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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 23 to 47 of 113. Go back in thread:
Posted by SLS on May 31, 2005, at 18:54:54
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on May 31, 2005, at 18:20:19
Hi Lisa.
I really can't answer all of your questions. They are good ones.
The thing about Prozac is that it acts as a temporary substitute. The half-lives of Paxil and Effexor are relatively short - less than 24 hours. The half-life of Prozac (and its metabolite) is over a week. Once you get enough in your system, it acts to gently allow the system re-regulate itself so that when it eventually disappears from the blood-stream, you have a mild and short withdrawal period. Some people take 10-20mg for 5 days and then stop. Others take 20mg for one day and then 10mg a week later. I don't know which way works best. With Prozac, you can even skip days and take it every day, then every other day, then every third day, etc.
I think I would try taking Prozac 20mg for several consecutive days and wait. The withdrawal symptoms will almost certainly disappear. If they reappear within a few days, take another 20mg and wait again. You should find that you can go longer and longer between doses. You might even elect to move down to 10mg doses. Hopefully, this process will not exceed two or three weeks. When you can go 5 days without withdrawal symptoms appearing, take a shot at complete discontinuation.
This is the best I can come up with for now. There really is no definitive method that I have seen published. There is no consensus here as to the details of a Prozac cross-over protocol. Maybe we can all follow you through the process and make suggestions to adjust things as we go along.
- Scott
Posted by LBB on May 31, 2005, at 20:49:44
In reply to Re: How long do Effexor XL withdrawals last? » LBB, posted by SLS on May 31, 2005, at 18:54:54
Scott, again, thank you.
I just got off the phone with my doctor. I had told him how I was feeling and he had acted "shocked" at the severity. I told him of the legit, peer reviewed studies I have seen on JAMA and in the BMJ, other psych. journals, etc. So, long story short, he called me back and said that "he learned a lot." (thankyouverymuch at my mental and physical expense! ARGH!), and he spoke to a Psycho-Pharmacologist colleague who confirmed my findings and that indeed, Effexor is hell to come off of. Needless to say, I felt vindicated, but also pissed at the same time, that he didn't know of these potential horrible withdrawal side effects and weaned me too fast.
So, what his colleague said that since I have been off the meds totally for 5 days, he would like to see me ride out 3 more days if I can and then we will re-evaluate. If I feel worse or just can't stand it, he said he would do the Prozac thing, but at this point in time, he would like to see how it goes if I am willing to try. And I am, so we shall see.
I am keeping my fingers crossed that these nasty feelings subside over the next 3 days, and then I will post again and update here.
Thanks again for all your help, reading what you and the others here have said has been a tremendous blessing!
Lisa
Posted by 4WD on May 31, 2005, at 22:00:14
In reply to Re: How long do Effexor XL withdrawals last? » LBB, posted by SLS on May 31, 2005, at 17:51:17
> Hi Lisa
>
> > My concern is what Scott said about having permanent-like withdrawal effects.
>
> Actually, I have never used the word "permanent". The worst scenarios I have seen described here involve a persistence of withdrawal symptoms for no more than a few months.
>
> > Since I am not going on another drug,
>
> This is a decision that might prevent you from getting past all of this quickly. I would think about using the Prozac cross-over method if I were in your position. It would only be for one or two weeks, and you wouldn't have to suffer. It might also shorten by months the time withdrawal effects persist.
>
> > Will I never feel better?
>
> Yes. The question is when. You could start feeling better tomorrow if you were to take 10-20mg of Prozac today.
>
> Perhaps it is worth waiting two months before trying to conceive so that you can treat your withdrawal syndrome properly.
>
> Please remember that part of the withdrawal syndrome is anxiety. Although it will be difficult, try to recognize this and not allow your thoughts to succumb to the power of the anxiety. Your thinking will be much clearer and things will seem less catastrophic if you can reduce your level of anxiety. Your thoughts aren't by themselves producing the anxiety. Your anxiety is producing thoughts that are overwhelming.
>
> Regardless of what decisions you come to regarding the management of your current withdrawal syndrome, it will eventually disappear. Perhaps it makes sense to make that happen sooner than later.
>
> I wish you nothing but the best of luck, and look foward to hearing good news from you soon. I'm sure we will soon see a healthy new addition to your family.
>
> :-)
>
>
> - Scott
>Scott,
I'm trying to relate this to my own situation. I tapered Effexor over a period of about a month from 50mg to about 10mg and started Celexa 20mg when I began the Effexor taper. So there was no time that I wasn't on an AD. I had switched successfully from Effexor to Celexa a couple of times before with no problem other than a slight increase in morning anxiety.
