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Re: help withdrawal

Posted by Sunnely on July 19, 2000, at 20:00:37

In reply to help withdrawal, posted by Bunny Goldberg on July 18, 2000, at 10:54:08


Please, allow me.

The weight of evidence, although based primarily on clinical reports, suggests that Effexor is associated with withdrawal symptoms that may be similar to but more severe than those observed with other antidepressants. Patients may show withdrawal effects after only a few weeks exposure and upon dose reduction or single missed doses.

Withdrawal symptoms from Effexor may include anxiety, agitation, tremors, severe headaches, nausea, cramps, dizziness, lightheadedness, vertigo, numbness, depression, rapid heart beat, ringing in the ears (tinnitus), motor restlessness, "shock-like" sensations. Auditory hallucination was also reported in one case.

Although the extended release (XR) preparation of Effexor appears to produce fewer adverse effects (such as nausea) acutely, it does not appear to differ from the immediate-release (IR) preparation in likelihood of causing withdrawal reactions.

Some authorities recommend a very gradual tapering of Effexor, perhaps even as long as 6 weeks. Others have suggested the addition of Prozac for about 4 weeks to assist with Effexor withdrawal. Once Effexor has been gradually tapered down and discontinued with the least discomfort, Prozac can be then withdrawn with minimal or no withdrawal symptoms at all. Prozac has a much longer half-life than Effexor (and the other SSRIs). The gradual drop in the blood level of Prozac after abrupt discontinuation acts as a sort of protective mechanism from withdrawal symptoms. Withdrawal symptoms from Prozac are uncommon.

Before you take that Prozac from your medicine cabinet, check the expiration date. I don't see any major problem with taking 20 mg/day but if you prefer to take a smaller dose, that will probably do, too. Actually, before Prozac was available in the lower dose (less than 20 mg capsule) and in liquid form, if lower than 20-mg dose is needed (e.g., the elderly), doctors were advising their patients to open the capsule and put half of the content in a glass of cranberry juice to make it more palatable. This preparation eventually became known as "Cranzac."

I will avoid the use of short half-lives SSRIs such as Paxil, Zoloft, Celexa, Luvox. They are about similar to Effexor in causing withdrawal symptoms. Their short half-lives (much, much shorter than Prozac) lead to drastic drop in blood level if the dose is reduced or stopped,. This, in turn leads to withdrawal symptoms.

Source: Venlafaxine withdrawal. In: Biological Therapies in Psychiatry Newsletter by AJ Gelenberg MD (editor), January 1999.




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