![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by jandea on July 12, 2006, at 10:00:36
I had been on Effexor ER at 300 mg a day for well over a year. That drug worked well for almost a year but then I began having breakthrough depression even on this high dosage. My doc did not want to increase the Effexor and, instead, recommended I wean off that medication so that I could try another antidepressant. She was not specific about what other drug we were going to try once I was off the Effexor and seemed to be open to suggestions. I have been on a gradual tapering of the 300 mg of Effexor for the past six weeks and am down to one 37.5 mg dose a day. The withdrawal symptoms have been terrible. I have vivid dreams, brain zaps, all-over body aches, just to name a few of the side effects of withdrawal. Now that I'm almost off the drug (and will NEVER take it again), I'm wondering what other antidepressant I'm going to try.
I have a long history of depression. I also have a strong family history of depression with multiple suicides in past generations. I know that depression is not something to take lightly and I know that I need an antidepressant. Prior to being on Effexor I was on Lexapro but I gained so much weight on that medication I stopped taking it. In fact, toward the end, I was also gaining weight on the Effexor. Prozac was a wonder drug for me for several years in the early 1990's but I was unhappy with the effects of that drug on sexual functioning. Even so, I would considering going back on the Prozac if nothing else seems promising. At least with Prozac I didn't have the breakthrough depression or the weight gain.
Can anyone give me suggestions for an antidepressant that might be worth a try?
Mainly I'm interested in a drug that will work for a person to whom Effexor-ER at 300 mg was no longer effective after a year. I am also interested in a drug that will not promote weight gain and one that has minimal effects on libido or female orgasm. Finally, I want a drug that one is able to wean get off of without going through the hell associated with Effexor withdrawal. Maybe no such drug exists.
By the way, my doctor also recommended I take Provigil as an adjunct to any antidepressant that I decide to take. I have a major problem with lack of energy and motivation and have a hard time getting out of bed in the morning when my antidepressant medication is less than optimal. If I do decide to take Provigil, I will have to cover the cost of the drug without the help of insurance since my particular insurance company will not cover Provigil prescribed to treat depression. Provigil is approved for use with sleep disorders.
Sorry for the long post but I would appreciate any help.
jandea
Posted by SLS on July 12, 2006, at 21:41:01
In reply to Effexor withdrawal: Now what???, posted by jandea on July 12, 2006, at 10:00:36
It is unfortunate that people don't arrive at this site until after they have suffered the consequences of discontinuing medications using methods that are less than optimal. To taper further from 37.5mg, you might consider either taking very small doses several times a day using a flexible-dosing strategy or crossing over to Prozac for a few weeks. The intensity of withdrawal symptoms can be mitigated using Benadryl (diphenhydramine).
Regarding the choice of another antidepressant, Wellbutrin (bupropion) would seem to fit your criteria.
- Scott
Posted by wacky on July 24, 2006, at 14:36:19
In reply to Re: Effexor withdrawal: Now what???, posted by SLS on July 12, 2006, at 21:41:01
I am new to this site and think it is wonderful. I am taking 450mg of Effexor - and have been on this high dose for close to a year. I also take 100 mg of Trazadone at bedtime for sleep. I've read so much on withdrawals that I am HORRIFIED especially since I'm on such a high dose.
I was planning on asking my pdoc to reduce dose because I am so sick and tired of sweating - but now I see that even using the 37.5 dose reduction isn't slow enough. How do you taper off slower if that's the lowest dose they make?
Posted by SLS on July 25, 2006, at 6:56:33
In reply to Re: Effexor withdrawal: I'm horrified!, posted by wacky on July 24, 2006, at 14:36:19
> I am new to this site and think it is wonderful. I am taking 450mg of Effexor - and have been on this high dose for close to a year. I also take 100 mg of Trazadone at bedtime for sleep. I've read so much on withdrawals that I am HORRIFIED especially since I'm on such a high dose.
>
> I was planning on asking my pdoc to reduce dose because I am so sick and tired of sweating - but now I see that even using the 37.5 dose reduction isn't slow enough. How do you taper off slower if that's the lowest dose they make?You can use 25mg tablets and break off very small pieces of it. I didn't bother with that, though. I just opened up the 150mg capsules and removed fractions of their contents. The tablet are a better alternative, though, and are worth getting.
When are you going to begin your taper?
I was able to discontinue Effexor 300mg within two weeks, but I used a flexible-dosing method.
- Scott
Posted by wacky on July 25, 2006, at 11:59:53
In reply to Re: Effexor withdrawal: I'm horrified!, posted by SLS on July 25, 2006, at 6:56:33
Thanks Scott! I didn't know it came in tablets. After what I've read, I'll ask for those. I see my pdoc August 23rd. That's when I'm going to TELL him I want to wean off. I don't care if it takes 6 months - as long as I don't have the horrific withdrawals I've read about. I can't afford to miss work for 2-3 weeks - aside from the living HELL it must be.
At this point I think the Effexor is more problem than it's fixing. I know he's going to argue with me because he wants me to stay on something for 2-3 years. But it's my body/mind and I'm very clear that's what I want to try. The risk is worth it.
