Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Ways To Wean Off Venlafaxine
Question: I need a Psychiatric consult
Brief Answer:
reducing 50 mg dose of venlafaxine do not cause such withdrawal
Detailed Answer:
Hello,
Thanks for writing to us. I can understand your concern for your daughter.
From her history first of all I think there is need of clarification of diagnosis. Onset of illness at age of 17 and no significant improvement with medicines suggest possibility of some personality disorder. Her symptoms you mentioned - angry, emotional, snappy and uses hurtful words to the surrounding people - suggest possibility of bipolar disorder or something more than depression like obsessive compulsive disorder. If you can describe her symptom history with onset as well as diagnosis given by psychiatrists I can comment further about this.
Reducing dose of venlafaxine from 200 mg to 150 mg do not cause any significant withdrawal. In my opinion symptoms are due to adding prozac to venlafaxine or they can be part of her illness rather than drug related. Her weight is pretty high ans she should take care of it as this may lead to other physical issues.
In my opinion if at all symptoms are due to fluoxetine, no need to worry. They should go away with time.
Venlafaxine and 40 mg prozac is good choice but venlafaxine is not useful since long so better to reduce is gradually and stop.
Using prozac alone is fine but I think alone it will not give sufficient result. Better to add wellbutrin as she also needs some kind of stimulant for her study and wellbutrin can help in that aspect.
There are many other options of medication but to comment on that I need her diagnosis and symptoms inn detail.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
reducing 50 mg dose of venlafaxine do not cause such withdrawal
Detailed Answer:
Hello,
Thanks for writing to us. I can understand your concern for your daughter.
From her history first of all I think there is need of clarification of diagnosis. Onset of illness at age of 17 and no significant improvement with medicines suggest possibility of some personality disorder. Her symptoms you mentioned - angry, emotional, snappy and uses hurtful words to the surrounding people - suggest possibility of bipolar disorder or something more than depression like obsessive compulsive disorder. If you can describe her symptom history with onset as well as diagnosis given by psychiatrists I can comment further about this.
Reducing dose of venlafaxine from 200 mg to 150 mg do not cause any significant withdrawal. In my opinion symptoms are due to adding prozac to venlafaxine or they can be part of her illness rather than drug related. Her weight is pretty high ans she should take care of it as this may lead to other physical issues.
In my opinion if at all symptoms are due to fluoxetine, no need to worry. They should go away with time.
Venlafaxine and 40 mg prozac is good choice but venlafaxine is not useful since long so better to reduce is gradually and stop.
Using prozac alone is fine but I think alone it will not give sufficient result. Better to add wellbutrin as she also needs some kind of stimulant for her study and wellbutrin can help in that aspect.
There are many other options of medication but to comment on that I need her diagnosis and symptoms inn detail.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What all symptoms she has I told you
But regarding snappyness and anger
The following are the examples
I ask her normally ' why are you not talking To me?'
She says: because you are a brat
I talk to her Normally and if she doesn't like what I say ' she flatly says ' stop it stop it I say'
Usually she is Abvery respectable Good and kind girl
But during those episodes she angrily says ' you are a a looser '
And she sometimes cries and says ' Iam not mean'
But most of the times
She is soft and very helpful
Docile girl
We have a family history of depression
my younger sisters and and my mother and my maternal Uncles are aggressive angry as well as have severe depression unfortunately
And we also have familial hashimotos thyroiditis as well
But regarding snappyness and anger
The following are the examples
I ask her normally ' why are you not talking To me?'
She says: because you are a brat
I talk to her Normally and if she doesn't like what I say ' she flatly says ' stop it stop it I say'
Usually she is Abvery respectable Good and kind girl
But during those episodes she angrily says ' you are a a looser '
And she sometimes cries and says ' Iam not mean'
But most of the times
She is soft and very helpful
Docile girl
We have a family history of depression
my younger sisters and and my mother and my maternal Uncles are aggressive angry as well as have severe depression unfortunately
And we also have familial hashimotos thyroiditis as well
Brief Answer:
add wellbutirn to prozac with psychotherpay
Detailed Answer:
Hi,
Thanks for information.
