From the Guidelines
Effexor (venlafaxine) withdrawal symptoms can be severe and should be managed with a gradual tapering schedule to minimize discomfort and risk of morbidity, as suggested by the most recent evidence 1. When stopping long-term antidepressants like Effexor, patients may experience a range of severe withdrawal symptoms, including severe anxiety, agitation, low mood, and somatic symptoms, which can be protracted and disabling 1.
Common Symptoms
- Dizziness
- Electric shock-like sensations (brain zaps)
- Headaches
- Nausea
- Vomiting
- Irritability
- Anxiety
- Insomnia
- Flu-like symptoms Some people may also experience confusion, sensory disturbances, tremors, excessive sweating, and mood changes including agitation or depression.
Management
The severity of withdrawal depends on factors like dosage, duration of use, and how quickly the medication is discontinued 1. To minimize withdrawal symptoms, Effexor should never be stopped abruptly; instead, work with your healthcare provider to create a gradual tapering schedule, which might take weeks or months depending on your situation. If you experience severe withdrawal symptoms, contact your healthcare provider immediately as they may need to adjust your tapering schedule or provide supportive treatments. It's essential to note that venlafaxine should be tapered when treatment is being discontinued because a withdrawal syndrome has been described 1. Determining optimal tapering procedures to minimize withdrawal symptoms for patients who wish to discontinue antidepressants is a current topic of debate among clinicians 1. However, the most recent evidence suggests that a gradual tapering schedule is the best approach to minimize withdrawal symptoms and ensure the best possible outcome in terms of morbidity, mortality, and quality of life 1.
From the FDA Drug Label
Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine, to include prospective analyses of clinical trials in Generalized Anxiety Disorder and retrospective surveys of trials in major depressive disorder Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment Reported symptoms include agitation, anorexia, anxiety, confusion, impaired coordination and balance , diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, flu-like symptoms, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting During marketing of venlafaxine HCl, other SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), and SSRIs (Selective Serotonin Reuptake Inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e. g. paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
The symptoms of Effexor (venlafaxine) withdrawal include:
- Mood changes: agitation, anxiety, confusion, dysphoric mood, irritability
- Physical symptoms: diarrhea, dizziness, dry mouth, fatigue, flu-like symptoms, headaches, nausea, sweating, tremor, vertigo, vomiting
- Sleep disturbances: insomnia, nightmares, somnolence
- Sensory disturbances: impaired coordination and balance, sensory disturbances (including shock-like electrical sensations), paresthesias (such as electric shock sensations)
- Other symptoms: anorexia, fasciculation, hypomania, nervousness, tinnitus 2 Do not stop venlafaxine HCl without first talking to your healthcare provider. Stopping venlafaxine HCl too quickly or changing from another antidepressant too quickly may cause serious symptoms including:
- Anxiety, irritability
- Feeling tired, restless or problems sleeping
- Headache, sweating, dizziness
- Electric shock-like sensations, shaking, confusion, nightmares
- Vomiting, nausea, diarrhea 2
From the Research
Symptoms of Effexor Withdrawal
The symptoms of Effexor (venlafaxine) withdrawal can be severe and may include:
- Headache
- Nausea
- Fatigue
- Dizziness
- Dysphoria
- Diarrhea
- Sweating
- Vomiting
- Insomnia
- Irritability
- Flu-like symptoms
- Hyperarousal
- Imbalance
- Obsessive-compulsive symptoms (in some cases) 3, 4, 5, 6
Severity of Withdrawal Symptoms
The severity of withdrawal symptoms can vary from patient to patient, but they can be severe enough to make cessation of the drug extremely difficult 3. In some cases, symptoms may resemble a stroke, making it essential to rule out other medical conditions 5.
Treatment of Withdrawal Symptoms
Treatment options for withdrawal symptoms include re-inclusion of venlafaxine or a selective serotonin reuptake inhibitor (SSRI) antidepressant 5. In some cases, switching to a different antidepressant, such as fluoxetine, may be an effective strategy for managing withdrawal symptoms 4. Additionally, treatment with escitalopram has been reported to facilitate remission of obsessive-compulsive symptoms that developed after abrupt discontinuation of venlafaxine 6.