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.


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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How to Quit Effexor | Anti-depressants

A little back story to how I got hooked on Effexor XR. I started getting crazy hot flashes after I started chemotherapy treatment back in 2008. In addition to chemo, I was also receiving monthly injections of a drug called Zoladex in an effort to preserve my ovaries. My body was in chemotherapy-induced medical menopause. Hot flashes come with the territory so my oncologist prescribed Effexor XR to combat my wacky body temperature. Effexor XR is an anti-depressant but has been proven to reduce hot flashes by about 50% in women with breast cancer according to a study done by Dr. Charles Loprinzi at the Mayo Clinic (breast cancer.org). I was willing to try anything that would ease the hot flashes I was having so I ran down to the local Walgreens and filled that sucker. I’ve been trying now for at least a year-and-a-half to kick Effexor XR and it’s nearly impossible.


The highest dosage of Effexor XR I’ve taken was 75mg. At this dosage I felt numb. I was completely void of emotion. I didn’t cry. I didn’t laugh out loud. I was pretty much a zombie. But I didn’t have any hot flashes either. When I complained about how I felt my doctor lowered the dosage to 37.5mg – the lowest dosage available. Coming off of the 75mg to the 37.5mg wasn’t that hard. I was advised to continue the 37.5mg for two weeks and then take it every other day. The days I didn’t take Effexor I would feel awful. Dizzy, nauseous, and blurry vision. It’s like the flu on steroids and hangover all mixed in together. So, for months and months I stayed at the 37.5mg daily. Eventually, I was able to get to an every other day regimen but nothing else beyond that. I’m stuck.

I brought it up to my doctor again at my last visit. Her response was less than what I expected. She suggested I just stay on the Effexor if it’s so hard to stop taking it. What? Continue taking a pharmaceutical drug that I do not need just because she doesn’t have a discontinue solution. Ridiculous. Thank goodness there’s Google.

By the way, I still occasionally have hot flashes but I know what triggers them for me (coffee, wine, and sugar). Additionally, research is showing that a higher total dose of 75mg daily is needed to get significant relief from hot flashes. So there is absolutely no point in taking the 37.5mg of Effexor.

I’m not alone.

Back to Google. Forums and message boards are flooded with people asking advice on how to effectively wean from Effexor. I found that many of us are stuck at 37.5mg. The side effects from discontinuing this drug are horrible. I’m lucky because some people have extreme withdrawal symptoms – brain zaps, shakes, and chattering teeth.

But, I think I’ve found two options on how to finally get off of Effexor. I can either white knuckle it – hunker down in bed for at least three days and deal with what’s thrown at me. Or I can pursue the Prozac bridge.

What’s the Prozac bridge? I’ll explain later this week!

I’d love to hear if you’ve taken Effexor XR and successfully discontinued the drug. Tell me what worked and what didn’t work.

Updated: I finally quit Effexor.  Read here how I quit Effexor without the withdrawals!

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