illustration of a head splitting in two with green waves of pain radiating out

Many years ago we heard from a reader who was trying to get off alprazolam (Xanax). It was not commonly recognized that short-acting benzodiazepines (benzos) could pose unbearable withdrawal symptoms if stopped suddenly. Her doctor chalked up her symptoms to a Xanax “deficiency.” His advice: keep taking Xanax indefinitely. This reader reports a somewhat similar story. Venlafaxine (Effexor) is an antidepressant. This person discovered that getting off venlafaxine is challenging. Her doctor had the same suggestion.

A Reader Reports that Getting Off Venlafaxine is Tough

Q. I have been on venlafaxine for two years. I am now feeling happy and would like to get off this antidepressant medication. My doctor believes I should just stay on it.

Whenever I have tried to stop, I feel bad. I think it is the after-effects of being on the drug, as I am not depressed. Some drugs are hard to get off. Is venlafaxine one of them?

What’s the Skinny on Getting Off Venlafaxine?

A. Venlafaxine (Effexor), like many other antidepressants, can be difficult to discontinue. The official prescribing information lists agitation, anxiety, muscle twitches, confusion, dizziness, nausea, nervousness, headaches, insomnia, electric-shock-like sensations and other symptoms when people stop taking this drug.

Doctors are advised to help patients reduce the dose gradually rather than stop suddenly. Unfortunately, neither the drug company nor the FDA offer specific tactics to accomplish this. For some people, withdrawal may take many months.

Other Readers Describe Getting Off Venlafaxine:

Amanda in New Zealand describes a zombie-like effect:

“I had a nightmare getting of Effexor. This drug led to seizures after I was on it for seven months to treat migraine anxiety. I never had seizures before in my 56 years. My doctor prescribed venlafaxine and described it as the best drug in his arsenal here in NZ.

“I still have involuntary body jolts brought on by certain triggers. I stopped the drug after a tapering program was devised by another doctor. If I had been warned about the possibility of ‘discontinuation syndrome’ and what that might mean, I would never have started this drug.

“Why do pharma companies avoid full disclosure about side effects? I feel ripped off…and yet also lucky to be back with the loving support of a best friend. I made it back from zombieland. My granddaughter said I had turned into a zombie (her words) after seven years taking the drug. How can these drug companies get away with it? How come no one is made responsible?”

Judy in Winston Salem, NC expresses her outrage:

“What upset me was that, when you tried to go off one of these meds and had problems, they would use that to say ‘you see, you really need this.’ I feel so angry that all of these years these drugs were marketed as non-addictive and that doesn’t seem quite true.”

Lisa in New York described brain zaps while getting off venlafaxine:

“I survived a withdrawal after stopping Effexor. I was on this drug for several years. I went off Effexor after extreme weight gain over the years. Withdrawal resulted in horrific vomiting, shaking, chills and what is commonly referred to as ‘brain zaps.’ Brain zaps are flashes that feel like I was just hit with minor electrocution.

“I saw my psychiatrist and described the horrible suffering and she said oh that’s from the sudden reduction in serotonin. She put me on a minimal dose of plain old Prozac. Instant relief!

“From there, I was able to slowly reduce my dose of Prozac until I was off it. I then opted for alternative medications that would not cause weight gain OR withdrawal upon ceasing to take it.

“My psychiatrist saved my life, but I surely wish I had been fully informed from the start. Leaving a patient, especially an extremely depressed patient, to read and comprehend the manufacturers’ inserts that come with the medication is just not reasonable. I am glad that this has really come to the forefront and is being discussed!”

Maddie describes getting off venlafaxine VERY gradually:

“I was prescribed Effexor in the late 1990’s. No mention was made of any kind of withdrawal symptoms. My prescription was renewed year after year for over twenty years, even though, to my knowledge, there is no research to show that long-term use is safe.

“In 2014, I suspected that the venlafaxine XR 75 mg I was taking was giving me unpleasant side effects as well as debilitating withdrawal symptoms if I missed by dose by as little as four hours – brain zaps, nausea, dizziness. One night I woke up and found that when I moved my eyeballs, I heard a distinct ‘click’ with each movement – this happened over several months any time I was late taking my dose. I also didn’t think I needed an antidepressant any more.

“I decided I would open up the capsule and take one less pellet every two weeks. I did this for over a year and finally reduced my dosage to 37.5 mg. After a couple of months stabilizing myself at the lower dosage, I started back reducing it by 1 pellet a week.