But the last four times I tried to switch from Effexor to a different drug (Paxil, twice -quick switch with short Effexor taper; Cymbalta once with 1 month Effexor taper and Cymbalta build up and now Celexa with 1 month Effexor taper) I have experienced the sudden onset of horrible fear anywhwere from one week to one month after the last dose of Effexor.
I guess I'm wondering (in a very roundabout way, sorry) whether the fear is truly due to stopping Effexor. And if so, how long might it last? At most?
Thanks,
Marsha
Posted by kcjuggler on May 31, 2005, at 23:05:02
In reply to Re: How long do Effexor XL withdrawals last?, posted by 4WD on May 31, 2005, at 22:00:14
I'd like to know the answer as well. I tried to go from 37.5 to zero, and failed. I ended up going to my "regular" doctor, whom suggested I continue taking the Effexor every day - but half the 37.5 mg pill until they were gone. (I still have some left, but wanted to try to stop, since this past weekend was a long weekend.)
I took half of the 37.5 mg pill every day for 20 days. Today is my 5th day without taking any Effexor. Every now and then I'll get the "brain shock" (I like that description - thanks Lisa). I'll also feel some vertigo and find myself to be very easily agitated. These symptoms are no where near as bad as before, but still annoying.
Should I try 1/4 of the 37.5 pill? How long 2 weeks?
I don't want to go back to Effexor, as I think tomorrow might be the "day" when there are no more withdrawal symptoms. If I try the 1/4 pill approach, how many days of withdrawal symptoms do I endure before trying an 1/8 of a pill?
I feel like I'm on the 1 yard line and it's 4th down. I'm so close, do I go for 7 points (no pill), or settle for a field goal (1/4 pill)?
kc
Posted by SLS on May 31, 2005, at 23:28:43
In reply to Re: How long do Effexor XL withdrawals last?, posted by kcjuggler on May 31, 2005, at 23:05:02
Hi.
To make a long story short, cut the pills into 1/8 if you can - precision is not necessary - and take small doses several times a day. You will probably end up dosing 3-5 times a day. You'll be using Effexor as a PRN like aspirin for a headache. It is important to wait until the withdrawal effects reappear before taking your next dose. This is a flexible-dosing strategy that works well when one is trying to taper the last 25% of the original dosage.
Like I said, precision in dividing up doses is not critical here. However, through experimentation, you would like to find the amount of Effexor that will allow you to be free of symptoms for 6-8 hours. This might mean using 1/4 pill to start off. I have no idea. If you go well beyond the 8 hours, take smaller doses. You will find that you need smaller and smaller doses to mitigate the withdrawal. When you get stuck in that you cannot reduce the dosage any further without making it lasting 6 hours, just discontinue it completely. The withdrawal syndrome should be relatively mild and short-lived.
I don't know what percentage of people this flexible-dosing strategy is ideal for, but I think it is worth a try. I find that I can get off of 300mg of Effexor within 2 weeks this way without suffering residual symptoms thereafter.
- Scott> I'd like to know the answer as well. I tried to go from 37.5 to zero, and failed. I ended up going to my "regular" doctor, whom suggested I continue taking the Effexor every day - but half the 37.5 mg pill until they were gone. (I still have some left, but wanted to try to stop, since this past weekend was a long weekend.)
>
> I took half of the 37.5 mg pill every day for 20 days. Today is my 5th day without taking any Effexor. Every now and then I'll get the "brain shock" (I like that description - thanks Lisa). I'll also feel some vertigo and find myself to be very easily agitated. These symptoms are no where near as bad as before, but still annoying.
>
> Should I try 1/4 of the 37.5 pill? How long 2 weeks?
>
> I don't want to go back to Effexor, as I think tomorrow might be the "day" when there are no more withdrawal symptoms. If I try the 1/4 pill approach, how many days of withdrawal symptoms do I endure before trying an 1/8 of a pill?
>
> I feel like I'm on the 1 yard line and it's 4th down. I'm so close, do I go for 7 points (no pill), or settle for a field goal (1/4 pill)?
>
> kc
Posted by kcjuggler on June 1, 2005, at 8:36:24
In reply to Re: How long do Effexor XL withdrawals last? » kcjuggler, posted by SLS on May 31, 2005, at 23:28:43
THANK YOU!!!! Fascinating!! I never would have thought of this approach. I will give it a shot. Just took my first 1/4 or 1/8 amt. I can't thank you enough for the help!
kc
Posted by Margie24 on June 1, 2005, at 23:02:15
In reply to Re: How long do Effexor XL withdrawals last? » kcjuggler, posted by SLS on May 31, 2005, at 23:28:43
I am 5 weeks pregnant, was taking 150mg of Effexor daily when I found out (had been for 2 years). Obststrician said to stop. 150 every other day for 2 weeks, 75 " ", then stop.
