View Full Version : Venlafaxine Information Needed
Hi Guys and Gals.
I may be joining you all soon in the Ven club! I won't go into my history too much but currently in a psychiatric hospital after a very horrible year of anxiety.
Was on Citalopram for 11 years. Came off last year. Nosed dived. Back on Citalopram. Didn't work. Now on Escitalopram. It sort of works but I keep nose diving every few weeks on it. It's not consistent which makes me think it might not really be very effective.
I'm obviously VERY worried about having to start a new medication. I know as well as everyone that it can cause problems initially.
I just would love to know as much about the drug as possible from a users point of view. I would love to know about the different doses and the different types such as the extended release etc? I understand this drug has a very short half life so missing a dose or being late for a dose can cause a few problems too?
How many of you have come from another ssri like citalopram or escitalopram and what was your experience?
Anyone suffer from depersonalisation/derealisation and found that this medication has helped or made worse? What is a good starting dose and how much should you increase by? What's a small dose and what's a large dose?
Sorry for all the questions. Just would love to hear as much information as possible from the people who have to take it.
My main problems are panic disorder, depersonalisation/derealisation, general anxiety disorder. I also have depression as an add on to all of this.
many thanks
Steven x
Hi Guys and Gals.
I may be joining you all soon in the Ven club! I won't go into my history too much but currently in a psychiatric hospital after a very horrible year of anxiety.
Was on Citalopram for 11 years. Came off last year. Nosed dived. Back on Citalopram. Didn't work. Now on Escitalopram. It sort of works but I keep nose diving every few weeks on it. It's not consistent which makes me think it might not really be very effective.
I'm obviously VERY worried about having to start a new medication. I know as well as everyone that it can cause problems initially.
I just would love to know as much about the drug as possible from a users point of view. I would love to know about the different doses and the different types such as the extended release etc? I understand this drug has a very short half life so missing a dose or being late for a dose can cause a few problems too?
How many of you have come from another ssri like citalopram or escitalopram and what was your experience?
Anyone suffer from depersonalisation/derealisation and found that this medication has helped or made worse? What is a good starting dose and how much should you increase by? What's a small dose and what's a large dose?
Sorry for all the questions. Just would love to hear as much information as possible from the people who have to take it.
My main problems are panic disorder, depersonalisation/derealisation, general anxiety disorder. I also have depression as an add on to all of this.
many thanks
Steven x
Hi Steven,
I hope you're starting to feel better.
I came to venlafaxine after a very unsuccessful time on Citalopram. On citalopram my emotions were all over the place, I felt lethargic, nauseous, my sleep was all over the place. I was bursting into tears uncontrollably all the time and it didn't help my anxiety at all. I ended up with uncontrollable suicidal thoughts and spent a night in A+E before I saw a pdoc who changed my rx to Venla.
Venlafaxine was a lot easier to start taking than any thing else I have ever tried. Maybe a little more rumination in the first 10 days of each dose increase and a slightly dizzy headache for a few days.. but that was it.
I take the XR version of venlafaxine (112.5mg in total) and have been taking venlafaxine for about 6 weeks. I have missed a dose by about 6 hours a few times and never had any problems with the start up of discontinuation effects.
I was started on 37.5mg, then after a couple of days went up to 75mg, then doubled to 150mg after another 9 days, but the 150mg seemed to give me the problem of slight erectile dysfunction (not sure if that would have stopped or not), but I dropped down to 112.5mg after 2 days on 150mg and everything went back to normal and that's where I've stuck for nearly a month now.
Most people don't seem to find any real benefit until they get to 75mg which is fine for some people. I think you'll find that an average dose on here is 112.5mg to 150mg. It's not uncommon to go up to 225mg or even 300mg.
Venla seemed to really allow me to get control of my anxious thoughts... but not the somatic symptoms so much. I'm also now on day 20 of pregabalin which I take alongside.
Just remember that the pill won't do all the work, It will get you part of the way there but you'll still have to put the effort in yourself (something which I am still struggling to grasp and get on with, although I am starting to get more of a handle on how to manage anxious thoughts I do still struggle with controlling the somatic symptoms and the thoughts that arise when I have them.
