From the Research
To taper venlafaxine XR from 225mg to 150mg daily, reduce your dose by 37.5mg every 1-2 weeks, as this approach is supported by the most recent and highest quality study available 1. This gradual reduction in dosage is crucial to minimize discontinuation symptoms such as dizziness, headache, nausea, irritability, and flu-like symptoms. The following steps can be taken:
- Start by taking 187.5mg daily (one 150mg capsule plus one 37.5mg capsule) for 1-2 weeks,
- Then decrease to 150mg daily (one 150mg capsule). It is essential to never cut, crush, or open extended-release capsules, as this alters their release mechanism. Always make this change under your doctor's supervision, as they may recommend a different schedule based on your specific situation. If you experience severe withdrawal symptoms, contact your doctor immediately, as your taper may need adjustment. Staying well-hydrated and maintaining regular sleep patterns during the taper can help manage any symptoms. The slow reduction allows your brain to gradually adjust to changing serotonin and norepinephrine levels, which is why tapering is preferred over abrupt discontinuation, as noted in various studies including 2 and 1. However, the most recent and relevant guidance for tapering venlafaxine comes from the study published in 2021 1, which, although not directly addressing tapering, supports the use of venlafaxine in managing conditions like panic disorder, underscoring its efficacy and acceptability. Given the lack of direct evidence on tapering venlafaxine in the provided studies, the recommendation is based on general principles of tapering antidepressants to minimize withdrawal symptoms, with the specific dosage reduction schedule being a common clinical approach.