I'm weaning off venlafaxine. help and advice appreciated

[EdwiniasRevenge]

Hi all,

I've been taking venlafaxine for 12m or so. Now is the time to come off. I'm currently taking 75mg extended release Venlalic per day. The plan I have been given by my dr is as follows:

37.5mg daily for a week
37.5mg alternate days for 1-2weeks
37.5mg every third day for a week if necessary.

I've heard that coming off this drug is hideously pants. Any advice or experience would be appreciated. I know I am likely to feel shite with the withdrawal. When is that likely to hit me? If I have an idea I can plan my withdrawal for when I have extra support.

I'm withdrawing from the same dose of extended release venlafaxine at the moment - the plan I was originally given by my doctor was a disaster (similar to yours but slower, starting with replacing a 75mg dose with 37.5mg dose twice a week). It might be that a sudden drop in dosage is less awful than the upping-and-downing I was doing but it will be very hard.

With my GPs agreement I've come up with another method which seems to be working really well. My doctor is fully supportive and even apologized for the week and a half of hell I went through on 'her' protocol - she hadn't known venlafaxine has such a short half-life and was following the protocol for withdrawal from SSRIs with a much longer half-life.

First I swapped to 37.5mg every 12 hours - so, no change in actual dose. This wasn't much fun.
I'm now stretching out the doses to give a reduction of 75mg over the course of each week, which has been fine so far. I'm only down 75mg per week from my original prescription to date (achieved by taking 37.5mg every 14 hours). I'll be going on to the second stage tomorrow - 37.5mg every 17 hours.

If you're interested I can show you my workings so you can discuss it with your GP.

I'll see how I go and come back to you if I struggle.

TBH the last couple of months I've been really bad and remembering my dose so I regularly miss one dose per weekand on ooccasions possibly 2. I just have no concept as to how missing 2-3...then more... in a row is going to affect me. I did once miss 3 days over a bank holiday when I thought I had more in the cupboard. That was hell but going from 75mg to nothing overnight.

I still have some 75mg tablets so could alternate 75 and 37.5 for a week then follow the above plan...but I worry about yo- yoing the dose.

I've also read that fluoxetine can be used to minimise the withdrawal....and I have a stash of that from 12m ago but would obviously be taking it without medical advice...

My DCs are spending the week with their dad next week. If I knew that the withdrawal symptoms were only going to last a few days I would time it for them and hide in a darkened room for the week....somehow I think a few days is optimistic...

It's really heavy stuff to come off and you can expect extreme irritability confusion and anxiety, as well as maybe paranoia and potentially hallucinations on top of the nasty physical effects (brain fog moving into total brain 'stop', headache and stabbing head pain, muscle pain and cramping, tiredness, speedyness etc. etc.).

It's important that your GP knows what your doing. Please don't take any other medication that hasn't been prescribed for this process - if you're thinking of doing the crash to 37.5mg whilst alone it's be wise to ask for some Benedictines to tide you over.

Benedictines = benzodiazepines (diazapam of family thereof). Monks could be quite soothing though

I came off it 'cold turkey' on medical advice as I had three small children at the time who would be away for a week so for me it was better to get it over and done with while they were away that have weeks of feeling unwell. I can honestly say it was the most ill I have ever been in my life (and I've had several illnesses requiring hospitalisation!). I literally could hardly move from the sofa for a week, I had 'electric shocks' in my head, nausea, dizziness, muscle pain, it was horrible. But by the end of the week I was much better and able to cope with the children again.

I would never take venlafaxine again but if I had to go through the withdrawal again I would reduce the dose veeerrrrry slowly instead (I did this with lofepramine a few years later- literally reduced the dose by quarter of a tablet at a time and took each new dose for three or four days before reducing by another quarter).

Good luck with it.

I'm a bit worried that my GP casually thinks that in 3weeks it will all be sweet as roses....

Well, it is possible that all will be OK in 3 weeks - the quicker you come off the more intense the withdraws will be and the more potential risk you have of lingering withdrawal symptoms. But, OTOH it'll all be over and done with pretty sharpish.

The withdrawals really can be very frightening if you reduce quickly (it feels dangerous, although it isn't really) because of that a lot of people then go back up to the original dose of this lifesaving but vile drug just to make it stop and a frightened to start another withdrawal program.

With this slow method I'm using I feel slightly grotty / anxious / etc. but I can function normally, which is essential in my current situation. IME the yo-yoing doses was unbearable, I couldn't function normally at all and the symptoms were totally unpredictable (and that was just two half does in a week) it must be because of the short half-life.

There's no right or wrong - just keep in contact with you doctor and be kind to yourself. If it's unbearable then you can always change to a different withdrawal protocol.

I've just come off Venlafaxine due to pregnancy, and it's fucking horrible. I did it as a fairly sharp taper on my GP's panicky advice, and was out of it for a week.

Brain shocks, headaches, everything as listed above. Of course, now that the depressions isn't being treated, I'm now feeling v depressed. Genius. That said, my blood pressure had dropped since stopping them and I've not had the racing heartbeats, so it's not all bad.
The one thing I was advised (not by useless locum GP)that might help with the head shocks was Nytol, it seems to a bit.

Nothing to add, but am v v sympathetic - at least I only have the cats to worry about

You've done damned well Catte!

The depression you're feeling might well part of the withdrawal (even though the drug is out of your system) rather than you being depressed IYSWIM. Don't despair, it may well get better yet. Here: en.wikipedia.org/wiki/SSRI_discontinuation_syndrome

It's good to hear these stories.

