Split dosage

[Jools33]

Hi gang, just a quick question. I started on 75mg venlafaxin 2 weeks ago last Thursday. Saw my doc last week due to side effects she has split my dose to 2 37.5mg twice a day. I am not sure that I am benefiting from this. My question is could I take both capsules together there by going back to 1 dose instead of the 75mg capsule? Or are the release timings different?

[MyNameIsTerry]

Ven has a very short half life which is why you have to split the dosage in the standand version. Taking it once a day, unless it's the extended release version, will actually cause you to go through withdrawal each day.

If it's extended release it will say on the box. This version is smoother in terms of side effects compared to the standard split dose version.

Are you saying your GP put you on one a day at 75mg? Was it standard or split dose? If standard, your GP hasn't a clue about using it. If it was split dose, and it has now be split across the day, they may be trying to get you onto it a little slower to reduce side effects but it makes no sense to give you 2 capsules as they could have just given you one 37.5mg dose and increase to 75mg once you were stable on it.

[KK77]

Your GP would have split dose to minimise side effects. What do you mean when you say you haven't benefited from split dose? If you take both capsules together you might as well ask for one 75mg (prolonged release) capsule. Reason many GPs start patients on 75mg instead of 37.5mg is because the former is considered the "therapeutic starting dose". Most GPs would consider it a waste of time - and money - starting you on 37.5mg, even though some patients could benefit from this.

[Jools33]

Thanks for the replies. I did start just over 2 weeks ago on the 75mg extended release capsule but last week due to side effects it was decided to split into 2 half doses. However I am seeing my GP tomorrow (Thurs) so may well go back to 75mg one dose. I have been on these before in the past & they worked extremely well. I had a lightbulb moment last night & may have found the reason why the side effects are worse this time.
I recently was on Pregrablin prescribed off label ,as they say, for nerve pain in my legs, nothing to do with panic or anxiety. Maybe these should have been tapered off gradually instead of a direct stop. This might explain why week one the side effects were not too bad but kicked in last week & this. Tomorrow will be 3 weeks on venlafaxin. Here's hoping they do the job for me again.

[MyNameIsTerry]

It can take some time to feel benefits from antidepressants and that's quite a short time.

Ven is a drug that has plenty of scope to increase as 75mg is a low dose. And until you hit 150mg it's really only a SSRI.

Your GP will most likely want to consider increasing. But it would be better to get back to one dose first to ensure you are tolerating the normal extended release dosing pattern.

[Jools33]

Thanks I tend to agree. Hopefully get something sorted tomorrow.