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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5334
Experience:  Dr. Mark is a PhD in psychology in private practice
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I have been taking 150 mg of Effexor XR for many years, but

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I have been taking 150 mg of Effexor XR for many years, but it has recently stopped working for me. Today I was prescribed 20 mg of Paxil. What is the best way to wean off the Effoxor onto the Paxil with the least side effects? Thanks!

Dr. Mark :

Hi! I'll be glad to help you with this issue.

Dr. Mark :

Have you talked with your doctor about a tapering off regime for the Effexor?

Customer: She actually is just a general Practioner and was unsure if what side effects I might have. She suggested maybe 1 Effexor capsule every other day. I live in a very rural area, so not a lot of options for mental health issues.
Dr. Mark :

Are you taking the 75 mg XR?

Dr. Mark :

or the 150 mg?

Customer: I have skipped a dose of Effexor before and will realize it before the day is up because of the brain zaps associated with missing a dose. I'm a little worried about the withdrawals.
Customer: The 150 mg
Dr. Mark :

Okay. First, let me say that brain zaps are a common side effect of SNRI withdrawal. Effexor is in that class of drugs. It is temporary and lasts for 10 days to 2 weeks for most people after total withdrawal. But you want to taper off and never quit cold turkey with SSRIs (Paxil) and SNRIs.

Dr. Mark :

I'm assuming you're already taking the Paxil 20 mg, which is a starting dosage. Is that correct?

Customer: I was just prescribed today, so tomorrow will be 1st dose.
Dr. Mark :

Good. This should help with the brain zaps.

Dr. Mark :

Next, it would be advantageous if you could get your doctor to prescribe the Effexor XR in the 75 mg capsules, enough for you to take 1 capsule every other day for a week or two. Then,

Dr. Mark :

you and the doctor monitor if your present "weaning off" procedure of every other day (not optimal to start, but you've already started so you can keep with it) is being tolerated well with the 150 mg every other day while taking the 20 mg Paxil every day.

Dr. Mark :

If not,

Dr. Mark :

then you want to switch to 75 mg every day while titrating up with the Paxil slowly to your eventual clinical dosage.

Dr. Mark :

If you are tolerating the 150 mg every other day well, then after a week or so, when you up the Paxil if necessary, you would now go down to 75 mg Effexor XR every other day for a week or 10 days.

Dr. Mark :

Then, you should be up to your maintenance dosage of Paxil and can now stop the Effexor. If there are still side effects, then 75 mg every third day, then every fourth day, etc.

Dr. Mark :

You might consider printing this out and discussing it with your doctor so the two of you are comfortable with the strategy, okay?

Customer: Sounds good to me and I appreciate your help Dr. Mark! I will discuss it with her tomorrow. Again, thanks for the excellent service.
Dr. Mark :

I'm very glad to help.

Okay, I wish you the very best!


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