EVER had anyone request to get off the medication... He seems to be following my lead..... Any suggestions?
Posted by bart on May 4, 2005, at 10:08:29
In reply to Getting off Effexor, posted by Lstevens29 on May 1, 2005, at 8:52:08
yeah, my doc also said it's very rare for patients to completely come off effexor. So then I asked, "well, what about those people who decide they would like to come off after some time has gone by?" doc said what to do in that case sometimes is to give the patient a 30 day supply of a low dose of prozac to alleviate the first few weeks of withdrawal from the effexor
good luck, I haven't come off effexor yet myself, 'cause it's just too difficult for me at this point to do it and still maintain two jobs
Posted by Lstevens29 on May 4, 2005, at 10:08:29
In reply to Re: Getting off Effexor, posted by bart on May 1, 2005, at 15:15:27
Thank you Bart.... I may mention that to my doc about the prozac.... I am also looking for a new job.... but I have such severe withdrawl today... it is hard to think about taking that on...Do you mind me asking what dosage you are at.... I was at 150 mg.... and was doing pretty good until I ran out of medicine (my fault) and went 4 days without.... that was 2 weeks ago.... and I have felt lousy ever since.... I have been on 75 mg for 2 weeks... maybe I should try 75 plus 25mg for awhile..... killer!
Posted by bart on May 4, 2005, at 10:08:29
In reply to Re: Getting off Effexor, posted by Lstevens29 on May 1, 2005, at 15:23:24
I'm currently on 75mg XR a day more or less just as a maintenance thing so I don't withdrawal. but if I go a couple of days without taking it I get very antsy and irritable and taking a 75 mg dose provides much relief. 150mg. doesn't really provide any better relief but rather makes me feel "drugged" or sleepy with a bad headache. Sometimes not though, kind of strange. but 75mg seems to be the target dose for me
Posted by lstevens29 on May 4, 2005, at 10:08:29
In reply to Re: Getting off Effexor, posted by bart on May 1, 2005, at 19:30:11
My doc called today and thought that my body was confused... and I should drop to 37 mg. He had heard of the prozac treatment because prozac has longer half lives than effexor... but he had not heard of prozac being a relief for withdrawl side effects from effexor and recommended I just tough it out. Bummer!
Posted by SLS on May 5, 2005, at 8:11:01
In reply to Re: Getting off Effexor, posted by Lstevens29 on May 1, 2005, at 15:23:24
Hi.
Going from 150mg to 75mg represents a decrease of 50%. That is a big number. If you would like to carry on with your tapering process and you are still experiencing a significant withdrawal syndrome at 75mg, You might want to restart from some intermediate dose and decrease more slowly. You should not be allowing yourself to suffer withdrawal symptoms constantly.
It is better to begin taking smaller doses of Effexor several times a day rather than only once or twice a day. This will become more important as you move to dosages less than 75mg. For now, try to find the daily dosage that will allow you to go most of the day without withdrawal symptoms. Maybe you could try 37.5mg three times a day. Hopefully, this will prevent symptoms from appearing. You might want to stay at this dosage for a week or so before moving further downward. At this point it becomes easier to work with the 25mg tablets. You could go to 37.5/25/37.5 for awhile and then 37.5/25/25, and then 25/25/25.
At lower dosages, I advocate a flexible-dosing strategy for discontinuing Effexor. What that means is that you take small doses of Effexor as you need them, rather than according to a daily or hourly schedule. What I found that has worked best for me is to cut the tablets into smaller and smaller pieces and take only as much as will get me through 6-8 hours without experiencing withdrawal symptoms. This usually means that I take 3-4 small doses a day. Wait until you begin to feel withdrawal symptoms reappearing before taking subsequent dosages, but don't allow the symptoms to remain unmedicated for more than an hour. I usually wait 1/2 hour before dosing. It usually doesn't take more than 30-40 minutes for symptoms to recede after the dose. You should find that you need smaller and smaller doses to last 6-8 hours. When you get to the point where no further reduction in dose facilitates the disappearance of withdrawal symptoms, that's when you discontinue the drug entirely. Hopefully, the final withdrawal syndrome episode will be mild and short-lived.
