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Forum Name: Antidepressants
Question: coming off effexor xr
|white - Wed Jan 25, 2006 5:37 pm||
i began taking effexor xr five years ago. i was put on 75mg a day. About a year ago i went down to 37.5 mg a day. i have been trying to wean myself off, following my doctors advice. take one every second day for a few weeks, then every third day for a few weeks and continue weaning until i'm off the drug. i am finding it impossible to get off this drug! i've been taking it every three days now for the last two months and by the third day i am so sick that i can't function. the fuzzy head,fatigue, nausea, emotions etc are so unbearable. Will it get better? should i be doing anything different? i truely feel addicted and it is awful.
i am a 31 yr. old woman.
|Dr. Tamer Fouad - Fri Jan 27, 2006 8:37 am||
Effexor (Venlafaxine) is a serotonin-norepinephrine reuptake inhibitor.
Discontinuation symptoms (withdrawal) are recognized with tricyclic antidepressants, MAOIs, SSRIs, and various other antidepressants, including venlafaxine (Effexor) and mirtazapine. The World Health Organization asserts that SSRI and SSRNI antidepressants cause dependence and that discontinuation symptoms can be troublesome and persist not withstanding taper therapy.
General strategies to prevent and manage symptoms associated with the discontinuation of SSRIs include a gradual tapering of the dose when discontinuing treatment with any SSRI except for fluoxetine (Prozac). If withdrawal reactions occur while tapering or at the end of treatment, it may be necessary to increase the dose and initiate a slower rate of taper.
Some authors suggest switching to fluoxetine (Prozac) if symptoms are severe and the patient is unable to discontinue the SSRI despite tapering.[2,3,4] For paroxetine (Paxil), some suggest reducing the dose by 5 mg/d at weekly intervals to below the initial minimum therapeutic dose.
1. Haddad PM. Antidepressant discontinuation syndromes. Drug Saf 2001;24:183-97.
2. Selective serotonin re-uptake inhibitors and withdrawal reactions. WHO Drug Information. 1998;12:3, 136.
3. Macdonald L. Discontinuation reactions associated with SSRIs. Can Adverse Drug Reaction Newsl 1998;8 (4):2-3. Also in CMAJ 1998;159(7):846-7.
4. Taman L, Ozpoyraz N. Selective serotonin reuptake inhibitor discontinuation syndrome: a review. Adv Ther 2002;19(1):17-26.
5. Schatzberg AF, Haddad P, Kaplan EM, Lejoyeux M, Rosenbaum JF, Young AH, et al. Serotonin reuptake inhibitor discontinuation syndrome: a hypothetical definition. J Clin Psychiatry 1997;58(Suppl 7):5-10.
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