Most of us will have to come off Effexor XR(Efexor XL in the UK) at some time or other. This thread will give some advice on tapering schedules or cross-tapering schemes.

Any suggestions for tapering off Effexor XR (Efexor XL) is not meant to be as a substitute for your Drs advice or recommendations.

Possible side effects from discontinuing Effexor XR
Most people on Effexor XR will be able to stop the drug with only minimal side effects some others may suffer from a range of symptoms such as electrical like shocks (brain zaps), dizzyness, sleeplessness, nausea, irritability, crying or nightmares.

Why do we get discontinuation side effects
Effexor XR has a much shorter half life (4 hours) compared to SSRI like Prozac which I think has a half life of around 3 days. So stopping Effexor or missing a dose may cause some discontinuation side effects ( a dr did warn me not to run out of Effexor). Effexor XR causes this type of side effects because our serotonin receptors have to adjust immediately to reduced levels of serotonin, whereas with an AD like Prozac our receptors have longer to adjust (this is my understanding and I am not knowledgeable in this type of process).

Tapering Off
My pdoc recommended to me that I came off Effexor XR in steps of 37.5 mg every 2 to 4 weeks, with the last 2 weeks of 37.5mg every second day. I choose to do it over 2 week periods. So from 225mg dose, it took me 12 weeks to come off Effexor XR. I had minimal or no side effects at all.

From dose of 225mg
Week 1 & 2 - 187.5mg
Week 3 & 4 - 150 mg
Week 5 & 6 - 112.5 mg
Week 7 & 8 - 75 mg
Week 9 & 10 - 37.5 mg
Week 11 & 12 - 37.5 mg on alternate days


Cross-tapering off Effexor XR (Efexor XL)
If you are experiencing severe side effects of discontinuing Effexor XR there is also another method for coming off Effexor and that is cross-tapering. What you do is reduce the effexor as much as you can without getting the disabling side effects and then switching onto another AD such as Prozac at the same time as the lowest dose of Effeoxr, then stop the Effexor, and then wean off the Prozac.

What I've found on other sites is that you need to come down to 37.5mg, then start 10mg Prozac and take both together for a week, then stop the Effexor, up the Prozac to 15mg or 20mg and then taper off the Prozac after a week or two. Again this is only a suggestion, please talk to your dr for professional advice.

From dose of 225mg
Week 1 & 2 - 187.5mg
Week 3 & 4 - 150 mg
Week 5 & 6 - 112.5 mg
Week 7 & 8 - 75 mg
Week 9 - 37.5 mg Effeoxr XR, 10 mg Prozac
Week 10 & 11 - stop Effexor XR, 15 or 20 mg Prozac
Week 12 - taper off or stop Prozac

Other meds that help combat the symptoms of discontinuing Effexor XR (Efexor XL)
Some people from the States have suggested that Benadryl may help with things like dizzyness or nausea.

If you are suffering from side effects, it would be better to talk to your Dr or pharmacist for advice on what you may be able to take.

Another person recommended Green Tea.

This post has been edited by firelizardee: Mar 9 2006, 05:44 AM

My regime was similar. Little steps. My biggest fear was that the 'withdrawal' effects would not go away: but each change only lasted 1 and a half days. It took me 9 weeks to get off completely.

Don't rush it. Look after your brain. Let it rest in between each drop in amount. The effects will go away eventually. The brain zaps stop eventually!

Yea when I went off it I slept for two weeks.

Please tell me if I need to be doing something different. I began Effexor XR 06/2005 after trying to cope with an ugly divorce, a job, and two little girls 8 and 10. The divorce is final, settlement is still up in the air, and my girls and I have relocated 900 miles and are living with my brother and his family. I am so very blessed to have the positive support in my life. I am working for my sister-in-law when able and taking care of myself mostly right now. In doing so, I have recognized that although the Effexor XR helped to get me through a very rough period of my life I cannot function at the level that I once did because of it.
I was tapered onto Effexor XR 75 mg, in 37.5 mg over a 4 to 6 week period. I have maintained the 75 mg level until a week and a half ago. I began taking one 75 mg every other day. Today is the first day I have not taken the 75 mg in three consecutive days. I am in a fog, my head hurts to the point that my hair almost hurts, I am naseatious, I cannot seem to focus on work at all, and really just want to go to sleep for the next month.
My question is should I take a 75mg dose today and repeat in three days for another week or should I simply tough it out?
Thanks for any direction,
Foggy.......The light in the forest is warm and inviting!!!!

foggy
you could try just toughing it out, but it depends on what you experience. If it gets too bad then take 75mg dose. You could try reducing to 37.5mg for a week or two and then taking the 37.5mg on alternate days for another week or two and then stopping.

