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Myth check

Stopping venlafaxine: was that withdrawal, or the depression back?

Withdrawal tends to begin within days of stopping and fade over weeks, and in one trial ten symptoms appeared only in the people who had it. Of 21 guidelines, none said how to tell it from relapse.

Venlafaxine

A first bad week after stopping venlafaxine reads like the depression returning. Withdrawal has its own shape: it tends to start within days, can bring electric-shock sensations, and for most clears within weeks. A trial of 103 people, venlafaxine pooled with its class, found 29% of those who stopped meeting a withdrawal definition, ten symptoms showing up in no one else, and more relapse inside six months. Withdrawal has a clock and a symptom list; no guideline handed out either.

The findings behind this

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Physical & bodyWithdrawal usually begins within days of stopping and fades over weeks

Symptoms, which can include shock-like electrical sensations, tend to start within days of stopping. Most clear within weeks; for a minority they last months, for some over a year.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.Twenty-three of the 61 reports were single case reports, and no pooled figure exists for how many people get a prolonged course. The label's drawn-out cases come from voluntary reports with no denominator. NICE puts the usual course at one to two weeks, occasionally months.Click to keep this openSupport moodVenlafaxine
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Mood & wellbeingWithdrawal can pass for relapse, and in one trial predicted more of it

Of 103 people who stopped, three in ten met a withdrawal definition, ten symptoms appeared only in them, and those with withdrawal relapsed more over six months.

★★☆Single study — solid evidence, such as one good trial or a large observational dataset, but not replicated at the top tier.One trial of 103 people, with venlafaxine pooled among drugs of its class and prediction intervals wide enough that the 29% could be anywhere from 8% to 72%. Taper lengths were chosen by the clinic. Whether withdrawal causes relapse or the two share a cause is not settled by this design.Click to keep this openSupport moodVenlafaxine

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