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.

[Em3978]

I decided to come off Venlafaxine (not slow release!) in spring a few years ago... By Christmas I was off it and free of withdrawal symptoms. I was only on 75mg a day!

I ended up cutting down sooo slowly as the brain zaps and nausea were hell. 2 weeks to level out with side effects, 2 weeks to relax a bit, then start again...

at the end I had to cut my tablets into 8ths, an interesting thing to do with tiny tablets, to have one morning, one evening. I KNEW when I was coming up to my next dose .

I really hope you manage better than me, but if you have to take a step back and take more time, don't worry about it, its ok.

[EdwiniasRevenge]

Day 6.

I think yesterday was marginally easier than the previous days. I was shattered all day but speech, confusion etc. Certainly no worse if anything better. Still have insects crawling over me constantly.

I went out for a run last night (I'm doing the race for life in 2 weeks). I struggled at the end feeling really ill. Just generally weak etc. Dunno wether it was just the knock on effect of the tiredness.
.
I slept better last night. Loads better. 7 hours solid I think.

I'm due to take my next tablet nowish. Yesterday I could barely type on my phone with the tremor. This morning I'm much less symptomatic at this time.

I've decided that for my next stage (due yo start Tues...might start today given relative stability? ) I might move to 36hrly dosing instead of strictly every other day. I might even be brave and give the fluoxetine a miss...

[MrsLettuce]

That's good to hear! If you can spare the time to wait until your withdrawals have gone before going down the next step then it'd be well worth it in the longer term.

[Bigglesfliesundone]

I'm terrified now - I've been on it for about 12 years on and off and have 75 mg every other day. I don't want to be on it for ever

[MrsLettuce]

Don't be terrified Biggles, coming off is honestly doable if you take it slow and steady, waiting for the withdrawals to subside between each reduction. Taking it slow also knocks out the chance of 'SSRI/SNRI withdrawal syndrome' course but the which can last anywhere from 3 - 18 months, IIRC.

75mg per day is the lowest therapeutic dose and you've already halved that so you're well on your way!

You on the extended release version? If you can speak to your GP about wanting to come off slowly and get some 37.5mg capsules prescribed to move over to you should be able to get it sorted. Coming off using just the 75's is always going to be to yo-yo-ish, I fear. TBH I found moving over from the 75's to 37.5s more challenging than the actual steps down but it really was fine and I was probably still leveling out from the yo-yo protocol I was originally advised to follow.

Your current dose of 75mg per 48 hours = 7 doses of 37.5mg in a week @ 24 hour gaps
6 doses of 37.5mg in a week = 28 hour gaps
5 doses of 37.5mg in a week = 33 1/2 hour gaps
4 doses of 37.5mg in a week = 42 hour gaps - this is the point I think I'll just take a dose when I get withdrawals

There are 168 hours in a week, this divided by the number of doses gives the interval needed for each reduction.

Number of mg per dose multiplied by the number of doses in the week, then divided by 7 gives the current daily dose, regardless of interval.

[MrsLettuce]

Erm typo - Taking it slow also knocks out the chance of 'SSRI/SNRI withdrawal syndrome' which can last anywhere from 3 - 18 months, IIRC.

[Bigglesfliesundone]

I remember coming off it before - going down to 37.5 for a few weeks. it's a while ago now though! Thanks, I think I'd like to stop soon.

[MrsLettuce]

But you say you're taking 75mg every 48 hours? If so you are already down to a daily dose of 37.5 and stabilized!

Jumping straight to another halving (37.5mg per 48 hours) might well be a bit hefty and stretching a 75mg dose out further than 48 - 60 hours is just asking for trouble with such a short half life. But, a small dose reduction should be doable.

Do you feel it's benefiting you? Being already under the (alleged) minimum therapeutic dose and with the potential that you're experiencing subtle side effects from taking a 'large' dose spread wide you may have little to lose and much to gain...

[Bigglesfliesundone]

Oh yes - derr!

I think I'm a bit scared to stop. I have had severe depression on and off for many years and this is the only thing that has ever stabilised me. fter coming off it 6 or 7 years and being drug free for a while, I was tried on so many other ones, finding the only one that 'works' is this.

[EdwiniasRevenge]

Day 7. My last dose was at 9pm last night. Not taking any today. Will take at 10am tomorrow (which will be 36hrs ish).

Good day. Bit shaky still a bit skin crawly. Was a bit woozy and giddy after a 5km run/walk.

Happy with current progress.

[EdwiniasRevenge]

Day 8. Am on 36hrly 37.5mg XR

Nothing new/unusual to report. ...should I be worried? ??

[MrsLettuce]

You certainly shouldn't be worried! Seems as if you have a very lucky metabolism - I'm stinking jealous!

[EdwiniasRevenge]

Don't get me wrong I'm not symptom free.

I just seem to be improving not getting worse.

To a certain extent its difficult for me to assess my speech and conversational abilities which hit me a few days ago but I seem to be able to process everyday thoughts better than I was so think any confusion has subsided.