I'm not sure, but I'd suspect that if you took a 75mg dose now and then nothing for another 3 days that you would experience the same symptoms as now.

Effexor has to be stopped gradually otherwise you may experience some discontinuation side effects. Your dr should be able to advise you on how to stop effexor.

This post has been edited by firelizardee: Mar 9 2006, 05:47 AM

Thanks for the advice firelizardee! I am really experiencing some ugly side effects which include nausea, dizziness, severe abdominal cramping and what goes along with it, sensitivity to light, and a massive headache.

I did take a 75 mg this morning out of desperation to function a little bit today. I guess I need to get a script for the 37.5 mg dosage in order to step down correctly. What do you think????

I wish I could get off the world for 2 to 3 weeks and just tough this out. However, life is not going to cooperate with that kind of schedule.

Any advice and/or encouragement would be greatly appreciated.
God Bless and be with you today and always

foggy

if you are on the extended release version with the beads inside, you could try opening them up and taking half out. But that would mean that you wouldn't get exactly 37.5mg. Depends on whether you can afford it.

I managed to remove roughly half the beads, I just opened it up, tipped the entire lot out and then separated in into 2 piles and put one half back into the capsules and just ditched the rest.

Hope whatever you do works for you. I am sorry you are having these bad side effects.

Eileen

I stopped taking this as it seemed to be having no discernible positive effects, for some reason I kept going to the doctors and getting the prescription and pills though - not sure exactly what my plan was but as luck would have it I can't remember where I put them so that prevents me doing anything "silly" with them lol

hi guys,
was on effexor xl before (225 max), went from being suicidal to feeling really good about myself. went off them (probably not in the right way) and have been getting progressively worse since (about 4 months now). started back on them a week ago, just praying that they will work again coz am just finding it so hard to get thru the day right now

jonny_irish

welcome to DF. I hope that you find this site useful and that this time around the meds work just as well for you as they did the first time.

Some drs believe that we should stay on meds for at least 6 months after the symptoms of depression have left us, this can help prevent a relapse.

I am sorry you've fallen back into depression. Do join in at DF.

Eileen

I had my last efexor dose on Saturday.....have been coming off it slowly since January..its still pretty rough...lots of anxiety, flashbacks, weepy spells, jitteriness....dizziness....

am still on remeron which I was taking in addition...so at least I get to sleep....

Im coming off effexor

im taking 150mg xr every two days

i suffer heavily from dizziness and become very light headed.

can anybody please tel me why

thanks
rap

rap I think you are tapering off at too high a dose, you must reduce much more slowly than what you are doing. I was advised to drop in steps of 37.5mg every 2 weeks. So instead of taking 150mg every 2nd day try dropping to 112.5 for 2 weeks then down to 75mg for another 2 weeks then 37.5mg for a further two weeks. Is there a reason you have to come off the way you are doing it?

Eileen

Hi - I am new to the board and wanted to see if anyone's switched from Effexor to Cymbalta? Basically I'm switching because (1) Effexor has only been so-so for me and (2) it's no longer on my insurance formulary and therefore's more expensive now. I've been taking 150 mg of Effexor.

My doctor said I could just take Effexor one day and Cymbalta the next (she has me on 30 mg the first week and 60 thereafter). Has anyone else switched that abruptly? Unfortunately my insurance doesn't cover mental health care, so I get my anti-depressants through my GP - and she isn't always up on all the issues involved. I know I have some reaction to quitting Effexor cold-turkey without a replacement - one day I forgot to take it and was dizzy and felt "drugged." But, I'm hoping that if I simply replace Cymbalta for the Effexor that won't occur.

