“Wait,” you think. “Haven’t I already heard from you about withdrawal from Effexor?”
Why yes, you have. I’ve been writing about this since January, when I climbed out of my bed (barely) to go to my first appointment with my new psychiatric nurse practitioner, Tabitha. She raised her eyebrows at the high dose of venlafaxine (Effexor) I’d been taking. So since then, I’ve complained about the agitated mind I experienced when I first decreased my dose. Later I wrote about suicidal thoughts and spending too much time in bed. And there was a post about how I couldn’t think about anything else.
This all settled down for a while when Tabitha and I figured out that I could take apart the venlafaxine capsules and pull out individual spheres of the medication. I slowly decreased my dose by 3-5 additional spheres ever several days.
Precisely because it was going so smoothly, I got a little over-eager. I wasn’t have a bad reaction to dropping at that rate. Perhaps I could go a little faster?
I was refilling my pill container on Sunday when I got the overly optimistic idea of dropping down about 20 spheres on Sunday and then holding that level for a few days. It seemed like a reasonable idea, and it would spare me taking apart more capsules and then searching for the spheres that fall on the floor, trying to get them all before the dogs licked them up.
Anyway, should any of you be considering a similar rush to reduce your daily dose, I’d tell you: do not try this at home. From Tuesday afternoon until Saturday morning, everything else in my life fell away, while my consciousness became consumed with
- “tremors” that were more like convulsions, starting deep in my core and jerking my neck and shoulders back sometimes hard enough to wake up my husband in bed
- non-stop nausea
- being too hot, no wait, being too cold, uh no, too hot
- a maximum of three hours of solid sleep per night, with short dozing naps during the day and consequently
- exhaustion
- terrible concentration, an inability to read books, process the mail or finish my taxes
- high activation of the Trickster Mind, the one who tells me beguiling tales of hanging by belt, burning by iron and other novel ideas for self-harm
Suffice it to say, I’ve felt better (mistress of understatement, c’est moi). The real question for me was what to do about this? I’ve been reading about this off and on for a while, and of course talking to Tabitha (PNWW – Psychiatric Nurse Wonder Woman). Although venlafaxine works on both serotonin and norepinephrine (and at high doses, on dopamine), its primary impact is on serotonin, and the withdrawal hell is really serotonin discontinuance syndrome.
The bad news: there is nothing that will make you feel better immediately, at least none I’ve found out about. Putting together the science and life experience (mine and others’), here’s the advice I’d give:
- Tell your family or a friend what’s going on. It’s good to let someone you trust know what you are going through. That person can help if things get really difficult (on my worst day, my husband did not leave the house, because I was honest enough to tell him that if he left, I’d probably hurt myself). You don’t have to be that explicit. A lot of people will respond well if you simply say, “I’m feeling like crap and would love to have someone just be around.” Believe me. I’ve done it before.
- Move as much as possible. While it’s true that exercise is always helpful to mood, apparently exercise increases the availability of serotonin for binding to receptor sites on nerve cells, so it can help make up for the the changes in serotonin levels that occur as you reduce your medication. This advice sounds great except when you remember that I’m dealing with exhaustion and nausea. The best I’ve been able to manage are 10-minute walks around the neighborhood.
- Go as slow as your psychiatrist suggests. Or slower. As hard as this has been, it would have been so much worse if Tabitha had not told me to go ahead and take apart the capsules and count out individual spheroids. The smallest capsules are 37.5 mg; the decrease that pretty much ruined my week was probably about 18 mg. I think I do best with decreases of of 3-5 mg every three or four days.
That’s it. Not very helpful, I know. But at least it’s honest. And at least I’m not trying to see you a worthless miracle cure.
Now that it’s Saturday, and I finally feel that life merits the time and effort, I am torn between getting outside in the first sunshine we’ve had in a while, taking a nap to make up for barely sleeping all week, or finishing my taxes.
Sage Burning 
Thanks for sharing. Do I sense a healthy underpinning in there somewhere?
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Maybe! Thanks for saying that. I think there might be one developing, bit by bit. It gets obscured when I’m triggered or chemically toxic, but it’s there somewhere.
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A couple of things I am doing that i found on line is taking fish oil and a supplement for liver function (N A C). after the reaction you had I assume you backed up to a higher dosage level. Wow, that is some awful drug.
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I had dropped it by 20 spheroids, and I went back up by 12 spheroids. Maybe I would have felt better sooner if I’d gone all the way back up, but I guess at the time I thought all that suffering should at least help me get to a lower dosage.
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Its a lot of work but will be worth it if the suffering lessens. Im thinking about you.
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I’m so sorry to barge in but I wanted to say hello to Cherished. I look forward to hearing your voice again (journal entries). Your absence is noticed and your voice is missed.
Faith
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Wow, thank you. I read posts on here multiple times a day but I think the depression keeps me from doing much of anything else. Onevgood thing is i have been eating more the last few days. Thanks for asking. If its okay with you id like to send another message in few days.
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I love your tips, those are three things I wish I would have done. You’ve made it through the worst of the time and are able to offer advice to the rest of us. Awesome. 🙂
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Well… I don’t know about advice, but at least I can share what seemed to make a difference for me! It’s amazing to me how so many people can experience depression and describe it in fairly similar ways, and yet medications work so differently for them. What was your experience going off Effexor (or other meds)?
