The most common symptoms of venlafaxine withdrawal are dizziness, nausea, and agitation that leads to mood swings. People who suddenly go off of the drug or miss doses may also experience blood pressure drops or spikes. Sexual dysfunction and loss of libido sometimes go hand in hand with this. In extreme cases, patients experience sensory disturbances, hallucinations, and thoughts of suicide or self-harm. The drug is strong enough that people can and often do begin to see withdrawal symptoms within a few hours of missing a dose, and in most cases these get stronger and stronger until the chemical balance is restored — either by resuming the medication or by slowly weaning off of it. Most medical professionals recommend that patients who wish to stop taking this medication do so with time, ratcheting down the strength of their prescription incrementally in order to avoid the worst symptoms.
Drug Basics
Venlafaxine is an antidepressant used for generalized anxiety disorder and major depressive disorder (MDD). Most patients know venlafaxine by the brand name Effexor®. Venlafaxine has become one of the most prescribed depression medications in the world, but it’s also very strong and skipping even one dose can cause withdrawal symptoms.
Some people experience side effects that are similar to withdrawal symptoms just after beginning the medication, too, particularly headache, nausea and vivid dreams. This mainly occurs because the SSRI is starting to balance the serotonin in the brain. These symptoms usually began to disappear within two to four weeks of starting the regimen. When missing a dose or reducing or stopping venlafaxine, withdrawal symptoms can start within a couple of hours and usually last a few days.
Dizziness and Nausea
By far the most common symptom of venlafaxine withdrawal is a general sense of dizziness, which frequently also leads to nausea and sometimes vomiting. Dizziness can set in at pretty much any time, but it’s most common when people stand up suddenly or switch movement or position really quickly. The sensors in the brain that adjust to quick movements are often a bit slower when going off of this medication, which can impact response times and leave a person feeling a bit disoriented.
The medication is available in an extended-release form known as venlafaxine XR, and most patients who are prescribed this version of the drug usually do not experience nausea. In most cases this is because the “XR” version slowly releases into the gastrointestinal tract. If not taken correctly, however, patients will have withdrawal symptoms, which can consist of restlessness, agitation, and hostility. A few others symptoms of withdrawal from the extended release form include dry mouth, excessive sweating and decreased appetite.
Agitation and Irritability
Many people also complain of generalized agitation and feelings of helplessness when going off of the medication; irritability and the desire to lash out at people or things for more or less trivial reasons is also common. Patients often describe feeling overwhelmed by anxiety and fear, and many say that these feelings are the first sign that something is amiss. These emotions often act as a trigger, reminding people that they’ve missed a dose.
Blood Pressure Issues
It’s also common for people to see spiked and precipitous drops in their blood pressure in the days and weeks after stopping venlafaxine. These sorts of symptoms take longer to manifest, and aren’t usually the result of periodically skipping a dose. Rather, they come about once the chemical has left the body completely and the brain is trying to rebalance itself all over again. Blood pressure imbalances can be dangerous if left untreated, and patients who are planning to go off of the medication are usually monitored to watch for signs of problems.
Sexual dysfunction often goes hand in hand with blood pressure issues, particularly for men. People who have trouble regulating their blood flow often have a harder time feeling sexually aroused. It’s often more difficult for the body to send blood to the sexual organs under these conditions, which means that erection and arousal may be hampered.
Sensory Disturbances and Imbalances
There have been reports of sensory disturbances in venlafaxine patients, including the feeling of electrical shock sensations in the head. Very vivid dreams and hallucinations have been documented, too; many of these happen while sleeping, but some patients also say they have an altered sense of reality while they’re awake and in the world.
Particularly dangerous withdrawal symptoms include homicidal or suicidal thoughts, delirium, impaired concentration, and depersonalization. These can cause a person to act in inconsistent and often incomprehensible ways, sometimes causing harm to themselves or others. These usually take a while to show up, but not always; a lot depends on the patient’s individual body chemistry.
Preventative Care and Treatment
The easiest way for patients to avoid venlafaxine withdrawal is to take their prescriptions flawlessly, which means taking the appropriate dose at the same time every day without fail. When it comes time to stop using the medication, slowly lowering the dose over time is usually a better idea than just quitting it outright. The decision to stop taking venlafaxine should usually be discussed between the patient and the provider well in advance, since planning can help ensure a safe and effective way to reduce problems. Sometimes taking a complementary medication can help make the transition easier and can limit some of the most troubling symptoms, but in most cases this is best determined by a physician or other care provider familiar with the patient and his or her individual needs.