“I ended up having withdrawal symptoms even with this tiny reduction. Now I’m stuck at that dosage. It makes me furious that a drug company can market a drug like this with no warning, and even with a denial that the drug is addictive. Of course it works well for them, since I’m still buying their pills!”

You can learn more about the pros and cons of venlafaxine and other antidepressants in our Guide to Dealing with Depression. It also discusses withdrawal strategies.

Anyone who would like a copy, please send $3 in check or money order with a long (no. 10) stamped (71 cents), self-addressed envelope:

  • Graedons’ People’s Pharmacy, No. E-7
  • P. O. Box 52027
  • Durham, NC 27717-2027.

It can also be downloaded at this link.

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  1. Cindy
    Seattle
    Reply

    A “Xanax deficiency,” eh? That doctor (quack quack!) should be kicked out of the profession!

    Another commenter mentioned the benefits of Ashwaganda. I couldn’t agree more! If someone has any need for “smoothing out,” i.e., for taking benzodiazepines, then they owe it to themselves to try Ashwaganda! I’m healthy, full of vim and vigor but all my life I’ve had sleep difficulties and manic traits though not full-blown bipolar.

    I’ve now taken Ashwaganda for 4 or 5 years. And all I can say is this: both the insomnia and the manic symptoms have gradually, gradually resolved! I used to have to take 3 or 4 things to get some sleep (melatonin, homeopathics, herbs). Now, I take NOTHING, and sleep just fine 90% of the time. And the manic symptoms? They’re just kinda GONE. Seriously! Only problem is: I used to use a puff or 2 of mj and then bomb around the house, cleaning furiously. Now, I’m much more likely to nod off, just like most other folks. (bummer)

    I started taking Ashwaganda because it’s an “adaptogen,” i.e., it helps reduce stress and anxiety. Well, it sure has! With extra benefits thrown in.

  2. Jennifer A.
    IN
    Reply

    Denying us meds that improve our quality of life can potentially lead to suicide or self medicating. Who are they saving in this mission of trying to save us from ourselves? It needs to change but will only be considered when we all stand and demand better healthcare. Chronic pain and depression need to be taken seriously and treated effectively. These conditions can lead to criminal behavior and are a main cause of overcrowded jails and prisons. Drs should work for our leading to a better quality of life. Prolonging a painful life in the name of the war on drugs is unacceptable.

  3. Jennifer A.
    Kokomo, in
    Reply

    I explained to my dr about my anxiety and depression issues. I told her please not to prescribe anything addictive because I have enough problems. She immediately gave me 120 1 mg xanax, effexor xr, lexapro, and seraquel. Adjusting to the effexor made me feel crazy. Then whenever I ran out I definitely felt crazy. My mind felt as though it was physically shifting front to back. It took being admitted to the hospital for 5 days to get myself off that overused drug.

  4. Lisa
    NY
    Reply

    I went off Effexor after being on it a few years and gaining substantial weight.

    Like a couple of others have stated in their comments: I saw my psychiatrist and described the horrible suffering and she said oh that’s from the sudden reduction in serotonin. She put me on a minimal dose of plain old Prozac. Instant relief indeed!

    I want to note that my psychiatrist was fully aware ahead of time that I was going off Effexor and she never warned me of any potential issues with it and certainly never said if those issues get severe I can fix it in a second with plain old Prozac.

    Final but important note, I switched from Effexor to a combination of Prozac and Wellbutrin and lost the weight and the severe sugar and carb cravings! Sure wish I had been warned that Effexor can result in extreme weight gain too!

  5. Sandra
    Washington
    Reply

    I know this is an older post regarding Xanax but maybe someone can benefit from my observations, as I have by reading these letters. My discontinue syndrome is about Neurontin. I took this drug for a few years for spinal nerve pain.

    As I became more susceptible to the side effects, I tried to drop it by tapering off. I immediately had the same symptoms your readers had.

    Shaking, tremors, anxiety, brain zaps, cognitive and memory problems!
    I have since gone back to a low dose….had to. Now, I will start again by emptying out some of the powder in the capsule, little by little. What to do for the pain? Hot Epsom salt baths….heating pads….and my TENS unit. I want off of the pharmaceutical merry go round!

