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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Mr Beev on February 14, 2003, at 8:19:06
I ceased taking 150mg per day of Effexor XR, with little or no trouble. For what it's worth, here was my experience, which I hope some might find helpful. Your mileage may vary, etc.
- Each day, open up a capsule. Remove 5 of the tiny spheres, say with tweezers. Remove 5 more each day. That is, remove 5 on day one, 10 on day 2, 15 on day 3, and so on. Don't swallow the spheres directly. Put the cap back on the capsule and swallow that, even when the capsule eventually contains but a few spheres.
- "There sure are lots of little spheres! Won't this take a long time?"
Certainly. But if you've ever stopped an anti-depressant cold-turkey or tapered too rapidly, then you know that patience is a virtue. Especially in these cases. Especially with Effexor. Also, if you've been taking an anti-depressant for years, a few months of slow tapering surely isn't so long. It appears to take the typical brain quite a while to adjust to psychopharmaceuticals, so it's likely to take some time adjusting to their absence.
- "But the spheres are all different sizes. Some are even stuck together!"
True, but 5 spheres is such a small amount that I wouldn't worry too much. Just count them out however they come. Count the stuck-together ones as a single sphere; sometimes the stuck-together ones are smaller than a single, big sphere.
- "Could I try taking out more than 5 at a time, say maybe 10?"
Sure. I tapered 75mg by removing 5 spheres per day. I suffered not a single problem. But not being able to follow my own advice (patience), I then tried tapering the next 75mg at 10 per day. This caused no trouble - usually. It may not be advisable to go beyond 10 per day. Five seems to be a good number.
- "I'm getting these 'electric shocks' or 'zaps' in my head!"
You're likely tapering too fast. With the 10 spheres per day regimen, every now and then I'd get the 'head zaps'. They weren't bad compared to episodes I'd had in the past, but the zaps are certainly unsettling. When this happened, I'd hold steady at the current dose until the zaps disappeared. This typically took no more than a day or two. For example, if you've removed 110 spheres and you start feeling some zapping, stick at the 110 level for a couple of days, then continue removing more spheres.
- "Things were going well, but now I've crashed. All my wretched depression and anxiety has returned. I better go back on the full dose!"
It may well be that your underlying problems are indeed still there, and so you need to say on Effexor or perhaps some other antidepressant. How long have you been on Effexor? My doctors have told that one ought to stay on antidepressant medication for 6-12 months, otherwise the improvement probably won't "take".
It is known that when some people taper too rapidly they suffer an apparent relapse in their symptoms. But it isn't a relapse so much as withdrawal.
-- "Then how can I tell whether I'm in a real relapse or not?"
I wish I knew. Years ago, when I tapered off fluvoxamine (Luvox) too quickly, all my original problems returned. But the problems, though awful, were not as intense as they originally were. In other words, I could bear the agony, though it was hard. It took two weeks for the symptoms to dissipate, except for the severe 'zaps' which took a full month to disapper. Then I was fine.
- "Some of the annoying, if minor, side-effects from my early Effexor use have returned during my tapering! What's the deal?"
I don't know why this happened to me. Try to stick with the program till you're done, if you can. In my case, a certain low-level agitation and moderate weakness (or tiredness) returned. This is exactly what happened to me when I first began Effexor. I just groaned and kept on. Some very mild zapping came and went during the home stretch (about 40mg to go). I suspect if I had returned to the 5 sphere per day removal regimen, instead of the 10, this would not have occured. The worst difficultly for me was, I think, feeling very tired during the home stretch. A week or so after completely quitting Effexor, I felt normal again - or at least what passes for 'normal' for me...
-- "Anything I can do to reduce these symptoms?"
-- If you're attempting to stop several drugs, it seems advisable to taper them one at a time. If you're taking pills to help with sleep or other such difficulties, you might taper off Effexor first, saving these other pills for last. I am particularly sensitive to insomnia, so I speak from experience when I say that a good night's sleep goes a long way towards helping.
-- Some doctors prescribe as a temporary measure an antidepressant with a long half-life, such as fluoxetine (Prozac). It takes a while for Prozac to get out of your system, so it's sort of filling in for Effexor while you cut down the dosage. I myself strongly prefer not to take one potent mind-affecting drug in order to get off another, but some people swear by this approach.
-- As anyone who has had the dismal misfortune to miss a dose or two knows, Effexor XR has among the shortest of half-lives. This means the drug goes out of your system quite rapidly. That's why I personally wouldn't recommend taking alternating Effexor dosages, as some attempt to do.
-- I've also found that the single most effective palliative is sustained, regular, aerobic exercise. It makes a tremendous difference: bad days won't be so bad, good days will be even better. I read somewhere that such exercise has been shown to be around 95% effective in improving cases of mild to moderate anxiety and depression. Even in my originally quite severe case - suicidal mania - exercise helped significantly.
---- "I'm not exactly feeling great. It's hard to get motivated to go out and exercise!"
---- Tell me about it. It's tough. Finding someone we can exercise with is a proven effective motivator. Each helps the other stay on track. Of course, the difficulty is in finding such a person.
Best regards and good luck,
Mr Beev
Posted by linkadge on February 14, 2003, at 11:08:16
In reply to Quitting Effexor easily? Here's how., posted by Mr Beev on February 14, 2003, at 8:19:06
This method provides a steady and
predictable tapering rate.Linkadge
Posted by Tabitha on February 14, 2003, at 12:47:27
In reply to Quitting Effexor easily? Here's how., posted by Mr Beev on February 14, 2003, at 8:19:06
Mr Beev, it sounds like a wonderfully soothing ritual. I wish all meds contained tiny speres. It's not nearly so much fun to slice up tablets and decide which of the resulting irregular chunks to use.
This is the end of the thread.
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