The People's Perspective on Medicine

How To Stop Venlafaxine: Very, VERY Slowly!

Are you surprised to learn that many antidepressant drugs are hard to stop? The discontinuation syndrome can be awful. Learn how to stop venlafaxine slowly!

It has taken the medical profession a very long time to acknowledge that many of the most popular drugs in the pharmacy can cause a kind of dependence. By that we mean such drugs can precipitate serious withdrawal symptoms when stopped suddenly. The FDA and the drug companies have come up with a sanitized term for this reaction. They call it “discontinuation syndrome.” What they do not tell people is how to stop venlafaxine. If this antidepressant needs to be halted, it must be done very slowly!

A Reader Wants to Know How to Stop Venlafaxine:

Q. I had tried to get off Effexor XR a few years ago (venlafaxine), and the results were typical: agony, muscle aches, brain zaps and a depression worse than I had before starting on the drug.

Six months ago, thinking I had learned from experience, I crafted a foolproof plan. I reduced super-gradually (counting little beads inside the capsule).

At first, this went well. I was so proud of myself. Finally, I was down to five of those little beads. Then I got a horrible dizzy spell, and soon I slid down the rabbit hole again, just as if I had stopped suddenly. After suffering for two weeks, I called the prescriber. The first time, he had told me that I was being a hypochondriac. This time, he told me that “Some people can never quit Effexor.” I wanted to smack him! Instead, I started taking half the regular dose.

I was literally “hooked.” Will I be forced to take it for the rest of my life?

A. Your doctor, like many others, should take antidepressant withdrawal very seriously.

An article in The Lancet Psychiatry (online, March 5, 2019) points out that the symptoms can be severe. 

“All classes of drug that are prescribed to treat depression are associated with withdrawal syndromes. SSRI withdrawal syndrome occurs often and can be severe, and might compel patients to recommence their medication. Although the withdrawal syndrome can be differentiated from recurrence of the underlying disorder, it might also be mistaken for recurrence, leading to long-term unnecessary medication. Guidelines recommend short tapers, of between 2 weeks and 4 weeks, down to therapeutic minimum doses, or half-minimum doses, before complete cessation. Studies have shown that these tapers show minimal benefits over abrupt discontinuation, and are often not tolerated by patients. Tapers over a period of months and down to doses much lower than minimum therapeutic doses have shown greater success in reducing withdrawal symptoms.”

The authors suggest that drugs such as sertraline (Zoloft) or paroxetine (Paxil) should be tapered very gradually. The smaller the dose, the smaller and slower the reduction. It may take many months or even years to get off the drug completely.

We suspect that this would also help with your withdrawal from venlafaxine, a similar antidepressant. Some people remove just one bead every few weeks as they get closer to weaning off completely. Yes, this is a slow process, but that’s how hard it can be to avoid the “discontinuation syndrome.”

You may wish to look for a doctor who can help you with this instead of telling you it is impossible. You might also be interested in our Guide to Dealing with Depression, which discusses difficulties due to withdrawal and suggests a few nondrug approaches that may also help. You may also find our FREE Guide to Psychological Side Effects of interest. 

Why Doesn’t the FDA Tell Doctors How to Stop Venlafaxine?

Drug companies and the Food and Drug Administration are very good at telling doctors how to start prescribing medicine. They seem far less interested in telling physicians or patients how to stop such medications. Here is an in-depth article we wrote titled: 

Getting Off Venlafaxine Can Be Incredibly Challenging

Desvenlafaxine (Pristiq) Withdrawal:

It’s not just venlafaxine. A chemical cousin of venlafaxine is desvenlafaxine (Pristiq). You can read about the problems of discontinuation syndrome with this drug at this link. There are 367 comments, should you wish to learn how other people have managed to overcome the discontinuation syndrome.

Share your own experience about how to stop venlafaxine or any other antidepressant in the comment section below.

Rate this article
star-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-empty
4.9- 11 ratings
About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
Show 983: Intriguing Approaches to Overcoming Depression
Free - $9.99

Nondrug approaches could replace or complement drug treatments for depression; one medication could lift severe depression within hours instead of weeks.

Show 983: Intriguing Approaches to Overcoming Depression
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 11 comments
Comments
Add your comment

I too am trying to quit taking Effexor X-RAY, due to its side effects. I have severe bladder leakage. In 1998 I had bladder reconstruction. Several years later, I thought it had failed. But I had started taking Effexor XR in the interim. I did not make the connection until last year, when, for the first time in years, I read the warnings accompanying my refill. So I started trying to wean myself from it.

