From the Guidelines
Discontinuing Effexor (venlafaxine) can cause withdrawal symptoms that range from mild to severe, especially if stopped abruptly, and it is recommended to taper the medication gradually under medical supervision to minimize these effects. Common withdrawal symptoms include dizziness, headaches, nausea, vomiting, diarrhea, irritability, anxiety, insomnia, fatigue, and electric shock-like sensations called "brain zaps" 1. Some people also experience flu-like symptoms, mood swings, confusion, and sensory disturbances. These symptoms typically begin within 1-3 days after reducing or stopping the medication and may last for 1-3 weeks, though in some cases they can persist longer. The severity of withdrawal depends on factors like dosage, duration of treatment, and individual physiology.
To minimize these effects, Effexor should be tapered gradually under medical supervision, usually over several weeks or months depending on the dose. A typical taper might reduce the dose by 25-50% every 2-4 weeks, with smaller reductions as the dose gets lower. This gradual approach allows the brain to adjust to decreasing levels of the medication, as Effexor affects both serotonin and norepinephrine neurotransmitters, and sudden discontinuation disrupts the brain's chemical balance that has adapted to the medication's presence. According to the most recent study 1, venlafaxine is one of the antidepressants that can cause withdrawal symptoms, and it is essential to follow a gradual tapering schedule to avoid these symptoms.
It is also important to note that the risk of withdrawal symptoms is higher with certain antidepressants, including venlafaxine, and that medical education, training, and experience are necessary to safely and effectively prescribe and taper these medications 1. By following a gradual tapering schedule and under medical supervision, the risk of withdrawal symptoms can be minimized, and the patient can be safely discontinued from Effexor.
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 withdrawal symptoms from Effexor (venlafaxine) 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
- Vomiting As reported in the studies 2 and 2.
From the Research
Withdrawal Symptoms from Effexor (Venlafaxine)
- The withdrawal symptoms from Effexor (venlafaxine) can be severe and may include several somatic and psychiatric symptoms, similar to those of selective serotonin reuptake inhibitors (SSRIs) but of higher intensity 3.
- Symptoms may resemble a stroke, and in some cases, patients may experience severe symptoms shortly after discontinuing the medication 3.
- The mechanism of venlafaxine withdrawal syndrome is similar to that of SSRIs, and the risk of withdrawal syndrome is high when the medication is discontinued abruptly 3.
- Treatment options for venlafaxine withdrawal syndrome include re-inclusion of venlafaxine or a SSRI antidepressant, which can help alleviate symptoms quickly 3.
Reducing the Risk of Withdrawal Symptoms
- Gradually reducing the dose of venlafaxine over time can help minimize the risk of withdrawal symptoms 4, 5.
- Hyperbolic tapering, which involves reducing the dose by a certain percentage at regular intervals, may be an effective strategy for discontinuing psychiatric medications, including venlafaxine 4, 5.
- However, the lack of standardization in guidelines for tapering psychiatric medications can make it difficult for prescribers to determine the best approach for individual patients 4.
Importance of Patient Education
- Patients should be informed about the risk of withdrawal syndrome when discontinuing venlafaxine, and the importance of gradual dose reduction should be emphasized 3.
- Educating patients about the potential symptoms of withdrawal syndrome can help reduce unnecessary stress and medical costs associated with misdiagnosis or inappropriate treatment 3.