Good luck and please do keep us all up to date on how your move to venla goes. I know for a lot of us, it has been a very helpful med.
Hi Steven,
There is loads of info on here about ven as quite of few of us take including me, as you know. Shed's given you a pretty good summary but here are a few key points from my perspective:
This is really the only AD I've taken. I did take sertraline for a week but it nearly pushed me over the edge so I had to stop. I can't really comment on the transition but there is a handy table showing how to cross-taper etc. which I think I've given you before but if not:
http://www.sabp.nhs.uk/moodhive/Documents/D3.31a.pdf
I've been on ven before but this time, I've been taking it for about 20 months. The start up is fine but make sure you don't start on more than 37.5mg a day. This should be increased after 3-4 days to 75mg. You'll probably get some physical effects but the anxious thoughts should start to die down pretty quickly. Stay on 75mg until you're comfortable and can judge if it's hitting the spot - don't be rushed if you feel an improvement. If not, ask to increase in 37.5mg increments, as Shed has said. I'm on 150mg a day.
Because of the short half-life, you need to divide the dose in 2 and take 12 hours apart. This applies only to the standard tablets. This is tricky on 37.5mg a day as there are no lower dose tabs so either just take once a day until you go up to 75 or, if possible, cut the pill in half. Reminder: standard tabs only.
The extended (or modified/slow) release come in tablets or capsules. You only need to take these once a day and you can't cut them up as it affects the slow-release mechanism. You can take them morning or evening - it's best to start morning and, if you find they make you tired, switch to evening to help you sleep. The original brand is called Efexor XR but there are loads of generics now which are just the same.
A lot of people get hung up on the reported withdrawal symptoms. I would say to focus on recovery and leave that till later. I have come off it twice and, whilst not particularly nice, it only lasts a couple of weeks and you'll have experienced far worse over the last few months. A bridge to cross when you come to it.
Regarding side effects, I haven't had many once I've settled into the dose. Nausea and headaches at first are common but soon pass. I've had a few vivid dreams and I keep clenching/grinding my teeth but that's about it. I did experience some of the sexual side effects last time I took them but they went after a few months (it can be overcome through a certain mindset - if you get that far, I'm happy to elaborate).
Overall, it's been a lifesaver for me. Don't believe everything you read about it because, as we all know, people are more than happy to tell you the horror stories but those hundreds of thousands of people for whom it's worked well tend to be fairly quiet.
Final point which I know you know: as Shed said, ven should give you some well-deserved breathing space. After you've started to improve, it's then time to put the hard work in and lead your own recovery. You've got a whole load of friends on here who will be more than happy to help you at every stage.
I would say go for it. You've been on cit/escit for months and it has to be time to try something else.
Good luck and take care
Pip x
Thanks guys.
One question I do have though, is that I understand that Venlafaxine doesn't effect the N neurotransmitters until 150mg. So most people are just taking it as an SSRI then?
Steven x
cokesmyth5
27-08-13, 16:33
I've been on V for over 10 years, swapped to it when a tricyclic stopped working for me. I am very lucky as far as side effects go, V makes me tired, that's all. I can live with that.
I take XR. I was in hospital when the switch took place; the dose increased by 37.5 mg every 4 days I think I had a headache for a day or two and felt a bit space out. I got up to 225mg but after 3 weeks was improving but my mood was by no means stable and I still had anxiety at times. Because I tolerated V well my psych decided to increase the dose to 300 mg. Within a week I felt pretty much normal , no anxiety and no side effects emerged.
I think I was something of a novelty on that dose at that time for my psych - didn't bother me at all. It made all the difference to me.
I stayed on that dose for over a year (in the meantime I had a brief relapse which was sorted out with Lithium (I'm not bipolar). L has proved an excellent mood stabiliser for me - I stopped it a few years back because I had put some weight on, became ill quite quickly and recovery was slow. I'll never stop L again.)
Until recently I took 150 mg for several years, dropping from 300 mg was no problem at all. I probably could have stopped altogether but didn't want to. I see it as an insurance policy with the L.