I am now down to one every 36 hours instead of 24. Already I’ve seen improvement. I only wake up 1-2 times a night to urinate instead of formerly every 1-2 hours. So I sleep so soundly that sometimes I don’t hear my alarm. I haven’t had much luck going longer between pills because spacing to 40 or 42 hours would require I wake up during the night to take a dose. Is opening the capsule and actually counting the beads the only other solution? It seems rather freakish and hard to do.

It took me over a year to get off Effexor. I SO wish I had never taken it.

I was prescribed Cymbalta over 10 years ago. My doctor told me that it would help with the chronic nerve pain that I was having. It wasn’t long before I started experiencing horrible side effects. I had anxiety, depression and suicidal thoughts. I was nauseous, dizzy and confused. I was weak and exhausted all the time. I would forget words and how to spell them. I had a hard time finishing my sentences. I had blurry vision and hearing loss. I lost a lot of my hair. I had excessive sweating. I lost interest in the things I used to enjoy. I still enjoyed making love with my husband but I couldn’t have an orgasm. I gained over 80 pounds, and I looked and felt like I was pregnant. My pain was worse than it was before I started taking Cymbalta. I was a miserable mess.

In the summer of 2017 I went to a doctor’s appointment and told him that I couldn’t live that way anymore. He told me I had a lot of years left to live, and I just had to learn to live with it. Well, I left his office crying, and I decided right then that I had to do something on my own. So I started researching Cymbalta, and I found an awesome group on Facebook called Cymbalta Hurts Worse, and they have helped me tremendously. There are over 18,000 members now and it’s growing larger every day. With their help I started tapering off 60 mg (356 beads) of Cymbalta in the fall of 2017 and I am now down to 1.3 mg (8 beads). I tapered off slowly by 10% of my last dosage taken every two weeks. When I got to 10 beads I’ve had to hold 3 weeks for every bead. Almost every side effect is gone now and I’m feeling like myself again. The pain is completely gone. I have started to lose weight and I no longer look or feel like I’m pregnant. I’m excited to be spending time with my children and grandchildren again. There is life after Cymbalta (and other medications like it). Personally I do not believe Cymbalta should have been approved by the FDA and it should be taken off the market.

I suffered from anti-depressant withdrawal symptoms for three and a half years after tapering off Lexapro too fast. I was under a doctor’s care, but she was ignorant of the potential problems as are most doctors and the FDA. I was fortunate to find a forum on the web started and run by a woman who’d been through antidepressant withdrawal, which probably offers the best advice and most comprehensive information available anywhere on how to get off this miserable stuff, and I hope it’s okay to post the URL here: https://www.survivingantidepressants.org/.

It was my salvation, although I ignored the advice to go back on the drug, stabilize, and then taper off more slowly. I was terrified of Lexapro at that point and wouldn’t touch it. I was a zombie. I had such bad insomnia I slept only every 60 hours and then for only five hours or so at a time. I was extremely light sensitive and only went out once or twice a month at twilight to get food and other necessities that I couldn’t buy online. I was asked to be a moderator on the above referenced forum, and later an assistant administrator, and helping others helped me a great deal. I spent a lot of time reading in bed and drank wine and brandy by the gallons. It was never enough to make me sleep, not even combined with a benzodiazapine or an antihistamine. I’m lucky I didn’t kill myself. I spent money impulsively, and although I didn’t end up in debt, I certainly regret the several thousands I spent on things I thought would make me feel better at the time. My usual interest in creative pursuits such as painting and sewing were completely numbed out as were most of my emotions. Saddest of all, is that I believe the severe depression was caused by a statin drug that had my cholesterol down to 134.

Over a period of ten years, Lipitor also destroyed my shoulders, weakening my upper arm muscles so that they continually dragged on my rotator cuffs, and eventually the cuffs wore away. I’ve refused to take any prescribed medication other than a low dose blood pressure pill since then. I no longer drink, and don’t miss it at all. One other thing that helped a lot was just getting out with other people. I went to a writer’s group at the library and met two other women who had had problems with addiction to Xanax. I also went to a sewing group at an Eastern Orthodox church, and made several very good friends there. I still go to their monthly Girls’ Night Out and occasionally to the sewing group. But please believe me that there’s no fast way to recover. Don’t waste your money chasing supplements or other drugs or special diets. Antidepressants change the physical structure of the brain when taken for longer than a few months, and it takes the brain a while to figure out how to repair itself.

