Well here we go... 150mg

[Paradise10]

Hi all, so after a week of non stop panic and a teary session in the doctors this morning, my doc has decided to up my ven dose to 150mg. I thought I would use this thread to a) keep track of progress and b) hopefully find some ven buddies on the same journey as me so we can support each other.

I had some bad news about a week and a half ago and since then my anxiety has skyrocketed. It has got to the point where I am really struggling to cope. Symptoms i am having are...
Pretty much 24/7 non stop anxiety at varying intensity levels.
A lot of unwanted thoughts.
Very breathless and sweating a lot with minimal effort.
A lot of thought rumination.
Can't concentrate on anything else.
Agitation.

I am already on 112.5mg and have been for quite a while so I am hoping the increase will not be too brutal. I also have 7 diazepam to help when needed. I won't lie I took one about 30 minutes ago as it all just got too much. I really hate taking them as I am petrified of addiction. I have only ever used them when starting or increasing an ad and they are only 2mg. My husband says I should use them if I need to and stop beating myself up about it but It's really hard for me to take one.

I am lucky that I am working from home until March next year so I don't have to go into work. My aim is to make sure I eat healthy through this as the last few days I have struggled to eat, to also drink lots of water and to ensure I go out for some exercise every day such as taking the dog for a walk.

Please feel free to jump on here with me and share your experiences of increasing as any encouragement is always appreciated.

I am taking the first 150mg tomorrow morning. I am hoping and praying and crossing everything that this increase works for me. The Doc did say I could go right up to 225mg (I only ever increase at 37.5mg at a time) if needed but I would love for it to just be the one increase.

Take care... Ava x

[panic_down_under]

Hi all,

:welcome: to NMP Ava,



I am already on 112.5mg and have been for quite a while so I am hoping the increase will not be too brutal.

It probably won't be as the percentage dose change is not that great.


I also have 7 diazepam to help when needed. I won't lie I took one about 30 minutes ago as it all just got too much. I really hate taking them as I am petrified of addiction.

I have bad news, you're already "addicted" to diazepam and its metabolites as they occur naturally in almost all foods. While the amounts are small we are so adapted to them that eating a benzodiazepine (BZD) free diet would soon trigger uncontrollable seizures.


I have only ever used them when starting or increasing an ad and they are only 2mg. My husband says I should use them if I need to and stop beating myself up about it but It's really hard for me to take one.

You husband is very wise. While there are other reasons not to take BZDs long term, white-knuckling through anxiety and AD side-effects is counterproductive.


My aim is to make sure I eat healthy through this as the last few days I have struggled to eat, to also drink lots of water and to ensure I go out for some exercise every day such as taking the dog for a walk.

Sounds like a good plan. Exercise is especially useful as it helps create the same neurogenetic (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413959/) brain changes as ADs.


the Doc did say I could go right up to 225mg (I only ever increase at 37.5mg at a time) if needed but I would love for it to just be the one increase.

I understand the sentiment, but there is no point in taking an AD at ineffective doses, indeed it can be counterproductive. The more firmly anxiety is caged the better.

[Pipkin]

Ava,

I finally settled on 150mg about 8 years ago and it has helped me a huge amount - there seemed to be a big improvement from 75mg (I think the noradrenaline inhibitor mechanism kicks in at 150mg). Increasing the dose usually does bring on side effects, as you probably know, but take comfort in that these pass and you’ll be feeling better in a couple of weeks. Don’t forget that if it gets intolerable, see your GP. I took beta blockers when increasing and they really helped with the physical effects (racing heart, sweating, shaking etc).

If I could give you any advice, it would be to make sure you’re keeping active. The temptation to do nothing can be huge but you will definitely feel better if you can get out and about. Tell your hubby to force you to do different activities (I did and whilst I wasn’t too happy at the time, it was the best thing to do).

Good luck and let us know how you get on

Best wishes

Pip

[Paradise10]

Thank you Panic Down Under for your reply, it's nice to know I am not alone on here.
Had a total anxiety meltdown this morning before i had even taken the increased dose and had to take a diazepam. I then managed a few mouthfuls of porridge to take the increased ven dose of 150mg. Wow, that's day one started. Few tears after that. I'm feeling like i can't get enough air when i breath and my bra suddenly feels too tight in the middle at the front. Want to burp constantly too.... Obvs this is freaking me out and I'm coming up with all sorts. Also got a blocked nose one side so I'm also struggling to breath through my nose. Back at work today, it's difficult but at least I have something to try and focus on. Working from home so not like I have to go in.

I have written my symptoms down and emailed them to my husband, he may be able to put my mind at rest.

Well I have made the start at least.

Take care if anyone is reading this.
Ava x

[Paradise10]

Pip thank you so much for your kind words, I am trying to make sure i get out every day for a walk with the dog, even if i don't want to. I could force myself to go see friends ect if it wasn't for this covid pandemic.

I will keep trying though x

[panic_down_under]

Had a total anxiety meltdown this morning before i had even taken the increased dose and had to take a diazepam.

I'm feeling like i can't get enough air when i breath and my bra suddenly feels too tight in the middle at the front. Want to burp constantly too....

An anxious mind in full flight can be a truly terrifying thing, Ava. They are also quite capable of producing our worst side-effects nightmares so not all you experience will necessarily be caused by the med and I suspect the breathing and chest tightness are anxiety. The burping is more likely to be from the med. The most serotonergic organ of the body isn't the brain, it is only a minor user, but the gut and its mini brain, the enteric nervous system (http://archive.is/9plAK) (ENS). The gut makes about 50 times as much serotonin as the brain and can be effected far more by SSRIs for a while, both when first taking ADs and also for a week or so after dose increases. The ENS appears to have considerable influence over the brain as most of the 'data' flow between the two originates in the ENS. It seems to be the tail that wags the dog.



Back at work today, it's difficult but at least I have something to try and focus on. Working from home so not like I have to go in.

Keeping occupied at these times is a very good thing. The less time we have to brood over every little twinge, or unusual feeling the better. The two things to keep in mind are that while side-effects can sometimes be unpleasant they are not usually indicators of harm and the results are mostly worth the trauma these meds put us through.

[Paradise10]

Thanks Ian, I'm glad you are on here... Another question coming in this update.

So day 2 on this journey and this mornings tablet has been taken. Managed to get through the rest of yesterday with no more diazepam and none yet today either. Today is better than yesterday but I always find that side effects tend not to kick in for the fist 4 or 5 days so they may be still to come.
Anxiety stayed with me all day yesterday but it was manageable. I also made myself eat a sandwich at lunch and pork steak, potatoes and veg for tea. I half watched some TV last night but wasn't really focusing. It took me quite a while to drop off to sleep too.
Woke this morning and seem to have a bit of an upset stomach and I'm quite out of breath for the first hour or two of the day. Little tired too but nothing too bad.
Been scaring myself this morning though as I keep thinking that the past year I have been on these tablets that I haven't felt sad but I haven't felt happy either... Ian do you think this will change with the increase or that I will stay like this? I've had to stop myself googling this. I've managed to keep shoving the thought away but it keeps coming back. I don't think the 112mg were 100% effective as I was still always tense, maybe that's why I lapsed.

Working today and it seems a little easier than yesterday. Every time I have a scary thought I keep saying to my self 'I'm not going down that road at the moment, i will deal with this when the tablets kick in.'

Well that's my update for now I will check back soon.
Ava x

[Maca44]

The best advice I can add is to be patient with dose increase, don't expect too much change just now give it time. I went from 225mg to 300mg and it took a couple of months to work but it sure did, I get bad HA and have just been told I have Diabetes and a couple of other things wrong (Wont go into details as it doesn't help other HA sufferers) but the Ven has worked so well and I just cant go into the anxiety thoughts the med just kind of shuts the door if you know what I mean.

The best thing I ever did was stopping the Google search around HA it can be done it just takes abit of willpower.

Take care Ava and keep posting it's a help to you and us.

[Paradise10]

Thanks Mecca, I do have a bit of HA. I can usually talk myself out of it in a week or so but it's just not happening for me and anxiety has just kind of taken over everything. Its like you can't win, if my anxiety isn't all consuming im worrying about health or my feelings, or if the anxiety is horrendous then that takes over everything.
Your words help though so much appreciated.
Ava x

[Maca44]

I really hope your increase works as well as it has for me those days/weeks of anxiety just takes the stuffing out of you doesn't it.

[Paradise10]

Thanks Maca, it sure does.

Tough day yesterday but I got through it with no tears and no diazepam so that's a plus. Anxiety and agitation were fairly high all day and I did some pacing between working, I find I can't sit at the laptop working for long at a time. Felt quite strange last night, we watched some TV and had some dinner but I didn't feel all there, like it was difficult even thinking. Went to bed about 9.30 but laid there having a lot of health anxiety and it took me quite a while to drop off, did sleep through till 7 though.
Anxiety this morning, mainly because i feel like i can't even think clearly. It's like a heaviness behind my eyes and in the middle of my forehead. Thinking is taking a lot of effort as my head feels very heavy, my body also feels like lead like even walking is an effort as my thighs feel like they have lead in them. I'm getting quite stressed with this today. This is all just so much and i'm so worried i am not going to get back to myself.... I can see some tears coming today.
Ava x

[panic_down_under]

Been scaring myself this morning though as I keep thinking that the past year I have been on these tablets that I haven't felt sad but I haven't felt happy either... Ian do you think this will change with the increase or that I will stay like this?

Hard to say, Ava. Some people do find that an AD numbs their emotions, for others they become more intense and most remain about the same as they were before. It could also be that the dose was adequate for controlling the anxiety, but not enough to overcome any accompanying depression. SSRIs, and despite what it claims on the box venlafaxine is really only a SSRI, not SNRI, are more effective anxiety meds than they are anti depressives. Time will tell. If you continue to feel emotionally deflated even at higher doses then switching to another AD would be worth considering as they won't all be the same in that regard.

[Paradise10]

Thank you Ian... I will keep that in mind with this increase. Im on just going up to 150 so I know there is more scope to go up further or try another med maybe when anxiety is more stable.

I will update more in a few days as I am spending too much time reading everyone's threads on here and scaring myself so I think I need to stay off line totally as im googling venlafaxine constantly and symptoms etc.
Take care all.
Ava x

[panic_down_under]

I will update more in a few days as I am spending too much time reading everyone's threads on here and scaring myself so I think I need to stay off line totally as im googling venlafaxine constantly and symptoms etc.

A good idea, Ava. Support groups can be a two edged sword, especially when we're at our most vulnerable. :sad:

[Paradise10]

Just popped in for a quick update...
Day 4 today, last 2 days have been difficult. Husband rang my boss yesterday and booked me a few days off. I managed the morning call but then went to pieces. Had a diazepam about 10 then did some writing in my journal. Went for a lay down from 1 till 3, I didn't sleep but I managed to lay there and breath. Its like I am awake but exhausted at the same time. Managed some tea and went upto bed about half 8 while hubby watched the rugby. Nodded off about half 9 and slept through till half 7 this morning. Today hasnt been a good one either... took the dog to groomers at half 8, had anxiety and was shake but coped ok. Came home and had a lie down for an hour as I felt exhausted. Went to Asda with the husband and it really went down hill... couldn't decide if I was dragging myself round or not, then started panicking about how much energy I had and if I was struggling to breath or not, did I have a pain in my chest? Was I struggling to walk? I then went into a full on bout of health anxiety and had to go outside and wait. Got home and took a diazepam. Keep repeating to myself that its only day 4. Only day 4. Hubby is just cooking tea then we are going to take the dog for a walk. This is so so hard! I'm praying this increase helps me.
Take care all. Ava x

[panic_down_under]

Went to Asda with the husband and it really went down hill... couldn't decide if I was dragging myself round or not, then started panicking about how much energy I had and if I was struggling to breath or not, did I have a pain in my chest? Was I struggling to walk? I then went into a full on bout of health anxiety and had to go outside and wait.

What I'm reading is mostly you self-talking yourself into a highly anxious state and little about typical post increase side-effects apart from maybe the loss of energy. It's as if in the absence of any real symptoms your mind is trying to incite some. You need to find ways of short-circuiting/diverting these thought patterns, Ava.


Keep repeating to myself that its only day 4. Only day 4.

Which is 4 days closer to where you want to be and almost through the most vulnerable period after dose increases. It takes 5-6 days for sertraline plasma levels Correction :doh: sigh!: It takes 3-4 days for venlafaxine plasma levels to restabilize to a steady-state after a dose change. Side-effects and mental states tend to be at their most volatile while the levels are in flux.


This is so so hard! I'm praying this increase helps me.

I think you mind has decided to make it seem harder than it actually is. This increase may have been well overdue.

[Paradise10]

Hello day 5.... God this is brutal.
I can really see how people throw the towel in on medication. I am defo feeling worse than before I started.
Woke up at 6 this morning and felt like my body was burning, it was like heat on the outside of my skin in all different places. My mind also felt so out of it that I was struggling to string a sentence together. My body seems to switch between feeling like lead and jelly. I often feel like my legs won't support me but of course they always do. Constant physical anxiety that won't switch off, cant sit still, have to keep moving something. Obsessed with my body and thoughts 24/7. The temptation was there just to lay on the sofa deep breathing all day, it seems i can only really try and clear my mind and deep breath when I am laid down. I have got up however and am just running a bath, don't think I will be able to lay there but as long as it gets me clean that's the main thing. The out of it feeling has worn off now, just feel scared and anxious about the way I feel.
Till later. Ava x

[panic_down_under]

Woke up at 6 this morning and felt like my body was burning, it was like heat on the outside of my skin in all different places.