  6. A
    Reply

    The best way to withdraw from it is to go down a milligram a day. How much is a milligram? Well , if you open up an Effexor capusle, you will find little white beads. At least with the brands I have seen, each tiny bead is a milligram! But make sure to count your version for yourself to ensure it matches the dose.
    Once you do that, you can go down by a miligram per day. Towards the end, repeat doses…like this:
    15mg-14mg-13mg-12mg-11mg-
    10mg-10mg-9gm-9mg-8mg-8mg-7mg-7mg-6mg-6mg-5mg-5mg
    4mg-4mg-4mg-3mg-3mg-3mg-2mg-2mg-2mg-
    1mg-1mg-1mg-1mg
    That’s the best way I have seen to do it.
    You may need some Meclizine and Tylenol on the way down to deal with withdrawal effects.

  7. Kat
    Reply

    At one time I tried to help my sister withdraw from Xanax. We wound up in the ER and the attending doctor explained to me that she’d almost died from withdrawal and would never be able to stop taking the drug. A year later her doctor also prescribed methadone for chronic pain and she was dead within the week from the deadly combination.

  8. Frances H
    San Diego CA
    Reply

    For about ten years, I took 20 mg/day of Prozac but had many body aches. A doctor suggested adding Effexor and this resulted in a complete cessation of the various aches and pains of arthritis and gout.

    When my doctor recommended elimination of Effexor, while concurrently increasing the Prozac I complied but with real reservations as I anticipated the return of the arthritis-like miseries.

    The switch was over a very short period of time–a week on 40 mg of Prozac. I gradually lowered my Prozac to 20 mg/day and have happily lived Effexor free and pain free for the past two years.

  9. Lois
    Dallas
    Reply

    I was given Effexor for hot flashes 15 years ago. Tried 2 times to stop by weaning off over 1 month – brain zaps horrible. In 2017, I read about the 3 month weaning off technique and it worked. I had 7 days of mild headaches after I totally stopped, but it was bearable; then felt OK. No mood issues before, during, or after Effexor. I wish I had never started with Effexor. Easy to start, big issue to stop.

  10. Elizabeth
    Santa Cruz, Ca.
    Reply

    Unfortunately, my 19-year-old enjoys the effects of Xanax but not on a daily basis. Are her mood swings from the withdrawal, as we have suspected or just plain teenage angst? I guess it would be hard to know! Does anyone know the effects to her body as she ‘takes’ Xanax as a party drug only? She won’t listen to us to stop taking it. Any advice is welcome!

  11. Elena
    Virginia
    Reply

    When my daughter first began high school, she suffered from anxiety at times and ended up in the nurse’s office just for someplace to have a break before she went back to classes. The nurse told her a few times that several of the students at the school regularly took Xanax and would come in periodically, take their prescriptions, and chill for 30 minutes or so before returning to classes.

    It seemed a little strange to me, however, at my daughter’s next appointment with her doctor, I mentioned what the nurse had told my daughter about Xanax. He seemed troubled and told us of several side effects, and I realized that Xanax’s effects on memory and cognition aren’t worth the trouble of taking it. On top of that, it’s just another psych drug that’s difficult to quit. Those poor kids!

  12. Linda
    USA
    Reply

    After I started using Ashwagandha for my own stress and lack of restful sleep I recommended that friends try it.

    They not only are now using it but have come off anti-depressants at the same time! It’s important to taper down on any “mind” drugs. Every other day for a week, every third day for a week, every fourth day for a week and then quit was the way I was told for my husband on Zoloft when he no longer needed them for anxiety.

  13. Sheri
    CA
    Reply

    I have been taking Effexor for years and want to get off. I am so scared to try because of all the withdrawal symptoms. I know I needed the medication years ago when it was first prescribed, but no doctor since has said I should stop. They just keep refilling. What a terrible situation! I’m sure there are thousands, if not hundreds of thousands, of people out there who are just like me.

  14. Jimi
    Reply

    Hi,
    A plant based diet with good clean drinking water and getting some sunshine on your body does wonders.
    60 and medication-free.

  15. Diane
    Raleigh, NC
    Reply

    I also had an intolerable reaction to getting off this drug. As with one of your other readers, my GP then put me on Prozac for two weeks. The relief was immediate, and there was no withdrawal when I went off the Prozac. Why don’t more doctors use this simple solution to help their patients get off Effexor?

  16. Ray
    Minnesota
    Reply

    I’ve been on Effexor and have no side effects if I stop it abruptly. After a while my depression
    returns so I stay on it. Why do you want to get off it? If you feel good stay on it.

  17. Catherine
    Edgewater florids
    Reply

    I wish doctors would be better advised and taught about phych drugs and getting off of them. I’m in the heat of xanax withdrawal right now. It’s been 6 months, and there isn’t a doctor out there that acknowledges it. It’s so maddening and totally frustrating. Then you wonder why patients are so very against the big pharma.

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