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MN Psychiatrist
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience:  Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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My daughter of 24 years has been on venlafaxine for 18 months

Resolved Question:

My daughter of 24 years has been on venlafaxine for 18 months now - 150mg slow release. She wants to come off it because she is getting no benefit any more and has started to self-harm. She had sleep problems before going on the medication and these have got much much worse. We understand that G.P.s vary in their approach to reduction. We want to make this as gradual as possible but understand that she has to reduce from 150 to 75 in one go and then down to 37.5. Is there not a gentler way?
Submitted: 2 years ago.
Category: Mental Health
Expert:  MN Psychiatrist replied 2 years ago.
Hello, I am a psychiatrist.

Venlafaxine ER can be reduced from 150mg daily to 112.5mg daily, by using three of the 37.5mg tablets (or one 37.5mg tablet and one 75mg tablet). Then it can be taken down to 75mg daily, and then down to 37.5mg daily. I would recommend spending no less than two weeks at each dose before proceeding down to the next lower one. After she's been on the 37.5mg daily dose for two weeks, she can stop it.

Does this make sense?
Customer: replied 2 years ago.
When my daughter mentioned that she had to drop from 150 to 75 immediately I suggested the 37.5 plus the 75. However she said that it was not possible to mix the 150 slow release with the 37.5. I don't know because I am not medically trained. My daughter however has spent 3 years studying to be a nurse and knows everything!! She is coming home to start the detox after Xmas and has yet to register with a G.P. I am concerned that she may not choose one with the appropriate knowledge
Expert:  MN Psychiatrist replied 2 years ago.
I see.
I'm not saying to combine a 150mg tablet with a 37.5mg tablet to somehow get 112.5mg.

I'm saying use a 37.5mg tablet + another 37.5mg tablet + a third 37.5mg tablet to get 112.5mg, or to use a 75mg tablet + a 37.5mg tablet to get a dose of 112.5mg.

I've been doing this with the slow release version of both Effexor XR (name brand) and Venlafaxine ER (generic version) for years. It works very well.
Customer: replied 2 years ago.
Sorry - I expressed my question badly. My daughter says she cannot reduce the 150 to 75 (slow release) and add the 37.5 to make a total of 112.5. I think she means because one is slow release and the other isn't.
When she finally comes off the drug how many weeks is it likely to take before she knows she is side effect free?
Many thanks
Expert:  MN Psychiatrist replied 2 years ago.
The 37.5mg dose is available in extended/slow release version as well as in "regular" immediate-release form, but even if it wasn't, it could still be mixed with the extended/slow release version just fine.
Once she is off of the venlafaxine, she should be free of any side effects from it within a few days. However if she has some discontinuation effects from it, it might take a couple of weeks for those to go away.
MN Psychiatrist, Psychiatrist
Category: Mental Health
Satisfied Customers: 792
Experience: Physician for 17 years, adult psychiatrist for 13 years working with a wide variety of patients.
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