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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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I am changing from 75mg of effexor xr to 10 mgs cipralex. Should

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I am changing from 75mg of effexor xr to 10 mgs cipralex. Should I do 37.5 effexor with 5mg cipralex for a week, and then 37.5 effexor with 10 mgs cipralex for another week, and then stop effexor completely?

The method which you are following for substituting Effexor with Cipralex is cross tapering which is indeed the preferred method in clinical practice. In cross tapering, the dose of the ineffective medicine is slowly reduced while the new drug is slowly introduced.

Now please note that the speed of cross tapering is best judged by monitoring patient tolerability and there are no clearcut guidelines for this. Therefore I request you to do any such cross tapering only under the supervision of your doctor.

I think, the method you are going to follow is appropriate except in the last step. Once you have started 10 mg of Cipralex, instead of stopping Effexor abruptly you can start taking either half of 37.5 mg tablet of Effexor (scored tablet so can be divided) or 37.5mg every alternate days for 3-5 days and then stop. This should somewhat help in avoiding withdrawal symptoms.

In the end, I would again like to say that cross tapering is a highly individualized process so please discuss with your doctor before trying any reduction in your doses.

If you have any other query, please feel free to discuss further.

Kind regards

Customer: replied 4 years ago.

My effexor are in capsules though, so going to half of 37.5 is not possible. It is effexor XR. So would u suggest every other day with the 10mgs of cipralex? After a week or two with the 10 mgs cipralex? Do I need to start as low as 5mgs, or can I start with 10?


Well, Effexor is also available in scored tablet preparation and your doctor can switch you over to tablet form for this purpose. Otherwise you can try taking Effexor xr 37.5 mg every alternate day for 3-5 days.

In my view it will be a better idea to start with a low dose of 5 mg and gradually increasing it.
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