Symptoms are of depression. Only thing is that 8 years long lasting depression is unusual. It was not treated adequately or it was not responding - resistant depression or some other problem with depression is there.
Considering strong family history this is more biological problem and we must use adequate medicines. As she has more weight we cannot add olanzapine otherwise adding olanzapine can give good results.
Wellbutrin is more or less weight neutral and with different mechanism of action than that of prozac. Adding wellbutrin (after stopping venlafaxine) to prozac likely will provide some relief. You can explore this option further by discussing with her treating doctor.
Apart from medicines she needs regular psychotherapy. In psychotherapy CBT - Cognitive behavior therapy and/or psycho dynamic psychotherapy can be used depending on choice and history of patient. It will give good results in long term.
Let me know her progress in future after changing medicines with following link.
http://bit.ly/drchintansolanki
by clicking on 'Ask me a question' on same page.
Feel free to discuss further.
add wellbutirn to prozac with psychotherpay
Detailed Answer:
Hi,
Thanks for information.
Symptoms are of depression. Only thing is that 8 years long lasting depression is unusual. It was not treated adequately or it was not responding - resistant depression or some other problem with depression is there.
Considering strong family history this is more biological problem and we must use adequate medicines. As she has more weight we cannot add olanzapine otherwise adding olanzapine can give good results.
Wellbutrin is more or less weight neutral and with different mechanism of action than that of prozac. Adding wellbutrin (after stopping venlafaxine) to prozac likely will provide some relief. You can explore this option further by discussing with her treating doctor.
Apart from medicines she needs regular psychotherapy. In psychotherapy CBT - Cognitive behavior therapy and/or psycho dynamic psychotherapy can be used depending on choice and history of patient. It will give good results in long term.
Let me know her progress in future after changing medicines with following link.
http://bit.ly/drchintansolanki
by clicking on 'Ask me a question' on same page.
Feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Solanki can you pl.answer the following questions
1. how do we reduce the dose of venlaflaxine from 150 mg to 0 mg and within how much time? weeks , months?
2. what would be the starting dose of welbutryn?
3. what would be the dose of prozac along with welbutryn
1. how do we reduce the dose of venlaflaxine from 150 mg to 0 mg and within how much time? weeks , months?
2. what would be the starting dose of welbutryn?
3. what would be the dose of prozac along with welbutryn
Brief Answer:
taper venlafaxine slowly
Detailed Answer:
Hi,
Thanks for questions.
1. Venlafaxine should be tapered off slowly. I recommend reducing 37.5 mg dose every 10 days and after reaching to 37.5 mg you can make half of that for more 20 days and then stop. This will help to avoid withdrawal symptoms. Clonazepam can be taken as and when required during this tapering if required for uneasiness.
2. Starting dose of wellbutrin is 150 mg and can be increased after 15-20 days if require.
3. Prozac can be taken in dose up to 40 mg with wellbutrin. Wellbutrin increases fluoxetine level so we should adjust the dose according dose of wellbutrin.
Feel free to discuss further.
taper venlafaxine slowly
Detailed Answer:
Hi,
Thanks for questions.
1. Venlafaxine should be tapered off slowly. I recommend reducing 37.5 mg dose every 10 days and after reaching to 37.5 mg you can make half of that for more 20 days and then stop. This will help to avoid withdrawal symptoms. Clonazepam can be taken as and when required during this tapering if required for uneasiness.
2. Starting dose of wellbutrin is 150 mg and can be increased after 15-20 days if require.
3. Prozac can be taken in dose up to 40 mg with wellbutrin. Wellbutrin increases fluoxetine level so we should adjust the dose according dose of wellbutrin.
Feel free to discuss further.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
