Withdrawing From Effexor

I know this is the most talked about subject on this site.  Many people have bad mouthed their doctors and Effexor.

My doctor, who I saw a couple of days ago could not have been nicer.  She took her time with me, and explained that my abrupt withdrawal from anti-depressants has always brought back depression feelings.  However, she is going to help me wean off slowly.  She says she will be with me all the way, and can see her anytime.

After 20 years on anti-depressants, this will be the first time, with the help of a doctor, that I will slowly go off medication.  As Effexor is the worst, I can take my time.  Last time, five years ago, I went cold turkey, and was very poorly for two weeks, but after that was fine for a year.  This time I mean to kick anti-depressants once and for all if I can.  

I am currently on 150mg Effexor.  My doctor has now suggested I take 150mg on day, and 75mg the next, and so on.  She said do this as long as I like, and then go back for the next stage.  I reckon I can do this.

Effexor has been really good for me, but now I want to be medication free.  I am 72 years old, and I am going to be really strong about this.

Doctor and Effexor no trouble for me - I am lucky.

Also I live in UK where at my age, I do not have to pay for drugs.  I hope I will lose all the weight I have gained on this drug, which is the only real drawback for me.

[4Maddie44]

It is now just over a week since I began the alternate days of 150mg Effexor and 75mg Effexor.  Today just a little dizzy and have a headache, otherwise, so far so good.

[4Maddie44]

I have been told by another member of the site that my doctor has given me the wrong information about taking 150mg Effexor one day and 75mg the nexts, and so on.  She says this will not help me stop taking it as I am confusing my brain with this type of dosage.

I want to co-operate with my doctor on slow withdrawal, and am doing what she told me.

Does anyone else feel that this is the wrong way to go about Effexor withdrawal?  I am feeling fine on this dosage, but now worried about what I have been told.  

[nursegirl6572]

I kind of agree, that's a strange way to taper.  A typical taper would include gradually dropping down the dose in SMALL increments, and then allowing the person to stabilize on the new dose for a while (a week or two, or more), then dropping down again.  With Effexor, the more slow and gradual, the better.

The million dollar question I guess for me would be, why do you feel you need to stop taking it?  You've said so many times that the Effexor helps you.  Anything specific change your mind?  Just throwing that out there for some food for thought.  Unless there is some big reason why you shouldn't be taking the Effexor, I'm of the mindset that "if it's not broke, don't fix it"...you know?

If you DO want to come off...I would talk to your doc about your concerns...ask her what her reasoning is behind her method.  My worry would be that for one, she's instructing you to make a big jump down, and then, going back up the next day doesn't make any sense.  The idea is to try to LOWER the overall dose.  Who knows...she may be aware of something we're not, so I think it's a good idea to ask her.  You never know...she may just not be very experienced with this.  Her support is wonderful though...it sounds as though she cares about how you feel about it, and is very open to your input, which is huge.

Let us know what she says...and hang in there!

[4Maddie44]

Hello there.  I did not ask the doctor if I could come off Effexor, I have done very well on it.

I have a yearly review with a doctor, to monitor how I am doing on my anti-depressant.  This time when I went, it was the doctor who suggested I come off Effexor.  I told her I was doing well, but did not like the weight gain.  I told her I had come off it cold turkey once before, because of the weight issue, but after a year the depression came back.  

The doctor said depression came back, even after a year, because I had not tapered off slowly!!  Is this possible?

You are right, if I am doing well, why stop?  I think the doctor thought that after 20+ years on anti-depressants, I may well not need them any more.  I suppose I could not argue with her over that.  

I agreed to go along with what you suggested, as she is a doctor, and I suppose I thought she knew what she was doing.  It is now I am having my doubts.

I will carry on with her regime a little longer, and then go back and she what she suggests the next stage is.  I have discussed this with my daughter, who is the person who has supported me for all these years.  She is a drugs rep, although not anti-depressants, but she knows me through and through.  Any sign of a problem, she will get in touch with the doctor, or come with me to see her.

Thank you so much for your input.  I am all confused as to what I should do now.  Oh dear!!

Take care and thanks.

[nursegirl6572]

Aw, Maddie, I'm sorry to hear you're perplexed.  These kinds of decisions are rough.

