Effexor XR

[jafco]

I'm discontinuing EFXR permanently. Possibly all AD's for the time being. When I get down to 37.5 can I open and modify the caps to a lower dose? I've done this before successfully with Cymbalta, but I think this is a completely different animal.

I am aware of the availability of low doses of Prozac 10 Mg cap, and even the liquid form,(unfortunately 20 MG is the only strength made in the liquid to my knowledge.

I might consider an MAOI in the near future. In any case there is a 2 week washout period required before making the switch. It's a big decision, and I simply haven't made it yet.

I've been through them all (except the MAOIs) and nothing has worked.

My pdoc is now reevaluating my Dx, from simple uniploar depression w/ comorbid anxiety to possible BP II or BP III. I've had several hypomanic episodes he feels were a result of the meds... I'm not sure what's going to happen at this point.

It seems there are a lot of undiagnosed BPs out there because they come to the pdoc presenting depression symptoms, and many times overlook manic episodes, especially if they are few and far between.

John

[Sunshine]

John,

I've done it with Cymbalta as well (under pdoc's direction). Seems like there was something else I did this with, too. I've never taken Effexor, and I agree - it's in a class of itself - so I can't give you my opinion on it, specifically. I don't know what the half-life is, but another option you might want to discuss w/your pdoc is once you get down to 37.5 mg, taking it every other day (or third day, etc.) for the last few weeks. I know this works for Prozac, but that has a pretty long half-life if I remember correctly (or is it a short half life? -- that chemistry stuff always gets me).

Sunshine

[Breeze]

Hey Jafco:

  Long time no see!  I just learned a cool trick from my p-doc. You can open a capsule and put it into water or oj. Then put that into the fridge - sip on it throughout the day. This way, you are getting just a little, and you can still manage what you want, in order to cut down.

  She taught it to me for when you miss a dose, but I don't see why it wouldn't work for trying to stop altogether and you are down to the lowest dose.

  By the way - I am off of neurontin. That stuff put me on hold for 6 months. WAY too sedating and apparently made me crabby. I am still on a little bit at bed time, but am on a whole new program that is working pretty well. I live in hope.

  God I just love being med resistant. Hope you are well.

breeze

[jafco]

John,

I've done it with Cymbalta as well (under pdoc's direction). Seems like there was something else I did this with, too. I've never taken Effexor, and I agree - it's in a class of itself - so I can't give you my opinion on it, specifically. I don't know what the half-life is, but another option you might want to discuss w/your pdoc is once you get down to 37.5 mg, taking it every other day (or third day, etc.) for the last few weeks. I know this works for Prozac, but that has a pretty long half-life if I remember correctly (or is it a short half life? -- that chemistry stuff always gets me).

Sunshine

<{POST_SNAPBACK}>

Hi Sunshine,

Thanks for the input.

By the way, Effexor's half life is about 5 hrs. Cymbalta is more in the range of 12 hrs on average. Prozac has an extremely long half life of 7- 9 days. (I think I'm correct on my facts).

Of course this discounts metabolites, and possible hepatic impairment.

I happen to have HEP C which complicates things a bit.

John

[jafco]

Hey Jafco:

[Breeze]

Effexor Ice Pops! Thats hilarious!

As usual John you mis read it - it's just water, not an "effexorcycle"    - they do this for SMALL CHILDREN that are having trouble taking their meds, or have to take smaller doses than adults.

Again, let's try it again John.  Break open a capsule of effexor into water, small amount of water, stir, and sip throughout the day. THIS WAY, you control how much of your med goes into your system. Simple, easy, and it works.

It's for children John, but I thought it might work for YOU in weaing off of effexor. But if you are going to laugh at my suggestions......well then...... I WILL have to start looking you up again and seeing about how the exercise program is going. How is it going John?  Are you out there yet with the consistant endorphin rush yet?

You have missed me huh?

Breeze

[jafco]

Effexor Ice Pops! Thats hilarious!

As usual John you mis read it - it's just water, not an "effexorcycle"

[Breeze]

Thanks John and sorry about the lung thing - yuck.

C'mon down to Springer land, I get pretty caught up down there, but thanks for reading. Once you get going, they are a supportive bunch.

I'll find you and keep in touch, you have always been one of my favorites, thought you disapeared, but here you are again!  Cool!

Breeze

[Perpetual Fatigue]

Hi John and anyone reading this,

Effexor XR is definitely a different kettle of fish, I have just finished tapering off it after 6 years on it.

Regarding Breeze's suggestion and one many doctors including my own and some websites recommend: Opening capsules into water or orange juice dissolving and sipping etc.

IT DOES NOT WORK, I REPEAT IT DOES NOT WORK!!!

I tried doing this on my docs. direction. One thing they seem to ignore having obviously never done it themselves or thought about it much is, these are time release capsules designed for the acidic warm environment of our digestive system to dissolve over time. They are granules not powder and do not dissolve in water or orange juice. I even tried leaving it sit for a while and "2 days later" the granules were still sitting on the bottom of the glass no matter how many times I stirred the glass.

Most Effexor withdrawal survivors open their capsules and count out granules gradually removing a few more each week. I had to do this too. Another important thing to remember is not all the granules contain the drug a lot are placebo's or 'fillers'.