This is a fairly common side-effect of serotonergic ADs. Serotonin is a signaling protein in the regulation of blood vessel tone, constriction and dilation, and ADs can interfere in this for a while initially and after dose changes. It will usually soon settle down, however, it can also increase skin photosensitivity and this tends to be ongoing so apply sunscreen if working outdoors in the brighter months of the year.


My mind also felt so out of it that I was struggling to string a sentence together. My body seems to switch between feeling like lead and jelly. I often feel like my legs won't support me but of course they always do. Constant physical anxiety that won't switch off, cant sit still, have to keep moving something. Obsessed with my body and thoughts 24/7. The temptation was there just to lay on the sofa deep breathing all day, it seems i can only really try and clear my mind and deep breath when I am laid down. I have got up however and am just running a bath, don't think I will be able to lay there but as long as it gets me clean that's the main thing. The out of it feeling has worn off now, just feel scared and anxious about the way I feel.
Till later. Ava x

Does all this diminish/stop after taking a diazepam, Ava?

[Paradise10]

No more panic - the diazepam just takes the edge of the physical symptoms as I know they are worse at the minute... I've only ever increased at 37.5mg at a time and its always the same, but when you are going through them at the time its so hard. The diazepam doesn't stop the mind effects of me looking for whats wrong. Even at the 112mg I was stable with no anxiety but still had the loops going in my mind a lot. I was OK because I at least cope when I don't have the physical anxiety.

Well its day 6...
I had my bath yesterday and walked the dog but had a melt down when I got back, tears and pacing. I took a diazepam and sat and spoke with my husband for an hour about everything. We then went to the tip and the supermarket. Came home and the agitation started about 3 o'clock... I took the dog out again then came home and paced about. It eased off about 7 and I laid on the sofa and half watched some TV... went to bed about half 9 and slept through till 7 this morning. I have an iapt assessment phone call for online NHS therapy at 2pm today. So im going to try and keep busy today and hope its a bit better than yesterday. Everyone is at work so I'm on my own. My dad is off work but can't even go round because of covid.
Take care whoever is reading... Ava x

[Paradise10]

Good morning all...

Yesterday I got up and took the dog on a mile long walk round the park, It was so difficult but I dragged myself round. Then did some pottering round. Had my cbt phone assessment yesterday and she said I qualify so she has referred me and I should get my online appointment within 2 weeks. Had a video call with my friend for half hour. Then took the dog out again. Had a bit more energy on this walk and wasn't dragging myself. Felt a bit lightheaded when I got home but that could be lack of food as I only managed a ham sarnie all day. Had some cottage pie and a few grapes and half watched some TV with my husband. Went to bed but it took me a couple of hours to go to sleep. I did sleep through till 7 this morning though. I woke up and my jaw was jutting outwards. Its really strange, like its doing it on its own.
Today is day 7 so a full week done on the increase. Im going to get dressed soon and take the dog out... till later all. Ava x

[Paradise10]

Agitation is literally through the roof this morning. I am struggling to keep still. Have a mild headache and feel exhausted but can't stop moving. This is really hard!!

[Paradise10]

So the agitation cleared off after half an hour of moving from side to side... Did my mile walk this morning with the dog came home with a headache and felt tired. Laid down for half an hour but I was too awake to sleep and my anxiety was having none of it even though I felt exhausted. Pottered round for a while then went to Morrissons for some shopping. Went a bit t**s up after that. I was walking round Morrissions and I felt out of breath, also keep getting an ache round my left boob. I have had a funny left arm for ages, think it's a trapped nerve in my neck but ohhhh noooo not today. Decided it's Heart disease. It's like I have the same 2 or 3 symptoms but I cant decide what they are so I just keep going over and over and over it in my mind.
Think Im doing some jaw tensing and arm tensing.... I suddenly notice that my jaw is stuck out at an odd angle and my shoulders are up round my ears.
I have not googled so i'm quite pleased with my self.
Felt a bit zoned out at times today and had the anxiety all day. It's like an impulse in the tops of my arms that make them want to tense up.... What is this? Driving me nuts.
Ok rant over... Ava x

[Paradise10]

Hello day 8....
Yesterday was a difficult one but I got through it... had a couple of spells of agitation but I typed on here and moved around and they passed. Also had some health anx again but got through that too. Last night though was surprisingly calm. I cooked my tea and managed to eat some mince. Then I sat and watched TV. No anxiety or horrible feelings. Still had the thoughts but much easier to deal with when you are calm. Went up to bed about 10 but sleep wasn't happening... I laid there but then got really bad restless legs and felt itchy. Got up a couple of times and walked it off round the house and then tried again. Think I got to sleep about 1am. Its all back today though... lots of anxiety this morning and have a really heavy head and feel exhausted. Im going to make myself get up now though and take the dog out. My son is also at the dentist at 10.30...
Laters fellow veners. Ava x

[panic_down_under]

You seem to be experiencing some better periods which is a good sign, Ava. They should continue to grow in duration and become more frequent as the body adjusts. Hang in there. :)

[Paradise10]

Thanks Panic Down Under....
After my calm period last night, this morning was horrific, the worst its been up to now. I had to take a diazepam at half 9. I've spent a lot of the day on here reading success stories and others experiences on ven. It sounds like day 8 to 12ish can be really rough. Feel a bit spaced at the moment, quite a bit of nausea, headache, especially across my cheeks and down my nose. Still tensing my arms up too. I really can't imagine being normal again which is scary. I WILL keep going though. X

[Paradise10]

Day 9...
Yesterday wasn't great, the morning was especially bad, I had to take a diazepam. I did take the dog out but it wasn't as long as usual. I just wanted to get back home. Spent a lot of yesterday pacing and reading ven stories on here. Forced some breakfast down, but my mum cooked me a dinner at tea time but I found I was hungry and I ate all of it. I slept at my parents last night as I think I always think this is my safe place. Watched some TV with them and went up to bed about 9... took me quite a while to nod off though but i was fairly calm. I remember having 2 really vivid dreams last night though... one where I drove my car the wrong way off a cliff into water by accident, I remember getting out of the car and swimming to the surface. The second where I worked in a hotel. (I had a busy night while I was asleep lol) my dad brought me a cup of tea in bed this morning. Im quite shakey this morning and a bit queasy but its nicer waking up to people in the house as at home my husband starts work at 6 so I wake up on my own. I take my ven about half 8 in the morning and I've been noticing I get agitation and hot face flushes about 4.30 every day.
Fingers crossed day 9 is better than the others. Till later. Ava x

[panic_down_under]

I take my ven about half 8 in the morning and I've been noticing I get agitation and hot face flushes about 4.30 every day.

Because of its short half-life splitting the dose and taking half about 12 hours apart may smooth out swings like this, Ava. In theory this shouldn't happen with extended-release formulations, but it often does. In fact there is a strong case for split dosing with most ADs, but doctors prefer not to prescribe them this way because the more often patients need to take a med daily the less likely they are to take it. We can be a contrary bunch. :ohmy:

[Paradise10]

Thanks Ian, its so nice to have you on here answering my queries.

Well I have managed another day on the ven train... and what a journey! I surprise myself some days with the trauma I put myself through. Still getting the chest ache on the left side above and below my boob, yesterday it was heart disease, today its high blood pressure caused by the ven. Just had to stop myself buying a machine to check. I have a telephone review with my doctor on the 17th so If I'm still having these aches then, i will tell her. Did my mile walk this morning but it was difficult was really out of breath and my chest was aching. Came home and had my agitated hour. Popped home at lunch time to get some stuff then went out to pick my son up from college. Watched some TV with my son and I have put some tea in for when my mum gets in from work. Managed with no diazepam as well today. I'd say for day 9 I'm experiencing...

Increased anxiety
Periods of agitation
Arm tension
Jaw ache
Headaches
Nauaea
Sometimes feel a bit out of it.

Not eaten much today but I have felt a bit more hunger. Sleeping OK just taking a while to nod off.

[panic_down_under]

yesterday it was heart disease, today its high blood pressure caused by the ven. Just had to stop myself buying a machine to check.

The good news is SSRIs and some SNRIs and TCAs, including venlafaxine, are mild anticoagulants which may reduce the risk of heart attacks and ischaemic stroke (but may slightly increase it for the much less common haemorrhagic stroke).

[Paradise10]

Day 10... please someone tell me this is normal. I feel so ill this morning. Headache, feel sick, absolutely nothing in me at all to do anything. Just need to go back to sleep but anxiety won't let me, its through the roof. When do these side effects pass, surely they should have gone by now. I cant seem to make myself get up. Please tell me this is the worse before better. My brain won't stop. I'm petrified.

[panic_down_under]

When do these side effects pass, surely they should have gone by now.

Apart from possibly the headache, this seems to be mostly anxiety. Unfortunately, it takes weeks for the anti anxiety effects of dose increases to take effect and in the meantime ADs often ramp it up. The best thing you can do is to get up and keep active to give your mind other things to work on. Staying in bed allows it to focus on the anxiety and how crap you feel.

[Paradise10]

Thanks Ian... I did get up and get dressed. Had to take a diazepam about half 10 though. I'd be forcing myself to go in to work which I know helps but were not back till at least March due to covid.

[Paradise10]

Bad start to yesterday, felt so poorly when I first woke up and anxiety was through the roof, I did manage to go back to sleep till about 10 but had to take a diazepam when I woke back up. Not a great day but I got through it... picked my son up from college at half 1 the took him for a hair cut. I wandered round the shops while I waited for him which was difficult, although I did buy a jigsaw. Got back to my parents and did some colouring. My husband picked me up at teatime and we came home, he had put the tree up. We had dinner, watched some TV and I went to sleep about 10.45. Felt very strange last night. Can't really explain it. Had some health anxiety but didn't google. This morning is shakey, and I keep yawning and burping. Anxiety is there lurking under the surface ready to take over at any second. Body feels heavy and like jelly. Going to get up and put some more Xmas decs up.

Day 11 please be a better one.
Ava x

[Paradise10]

Just managed a shower and hair wash but wow what an effort... my whole body feels so heavy, like lead. Doing anything is such a huge effort and leaves me breathless. Is this depression? This is always what sats my anxiety off. I hate this feeling that things are an effort. I want to just get on with things like other people. Not sit procrastinating about it then having to force myself. This makes me frustrated then my anxiety kicks in. Always the same thing since my 20s. As soon as I get that heavy head and heavy body feeling and I have to force myself them bam im in anxiety hell.

[Paradise10]

Lebonvin... Ian has been a big help to me so I would prefer that you don't comment on my thread with stuff like that. It's you that is coming across as the idiot not Ian. You know the saying if you haven't got anything nice to say then don't say anything? Well I think you should bear that in mind.

So day 11 was a busy one, got up and forced myself in the shower. We got ready and went out... husband got a hair cut so I wandered round for a while, we went in a few shops then went into town. Got a few bits we needed then came home. Pottered round at home and put some more Xmas decs up. I had the anxiety all day but more under the surface and it couldn't break through to full on. Had some agitation spells too. Quite a bit of nausea and a headache for most of the day too. Was relatively calm last night but then I got some health anxiety which played on my mind for the rest of the evening. Was aching everywhere when I went to bed last night but fell asleep quite quickly and slept through till 8.30 this morning. Woke a bit out of it this morning but I think that is wearing off. Got the decorators coming at 11 and we need to pop to the blind shop and b and q today.

Day 12 today... let's hope it's a decent one.

[panic_down_under]

Just managed a shower and hair wash but wow what an effort... my whole body feels so heavy, like lead. Doing anything is such a huge effort and leaves me breathless. Is this depression? This is always what sats my anxiety off. I hate this feeling that things are an effort. I want to just get on with things like other people. Not sit procrastinating about it then having to force myself. This makes me frustrated then my anxiety kicks in. Always the same thing since my 20s. As soon as I get that heavy head and heavy body feeling and I have to force myself them bam im in anxiety hell.

So the heavy head and body feeling comes out of the blue and propels you into full blown anxiety, Ava? If so, does it come and go on its own, or only after treatment, how often does it come and have you noticed a recurring trigger, or pattern to its onset?

[Paradise10]

I've never noticed a trigger for it Ian, it just comes on... then I'm in full anxiety trying to figure out why. It does come and go on its own. Sometimes it last for days.

[panic_down_under]

I've never noticed a trigger for it Ian, it just comes on... then I'm in full anxiety trying to figure out why. It does come and go on its own. Sometimes it last for days.

I don't think it is depression. It might be anxiety related, but there are many other possibilities. Have you ever seen a GP during one and had blood, or other tests?

[Paradise10]

No I haven't but that would be a good idea. I always consult Dr Google... but... I haven't done this for 4 days now. I made a promise to myself I would never google symptoms again. Im starting one cbt on the 15th and I have a telephone doctors appointment on the 17th for a catch up since I increased my dose so I will ask her then. I have realised I need to change the way I react to things. I need to talk to family and then the doctor if needed rather than keeping quiet, consulting Dr google then worrying it all in my head.
Ian you are a massive help to me through this and I just want you to know I am thankful.
Ava x

[Paradise10]

So yesterday was manageable... kept fairly busy this weekend. Got up yesterday and went out with my husband to get a few bits. Went to b&q, home base, then went to sainsburys. Came home and we watched some TV, then had a Sunday dinner. Anxiety was fairly low level and bubbling under the surface all day and just peaked here and there due to my thoughts. Had another round of health anxiety. My mind is still in the same loop. Its like a washing machine with a few thoughts in there that just goes round and round all day. Still scanning myself all day for symptoms and have that uncomfortable feeling in my tummy like something is wrong and I just feel quite achey and unwell in myself. Anxiety won't go into a full on panic though like before so the ven is clearly doing something. Motivation is still low and everything is an effort. Just waiting for a parcel to arrive then im going to my parents this morning. Dads at work this afternoon though so I might come home and wrap some Xmas presents.