While your doctor sounds like a nice person, I don't necessarily agree with her thought processes.  For one, for SOME people, I don't think depression just GOES AWAY, you know?  I think it has its ups and downs, but some people are a "lifer".  You've been doing this dance for a LONG time..I think you just might be one of those people.

You have to do what YOU think is best hon.  If you're feeling pretty good on it, then don't make any changes!  You've been down the road of getting off, only to have the depression return within a year or so (which, IMO is another reason to stay on it).  I think this recommendation is being based on two things...one...the old "well, you've been on it so long, maybe you don't NEED it anymore"...and the weight issue.  The first reason...I just flat out disagree with.  If anything, I think after so long, it's ovbvious that a person does so well BECAUSE of the med, not in spite of it..just my opinion.

The weight issue is a toughie...been there, done that!  My honest to GOD opinion, as much as I don't like any kind of excess weight...is, I'd much rather have the depression under control with some extra weight, than be thinner and miserable.  That's just my opinion.  For others, the weight is a MUCH bigger deal...it's a deal breaker in fact.

Please don't follow the doctor's lead because you think you should listen to what she says, or feel funny about speaking up.  If this doesn't feel right, and you'd rather stay on it...then simply tell her you would prefer not to mess with it, and leave things the way they are.  She sounds like a really nice doctor, so I'm sure she would be receptive to your input.  The last thing I would want to see is you ending up taking a bunch of steps back as a result of this....especially if there isn't a really good reason to make that decision.  That is something you have to decide.  If you WANT to give it a go, and see how you'll do, that's reasonable..I just think you've been on that rollercoaster enough times to know how this will probably end up.  I'm not meaning to sound like a Debbie Downer...just being honest.

I'm so glad to hear you have your daughter to support you and keep a watchful eye on you either way. Thank GOD for that huh?  Keep us updated..you know any decision you make has to be YOURS and YOURS only...not mine, the doctor's, your daughter's, the butcher's (lol)...you know what I mean.

I'll be anxious to see what you decide.  I know you've got a lot of insight into how you feel...you've done this long enough where that's a Godsend...the ability to be able to assess when things aren't so great.  If you stay on the taper, just stay hypervigilant to how you're feeling.

Best to you.

[remar]

Excellent advice as always Nursegirl. I agree with everything you've said.
I took Effexor myself and was on it for about 5 years. It did help my anxiety and depression. The reason I went off it was because it was causing medical problems for me. I did a very slow taper with my Drs help and it was still so hard!
Maddie, you may want to really think about doing a much slower taper. I do agree with Nursegirl. I would'nt worry about weight.I think you look healthy and really don't need to lose weight. I've seen your pictures and you are beautiful.

[birdie0907]

I don't mean to hijack this thread with my question, but I was given an alternate up and down pattern to taper off my med too as 4Maddie was. My doc is a 35 year old gp, who has been very good in all decisions with me, so I tend to think they are up to date on all things.
I know we are not supposed ot give taper instructions on MH but will ask the following question assuming it is ok. My question is, you are sure the bouncy taper is not a good practice?

[nursegirl6572]

My question is, you are sure the bouncy taper is not a good practice? .

I honestly don't know...that's why I said maybe the doc knows something I'm not aware of.  It just doesn't make sense, knowing how the medication is supposed to work.  That's just my reaction when reading about it.

Maddie has done well so far after 4 weeks, and you did well too, so maybe there is something to it.  I would love it if Maddie would ask her doc about the rationale behind this method.  Maybe if we were told the "whys" or who came up with it....I would be more willing to buy into it.

I'm just happy thus far, it seems to be working, with very little symptoms.

[birdie0907]

Although lots of the med stays in your body for days, I think most of it goes away in 2 or 3 days. So the bounce up just helps maintain the overall average move downward on a slower decline than a pure drop off and holding at that level would. i.e. A bounce method takes longer to get you to a lower level than just dropping to that level, so it has to be a slower average rate of drop in med.
If you drop to one level straight for a week, the drop after a day or so would be quicker than a bouncey style, I presume.

That is how I guessed it worked after my doc said to bounce. I will now move to listening mode.

