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Suggest Treatment For Withdrawal Symptoms Of Effexor

Posted on Wed, 1 Feb 2017

Question: I have tapered Effexor XR d/t akithisia. Was on med for 5 weeks and ended up at 187.5. Most recently, I did 75 x 2 days then 37.5 x 2 days. My MD is doing a 3 day wash. I'm on day 2 no Effexor XR and feel dizzy, tired, achy irritable, have vertigo and having difficulty concentrating. I am also more anxious. I am also on 1mg Ativan prn QID and Inderal tid for the restlessness. Are these symptoms normal and is there anyway to relieve them?

Answered by Dr. Alexander H. Sheppe (1 hour later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Yes, these symptoms are normal symptoms of Effexor withdrawal. They will go away in a couple days. They do not indicate anything dangerous. Gets lots of fluids and rest and you will feel better!

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Alexander H. Sheppe (18 minutes later)

I am still having akithisia, although the episodes seem to be shorter, today even without Effexor XR x 2 days. Should the Effexor be out of my system yet?? My MD states if it is gone by Monday, we will try Pristiq. If not, Trintellix. Any thoughts on these meds choices.

Also looking for effective treatment for akithisia....Ativan 1mg, Inderal, Benadryl not working the best.

Answered by Dr. Alexander H. Sheppe (21 hours later)

Brief Answer:
Followup

Detailed Answer:
It will take about 5 days for Effexor to leave your system.

Pristiq and Trintellix are both excellent medication choices. Either would be very effective with low risk of akathisia as a side effect.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Alexander H. Sheppe (6 minutes later)

Any suggestions for the akithisia?

Answered by Dr. Alexander H. Sheppe (29 minutes later)

Brief Answer:
Followup

Detailed Answer:
Ativan and Inderal are the best available treatments for akathisia. It sounds like they aren't working very well for you, unfortunately, but the good news is that once the Effexor is out of your system, the akathisia will stop on its own.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Alexander H. Sheppe (11 days later)

I have a couple questuons: I don't feel like the Ativan has helped my Akathesia (saw neuro and she believes it's some type of dyskinesia) and would like to taper. I've been taking small doses prn for the last 6 months (.5 to 1mg) but 2-3mg for the past 6 weeks. What is a safe way to taper from 2-3mg per day. Also, I have been prescribed Gabapentin for the dyskinesia at 300 mg; is it likely to be effective at this low dose? My other meds are 10 mg Trintellix and 7.5 mg mirtazipine for sleep. I've just started the Gabapentin & mirtazipine...feel foggy and dizzy...will this pass? Regards, XXXXXXX

Answered by Dr. Alexander H. Sheppe (22 hours later)

Brief Answer:
Followup

Detailed Answer:
1. Taper Ativan by 0.5mg per week to avoid withdrawal.

2. Gabapentin typically requires doses of at least 300mg three times daily to be effective.

3. The fogginess and dizziness should pass in 1-2 weeks.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Alexander H. Sheppe (21 hours later)

I am taking 100mg gabapentin in the am and 200 mg before bed. It is supposed to be sedating but I feel like it keeps me up. Would it be okay to take one pill at noon instead of 2 at night? I've heard this med can help w/ anxiety...is that the case?

Answered by Dr. Alexander H. Sheppe (20 hours later)

Brief Answer:
Followup

Detailed Answer:
Taking one pill at noon instead of 2 at night is perfectly fine -- people often take 100mg three times daily, as you are suggesting, as a standard regimen. And yes, gabapentin does treat anxiety. Typically higher doses are required, but you may feel positive effects even at your current dose.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Alexander H. Sheppe (3 hours later)

So I took gabapentin in the am, noon, and before bed and had terrible insomnia last night despite taking mertazipine and Benadryl. I was told it is sedating but I think it's keeping me up. Is it possible for gabapentin to cause insomnia?

Answered by Dr. Alexander H. Sheppe (10 hours later)

Brief Answer:
Followup

Detailed Answer:
It is highly unlikely, as gabapentin is typically used to treat insomnia. However, in very rare cases people can experience paradoxical (opposite) reactions to medications. I find it unlikely -- it's probably just coincidence that you're having insomnia. I would try a higher dose of gabapentin at night to see if that helps (in the 300mg-1000mg dose range at night, under the supervision of your doctor).

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Alexander H. Sheppe (5 days later)

I have been struggling with insomnia. When I wake at night, I am anxious. I have tried mirtazipine, Vistaril & Zoloidem. I also take 10mg Trintellix, 100 mg gabapentin tid, birth control pills, and .5 to 1 mg Ativan prn. Could I increase the zoloidem from 5 to 10mg. Any suggestions. I have also tried Melatonin.

I have used mirtazipine the past two nights and slept well bad lag night had bad dreams which I typically don't have. Could this be due to the medication and will this pass?

Answered by Dr. Alexander H. Sheppe (2 days later)

Brief Answer:
Followup

Detailed Answer:
Bad dream are likely not due to the medication and will resolve over time. Mirtazapine is a good sleep medication so I am glad it is helping you.

Please remember to rate and close this answer thread.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

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Above answer was peer-reviewed by : Dr. Prasad