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Yes, it is quite an interesting experience for so many different people. I dropped from 150 mg to 0 mg because i couldnt afford the medication and i couldnt leave my bed for some days. I could hear my eyes rolling in my head and the vertigo was so bad i couldnt stand for more than a few minutes. Some nausea and hot/cold flashes. I didnt sleep for three days and that only sparked up my paranoia and i spent a few nights drawing demons that were holding me hostage in my room and posessing my cat.
It was bad. That was after only being on that drug for….a month and a half? 2 maybe? My psych drug experiences are usually similar to that, but effexor was the worse. My psychiatrist wanted to start me on antipsychotics so i left her office and wont be going back lol.
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What was your initial dosage and are you aiming to be completely off of the Effexor? I take 225mg a day. I don’t know what I would do without it. That and all of the other meds I’m on keep me stable.
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Hi Tina! My original dosage was 300 mg, and I was not doing well on it at all. I’d been feeling for a little over a year that my previous psych nurse practitioner wasn’t really hearing me when I’d tell her how I was doing (and I’ll admit, maybe I wasn’t communicating assertively enough). When she registered anything about my depression, she just kept upping the dose of Effexor. It got to the point that I barely got out of bed and spent huge amount of time contemplating ways to die. So clearly it wasn’t working for me. I switched psychiatric nurses in January, and our goal (because it does feel like a partnership) is to get me off the Effexor, get me as healthy as possible, and then taking the minimum dosage of some other anti-depressant needed to ensure I feel good. Right now I’m down to 112.5 mg (plus 10 spheroids), and I also take Wellbutrin (not sure if that will continue longer term or not). I recently started a lot of supplements (under the guidance of the new psych nurse), and I feel like that is helping me with my energy.
I’m not anti-meds at all–just opposed to meds that don’t work or that make me feel even sicker. I’m glad you have the right meds to help you.
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I am in total agreement with you on opposing meds that make you feel worse. I was on Wellbutrin and it made me have suicidal tendencies, I was taking off of it rather quickly after going on it. It is all in our chemistry as to what works well for each of us. I was thankful that Effexor worked so well for me. I hope you find something that works as well for you. 🙂
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Q what was your dosage at your highest and what does are you taking now. I too am on this medication.
Hope all is going well now x
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I was at 300 mg in January. When Tabitha and I first talked about dropping down, I went to 225 mg, but I had a terrible reaction with that, so I went back up to, hm, 262.5 probably, and then have been tapering down slowly for about three months now. Not everybody has this much trouble coming off Effexor, but then again, it’s not uncommon. It’s one of the harder meds to come off of, because it has the shortest half life. Tabitha told me that when I get to around 75 mg, she’ll probably also have me take Zoloft or something similar for a little while, to avoid the “brain zaps” that people often get when going off the last of the Effexor.
Right now I’m on 112.5 mg (a 75 mg and a 37.5 mg capsule) plus 10 spheroids taken out of another capsule. And clearly, just those extra spheroids make an enormous difference, at least for me.
I’m feeling so much better right now, thanks. I don’t even feel like I’m the same person!
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I’m glad you are feeling better. This bed definitely isn’t fun to come off. At my highest I was on 225mg. I’m now on 75mg. I’m seeing the doctor next month for a meds review. My venlafaxine tablet is a nightmare. If I forget to take one I feel so ill. Shaky, sick, brain zaps, teary, flu like etc. I’m worried about coming off it completely. I guess I’ll see what the doctor says x
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I also used to feel really sick (physically and mentally) if I accidentally missed a venlafaxine dose, too. That’s also a product of its short half-life. Good luck with the doctor check-in next month and be sure to speak up about your worries about coming off it completely. Are you planning to substitute something else? Or not take anything?
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Well I currently take the venlafaxine and also quetiapine (seroquel). This combination is working (sort of) but the quetiapine has caused me some major weight gain so I want to try something else if possible. X
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Will massive amounts of chocolate help the serotonin disruption? Would a TENS unit on the neck and spine assist to break up misfired …things…? I’ve found that my TENS unit helps me with anxiety as well as concentration. Experimental therapies, out side of the box is where my thinking goes now days.
I can’t send this comment without noticing the way the letters WTF jump off the screen at me. I know the S is there but WTF jumps right off the screen. LOL. LOL. Too funny on a med box!!
I caught that bit of French in there so here’s an update on my French lessons. I did fail it and said I’m switching to Spanish but I can’t let myself do it. I’m studying and immersing myself in it. I’ll be back to take it on again… this time with passion.
Faith
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wow q. I never want to take this med. my friend is on it and got terrible brain zaps when she missed one dose. I certainly don’t want that. I don’t think dr. barry would put me on it anyway. i’m currently taking Prozac for an antidepressant. it works well for me mostly anyway. xxx
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[…] I have generally come to interpret these pains as symptoms of medication withdrawal, especially withdrawal from venlafaxine (Effexor). The thing is, I haven’t changed my venlafaxine levels for the past couple of […]
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[…] WHO ARE THESE PEOPLE AGAIN? (in case you forgot) E: my long-term therapist, from 2003-2005 and again 2009-2021; I ended my sessions with her last August Charo: a therapist I started seeing online in 2021, as a support while I get used to coping without E–maybe a bridge to independence? Tabitha: a psychiatrist nurse practitioner I started working with in 2017, and she gave me a lot of support as I battled my way off Effexor […]
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