Medication Tapering

Effexor® Withdrawal

Get a holistic picture of the risks and benefits of tapering off Effexor (venlafaxine), including understanding withdrawal symptoms. Before deciding to stop a medication, consult with a clinician trained in deprescribing to determine whether tapering off Effexor is right for you.

Generic name

venlafaxine

Common dose Range

37.5 to 225 mg

Half-life profile

Shorter half-life

Class

Serotonin-norepinephrine reuptake inhibitor (SNRI)

Dr. Bryan Shapiro, Medical Director | Outro Health

Content reviewed by: 

Bryan Shapiro, MD
Withdrawal Symptoms

Understanding venlafaxine withdrawal

Why does withdrawal from venlafaxine happen?

Withdrawal symptoms from antidepressant medications like Effexor happen because the brain adapts to the drug overtime. While historically underrecognized in clinical practice, the common nature of withdrawal symptoms is increasingly accepted. In order to safely stop a medication like Effexor, it's recommended to work with a clinician trained in deprescribing.

How long can venlafaxine withdrawal last?

The duration of Effexor (venlafaxine) withdrawal symptoms varies by individual, based on several criteria. Generally speaking, the longer one uses a medication the greater the risk for severe and extended withdrawal symptoms. Traditional studies, based on people using antidepressants for only 6-8 weeks, suggest that withdrawal symptoms last only days or weeks. New data suggest that withdrawal symptoms can last for months or years. Tapering medications like Effexor more slowly and at a personalized pace can reduce the risk of severe and long-lasting withdrawal symptoms.

What are the common side effects from venlafaxine?

Effexor can produce side effects that vary in occurrence and severity among individuals. Common side effects may include increased blood pressure, sleep disturbances, anxiety, changes in appetite, drowsiness, and gastrointestinal discomfort. Some individuals may experience changes in sexual function or increased sweating.

What are venlafaxine's long-term risks?

Long-term use of any medication requires consideration of potential risks. With Effexor, some studies have noted persistent effects on sexual function or changes in weight in some individuals. There is ongoing research into potential cognitive and cardiovascular effects associated with long-term antidepressant use in general.

What is the half-life of venlafaxine?

The half-life of a medication is relevant to understanding its effects and potential withdrawal symptoms. Venlafaxine has a half-life of approximately 5 hours, while its active metabolite, O-desmethylvenlafaxine (ODV), has a half-life of around 11 hours. This relatively short half-life is why Effexor is typically prescribed for daily use, sometimes multiple times a day for the immediate-release form.

Concerned about venlafaxine withdrawal?

Book a visit with a clinician trained in evidence-based tapering.

Tapering Methods

Coming off venlafaxine safely

Can I stop venlafaxine cold turkey?

Stopping Effexor abruptly is not recommended. In fact, based on the science, it is recommended to taper to daily doses lower than what are typically available. When a medication is taken for months or years, the body adapts to its presence. Sudden removal can lead to withdrawal symptoms, which can be acute or protracted (long-term) in nature.

What is hyperbolic tapering?

Hyperbolic tapering is a neurobiology-based tapering method, based on the relationship between dose changes and brain activity. It is the only science-based method for stopping antidepressants, and is the backbone of Outro's personalized methodology. tapering based on this method gradually backs you out of the drug with reductions following this natural curve, with the size of dose reduction getting smaller as the dosage gets lower. As very low doses (e.g. 1 or 2mg) have much larger effects than people expect, many people need to taper down to very small doses before stopping so that the final ‘jump’ to zero is not too large a shock to the nervous system.

How do compounded medications work?

Compounded medications are often crucial in the tapering process, as commonly available dose sizes aren't small enough to reach the sizes necessary to follow a safe tapering plan. For example, the smallest usually available dose size for venlafaxine is 37.5mg (a drop from 37.5mg to 0mg can easily lead to debilitating withdrawal symptoms).

Creating a personalized venlafaxine taper plan

The development of a taper plan for Effexor should be personalized, based on factors like duration of use, current dosage, and overall health status. A typical approach involves gradual dose reductions over time, following the hyperbolic curve, with periods of dose stability to allow for physiological adjustment.

Thinking about tapering venlafaxine?

Book a visit with a clinician trained in evidence-based tapering.

Hyperbolic Tapering

A science-based approach to reducing venlafaxine withdrawal

The hyperbolic tapering method is a groundbreaking approach to safely and effectively help individuals get off medications like Effexor (venlafaxine). Unlike traditional tapering methods, hyperbolic tapering takes into account neuroscience and the unique needs of each individual, allowing for a more personalized approach that reduces the risk of Effexor withdrawal symptoms.