I've felt for a while that V gets a press it doesn't deserve. It certainly works well for me for anxiety and depression. In the unlikely event I will stop taking it, I will research that at the time and not think about until then.
One thing my psych does say is to get my bp checked regularly.
I hope this is of some use even though I don't have all the same symptoms as you.
Take care
nicola1980
27-08-13, 18:30
Hi Steven, yes your right venlafaxine acts as an SSRI Until 150mg and above and this was prob why i didn't improve until i reached 150mg? I now take 187.5mg slow release, i started off on 37.5mg with side effects of a dry mouth, nausea, headache and dilated pupils! I only started the slow release when i reached 150mg as due to venlafaxine being expensive docs Brent very keen to prescribe it in slow release but i insisted due to it being so much easier only taking it once a day instead of having to remember to take 2 tablets 12 hours apart, as for withdrawal ill cross that bridge when i come to it but pinkdove on here reduced from 150 to 75 no problem at all, hope this helps x x
Steven,
As Nicola says, you're right about the 150mg threshold so whilst it acts as an SSRI at lower doses, all ADs act differently and one will suit you and another may not.
And oh yes, I had forgotten about the saucer eyes which I got for a couple of weeks. I walked round looking like :scared15: which was more funny than scary.
Pip
Hi Steven. Welcome! I've been on venlafaxine for about ten years the majority of the time at 75mg. I am currently increasing to 150mg after a stressful time. I did this once before, just for a few months to (give me a boost my gp said) I had no issues dropping back to 75mg.
I won't pretend there aren't side effects. When first starting it or increasing my anxiety increased a lot and I suffer from sweats, headaches, tiredness . I'm sure you're used to this with med changes. But this does go and slowly things start to improve. I have been on this drug for a long time and it has really worked for me after a miserable experience with Prozac in my early twenties.
I came off once and the withdrawal symptons are tricky, but manageable. Once I had been on this s while I could miss a dose without any issues ( obviously not advisable). I wouldn't even think about withdrawals, you just need to concentrate on getting better. Who knows this may be the drug for you, so try not to research too much or read into the horror stories too much.
There are a lot of us here who have had really positive experiences and if you are prescribed ven, we will all be here to support you and give you the benefit if our experiences so far.
Take care xxx
You guys are right. Withdrawals are the last thing on my mind!!
Dilated pupils???!! Sweet jesus!! I don't want that!!! :ohmy:
Well I can't say that I'm not bl**dy scared right now! I'm rather sensitive to drug changes so it's bound to hit me for a couple of weeks.
I read SPAWNS posts on this section of the forum about starting Ven. I read the entire thing from the 'Day three... not feeling too bad!!!' to 'OH GOD THIS ANXIETY IS AWFUL!!!'
It's inevitable but I know it gets better (in theory). It's either Venlafaxine or he puts me on another Antipsychotic whilst on the Escitalopram. I'd rather not....
So I guess if that's what he suggests tomorrow, it's another month or so of the dose changes, up and down up and down. And it's my birthday in a few weeks :(
Steven,
Did you read further on in Spawn's story when he felt much better, went to Cyprus to get married and had the time of his life? It's tough to get there but you're used to things being tough, aren't you? You'll be fine, honest!
Pip x
I'm with Pip. It's better that you are realistic than expecting a miracle within days. You are strong enough to get through this, it's a few weeks out of your life and one birthday out of many. If everything goes to plan who knows what you could be doing on your next birthday ! X
nicola1980
27-08-13, 21:03
Hi and spawn is now tapering down to 37.5mg which is Fab! You'll be fine hun and we're all here to support you, its not as hard a med to get on as cit not by a long shot but i know how scary med changes are x x
Steven, further to my PM I would just like to add that I agree with everything said here and I also had the owl eyes too :scared15: (which as Pip says was more funny than scary!!)
Also forgot to add that I am not on the slow release, I am quite happy taking the normal tabs twice a day.
We are all here to support you through...oh, I and I have just come home from a long weekend away camping and had the time of my life! For someone who hates being away from home and out of my comfort zone this was an amazing achievement for me.
All the best xx
Hey kitti,
Well done you, long time no here!
Really pleased for you great achievement!
