Back on Venlaxafine. [Archive]

spamvicious

20-09-14, 11:54

After 2 months of hell, non stop panic attacks, weight loss and being able to leave the house. I've been convinced to go back on Venlafaxine. I stopped it before as despite it working very well for my depression, if I missed a days dose I would go into withdrawal straight away. However a psychiatrist advised me that there wouldn't be anymore shortages in the chemist like last time which caused the issues.

This is the schedule I'm on for changing meds.

Week 1: Trazadone 100mg (reduced from 150mg)
Week 2: Venlafaxine 37.5mg am and Trazodone 50mg pm
week 3: Venlafaxine 75mg
Week 4: Venlafaxine 75mg twice daily.

Today is the second day of reintroducing venlafaxine (week 2) and already I'm feeling nauseous, drowsy and heavy headed. Is it possible to be back in my system that quick or is it cos I'm taking it with Lorazepam as well?. The Lorazepam on its own doesn't make me feel like this. I know I have to just get through it anyway but I'm curious if its happening or it's psychological.

MrAndy

20-09-14, 16:29

Baggs

21-09-14, 08:37

In my personal experience the bad effects of anti d's kick in straight away and the good effects take a while. I took Effexor some while ago and it worked for me and was really good. I wish you all the best.

spamvicious

21-09-14, 13:20

Thanks for the help guys. I'm wondering if this could be the reducing/withdrawing from the trazodone if it's not the venlaxafine. I hope it kicks in a little faster as I was only off venlaxafine for 2 months. I need to get back to normal.

Every day I'm just staying in and counting the hours until I can sleep, I don't want to wake up and have to start it all again. I know it's not gonna happen overnight but if I could just have a day where I don't have full terror the second I wake up, then I'd know I was on the right track.

spamvicious

23-09-14, 11:44

I'd also like to know the differences between having 1 tablet in the morning (150mg) (slow release) and having 2 tablets, morning and evening of 75mg. I will be taking the standard 75mg twice a day. However in the past I had major issues when there was a shortage at the chemist and I missed 1 or 2 tablets, my body would go into complete withdrawal.

So my question is, would the slow release be better for me if I have high risk of withdrawal or should I stay with the standard release ones?. Obviously it would be easier for me to just take 1 tablet in the morning anyway so not sure why I was put on the twice daily ones if theres no major difference?.

KK77

23-09-14, 15:34

Some of the side effects like nausea, anxiety, dizziness etc are better on slow release and it's easier taking one tablet in the morning. Ask your GP about it. I think they prefer standard immediate release type because it's cheaper lol.

aprilmoon

23-09-14, 19:05

I take my dose of Venlafaxine (150g slow release) plus one 37.5,all together in the morning,as instructed by my psyche,and find it no different than taking the 2 ordinary individual 75s twice a day.

spamvicious

25-09-14, 17:02

I started the venlafaxine 37.5mg last Friday and on Saturday I was feeling a lot calmer which lasted for a few days but last night the panic started to return and this morning I woke up with the terror again. Tomorrow I double the dose to 75mg and take that for a week and then double again to 150mg which will be the dose I was on before I changed medications a few months ago. My question is, will the doubling up calm me down again or am I gonna go back to weeks more of feeling horrible and panicked. Having these few days of feeling even partly normal have been amazing and going back to the panic has left me distraught.

KK77

26-09-14, 17:35

Wish you luck Spamvicious but personally I think it's too quick a dose increase. I would stabilise on 75mg for at least 2-4 weeks and see how you feel before making a decision. Know you were on 150mg before but you might be fine on 75mg and with fewer side effects.

spamvicious

26-09-14, 18:54

Well I'm just following the advice of the crisis team I saw. It's been 2 months now of panic attacks and barely being able to leave the house. Two weeks ago it was so bad that I was considering hurting myself so i could be unconscious and not have to deal with it for a while. I was given an emergency appointment with a psychiatrist who gave me a month long plan to switch between the trazadone to venlaxafine. I guess they just want to get me on the dose that they know works for me.

Once I'm stabilised then I can talk about reducing it. However today has been horrendous, I've just wanted to sleep all day and have no appetite, tonight is the first night without any trazadone so I'm scared I won't be able to sleep but right now I'm just counting the hours again before I can go to bed. Will it be a long time till I see improvements again?. The psychiatrist said that by the end of week 4 (1 week of being on full dose) I should be "back to normal". Is she being optimistic? She also said it would get worse before better which is what is happening now I think.