Dr. Mark Horowitz, Outro Co-Founder
Outro's Tapering Program

Creating a personalized venlafaxine taper plan

The development of a taper plan for Effexor (venlafaxine) should be personalized, based on factors like duration of use, current dosage, and overall health status. A typical approach involves gradual dose reductions over time, following the hyperbolic curve, with periods of dose stability to allow for physiological adjustment.

Hyberbolic Tapering

A science-based approach that helps reduce the risk of withdrawal symptoms and relapse.

Expert Clinicians

Outro clinicians are trained by world-leading experts in medication deprescribing.

Key principles of tapering

Use science-based methods

Hyperbolic tapering is the only science-based discontinuation method, based on the neuroscience of how dose changes impact withdrawal symptoms.

Go slowly & check in

Reduce medications at a rate that the body and mind can tolerate, and make sure to check in to know if you're going to quickly.

Consider compounded doses

When getting to dose sizes smaller than what are usually available, compounding pharmacies can help formulate custom pills and liquids.

Developed by world-leading experts in deprescribing

Outro's interdisciplinary team of clinicians, researchers and patient advocates is dedicated to building safe, evidence-based options for people looking to live life free of medications.

FAQs

Explore commonly asked questions about Outro's services, medication withdrawal, tapering and more.

Who is Outro for?

Outro is for people 18 years and older who are currently taking an antidepressant medication and thinking about decreasing or stopping the medication altogether.

As a virtual care service, Outro’s services are currently not available for people in certain situations or with certain conditions. These include (but are not limited to) people who:

  • Have active and serious substance abuse issues
  • Have been diagnosed with dementia
  • Have been diagnosed with schizophrenia or schizoaffective disorder
  • Have been hospitalized for bipolar disorder in the past 12 months
  • Have attempted to end their life in the past 12 months
  • Are actively suicidal or in crisis
How is Outro different?

Safe antidepressant deprescribing requires a comprehensive approach that is often difficult for an individual prescriber to provide, due to the time required. It also requires up-to-date knowledge on the latest techniques in tapering antidepressants that are not yet widely taught in North America. Think of Outro as a specialist in tapering.

At Outro, we walk with you every step of the way. Our specialized, high-touch care team takes time to get to know you and your goals, and provides an advanced, individualized approach to tapering off antidepressants informed by the latest guidance and clinical evidence. Through Outro’s app, your symptoms and progress are continuously monitored by your Provider, who can reach out to offer coping strategies or adapt your care plan accordingly. If you have questions or concerns that arise in between appointments, your Outro provider is available via 1-to-1 chat.

What if I've tried to stop before?

Many people have difficulties when they try to go off antidepressants. Our team of expertly trained clinicians will develop a tailored tapering program, informed by the latest scientific evidence and designed to minimize withdrawal effects - even for these people who have tried to stop before.

What is hyperbolic tapering?

Hyperbolic tapering (sometimes called the Horowitz-Taylor method) is based on the fact that as antidepressant dose goes up, drug action on brain cells increases, but not in equal steps, higher dosages having less and less additional influence – a decreasing return on investment. The graph showing this is called a hyperbolic curve (goes up faster at low doses and flatter at higher doses).

Tapering based on this method gradually backs you out of the drug with reductions following this natural curve, with the size of dose reduction getting smaller as the dosage gets lower. As very low doses (e.g. 1 or 2mg) have much larger effects than people expect, many people need to taper down to very small doses before stopping so that the final ‘jump’ to zero is not too large a shock to the nervous system.

How do compounded medications work?

Compounded medications are often crucial in the tapering process, as commonly available dose sizes aren't small enough to reach the sizes necessary to follow a safe tapering plan. For example, the smallest usually available dose size for venlafaxine is 37.5mg (a drop from 37.5mg to 0mg can easily lead to debilitating withdrawal symptoms).

The costs of medications are not included in your Outro subscription. To help you in your taper, Outro works in partnership with leading compounding pharmacies to provide the most reliable and affordable medication formulations and sizes. Speak with your Outro provider to learn more!

What medications does Outro taper?

We currently offer taper management for antidepressant medications (e.g., duloxetine, escitalopram, sertraline, venlafaxine). You can see the full list here.

We are making preparations to expand to other psychotropic medications like benzodiazepines and gabapentinoids, which also follow the hyperbolic tapering method. You can express an interest in tapering these medications in our sign-up form.

Where is Outro available?

Outro is currently serving patients in California. If you are located in another US state, be sure to express your interest via our sign-up form. We'll be providing regular updates and announcements as we expand our reach.

Personalized tapering support that’s ready when you are

Explore Outro's antidepressant tapering progam