Effexor XR and Prozac | Bridging the Two Drugs

So you’re wondering what a Prozac bridge is, right? Well, if you take Effexor XR and have been trying to wean yourself from the drug but simply can’t get below 37.5mg, 75mg, or even more than maybe the Prozac bridge is the answer. Or not. You should DEFINITELY consult with your doctor before changing the dosage of any medication. This is NOT intended to replace your doctor’s advice. I’m sharing with you what my research has yielded and I will bring my findings to discuss with my own doctor when I see her next month.

bridge

A few days ago I wrote about how I can’t stop taking Effexor XR. I’ve successfully gotten down to the lowest available time-released dosage of the medication. For a short time I was even able to get into an every-other-day regimen but currently I am taking it daily.

I’ve spent a good amount of time reading message boards and online forums from people with the same problem as mine. I came across a Q&A with Dr. James Phelps (I don’t know anything about this guy — he could be some random dude playing a doctor online — so consult with your doctor first!). He references Joseph Glenmullen’s book, Prozac Backlash and a chapter called “Held Hostage” where the author writes about the theory behind “Prozac bridging.” In the simplest terms: you replace Effexor XR with Prozac.

Now I know it sounds like you’re just replacing one med for another but there is science behind this idea and it has to do with the “half-lives” of the drug. All anti-depressants have “half-lives” and what that means is how quickly the drug leaves a person’s blood stream after you’ve taken your last dose. Effexor XR has an extremely short “half-life” which is the reason behind the horrible withdrawal symptoms. Phelps explains the details here. I also found EffexorWithdrawl.com to be a good source too in understanding “half-lives.”

So what’s Prozac have to do with it? Prozac is an extremely long “half-life.” It takes Prozac 7-9 days to leave the blood stream (as compared to Effexor XR at 15 hours). Withdrawal symptoms are considered unusual when taking Prozac. When you are able to get to the lowest dose possible on Effexor XR is when you are suppose to replace – or bridge – it with Prozac. It’s up to you and your doctor when you decide to wean from the Prozac but apparently it’s supposed to be head and tails easier to do than Effexor XR.


A couple of suggestions I received from this week’s earlier post on the subject that I thought were worth considering:

– My friend and nurse Kathleen suggested progressively lengthening the intervals. “It might be inconvenient (maybe having to set an alarm for the middle of the night), but you could make up a schedule for every 48, 50, 52 hrs, etc…? Or try taking one every 2.5 days (60 hr intervals)?” My note: I don’t know for sure if this would work considering those pesky short “half-lives.” I think lengthening the time between is just prolonging the withdrawal symptoms and then you are back at square one once you take it.

– Another friend suggested seeking help from naturopathic doctor. I’m seriously considering consulting with the specific doctor she recommended for this and possibly other issues I am experiencing (inflammation, fatigue, etc.).

– A family friend and pharmacist suggested taking the immediate release Effexor (I currently take the XR – “extended release”) which at its lowest strength is 25mg and it comes in tablet form that can be cut in half and quarters to decrease the dosage over time. The XR comes in capsule form which cannot be cut. Her thoughts on bridging Effexor and Prozac “would basically be adding a different drug that has the same mechanism of action” and “would not gain a great deal from that switch.”

I’m not exactly sure what avenue I’m going to pursue yet. I’ve really considered the white knuckle approach but I’m so worried that the side effects would last longer than three days. I’ve read some people feel sick up to a month. I really don’t want that. I’m definitely going to discuss the options with my general practitioner (as opposed to my oncologist who said I should just keep taking it). I’ll keep you posted.

This information is not to replace any advice your personal doctor has given you.  I do not make any claim that Prozac bridging works.  This is simply the research I have found.  Go talk to your doctor!

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Comments

  1. Wendy,
    Yes, I hope I remembered to send the tweet but I do know they were doing this with effexor when it first came out. And the drug of choice was prozac. I am a nut when it comes to researching meds and let’s just say this drug was NOT for me, it was a loved one… making me that much MORE OF a nut!

    Curious to hear what your doctor says but I think you are spot on…..

    Good luck!
    AnneMarie

  2. These are good tips! My therapist for my PTSD (which I’m improving without medication) always wants me know I can take prozac.
    Me: but I’m not depressed
    Him: but you have anxiety, so it might help
    Me: Do you think I’m severe enough where it would be troublesome in my life if I didn’t take it?
    Him: No
    Me: Okay, then I’ll skip it.