I wanted to get off quicker, because I don't trust it with the fetus. Went straight to 75 for a week. Was okay. Split 75 (roughly, becasue I have the beads), and took 37.5 for 4 days. Quit altogether today.
My brain is half shut down. I can't reason through anything too complex. I have to print out one of your responses regarding tapering with 1/4ths so my husband can read it and explain it to me! Anyone else feel just flat out STUPID??
The worst is the swooshing in my ears when I turn my eyes.
I see other meds can alleviate effects, but I really don't want it in my bloodstream right now. This period in pregnancy is supposedly one of the most delicate.
I think I can hold on for a few days.
My question is....IS IT SAFE TO FEEL THIS WAY? WILL I HAVE BRAIN DAMAGE? And WHY does this happen? I have close friends who are alcoholics and former drug users. They didn't have such prolonged withdraw.
WILL IT STOP SOON?Thank you so much to all who have posted on this topic.
Posted by LBB on June 2, 2005, at 1:03:59
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 1, 2005, at 23:02:15
Hey everyone, well I made it today with the same side effects, but less powerful than yesterday. Today I found that if I ate and didn't let my blood sugar get too low, the side effects were not as strong. The most significant improvement seems to be those flippin 'brain shocks.' Those seem to have improved (they used to make me feel like not only my brain was being shocked, but also my tongue would feel a bit shocked and numb, if that makes any sense).
So today still sucks, but not as bad as yesterday. Tomorrow will be day 7 off Effexor. I hope it gets better each day, even if just a little.
Margie - I wonder the same thing. Is my brain permanently damaged from this or what? I imagine that in the long term, maybe nobody has the answer, which scares me now to think about. I guess we take risks anytime we take these meds. I just wish I had known about this before I opted to take them. Had I known about this, I never would have agreed. And I am someone who prides herself on doing research before taking medication, etc. After my baby died, I just didn't care about it, and went with what my shrink said. Anyway, I hope it gets better for you. ((HUGS))
Lisa
Posted by jdjour on June 2, 2005, at 3:29:17
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on June 2, 2005, at 1:03:59
Thanks to everyone who has written here about Effexor. You've all been a great help. I've been tapering off of it slowly for a month and on Sunday I took my last capsule. I've been feeling awful since Tuesday - brain zaps, eye pain, fatigue, vertigo. To make matters worse, I developed a "floater" in one eye and had to see an opthalmologist since I was seeing some flashes also. Who KNOWS if that had something to do with the withdrawl, but I had to have it checked to see if I had torn my retina (no). The flashes are gone, but the annoying floater is still there. Anyway, I had to go to a work function tonight, and before I went, I took a few beads from one of my capsules - feeling like a complete junkie! - and it helped the withdrawl symptoms. I'm determined not to do that again unless I can't function when I need to. I want this junk out of my system forever.
I keep wondering why pharmaceutical companies get away with marketing drugs without issuing a severe warning about going off them. I would NEVER have taken these, had I known how horrible I would feel trying to get off of them. I feel worse than I did when I started taking them for the stress I was experiencing around caring for my aging mom.
My doctor who prescribed these (who is supposed to be cutting edge), said to me on Tuesday, that since it was 48 hours after my last pill then, that my withdrawl symptoms wouldn't get any worse than they were. She must have been trained to give "anxious" patients a positive message. Thanks, yeah, big help.
Looking forward to feeling better...
Jdjour
Posted by LBB on June 2, 2005, at 10:24:44
In reply to Re: How long do Effexor XL withdrawals last?, posted by jdjour on June 2, 2005, at 3:29:17
It makes me so mad and sad to see all these posts... how do the pharmaceutical reps. sleep at night? Seriously! I mean of course Effexor does some good, it helps with depression - but this withdrawal syndrome, it is such an evil monster and no where are we told about it except through others like ourselves. I guess all we can do, those of us who have and are suffering through this hell, can be warriors for the cause, to warn people of these risks - then at least people can make an informed choice about taking Effexor as their antidepressant.
Part of me thinks we should print out these posts and send them to the media, send them to the drug reps., send them to the FDA!
I hope everyone feels a little bit better today than yesterday. ((HUGS))
Lisa
Posted by SLS on June 2, 2005, at 11:20:07
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on June 2, 2005, at 10:24:44
> I guess all we can do, those of us who have and are suffering through this hell, can be warriors for the cause, to warn people of these risks - then at least people can make an informed choice about taking Effexor as their antidepressant.