If anyone else has switched from Effexor to Cymbalta I'd love to hear their story.

Thanks!

This post has been edited by charlie21: Aug 1 2006, 10:34 PM

I havent' heard of folk switching straight to Cymbalta but you should trust your dr. I've only heard of folk switching from Efexor to Prozac.

I hope it works well for you.
Let us know how you get on.

Eileen

I feel out of place and awkward posting this because I haven't really read any stories about people quitting Effexor painlessly... and to be honest I feel kind of weirded out that I haven't felt any horrible effects. It's been about 5 days since I stopped cold turkey.

Although, at the point when I stopped I couldn't possibly have felt any worse - I seemed to be experiencing a delayed side-effect reaction to a dosage increase. These side-effects were the most horrible and most violent of any I had experienced in my 11 weeks on Effexor - much like the effects that people go through in withdrawal rather than with increase. (muscle spasms, brain tremors, intense migraine, jittery, tense, teeth grinding, nausea, vision weirdness, etc...) I hadn't experienced anything close to the sort of pain I was in, and I found it extremely worrying that these started only 7 days into the dose increase and didn't show much signs of letting up. So I was at 300mg for 12 or so days at this point.

Freaking out that I was going to end up in a worse place (e.g. brain damage or swallowing my tongue or walking out in traffic - all which seemed real or came close) I just couldn't take it and decided I would reduce my meds. Being as I only had 150mg pills, any "tapering" seemed out of the question. I neurotically scoured the internet looking for help for hours until my body gave out in sheer exhaustion/delirium and I passed out on my bed fully clothed having taken NO dose. (Usually 100% night dose. And on 300mg I was usually meticulous about taking it regularly fearing extreme complications otherwise.) By the time I woke up the next day it was about evening again. That had been the longest continuous sleep since I had started on the meds.

I realized over 2 days had effectively gone by without my 300mg. I actually felt much better than I had in weeks in terms of side-effects. I decided to forego the Effexor indefinitely and braced myself for some harsh withdrawal "pangs" since I would usually feel negative effects immediately if I missed even one dose at a lower level. But strangely I've felt just fine.

Maybe I've just jinxed myself and tomorrow I'll experience another "delayed" attack. But I'm not counting on it. I have no idea what happened... it's almost as though the 300mg level pushed me through a "twilight zone" where everything started happening backwards: like the effexor was all of a sudden giving me withdrawal effects and being off it was my relief. Or maybe I've just forgotten what 'normal' feels like after that intense episode of pain.

~

I've mulled over and over this situation and I can't really explain it. I wouldn't advise anybody else to quit cold turkey but I just had to say that not everybody has a bad experience. (Or in my case, I didn't have a bad experience stopping after my bad experience upping.)

The only single other change I've made during this whole episode of stopping Effexor is that one day before I stopped the Eff I started taking omega3 supplements (am and pm). So for the past 5 days I've been taking only omega3 and I feel just fine (relatively). I'm sure this couldn't account for everything. I am almost back to square one. My sleeping returned to usual 10+ hours immediately and I can almost feel the mollasses 'lowness' settling back in place. Just an occassional very mild headache and some faint occassional muscle spasms linger. Physically & emotionally it feels almost like I was never on anything. If it weren't for the $$ worth of Effexor leftovers and receipts sitting here that I feel guilty about wasting, I might start doubting whether I was even on it. And I know my pdoc is going to be extremely upset at next appt. I'm so impulsive sometimes. In a flash I negated 11 weeks. And I've got no idea where to go from here. Wow I feel like a headcase...

I don't know if this forum was a good idea for me. It's just a reminder of how indecisive and longwinded and ultimately pointless all my thinking about everything really is. I write essays about everything and still nothing gets explained and still nothing comes of anything and still I remain as I've always been - but I guess at least I can stop worrying that my head is going to explode on effexor? for now? And I'm happy about pursuing omega3... although now I've gone ahead and reduced it to my only "treatment"... what am I doing?

kerosene

I have posted positive experiences of stopping effexor without any problems as have others.