KK77

26-09-14, 19:34

When will you be seeing your psychiatrist or MHT again? If venlafaxine worked well for you before, I don't see why it shouldn't again, but understand the horrid anxiety in the meantime. If you have further concerns you should try and get in touch with MHT who can advise you. You shouldn't be abandoned till the med 'starts' working. Hope you manage to sleep anyway. If not, maybe you could take 50mg traz to get you through the night?

spamvicious

26-09-14, 20:32

I see the psychiatrist on 9th October. I will stick to the instructions she gave me and hope that it kicks in soon. Even if I'm not in an actual panic attack I still can't concentrate on anything and If I manage to leave the house it's only for an hour or so before I need to return home. I just want my normal life back again.

KK77

28-09-14, 13:32

How are you doing Spamvicious? You managing to sleep?

spamvicious

29-09-14, 12:06

I'm managing to sleep ok but during the day I have non stop palpatations and tightness in the chest. It's almost like I can't get my breath at all, like someone is twisting right in the centre of my rib cage. I understand this can be a side effect but with my anxiety already so highi it's making it worse. Making me feel light headed and now I just want to sleep all the time. I don't expect miracles but I thought I would be feeling better by now. 3 weeks into a 4 week transition from trazadone to venlafaxine.

SADnomore

29-09-14, 21:12

This sounds like the knots-in-the-stomach side effect I had when starting ven, too. The good news is that it does ease off, although it was the last "strong" side effect to pass, at around 5 weeks when I last noticed it happening regularly. Several long, slow deep breaths do help. Hang in there, I'm sure it will pass for you too!

On another helpful note, the thing I like best about venlaxafine is that it really does continue to show new benefits as far as 6 months out! After that point, I started ramping up the dose and the side effects from those increases have been minimal. :) You are coming to the end of the hardest bit, hang in there! :yesyes:

Marie

spamvicious

30-09-14, 14:23

Had the most horrendous night, was up till 5am because the chest pains made me paranoid about my breathing and once I got into that cycle of trying to breathe properly then of course i started hyperventilating. Had a few bourse sleep since but still really anxious and sleepy. I can't take much more of this, I need the anxiety to go and I can start to go out more. Friday will be the start of the 3rd week on venlafaxine and the highest dose, when is it gonna kick in?

SADnomore

30-09-14, 15:30

I realize this isn't what you want to hear, but part of ven's "kicking in" will normally be increased anxiety and physical symptoms early on. So you are right where you are supposed to be! It's temporary and will pass, try not to worry. Blocking the "reuptake" of the neurotransmitters allows more serotonin (and at higher doses, norepinephrine,) to be available to your system. This should once again help you "feel normal", as you say. Venlaxafine helped before so there is every reason to believe it will help again, longterm, once you get past the start-up.

*NB* Typically, there will actually be a temporary decrease in serotonin production at one point for a number of days. This is because your system has a brief "fail-safe" mechanism that halts new serotonin production upon detecting the stoppage of its reuptake. This temporary lessening of serotonin causes a spike in anxiety symptoms. This normally resolves within 4 to 6 weeks with venlaxafine, as production normalizes and the extra serotonin stays in your system.

Come Friday when you are on the highest dose prescribed (150), why not ask your GP for the extended release capsules so you are just taking it once a day? I take mine at breakfast, and it tends to not interfere with getting to sleep at night. Ven is somewhat activating, so taking part of your dose later in the day is something you may want to get away from, and the single capsule in the morning should help.

Meanwhile, I have to concur with the others who have said that your dose has been titrated up really quickly. It makes sense that you will be in a state of steadily increasing side effects until your dosage levels out. Try to be patient, what you are experiencing is perfectly normal and most importantly, temporary. Some meds (like re-uptake inhibitors) take time to establish their positive effects. Like Aprilmoon and many others, I have found the wait to be worth the investment of time. Don't quit before giving it a good 6 - 8 weeks, especially having risen as quickly through the dosage increases as you have!

Do you have techniques you can use to deal with the physical symptoms of anxiety? Progressive relaxation works for me when I put all my focus into it. Beginning with one foot, then the other, I mentally identify each part (big toe, then "rest of toes", balls of foot, arch, instep, heel, ankle) and tell it to relax, relax. I take a good long time to work through each limb that way and by the time I reach my chest, my breathing has naturally slowed and I am well on my way to being completely relaxed. Maybe others will have suggestions that you can try, as well, and there are all sorts of games for panic etc., on the site.