Please remember that EVERY SRI has been observed to produce intense withdrawal syndromes. Effexor is not unique. Unfortunately, with its short half life, Effexor makes tapering difficult *unless* one is prepared to take small amounts several times a day rather than once a day or skipping days.
Fair reporting to people regarding antidepressants should suggest that the SRI discontinuation syndrome exists for all of the drugs represented in this class.
- Scott
Posted by Margie24 on June 3, 2005, at 15:47:16
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on June 2, 2005, at 1:03:59
I went to petitiononline.com/effexor/ and signed it. It's a petition to the manufacturers asking them to disclose effects to public. You can leave a comment. It just made me feel good for some reason-just thought I'd let you all know.
Mags
Posted by kcjuggler on June 3, 2005, at 21:21:43
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 3, 2005, at 15:47:16
Just a follow up - I've been able to make it thru 2 days effexor-free! Yeh! I hesitate to jump up and down, as I'm afraid this isn't a "permanent" and/or "real" thing... don't want to "jinx" it, if you know what I mean.
Taking small portions like an aspirin seemed to work. I had to do it only 1 day. The next day I didn't feel any of the physical symptoms. I have been a bit cranky, but don't know that it's related to lack of effexor.
I hope I remain symptom free. I wish all of you luck and speedy recoveries from the withdrawal effects. I also want to thank all whom have posted. This forum really helped me, when I didn't know where to go for help.
kc
Posted by Margie24 on June 3, 2005, at 22:49:12
In reply to Re: How long do Effexor XL withdrawals last?, posted by kcjuggler on June 3, 2005, at 21:21:43
Today I had a much better day too. I'm not free, but trying the flexible dosing and it seems to be working rather well.
I'm so glad you have good news. There isn't enough. I think it's easier for us to get on here and rant and rave, then forget to come back and talk about the positives.
Thanks jugg.
MW
Posted by jdjour on June 5, 2005, at 5:13:08
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 3, 2005, at 15:47:16
Hey, Thanks for the info about the petition. I signed it also. I've also felt better today and have been using the dosing schedule when needed. Today I didn't have those head zap symptoms and didn't need to take "beads" (!). Now if I could just get this insomnia under control...! I didn't exercise today, and that might be the problem.
Posted by kcjuggler on June 5, 2005, at 13:28:16
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 3, 2005, at 15:47:16
Well sad to say I had to take some beads today. I had 2 days without any physical symptoms, which I'm grateful for. I was easily agitated though, and a bit anxious those 2 days. I don't know if these were drug side effects or not. Saturday, I felt a bit lite headed, and thought: "it can't be withdrawal can it"? I tried to ignore the symptoms, thinking it was something else. I played my tennis match and I wasn't really there on the court. I was very disappointed & frustrated with my my play. I play for fun, so it shouldn't be a big deal, but it was a downer nonetheless. Today (Sunday), I finally took a few beads as again I am feeling a bit lite headed.
How many days to you have do you have to be "clear" of symptoms before you know you are done with the drug?
kc
ps. trying not to let this get me down, I'm trying to be patient, which isn't one of my strengths. Also thanks for the petition website. I finally signed it today.
Posted by Margie24 on June 6, 2005, at 12:56:06
In reply to Re: How long do Effexor XL withdrawals last?, posted by kcjuggler on June 5, 2005, at 13:28:16
Anyone else extrememly irritable trying to come of this. (I'm pregnant, but this is like serious anger). Yesterday, I was trying to resist taking another 1/2 becasue I had made it through 1 1/2 days without symptoms much, thought it would get better from here. Yesterday, it just got worse and worse and worse.
I've known my husband for 3 years. WE NEVER YELL AT EACH OTHER. Yesterday I slammed a door in his face and told him to go away because he moved something and I was looking for it.
Also, when the withdrawal is bad like that I CANNOT THINK. Seriously, like I'm mentally retarded.
Anyone have the same?
Mags
Posted by Margie24 on June 6, 2005, at 12:58:40
In reply to Re: How long do Effexor XL withdrawals last?, posted by kcjuggler on June 5, 2005, at 13:28:16
One more thing....
CHECK YOUR PUPILS.
My pupils are tiny. They are usually larger. I compared them with my husband, almost half the size!
Anyone else?
Posted by SLS on June 6, 2005, at 16:59:47
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 6, 2005, at 12:58:40
Don't be so "brave". It will just cause you great stress and discomfort. Imagine what your baby is experiencing from these withdrawal effects.
