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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19321
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I just wondered , I am going through severe endogenous depression

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I just wondered , I am going through severe endogenous depression ,I have a history of it. I have been in touch with you with my earlier questions and if you could kindly take a look at the previous questions as a follow up please. my question was that I was on venaflaxine 75 mg for 1.5 yrs and was absolutely great. I wanted to taper it with the supervision of the dr , who was different from the original and he gave me 37.5 but not modified release which made me very queasy .
Hello again.

If someone is currently taking an extended release form of the drug, I usually would perform a taper using the extended release forms, at least as long as is possible. For most people, changing from the 75 mg XR to the 37.5 mg XR for a couple weeks, and then stopping the drug would be adequate, particularly if also starting an alternative drug at the same time, such as the citalopram.

However, there is more flexibility if the immediate release form of the drug is used, both because there are more options in the strength of the pills and because the immediate release pills can be cut in half. When greater flexibility is needed and I change from an extended release form to the immediate release form, I typically prescribe the immediate release form twice a day at the same total daily dose. So, in your case, would change from 75 mg XR to 37.5 mg twice daily, and then taper from there.

So, at this point, there are a few options, since you are having symptoms with this change in dose. If you have any of the 75 mg XR remaining, you can resume this dose until you can discuss the issue with your doctor. It is an option to start taking the 37.5 mg immediate release twice daily, but this should be done with the consent of your physician. It also would be an option to take the current dose (37.5 mg per day) by cutting the pills in half and taking half a pill twice daily. This will prevent long periods of time with significantly less drug in the system.

If I can provide any further information, please let me know.

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