Day 13... incoming!!

[panic_down_under]

I always consult Dr Google... but... I haven't done this for 4 days now. I made a promise to myself I would never google symptoms again.

Good!! :) Dr Google is a quack who apparently can't tell the difference between a paper cut and terminal cancer, if HA forums are any guide.


Im starting one cbt on the 15th and I have a telephone doctors appointment on the 17th for a catch up since I increased my dose so I will ask her then.

I know it's still early days, Ava, but is the CBT helping?


I have realised I need to change the way I react to things. I need to talk to family and then the doctor if needed rather than keeping quiet, consulting Dr google then worrying it all in my head.

Yep. The squeaky hinge gets the oil. Suffering in silence never gets us anywhere.


Ian you are a massive help to me through this and I just want you to know I am thankful.

Cool. All part of the service...er...um...you did sign up for the super deluxe NMP package didn't you? :emot-giggle:

[Paradise10]

Yes I signed up for the bells and whistles service, ha-ha.
I dont know if the cbt will help as not started till the 15th. Worth a shot though. Im going to go back to work tomorrow I think. Im working from home but I think it will give me some structure back. Im sure it won't be easy but at least its a focus during the day as at the minute I'm just wandering round aimlessly which I dont think is helping.

[panic_down_under]

Yes I signed up for the bells and whistles service, ha-ha.

Oh, good. I'm having a new house built atm and every time I talk to the builder another zero gets tacked onto the price so every extra farthing helps :winks: I'm having an extra expensive chat on Friday :scared11: :weep:


I dont know if the cbt will help as not started till the 15th.

:oopsie: Sorry, misremembered. :doh: <--now you know why this is my avatar :sad:


Worth a shot though.

Definitely. Sadly, it never worked for me, but when it does it can make an enormous difference.


Im going to go back to work tomorrow I think. Im working from home but I think it will give me some structure back. Im sure it won't be easy but at least its a focus during the day as at the minute I'm just wandering round aimlessly which I dont think is helping.

No, it won't be. The less time an anxious mind has to ruminate the better. They're like 2yos, you need to keep them occupied/distracted or they'll spit the dummy, big time.

[Paradise10]

I'm not holding my breath with the cbt but can't knock it till I've tried it so I will give it a go.

Re the builder, tell him his payment is on the way from England, but what with covid and everything it may take awhile ;-)

[Paradise10]

Been a mixed bag today, came round to my parents this morning and was actually fairly chirpy ... I think it's the best I've felt up to now..
Walked to the shop for some stuff for my mum . This afternoon hasnt been so good though felt the anxiety creeping back in then it did go into full anxiety and I got the flushed cheeks. Tried to just keep busy and tided round and did some colouring, its eased a little but still there now. This is so frustrating, its like you get a glimmer of hope then it gets taken away. I have also had a headache for most of the day and get a weird nausea feeling after I yawn, which has been quite a lot. Also had some health anxiety again today.
I have spoken with my boss and I'm going back to work tomorrow, she knows why I have been off and she is very supportive and said if I need to leave early or go out for walks thats totally fine. I think the structure will do me good. Strange when I'd rather be at work than not! Bloody anxiety!!

Is this all normal for day 13 of an increase? I thought I would have seen more progress by now. Im worrying now that the ven won't work.
I guess I do know that 13 days isn't long enough but by God its frustrating!

[panic_down_under]

Is this all normal for day 13 of an increase? I thought I would have seen more progress by now. Im worrying now that the ven won't work.
I guess I do know that 13 days isn't long enough but by God its frustrating!

In as much as anything is "normal" with anxiety and ADs, yes it is and 13 days is not long enough for a dose increase is likely to become effective, except maybe throught the placebo effect. It could take up to 12 weeks, though 4-8 weeks is more likely. :sad:


Strange when I'd rather be at work than not! Bloody anxiety!!

Anxiety is clearly part of a capitalist conspiracy to keep peasants' noses to the grindstone. :chained: Viva da revolution!! :wacko:


Re the builder, tell him his payment is on the way from England, but what with covid and everything it may take awhile ;-)

It would probably get to him even quicker. Got a water bill last week that took 10 weeks to travel 50 km/30 miles. :mad: An arthritic snail could have delivered it in less than half the time! Sigh. So now I'm up for a late payment fee, plus interest at 6%. :curse:

[Paradise10]

Wow do snails get arthritis?

Well another day... Another headache!
Last night wasn't that good, only way to describe it is that I felt weird! I didn't feel like I was me anymore, it was really freaky. I didn't have the anxiety but I still felt really frustrated and wound up. Decided to go to bed at 9.15 as I was getting on my own nerves. Sleep was having none of it. I was pacing round the bedroom at 11.30 with really bad agitation. It was like I was tired but wired. It eased eventually and slept through till 7 this morning but the anxiety and agitation are back with friends this morning! I am exhausted and not sure how much longer I can keep going with this. I know it's meant to get worse before better but jeez come on it's day 14 now, feel free to ease up any time about now! I know I am getting stressed and frustrated that I am not seeing more progress. My doctor didn't want to see me till I have been on the increase for 3 and a half weeks so I guess I can't evaluate before then.
Back at work now and set my laptop up at my parents house so I have to get up and out the house in the morning. I am facing out of the window here, whereas at home my desk is in the bedroom facing the wall. Plus there are people about here rather than being on my own all day. Only got one video meeting today so not overly busy but i will catch up with all my team at some point today too so I keep busy.

Right then Day 14, Let's do this!!
Ava x

[Paradise10]

Well almost completed my first day 'back' at work. Anxiety has been bubbling away low level all day, manageable just annoying not spilled over into full anxiety or panic. I thought it was going to but it didn't. Had a few spells of agitation though where I have had to get up and move my legs, and jig about, this seems to come on at the same time that I get a yawning spell and lasts about 15 mins to half hour. Had one at 12ish then again about half 2 and just recently. Mind is still going round quite a bit though although sometimes I can cut them off. I am still scanning myself 24/7. Wicked arm tension though, I can't decide if it's me that is super tense or if the ven is doing it a bit like the jaw clenching. Had that horrible feeling in my tummy all day too...
Still getting the aches around the left side of my chest, back and my arm but I still haven't googled. I will ask the doctor on the 17th about them.
That's almost a week that I haven't googled symptoms for so I am pleased with that as I have been tempted.
These side effects can do one now though!!
Till tomorrow my Ven buddies (or lack of... Ha-ha) Ava x

[panic_down_under]

Wow do snails get arthritis?

I doubt it, which is fortunate as they are pretty much all foot.


I get a yawning spell and lasts about 15 mins to half hour

Yawning is a relatively common side-effect of all serotonergic ADs and especially the citalopram and escitalopram twins. There are several hypotheses with an increase in body temperature seeming the more likely trigger (serotonin is involved in thermoregulation through its effects on the blood vessels of the skin). It usually diminishes within weeks, but it lingers for some.


I can't decide if it's me that is super tense or if the ven is doing it a bit like the jaw clenching.

I suspect it is a bit of both, Ava.


Well another day... Another headache!

Do you take anything for the headaches, and if so have you noticed any change to the agitation, yawning, or other side-effect afterwards?

[Paradise10]

I tend not to take anything for the headaches, I take 20mg Nortryptline before bed which I have taken for a long time and what with taking the ven in the morning I am reluctant to take more pills. I'm not even sure why I am on the nort, I think it was to help me sleep before I started ven. To be fair I have never had a problem sleeping since being on them so maybe they help with that. Conversation with my doctor next week maybe, not even sure if I need to be on them. My doctor sorts out my meds but I have wondered previously if I would be better seeing a psych doctor. I did see one years ago and he kept asking me what I thought I should take, I kind of sat there and thought 'isn't that why I am paying you' I never went and saw him again. I know some people have strong views on what they should take but I don't understand the meds so I always think they are the ones trained to know.

Well Day 15... Into the third week now!
The current theme at the moment is..... Agitation!! I think it's replaced the anxiety. It's like the ven has given my body to much to cope with, I feel like any minute I am going to start running round waving my arms in air. Not quite manic but a feeling like I am about to burst!! My brain feels the same way, I keep singing in my head and I feel the need to keep talking to everyone. It's freaking me out. Are they maybe too activating? Should I give it more time? It's quite scary. I feel like I am going to go over the edge at any moment.

Went home last night after work and had tea but I felt like I really rushed it... The had to stand up and agitate all through Eastenders (TV programme for anyone not in the UK) Then just zoned on the sofa for an hour or so before I went to bed. Nodded off quite quickly and slept right through to just before my alarm.
Drove to work (at the parents) and sat here now at my laptop with another headache.

So going into week 3 i would say i am experiencing...
Reduced anxiety
Agitation
Headaches
Waking up feeling like I've done 10 rounds with Mike Tyson.
Loads of burping and the feeling that something in stuck in the middle of my chest. (indigestion maybe)

Got an online meeting now so I will catch up later.
Ava x

[Paradise10]

Good morning and welcome to day 16...

Yesterday was quite manageable and I am pleased to say there was no agitation dancing yesterday, it seems that the agitation side effect did indeed listen to me and buggered off!! Had low level anxiety all day, peaked a little bit about half 6 last night. I had to pick my son up from football and it cleared while I was doing that. I just sat and watched TV last night and went up to bed around 11.

Slept fine and woke just before the alarm this morning. Low level anxiety is bubbling but it's not spilling over into full anxiety and I don't seem to be getting the 'fear flashes' as I call them, at certain thoughts. Also have a bit of jelly legs today. Also no headache so fingers crossed all the side effects have passed now.
I guess I just feel unsettled now, like something is wrong but I don't know what, still tense too.

Is this the part now where I need to be patient and wait for them to work? I am not speaking to my doctor till the 17th so I will keep on with this journey and assess when I speak to her. I would say I am better than I was but not what I would call relaxed. Still wanting to keep burping too. Bit of frustration going on this morning.

Early days Ava, Early days! I will keep trucking on and catch up soon. x

[panic_down_under]

I take 20mg Nortryptline before bed which I have taken for a long time and what with taking the ven in the morning I am reluctant to take more pills. I'm not even sure why I am on the nort, I think it was to help me sleep before I started ven.

Hmmm. Nortriptyline at such low doses is usually prescribed for neuropathic and other forms of chronic pain. It isn't a particularly sedating AD so I'd be surprised it would be prescribed for insomnia when there are more sedating options such as mirtazapine. And I wonder why venlafaxine was prescribed instead of simply upping the nortriptyline dose to therapeutic levels for anxiety/depression. It was as likely to work as venlafaxine and you were already on it.


Is this the part now where I need to be patient and wait for them to work?

'Fraid so. :sad: It takes a while for the new brain cells stimulated into growth by the higher AD dose to reach full maturity and there is no way of speeding up the process. Plus, there may still be setbacks. AD kick-in can be the biological equivalent of playing snakes and ladders at times. But my observation is this is often a more positive sign than having a smooth uninterrupted lineal improvement which can owe more to the placebo effect than the med.

[Paradise10]

I don't know why they didn't increase the nort and started ven, I have been on Citalopram 4 or 5 times in the past but my doctor went for ven. She said she has had a lot of success with it so I just went with it.

Today has been a little more difficult than yesterday, was chugging along till about half 12 when I started getting the pains around my left side and in the middle of my chest and back. Was strange though as I could tell I was panicking but I could only feel it under the surface so the ven is clearly doing something as I think that would have been a full on panic episode previously. Still didn't like it though. Started getting really hot cheeks about half 2 and they are only just starting to cool down now. Oh and I must have burped about 40 times today! No mad anxiety or agitation just restless, shakey, a bit flat and very unsettled I would say. Went out and picked my son up from college at half 3 and we popped in the shop for milk and dog food, wasn't a panicked rush like last week so that's a plus.
I was so tempted to google to see if my pains were indigestion but I didn't. I'm really proud of myself with the google thing as I google everything usually, I haven't even been googling venlafaxine or anything.
Going to wrap some Christmas presents tonight to keep busy.
Till tomorrow... Over and out. Ava x

[Paradise10]

Morning 17, it's a wet, windy and grey day here in Yorkshire!
Didn't wrap the Christmas presents last night, I had really bad stomach ache and the pains again last night.... Had some dinner, then just laid on the sofa watching TV. Felt quite unwell. I fell asleep straight away last night. I don't know if I am causing the pains as when I tense up I am holding my stomach in, so I guess it would make sense that it will all hurt when I have been doing that for a while. Woke up this morning and feel a bit rubbish. I have a bit of a cough and my head feels stuffed up. Just feel under the weather and that i had another boxing match yesterday. Anxiety is under the surface but I would say I feel tense and aprehensive rather than anxious. I am coping better though and functioning again but nowhere near right.

Work is calling so have a good day all. Ava x

[Paradise10]

Morning all... another day completed on the ven train. Was quite unsettled yesterday, still having the anxiety but it doesn't go into a full on panic now like it used to. I dont know if I feel low or just completely wiped out. Doing things is a huge effort, I feel like I weigh 40 stone and I'm having to heave it all around. I know I need to lose some weight but general walking round the block and housework shouldn't be this hard, surely? I feel awake but tired at the same time. I have no motivation what so ever, I think that buggered of with the side effects. Managed work ok but the headache made an appearance about 12 and on cue the hot cheeks turned up at 2.30. Went to get my hair cut at 4 and I could feel myself getting wound up while I was in there, this feeling stayed with me while I went to pick my son up from football and it went about 7. Had a fairly calm evening after that and just watched some TV. Im quite irritable and snappy at the moment and I have no patience. Fell asleep quite quickly again but woke this morning drenched in sweat... thats a new one! Got up and put some washing in and made myself take the dog out. Husband is due home from work in about an hour and we are emptying my sons bedroom today ready for painting. I guess I should go and force myself to do something or I will just sit here thinking. My mind isn't racing but its constantly thinking about all this 24/7 still and I'm obsessed with how I feel.