I was on 150mg caps. and counted out all the granules in a cap, it worked out that approximately 3granules=1mg and I wanted to drop no more than about 10% each time and stay at that dose for a week before dropping again. The different dose capsules have a different number of granules in them so it's better to do your own count of the capsules you take. This seemes to work for me and I took a buffering med 'Dothep' TCA AD (it's banned in the states but still legal here in Oz) while tapering and increased the dose as the Effexor dose dropped.

I've been off it about 3 weeks and I'm still getting awful withdrawals even while taking the other med. Going to ask pdoc about taking something else coz Dothep isn't helping anxiety or depression much.

If anyone wants to conduct their own experiment and see if they can come up with a hot or cold beverage that the granules dissolve in feel free and get back to us.

The other thought that occured to me when considering dissolving a time-release drug is it wouldn't be time release anymore you would absorb the lot into your system in a short amount of time. I don't know what effect this would have on it's efficacy.

So counting the granules seemed the safest option to me, however much of a pain in the ass it was to do, especially when your in side-effect hell and not being able to concentrate much.

PF

[jafco]

Hi John and anyone reading this,

Effexor XR is definitely a different kettle of fish, I have just finished tapering off it after 6 years on it.

Regarding Breeze's suggestion and one many doctors including my own and some websites recommend: Opening capsules into water or orange juice dissolving and sipping etc.

IT DOES NOT WORK, I REPEAT IT DOES NOT WORK!!!

I tried doing this on my docs. direction. One thing they seem to ignore having obviously never done it themselves or thought about it much is, these are time release capsules designed for the acidic warm environment of our digestive system to dissolve over time. They are granules not powder and do not dissolve in water or orange juice. I even tried leaving it sit for a while and "2 days later" the granules were still sitting on the bottom of the glass no matter how many times I stirred the glass.

Most Effexor withdrawal survivors open their capsules and count out granules gradually removing a few more each week. I had to do this too. Another important thing to remember is not all the granules contain the drug a lot are placebo's or 'fillers'.

I was on 150mg caps. and counted out all the granules in a cap, it worked out that approximately 3granules=1mg and I wanted to drop no more than about 10% each time and stay at that dose for a week before dropping again. The different dose capsules have a different number of granules in them so it's better to do your own count of the capsules you take. This seemes to work for me and I took a buffering med 'Dothep' TCA AD (it's banned in the states but still legal here in Oz) while tapering and increased the dose as the Effexor dose dropped.

I've been off it about 3 weeks and I'm still getting awful withdrawals even while taking the other med. Going to ask pdoc about taking something else coz Dothep isn't helping anxiety or depression much.

If anyone wants to conduct their own experiment and see if they can come up with a hot or cold beverage that the granules dissolve in feel free and get back to us.

The other thought that occured to me when considering dissolving a time-release drug is it wouldn't be time release anymore you would absorb the lot into your system in a short amount of time. I don't know what effect this would have on it's efficacy.

So counting the granules seemed the safest option to me, however much of a pain in the ass it was to do, especially when your in side-effect hell and not being able to concentrate much.

PF

<{POST_SNAPBACK}>

Hi PF

I had to do a taper on Cymbalta back in June. You are right, the granules do not dissolve in liquid. What I did was put smaller and smaller amounts in applesauce. It worked just fine. The granules in Cymbalta are enteric (a buffering agent). The capsule itself is just a vehicle to get the contents down into your stomach, where they dissolve at relatively the same time. They are not timed release!

The question that arises with Effexor is "do the granules have a time-release factor? If they do, there is no way of measuring correctly because you wouldn't know which granules dissolve when!

You might want to read the thread we had going back in June. Here is the link:

http://www.crazyboards.org/index.php?showt...pening+capsules

So the question remains, CAN YOU OPEN AN EFFEXOR CAPSULE as you would a Cymbalta capsule?

Last time I titrated onto another drug so the withdrawal was short-lived. This is the first time I'm going to stop AD's completely for a period of time. I can imagine what you're going through. Even with a slow taper, when you reach the end of the taper it isn't over.

I've been told it's the Serotonin factor that causes most of the problems. Try taking a 10mg dose of Prozac for a week or two, start skipping days. Every other day, twice a week, etc.

The same approach can be taken with the Effexor early on... when you get down to the 37.5 mg caplets, start skipping days etc... That was Sunshines suggestion in her earlier reply.

It seems you took a very conservative approach, which is fine. The fact remains though that when you reach the end, regardless of your tapering schedule, there is still quite a battle ahead of you...

Cheers

John

[jafco]

See new topic which answers this question.

http://www.crazyboards.org/index.php?showtopic=2271

[Breeze]

IT DOES NOT WORK, I REPEAT IT DOES NOT WORK!!!

OOOPPPPSSS  sorry. I guess I should have actually TRIED this before suggesting it. But she seemed so SURE of herself, and has never steered ME wrong that I thought I would......well never mind. The apple sauce thing seems the way to go.

Boy is my face red. Maybe I should slink back to "what you actually know" land or just shut up altogether. I apologize. Sheesh.

I of course, was only trying to be helpful from what I THOUGHT was a good source. I know effexor is a bitch to come of. And I wish you guys luck and happy days. Argh. Still like me Jafco?

breeze