Hey kitti,
Well done you, long time no here!
Really pleased for you great achievement!
Aww, thank you Clio :hugs: I hope you are doing ok hun xxx
You guys are right. Withdrawals are the last thing on my mind!!
Dilated pupils???!! Sweet jesus!! I don't want that!!! :ohmy:
Well I can't say that I'm not bl**dy scared right now! I'm rather sensitive to drug changes so it's bound to hit me for a couple of weeks.
I read SPAWNS posts on this section of the forum about starting Ven. I read the entire thing from the 'Day three... not feeling too bad!!!' to 'OH GOD THIS ANXIETY IS AWFUL!!!'
It's inevitable but I know it gets better (in theory). It's either Venlafaxine or he puts me on another Antipsychotic whilst on the Escitalopram. I'd rather not....
So I guess if that's what he suggests tomorrow, it's another month or so of the dose changes, up and down up and down. And it's my birthday in a few weeks :(
When I first went on Ven I was in a very bad way after already trying 3 AD's in 3 months, all which didn't agree with me and made me very ill. I couldn't eat, was being sick every morning, I lost a stone and half in weight, started experiencing social anxiety and panic attacks, to add to the list of my problems!
I got a new doctor and she suggested swapping drug groups to the Ven and thought I would tolerate it better.
Since then it has been a very up and down ride! I won't lie, you probably will
feel crap for the first few weeks when starting it, but it doesn't last for ever!
I went up to 150mg's, but found the SE's to much for me, so slowly reduced.
I'm now on 37.5mg's and my life is pretty much as normal again, I seriously did not think this would happen this time last year!, I was in such a dark place and I didn't want to wake up!
The main points that helped me was to think positive, and give th drug time to work, it won't happen over night, it takes months/years.
I have come a long way, thank you for taking time to read my story.
If you have any questions feel free to ask.
Gav.
I won't be joining you guys just yet it seems!! :(
I won't be joining you guys just yet it seems!! :(
Just read your update on the other thread Stephen....so not changing meds just yet then?
You mentioned your Clinical Psychologist...mine had a doctorate too and was absolutely brilliant...I am sure the sessions with her will help you to progress further and rationalise your worries.
Good luck with everything, thinking of you :hugs: Kitti xx
I think I'm going to ask to change to Ven on my next ward round and not take no for an answer this time.
I've given Escitalopram long enough. I'm just back to having lots of panic attacks again. I just can't deal with it.
nicola1980
30-08-13, 20:52
Hi Steven, i totally agree with you, you've gave esc long enough, id insist on a med change too, keep strong hun your doing really well x x
Hi there, a very lucid set of questions and I hope you are feeling better _ you seem to have had a tough time. I think I have learned that all the drugs there react differently with everyone. I've been on 100mg of Venlafaxine a day for just over a year and now moving up to 175. All I can say is I think it has helped. My anxiety episodes have decreased in intensity and I manage better but I want to be healed so happy to for the next level. I have not had any nasty side effects. I hope it goes well for u.
Buj
Hi there, a very lucid set of questions and I hope you are feeling better _ you seem to have had a tough time. I think I have learned that all the drugs there react differently with everyone. I've been on 100mg of Venlafaxine a day for just over a year and now moving up to 175. All I can say is I think it has helped. My anxiety episodes have decreased in intensity and I manage better but I want to be healed so happy to for the next level. I have not had any nasty side effects. I hope it goes well for u.
Buj
Hi Buj,
Just curious, Venlafaxine normally comes in multiples of 37.5mg - how are you managing to take 100mg? Do you divide the pills?
Pip
Well I am starting Venlafaxine this week (have the tablets ready). After some years on Citalopram which I found helpful for anxiety/sleep, but had to stop because of itchy skin, and the last year or so on Mirtazapine (now 30mg) I have seen the psychiatrist who thinks Venlafaxine is a good idea alongside Mirtazapine (long standing treatment resistant depression/anxiety) for my current predicament.
I'm going to start on a low dose of 37.5mg per day (split tablet) later this week, so will post how I get along on another thread. Good luck to anyone else starting it soon (or who already has..). :)
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