Hang in there, you'll be out of the woods soon! :hugs:
Marie

spamvicious

30-09-14, 15:57

So I have another 4 to 6 weeks or does it start from the first tablet etc and I have another 1 to 2 weeks?. I just had a shower and started hyperventilating and nearly passed out. Had to lie on the bathroom floor. I have already battled for 2 months I don't think I can do this anymore

SADnomore

30-09-14, 16:59

It's this next Thursday when you see your pdoc again, right? Until then, if you are able to get in to see your gp, maybe a short course of propanolol will help with the palpatations and slow you down.

Do you have techniques specific to breathing that you can try? If not, try to get some happening! Your symptoms will also be from the trazodone withdrawal and may continue for some time, although steadily getting better. Suddenly stopping the venlaxafine cold turkey now will likely only pitch you into withdrawal from that, too. As you said yourself, to stop taking it even for one dose will cause that to happen :wacko:

Not too much longer now before your appointment. If you really find yourself panicking and unable to wait, I would go see your gp or try for an emergency appointment with your pdoc.

It's nasty I know, but this business is the only way to get to the good effects, be happy that you are at least now on the drug that you have had success with before. Almost 2 weeks in already!

Marie :bighug1:

spamvicious

30-09-14, 18:15

I'm supposed to be seeing her back in London where I live but I'm up in Yorkshire as I'm unable to cope on my own. She made the appointment with the assurances that I would be ok by then but that's not very far away and I won't be going back until I know I can cope and the anxiety attacks have stopped. I have her number so I might call her tomorrow. I also have lorazepam that I can take but it's not very effective when it's the breathing problems rather than just general anxiety etc.

KK77

30-09-14, 19:59

SV - I know you're really struggling here but you're trying too hard to cope on your own IMO. My original point was that if you're having all these awful side effects now, then doubling the dose could become intolerable. And I agree with Marie that you're in a difficult situation because this isn't a med you can simply stop without careful tapering. I would definitely ring your doctor tomorrow and ask for advice re delaying the increase till this dose has at least somewhat stabilised.

spamvicious

01-10-14, 12:15

I had a good nights sleep last night so that's helped. I know I'm gonna get side effects with either dose and I know that 150mg works for me so it makes sense to start that dose in a couple of days rather than waiting and being on 75mg longer and it probably not do anything for me or help the anxiety anyway.

SADnomore

01-10-14, 18:33

Okay, if you are going to do that though, I would still encourage you strongly to ask for the extended release capsules and take in the morning (after food). The food is needed to offset nausea side effect, more than just a biscuit or a piece of toast, something substantial. This will also help prevent sleep interference from the ven.

I've been on the extended release from the start. I have no doubt that this form reduces side effects, but it seems I'm sensitive to side effects and need to just ride them out. I sat tight through the start-up phase eating small meals and snacking regularly, keeping my water bottle filled and at my elbow, and curling up with a blanket and taking it easy (tv, this forum, etc.) There are lots of good threads on venlaxafine, very informative and encouraging, and that's mostly what I read. I hope that you have this time to be gentle with yourself, too, and wish you much luck in any case! :hugs:

Marie

spamvicious

01-10-14, 22:47

I've already been given the tablets I have to take which are the standard release ones. 75mg twice a day etc. I won't be able to get a new prescription from the psychiatrist over the phone so I'll just have to take them as they were prescribed. I was on these ones before and was ok, I think I'm just so sensitive to the side effects now as I'm already so anxious. When I tried ven the first time I didn't suffer any side effects as I was stable when I changed over etc so now it's just playing on the anxiety that is already there.

KK77

01-10-14, 23:31

The extended-release capsules are milder on side effects because they release the drug far more slowly, thus also easier re missed doses. This was a question you asked previously SpamV, so don't know why you're suddenly being so dismissive.

Good luck with increasing your dose but your obstructive attitude will not help matters.

spamvicious

02-10-14, 11:10

Sorry I didn't mean to be dismissive, I just mean the situation I'm in at the moment being away from home and staying with family means it would be hard for me to get a change in prescription right now. I'm going to call my psych today and discuss what you guys have said about whether to stay on 75mg for a bit or trying to get a prescription for the extended release tablets.