Somehow and some way I will get there as giving up isn't and will never be an option for me! The one thing I will say to anyone suffering with anxiety or even depression is dont ever think you are weak or not courageous. We endure and face so much more than anyone who hasn't experienced anxiety. I am literally the strongest person I know. Things may hurt, things may be crap, things may be scary but they will never stop me trying to get better. Please always believe how strong you are, even when you don't feel it.
Take care all. Ava x

[Paradise10]

Yesterday wasn't to great to be honest... it's like one thing goes and another appears in its place. Took the dog out yesterday morning, but cut it short as I was exhausted. Pottered round at home then started clearing my sons bedroom ready for decorating. It was taking that much effort and I felt so rubbish that I broke down in tears. First time I'm cried for a few weeks, don't know if I'm feeling a bit low at the moment. Went out to tip and did a few jobs, was waiting for the hot face to appear but it didn't. I feel quite emotional at the moment. Watched TV last night and then nodded off quite quickly.

Day 19 today... husband woke me up but I really didn't want to get up, feel like I could stay in bed all day. I think I am jaw clenching in my sleep and tensing my body up too... I woke up with a headache which is also across my cheeks, my arms ache as does my whole back. I just feel done in. I'd say its gone up to now...

Week one... not too much change, extra anxiety started to hit towards the end, took longer to get to sleep. Headaches and burping.

Week two... a lot of increased anxiety, a lot of agitation, took longer to get to sleep. Headaches and burping.

Week three... reduction in overall anxiety. Agitation went. Feeling low and tired and everything is an effort. Headaches and whole bodyaches. Falling asleep quickly. Feeling of being generally unwell.

Do you think this is normal for where I'm at?

Decorator is coming soon so I guess I should get out of bed and get dressed.
Day 19... let's do this!! Ava x

[panic_down_under]

Do you think this is normal for where I'm at?

I wouldn't use the word 'normal' for anything that happens when first taking an AD, or increasing the dose, Ava, but it is not unusual. SSRIs are better anti anxiety than anti depressive meds so anxiety tends to ease before depression and depression can be a side-effect, or deepen at the beginning, or following dose increases. Just part of the 'fun' of the antidepressant experience. :sad:

The better news is that at 4 weeks you're now into the kick-in time frame. It may still take a few weeks, but it could happen tomorrow. Only time will tell.

[Paradise10]

Well it's day 20, almost reached the 3 week mark!
Yesterday was the same as Saturday really but without the crying. Pottered round at home and then went to the shop for some food, the decorators came and I did some ironing. Then wrapped some Christmas presents last night as we have so much to wrap and nothing started so thought I should rather than that I wanted to. Still having to force myself to do everything otherwise I would just sit playing mindless games on my phone.
I found a journal the other day of when I increased ven before and it said that I had been on the increase just over 3 weeks and my anxiety in general was slightly better that I was tense a lot of the time, that I had no energy and that everything was an effort. So it seems this is normal maybe? I never wrote in it again after that so can't see how long it took.

I find I am getting a lot of frustration, it's like a tension building inside but never peaks or spills into anxiety. Also getting stomach ache and still burping left, right and centre! Still getting the pain in my left side which is winding me up but I have my doctors review on Thursday so will mention the issues I am having with my doc. I start my CBT tomorrow too.

I was always a citalopram girl and have been on and off it numerous times in the past at 20mg, and the one thing I would say with ven is that it has never lifted my mood. Cit helped with the anxiety then my mood lifted and I sorted out the rest. Whereas ven does help with the anxiety but has never lifted my mood, I wonder if that's because I need a higher dose or it's not the right med? My anxiety returned when I was on 20mg of cit and I increased to 30mg but it sent me manic, I kept going for 2 weeks but it wasn't stopping so my doctor lowered it and we swapped to ven.

Back working at my parents today and I was completely zoned out on the video call this morning. I feel like I've been beat up by 20 people (most likely being dramatic there, maybe just 2 people) as I ache or hurt nearly everywhere.
Got to go out at lunchtime and get new blinds for my sons bedroom and I am putting my parents Christmas tree up this afternoon. (Don't tell my boss.)

Take care all. Ava x

[Paradise10]

Ok so my upper body muscles are constantly tensed and as soon as I relax them they tense straight back up. My back and arms are so painful. I've had to have a bath and come to bed I hurt that much.. Will this wear off as this is becoming a nightmare?

[panic_down_under]

I found a journal the other day of when I increased ven before and it said that I had been on the increase just over 3 weeks and my anxiety in general was slightly better that I was tense a lot of the time, that I had no energy and that everything was an effort. So it seems this is normal maybe?

It's not a general characteristic of venlafaxine, but it may be one for you.


I find I am getting a lot of frustration, it's like a tension building inside but never peaks or spills into anxiety. Also getting stomach ache and still burping left, right and centre! Still getting the pain in my left side which is winding me up but I have my doctors review on Thursday so will mention the issues I am having with my doc.

A good idea, imo.


I was always a citalopram girl and have been on and off it numerous times in the past at 20mg, and the one thing I would say with ven is that it has never lifted my mood. Cit helped with the anxiety then my mood lifted and I sorted out the rest. Whereas ven does help with the anxiety but has never lifted my mood, I wonder if that's because I need a higher dose or it's not the right med?

It could be either, or both. There's no way of knowing except by ramping up the dose and seeing what happens, unfortunately. :sad:


My anxiety returned when I was on 20mg of cit and I increased to 30mg but it sent me manic, I kept going for 2 weeks but it wasn't stopping so my doctor lowered it and we swapped to ven.

This is fairly common. An AD, especially a SSRI, may become progressively less effective every time it is stopped and restarted, often requiring higher doses to achieve the previous level of control, or not working at all. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123793/), 2016 and Amsterdam JD (http://www.karger.com/Article/FullText/226611), 2009, found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC (https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30041180/), 2018; Amsterdam JD (http://www.ncbi.nlm.nih.gov/pubmed/18694599), 2009; Leykin Y (http://www.ncbi.nlm.nih.gov/pubmed/17469884), 2007; Paholpak S (https://www.ncbi.nlm.nih.gov/pubmed/12501907), 2002). In light of this it may be better to remain permanently medicated if anxiety and/or depression keep reoccurring. That is what I chose to do after having to go back onto meds for the third time, although way back then the tolerance problem was unknown. I just didn't want to go through the whole side-effects drama over and over.


Got to go out at lunchtime and get new blinds for my sons bedroom

Good luck with that. I spent much of last Friday going around in circles over blinds with one of my builder's 'interior designers'. I may as well have been talking to one of their brick walls. I might try repeatedly headbutting one next time - wall that is, not designer...although... :winks: At least I'll get the sense of relief when I stopped. Sigh! :wacko:

[Paradise10]

Sounds like the house renovation is going well Panic Down Under! Ha-ha.

Well 3 weeks today, a whole 21 days I have done up to now on this increase. Still plodding along. Hot cheeks turned up on cue today at 2.30, I actually knew the time before I looked at the clock. Not in so much pain today from aching muscles so the hot bath must of helped a bit. Had a busy morning at work then I had my first Online CBT session, not really sure what to make of it really, she asked me what causes the anxiety... I never seem to explain it very well but I think she has a bit of an understanding. That took up most of the session. She has sent me some stuff to read through and a video to watch before our next session in 2 weeks. I will keep on with it and see how it goes, but I'm not holding my breath.
Had to go get some Nexium at lunch time as this burping, stomach ache and uncomfortable feeling in my chest is driving me nuts, not sure It's done much good though. It said in the leaflet with it that you can't take it with Citalopram or Imaprime (or whatever It's called) or Diazepam, never said Venlafaxine and I haven't taken a diazepam for well over a week now so I'm guessing I was ok to take it.
No crazy anxiety just the same under the surface low level anxiety all day that seems to ramp up a bit late afternoon for a few hours and then settles.
Work is very quiet this afternoon so I'm looking around to keep busy, I have a busy day at work tomorrow though so that's good.
Take care all, Ava x

[Paradise10]

Good morning all, well yesterday was another mediocre day, seem to follow a bit of a pattern. Mornings are a bit shakey and it's takes me ages to muster up the effort to get ready. I'm not bothering with doing my hair or makeup, I'm just shoving my hair in a bun. I have a shower before bed so I just brush my teeth get dressed and I'm out the door. Had my CBT yesterday, popped back to the blind shop as I only ordered one room and was meant to do two. Got home last night and went to Sainsburys by myself, Didn't feel great but had a wander round and got some food shopping. Had tea and watched some TV last night. Went to bed about 9.30 and had some health anxiety while I was laid going to sleep due to the pains in my side and the stomach ache.

Woke this morning, another headache... still got the stomach ache and pains in my side and still wanting to burp constantly. Took my ven a little later today after breakfast to see if that helps. Found another journal yesterday (that's why I'm keeping it in one place on here this time) and it seems there were a lot of ups and downs on the last increase and it was 8 weeks before I wrote that I was feeling ok so I think I need to keep going at this dose till at least then before I consider an increase. I'm going to mention the pains and burping to doc tomorrow at my review but ask for another ven review in a few weeks. I might also look to reduce and come off the nortryptline after Christmas too as I'm not sure that's even doing anything.

Not really anything else to report so I will just carry on as is.
Ava x

[panic_down_under]

Had to go get some Nexium at lunch time as this burping, stomach ache and uncomfortable feeling in my chest is driving me nuts, not sure It's done much good though. It said in the leaflet with it that you can't take it with Citalopram or Imaprime (or whatever It's called) or Diazepam, never said Venlafaxine

Nexium (esomeprazole) slows the rate at which citalopram, imipramine and diazepam are metabolized which may increase their blood levels. That could be an issue with citalopram at its maximum dose, less so with the other two. Esomeprazole has a very short half-life, about 80 minutes so even with citalopram this is unlikely to be a significant problem with a single dose, but taking esomeprazole regularly for some days might raise citalopram plasma levels enough to trigger side-effects.


I might also look to reduce and come off the nortryptline after Christmas too as I'm not sure that's even doing anything.

Probably a good idea, although there is a chance it is having a positive effect, Ava. In the days before SNRIs were readily available nortriptyline was sometimes prescribed with a SSRI, usually sertraline, to create a bespoke SNRI. Many of the old time psychiatrists still prefer this to prescribing SNRIs because their short half-lives often creates both severe initial side-effects and withdrawals. I'd also wait until the side-effects you're currently experiencing settle down so there is less risk of confusion between them and any withdrawal symptoms from discontinuing the nortriptyline. Withdrawal from TCAs is usually less severe than from SSRIs/SNRIs, but there are always exception to prove the rule, so... I'd cut back in two stages dropping the dose to 10mg for two weeks.

[Paradise10]

Afternoon all, I hope you are well.
Not much stomach ache and burping yesterday so fingers crossed that was just a side effect which is starting to pass, or the Rennie Deflatine (god knows if that's how you spell it) is working. Felt a bit low yesterday afternoon and evening but went and picked my son up from football training last night and watched some TV, there were a couple of times yesterday where I almost cried so think I must be a bit emotional too. Took about an hour to nod off last night but I was calm laid there waiting. Same morning as usual where I just couldn't be bothered to do my hair or makeup, still very low anxiety and stomach feels like there is something wrong. Still having really achy arms and fingers which must be tension. Spoke with my doctor on the phone this morning, she thinks the tension is me and some of that tension is what is causing the pains, she said because I am anxious I am constantly scanning myself to see how I feel. She was right to be honest.

She has said to stay at the 150mg ven for another 4 weeks and we will review it then, but surprisingly she has increased my Nortryptline to 30mg to see if that will ease the tension. She thinks I am getting tense in my sleep as well and that's why I am waking up with sore muscles and headaches.
I agree with leaving the ven for another month as it was 8 weeks last time so that will bring it to a similar timeframe. Not sure on the nort but she's the doctor not me so I will go with it. I don't usually get many side effects with the nort, only a spacy feeling the first couple of mornings and a dry mouth for a couple of weeks so it's worth a try I guess. Prescription will take a few days so I will have a think when to do it.
I have all the things I want to say to the doctor, then when I am on the phone with her I just agree to everything. She does seem to really know about these kinds of meds though because she mentioned Olanzapine to me once before as a potential add on which I declined as the though of it scared me, I didn't realise doctors could prescribe that kind of thing, I thought it was just P Docs. My husband once said to me if you are going to question your doctors decisions what's the point in seeing them, I think if you have a doctor you can trust then that's true and I do trust her. My old doctor retired a couple of years ago which is a good thing as I had a lump on my leg which he kept freezing for 3 years, he finally referred me as it started bleeding. It was a sarcoma and luckily for me it was slow growing and I have now been in remission for 2 and a half years. Bizarre as I never had one worry over that lump, not one bit of health anxiety in the whole 3 years I had it. Whereas I get a bit of a cough now and think I must have something really serious.

I hope anyone reading and is on ven or any other med is doing well and I'll update soon.
Ava x

[Paradise10]

Afternoon all... Day 24ish I think, so around 3 and a half weeks. This is a long and frustrating journey and sometimes it feels like one step forward and 2 steps back.

Went home last night and had to mop my sons rooms and peel all the transfers off the walls ready for the painters today, I felt really unwell again last night so it was quite difficult getting it done, only managed half my tea as i felt quite sick. I feel like I have a stomach bug. I am having various symptoms (which I don't think are caused by the ven) and some that maybe are but they are making it very difficult for me to keep busy as I feel so unwell.