I'm on day 3 at half dose (37.5mg) and so far so good. I developed an all over pressure type headache yesterday which I just thought was tiredness but its back again today so I'm not sure. It might be withdrawal. It might me phsycosomatic.

I've done lots of reading and I have to say that given the short half-life of this drug I really can't see how alternate day or yo-yoing doses is going to help. I'd like to be able to cut the tablets down and go down that way but unfortunately I'm on the XR so thats not an option.

I have decided though that once I get down to the alternate day I am going to self medicate with fluoxetine. I know you've advised against it but I do have a background in pharmaceutical R&D in particular drug metabolism and clearance and I am comfortable with this plan. I am only going to use 1 fluoxetine bridge tablet on my first 'skip' day of the new venlafaxine dosing regime (so 3 at most - at the beginning of each week) and let it taper naturally.

It is the school holidays here from tomorrow so I can cope with the extreme withdrawal I may get. I'll be getting support from my neighbour so won't be 'alone' and my first full week of nothing (if all goes to plan, but I'm prepared to be flexible) my DP will be on leave and here with me for 3 weeks.

But I have to say...day 3 of reduction and so far so good, I don't seem to have reacted horrifically...yet.....

Thanks Lettuce. Went to the docs this morning as I'm struggling to make it to work, or do much when I'm there.

It's just unnerving feeling things I hadn't felt for ages.

You'll get there Catte. Did the dr offer any help?

I also meant to say I do have some Nytol. I had read that Benadryl may help (same family of drugs as nytol) so will keep that on standby.

Please go back and see another your GP Catte. There are other anti depressants that they are more happy for people to take during pregnancy.

No more drugs this time, but have been asked to go back next week for assessment. I'm keen to get a grip on it now before it spirals out of control and affects my baby.

I'm partly signed off work as my concentration is Fucked and my head hurts, suspect I'll be on my knees for more drugs

Edwinia, glad you have people around. I was a soda bound husk!

Well I think the withdrawal is starting to kick in.

I have developed a terrible tremor and am very jumpy (jumped a mile when the phone rang earlier). This is normal for me when I miss a day or two anyway.

I'm starting to get nauseous too. Kind of like a morning sickness nausea. It was triggered by the smell of someone cooking bacon. Worst thing is that my dp is a bacon addict and he's home for the weekend. This is not going to be a good combination...

Day 4.

Didn't sleep well last night. Struggled to get to sleep. Struggled to stay asleep. Struggled to get back to sleep.

The wacky dreams have started too.

And another thing that started yesterday which I've just realised is probably related. My skin keeps tickling/itching. As though an insect has landed on me and is crawling across me. Other than the headache that's probably the most annoying ATM.

No brain zaps yet.

hope you're doing ok Catte

The tickling is bizaare and driving me made

I feel as though I have insects randomly landing and crawling all over me. I feel as though I have headlice crawling through my hair.

I was feeling a little blasé, if scared about this. But I am currently a little freaked out by the reality of it.

Having said that it is tolerable ATM.

I too am on venlafaxine, I go on a Nomorepanic web site. There a medication thread on there,lots of meds on it venla is there.

Doctors want you to come of to soon because it costs about £40 per box,
My psych as told me when I've had 2 free years of no depression/anxiety then come off it if I want to.

If i do, I would do it v v v slowly even if it takes a year. I would also use Prozac and Benadryl as I've read this help through the process.

Reading with interest, good luck

You'll be alright EdwiniasRevenge, but erm, yeah, I'm sorry to say it'll get a good bit worse before it gets better. You have my utmost sympathy, you're a strong woman!

The way I'm doing it (by changing the timings to give a more subtle taper than is possible than by changing the doses of XR) is approximately equivalent to going down in steps of 10mg per day at a time. The original yo-yo protocol I was given was terrifying to do TBH, really awful.

I'm now down by just over 20mg per day - was spaced as fuck yesterday with simmering anxiety, but that's about it. Still not fun by any stretch of the imagination, but it's absolutely doable and more importantly(?), I feel in control of the process. Next step down soon - from 37.5mg every 17 hours to 37.5mg every 21 hours, it's small but I sill feel nervous.

I'm not planning to use benadryl. At least not whilst still taking venlafaxine.

I've read up on the way benadryl "works" to combat the withdrawal and I'm not convinced its safe - at least not for everyone.

For those that are planning to use it - it is the US formulation which isn't the same as the UK formulation. It is the drug diphenylephidrine you need which is the same as bog standard UK Nytol.

Day 5
very shaky tremory
horrific nights sleep last night. Think I onky slept for 30-60mins at a time. Followed by 30-60mins awake.

stuggling to play my favourite bubble witch on my phone due to tremor. Boo.

feel a bit spaced out. Bit vacant. Easily confused. Slow to process thoughts. Slow speech at times. Forget qhat I'm saying mid sentence.

in fact this is remarkably like it was when I first had my breakdown.

but aa I'm not working it isn't affecting my function so having in there.

Glad to hear your getting on OK. I'm like that after missing two doses! Maybe I'm oversensitive to the stuff.

Am now on day 3 of 37.5mg per 17 hours, feel a quite stoned but no drama. I'd hoped I could go down in dose again tomorrow despite planning to do one reduction a week but am going to wait until I'm properly symptom free first.