Everyone is different and will react differently to meds.

Just think of all the people who take the med without any problem and who don't post.

I hope your coming off of Efexor works for you but I would not recommended anyone to stop efexor Cold Turkey without at least informing their dr.

From the list of side effects you were getting it did sound like you have done the right thing in not continuing with the increased dose.

All the best to you.
Eileen

I'm in need of some help here please. As I write I am twitching like a monkey on E, my face is tingling, I'm getting shocks in my brain and I can barely focus on the screen. Started SSRIs many years ago having always been what people used to call 'melancholy', but having lost my brother several years ago, went on Seroxat and then two years ago switched to Effexor. I have recently quit the drug. Have never liked the effects - night sweats and well crazy dreams - having to change my bedclothes 1- 3 times a night, not feeling comfortable staying in other people's houses, feeling pre-menopausal at the age of 30, etc etc. I didn't like my doc's rationale for staying on anti-dees FOREVER - that I get ok when I'm on them, and stabilise and then come off them and get low again. I would rather feel at this stage, and maybe have to go back on them in the future, then never really now how I'm doing. Besides, I am actually happier now than I ever have been in my life. Getting older is great, as is good counselling, close family and friends etc. I'm remarkably well adjusted ! Which is why I don't feel I need what amounts to a safety net anymore. To clarify, I think SSRIs were BRILLIANT when I needed them, probably saved my life. I just dont' think I need them any more.

Well, the withdrawal side effects are fun and no mistake... I took my last 37.5 dose a week ago now, having reduced under the supervision of afore mentioned doctor, who never talked about withdrawal. I'm feeling quite resentful of doctors right now - fob the sad girl off with drugs and then leave her with horrible side effects when she decides she wants control back of her brain. So, I have most of what people have mentioned - tingling, electric shock sensations, nausea, liqui-poo, can't get out of the bed/can't sleep, if I get blinkin hallucinations next I will NOT be impressed ! My question is, how long does this last ? I'm finding it really difficult to function normally. I had to take two days off work last week, told them I have a stomach bug/flu or something - well, you can't exactly tell them the truth, can you, especially in my situation where its a new job - ' I went a bit mad there a few years ago when my little brother died, but I really am quite good now and well adjusted and now I want to not be on anti-depressants anymore, and thats why I look and feel like s***. Cup of tea ?' I've read on ye olde internet symptoms can last 1, 2 or several weeks. I am DETERMINED to not take another pill, I couldn't face this again, so how long is it likely to be before I feel normal again ?? I have big stuff life-wise coming up in the next couple of weeks and my ability to deal would be seriously affected if I'm still feeling this awful. Any advice is greatly appreciated. Cheers.


--------------------

"There is no use trying," said Alice; "one can't believe impossible things. "I dare say you haven't had much practice," said the Queen. "When I was your age, I always did it for half an hour a day. Why, sometimes I've believed as many as six impossible things before breakfast." Lewis Carroll

"The deeper that sorrow carves into your soul, the more joy it can contain" Kahlil Gibran
Full PM
Quick PM

SillySoo
I don't know how long the symtoms will last as I didnt' have the same problems you are having. Some people have taken Benadyrl to help with the side effects if thats any help.

I hope it doesn't last too long for you.

Take care.
Eileen

Can you take benadryl between dosages coming off of effexor if you get the side effects?

The guy I don't really know, noone has actually said. I presume if you get dizzy side effects then take it for that.

but maybe you should check with your dr or with a pharmacist first.

Eileen

i was on effexor for about 5 years and about a year ago decided to get off....the benadryl was a life saver....even though it made me feel weird too, it was a HUGE help. I drank lots of water and even tried Bikram Yoga to sweat out all the bad stuff.....

It has been one year since I was on AD...and I am really starting to feel the effects of not being on anything. I can't make any decisions, even small ones, I feel paralyzed mentally, and just depressed all the time. I have tried a few things lately, wellbutrin, lexapro, but too many side effects. Effexor was the best thing I ever took, but the worst experience was getting off of it.....Any suggestions?

Thanks.

executivewoman
the only thing I could think of if you dont want to start efexor again is talking therapies.