[sara12345]

I think that nursegirl made some very good points about why are you going off an anti-depressant which you have done well with.  My psychaitrist warned me that when someone has suffered from depression for a long peroid in their life, that is, not just short term depression, then going off of the anti-depressant can cause more problems with treating the depression again when you go back onto it and that you may need a stronger dose to accomplish the same effect.  

Maybe you got away with it last time, but I would wonder about your intent to be "really strong about this" as if it is about willpower.  Depression is a chemical imbalance just like a diabetic has an insulin imbalance.  Would you expect a diabetic to be really strong to get off of insulin?  Also depression is now  believed to affect the whole body.  For example, it brings on diseases much faster that are associated with older age such as osteoporosis and strokes.  This is due to the telemeres being affected by depression.  I also question you getting off of it.  But if you feel that you need and want to, then you will, but don't fool around with going back on to it ASAP if you start to feel at all badly.  Wish you the best.

[4Maddie44]

Hurrah, someone else advised by GP to alternate dosage.  You really made me feel so much better about this.

Can you give me more details about how you are tapering off?  Have you completely withdrawn, or are you still withdrawing?  I want to know all about it please.  So glad I am not alone in this method.  

Yes sara I have had depression  for many years.  It has always come back.  It may do so this time.  That's OK I am prepared for it.  I can be strong willed, but I will know if I have to take anti-depressants for the rest of my life after this.  I am used to it, so know the signs.  I know all the dangers, I am well versed on depression.  Just thought it would be nice to be completely drug free again, if only for a while.

Don't think me silly for doing this, I know full well the consequences.  Thank you all for your input.  I'll keep you posted.

[nursegirl6572]

No one thinks your silly, Maddie.  We're not passing judgement in any way.  I don't want you to feel like that.  I think probably most of us have been there.  I know I have gone off meds many times...for the same reasons.  Unfortunately for me, the anxiety (my primary reason for the meds) always returned with a vengeance.  I just think none of us want to see you take a step back, when there isn't a real strong reason to come off in the first place.

Again, that's your choice, and I have no doubt you are very aware of how you're feeling.  I know you will do whatever you have to to get back on track if you start having problems.

When you see your doc again, ask her about this method...if it's something fairly commonly used (I personally have not heard of it, but that doesn't mean anything)...and what the rationale behind it is.  How often do you actually decrease your primary dose?  Do you continue to go up and down all the way to the end, even on very small doses?

This has definitely peaked my interest, I'd like to hear more about it.  Who knows, they may be onto something...especially for a drug like Effexor, which is hard enough to come off....if there's a better way, I'm, all for it!

[birdie0907]

MH does not allow me to go into taper details, and I am not a medical professional so that is a good policy. Maybe you can ask your pharmacist, as they see many people going through this process?

[sara12345]

No I do not think that you are silly.  Nothing that I have read from you has ever been silly.  Take care.

[4Maddie44]

Thank you all for your input.  I will carry on with what my doctor has told me for a few weeks yet.

I love the support here on MedHelp.  

[4Maddie44]

What anti-depressant are you on, and what dosage?  I am at the moment coming off 150mg daily Effexor XR.  

I see you are getting good support here.

Take care

[4Maddie44]

I will be returning to my doctor next week for the next stage of tapering off 150mg Effexor.  It will have been six weeks since I started the alternate day regime.

I have been perfectly OK on this regime.  No change at all.  My body and mind do not seem to object to this "bounce".  As you see, I am taking it very slowly.  As I have been on anti-depressants, a long time, I think siux weeks at a time is a good time frame.  I don't mind how long the withdrawal takes.  

I will let you know how I get on when I have seen the doctor.  I expect the next stages to be much more difficult - wait and see,

[nursegirl6572]

That's so great that it is going well.  I agree with you too that there is never a need to be in a hurry.  The slower, the better, IMO.

[mandy876]

I think you should listen to  your doctor.  they should know what they are doing.  sometimes I wonder about my doctor.  seems to enjoy is computer more than my problems.  I am doing much better I have done a lot of thinking.  and I am going to try harder to fight back and get over myself.  mandy876

[4Maddie44]

Luckily I have found a doctor in my local practice who is very understanding, and she suggested I withdraw from Effexor.  She took her time with me, and will be there for me all the way.  An understanding doctor makes all the difference.