I am experiencing...
Stomach ache and nausea but I haven't been sick.
Pain in my sides around what I think is the kidney area.
An ache in a C shape around my left breast.
An ache in the centre of my chest, cough and constant burping.

These things are coming and going but make me feel quite unwell when I have them. The one positive is I have not googled any of them as I know that will leave me with more questions and will scare me even more, so however difficult it is, I will not google. It's been around 3 weeks nearly so I'm not going to break it. Because of the anxiety, I feel every twinge so I know I am more sensitised at the moment. The problem is sitting and doing nothing doesn't help with my anxiety, but making myself do things when I feel so poorly make me anxious... Can't bloody win sometimes.

I would say the ven in helping me physically as in it is stopping me going into full anxiety and panic. I'm not freaking out and pacing about anymore. It isn't helping with the low level simmering anxiety that lasts all day and it isn't helping me mentally either I would say as I am still thinking about it all 24/7 and it hasn't lifted my mood at all. To early maybe?
Still getting the odd headache and am very tense too. It does help me writing it all down here though as I don't seem to be able to talk about it very well.
Oh well I'll keep on keeping on... Till next time. Ava x

[panic_down_under]

She has said to stay at the 150mg ven for another 4 weeks and we will review it then, but surprisingly she has increased my Nortryptline to 30mg to see if that will ease the tension.

This is a decision that I suspect could have gone either way. I'm not a fan of poly-pharmacy, taking several meds when one could probably do the job, but given you are already on 2/3rds of the dose and significant side-effects from the modest dose increase are unlikely it's worth a shot.


I would say the ven in helping me physically as in it is stopping me going into full anxiety and panic. I'm not freaking out and pacing about anymore. It isn't helping with the low level simmering anxiety that lasts all day and it isn't helping me mentally either I would say as I am still thinking about it all 24/7 and it hasn't lifted my mood at all. To early maybe?

Afraid so. But you must be getting close to a solid kick-in. At least all the signs are positive, Ava.

[Paradise10]

Afternoon, it will be 4 weeks tomorrow on the 150mg dose.
Been pretty up and down this weekend. Saturday wasn't that good, I had a really busy day. Had to drop the dog at the groomers at 8.30 then was at the hairdressers for 9am. Got home and had to do two tip runs and lots of sorting out. I was quite stressed with it all. Yesterday was a little better. I sat and wrapped presents for most of the day, then put a few bits up in the loft. Went and dropped the presents of my parents doorstep ready for Christmas day.
Today has been fairly difficult... I am back working at home as we have parcels arriving and someone needed to be in for them. I feel quite wound up today. There are loads of things I could be doing but I just can't seem to make myself start them. I am getting impatient now and just want to feel better. I go to sleep every night thinking tomorrow could be the day that they kick in fully... Even though it took 8 weeks last time.
Here's hoping!! Ava x

[Paradise10]

Hi, I hope everyone is well. Today is 4 weeks exactly on the 150mg.
Yesterday wasn't that great, anxiety was higher than it has been for a while and it carried on all evening too. Tried to keep busy and I built my sons new wardrobe and put all his new bedding on. Went to bed about 10 as I was fed up with it all. Today has been a bit better. Back to simmering low level anxiety all day. Went into work this morning so that was an hours drive as I needed to pick a few things up. Then got my nails done and went to pick the blinds up I had ordered for my sons bedroom. So it's been a busy day. Still constantly checking how I feel though and thinking about it 24/7. Things are still an effort and I have very little interest or enjoyment. I feel like I could eat and eat at the moment which isn't a good thing. I get very frustrated at the way I am feeling and wish these would kick in. I feel like I'm there just waiting to be me again but it's just not happening. It's like waiting for something that you don't actually know is going to happen. I think I am doing all the right things though, I am still working and also keeping busy. Woke up this morning with a headache again and all my shoulders, neck and back ache which must be the tension. The hot cheeks turning up at 2.30 has me sussed out and decided to turn up at 11.30 today.
I'll keep going as tomorrow could be the day the light goes back on.
Ava x

[panic_down_under]

I think I am doing all the right things though, I am still working and also keeping busy.

I think you're doing much better than you think you are, Ava. I usually spend the first 4 weeks in a daze when weaning onto an AD. Unfortunately, ADs work to a rhyme and rythm of their own and no amount of willing them to kick-in seems to have any effect. Sometimes just going with the flow may be the better tactic.

[Paradise10]

Yeah I think you are right Panic Down Under, they will work only when they are going to and not before so I'm just trying to keep busy and go with it.... Doesn't stop me getting frustrated though.

Lost of count of the days but it's four and a bit weeks, last night was probably the best night I have had up to now... Was working yesterday and kept myself busy doing jobs at home to get ready for Christmas. Same effort and low level anxiety all day. Last night I went to pick my son up from football and got home and was still wrapping a few presents and pottering quite happily. Had no forcing to get in the shower last night it was just easy. I wasn't 100% but I felt like I was getting somewhere. Today however is back to forcing myself to do everything and low level anxiety again... Also feel quite a bit of nausea today. Oh well, hopefully those times will become more and more. I am happy to report that the stomach ache and burping have now been gone for a few days. I also still haven't googled. This is one of the best things I have done, even though it has been difficult. I know it has stopped me from a lot more anxiety and going down stupid roads of though worrying about all sorts.
Got the two older kids home from uni today so It's takeaway and games night which we always do on Christmas Eve, then we are going to my parents tomorrow for Christmas dinner and presents. The positive is that I am better than I was 4 weeks ago so I know I will cope OK.

Panic Down Under I hope you and anyone else who may read this have a lovely Christmas.
Take care, Ava x

[panic_down_under]

Panic Down Under I hope you and anyone else who may read this have a lovely Christmas.
Take care, Ava x

A belated Merry Christmas, Ava. May the New Year treat you and yours kindly.

Take care

Ian

[Kalie galea]

How are you feeling today I started venlafaxine 16 days ago 37.5mg for five days upped to 75mg for a week then upped again to 112.5mg for 4days I was on citlapram 20mg but it stopped working upped to 30mg and still didn't do nothing so switched to venlafaxine I've suffered anxiety and panic attacks for over 20 year always been managed with medication but 3 weeks ago I got tested positive for covid I broke down I was saying I'm going to die since then my panic attacks and anxiety has been through the roof i have numerous ambulance call outs a visit to er had bloods ecg and xray done all came up perfect yet I'm still suffering from the anxiety and attacks constantly thinking about not being able to breathe that something is seriously wrong with me that I'm dying like I feel so I'll like something's wrong I take a dizapam if a night time to go asleep but every morning I wake up between 3 and 4 straight into thinking I can't breathe I'm worried this is me now that I'm never going to feel normal again feel like something is seriously wrong took another test came back positive again that sent me in another panic thinking whys it still in my body is it going to make me get worse again although my symptoms have now gone I know it sounded silly but I wanted to get a test to say negative to then maybe jog my mind back to how it was to say I'm ok but when it came positive again I don't know just thinking I'm going to just stop breathing or my heart is going to stop beating that I'm going to end up in hospital that I'm dying is so exhausting I just want to feel me again 😪 worried I'm not going to feel myself ever again

[panic_down_under]

How are you feeling today I started venlafaxine 16 days ago 37.5mg for five days upped to 75mg for a week then upped again to 112.5mg for 4days I was on citlapram 20mg but it stopped working upped to 30mg and still didn't do nothing so switched to venlafaxine

...I just want to feel me again 😪 worried I'm not going to feel myself ever again

I'm sorry that you're going through this. :sad: Unfortunately, antidepressants (ADs) take time to begin working. They have no direct effect on anxiety, or depression in the way, say, aspirin has on a headache, but work by stimulating the growth of new brain cells in the hippocampal regions of the brain (neurogenesis). It is these new cells and the interconnections they forge which provide the therapeutic response and they take time to bud, grow and mature. As you've been on ADs before it may take venlafaxine longer to kick-in than previous ADs did.


I take a dizapam if a night time to go asleep but every morning I wake up between 3 and 4 straight into thinking I can't breathe

Diazepam and the other benzodiazepines (BZDs) are not good long term sleep aids as the sedative effect wears off quickly. There is also strong *evidence that BZDs significantly reduce the effectiveness of antidepressants by inhibiting hippocampal neurogenesis (don't stop taking the diazepam until you've discussed it with your GP). Small doses of the very sedating AD mirtazapine might be a better option. Its sedative effects may also help you better cope with the great fear you're experiencing because of Covid until the venlafaxine kicks-in.


* see: Boldrini M (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374628/), 2014; Nochi R (https://www.ncbi.nlm.nih.gov/pubmed/23963779), 2013; Sun Y (https://www.ncbi.nlm.nih.gov/pubmed/23639432), 2013; Song J (https://www.kurzweilai.net/how-the-brains-stem-cells-find-out-when-to-make-new-neurons/comment-page-1#comment-96481), 2012; Wu X (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(09)00106-1/abstract), 2009; Stefovska VG (https://www.ncbi.nlm.nih.gov/pubmed/18991352), 2008)

[Kalie galea]

Thank you for your reply how long did it take yours to start kicking in

[Paradise10]

Hi Katie, I'm so sorry you are suffering like this... I am coming up to 5 weeks tomorrow on the 150mg dose, and while I am not there yet my anxiety is reduced from what it was. You ate most likely in side effects window at the moment, it really ramped my anxiety up from about day 4 to 14. Just remember you can breath, you will always get enough air, its just anxiety. You have also been checked out at hospital so you need to remind yourself its just anxiety and it will pass. As Ian said these tablets don't work quickly as it takes time for the new brain thingies to grow. It took me 8 weeks previously before I felt somewhat back to normal so I have another check in with my doctor on 14th Jan to see if I'm happy on this dose or if I need to increase again. Writing on here has really helped me, especially when I was at my worst and Ian has and still does help me enormously when I have questions or worries about my medication. Have you told your doctor how bad you are feeling, and that you are not sleeping through? He might be able to prescribe a sleeping aid rather than diazepam. I did use 5 or 6 diazepam when the side effects ramped up but I haven't needed it for a few weeks now. I am also having online cbt but I have only had one so I cant say if that will help yet.
I will update on my last couple of days tomorrow as im on my phone and not laptop at the moment.
Take care, Ava x

[panic_down_under]

Thank you for your reply how long did it take yours to start kicking in

I don't take venlafaxine, but one of the older tricyclic class antidepressants (TCAs), Kalie. I've been on it continually for about 26 years after switching from another TCA. I was taking the previous AD for the third time and from memory it took around 9-10 weeks to kick-in that time.

[Kalie galea]

Thank you so much for your reply where I'm always waking up between 3 and 4 I'm ending up falling asleep around 5pm which I did last night and I then woke up at 1pm I took a dizapam hoping to fall back to sleep which I manage to until 3.40 but the moment I wake up to my heart racing that bk thinking I'm unable to breathe and I just don't know why it keeps happening im constantly thinking about stopping breathing and ending up in hospital and I just don't know why I'm always thinking that the pass 2 days I've also been waking up with a headache it gets so exhausting all this thinking I'm dying lark just want to be my happy self again I've also been prescribed promethazine for the sleep I've had 10mg and would sleep for a few hours then up again this time they have prescribed me 25mg but because I heard how dizapam sends you straight to sleep I kind of just took that one for the past 4 nights I'm so worried that this is me now how I'm going to o be stuck like this forever

[panic_down_under]

the moment I wake up to my heart racing that bk thinking I'm unable to breathe and I just don't know why it keeps happening im constantly thinking about stopping breathing and ending up in hospital and I just don't know why I'm always thinking that the pass 2 days

You've had a big shock because of Covid-19 which can affect breathing and your mind seems to have fixated on that. And anxious mind in full flight can be terrifying.


I've also been waking up with a headache it gets so exhausting all this thinking I'm dying lark

Venlafaxine may be causing, or contributing to the headache. Serotonin has many functions in the human body in addition to being a brain neurotransmitter and one of these is regulation of blood vessel tone, constriction and dilation. SSRIs and SNRIs may interfere with this initially and one of the side-effects can be headaches. The body usually adapts fairly quickly. Paracetamol (acetaminophen) usually works well and is preferable to aspirin and other NSAID painkillers.


I've also been prescribed promethazine for the sleep I've had 10mg and would sleep for a few hours then up again this time they have prescribed me 25mg but because I heard how dizapam sends you straight to sleep I kind of just took that one for the past 4 nights

Promethazine (Phenergan is a sedating antihistamine often prescribed for insomnia and it a better option than diazepam, imo, if it works for you as it doesn't inhibit the neurogenesis mechanism by which ADs work.


I'm so worried that this is me now how I'm going to o be stuck like this forever

You're not going to be like this forever, however, there are no quick fixes. It is going to take a while to regain control.

[Kalie galea]

Thank you again panic down under for your reply I've took a paracetamol and my headache has now gone it seems to be when I take a dizapam I wake up with a headache don't help with 4 young children also to add to it 😆tonight I'm going to try the promethazine rather then the dizapam and see how I get on with it thank you for your positive message

[Paradise10]

Hi Kalie, how did the promethazine work rather than the diazepam? Did you sleep better? Managing 4 young children with all this going on must be really difficult, do you have help? I have 3 of my own but the youngest is 16 so they tend to just get on with things themselves these days, apart from being the bank of mum and mum's taxi service ha-ha.

Well the last few days have been pretty much of the same as was... Anxiety is highly reduced, tends to ramp up a bit over tea time (4-7pm) but apart from that very low level. I'm still scanning myself and thinking about it all though. Energy levels are quite low and I think I could sleep for England at the moment. It's like everything has slowed down, including my brain. Feel quite sluggish and things are still a massive effort. I am very tense a lot of the time too and don't relax fully. I could just sit and play mindless games on my phone 24/7. Despite this I am still pushing myself and keeping busy.

