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Venlafaxine / Venlalic XL - Withdrawal

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    Obviously I'll put to the docs as soon as I can but i just wanted some advice. Ive been on Citalopram 60mg which is the highest dose that should be prescribed, since May. A few months ago I swapped over to Venlafaxine (just 75mg 1x day).

    I guess kinda a life style change, I don't want to be taking them anymore. I'm under the impression that 75mg is such a small dosage that I wouldn't really need to ween off of them? That said, twice in the last month I've decided to stop taking them and on the 2nd day I felt very out of touch, confused and disorientated. As soon as I take one, I'm fine in a few hours. I though that 75mg was such a low dose? I don't even think it can be prescribed in a lower dose with a single pill? So how would you ween off of it?

    I might cut them in half so they're around 38mg and take that for a week and see how I get on. As said, I've only just recently switched from Citalopram, I know exactly how to ween off of Citalopram without medical advice because I used it for quite some time and I understood the mechanisms of it.

    So anyone had any experience?

    All help is welcome, as said - I will be going to the doctors to speak about it but some people on here may raise interesting points that I may not have thought to talk to my doctor about.

    Ta, Rybee =) x
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    They do a 37.5mg tablet that your GP can prescribe. Because it's not in the same group of drugs as Citalopram, it has a different drug profile. Don't change anything unless under your Drs advice though, it might mess up things that they are trying to do.
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    Yes, they do lower strength preparations (I regularly dispense with instructions to take 37.5mg per day), and withdrawal is common so you shouldn't just stop. Neither should you just snap your tablets in half, especially if they're modified release ones, which is what the XL means, because by snapping them in half, you're altering and removing the coating that determines how slowly the drug is absorbed from your gut. I don't know if it's significant enough to cause overdose, but it will certainly affect whether your dose will 'last you' until the next dose or not. You really need to speak to a doctor if you want to come off this drug, and they'll be able to give you the right prescription to taper your dose down until you can stop.
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    (Original post by *Joanna*)
    Yes, they do lower strength preparations (I regularly dispense with instructions to take 37.5mg per day), and withdrawal is common so you shouldn't just stop. Neither should you just snap your tablets in half, especially if they're modified release ones, which is what the XL means, because by snapping them in half, you're altering and removing the coating that determines how slowly the drug is absorbed from your gut. I don't know if it's significant enough to cause overdose, but it will certainly affect whether your dose will 'last you' until the next dose or not. You really need to speak to a doctor if you want to come off this drug, and they'll be able to give you the right prescription to taper your dose down until you can stop.
    Aaah thanks for the tip on the XL/Release coating, I wouldn't have known that otherwise. Still not been able to take a trip to the docs but i was unaware that they did smaller tabs so I guess I'd have to pick up a prescription of them.

    Appreciate the help
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    There are benefits to continuing the venlafaxine for a few months (normally six) after you feel better - studies show this helps reduce the chance of future episodes. Of course you have to weigh this up against any side effects you're getting or you not feeling comfortable taking them and if you want to stop, that's fine. I don't know enough about you to help you judge nor am I a doctor, but definitely a discussion you should have with your GP.
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    Going cold turkey is never going to be good, in terms of stress and coping because your body will throw up a fuss. I just looked it up in the BNF and coming off it might cause GI disturbances (ie nausea, vomiting, constipation) and headaches but i suspect you maybe used to those sorts of things if you've taking venlafaxine for some time and you've taken citalopram in the past.
    I hope this helps.
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    This is a really interesting thread, I am on 300mg and have been for about 2 1/2 years. At my yearly review, the gp asked if I felt ready to reduce, and quite honestly, I dont think so at this present time. I am about to graduate, and start looking for a job, which will in turn trigger me moving out with my boyfriend. I dont envisage staying on this level of meds forever, but a reduction will happen at some point. I do remember that some website compared it to heroin withdrawal
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    Since making this thread I've actually doubled it up to 150mg per day but think it's going up to 225mg next week...
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    (Original post by Rybee)
    Obviously I'll put to the docs as soon as I can but i just wanted some advice. Ive been on Citalopram 60mg which is the highest dose that should be prescribed, since May. A few months ago I swapped over to Venlafaxine (just 75mg 1x day).