    I know people who really had an improved quality of life of Prozac, but after reading what you wrote on how hard it is to get off the drug, I’m glad I decided not to take it. My quality of life is pretty darn good and my anxiety is only with medical things (hypochondriac, anyone?)

    Seriously, Wendy you are a wealth of information! Validating my thoughts, while also making me know if I ever did need to take it what to watch out for.

  3. Wendy,
    Ugh I can totally relate. I had a really hard time last year when I was on Wellbutrin. It was hard to come off and I honestly thought I was going to lose my mind. I’m now onto trying alternative therapies and feeling a million times better but that transition almost sent me to the mental hospital. I hope your transition is smoother than mine. Good luck and keep us posted.

  4. It is all about the half-life. A body metabolizes drugs just as it does food. For instance, it takes 2 weeks for dairy to get out of your system. Getting your body used to having smaller and smaller amounts of (whatever it is) is the key to kicking it I would think. LIke a baby from the breast. While you may be “replacing” one drug with another, they act differently in your body but the same… know what I mean. They have the same effect, but act different in that they don’t metabolize the same.
    I think you are on to something here my friend and I can’t wait to see what comes of it.
    Good luck!

  5. Wow. This is fascinating. It’s not something I have to address in my life, but the info is great and I will pass it on. And thank you for being so careful in saying that the research is your own and doesn’t replace a doctor. I do think we need to advocate for ourselves (and loved ones) when dealing with the medical system. You’re well informed, not passive. Hope you’ll keep us updated on your decision and progress. Routing for you!

  6. Great information! I am thankful that no one in my life has to struggle with this but bookmarking for a friend….

  7. Diane Hyler says:

    I wanted to stop the Effexor 75mg it was given to me for hot flashes for post menopause, which really, I was till having them some. so the doctor gave me 37.5mg of Effexor an said to take it about one week and then stop, well instead I did not take one yesterday and felt tired but ok, and today I feel very dizzy and not really with it. I took one today, I was going to try going every other day and see what happens but soon after taking the lower dose I am not feeling so good, very dizzy and fatigued. feels like a wave of dizziness is going on in my head… any suggestions???

  8. Heather Arabie says:

    Wendy are you still active on this thread?

  9. I weaned off Effexor after 4 years on it for Menopausal Panic Attacks. I have been completely off for 4 weeks now but think I may have to try the Prozac – I hate my personality these days after the Effexor – I was so calm and tolerant and friendly of everyone – a super positive person – now I feel like I am a BITCH all the time and just can’t handle being that way – the REAL me is not like this- I am not impatient, moody, and weepy – even before the Effexor that was not me!! This drug really helped the panic attacks as they were VERY BAD – but the withdrawal is awful – I want to be ME again. Have been trying SAM-E and going the natural route but it is just not working so far!!

    • wendy nielsen says:

      I’ve recently started taking Brintellix for depression and similar moods like you’ve described. I’ve seen a huge difference.

    • Larry Smith says:

      Jana

      Prozac is a great drug. I went from Drill Sgt to nice man on it. If your Dr. said go for it , you should. After a month on it you will feel and act better. That is all you’ll feel. You won’t even know you are taking it other than feeling better.

      • Larry Smith says:

        I’ve read a lot about the effects of coming off Prozac. Firstly, I don’t understand why anyone would. You are taking an antidepressant for a reason. I’ve found Prozac is the least harmful and never had any withdrawal. All that happened to me when I stopped taking it was I reverted back to my depressed and mean self. Prozac has no side effects I know of by really gets the job done. I’m on day 3 of the bridge and haven’t felt too bad. When I’m finished I’ll never stop taking the Prozac. There is no reason to feel bad when a good drug like Prozac is out there. PS it also helps with PTSD. After 3 tours in Viet Nam and one very horrible one in South America, Prozac really helped me.

  10. Larry Smith says:

    I’m a retired Army Vet and took Prozac for 22 years for depression and PTSD. Over the 22 years I quit Prozac and other than reverting to my depressed, mean spirited and hateful self I felt no withdrawal at all. I switched to Remeron which withdraw makes Effexor seem like a pussy cat. I’m still trying to get off it.