I really appreciate all the support you guys have given me, it's just hard I'm trying to follow the plan I was given and I'm feeling so much worse panic wise than I have in weeks. I'm barely eating as I just can't face it.

valatpaws

03-10-14, 11:20

Hi
I can sympathise with you as I am going through the same at the mo. Thought I could cope on a low dose of venlafaxine and orbited straight into mega anxiety. I have gone back up to my original dose and have been there for a week. The mornings are like a death sentence and the days not much better. Wish I had known the implications of withdrawal. The anxiety is like dying inside and getting help from this site is a godsend.hang in there we will get there.im told it's just time

spamvicious

03-10-14, 17:01

Val that's exactly how I feel like I'm so scared that my heart is going to stop. I spoke to my psychiatrist yesterday and she said there is no evidence of the extended release tablets are more effective than the standard release ones so wouldn't change the prescription. She said it will get worse so in the mean time I have to take 1mg lorazepam 4 time a day. Before I was on 1 or 2 a day but now I have to take all 4 until the venlafaxine kicks in. I hope in a week or 2 at most .

SADnomore

04-10-14, 20:13

Hi, again! Maybe once you are being monitored and cared for moreso by your gp, you could see about switching to the extended release capsules, it is just a suggestion, and of course, up to you. The reason we all have suggested switching to the extended release is not because it would "work" better, but rather because the side effects may be lessened due to the slow release of smaller amounts over the day, as opposed to immediate release, twice daily. Plus it is easier to remember the one capsule taken with breakfast than two different doses each day as time goes on. At any rate, no doubt being ramped up so fast to 150 will naturally have you feeling side effects exponentially. My heart goes out to you. We are all glad to help in any way we can, so you can be successful again with the drug that has helped you before (and lots of us here too!)

Rightly or wrongly, it seems as though our doctors don't give very much consideration to side effects as they weigh out benefits of medications and dosing and timing. Unfortunately, patient compliance often falls victim to side effects, no matter how much the patient wants to stay the course. As some have put it, maybe if the doctors actually had to take the drugs themselves for a bit, they would give them more regard and plan for them better! If you are still finding that the lorazepam is not helping enough, maybe have a chat with your doctor(s) about some propranolol for your physical symptoms that can help to slow you down a little without the woozies (and potential for addiction).

Most likely your pdoc is trying to get you ramped up to 150 asap because of heightened concern for your wellbeing. She clearly believes that it is imperative for you to become stabilized as fast as possible, even if it means having to weather a storm of side effects right now. She may be worried that there isn't time to lose, and we all have to respect that. I know we appreciate your resolve to follow her instructions and to get feeling better. :hugs:

I can relate very much to your breathing symptoms. For me, I felt they were tied to a strong feeling of knots in the stomach that took my breath away! If you have a heating pad, you might try bundling it inside a towel and sitting with it against your chest and abdomen for a bit, that helped me a lot. The gut is filled with serotonin receptor cells, and these are what are being triggered and this may be felt in a physical way. (Put very simplistically, there is another "end" to the receptor which will shut down production of serotonin in response to the other end no longer uptaking it, (due to the ven). We experience this loss of serotonin as a spiking in anxiety. For myself, it was mainly felt as physical tension, and the heat and slow deep breathing helped a lot.) Over time, the cell becomes desensitized to the continued blocking response, and serotonin production begins again. This is when the side effects ease off, and we start to feel the benefits of its increase.

Many people note that at 150 mg, venlaxafine begins to block the reuptake of norepinephrine, so that more of this neurochemical is also made available to the system, with a similar temporary spike in anxiety to be gotten through first. (My pharmacist however says that the dose at which this occurs varies from person to person.) Then too, after a time, this temporary spike in anxiety abates and benefits begin to be felt from the rise in norepinephrine.

I don't know if you find this explanation reassuring, or boring (lol!), but hopefully you can take faith in the fact that relief is around the corner. :D Do keep reaching out, try to hang on, and see what other encouragement you can find on the site regarding venlaxafine. Do you plan/hope to stay on it long-term?