I'm not finding my day to day functioning is sffected which is what I was expecting.

When I was reading up on using benadryl/nytol I came across some scientific literature which discusses populationvariationin an enzyme that metabolises this drug which I think is how the benadryl "works" - by slowing its metabolism. I guess I'm just in the slow metabolism camp.

[EdwiniasRevenge]

Day 9

Nothing new again today. If anything I'm better again

I'm due another dose at 10pm....I'm tempted to skip it and wait until the morning which will put me at 48hourly.....

[CatteLady]

How's everyone doing? 3 weeks after my last tablet I'm feeling ok - some minor signs of meant a bit insane, like having to check I've turned my iron off loads of times, struggling to get on crowded buses, but nothing I can't deal with. Minor head jolts, and small terrors about getting PND.
Seeing GP next week, I'm hoping to stay off drugs. Just because I'll forget to take the buggers once the baby's here and I'm sleep deprived and stuff and I'll have to deal with withdrawal again.

[NiceCupOfTeaAndASitDown]

Just thought I'd add a little of my experience in case it helps anyone. I came off this drug 5 years ago after being on it for around 8 years at various doses. I did it without my doctors knowledge or help which I shouldn't have done really but I was determined not to be talked out of it. I had had withdrawal (which you all know is horrific) when forgetting to take a dose or forgetting to take it with me for a weekend away so I knew I couldn't miss doses. I decided instead to cut down the amount I was taking each day very slowly.

Firstly I changed from the capsules to the tablets and bought a pill splitter. I can't remember how many pills I was taking a day but I split them into 4 and took one quarter of a tablet (9.something mg) less every 3 or 4 days, sometimes I needed to wait an extra day for the symptoms to subside a little before cutting down to the lower dose but having had the full withdrawal symptoms before I knew they were bearable in comparison.

right at the end when I was taking under 10mg (so a quarter of a tablet) a day I went to my GP and asked for the drug in liquid form and began to take 1mg less every few days, in the end I think I went cold turkey at about 4mg because it felt right, any symptoms I had lasted maybe 10 days. As I say I've been off them now for 5 years and will never go on that drug again.

If it's working for you to reduce the frequency of when you take them then best of luck, but this method worked well for me so I wanted to share. The only thing I would say is write down your plan before you start (and you get a hazy brain) and if you've a good GP at least tell them your plan so they can be on hand for support.

The very best of luck to all those coming off venlafaxine, I'm living proof it can be done!

by the way benedryl did help a little with the symptoms but although unpleasant they were bearable with this method

[EdwiniasRevenge]

Thanks for the comments. I've had a rocky couple of days.

Day 10
I decided that going to 48hrly was the right thing to do. I fept I was ready for it. Drugs due at 10am as a result. By 00:10 I was wide awake after 2 hours sleep. My whole body had the tingling/itching/insect crawling sensation. I barely slept all night.
I had a headache all day. I was lightheaded and dizzy. I couldn't focus or concentrate on anything. I couldn't process thoughts or feelings. I felt vacant, spaced out, agitated. Just wierd. Couldn't concentrate. Tremor all day. Dunno if this was it or coincodence but I went to bed at 7pm cos I literally couldn't cope with being so useless and not being able to do anything useful.

Day 11.
Speech still a little garbled. Still keep loosing my track mid sentence. Getting frustrated by it but not as bad. I took a prozac today to try and avoid a repeat of yesterday. Sleep was very broken last night but going to bed at 7pm thats to be expected.

I'm actually on day 12 today...lets see what the day brings

[EdwiniasRevenge]

Day 12 & 13
much the same. Its the lack of focus and concentration which frustrate me the most.

Day 14
Focus, concentration and moral all much better. Still a bit headachey and light headed on the day I'm due to take meds and its a horrible all over crushing headache.

I'm on day 16 now and it's only the headaches that remain and bother me. I'm due to run the race for life on Sunday. I'm theoretically on 48hr dosing and have been for a week. I can't decide whether to keep dosing as most of my withdrawal symptoms are under control, but I predict a headavhe and possibly lightheaded dizziness on race day which won't be good, but I think its related to the yo yo dosing.

OR I could go cold turkey from today and hope any further withdrawal symptoms subside by Sunday....but could be unpredictable.

What would you do guys if you are still reading?

[MrsLettuce]

That's grand news!

I'm not sure what'd be for the best really, probably I'd just stop the doses but the race is surely a complicating factor, maybe take an odd dose if the withdrawals get too hefty? It's hard to say, could well be fine or, well, not.

Am down to 24 hourly 37.5's myself now. Over to the next stage, 28 hourly, later in the week.

[EdwiniasRevenge]

Well done. I think you were on 14hrly when I started this thread?

I think I'm going to skip this mornings dose. I can always take it 'late' if need be and play it by ear. I might consider another fluoxetine bridge as an alternative....

I can't believe how straightforward this has been. Not a walk in the park but it has been much much better than I expected. I think I'm in the lucky 8% of the population that are slow metabolisers.