Question 1

How do I taper venlafaxine?

Accepted Answer

Venlafaxine XR is widely regarded as one of the most difficult antidepressants to discontinue. The Maudsley Deprescribing Guidelines recommend hyperbolic tapering — proportional reductions (e.g. 10% of the current dose every 2–4 weeks) rather than equal milligram cuts — because receptor occupancy changes disproportionately at lower doses. Below the smallest available capsule (37.5 mg), clinicians can open the XR capsule and count or weigh the coated granules inside, removing a small number each step. This preserves the extended-release coating and allows precise micro-reductions down to final doses well below 5 mg before stopping.

Question 2

What's the difference between relapse and discontinuation syndrome?

Accepted Answer

Discontinuation syndrome typically appears within days of a dose reduction, produces physical symptoms like dizziness, electric-shock sensations, and nausea, and resolves quickly if the previous dose is restored. Relapse of the underlying condition usually emerges weeks later with a return of the original psychiatric symptoms. Distinguishing the two is critical because one calls for a slower taper, while the other may require resuming treatment.

Question 3

How can the tapering planner help you save time documenting a tapering plan?

Accepted Answer

Select the drug, enter the starting dose and target, and the planner generates a week-by-week schedule with calculated doses at each step. You can adjust the pace or number of steps, then export the finished plan as a clean PDF for the patient record.

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