Marie
p.s. Good for you Val for accepting you need to go back to your original dose, and yes, absolutely, time and patience will pay off. Atta girl! Same advice off to you with hugs!

spamvicious

09-10-14, 21:20

Tomorrow is the 7th day back on 150mg and I'm already feeling a lot better. I'm still getting chest pains and heart jolts but not the mental anxiety that goes with it. Here's hoping I'm finally back on track :)

SADnomore

09-10-14, 22:11

Awesome news! I'm very happy for you! :yahoo:

spamvicious

14-10-14, 17:04

Well that didn't last long, felt my anxiety slowly returning the last couple of days and today I had 3 panic attacks and crying. I had this before when I upped the dose, a few days of feeling amazing and then returning back with a bang. I have to go back to London on Tuesday and apart from seeing the psychiatrist on Thursday I'm not gonna have any more support. I'm terrified of it going back to before, anyone know how long before I level out properly?. Friday marks the start of my 3rd week on 150mg venlafaxine.

SADnomore

15-10-14, 02:34

Well, depression is more my "deal", but I have to say that I have also experienced something similar in that, sometime within the first week or 10 days on a new dose, I have one or two really good days, with uplifted mood and positivity. That then goes away. I have however taken it as a "good sign" that once I am finally on the right dosage, that will be how I feel more of the time (once it has settled in). Now on my second week at 187.5, I had a couple of really good days last week. I have my fingers crossed that 225 will be my "magic number". Next month ...

KK77

15-10-14, 11:02

You have a very positive attitude Marie and I think that goes a long way. Hope your new dose increase helps and all goes well - I'm sure it will ;)

SADnomore

15-10-14, 20:48

Aw, thanks so much! Well, there's so much to try, and so many success stories, I can't help but feel optimistic that some combination of meds and behaviours will give me that boost I need to get me through the winter. And I do think the ven is helping already. Sometimes I look to what I'm NOT doing and feeling for signs of improvement. For example, I'm NOT feeling despair and a constant sense of low-level panic this fall like I usually do. That's huge. I appreciate that a lot. Now if I DON'T start crying all day and carb loading and isolating come January, I will consider the meds trial a roaring success, lol!

Best wishes to you too :hugs:

KK77

16-10-14, 17:11

True, it's the small improvements which matter. I don't expect to wake up one morning feeling a different person - ie, one who does not have depression and chronic pain - but do expect some change in return for tolerating the side effects of this med. I'm only on a low dose of 75mg and will only increase in the future if I feel it's made a significant difference. Not been long enough to judge yet. More crap days than good ones, and although my main problem is depression, I have felt the heightened anxiety which in someone already struggling with it could be intolerable at times.

I did notice a big differencce between the IR and SR though. I think the IR causes unstable blood levels of the drug which is why it's indicated only for depression, whereas the SR also includes anxiety disorders such as PD and SAxD. As mentioned before, this doesn't mean the IR is less effective but just more prone to causing spikes in anxiety levels - which is why we both suggested the SR to SpamV. I hope she does well anyway.

Take care and onwards and upwards :D

spamvicious

21-10-14, 20:49

Still feeling horrific and no improvement at all, been on 150mg for 2 1/2 weeks now, I just hope there's some change soon because if they turn round in 3 weeks and say they want to try something else I really don't know what I'll do. I've been living this hell for 2 1/2 months now, no respite, every single day is a battle and all I want to do is sleep but I know I'll wake up in terror each morning.

I'm also having major issues with doctors as well. I'm in yorkshire still as theres no way I can return home yet. I have had to reschedule my appointment with my psychiatrist twice now as I'm still unable to leave the house, never mind get on a train to London. The problem is she is saying she won't give me another prescription for Venlafaxine until she sees me. I registered temporarily up here with a doctor and they are saying they also won't give me a prescription. I understand if I was asking to be put on the drug but I'm on it now, I just don't want to go into withdrawal which is the reason I changed to a different a/d in the first place and this whole mess started.

Any advice? the doctor up here told me I had to "go get a prescription in London" which is just not possible, also I know that even if i managed to get down there to see the psychiatrist she would just say "lets give this more time".

KK77

23-10-14, 02:00

You said you felt better the first week you upped dose to 150mg - I thought you'd have gone back home then but obviously don't know your full circumstances and reason for not doing so.

However, to be fair, it looks like no one wants to take responsibility and seem to be passing the buck so to speak.

Based on the fact you said this med had helped you before, and the fact you don't want the trauma of starting on a new med, I would say try to continue. It has to get better. (I would advise against increasing the dose further till you feel it has helped though.)

Is it not possible for someone to help you get back to London? I don't think you have any other option left if you are running out of venlafaxine - and you really don't want to be left in that position.