Christmas Eve was a games night as we have the two older kids home for Christmas, then on Christmas Day we went to my parents for the day. I coped fine and enjoyed the day as much as I could. Boxing day was quiet and we just watched TV for a lot of the day in our PJs which I found quite difficult. Yesterday I went into town with my husband to spend some of my Christmas money. Again it was a struggle but I coped OK and got some new clothes.
Feel very flat at the moment, not happy but not sad. Not emotionless though either if that makes sense.
My CBT therapist asked me to watch a video by Russ Harris called 'The Happiness Trap' which I watched this morning, it was quite interesting to be honest. I have my second online session with her in 5 mins so I will update later.

I do hope you are all doing OK and keep going Kalie, keep posting on here as it does help.
Ava x

[Kalie galea]

Thank you ava for your reply I managed to fall asleep with it I woke up thinking I couldn't breathe and heart racing but I didnt go into a full blown panic then I started thinking why am I feeing like this I thought I was getting better as yesterday was a ok day and I kind of felt like I was here no derealization I checked my sats they were a 99 percent but chest felt tight I was thinking that I'm dying that I'm not going to see my husband kids and mum and dad anymore felt this time it felt real I literally ended up crying I look around and see so many ppl happy and I feel so lost and sad I'm sick Nd tired of thinking every day I'm dying that my heart is just going to pack in and stop beating or I'm going to stop breathing thinking no surely this can't be anxiety and panic attacks I can't feel like this 24/7 it's so exhausting thinking are my tablets going to start working or Ami going to be like this for ever this has been the worst for 23 days since that positive covid result even tho my symptoms behave now gone I'm still worrying is it still in my body because it still came back positive a week ago that I'm going to end up in hospital even tho I have no symptoms now and it's been 23 days I just can't seem to switch my mind off.
I'm so happy for you ava that now your anxiety is really reduced it's a total beast and so horrible and that your managing to do things even if you are struggling do you have the same feelings and thoughts as I do or are yours different and your right it really helps to write on here.thank you so much

[panic_down_under]

even tho my symptoms behave now gone I'm still worrying is it still in my body because it still came back positive a week ago that I'm going to end up in hospital even tho I have no symptoms now

Buy yourself a packet of balloons and every time the anxiety demon tells you Covid is coming back and especially when you think you can't breath, blow one up. Anyone at death's door because of Covid couldn't get enough air into a balloon to smooth out the wrinkles.

[Kalie galea]

Thank you that is a fantastic idea I'm going to try this one

[Paradise10]

Kalie, I don't get the same thoughts as you as I haven't had covid but regardless of what the thoughts are they are still fuelled by anxiety. I get anxiety when I don't feel well and i don't know why, I then start googling and make myself more anxious. I haven't googled now for a month and it's helping. The balloon idea that Ian suggested is a great idea and worth a try. I've found ven quite a slow acting med and it was 8 weeks previously on the 112mg dose before I felt better so you are still early days. Keep going you will get there.

Very up and down at the moment, yesterday was OK, didn't really do much but I managed alright. Today has been difficult though. Felt a bit sick today and really felt like I was dragging myself around. Took me ages to wake up properly this morning. Went out with my husband this morning to get a few bits and then went into town with my youngest this afternoon as he wanted to swap some trainers he had bought. I struggled through most of it.
My CBT therapist has given me a sheet I have to fill in where I have to put a task in morning, afternoon and evening each day and I have to fill it out for the week beforehand. The tasks have to be things I used to enjoy like baking, things with other people (i did try telling her we are in a pandemic) and things that involve a form of exercise. So tomorrow, the morning task is to do my hair and make up, the afternoon is to take the dog out and the evening is family games night. I have to do all of them regardless of how I feel then put a rating next to them. I've planned a full 7 days so I will give it a go, although I think I already make myself do a lot.

Kalie, Ian and everyone else I wish you all a Happy New Year as I doubt I will get on tomorrow.
Take care, Ava x

[Kalie galea]

Thank you so much Ava for your reply anxiety sure is a beast altho your struggling while you out the main thing is you still go out no matter if you struggle your strength is inspiring I really think I would benefit from some CBT it never worked years ago but it's been over 10 years since I tried so wouldnt harm to give it another try I hope you continue to make improvements and overcome the demon I wish you a happy new year and may it bring you lots of happiness x

[Paradise10]

Kalie I got cbt through self referral with iesohttps://www.iesohealth.com/en-gb
Link for you, it was really easy and I got an appointment within 2 weeks. My doctor told me about it.

You are strong too, anyone who suffers anxiety is strong, you may not feel it but you are. X

[Paradise10]

Ok so tomorrow will be 6 weeks on the 150mg dose... While I feel better than I did and the anxiety is greatly reduced I can't say that I feel at 100%. I'd say more like 75%. I have yet to start the increase of the Nortryptline up to 30mg. For some reason I keep putting this off, I think it's because I don't want to knock the fragile boat I'm in as I don't think it would take much. I must start them though so I will go for Friday in case they make me a little groggy for the first few days. Had the hot cheeks this afternoon which I haven't had for a while now. Anxiety does creep up late afternoon every day for a little while still. I have been keeping up with my CBT very day and continuing to do the daily tasks that are on there. It is defo making me do more than I was as I have to do these things no matter how I feel then rate the emotion of how I felt doing them. Is frustration an emotion as that's what I mainly feel doing them, mainly because I just don't feel right. My dog is loving it though as he hasn't been out so much in ever!

I have a review in 10 days with my doctor and I imagine she will want to increase me to 187.5mg if I am as I am now, that terrifies me to be honest as although I am not 100% I am better than I was and I know I will have to go through hell again if I increase. Anxiety really sucks sometimes!
I am still scanning myself and thinking about it 24/7 even though the anxiety is reduced, my mood hasn't shifted at all and although I don't feel sad I think I just feel flat in that I don't get excited or look forward to things or feel content and settled. It's so hard to explain feelings isn't it?

Had a busy few days, we had a games night on News Years Eve, I didn't have anxiety but found myself wanting it to be midnight so I could go up to bed. Took the tree down over the weekend, did a load of ironing, cleaned right through the house, had a bubble bath, walked the dog 50 thousand times (OK a few times) and did some baking. Was a struggle getting up for work today but I had put on my CBT sheet to do my hair and make up for work so had to do that before 9am. Well I think that's it for now, will update soon.
Take care all, Ava x

[panic_down_under]

Ok so tomorrow will be 6 weeks on the 150mg dose... While I feel better than I did and the anxiety is greatly reduced I can't say that I feel at 100%. I'd say more like 75%.

75% is pretty good for 6 weeks, Ava.


I have yet to start the increase of the Nortryptline up to 30mg. For some reason I keep putting this off, I think it's because I don't want to knock the fragile boat I'm in as I don't think it would take much.

A 10mg jump is unlikely to trigger significant side-effects especially as 30mg is still a low dose. You could increase by 5mg for the first week if you wish and the tablets you have allow for it.


Anxiety does creep up late afternoon every day for a little while still.

Has an increase in anxiety through the day peaking toward evening been your usual pattern, or is this a change since increasing the venlafaxine dose?


I have a review in 10 days with my doctor and I imagine she will want to increase me to 187.5mg if I am as I am now, that terrifies me to be honest as although I am not 100% I am better than I was and I know I will have to go through hell again if I increase.

Don't go crossing bridges before you get to them, Ava. A lot can change in 10 days at this point in a dose increase. You may well be in a completely different frame of mind by then.


Anxiety really sucks sometimes!

Sometimes?


I am still scanning myself and thinking about it 24/7 even though the anxiety is reduced, my mood hasn't shifted at all and although I don't feel sad I think I just feel flat in that I don't get excited or look forward to things or feel content and settled. It's so hard to explain feelings isn't it?

Occasional introspection is good, but not as a daily habit. Most of the time just blissfully sallying forth singing 'Que Sera, Sera' makes for a much more pleasant life. It is delving into the minutiae that often brings us undone with anxiety, not the big stuff, so avoid 'sweating the small stuff'.

[Paradise10]

Hi all....
Ian it has been this way since I started the increase, my usual anxiety will be first thing in the morning and maybe ease evening time, since the increase I notice my anxiety ramps up late afternoon for a few hours but is OK during the day. Always seems to be about 7 hours after I have taken the ven. Nothing I can't handle though just a bit uncomfortable.

So about 6 and a half weeks in now and this week hasn't been that great, mainly because I've felt quite unwell all week. This is usually a trigger for my anxiety and although I have noticed it creep up a bit, it hasn't been full on anxiety meltdown so that's a plus. Another plus which is a massive one for me is that I still haven't googled, even though I have been so temped to this week to try and find out why I'm feeling unwell. I would normally put my symptoms into google and then spend hours looking into this ache or that and contemplating all sorts, but not once have me and google crossed paths in well over a month. (Well done me.) I've been hitting the paracetamol the last few days as I am waking up with such sore muscles in my arms and back, they are so stiff and tight and even my jaw ached this morning as well as my fingers and hands. Also have a headache. I seem to have an upset stomach too, it changes between stomach ache and intense nausea. It's either the ven causing these things (although surely not after 6 or so weeks) or maybe I just have a stomach bug. It's the nausea getting me down the most as it's difficult to do things when you feel like this and I have things on my CBT sheet that I have to do daily, I've found this hard the last couple of days. My husband said to ring the doctor but I will start the Nortryptline tonight and if I am still having these issues when I have my review on Thursday I will ask the doctor about them then. As usual though it's my physical health that is setting off my mental health.

Have an online quiz tonight with friends and I also ordered some craft stuff yesterday which is coming today as I didn't enjoy the baking last week and I've read that crafting is often good for mental health so I will give it a whirl.
I will update again soon.
Take care, Ava x

[panic_down_under]

since the increase I notice my anxiety ramps up late afternoon for a few hours but is OK during the day. Always seems to be about 7 hours after I have taken the ven.

Plasma levels of extended-release venlafaxine peak at between 6-9 hours after taking the med, Ava. However, that is for a one-off dose. With regular dosing plasma levels usually stabilize to a steady-state after a few days and then normally don't vary much across 24 hours, but fast metabolisers may experience some variation although I would have expected it to occur closer to the time of the next dose. You may be the exception that proves the rule...there always has to be one. Sigh! :winks: You could try taking it say 4-5 hours before bed so the anxiety ramps up while you're sleeping, although this might affect sleep.


It's either the ven causing these things (although surely not after 6 or so weeks) or maybe I just have a stomach bug. It's the nausea getting me down the most as it's difficult to do things when you feel like this and I have things on my CBT sheet that I have to do daily, I've found this hard the last couple of days.

Given the timing I suspect it is some type of bug, but can't rule out it being the venlafaxine. Ginger and/or vitamin B6 supplements may help.


As usual though it's my physical health that is setting off my mental health.

Anxiety disorders (also depression) are arguably auto-immune disorders and an immune system in overdrive battling an infection can cause a worsening of both anxiety and depression independent of any psychological impact. Patients prescribed immune system boosting meds such as interferon (http://www.hepmag.com/articles/hepatitis_interferon_depression_2501_22378.shtml) are how also routinely prescribed an AD because of this.

[Paradise10]

Ian you are such a help to me and I really appreciate it... If there was going to be someone it affects differently it would have to be me...
Would be worth taking the ven in the afternoon to see if that is the case but I might wait a little longer as I increased the nort on Friday night so will give that a few weeks before I start fiddling with things I think.

Not been a great weekend to be honest, Friday night was ok, did the quiz with friends and took the increase dose of 30mg of nort before bed, woke up Saturday morning and as expected I felt a little bit out of it / spacy but nothing major. Felt so unwell though, managed to do the things on my CBT list and took the dog for a walk with my husband. Today I woke up spacy again at 10.45 (really late for me) and this lasted a couple of hours. Not even got dressed today as I've felt so poorly, or managed anything from my CBT list which makes me feel bad. Fell asleep on the sofa from 2.30 till 5.30. Couldn't really eat my tea and my anxiety has ramped up quite a bit tonight, the worst it's been for a while. My husband said I have to call the doctors in the morning and not wait till Thursday. Maybe increasing the nort while I was feeling unwell wasn't a great idea but It's done now so I will carry on. The nausea is the worst, I can force myself to do stuff but when moving makes you feel like you are going to lose everything in your stomach, then it makes it really difficult. I've not been sick though, felt it in my throat like I was going to a couple of times but not actually been sick, it's more just the feeling. Also feel totally wiped out. I'm rubbish at telling the doctors what is wrong though, even though I try to write it down first, I always think they will think I'm a pain because I have anxiety and think it's that. I say this but my doctor is lovely so I don't know why it worries me. I'd tell anyone else not to be silly and just ring them but for some reason I find it really hard to contact the doctors.

Going to watch a little TV before bed, I'm back to working at home on my own again as now we are in total lock down again I can't work from my parents house. I have my craft stuff now so I will try some of that tomorrow afternoon.
I will update tomorrow after I have called the doctors (gulp)
Take care all. Ava x

[Paradise10]

7 weeks today, seems so long ago that I increased. Still bumbling along! I really do not like this working at home all day on my own though, even when you are in the office you might not be in every conversation but there are people to look at and things going on. It's so much easier to be distracted. I do have online meetings once or twice a day for 10 mins at a time but the rest of the time it's just me, the laptop and my thoughts. Not a good combination. I do talk to the dog but he just ignores me ha-ha.

Well I tried the crafting, must admit I'm kind of into it now, I'm making a picture frame thingy (looks better than it sounds, honestly) and I can just put down and pick up as I want to. Had my 3rd CBT session this morning, really don't think this is going to work for me but I will keep on with it, today was about progressive relaxation and mindfulness. Now have to add them into my daily routine along with my activity sheet. Most of the emotions next to my activities say frustration though, hope this improves as I go along. It has made me walk 8 miles up to now this month so i guess there's a plus.

