From the Guidelines
I strongly advise against stopping Effexor (venlafaxine) without consulting your healthcare provider, even if you're already taking it every other day. According to the prescribing recommendations for SSNRIs, such as venlafaxine, the maximum dosage is 225 mg/d, and the duration of an adequate trial is 4-6 weeks 1. However, this information is not directly relevant to tapering or discontinuing the medication.
When considering discontinuation, it's essential to prioritize a gradual taper to minimize withdrawal symptoms, which can include dizziness, nausea, headache, irritability, electric shock-like sensations, and mood disturbances. The study provides guidance on titration and maximum dosages for various medications, including venlafaxine, but does not specifically address tapering schedules 1.
Given the potential for withdrawal symptoms, it is crucial to consult with your healthcare provider before discontinuing Effexor. They can create a personalized tapering schedule based on your current dose, how long you've been taking the medication, and your individual response. This may involve gradually reducing the daily dose over weeks or months, and potentially switching to a liquid formulation or opening capsules to allow for smaller dose reductions if needed.
Some key points to consider when tapering Effexor include:
- Gradually reducing the daily dose over weeks or months
- Consulting with your healthcare provider to create a personalized tapering schedule
- Potentially switching to a liquid formulation or opening capsules for smaller dose reductions
- Monitoring for withdrawal symptoms and adjusting the tapering schedule as needed
By working closely with your healthcare provider, you can minimize the risk of withdrawal symptoms and ensure a safe and effective discontinuation of Effexor.
From the FDA Drug Label
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
You should not stop taking Effexor (venlafaxine) without first consulting your healthcare provider, even if you are already taking it every other day. Stopping the medication too quickly can cause serious symptoms. It is recommended to discuss your treatment plan with your healthcare provider to determine the best course of action 2.
From the Research
Stopping Effexor (Venlafaxine) When Already Taking Every Other Day
- Stopping antidepressants like Effexor can cause withdrawal symptoms, the return of the original illness, and rebound effects 3.
- Withdrawal symptoms are often mild and self-limiting, but distinguishing them from the recurrence of depressive symptoms can be difficult 3.
- There is insufficient evidence on the extent and frequency of rebound depression, but the risk implies that the short-term benefit of medication must be weighed against the possible long-term risk of chronic depression or the need for long-term medication 3.
Tapering Off Effexor
- Withdrawal from Effexor should take place gradually, except in emergency situations, with small steps taken especially in the low-dose range 3.
- The optimal dose of Effexor for treating major depression is not well established, but studies suggest that lower doses may be effective and have a better tolerability profile 4, 5, 6.
- A review of the efficacy and tolerability of venlafaxine found that it is effective in treating major depression and has a favorable tolerability profile compared to other antidepressants 5, 6.
Considerations for Stopping Effexor
- Patients should be informed about the risk of withdrawal symptoms and rebound effects when stopping Effexor, and the decision to stop medication should be made jointly with a healthcare provider 3.
- There is no direct evidence on the safety of stopping Effexor when already taking it every other day, but gradual tapering is generally recommended to minimize withdrawal symptoms 3.