    After one day with the bridge I seem to be experiencing very few withdrawal symptoms went from 75 to 37.5 mg. I feel like this will work well to get rid of Effexor. I’ll post when I’m done.

    I missed on 7.5 mg of Remeron and went into full withdrawal the next day. I’ll have to keep tapering down on this stuff. My doctor recommended the bridge and then work on the Remeron. I’ve lost 38 lbs trying to get off Remeron.

    The reason I quit Prozac is it interacts with Nexium and becomes a blood thinner at a certain high dosage of Prozac. Since I also take Plavix this caused excessive bruising and bleeding from my arms ect.

    My plan to get back on Prozac since Effexor does the same with Nexium as Prozac. I will never take another drug like Effexor and Remeron again. The risk do not outweigh the benefit. I don’t recommend these drugs to anyone.

  11. Hi,
    I’m gaving trouble coming off Efexor. I did however try Prozac earlier at 20mg and I had to go off them because they gave me a lot of side effects. Do you think I still could use them at 10mg to come off Efexor? I will of course discuss this with my psychiatrist, but I’d like your opinon. Thanks!

  12. hey,

    I’ve been on 75mg effexor for 3-5 years i can’t remember. after reading everyones stories not just on here but other sites too. it makes me want to cry, that I’m never going to get off this drug. I just started last week by taking 1 pill every other day and this week taking 1 pill every 2 days then 1 every 3days the following week. I hope this works. i don’t want to reply on pills anymore and i want to loose this weigh it gave me from taking it. So far I’m just nauseous, i have the brain ticks and my arms feel numb sometimes.

    anyone else have any advice?

  13. Wendy I Have been on venlafaxine 150mg. XR / generic for Effexor cap 150mg. I am having horrible side effects while taking this medication and I want to ween off ! I have tried many times . I originally started with a low dose of Prozac … Then my Doctor told me he wanted to change me to the Effexor ER ! My side effects from this Effexor are Horrible from ear ringing, electrical shock to my head or ,& sweating,& blurred vision !!!! I am going to my Doctor to do what you have done . I pray????????this works for me . Thank You So Very Much for your help ????

  14. Thanks to resources like yours and a lot of others online, I’m able to get off Effexor.
    I was on 150mg Effexor, did not like how it made me feel if I was a few hours off on my dosage time. I broke open 7 capsules and decreased my dosage for each one. I also broke open 7 capsules of Prozac and increased the dosage over the same time span.
    From what I was reading, I was not very optimistic… however, I can’t believe how well it worked. I did not get the brain zaps, depression symptoms did not come back, and I was fully on Prozac at the end of the week. I titrated off the Prozac the following week and now am not on any depression meds. Thank you for sharing!

  15. You all need to consider what happens within a few months after you taper off these meds. They can seriously screw up your immune system (your regulatory T cells) and cause autoimmunity – hence the inflammation. They also do a number on your adrenal system – hence the fatigue. More serious side effects of SSRI/SNRI discontinuation can also manifest. So it’s not just the horrible withdrawal symptoms, these medications will alter your physiology permenantly for the worse. Please advise your close friends and family not to start antidepressant treatment. There are natural ways to get rid of depression and anxiety that work much better than antidepressants.

    I have been using Effexor XR for 18 years. I wish I could build a time machine.

  16. D. Poff says:

    I started weaning off of Effexor XR 300mg, two weeks ago. My neurologist gave me instructions to decrease from 300 mg to 75 mg for 14 days. The same day I started using Prozac 10mg along with the 75 mg. of Effexor XR. Also take 2-3 omega 3 fish oil, it was suppose to help with the withdrawal symptoms. Take ibuprofen for headache and body aches, and meclazine for nausea. The first 14 days went great, I had mild headache every day, along with nausea,but three days after completely off effexor, I am feeling terrible today. Nausea, body aches, chest pain, and just blah!!! I pray this ends soon. Thank you Lord for helping me this far.

Trackbacks

  1. […] single day because there isn’t an easy to stop taking Effexor. And then I found out about the Prozac Bridge. Basically, you swap Prozac for the Effexor XR. Sounds easy, right? And you know what, it was! With […]

  2. […] might want to read about the Effexor-Prozac Bridge here […]

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