Valerie asked
I have gained 30 pounds while on Effexor 75ER so my doctor and I discussed changing to Wellbutrin 150 for depression. He has prescribed Effexor 37.5 to wean me...our plan is to take each medicine on alternate days for 2-3 weeks. Is this a good plan of action?
Answer
Having to discontinue or switch antidepressant medications is extremely common. In fact, over two-thirds of patients need to stop or switch medications to due ineffectiveness or adverse reactions, so you're not alone.
In regards to how to stop Effexor XR and start Wellbutrin, there isn't a single "recommended" way to properly taper (or in your case "cross-taper") the medication. Tapering plans need to be patient specific and often need to be altered based on response/adverse reactions etc... As such, you are your doctor should work together to best come up with a plan that works well for you.
Having said that, for most patients, a gradual taper for Effexor (venlafaxine) is recommended to avoid withdrawal effects.
Some studies recommended reducing your dose by 37.5 mg to 75 mg every week to reduce the likelihood of withdrawal effects happening.
If you're having issues with the taper or having pronounced withdrawal effects, one study recommends a more conservative approach by reducing your dose by 25% every 4 to 6 weeks.
The method your doctor is recommending (alternating doses of antidepressants) has been used with success too. Many times, employing a "cross-taper" technique (e.g. tapering up on one medication while discontinuing the other) is effective for retaining the antidepressant effect of your medication while hopefully reducing withdrawal effects from the medication being discontinued. The most important thing you can do is for you to keep track of how you are feeling and be sure to speak with your doctor if you are having any withdrawal effects. These are often signified by the acronym FINISH:
- Flu-like symptoms
- Insomnia
- Imbalance
- Sensory disturbances
- Hyperarousal
It is important to remember too, that tapering your medication, regardless of how slow you take it, may not completely eliminate symptoms from occurring. If they do occur, speak with your doctor but know that they are generally mild and last only for a few days, if that.
