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Two methods for Tapering Effexor -- hope it is a help to someone

METHOD 1:

I have taken Effexor and my highest dose was 150mg XR/once a day (extended release capsules) for 1 1/2 years; I have been tapering for 8 months and I'm now at 28.06mg/for the day (using tablets). I have had minimal withdrawal to this point and I attribute that to the very slow tapering and cutting doseage's at a rate between 5-10% (and no more than that) each time.

Now for the how to's:
Instead of counting out granules (which really isn't accurate as granule capsule contents vary anywhere from 105 - 124 granules per capsule), use Effexor immediate release tablets (don't worry you won't feel any different than using the capsules---I know because I switched from the capsules to the tablets). The only difference is that you will take one half of your tablet dose in the morning and twelve hours later take the second half of your dose.

THE GOOD NEWS: Effexor comes in tablets: 100mg, 75mg, 50mg, 37.50mg, and 25mg. You can purchase a "pill splitter" from any pharmacy--the cost about $4.00 (american money) and split your pills in half, quarters, and even eigths--(with a little practice for the 1/8s). Splitting tablets will enable you to have more control stepping done your medication. When I got to a dose that is in between one of the tablet sizes listed above, I respectfully requested from my doctor a prescription of two different amounts of tablets (for example 37.50mg tablet and 25mg tablet). When I was ready to step down from 37.50mg I did NOT want to go directly to 25mg--that is WAY TOO MUCH of a cut. Instead this is what I did:

---I cut a 37.50mg tablet into eights = 4.66mg/per eight and then cut a 25mg tablet in half = 12.50 mg. I would then take: one 4.66mg plus one 12.50 mg = 17.16mg (morning dose) and then do the same thing 12 hours later. 17.16mg + 17.16mg = 34.32mg for the day. I stayed at this new amount for a month.

Then I tapered to 31.24mg for the day. I got that by: cutting a 37.50 in quarters = 9.37mg and cutting a 25mg into quarters = 6.25mg. I then took 9.37mg + 6.25mg = 15.62mg in the morning and then same thing 12 hours later. 15.62mg + 15.62mg = 31.24mg for the day. I stayed at this amount for a month.

I currently take 1/8 of a 37.50mg tablet = 4.66mg plus 1/4 of a 37.50mg tablet = 9.37mg. 4.66mg + 9.37mg = 14.03mg. 14.03mg + 14.03mg = 28.06mg for the day.

You can see this is MUCH EASIER on your system than going from 37.50mg to 25mg.

WHEN CUTTING YOUR PILLS of differing milligrams, have some empty, clean, prescription bottles that are labeled (for example 4.66mg on one, 9.37mg on another, 6.25 mg on another, etc.) so that you don't get them mixed up. As you cut smaller amounts it gets harder to distinguish what is what--the labeled bottles will keep you straight. Just be sure to put the correct amounts in the correct bottles!

BE SURE once you step down on a doseage that you remain at that amount for at least 3 weeks, preferably 4 weeks. It will give your brain chemistry a time to adjust to the lower level of chemical serotonin.

DON'T BE SUPRISED as you get lower and lower on your dose that you may need more than 3-4 weeks to stablize; remember your brain is going through a HUGE change--give it the chance to even out. It's not important how long it takes to taper from dose to dose, it matters that you take your time!

ALWAYS take Effexor with food in your stomach and drink plenty of water.

Do NOT eat or drink anything containing GRAPFRUIT, it can create a serious toxic reaction.

NEVER, EVER take St. John's Wort or 5-HTP--they have a serotonin in them. Mixing them with an anti-depressant or taking then after you've been off of an anti-depressant for only a year of less can lead to SEROTONIN SYNDROME - a toxic and deadly condition.

Drugs that may induce serotonin syndrome when taken with antidepressants (not a complete list)
ecstasy
cocaine
lithium
St John's wort (Hypericum) - herbal antidepressant
diethylproprion - an amphetamine
dextromethorphan - found in many cough suppressants
Buspar (buspirone) - for anxiety
Selgene, Eldepryl (selegiline) - for Parkinson's Disease
anti-epileptics - Tegretol, Carbium, Teril (carbamazepine)
analgesics - pethidine, Fortral (pentazocine), Tramal (tramadol), fentanyl
anti-migraine drugs - Naramig (naratriptan), Imigran (sumatriptan), Zomig (zolmitriptan)
appetite suppressants - phentermine and fenfluramine
tryptophan - an amino acid


NEVER, EVER take Effexor or any anti-depressant every other day--withdrawal will start and you will never get back on an even keel. I know, I know your doctor told you to do this, but MOST doctors are truely ignorant of the hell they are about to put you through doing this. If you are currently on this program get back to taking your dose everyday and after you are stabilized you can start your tapering.

I have two excellent webpages with more information on what is important during tapering. Please e-mail for those as I cannot post them here.

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METHOD 2:

WATER TAPERING - makes possible tiny reductions in medication.


***CAUTION*** This method can ONLY be done with tablets. XR (extended release) versions of medications CANNOT use this method; it will lead to overdose.