    I guess kinda a life style change, I don't want to be taking them anymore. I'm under the impression that 75mg is such a small dosage that I wouldn't really need to ween off of them? That said, twice in the last month I've decided to stop taking them and on the 2nd day I felt very out of touch, confused and disorientated. As soon as I take one, I'm fine in a few hours. I though that 75mg was such a low dose? I don't even think it can be prescribed in a lower dose with a single pill? So how would you ween off of it?

    I might cut them in half so they're around 38mg and take that for a week and see how I get on. As said, I've only just recently switched from Citalopram, I know exactly how to ween off of Citalopram without medical advice because I used it for quite some time and I understood the mechanisms of it.

    So anyone had any experience?

    All help is welcome, as said - I will be going to the doctors to speak about it but some people on here may raise interesting points that I may not have thought to talk to my doctor about.

    Ta, Rybee =) x
    I've had every anti-depressant going as I had drug resistant depression and it took years to find anything that actually worked.

    Venlafaxine was the thing that cracked it in the end. I dislike it in some ways because I have found it makes me put on weight. However needs must and better some weight than the alternative. Apart from that and the need according to NICE to have regular ie six monthly blood pressure and heart checks which is a pain, it is very effective. I have taken 325 a day now for approx. eight years and will probably need to stay on it pretty much forever unless something new comes along. It doesn't bother me. I think of it like someone with diabetes has to remember their insulin. Depression is an illness. If there is a medication that reduces the effects then fine.

    Compared to other anti-depressants I think that reducing the dose or forgetting to take it for instance results in fairly immediate and noticeable effects. The plunge back into a depressive state for instance can be very quick.

    Therefore I think careful reduction is key. No different really from reducing from other drugs though I think Prozac as a cross over medication to reduce any withdrawal side effects has been researched and shown to be effective. Maybe pharmacy students know more about this.

    Good luck with your plans.

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    (Original post by Rybee)
    Since making this thread I've actually doubled it up to 150mg per day but think it's going up to 225mg next week...
    That would make sense as an effective therapeutic dose.

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    I'm under the impression that it has little to no effect for anxiety until a dosage of 225mg is administered?
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    (Original post by dairygirl224)
    This is a really interesting thread, I am on 300mg and have been for about 2 1/2 years. At my yearly review, the gp asked if I felt ready to reduce, and quite honestly, I dont think so at this present time. I am about to graduate, and start looking for a job, which will in turn trigger me moving out with my boyfriend. I dont envisage staying on this level of meds forever, but a reduction will happen at some point. I do remember that some website compared it to heroin withdrawal


    You can stay on the dose that works for you forever if need be. Some people take anti-depressants for life. You should only reduce dosage if you feel ready and want to try what it is like on a lower dose. Even then it should be done very, very slowly over an extended period and then you will be very unlikely to suffer severe withdrawal effects and certainly nothing like heroin!

    Worse case scenario is that new research shows that if there are any side effects the patient can be treated by reducing the dose of Venlafaxine and replacing it with small amounts of Prozac. Once the process is complete it is then relatively easy to reduce the Prozac without severe side effects. All this obviously has to be done by a trained physician who understands the inter-action between the two drugs and the necessary relative dosages so don't try this at home folks!!!.

    In short.. don't worry. You will be fine whatever you choose to do.
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    (Original post by Rybee)
    I'm under the impression that it has little to no effect for anxiety until a dosage of 225mg is administered?
    I understand that to be the case too. They usually build up the dosage in stages to what is considered a therapeutic dose that will have the effect desired which is what it sounds like your doctor is advising. Sometimes they take the dose over the therapeutic threshold if it seems the patient is very depressed and then reduce it back later.

    I am not too clear though that Venlafaxine is considered to be a drug to treat anxiety as such?????? It is definitely targeted at depression and the lessening of anxiety may be a result of a lifting in general mood.

    Hopefully you're feeling well in yourself and the tablets are beginning to help a little. If not, then as the dose increases you should start to feel the full benefit.

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