SADnomore

23-10-14, 04:26

I agree with KK, you can't run out of venlaxafine. Go in ahead and speak to the pharmacist where you got it, if local. When I ran out ahead of when I was supposed to be home last time, the local pharmacy quickly agreed to sell me enough pills to carry me through. They fully understand (even if your doctor doesn't) why you cannot go without it, and told me they will always do it in a pinch. In fact, they gave me an extra week's worth to make sure I had time once home to make a doctor's appointment for a refill scrip. :yesyes:
ps It has taken me, honestly, about 3 full weeks each increase to get back fully to "normal" (with, yes, still the occasional jitters). And that's by half each time (37.5, not 75 mg capsules). Once I'm on 225 mg, IF that works out okay after a month, I will start taking 3 x 75mg. Get more pills and give it another week or so. :hugs:We're rooting for you!

spamvicious

26-10-14, 16:09

I have an appointment with my psychiatrist on the 5th November so I have to go back next week. There hasn't been any real improvement, I'm having horrific nightmares and constant palpitation/heart jolts. I really don't know what to do anymore. I'm not sure if I want to up the dose if 150mg was the dose I was on and it's not working yet. I've just started my 4th week and i'm become more and more desperate that my life is ruined and it's never gonna go back to normal. I'm scared they the psych is gonna say "oh lets try something else" and I'm going to have to go through withdrawal from this and try something else and it's gonna carry on even longer. I can't do this anymore and I'm getting really bad thoughts again.

SADnomore

26-10-14, 20:28

Don't panic, SV, it's going to be allright! I'm sorry it's not working out for you, but a better med will be found, there's too many and too many combinations for you to not have that hope! How have you done with fluoxetine, (Prozac), if you've tried it in past? Unlike venlaxafine, it has a long half-life, and works well against withdrawal symptoms of venlaxafine for transitioning, I've read. They often will start fluoxetine and then slowly withdraw from the ven, or use it as a transition to another med. So it doesn't have to be hard on you!

Even if fluoxetine doesn't work for you long-term, you are bound to find it helpful for it's long half-life as you taper from the ven. I'm sure the psychiatrist will be able to help, hang in there! Just hang on now, you have the appointment, and the doctor has the knowledge. They just need to come together now, not much longer. :hugs:

Marie xx

spamvicious

26-10-14, 20:59

Thanks Marie. In June I tried to come off Venlafaxine and they put me onto Citalopram which started the anxiety in the first place and caused all the issues so I'm worried that another prozac based med would spike my anxiety even more. Three months down then line and I really don't know what to do, I can only hope that it finally starts working. I still have no 'normal' life at all, I spend more or less every day in the house counting down the hours till I can sleep again. The psych put me back on venlafaxine cos thats what I was on before and it worked, apart from withdrawal when I missed a dose which is why I wanted to come off it which turned out to be the worse mistake I have ever made.

KK77

26-10-14, 22:15

I think you've given this med long enough. I know it's starting over again but there must be something that can help. SSRIs do the same thing, but they do it in different ways, with slightly different side effects. Fluoxetine due to its long half life might indeed suit you. However, it can also cause heightened anxiety initially. Alternatively, your psych might suggest a more sedating med like mirtazapine. Have you had any CBT/psychotherapy?

SADnomore

27-10-14, 02:26

Don't blame yourself, SV, you are not the first to become afraid of the "instant" withdrawal symptoms from venlaxafine, should a dose be missed. I was blown away by how sick I felt within hours when it happened to me. :wacko:

And if I had had to take it in split doses, I am sure I would have missed the second dose often enough to have given up, never mind having to deal with a "shortage" at the pharmacy! Completely unacceptable for a psych med. :mad: I applaud your courage for starting ven again in hopes it will work its magic for you once more, given time. It's logical that it will. Maybe what you need is a booster for awhile, the mirtazapine that kk is suggesting has been used for that purpose. It should help you to sleep better at night, if nothing else. From what I understand it has quite the hangover effect at first, so you'll want to pick a time when you don't have to be up and out the door of an early morning. A low dose of an anti-psychotic can be useful for anxiety and for sleep also. This would be much, much lower than is considered a therapeutic dose for treatment of psychosis. Commonly used as adjunct therapy in depression :winks:

I have to say it is only by having a strict ritual each morning that I haven't missed another dose of ven since. Porridge and fruit on waking whether I feel as though I could wait or not, or whether I'm in fact going to be joining someone for breakfast or not. As soon as I set down the spoon, I open the bottles and take my meds immediately. Done for the day. I can always have toast and tea with family when they're ready to eat, but I can't afford to miss a dose of ven. ... Do ask the psych for the extended release! It really lowers the chance of missing a dose, and helps to smooth out the bumps as well. My doc writes on my scrip: Brand name only, no substitutions. One druggist refuses to bring in brand names, so I switched to one that will. Apparently Effexor is only available now in extended release, so I am always sure to be getting those capsules, not immediate-release tablets. Remember, it's not our job to worry about cost. And not your doctor's either - my own doc is not impressed with most generics because of the oddball fillers some companies use, and was annoyed they'd been given to me. For one thing, despite what many may say, they are NOT exactly the same, the standard for the active ingredient is lower, and so it is possible for patients to wind up with less of this per dose. Maybe that's part of your problem. Insist on brand name, your mental health is worth it. Shout the walls down if you must but get the real deal before you leave!

Marie

KK77

27-10-14, 11:04

Some good points Marie. Maybe adding mirtazapine at night and swapping to slow release version of ven will make a difference. Or as you say, low dose antipsych with mirt - eg, olanzapine.

There are lots of options left SV, so try to remain positive that you will get your life back on track. We've also been on the road you're treading and have come out the other side. You can too.

spamvicious

27-10-14, 19:58

Thanks for all your help guys. So when I see the psychiatrist next week, should I insist that I don't want to up the dose of venlafaxine anymore?. Basically I'm scared that the higher the dose, the worse it will be when I have to come off it. I was on 150mg before and I had a pretty horrible couple of weeks when I went through the withdrawal. I've been on the same dose this time for 4 weeks as you know and nothing has helped, in fact its made me mood even worse. When I see her it will be coming up to 5 weeks. So really it's knowing what to do. Also if I do have to come off Venlafaxine, can I ask for other stuff instead/as well as fluoxetine? like something just to knock me out etc.

SADnomore

28-10-14, 01:07

Aw, sweetie. I feel bad for you. I have been in the same position, where I would be content to sleep through the days just to escape how I'm feeling. It will get better though, you know that. And your conscious participation will be important to that end, lol! ...

So, I think if you're still the same then, you really ought to ask him to consider a trial with either mirtazapine, or else olanzapine. Either one will help you to sleep better. Mirtazapine is very, very sedating at first for most people, day and night. Olanzapine has been most helpful as a long-term adjunct for some. I think when the doctor has a good feel for what you are going through he will be able to discuss with you which to try next. Honestly, rather than starting withdrawal right now, I think it is worth trying a little longer and harder, since you've spent all this time getting built up with the venlaxafine!

The psych might want you to try a bump up again in dose. Maybe he will be able to figure out the puzzle of why ven worked for you before at this same dose, but is slow to act this second time round. Could be you need more of the drug now, to battle down the increase in anxiety, and it could be that a graduated increase will work quickly to get you over the hump. There is a difference between 150 and 187.5, I find myself feeling noticeably calmer than I was even on 150 (once again though, it has taken until week 4 to get there). At certain points with ven, other neurotransmitters come into play besides serotonin. That's a huge advantage. One, then two, and even three different neurotransmitters can be affected, all with the same med. No need to go through start-up side effects and withdrawal again and again, IF it kicks in at some point and is tolerable.

A good, competent psychiatrist will be willing to try different approaches, beginning with immediate substitution for the extended release form for ease of use, and lessened side effects. At the end of the day, if you decide to try something else, you can certainly ask about a long shelf-life med to make it much easier to deal with ven's discontinuation effects. I can understand your reluctance to go back to an SSRI again. My own doc likes to go to a different category altogether when trials with one haven't helped, that's how I ended up on ven!

Just a bit more than a week to go now. Maybe you could do a bit of research on the other SNRIs and NDRIs. Or combinations. Or other classes of anti-d's ... Take heart, the world is your oyster! :)

spamvicious

29-10-14, 13:11

Thanks for all the support guys, yesterday was really really bad, my mum and I were discussing whether I should get myself hospitalised, as it was just waves and waves of absolute despair and then horrific panic attacks. Still hoping I can negotiate something so I don't have to go down to London for 1 appointment and then come back.

I've decided to come off the Venlafaxine because as well as it not working its bringing side effects of muscle spasms (tics), tinnitus, dizziness and weight gain (managed to put on 7Ibs eventho I can barely eat). The dizziness and tinnitus I thought was due to my meniers disease which I suffer from (its an ear/balance) thing. But in the 3 months I wasn't taking the drug I realised those symptoms hardly happened.