Have you got a therapist?

Here is my effexor xr schedule. I am currently lowering the dosage on recommendation from the doctor as the side effects are just too much for me:

effexor start

37.5mg sept 23 / 06
75 mg sept 30 / 06
112.5 mg oct 7 / 06
150 mg oct 15 / 06
187.5mg oct 27 / 06
150mg octg 31/ 06 start - side effect at higher dosage too much at this time
112.5 mg nov 9 /06


For some reason the right side of my head is affected the most. I have a lot of pressure there and I started to feel irritable when I took my 112.5 mg this morning about 1.5 hours later. I feel like crap and I don't know how to describe it. Well I feel irritable, not relaxed to start, oh and constipation/bloating/congested intestinal feeling. I know I felt a little bit like this going up on the med but am I experiencing withdrawal at this point or the side effects of the med? My tapering schedule has been 37.5 mg decrease about every 7 days as the doctor told me too. Is this too quick? I can't imagine taking the med at 112.5mg for another 7 days before I go to 75mg.

I dropped by 37.5mg every 2 weeks, but see how you get on with taking it a week at a time. Hopefully you will be ok. Maybe you could space out the lower doseage more which should be more tolerable to you.

Take care and good luck.

Eileen

Effexor was the first AD I tried. I really didn't know what was happening, and thought I could feel a difference, when I don't think I could. My family doc got me up to 150mg/day then referred me to a psychiatrist. He added Wellbutrin (150mg twice then 200mg twice) That made a big difference. We tried upping the Effexor to 225mg then to 300mg, but that didn't do anything so we dropped back to 225mg. Since it didn't seem like the Effexor was doing anything my doctor discussed coming off the effexor and trying something different (Adderall) He wanted to have me completely off the effexor before adding anything else so we could tell 1 whether it was the Wellbutrin, or the combination with the Effexor.

So, we planned from 225 to immediately drop to 150mg for a week, then to 75mg for a week, 37.5 for 2 weeks, then off. I think the first day at 75mg I first noticed becoming very depressed, crying, sleeping from the time I would get home from work until getting up the next morning--which was new. I think it got better as the week went on, until I dropped to 37.5. Somewhere along the way I started getting the brain zaps and some vertigo. I was also on doxycycline (antibiotic) and was getting nausea in the morning, I thought it was from the antibiotic, but I'm not sure now. Somewhere along the way I also started getting fairly mild headaches, I'm not sure if it was the withdrawl, or the Wellbutrin though. Anyway, so after being on 37.5 for about a week, I went to my family doctor (for the infection) and he increased the effexor back to 75mg (because of the depression.)

I went back to the psychiatrist 2 days later, and I guess my family doc had called him and they decided to get me off of the Effexor. So he said to go back to the 37.5 for a week and stop it. That was last Wednesday. Yesterday, (this wednesday 2 days short of the week) I forgot to take the Effexor and left for work--I had taken everything else though.

It was interesting. I got the brain zaps as bad as I've gotten them, had a headache, hard time concentrating, really mild vertigo (the feeling that I've heard described as like your brain keeps moving when you move your head--really strange.) After reading online I have a bunch of coworkers with bad allergies, so found some benedryl which I took. It did seem to help some.

This morning, I'm still having the brain zaps, but not too badly. I guess we'll see how it goes.

Robert

durhan
it sounds like you are having mild discontinuation symptoms, I hope they don't last too long.

Eileen

Hi

Thanks.

So, day 3 off Effexor. The brain zaps are much less severe today. However, the vertigo is worse. Weirdly, emotionally I'm doing pretty well too.

