HRT - Venlafaxine

Treatment and medication
1

Hi am 58 years old been Venlafaxine for 8 years and have no period for 4 years it really helps my hot flashes, mood but I'm worried about several things . My sexual desires are zero and haven't had sex for a few years my husband is very understanding but it takes it toll. I have no motivation I feel very foggy a lot and sometimes could less about life in general. I would very much like to come off Venlafaxine very much but scared.

Anyone that could give me some advice so I could discuss maybe a plan with my gp

2

Hi Cori,

I tried to come off over a year ago, too quickly after 12 years on it, and it was a disaster.  I also had no sex drive from ven and am menopausal.  I was in withdrawal for 10 months before reinstating, so a failed attempt.

I then learned about the need to taper off of these meds very slowly.  Our nervous system adapts to the action of the drug by down-regulating, to regain homeostasis.  Removing the drug too quickly creates neurotransmitter imbalances that cause withdrawal.  When our system has been operating taking the drug's action into account for so many years, it is very slow to change back, so we must taper slowly to allow our systems to come online and return to functioning without.

I am now doing a micro taper and it is going very well.  The hope is that when I finally come off of the final tiny dose, what withdrawal I do have will be manageable.

You can read about doing a 10% taper in this discussion:  https://patient.info/forums/discuss/depression-resources-298570

The forum that link comes from is THE withdrawal forum for coming off psych drugs and generally accepted as a harm reduction approach.  It is a far more conservative taper schedule than most doctors even have their patients do, so how can they argue with going slower?  You could tell your doctor that since you have been on it so long, you'd like to slide down slowly, being sure that you are without symptoms before cutting further.

3

Hi Cori,

I am about to turn 60 years old and have been off Venlafaxine for 8 months after taking for 17 years.  I don't know if you are able to search the site for this discussion, but I posted a fairly lengthy description in June 2015 when I was first Venlafaxine-free on what the process was for me.  On Ven, I experienced the lack of interest in sex and decreased motivation.  I never considered myself a lazy person, but would feel so lathargic and exhausted on weekends (I work at a fairly fast paced challenging job during the week) that I would take long naps. literally "wasting" the entire weekend. I slowly gained about 25 pounds.  But the worst thing for me was the decline in cognitive ability.  I didn't experience it so much when I initially started taking it, but the last 5 years on the drug it became much more noticeable and was the primary reason I decided to stop.  Unfortunately, withdrawl  was/is a long process that continues still.  I was taking 75mg and reduced to 37.5 without too much difficulty.  I stayed at 37.5 for about 8 months to stabilize.  In my case, my 37.5 capsules were ER and each capsule contained exactly 37/38 little beads.   I reduced my "bead" intake very slowly over the next eight months. (painstaking and probably painful! description in that earlier entry!). (Do not try a "cold turkey" or fast reduction, it is harsh beyond measure and you will likely end up back where you started)   The symptoms during the bead reduction months were difficulty in focusing, anger, irritation, difficulty in planning and strategizing.  Still, I knew it was symptomatic of withdrawl and so continued on.   Once I was off the drug the symptoms changed--I experienced panic and anxiety in the morning and evenings. Irritation, sadness.  Again, I'd never had panic or racing heartbeat before taking Ven, so I knew it was related to withdrawl and had to diminish eventually.  Gradually those windows of panic decreased (after about month 4), but I do still experience them.  The good:  I dropped 20 lbs without even trying. I definitely have more energy, and don't nap on the weekends any longer,  I have renewed interest in a physical relationship with my husband.  The bad: My memory and cognition have not really improved.  My focus/planning/organization is better than in those early days, but memory and verbal acuity and writing has not improved and feels like it may be getting worse.  I was on the drug a long time so I know that it will take a long time for my brain to heal/adjust.   I have found that Omega 3 vitamins, B12 and minimizing intake of sugars and carbs seem to make a difference for me.  Some doctors recommend a "bridge" period of taking Prozac while decreasing/eliminating venlafaxine and then eventually stopping Prozac wihich is said to be easier to go off of.  I didn't do it that way because I didn't want to add another drug to the mix and then have to go off that one too.  But that might be an option as well.  To make a long story long, it has been a journey, and it is not over yet.  I do not take any other medications and had hoped it would be a little easier.... but there you have it.  I wish you all the best in your journey and please take care of yourself and  enlist the support of those around you.  All the best!

4

I bow to you, m89928!  You have done a fabulous job of coming off in the most sane manner possible!  Hopefully, the withdrawal after coming off completely is not as severe as it might have been. 