If your system responds as mine does:I would restart the Effexor and take small amounts several times a day when you feel the withdrawal symptoms appear. This is a flexible-dosing strategy. Use small amounts of the drug as if it were aspirin to treat a headache. When the headache appears, take enough aspirin to last 6-8 hours. Wait until the headache reappears, then take more. You will see that you can take smaller and smaller amounts to get you through the 6-8 hours. You will eventually reach a point when a further decrease in the dose no longer gets you through 6 hours. At that point, just stop taking it. You will go through a mild withdrawal that lasts only a few days at the most.
Your other option is to switch over to Prozac for a few days. Its long half life will act as a naturally gentle taper.
Either of these two methods should have you free of medication in 2-3 weeks.
Again, don't be a hero. Continue to use medication as a tool to gently remove them.
Good luck.
- Scott
Posted by LBB on June 8, 2005, at 0:29:41
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 3, 2005, at 15:47:16
Hey friends, well I have been Effexor free for almost 2 weeks now! All side effects are gone now, except for slight vertigo every so often. I went to my acupuncturist 3 times last week and also went on a toxin "juicing fest." Drank lots of fresh veggie and fruit juices and ate really healthily. I think my body really was craving certain foods to help rid my body of this crap. Whatever it was that worked: whether it was a combination of time, acupuncture and trying to maintain a diet to help keep me on a more even keel to be able to deal with the withdrawal - I am just super thankful it is over.
Anyway, I have decided to grieve the death of my daughter without any meds if I can. I will never go back on Effexor, that's for sure!! I have also signed the petition. I don't care what the pamphlet says that the pharm. co. puts out, it does NOT discuss this severe type of syndrome that so many of seem to have gotten.
I wish all of you the very best and thank you for your support. ((HUGS))
Posted by margie24 on June 8, 2005, at 1:49:33
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on June 8, 2005, at 0:29:41
Thanks so much LBB, for coming on to post something positive. That's hard to find in this mess. It's nice to see there may be a light at the end of this tunnel.
M
Posted by kcjuggler on June 8, 2005, at 12:19:51
In reply to Re: How long do Effexor XL withdrawals last?, posted by Margie24 on June 6, 2005, at 12:56:06
I've been wanting to reply to this and just haven't made the time - sorry.
I SO RELATE TO THIS!
I'm a dog person, and am blessed with the best, sweetest dog in the world (yes I'm biased).
I had several days where I yelled at her for no reason. I felt very bad about it, but I couldn't stand to be near her. She did absolutely NOTHING to deserve it. I feel like a horrible person, but it just came out before I could squelch it.
I've been better about this the past few days, I'm no longer immediately yelling. I'm at more of a tolerant stage, and I think, (please oh please), even that is improving.
Posted by kcjuggler on June 8, 2005, at 12:21:04
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on June 8, 2005, at 0:29:41
Congrats!!! I'm so happy you've made it through. I hope the rest of us will follow in your same steps!
Posted by Emmi on June 9, 2005, at 17:30:05
In reply to Re: How long do Effexor XL withdrawals last?, posted by margie24 on June 8, 2005, at 1:49:33
Well..after a year of tapering off...I think I did it!! The last several weeks I opened the capsule and counted out the granules. I went from 150mg down to 65mg capsules. Once I hit 65mg, I started opening them. There's 150 granules in a 65mg capsule. I got daring and only took 50, or 1/3. Did that for 4 days...then dropped to 49, then 48, th45, the 35 for a few days..then a big leap down to 10 granules for 3 days. I'm on my fourth day with NONE..ZERo..ZIPPO...yeah I'm a little lte headed and some double vision. but I guess since I had been recuding so slowly, I ended up having only about 5mg inme when i quit cold turley for days ago. Had a tooth pulled today and he put me on activan. HOpefully I"ll now sleep through the last hours of withdrawl. Finally.....
Hang in the gang and remember...slower is better!
Emmi
Posted by canadiangirl3 on June 10, 2005, at 20:54:24
In reply to Re: How long do Effexor XL withdrawals last?, posted by LBB on June 8, 2005, at 0:29:41
Hey Lisa,
I'm happy for you feeling so good. I did a fast effexor taper with small prozac doses and was feeling good until i tapered off the prozac. I'm paying for it now....It's been almost five weeks off prozac and I feel like crap. Zappy, moody, achy and bloated.....and really really scared about when (and whether) this will ever end! Can you tell me more about your juice cleanse as well as what your acupuncturist did. Was there a particular area on your body that you were treated on? My stepdad does acupuncture so maybe I should try that route. I am dying to feel better!!!
D.
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