Robert

Hey all,

I have been on 225 of E for almost three years now. About four months ago I started to think I could taper off the drugs and see how I could handle it. I took 187.5 for about 5 weeks and then down to 150 for about another 5 weeks. The only thing was I started to have unmotivating thoughts, anxiety, and 'old' thoughts about 'what is the point?' So I gradually increased back up to 225. The only problem is that it has been about 2 months and I still feel bummed. I know my job is hectic and coworkers are also tired etc. but I seem to be at my worst when it is hectic (try and sleep a lot but am still tired/unmotivated)
Anyway, if I go to my doctor I know he will just say "it's time to try another one" which kind of scares me with just quitting this one and trying another. I feel I will spaz out or something. I know he has mentioned in the past that you may have a psychological dependance on these pills-so I know he will just say to start another one and all will be good. Should I ask him to taper of E while starting another.....confused and scared....thanks for any insight

Hi Bigblue,

I hope you will feel better soon and be more at ease. If not, do not assume your doctor will take you of this medication and start a new one, could you go in and talk about it with him? Decide togheter on what move would be best next?

Good luck,

SN

I have been on the 37.5 dosage for about 2.5 weeks then I stopped. When I started the 37.5mg dosage I also started celexa at 10mg. I went to 20mg about 4 days after stopping Effexor. Today I am getting hot flashes in my face and neck, have anxiety, some head pain, feel down and a little dizzy. Can I still be suffering from Effexor withdrawal?

it might be discontinuation from Efexor, it might also be side effects of the Celexa. More likely to be the efexor though. It shouldn't last too long. Talk to your pharmacist or dr to see if there is anything to help with the dizzyness. Some Americans have said that Benedryl helps them (I'm not sure if thats an antihistamine or what).


Eileen

Thanks, on another note. I have just come down with the flu or at least I am assuming it is as Ihave body aches, I am vomiting a little, nauseous, high fever etc. I understand that withdrawal can mimic the flu so my question is, can this be withdrawal as well from the effexor or perhaps I actually have the flu? Note: Is is winter here and people are getting sick but I have never been hit so hard with the flu before in my life. What do you think?

Have you come into contact with people who have had the flu? It might just be coincidence that you have flu and stopped taking efexor. Or it might be the efexor. Since you are throwing up a bit, I'd ask the dr for advice. I haven't heard of others actually being sick after stopping efexor and it has been a while since you came off it.

Is there anyone else sick in your immediate family (if you live with people) that is?

Eileen

Actually I do think I got the real flu as I got a chest infection to

I decided to go off Effexor (the regular kind, not XR) a few weeks ago and I would like very much appreciate some advice on what I'm going through right now. Today has been a week since I've stopped it completely. I wasn't taking a high dose to begin with. I started on 37.5 mg 2x a day many, many years ago and was very recently increased to 75 mg 2x a day. This is how the doc said I should do the decrease:

First week-half of the 75 mg pill twice a day
Second week-half of the pill once a day
Third week-none

That's exactly what I did. I'm on week four now. The physical withdrawal symptoms are starting to go away, except I get hot flashes (is that a normal symptom?). Here's the problem-the longer I've been off of the medication the more I feel like my old self-the one I would like to make go away and never come back. These are the same feelings and emotions and thoughts I had when I started going through depression and "chemical imbalances". Every emotion is magnified. Fear, guilt, sadness-I feel it longer and more intense then I did 4 weeks ago. Something I probably wouldn't have given much thought to before stays with me incessantly. I want to improve the quality of my life and live it the way I want, but if I continue to feel like this its going to get in my way.
So, this is what I want to ask....
Does this mean I should go back on it? Is this was the medicine was controlling or is this just my mind readjusting?
Should I wait a little longer to see if it straightens itself out?
How long is someone supposed to be on Effexor?
Caffeine seems to have a strong effect on me now, too. What's up with that?
I would really appreciate any comments, advice, or whatever anyone can offer. Thanks.

I came off of effexor and went to celexa and about 3 weeks later I am getting hot flashes and a sense of fear, and anxiety. I am unsure if this is withdrawal for me but I would not doubt it.

I doubt whether it is the efexor withdrawl since you've been off 3 weeks, it could be the celexa, have you tried asking questions in that room and see if anyone else there has had the same symptoms?

Eileen

I have not asked that specific question but I have never felt fear before on these meds. I will have to look it up in the celexa forum.

I made the mistake of going cold turkey due to quitting a job and not having the money to continue. For the first week I got that awful "zapping" feeling in my head and it wasn't pleasant. They lessened every day until after a week they were gone. I wouldn't recommend going cold turkey for anyone.