- Scott> Thank you Bart.... I may mention that to my doc about the prozac.... I am also looking for a new job.... but I have such severe withdrawl today... it is hard to think about taking that on...Do you mind me asking what dosage you are at.... I was at 150 mg.... and was doing pretty good until I ran out of medicine (my fault) and went 4 days without.... that was 2 weeks ago.... and I have felt lousy ever since.... I have been on 75 mg for 2 weeks... maybe I should try 75 plus 25mg for awhile..... killer!
Posted by meliss337 on May 5, 2005, at 18:37:46
In reply to Re: Getting off Effexor » Lstevens29, posted by SLS on May 5, 2005, at 8:11:01
Hi Scott,
From reading this board you seem quite knowledgable in tapering off Effexor, so I thought I'd ask you a couple of things, if that's okay.
Quick history: was on 150 mg. for 1 1/2 years. Started tapering down 19 days ago... 112.5 mg for a week, and (whatever mg. is 5/8 of 150) for the past week and a half. Today I started 75 mg (approximately, I still have 150 capsules, so I have to estimate).
I decided to go off due to sleepiness while ON the pills... and after reading some other people's stories, I bet the stomach problems I seem to have acquired in the past 3 years (was on Celexa 40 mg. for 18ish months before Effexor) were because of these antidepressants. Also, I'm graduating college, and want to start this new "lease on life" pill-free. There were circumstantial reasons why I was put on antidepressants in the first place, and none of these reasons are still in place. Basically, there is no logical reason I should BE on these pills, am tired of being sleepy and unmotivated (I can sleep for 12 hours, uninterrupted), and want OFF.
Anyway. Does it sound like, so far, I'm doing this okay? (I DID go from 112.5 to 75, and on the 3rd day felt HORRIBLE, so I added the other 18.75 back in.) Otherwise, I feel okay - slight dizziness/nausea, but not too bad, and am just EXTREMELY emotional, and will cry at sad OR happy things at the drop of a hat. Should I continue with 75/day for another week? Week and a half? Two weeks? Should I then go to 3/8 of 150mg, then 1/4, then an 1/8, then 1/16... etc? What would you recommend, or have heard success of doing? I know you stand behind taking small doses multiple times a day... is there any sort of standard schedule of how often, and when to go down to the next level?
Thanks so much for any information. :)
Sincerely,
Melissa
Posted by SLS on May 7, 2005, at 8:44:38
In reply to Re: Getting off Effexor » SLS, posted by meliss337 on May 5, 2005, at 18:37:46
My first recommendation, as you mentioned, is to take smaller doses of Effexor several times a day, as this will help mitigate withdrawal symptoms. It might be advantageous to use the 25mg tablets to taper further, although I have done it using the contents of 150mg capsules. You really don't need to be too exacting with dose size if you remain flexible with the dosing period. In other words, you can wait until you feel withdrawal symptoms coming on, and only then take a small dose of Effexor to make them disappear. The rule-of-thumb that I have had success with is to take only as much Effexor as is necessary to last 6-8 hours. You will be dosing 3-4 times a day. When you are sure that the withdrawal symptoms are returning, take your next dose. Ideally, you will find that you can use less and less Effexor to last the 6-8 hours. There really are no "steps". Each day, the brain makes small adjustments based upon the dosing of the day before. This allows you to make similarly small adjustments subsequently. I think it is important to try to use the minimum amount of drug necessary. One way of doing this is to use the appearance of withdrawal symptoms as a dosing guage. Purposely allowing withdrawal symptoms to begin to reappear is a good way to do this. Try not to let the withdrawal symptoms persist for more than an hour, though. The idea is to discontinue Effexor comfortably and completely rather quickly and incompletely.