I eventually grew a pair yesterday afternoon and called the doctors, she said to call back at 8am this morning and they would give me an appointment on the day. I woke up this morning and ummed and arred about how I felt and wound up not calling. I am such a muppet. I do have a phone appointment with her on Thursday though so I am sure I can hang on till then.

So how I am doing at 7 weeks on the 150mg dose...

Frustrated is the big theme I would say.
Anxiety is reduced from when I started but not where I would like it to be.
Not lift in mood at all.
Tension, tension and more tension... The tops of my arms and shoulders hurt as does most of my back and my thighs. Even my fingers are aching. (Can't decide if the tension is from me or if it's from the meds.) (I might be in a tension circle)
Upset stomach and nausea, this could just be a bug though and not the meds.
Also have the pain still around and under my left boob, this could just be tension pain also (but my health anxiety likes to wind me up a lot with this one.)

Things did turn a lot for me last time at 8 weeks so I am determined to wait till then, and I have only been on the nort at 30mg for 4 nights. Might use that list for the doctor on Thursday... God knows what she will think to that lot.

Right I am off to glue more beads onto a cardboard heart while monitoring my empty work inbox!

Take care all... Ava x

[panic_down_under]

Had my 3rd CBT session this morning, really don't think this is going to work for me but I will keep on with it, today was about progressive relaxation and mindfulness.

Please stick with it, Ava. CBT didn't do it for me either, but I did pick up some strategies/techniques which helped in the darker times.


I have only been on the nort at 30mg for 4 nights

The dose increase may be playing a part in the tension. The noradrenaline/norepinephrine (NA) reuptake inhibitors can be activating at the beginning. But just as with SSRIs and serotonin, after a week or two the brain responds by down-regulating NA synthesis and expression and the side-effects diminish.

[Paradise10]

I will keep with the CBT Ian as there are parts that I like, and like you say I will most likely pick up some tips along the way.
5 Nights on the increased nort now and I must say this is the worst I've felt in a few weeks, I've even contemplated the diazepam this morning, I won't though as I'm not quite climbing the walls. I hope this is just the nort settling in and not me going backwards. Could the nort be raising my anxiety, even though it's only a 10mg jump?

Think I'm going to move my desk downstairs today in the back room, we have big double doors in there so I can see outside rather than working in my bedroom where it faces the wall. Plus I don't like being in my bedroom all day as my husband often wants us to watch a film in bed after work so I'm back in there at half 7 after working in there all day. I wish corona would do one so I could work at my parents house, I like chatting to my dad between work. The older two kids have gone back to their uni houses and the youngest is on teenager time so he doesn't surface till at least 3pm after being up on play station all night with his mates. I think he is starting to struggle with lockdown, he is really sociable and is always out either at college or out with mates or his girlfriend. His girlfriend lives in the next town so he can't even go for a walk with her. The dog is also poorly this morning, he back been sick 3 times so I need to keep an eye on him and call the vets if it carries on. What I wouldn't do for a hammock on a tropical beach with a woo woo or 3.

Right, onwards and backwards (I saw someone on here has put that as their footer on their posts and I felt it was quite apt.)
Take care. Ava x

[panic_down_under]

5 Nights on the increased nort now and I must say this is the worst I've felt in a few weeks, I've even contemplated the diazepam this morning, I won't though as I'm not quite climbing the walls. I hope this is just the nort settling in and not me going backwards. Could the nort be raising my anxiety, even though it's only a 10mg jump?

It may be the nortriptyline, Ava. While it is only a small dose increase you're raising it at a vulnerable time with the venlafaxine dose increase not yet working that well and possibly also elevating anxiety levels, or at least keeping them on a hair trigger. It probably more the nortriptyline being the straw that broke the camel's back than the whole load. :ohmy: The better news is this will likely be short-lived. 🤞


Right, onwards and backwards

This is the real metaphor of life, not the 'onwards and upwards' rallying cry. What mostly happens with the 'upwards' bit is you faint from lack of oxygen and find yourself flat on your back looking up at your starting point. :sad:

[Paradise10]

Ian I never knew that's what it meant... Makes sense though!

Been another difficult day, Doctor called this morning and I did manage to get most things out to her, she thinks I have a water infection so has prescribed me some antibiotics which I need to collect tomorrow. With me only increasing the nort last week she doesn't want to mess with the ven dose just yet so she is calling me in 4 weeks for another review.

I seem to be suffering more with a 'wound up' sort of agitated feeling today rather than actual anxiety. I also feel quite tired today too and it's a massive effort making myself do anything which really annoys me and I get agitated rather than anxious. Still need to print off the mindfulness and relaxation stuff from the CBT woman and start that but I just can't seem to motivate myself to do it.
I used to read all the time so I downloaded a book to my kindle as I had put reading on my afternoon activity, I've read about 20 pages on and off as I'm finding it a struggle even though it's a story I would usually love. I think that's why I get so wound up and frustrated as I am doing all these things as instructed but I'm just not enjoying them as I usually would. It's like I put in a massive effort to do them and still feel pants when I do.

Starting the Keto way of eating on Monday which is low carb... It's meant to be good for weight loss and also for making you feel better with more energy ect, my husband said he would do it too so we're are going to meal plan for the week and then go shopping at the weekend. Also walked 2.5 miles yesterday. The one thing people can't say is that I'm not trying to help myself, that's for sure. Just wish it would all start to bloody work. It's hard not to get disheartened sometimes.
I am hoping things start to improve over the next couple of weeks.

Fingers crossed... Ava x

[Paradise10]

Morning all... It's a week today that I increased the nort to 30mg and I think it's fair to say my get up and go has literally got up and gone! It was hard motivating myself before but at the moment I seriously need to be Wonder Woman to make myself do anything. Not sure of this is the nort increase or just me. Started my antibiotics this morning so fingers crossed they help.

Didn't really do much yesterday, worked during the day then just read my kindle last night. Actually got quite into it in an on and off kind of way. Had some health anxiety last night but I couldn't even be bothered to get too wound up about it. I do find that I can't go too into my health anxiety which must be the ven helping.

Going to drop the dog at the groomers shortly and then go to the supermarket with my husband to get food ready for keto. Got an online quiz tonight with friends. Glad to be getting out of the house today. Still haven't printed stuff off from CBT woman and I have lapsed a bit on my activity sheet so really must make myself do them today. Feel very flat and uninterested. Not climbing the walls with anxiety though! Can't bloody win can you!!

Right, that's me over and out for another update. Take care. Ava x

[panic_down_under]

It's a week today that I increased the nort to 30mg and I think it's fair to say my get up and go has literally got up and gone! It was hard motivating myself before but at the moment I seriously need to be Wonder Woman to make myself do anything. Not sure of this is the nort increase or just me. Started my antibiotics this morning so fingers crossed they help.

It could also be the infection. It is a common response.

[Paradise10]

Well it's not been the best weekend... Anxiety has been quite bad today and I'm struggling quite a lot this evening. It's so hard to keep busy when you feel unwell and like you have no energy to do it.

Did the quiz last night, I was ok but started flagging at the end. Today has been really bad though, went in the car with my husband to the shop this morning, then came home. Spent the rest of the day sat on the sofa. Everything has wound me up, my thoughts have been going round and round all day, I am so hyper vigilant where I notice every ache or change in my body and it's so annoying. I just feel like I don't have the strength to deal with this at the minute but don't have a choice. Thought about a diazepam a couple of times today but I haven't had one and I have done nothing on my CBT stuff this weekend. Only been on the antibiotics a couple of days so I guess they won't be working yet. Keep questioning if it is a water infection... I get so frustrated with myself but the bottom line, regardless of water infection or not is that I am still having anxiety that is significantly affecting my life. I thought I was getting somewhere, I was coping with it at least whereas today I feel like I am not coping at all.

Let's hope next week is better. Ava x

[Kalie galea]

Good morning Ava
I'm exactly the same at the moment on this venlafaxine train been on these meds about 4 and half week I've had them upped 4 times in that time I'm currently on 225mg and have been for about 6 days now the past 2 days have been alot better then I have been but this morning I woke up at 3.30am thinking I can't breathe and I thought to myself no I'm not going backwards again that I'm fine and it's just anxietys ugly head showing its face I felt my chest tight but I wasn't going into a panic then I felt calm again but it was still there in my head it was as if I was putting them own thoughts into my head because I was feeling calmer I thought about taking a dizapam but then I thought no I'm not I seem to have good days and bad I mean 2 days ago I was calling the 24/7 crisis line for mental health because I was in tears fed up with feeling like this and things wasn't getting better I'm waiting for my phyatrist assessment on the 26th the doctors referred me because they specifically specialise with anxiety disorders panic disorders etc and they know what meds work well together it certainly has been exhausting and draining suffering from mental health and very disheartening when you have a few good days and you think finally I'm on the road to feeling better then bam it comes back again my fear and trigger is dying all the time I'm thinking I'm just going to stop breathing or my hearts going to stop beating hoping my day is not going to be a anxious mess and I hope you are ok

[Paradise10]

Hi Kalie, wow they have got you up to that dose quite quickly, do you know why? My doctor only increases me at 37.5mg at a time and I stay on each dose for at least 4 weeks before we look to increase. I do think something else kicks in at 225mg though so that might be it... Ian will be able to advise what.

My trigger is feeling unwell, but when it's vague and I can't describe it. I always have to know what it is so I can fix it and get better, but when it's difficult to describe or you have quite a few symptoms then I get myself in an anxious state. I've been feeling unwell the last few weeks, my doctor thinks it could be a water infection so I am on antibiotics... My brain keeps saying what if it's something else. We are also super vigilant so any new symptoms.
I know what you mean about feeling calm but all in your head, it's like we go looking for it, or the tablets help physically but not mentally. I think up to now ven has helped me physically but not mentally, my mood hasn't lifted at all... I wouldn't say i was depressed but I'm not feeling positive or hopeful, when I was on citalopram previously they would help physically then mentally and then I would be better. It does help me getting it all out on here though.

Back on my CBT activity sheets today and I also have to add in progressive relaxation. Read through the mindfulness stuff and I'm not keen on that to be honest, I will give it a go when I take the dog for a walk later though.

Always here Kalie if you need a chat. Take care. Ava x

[Kalie galea]

Thank you for replying to me Ava yea I increased quite quickly I started on the low dose of 37.5mg then to 75mg then 112.5mg then 150mg to now 225mg the phyatrist upped I was on venlafaxine 150mg before I fell pregnant a couple of years ago but wasn't advised through pregnancy so went back onto citlapram but it stopped working for me so that's why I went back on venlafaxine my anxiety and attacks have been worse then ever for about 6 weeks now when I got tested positive for covid that's when it all went worse I luckily only had it mildly but I got myself so worked up was in a state saying I'm going to die and that's when my anxiety and attacks went through the roof got my assessment with my phyatrist on the 26th so hoping that maybe there be a combination that works well with venlafaxine that I could try I mean I think the venlafaxine is working in a sense I'm don't go into full blown panic but still more anxious then I would like to be but then I have only been in the increased dose of 225mg for a week hoping for better days for us both.

[Paradise10]

Hi Kalie, the 225 dose could be the right dose for you and you may not need anything else, I would give this dose a good 6-8 weeks though as ven has taken quite a while to work for me previously going up. I had always been on citalopram before this. On and off for 20 odd years and it always worked quite quickly for me in about 2 to 3 weeks. 20mg was always the dose I had been on, then my anxiety came back while I was on 20mg and I increased to 30mg but it sent me manic. They then tried me on duloxetine which did nothing and also sertraline which again did nothing so here I am on ven. I settled well on 112mg and I was at the dose for quite a while, no anxiety at all, although I was still going over it in my head and I had no lift in mood. The anxiety reappeared in November so here I am at 150mg.

Been a bit of a struggle today, anxiety has been here all day and I feel quite low. I am about half way through my antibiotics but no let up in symptoms yet... I am due to finish them on Friday night so if I am still having issues I will contact my doctor on Monday. It's also been a week and a half on the 30mg nort, haven't noticed any benefit in increasing the dose as of yet. Still trying to keep on with my cbt activities but it is a struggle.

At the moment I am experiencing...
Nausea / Queasy feeling.
Bra feels too tight in the middle at the front.
Stomach ache in the upper part of the stomach, can sometimes feel it in my back too.
Fatigue.
And of course not forgetting Anxiety.
Just feel all round rubbish!!

My get up and go has most definitely got up and gone.
I too am hoping for better days for us Kalie.
Ava x

[Kalie galea]

Hi Ava, I to have been on citlapram on and off for 20 odd years always worked well for me but always after a couple of years would stop working I was upped from 20mg to 30mg but didn't make no different so that's why I changed onto venlafaxine I remember when I last started venlafaxine I was started on 150mg straight away as I also tried steraline and it did nothing but I noticed I felt so much better after a couple of weeks so I was worrying thinking why isn't it working yet I am seeing improvements now been near on 5 weeks on them I still have the anxiety side but not the full on panic attacks I'm hoping the anxiety will soon subside to is the other tablet just to help you sleep I hope you have a better day today take care
Kalie x

[Paradise10]

Hi Kalie, I have been on the nort since before I started the ven but only just increased to 30mg, I'm not really sure what that is for, I think because i tense in my sleep and I was waking up with really sore muscles and headaches. I am glad you are seeing improvements, fingers crossed it gets easier and much better from here for you!