Is there any way you could see another doctor? Are there other doctors in the practice where you go?  You can ask to see another one.

Glad you are doing better.  That is rea;lly good news.  Keep it up.  Yes we have to fight for ourselves, because no one else can do it for us.  

[mandy876]

it is hard to find a good doctor when you are on medicare and second ins.  they don't get much money I guess.  my doctor took me before I went on the medicare.  and he was not taking medicare patients at all.  but since he was my doctor before he kept me.  I am afraid if I find another doctor that will take me I might do worse.  another thing which is crazy.  I don't like changes it really upsets me I have been that way since I was a child.  mandy I think about you and hope you are doing well.  sounds like you have a good doctor.  I would miss you if we were not friends.  mandy876

[4Maddie44]

Hi, I did not realise how difficult it was to find another doctor if you are on Medicare.  As I live in UK we have the National Health Service, so things are bound to be different.

No I don't like change either, but if I know it is to my good, then I will obviously take what is best.  

I will be seeing my doctor next Thursday.

[mandy876]

I go in nexrt week too.  he sent me papers for a bunch of blood work.. mandt876

[4Maddie44]

Update on Effexor XR withdrawal.  Saw doctor today.

I have been on alternate doses of 150mg and 75mg and have been fine.  My doctor wants me to stay on this for another 2 months.  I have already done six weeks on this regime.  Then after that time, I will reduce to 75mg daily for at least three months.  Now I do call that a slow withdrawal.  My doctor says doing it over a year, I will have a much better chance of not having such bad withdrawal symptoms, and less likely to get reprecussions months later.

Last time I stopped, after a year what I thought was depression returned.  My doctor said it could well have been the withdrawals still.  So this time I am not going to jump to conclusions that my depression has returned. I am going to give myself time to decide whether to go back on medication or not.

[mandy876]

  maybe slow is better.  I always thought they went faster.  maybe that's why so many people have relapses. sounds like you have a doctor  who cares.  good luck .  and god be with you.

[4Maddie44]

Thanks.  Yes I am quite happy to take a year withdrawing.  No hurry.  I am feeling so very well at the moment, that I will listen to my doctor.  I believe she knows what she is doing.  

[4Maddie44]

Update on Effexor XR 150mg withdrawal.  Nearly 3 months now on the alternating days 150mg and 75mg.  No problems at all.  Still don't know if this is a good way to begin taper, but I am taking my doctor's advice.  Reading all the posts  the Effexor Withdrawal (830+) comments, so many people withdrawing and finding it difficult.  Others find it easier.  

Who can say exactly how long it takes to withdraw from Effexor.  There is no definitive answer.  Purely a personal thing, as we are all different.  Good luck to all those people, who like me, are withdrawing.  My advice, take it slowly.

[mandy876]

  Good luck i am thinking about you.  my prayers and thought are wih you.  I know you can do it.  you are such a strong person.  i wish i was ready.  but i know iam not.  taking it slow sounds like a very good idea.  mandy876

[bbaggins]

First time I've ever heard of alternating. Usually they'll just reduce your dosage until your off of them. Generally it would be 75 for two weeks (or more if needed), then every other day, then 37.5 for a period of time, then every other day, then every third day, then off.

No matter what, though, you WILL experience some withdrawal symptoms. When I went off of them via tapering, I got what are called "brain zaps" (almost like mini seizures). Had those for several months. Knew what they were, so they didn't bother me much, unless I was driving or speaking at the time.

[4Maddie44]

I withdrew from Effexor XR 150mg cold turkey before, so I know all the withdrawal symptoms.  I expect to experience some of them again.  I am quite prepared for that.

Yes I had bad "brain zaps" whilst withdrawing, but after 2 weeks, never had them again.

Only one other person on this site says they withdrew with the alternating method.  I don't know why my doctor has put me on this regime.  She seems to think I will adjust better when lowered to 75mg.  I will just have to wait and see.  As I said at least three months at each stage.  

[sara12345]

It's been over 2 months since your last posting on this thread.  Wondering if you are continuing to go off the Effexor or decided to go back on it?  How are you doing?