> I decided to go off due to sleepiness while ON the pills... and after reading some other people's stories, I bet the stomach problems I seem to have acquired in the past 3 years (was on Celexa 40 mg. for 18ish months before Effexor) were because of these antidepressants. Also, I'm graduating college, and want to start this new "lease on life" pill-free.
Go for it!
Is there any history of mental illness in your family? If for some reason you find yourself experiencing recurrent episodes of major depressive disorder in the years ahead, you might need to consider a more indefinite period of treatment. Hopefully not.
> Anyway. Does it sound like, so far, I'm doing this okay?
Yes. Very much so.
If you feel comfortable staying at 75mg for a week or two before continuing with a flexible-dosing strategy, that might give you a point of stability from which to work. I would take 25mg three times a day. Alternatively, you can wait to invoke the flexible dosing method until you get down to 37.5mg (12.5 three times a day) if you prefer to keep a more rigid schedule. Near the end of a taper, I actually estimate and nibble off smaller and smaller pieces of the tablet throughout the day. Whenever the withdrawal symptoms reappear, I nibble off some more. Sounds simple? I hope it is as simple for you as it has been for me.
Best wishes.
- Scott
Posted by cubic_me on May 7, 2005, at 8:50:09
In reply to Re: Getting off Effexor » SLS, posted by meliss337 on May 5, 2005, at 18:37:46
> Quick history: was on 150 mg. for 1 1/2 years. Started tapering down 19 days ago... 112.5 mg for a week, and (whatever mg. is 5/8 of 150) for the past week and a half. Today I started 75 mg (approximately, I still have 150 capsules, so I have to estimate).
> I decided to go off due to sleepiness while ON the pills... and after reading some other people's stories, I bet the stomach problems I seem to have acquired in the past 3 years (was on Celexa 40 mg. for 18ish months before Effexor) were because of these antidepressants. Also, I'm graduating college, and want to start this new "lease on life" pill-free. There were circumstantial reasons why I was put on antidepressants in the first place, and none of these reasons are still in place. Basically, there is no logical reason I should BE on these pills, am tired of being sleepy and unmotivated (I can sleep for 12 hours, uninterrupted), and want OFF.
All of this sound sooo similar to me, right down to the graduating this year. I often sleep 12 hours uninterrupted, I could sleep all day if I let myself.I started tapering down from 150mg 2 and a half weeks ago, but am only down to 112.5 at the moment, I'm planning to start halving my 37.5 mg tab at night so that I'm ready to go down to 75mg in another 2 weeks time. So far there aren't too many withdrawal symptoms, which is surprising as I've had real trouble with them before (both on effexor and other anti-ds).
I hope that it continues this way, and I will be off Effexor in about 2-3 months if all goes to plan.
Posted by readersleaders on May 9, 2005, at 19:22:38
In reply to Re: Getting off Effexor, posted by lstevens29 on May 2, 2005, at 17:52:42
That doctor is an idiot!!! Go find one that will give you the prozac. How would he like to suffer?!
RL
> My doc called today and thought that my body was confused... and I should drop to 37 mg. He had heard of the prozac treatment because prozac has longer half lives than effexor... but he had not heard of prozac being a relief for withdrawl side effects from effexor and recommended I just tough it out. Bummer!
Posted by themusik on May 19, 2005, at 14:50:22
In reply to Re: Getting off Effexor, posted by readersleaders on May 9, 2005, at 19:22:38
It seems like we're all college students getting off Effexor here! I'm ready to graduate this year with my BA and am getting off Effexor.
My Doctor said that withdrawls would only last for 1-2 days. He suggested I go from 150mg to 75mg in two days then from 75mg to 37.5mg within the next two days and then off of Effexor completely.
I followed his instructions and have been completely nauseated for about 3 days! Yesterday was my first 0mg day. I think I'm going to get back on 75mg and see if that relieves the symptoms and then taper off like I've read works.
I've been on Effexor for about 2 years. I'm glad that board is here!
--grant
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