Thanks for the input.
Nancy
Posted by SLS on July 25, 2006, at 22:49:36
In reply to Re: Effexor withdrawal: I'm horrified!, posted by wacky on July 25, 2006, at 11:59:53
> Thanks Scott! I didn't know it came in tablets. After what I've read, I'll ask for those. I see my pdoc August 23rd. That's when I'm going to TELL him I want to wean off. I don't care if it takes 6 months - as long as I don't have the horrific withdrawals I've read about. I can't afford to miss work for 2-3 weeks - aside from the living HELL it must be.
It shouldn't take 6 months to taper, but it is good that you are thinking along those lines and have the luxury of time. Everyone's optimal taper rate will be somewhat different, and I believe there should be an element of flexibility allowed in the construction of a program to discontinue one of these medications. There is no reason why you should have to experience chronic withdrawal symptoms. If symptoms persist beyond 12 hours, you are tapering too fast.
To use a flexible-dosing strategy, there is some trial-and-error involved. Remember, though, that if withdrawal symptoms appear, they can be extinguished very quickly by taking a small amount of medication. It usually doesn't take more than 30 minutes after taking the medication for symptoms to ease. This will actually be your most basic maneuver in this taper method, especially once you reach the lower dosages. Once you reach the lower dosages in your taper program, you purposely wait until withdrawal symptoms begin to reappear before taking your next dose of medication. However, you want to take only enough so that you remain symptom free for only 6-8 hours before needing your next dose. You end up taking very small doses (fractions of pills if necessary) several times a day. You will find that the amount of the dose necessary to prevent withdrawal symptoms becomes lower and lower. Starting at the higher dosages, you can follow a more structured schedule. However, you can let the same basic principal guide you to making choices of how much medication to take and when. It is not necessary to allow yourself to experience withdrawal symptoms for extended periods of time. If they appear and persist for more than a few hours, you will know that you have reduced the dosage by too much or allowed too much time to pass. At this point, you can either take a small amount of medication or take your next dose. Adjust your dosing schedule afterwards. It is not necessary to be precise with dose amounts or dosing times. Approximations work well. This taper method allows for a certain amount of flexibility.
I was able to discontinue Effexor 300mg within 2 weeks using this method. Perhaps this is not the right method for you. Your system might be very different from mine. However, it has worked for many others who have tried it.
- Scott
Posted by wacky on July 27, 2006, at 12:11:10
In reply to Re: Effexor withdrawal: I'm horrified!, posted by SLS on July 25, 2006, at 22:49:36
Sounds like it's a plan that really works. I'm going to print this out and refer to it when I start the taper.
Thanks so much.
Nancy
Posted by SLS on July 27, 2006, at 16:17:43
In reply to Re: Effexor withdrawal: I'm horrified!, posted by wacky on July 27, 2006, at 12:11:10
> Sounds like it's a plan that really works. I'm going to print this out and refer to it when I start the taper.
>
> Thanks so much.
>
> NancyI always have difficulties describing this thing for some reason. Does it make any sense? I'll be happy to answer any questions you have.
- Scott
Posted by Dreamcatcher1 on September 6, 2006, at 17:48:57
In reply to Re: Effexor withdrawal: I'm horrified!, posted by SLS on July 25, 2006, at 22:49:36
I have been taking Effexor XR for approximately 4-5 years. It has done well for my panic attacks and social anxiety. However, I was getting tired of the sexual side effects. So, I requested my physician to give an opinion on other prescription he felt would control my anxiety but not have the sexual side effects. Buspar was suggested.
I have been tapering off of Effexor 75mg twice daily since July. I started taking Buspar 7.5mg twice daily in July. I tapered down to Effexor XR 37.5mg once daily for a little over two weeks. I then stopped as 37.5mg is the lowest dose of Effexor XR. Approximately two and a half days later, I felt like I had been hit in the head with a brick. The last five days have been miserable. Words can't describe the dizziness.
I went to another physician yesterday as my physician is out of the office. I was told to start taking the Effexor XR 37.5mg for seven days and on the eigth day start taking the 75mg.
Reluctantly, I did take 37.5mg to see if this was the real reason for the dizziness, nausea, etc. It was!!!! That really concerns me and makes me want to stop taking it even more so.
The dizziness subsided today. I have a horrible headache. I have decided that I will not return to taking the Effexor XR 75mg. I was not having any side effects from the Effexor XR 37.5mg daily. Therefore, I am going to divide the little pills in the capsule up and wean off little by little.
Thanks to Scott for advising he divided the little pills in the capsule! I had given some thought to that but did not know if each little pill in the capsule had the same ingredients.
One would think the physician I saw could have recommended that!!! Once my physician returns to his office, I will request his opinion. I wonder if he will suggest dividing the little pills in the capsules. If he doesn't suggest, I will suggest and await his opinion. I will update this site as to my success. I would never have thought that I could feel so bad withdrawing from Effexor XR.
P.S.: Now I am starting to wonder about Buspar. Anyone have terrible side effects withdrawing from Buspar?
This is the end of the thread.
Psycho-Babble Withdrawal | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.