Side effects - should I change medication?

[ants]

Hi guys,

New here so hello :)

I was previously on 20mg but went up to 40mg. 20mg wasn't really doing much and at 40 I am having more side effects.

PLEASE NOTE - I'm not taking ADs for depression but for a health issue which causes me to blush quite frequently. It's called Chronic Blushing

Side effects since going up to 40 are..

I absolutely can not drink alcohol - it changes my personality completely and I get blackouts and complete memory loss.

My sleep is terrible, constantly interrupted and at most 4 hours a night (yes, I take the tablet in the morning)

Loss of sex drive and my wang / willy just has no life in it, feels limp. I can get it up but it's not as impressive as normal :(

Dry mouth - Had an interview the other day and could barely talk in it!

The annoying thing is that I don't want to give up alcohol, I really enjoy alcohol in moderation and would like to drink occasionally.

My question is, if I change to Effexor is there a chance it won't have such a terrible interaction with alcohol?

I also hate (this may sound silly) that I can't take MDMA on ADs. I'm very educated about it and would only take it 1/2 a year at the correct dosage but meh

I've also Mirtazapine but that didn't agree with me at all. Main side effect here was constipation and massive appetite increase.

Thoughts please? :flowers:

[panic_down_under]

New here so hello :)

Welcome to No More Panic, :welcome:


I was previously on 20mg but went up to 40mg. 20mg wasn't really doing much and at 40 I am having more side effects.

There often is an increase in side-effects after raising the dose. As with the initial side-effects they usually diminish after a few weeks, but can linger for some.


I absolutely can not drink alcohol - it changes my personality completely and I get blackouts and complete memory loss.

There are three issues. Firstly alcohol can increase the effects of the med, and the med may increase alcohol's effects.

The second issue is that antidepressants do not directly affect anxiety (or depression), but work by stimulating the growth of new brain cells in the hippocampal regions of the brain to replace cells killed, or prevented from growing because if chronically high brain stress hormone levels, mostly of cortisol. They literally cause the hippocampi to atrophy/corrode. The antidepressant therapeutic response is produced by these new cells and the stronger interconnections forged, not the med itself.

The problem is alcohol has the same affect on hippocampal neurogenesis as cortisol. Even moderate drinking [URL="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4568748/"]can reduce (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) hippocampus neurogenesis by nearly half (see also: Morris SA (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861155/), 2010; Crews FT (https://pubs.niaaa.nih.gov/publications/arh27-2/197-204.htm), 2003)

A third issue is that the interplay between alcohol and antidepressants can be unpredictable. On some days it may be possible to drink a herd of alcoholic elephants under the table without raising a sweat, on others a small drink may turn legs to rubber.


My sleep is terrible, constantly interrupted and at most 4 hours a night (yes, I take the tablet in the morning)

Insomnia is a frequent SSRI side-effects, although some find them sedating. This usually diminishes over time, but small doses, <= 15mg, of mirtazapine (Remeron) are usually effective and hopefully without the issues you've had with this med.


Loss of sex drive and my wang / willy just has no life in it, feels limp. I can get it up but it's not as impressive as normal :(

Youy may find the info at the bottom of this post (http://www.nomorepanic.co.uk/showthread.php?p=1675808#post1675808) useful.


The annoying thing is that I don't want to give up alcohol, I really enjoy alcohol in moderation and would like to drink occasionally.

A couple of drinks a week may be okay, but as per above, any more is likely to be counterproductive.


My question is, if I change to Effexor is there a chance it won't have such a terrible interaction with alcohol?

This is a potential problem with almost all antidepressants. The maker of Effexor specifically recommends (http://www.drugsdb.com/rx/effexor/effexor-and-alcohol/) against drinking. This is not the only issue with venlafaxine. Imho, another SSRI would be a better bet.


I also hate (this may sound silly) that I can't take MDMA on ADs. I'm very educated about it and would only take it 1/2 a year at the correct dosage but meh

MDMA has the same negative impact on neurogenesis as alcohol. It can also trigger hyper secretion of serotonin to the point cells exhaust their fuel supply causing them to prune serotonergic axons as self protection. Primate studies have shown this damage may still be evident up to 7 years (https://www.ncbi.nlm.nih.gov/pubmed/10366642) after the last exposure.

[ants]

Thank you very much for taking the time to get back to me.

I have dropped my dosage to 30mg for the time being which is kinda annoying as I have to break up the 40mg tab and hope it's as close to 30mg as possible.

[panic_down_under]

I have dropped my dosage to 30mg for the time being which is kinda annoying as I have to break up the 40mg tab and hope it's as close to 30mg as possible.

Get a pill-cutter from your chemists/pharmacy. They are more accurate and much less bloody than knives, ime.