Allan asked
I am currently on 37.5 mg of Effexor and want to wean off of it. What's the best way to do this? I want to avoid withdrawal. I am weaning under my doctors supervision and advice, I would just like another opinion.
Answer
You are certainly doing the correct thing by weaning your Effexor (Venlafaxine) medication under your doctors supervision. Weaning, also known as tapering down, to prevent a withdrawal syndrome or disease state worsening is suggested for several medications, including Effexor.
There are a variety of different tapering methods that can be utilized and it should be noted that approaches to tapering medications effectively are mostly based on anecdotal evidence. Your doctor knows your specific situation best and therefore should be relied on to provide what they believe is the most effective solution for you. Different patients may require different approaches based on their medical history.
The most important thing is to be educated on possible withdrawal symptoms in which you should alert the prescriber or seek emergency treatment. Withdrawal symptoms are often noted with the acronym FINISH:
F: Flu-like symptoms
I: Insomnia
N: Nausea
I: Imbalance:
S: Sensory disturbances
H: Hyperarousal
These symptoms most often begin one week after stopping or decreasing your medication and are generally the worst by 1-2 weeks...if they happen at all. Not everyone will have negative effects or have major problems. In fact, most withdrawal symptoms are generally mild and go away quickly.
As we mentioned above, there are multiple tapering methods that could be employed for you. Various studies have shown that drugs like Effexor can be successfully tapered by reducing the dose by 25% every four to six weeks and adjust based on any side effects you are having. The duration and amount you are decreasing by can certainly vary depending on how long you have been on the drug and what dose you were taking.
From your question, you mention you are taking 37.5 mg, which is considered a low dose. If you are taking the extended release version, Effexor XR, your tapering options may be more limited due to the low dose and the fact the medication is extended release. Your doctor may suggest tapering by extending the dosage interval of the medication or by switching to the immediate release version. Also, Effexor XR can be carefully opened to reveal small drug pellets that could be taken in divided doses. This option isn't often used to divide doses from a single capsule since it is difficult to get a consistent dose for tapering purposes. It is important to work closely with your doctor to any make them aware of how you are progressing.
