Is medication to blame? Please help :(

[ana]

Hi everyone, please help me out, I really need it...

Yesterday, after it had been 6 weeks of upping my Venlafaxine dose to 187.5 mg, I experienced a complete and utter meltdown at work. My panic attacks were unbearable; I had very severe depersonalisation and almost rang the ambulance from how bad it was. I'd not felt like that in a long time, and I just am so worried about myself.

I rang my therapist this morning. I'm seeing her on Tuesday for a therapy session, but she suggested I go down by 35.5 mg and see if that makes a difference. I'm scared my current situation isn't medication-induced, but I've not been well in a while and my panic attacks feel out of control whereas I felt like I could control them on a lower dose. Basically, I'm scared of lowering my dose in case it makes me panic more.. What if I need a higher instead of a lower dose??


Has anyone ever had a higher dose of medication create more anxiety? Please help!

Btw I'm 114 lbs in case that's relevant...

[KK77]

Captn KK here...

Many doctors/therapists think the answer is usually increasing dose when an AD doesn't appear to be having desired effect but I actually don't always agree. A known side effect of many of these meds is actually increased anxiety, which can cause PAs, and with someone in lower end weight bracket, the dose could simply be too high. Trying not to be biased here because my own increase of Ven hasn't really helped my mood, although anxiety is perhaps slightly better, but not significantly. I would go with the lower dose and see if your panic situation improves.

PS - Can I order two T-shirts. One medium and one extra small (my cat is also a fan now)

[Ethansmom]

It could be the medication, maybe you should go back down since you have such a tiny frame?

I tried reduce my clonazepam by a quarter yesterday and felt anxiety! I'm so worry that i'm physically and emotionally dependent on these things. I also take Lexepro, which helps a bit, but not as much as I had hoped.

[MyNameIsTerry]

At 150mg Ven starts acting on your adrenaline. This can mean different types of side effects in my experience. You're not the only one to have this trouble (see Nicola1980 who had the same going to that dose) but not everyone has the same problems.

When I went over the threshold on my SNRI (Duloxetine) my anxiety was ramped up to levels I had never experienced and it took a long time to adjust (my GP should have adjusted, he thought it was my anxiety despite so many symptoms never before experienced until that very week and I trusted him) but it's impossible to predict as we are all so different.

If you handled 150mg it may just be a bit too activating right now? But some people can't tolerate higher doses of some meds too.

[pulisa]

Captn KK here...

Many doctors/therapists think the answer is usually increasing dose when an AD doesn't appear to be having desired effect but I actually don't always agree. A known side effect of many of these meds is actually increased anxiety, which can cause PAs, and with someone in lower end weight bracket, the dose could simply be too high. Trying not to be biased here because my own increase of Ven hasn't really helped my mood, although anxiety is perhaps slightly better, but not significantly. I would go with the lower dose and see if your panic situation improves.

PS - Can I order two T-shirts. One medium and one extra small (my cat is also a fan now)

I agree with KK here but ven is a beast as regards dose reduction so it may be difficult to assess whether it is ven dosage or the reduction or in fact a completely random blip..

I'm your weight and could never tolerate "therapeutic" doses. I'm not convinced that these meds touch anxiety anyway.

[ana]

To be honest, this last month has been the most stressful one in a very long time. I've had a number of bad things happen to me, hence why I'm inclined to believe that the medication simply might not have had the time to properly work.
After reading all your replies, I've decided to wait a bit more as a stressful situation is due to be resolved in the next two weeks, a change for the better is also due, and if the positive change doesn't improve my overall condition, then I'll know it's the medication dose that's to blame. I've always required higher doses of every medication I've ever been on, despite my small frame, as my anxiety is so high.

My therapist has mentioned that none of her patients that have been on Venlafaxine have ever experienced increased anxiety when on higher doses, but she also states that everyone is different and we all respond to medication differently.

Having said all that, I had a completely normal day today, after yesterday's horrific experience. I had no issues before, during, or after work. Anxiety works in mysterious ways!!

Thank you, everyone, for your replies, and KK, I'll even include a complimentary 'Ana' collar for your cat.

[robinhall]

Hi Ana

You posted the other day asking about CBT4Panic - was it legit etc

I hope you were reassured by the replies

I appreciate that your post here was regarding your meds - but can I suggest that you have a look at CBT4Panic - what have you got to lose? - it's FREE - it's CBT - it's a fun read full of cartoons - and it is specifically for Panic Attacks

You really don't have to suffer from panic attacks forever - CBT is incredibly effective with panic disorder - but you have to start somewhere - YOU have to set the ball rolling

Why not click on this link and read the first workbook or watch a few of the videos or listen to the audios - or read the dialogues between myself and some clients

www.cbt4panic.org

[MyNameIsTerry]

My therapist has mentioned that none of her patients that have been on Venlafaxine have ever experienced increased anxiety when on higher doses, but she also states that everyone is different and we all respond to medication differently.

The same gets said about the SSRI's but there are plenty of people out there who experience problems increasing dosages as we all see on here.

I tend to look at when things start and if they are new. Suddenly feeling very different around the same time as starting a med or increasing it is a pretty good indicator over possible coincidence.

Since you've had a very stressful month though maybe it's a combination?

Whilst Ven reached strady-state very quickly (3 days) that's not how long it takes to do it's stuff as these 2 stage meds are just triggering more of a neurotransmitter. The later down regulation takes a bit longer. It's hard to judge and I think to an extent you play it by ear.

[ana]

Terry, I think it's possible that it could be a combination of the two - stress & medication. I will not reduce the dose just yet, until I've spoken to my therapist on Tuesday morning. I think she'll help me better understand what's gone wrong with me, and I will therefore be able to make a decision as to what to do accordingly.

Honestly, I fear reducing medication in case the dose is not high enough. I'll ask my therapist as many questions as I can about Venlafaxine and how exactly it works. I don't see the logic in prescribing it to an anxiety sufferer in case there's a possibility it might stimulate them at higher doses!

---------- Post added at 08:51 ---------- Previous post was at 08:49 ----------

Hi Ana

You posted the other day asking about CBT4Panic - was it legit etc

I hope you were reassured by the replies

I appreciate that your post here was regarding your meds - but can I suggest that you have a look at CBT4Panic - what have you got to lose? - it's FREE - it's CBT - it's a fun read full of cartoons - and it is specifically for Panic Attacks

You really don't have to suffer from panic attacks forever - CBT is incredibly effective with panic disorder - but you have to start somewhere - YOU have to set the ball rolling

Why not click on this link and read the first workbook or watch a few of the videos or listen to the audios - or read the dialogues between myself and some clients

www.cbt4panic.org

Robin, if your programme cures me of this, I'm having a statue of you erected in the town square!

[robinhall]

Please let me know how you get on

best of luck