I was always on the lowest dose of Effexor. The way I stopped it was by doing biofeedback for 6 weeks in 2012. When I went back to my doctor (who was not the one who prescribed it to me for anxiety disorder) I said, “yet they say it is not addictive.”

Now I’m trying to get off klonopin (listen to Dr. Heather Ashton on withdrawal from klonopin) is anyone trying toget off this benzo?

Here is the general plan I have used to help my patients:
1. If on doses higher than 75mg, gradually reducing the dose using a 2nd prescription for the next lower dose, and alternating it with the higher dose. Usually 2-4 weeks of this routine before patients are able to tolerate the lower dose. If on doses higher than 150, you will need to repeat the pattern until the patient is on 75mg and stable (4-6 weeks without withdrawal symptoms.)
2. Once at the 75 mg dose, obtain prescription for the lower dose of 37.5 mg, to be taken 2 times a day. Alternate taking 2 times a day with 1 time a day 2-4 weeks.
3. When down to the 37.5 mg 1 time a day, you CAN switch to celexa or lexapro * if you are going to need continued antidepressant help or switch to every other day dosing and then wean off.
4. Some people will need to open the capsules and take only partial doses for a few weeks, before being able to skip days entirely before weaning off.

Many people do quite well at avoiding side effects from the Effexor XR, by switching to another class (SSRI’s) at the point of 37.5 mg /day. I find this approach best for those who have required medication prior to Effexor and will likely need to continue anti-depressants.

I have weaned myself twice from Cymbalta. The only way I have been able to do it is find a doctor that is willing to write you a prescription to have the medication compounded in lower doses by a compounding pharmacy. This is more accurate than counting those time released beads in the capsules. It can be expensive but will save your sanity. I took 6 months to get off only 20 mg of my medication. I tried it earlier and had horrible side effects using the doctors titration plan. The longer and slower you are willing to go the better. I usually suggest going down 2.5 to 5 percent every 10 days to 2 weeks. It is a slow process but your body can tolerate it better.

I had terrible Discontinuation Syndrome symptoms when just missing one dose of Effexor. I really wanted to get off of it but was scared to death. My husband, who is a physician, did some reasearch and made me a tapering schedule. He uses a similar schedule when weaning his patients off of narcotics. I took this to my doctor, and she let me try it, and it worked beautifully with no adverse effects at all.

First of all he had me switch from the extended release to the immediate release. This makes it easier from the beginning. Then I was easily able to decrease my dosage by 12.5 mg every 2 weeks. I also went on 20 mg of Prozac to act as a “bridge.” The prozac has a long half-life so there is no need to wean off of it. It continues to stay in your system. The day that I took my last dose of effexor, I also took my last dose of Prozac. It took months to get off of Effexor but I never felt bad or had any of the horrible side effects that I had had in the past.

I am in the process of tapering off Duloxetine (Cymbalta). It has been a year-long ordeal, starting in April 2018. I am currently down to 20 beads (from a starting 20 mg dose, about 115 beads), and expect to complete the taper May 1, 2019. Previous attempts to come off Duloxetine were unsuccessful. The withdrawal symptoms were horrendous: brain zaps, muscle pain, agitation, anxiety. This latest attempt is very gradual and the withdrawal much easier to tolerate – although I have excruciating lower leg and feet pain on some days. Anticipating the withdrawal symptoms, I started using CBD oil (300 mg) and a CBD topical (600 mg) for the leg pain.

I believe doctors should not be prescribing drugs without knowing how to get off of them. Before crafting my own taper schedule, I spoke with my PCP, pharmacists, and my insurance company. NO ONE could help me. This is unacceptable!

I have successfully used a long taper to remove myself from Prozac (long ago) and more recently Wellbutrin.

Here’s what I did:
First month take a half, dose only once per week, otherwise regular dosage.
Second month, half dose spaced (Mon, Thurs) twice a week for a month, other days regular dose. Third month, half dose spaced three times per week (M, W, F) for a month.
Continue to decrease 1/2 more each week for a month until every day is a half dose.
After seven months, repeat the process eliminating one half dose (no medication) each month.

Yes, it’s a long process, but it did work for me twice. Good luck.

Drugs. Mind controlling drugs. Even a colony of ants control its population with chemicals.

* Be nice, and don't over share. View comment policy^