Here is a better WATER TAPERING method than the previous one I had posted (which I have removed).


Equipment needed:
a tall lab cylinder that holds 250 ml
a small lab cylinder that holds 10 ml
a dropper or syringe
a mortar and pestle
a small battery-operated mixer
a continuing supply of the med. you are using


Process:
grind the tablet in the mortar and pestle.

Fill the tall lab cylinder to a predetermined amount of water. Use this same amount of water each time you make a reduction. The amount you start with will determine just how small the cut is. Another words the greater amount of water you use, the fewer medicine particles per ml will be suspended in it. The less water you use the greater the amount of medicine particles per ml will be suspended in it.


How to determine the amount of cut you'll be making:
Divide your dose by the milliliters of water you intend to use to find the amount of drug per 1 ml of water.


Examples:
37.50mg Effexor tablet divided by 200ml of water = 0.1875mg per 1 ml of water.

37.50mg Effexor tablet divided by 150ml of water = 0.25mg per 1 ml of water.


Pour a little of the water in the cylinder onto the powdered drug and grind it some more. Then rinse the mortar into the battery-operated mixer, using the water in the cylinder until all of the powder in the mortar and on the pestle has gone into the mixer, as well as the rest of the water in the cylinder. The mortar will become colored from the dye used in the pills, do not be concerned about that.

Hit the spin button on the battery-operated mixer. This puts the drug particles into suspension in the water. There is no need for the pills to dissolve or be water soluble; putting the particles into suspension is sufficient to insure random dispersal for long enough to adjust your dosage.

While the mixer is still ON, take the dropper and remove a small amount of the water. Use the small lab cylinder to measure this amount to 1 ml. Discard this amount and drink the water that remains in the mixer. Then add a little more water from a cup and hit spin again to get all the residue out of the mixer and drink that. The next dose, repeat the process but discard 2mls of water and drink the rest.

The advantage to this method is that as long as you have a sufficient supply of tablets, you can reduce at your own rate and make tiny reductions. The brain doesn't differentiate between very small reductions of dose over a few days, but the cumulative cuts do add up so if you feel withdrawal setting in, STOP and let your body adjust.

Now all you have do is find the equipment. A Power Mixer can be obtained from bodybuilding. It's called the Personal Power Mixer. Or just go to Google and type in the words "Power Mixer", I'm sure you'll find lots of places that sell them and then you can look for the best price. The same thing goes for graduated cylinders and mortars and pestles. Here is website so you can at least see what they look like, pharmex.

I have not affliation with above companies and do not profit in any way from their businesses.

Sweettooth
 
  sweettooth on 2005-11-20
This is just a forum. Assume posts are not from medical professionals.
hello ! wow I wish i could have talked to you first !
I am new to all of this and first time i have posted , I am a month into this and will never take another effexor pill again !! I have been having severe withdrawl reactions for over a month now !!! when will it end !!! I am already off and will not take more at this point to try to wean off easier to me that would be a step backwards !! is there any thing I can do at this point to help myself !? I cannot drive and coping is getting harder ! It is dragging on so !! I have horrible nights !! It is like after 4:00 I have the flu every night !! I mean killer flu symptoms !!! I have major dizziness and body aches and actually run low grade fevers in late afternoon and at night only !! Already been weaned off ! Taken no product whatsoever for over two weeks now !!! What do i do !?! I am in total shock !!!!! I have been dizzy and achy and whimpy for over a month !!! Crying easily at night when i feel awful turns into sobs when no one is looiking !! I think people think I am faking it !! God I wish !!!!!!!!! Please help me with some advice because clearly doctors have no idea what they are doing !!!!
T.lynn
 
tlkbeep last decade
Hi T.Lynn,

You are having withdrawal. How long it lasts is different for every single person.

What was the dose you were at when you stopped?

Please listen. I know you don't want to go back on the drug, but the only way to get you better without doing further damage to your nervous system and the rest of your body chemistry is to get you back onto the med. at a lower dose and get you tapering.

You're chemistry is so off balance and with the added anxiety you feel experiencing the withdrawal makes it worse.

Please get back to me so I can try and help.

Sweettooth
 
sweettooth last decade
hello sweet tooth !
I like that name I can relate ! hahahaha
I am happy you got back to me thank you ! I really appreciate what you said ! I felt like i was crazy ! some days felt like i might be having serious trouble ! It is so hard to believe they just put you on stuff that can ruin your life in both directions !!!! *sigh* oh well whats done is done , just got to ride it out now !!! I am pleased to hear it will end eventually !!
But my husband and i agree going back on will not help me now...I have been off too long !
I am actually feeling better just these last few days! Thank GOD !!! I am much wiser aboout these things now , I will never just take a doctors word for it again !! No matter how well informed or how well their intentions seem !! My body is so wore out i have gotten two colds in just this last month ! Have not been sick all year , now eerything all at once ! *sigh*
well i will keep reading to find a btter way once i recover ! I know I will need more of something in the future but not going this route ever again !
Thanks for your help !
Sincerely ,
T.L.
 
tlkbeep last decade

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