I came off 75 mg much too quickly after 12 years of use.  I took serotonergic supplements to make up for not being on the ven anymore, and all I can say is that maybe they delayed the worst of it getting started, which really confused the issue for me since I didn't have severe withdrawal symptoms up front; the delayed onset prevented me from putting two and two together!  Add to that that I also came off the BCPs after a lifetime of being on it, and was clearly in menopause, I confused the early symptoms as caused by menopause. Severe sweats, prickly skin sensations, increased pulse and blood pressure to name a few.

I also had the severe cognitive issues, both on and worse when off.  I think the cogntive problems got a little better the further I got out, but the emotional got a lot worse.  Apathy, severe anxiety, doom, fear, agoraphobia, intractible insomnia, etc. and I was desperate for relief.  Sadly, at 10 months out, I reinstated 37.5 mg, resigned to the fact that I had a "depressive brain" and needed to be on the meds forever.  It was only after I restarted (and got relief within an hour, a true sign of dependency!) that I learned the truth, that the drug itself had caused all of this, or more accurately, the lack of the drug that my nervous system had built into the workings.  Taking the drug away was like taking a cog out of a machine and having it fail to work properly!

So, now I am doing the slow taper.  I'd love to stay in touch with you and see how you are doing over the course of healing.  I'm sure awareness of the process brings you some sense of relief/peace when the waves get ugly.

Do you take magnesium?  It is supposed to help with anxiety and insomnia.  Some find the B vits to be too activating, so keep tuned in.  Pretty much anything that could be tolerated at one time may cause worsening symptoms at a later time. I've even read of people having the fish oil go paradoxical on them!   I was never good at listening to my body but am getting better at it, trying to notice correlations like that. 

5

Luckily you have only been on for 4 years. I was in for almost 10 years. The longer you stay on the harder it is to get off. I would suggest if you are not having any issues that are bothering you that bad to go off slowly. I came off somewhat quick because I was already in withdrawal on a steady dose of 75mg. I was put on for anxiety. After tapering off for about a month I was supposed to switch to Zoloft. Well those didn't work so then I went to Celexa. That was no good. I gave Prozac a try because I had been on that prior to the Effexor. I tried to take barely 10 mg for at least a month. Nope. So i came off the Prozac in a about 2 weeks. I think I was experiencing a lot of withdrawal while trying to go on other meds. And while taking the Prozac. I felt like I was losing my mind. But all that happened while I was still on it. They wanted to up my dose and I said no. I should have been taken off years ago to see if I could cope. It's been almost a month off everything. I just barely had a good week. But the symptoms come and go still. I just recognize them as withdrawal. I also have been reading up on ways to cope with anxiety without medication. I felt like I was becoming bipolar to thinking I was going to hallucinate any minute. I think the Effexor had slowly been pooping out on me and my brain was trying to fix itself and the drug kept confusing it. I notice I feel like an airhead lately but I was kinda like that on the medication lol. Don't get me wrong if I wanted to start having a full on anxiety attack I could probably sit and think about stuff till it came on. But with me I needed to learn how to retrain my brain. I'm hoping since I was not put on this for "depression" that I will be able to manage my anxiety without medication. I notice a lot of the people that relapse are diagnosed with depression. When coming off the meds you might or might not have every mental illness experience. I felt like I did for a while. I have noticed my allergies have been terrible which are not helping with anxiety and brain fog. I don't want to scare you cause that's why I never tried to come off before. I would get up the nerve to try and come off and not even try because off all the horrible stories I read online. Some people have came off semi slowly and never had a problem. But it's true sugar makes me feel worse the next day so I try and limit that. I'm not where I want to be but I'm better than I was a couple months ago. Everyone tells me I should reinstate on a low dose so my symptoms will go away. But that doesn't always work , especially since I have been off the "Effexor" for almost 3 months. Hormones can be tricky. I notice I get worse when ovulating and pmsing. I just keep telling myself as long as it doesn't get any worse than it is now I can deal. I'm praying 3- 6-12 months down the line I don't have some kind of weird freak out 😟 my therapist says take it one day at a time. No weight loss for me yet but I have noticed my libido and feeling in those areas have increased.

6

When did you notice weight loss? I have been off the Effexor for almost 3 months but was trying others which did not work. So I just came off the Prozac ( small 10mg) almost a month ago that I was on for 5 weeks. No weight loss, in fact I started working out again and gained 2 pounds lol. I know it's probably water weight from my sore muscles. But I was hoping for a miraculous weight loss and it's not happening 😒

7

I think the recommendation to reinstate a small dose is recommended when the symptoms are so severe that the person can't cope, but it sounds like you are in a really good head space to forge ahead, Shelbytrev! I wish I had known I was in withdrawal when I was freaking out, because with awareness comes strength! You're doing all the right things and your response was inspirational to me!