I will need another anti depressant to switch to, so I'm asking for something with a long life to help with the withdrawal? or is just fluoxetine they will put me on?. I just want to be able to smile again!

KK77

29-10-14, 13:47

Fluoxetine is the best choice if you've decided to come off Ven and I agree that going to hospital is your best bet. You are not wasting anybody's time - you really have been suffering awful symptoms and this can't continue. Something needs to be done before it pushes you over the edge, and you can't be expected to travel all the way to London for one appointment in your current state.

Keep us updated.

SADnomore

29-10-14, 20:05

Yes, good luck SV!! Great advice from kk, go for it, your mental health is worth it! Please keep us in the loop, we care!!:bighug1:
Marie xx

spamvicious

30-10-14, 14:12

I'm hopefully going to sort it out today, but it depends on my mum who sadly is going through a bad time as her mum has dementia :(

I was looking online for swapping venlaxafine to fluoxetine and I found this http://wiki.psychiatrienet.nl/index.php/Venlafaxine-fluoxetine

which is odd cos when I was taken off ven in June, the doctor told me to stop taking it over night (150mg) and start the citalopram 20mg the next day. Is that what started all this?. If so I want to sue the idiot for messing me up.

SADnomore

30-10-14, 18:13

Yes, SV! Oh, dear. Yes, a switch goes something like what you've shown. So you were slammed badly with discontinuation from 150 ven and startup s/e from the cit. Most doctors have tunnel vision when it comes to s/e (unless it's life-threatening, they don't want to hear about it), or discontinuation symptoms/withdrawal (same, and plus of course they don't get into it in school, only for narcotics, and that is usually done all at once). So sorry this has happened to you. Good luck!

spamvicious

30-10-14, 19:03

I think I'll look into legal advice should I ever feel better the doctors surgery I'm with made several mistakes which I think has led me to being this ill. I spoke to my psychiatrist today and she was very unhelpful and I was in tears at the end of the conversation. She kept on saying things like "and what would you like me to do Sam? I don't have a magic wand" and when I said about Venlafaxine, she said it could take up to 3 months to work. Well I won't be able to cope with another 3 months of this thats for sure.

She said she's gonna ring me back tomorrow after speaking to her superior as she doesn't understand why the venlafaxine isn't working and she thinks i'm unsatisfied with her (duh). She also said its complicated for me to go to hospital as they won't know what to change my medication to as i've 'not got on' with some in the past. arghhhh

KK77

30-10-14, 21:47

Well done for managing to call psych. I think her attitude stinks. No one knows why certain psych meds don't work - any more than why it rains on a Monday. "Speak to her superior"? Is she a trainee psych? Doesn't really matter but it's her general dismissiveness that sucks.

Hope she comes back to you with some answers because saying that Ven might take '3 months' to work is not good enough :lac:

spamvicious

01-11-14, 12:26

Seeing a GP here on Monday as the psych has finally realised that she can't sort anything out down there. I don't know whats going to happen next, I don't know if the GP will be able to do anything or I will have to wait for a referral. I want to feel better but I'm scared it will get even worse when I change drugs. Also these tics/spasms are convincing me that I have some kind of disease and this is all down to that and thats why no a/d's are working.

KK77

02-11-14, 11:16

Second day of swapping to fluoxetine and I slept two hours last night. No other side effects (yet) but I was on a lowish dose of ven so maybe you should reduce to 75mg first for while if you decide to change med as well.

Good luck with appointment tomorrow. I would think GP is capable of giving you script for whatever it is you need.

spamvicious

03-11-14, 16:31

Saw the doctor today and she said she didn't want to change my meds too much as she has referred me to specialist. However when I told her about my side effects she's reduced it to 75mg and put me on the modified release ones. When I picked them up it said venlacic not venlafaxine. She said the reduction wouldn't make my mood/anxiety any worse which I'm dubious about. Will I feel ill with the reduction?

---------- Post added at 16:31 ---------- Previous post was at 13:52 ----------

Second day of swapping to fluoxetine and I slept two hours last night. No other side effects (yet) but I was on a lowish dose of ven so maybe you should reduce to 75mg first for while if you decide to change med as well.

Good luck with appointment tomorrow. I would think GP is capable of giving you script for whatever it is you need.

Hope your switch is going ok