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Re: Effexor Withdrawl » CMG

Posted by Cam W. on December 20, 2001, at 11:55:29

In reply to Re: Effexor Withdrawl, posted by CMG on December 17, 2001, at 21:18:28

CMG - The venlafaxine (generic name) that you are taking the regular Effexor™ and your mom is taking Effexor XR™. The difference is the half-life (the time it takes for half of the drug to leave your body). The half-life of Effexor is about 5 hours and the half-life of Effexor XR is about 15 hours. This means that your mom can take one dose per day, while you have to take at least 2 doses per day.

I actually do not recommend anyone taking the regular Effexor, as you can run the risk of starting to go through the serotonergic withdrawl within 8 hours of missing a dose. So, even though you are decreasing your dose in an effort to come off of the drug, you must still take multiple doses per day to minimize the risk of withdrawl symptoms. I do not recommend withdrawing from Effexor without having a doctor monitoring your doing so.

In actuality, most people do not have a problem withdrawing from Effexor, if done properly. Many people can even stop taking the drug cold turkey, if they are taking the Effexor XR in doses equal to or less than 75mg/day, with minimal withdrawl symptoms. The one's who do have problems are those who metabolize the drug faster (ie. have multiple repeats of the gene that encodes a liver enzyme called cytochrome-P450-2D6 or CYP-2D6).

The very fast metabolizers, thought to be about 5% of those of European decent, do need help withdrawing from Effexor (and Paxil™ [paroxetine], Luvox™ [fluvoxamine] and occasionally Zoloft™ [sertraline]). A doctor can prescribe Prozac™ 10mg or 20mg per day, to be taken with as low a dose as possible of Effexor XR (ie. the dose at which the withdrawl symptoms apppear). The Prozac and Effexor XR are taken together for a week, then the Effexor XR is stopped, and the Prozac is taken for another week. The long half-life of Prozac (4 to 6 days) prevents the appearance of serotonergic withdrawl symptoms, as the drug leaves the body very slowly, allowing the body to adapt to the lower levels of serotonin.

I believe that the appearance of withdrawl symptoms is (partially) an indication that the depression (or anxiety or obsessive/compulsive symptoms, etc.) has not resolved and the SSRI should be continued. In other words, the body has not started to produce enough serotonin on it's own, meaning that the situation that caused the depression has not been resolved (ie. in the case of a reactive or exogenous depression - not genetic depression - one has not dealt with and resolved the issues that caused the depression in the first place - usually through some sort of cognitive psychotherapy).

I hope that this helps you to understand what could be causing you to experience serotonergic withdrawl symptoms from Effexor. - Cam




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