I am feeling dreadful at the moment and I really don't know what is going on or what to do for the best. I am sat at my laptop ready for work but oh my god what a struggle it was, I really feel like I want to get back in bed and sleep but I don't in case what I am feeling is anxiety and depression in which case you shouldn't lie in bed. This is where my trigger really is. When I don't feel well I never know if it's because I have something wrong such as a UTI or stomach bug, or if it's anxiety and depression. If it's an illness that I should be laid up and resting whereas if it's anxiety and depression then I should be making myself do things regardless of how I feel. If I just rest up without knowing that it's something I should be resting for then I lay there with anxiety and mind keeps going backwards and forwards, whereas if I know for certain there is a bug or something then I can rest and just tell myself that. At the moment the doctor thinks I could have a water infection so has prescribed me antibiotics but because we don't know for sure that is what it is and because I seem to be feeling worse at the moment but anxiety is through the roof, I am still pushing myself to do things. I took the dog for a long walk last night and felt like I was going to pass out when I got home, I sat down for a while and it passed but I felt so ill, I went to bed at 8 and slept through till this morning. Today I can't do my jeans up because I can't stand anything pressing on my tummy, and I feel so sick and run down but I never am sick. I feel if I just felt well I could deal with the anxiety much better.

Wow what an offload and it's not even 9.30.
Ava x

[panic_down_under]

I went back on venlafaxine my anxiety and attacks have been worse then ever for about 6 weeks now when I got tested positive for covid that's when it all went worse I luckily only had it mildly but I got myself so worked up was in a state saying I'm going to die and that's when my anxiety and attacks went through the roof

The symptoms may have been mild, but your immune system was likely working in turbo mode and that may account for some of the anxiety/panic in addition to the psychological trauma of having covid. These (and depression) are arguably auto-immune disorders and infections will often exacerbate them.


I remember when I last started venlafaxine I was started on 150mg straight away as I also tried steraline

Were you switched from sertraline to venlafaxine, or did you start if from scratch after being off sertraline for a while, Kalie?

[panic_down_under]

I do think something else kicks in at 225mg though so that might be it.

At around 225mg venlafaxine begins to inhibit noradrenaline (NA), aka norepinephrine, reuptake supposedly making it a SNRI, but it is only a weak effect. The 30mg of nortriptyline you're taking is probably inhibiting NA reuptake more than venlafaxine would even at the maximum 375mg dose. Despite what is says on the box, venlafaxine is really only a SSRI. Fluoxetine, paroxetine and sertraline are more potent NA inhibitors, albeit still only weak ones compared to nortriptyline.

[Kalie galea]

Hi Ava,
It really is a rollercoaster ride isn't it I mean I'm not as bad as I was when I started venlafaxine I don't go into a full blast en panic attacks but do still get quite anxious like today I've woke up at 3 o'clock and last night I noticed my throat is sore when I turn my head now I'm worrying about that thinking something is wrong and I still have the feeling like I'm just going to stop breathing and I hate that more then anything it gets so frustrating just wanted to feel well and myself again I really hope you have a better day today Ava.

[Kalie galea]

Hi panic down under
I switched straight from citlapram to venlafaxine started on 37.5mg for 5 days 75mg for 6 days 112mg for 7days 150mg for 14days now 225mg for 11 days I see a little improvement like I don't go into full blown panic attacks but I'm still quite anxious and still get the thought that I'm going to stop breathing and last night I noticed where my tossel/gland is on my neck it hurts when I turn my head so now I'm worrying about that it just seems like one big worry one thing goes another one comes maybe that's all the tablet will work for the panic side of things

[panic_down_under]

Hi panic down under
I switched straight from citlapram to venlafaxine started on 37.5mg for 5 days 75mg for 6 days 112mg for 7days 150mg for 14days now 225mg for 11 days I see a little improvement like I don't go into full blown panic attacks but I'm still quite anxious

Six weeks is about when ADs often begin to kick-in, but previous exposures to ADs can often delay it so it may take some weeks yet before you begin to notice a significant improvement, Kalie. :sad:


and still get the thought that I'm going to stop breathing

That's the anxiety 'talking'. The breathing reflex is controlled from the brainstem, the most primitive part of the brain which is insulated from much of what happens in other brain areas. If it fails you'll already be in big trouble elsewhere.


and last night I noticed where my tossel/gland is on my neck it hurts when I turn my head so now I'm worrying about that it just seems like one big worry one thing goes another one comes maybe that's all the tablet will work for the panic side of things

I can't comment on the neck/throat pain, but I doubt it is related to the breathing issue other than both perhaps being anxiety based. It is persists get your GP to look at it. Anxiety and panic are essentially the same thing mediated by the same brain pathways with severity being the main difference. As per above, it is still early days so don't read too much into the response, or lack thereof.

[Kalie galea]

Thank you panic down under for replying to be well that gives me hope that maybe the meds are starting to kick in and in time maybe the anxiety side of it will subside too I was previously on this med but was on 150mg around 2 and half years ago came of it because wasn't recommended in pregnancy I guess I'm a little bit more calmer and relaxed then I was when I started was constant 24/7 anxious and panicky now I'm getting some relaxing time so I should be grateful for that and to know it's still early days gives me more hope thank you

[Paradise10]

Hi Kalie, we sound so similar in a lot of ways with previously being on Cit and now ven. It's good you are getting some relaxing time and fingers crossed in a few weeks things will be significantly better.

Still chugging along here, no change really. 8 weeks on the 150 ven dose and 2 weeks on the 30mg nort dose. Still suffering with anxiety. Better than I was but not anywhere near where I would like to be. It's the stomach anxiety I hate the most which I have today. Might give my doctor a call in two weeks when I have been on the nort a month and ask to be increased to 187. As much as I really don't want to increase, it's pointless being on the medication if it's not working correctly. I think giving it 10 weeks is long enough, unless i feel better in the next 2 weeks that is.

Still feeling sick and feel like I have an upset stomach and it's really doing me no good being at home on my own all day. Roll on Saturday when my husband is off work.

That's it for now. Ava x

[Kalie galea]

Hi Ava,
I know it's so disheartening when your getting some improvement but not completely where we want to be they do say some time it can take upto 12 weeks to get full benefits from the med especially if you have previously been on the med before for some reason it can take even longer to settle I joined at know when I was previously on this med it worked wonders for me and I hope to be at that place again soon I think it's also to do with covid and lockdown and feeling fed up with not many things we can do that makes it even worse for us hopefully not long and we will both be where we want to be with this medication I hope your sicky feeling goes soon nothing worse then feeling sick.
Take care
Kalie x

[Kalie galea]

Hi maca44
How long did your increase take to work I've been on it 5 weeks but have it upped 4 times in that time frame I'm currently on 225mg for 12 days now I see a little improvement like I don't go into full blown panic attacks but I am still quite anxious at the beginning I was getting a couple hours sleep now I'm falling asleep at 8 and sleeping until 3.30am the past 4 nights, I woke up today feeling panicky think I had a horrible dream last thing I heard in my dream was being put to sleep it's come and gone and come again the panicky feeling but without going into a attack my trigger used to be the big C word not covid because my nan died from it when I was 6 that's when my attacks started I'm 30 now they been worse then ever these last 5 weeks because my tablets stopped working so thats why I switched straight onto venlafaxine also I tested positive for covid I literally broke down and cried saying I'm going to die I only had it mildly thank god and symptoms went in 9 days but now I was stuck with the crippling anxiety and panic attacks I'm having so much more calmer relaxed days but the anxiety is still quite there a bit now all I keeping thinking is about stopping breathing and that's now my main trigger I think which I don't understand why I've not really had that before with my anxiety but it's like I'm fixated on it now well I seem to be alot this morning for some reason I had bloods done yesterday for reassurance like a full blood count thyroid liver kidney etc so I don't know if I'm subconsciously thinking about the results because my brother passed away 2 years ago from the horrible C to at 37 years old but I think I've coped well my anxiety didn't get worse or anything sorry for the long post I'm just rambling on also I think subconsciously Im worry if I would catch covid a second time again I'm sorry for my long post

[Paradise10]

Kalie you sound like you're really going through it at the moment, I was always told to give each dose increase at least 6 weeks before evaluating and I know some people say longer. I only held off increasing up to 187 and I had just increased the nort. if I am still as i am now I will ask to increase at my next review, then give it 6 to 8 weeks on that dose before I decide where to go next. With your worry of stopping breathing, is this just a worry or do you have symptoms that support this? Have you been checked over by a doctor?

Lost count where I am with both meds but I think almost 9 weeks on the ven and 2 ish weeks on the nort. No major changes, still having anxiety over not feeling well and still not feeling that great. Still have no get up and go and would just sit playing games on my phone all day if I let myself. My body just feels like a big block of lead and it's a massive effort heaving it around. Went to Asda yesterday lunchtime with the husband and it was a big shop because we needed food for Keto, I started really struggling half way through and really wanted out of there. Managed to finish it but felt out of breath and exhausted when I got back in the car. Felt like this till about 8pm where I could have happily attempted to jog round the block, popped out to get petrol and felt totally fine. Maybe I should save everything I do till after 7pm as I often feel a bit better then. Woke up today to the same aching muscles and huge effort feeling. Need to do some baking today as we are starting keto tomorrow, we wasn't quite organised enough last week. Also need to do some ironing. It's pants when you wake up feeling bloated, achy and exhausted. I have things to do and I just want to feel normal and get on with them. Hands are really aching today and i have to keep squeezing and flexing them.

Well I best get on with stuff and wait till 7 when I hopefully feel a bit better.
Till later. Ava x

[Kalie galea]

Hi Ava
It's horrible we are in this waiting game to see if the meds will work it's full effect, it's a worry I feel I have a oximeter my sats are always 99% even when I say to my husband I can't breathe the only symptom I get is the chest tightness I've had ecgs done which was perfect and bloods which all came back clear just irons low so on folic acid for 4months I woke up today in a feel good mood bout 11.30 I was scrolling through FB saw something about Boris Johnson wanting to extend lockdown until September I wasn't feeling anxious and panicky then suddenly I felt my heart beat out my chest checked pulse was 114bpm sats 99% I don't suffer from heart palpitations so unsure if this was one so got me thinking why did it do that but then I think I was having such a relaxed calm day hoping it was just nothing and all part of anxiety.
We both seem to be going on this rollercoaster hoping for more and more calmer relaxed days for us both.
Take care
Kalie x

[Paradise10]

Well today has been the best day since this all started, not perfect by any means but so much better than I have been. Pretty much no anxiety, mood fairly decent and got loads of work done. I will take that glady.

Started keto today, I think it's just a coincidence I've felt better but I enjoyed it and will be continuing. I've read that its anti inflammatory and is also good for energy. Even my 16 year old has had the same food as me today and enjoyed it. (He also drank 2 pints of milk though.)

I'm not counting my chickens though as I've had anxiety long enough to know not to quite trust it just yet but I will worry about tomorrow... tomorrow!!

Ava x

[Paradise10]

Morning all... Not updated for a few days so here goes.

Still feeling OK, no anxiety at all to speak of this week, It's taken a good 10-11 weeks to get here but glad I didn't increase too soon. Not sure if it's the extra 10mg of nort that's done it or the ven just kicked in more but either way I'm pleased.
Mood is still a little low but I still have a few weeks before my next review with my doctor so I will see how I go. I'm still doing my weekly planner for my CBT and I find I quite like this, makes me do things I wouldn't normally do, don't have to push myself quite as much but still takes a bit of effort. Didn't like the mindfulness but at least I tried it. Not quite as tired this week either and no chest pains ect... It is clearly linked to the anxiety but it's very hard to see that at the time.

Started Keto on Monday so been on that all week and I'm finding I actually like it, it is meant to have a lot of health benefits and not just weight loss so I will keep on with it. That's it really but I will update soon.

Take care, Ava x

[panic_down_under]

All looking very positive, Ava. Long may it last!! :) :yesyes:

[Paradise10]

Hey all, not updated for a month and things have been going OK. Not fantastic but I have been coping fine. Mood has been a little low but some of that could be to do with lockdown so I haven't really looked into it that much.

Been on Keto for 4 weeks now and I have lost over a stone so that's going in the right direction.

I have been released from my CBT, had about 5 sessions, didn't get loads out of it but a few things that I use.

Anxiety had been completely absent until yesterday... I woke up completely drained, I felt tired, weak and like I had no energy at all. Work was a massive effort and of course it didn't take to long for my old friend anxiety to pop up. I had the conversation with myself (I do that a lot) about how it might just be my body getting used to the reduced carbs with keto. It has been taking me ages to get to sleep the last few weeks and it's been gone 1am before I have drifted off. My alarm is then going off at 7am for work. I went to bed at half 9 last night and nodded off after an hour or so. I don't feel quite as weak today and I made myself eat more than I have been last night. Anxiety is lurking though.

I think I need to get back into a routine of using my weekly planner as I stopped doing this, and also of getting more sleep. I don't want to go rushing back to the doctor as she will most likely put me up to to 187mg and I am hoping this is just a little blip. Stuff I have easily gone past the last 4 weeks is now bothering me so it tells me that it's anxiety.

I will give myself a few weeks and see if I can use the tools I have to help myself first!

Ava x

[panic_down_under]

I don't want to go rushing back to the doctor as she will most likely put me up to to 187mg and I am hoping this is just a little blip. Stuff I have easily gone past the last 4 weeks is now bothering me so it tells me that it's anxiety.

Everyone has bad days, even those without anxiety disorders, Ava. All part of the rich pageantry of life. The trick is to roll with the blips and not give them more attention than they deserve for that can set anxiety inclined minds to ruminating. The odd patch of a few days here and there are of no moment, especially in these unsettling times. If it becomes a week or two then action might be required.

However, the difficulty getting to sleep may be worth exploring. Do you have any thoughts on what may have set it off, or why it's continuing?

[Paradise10]

Hey PDU, I hope you are doing well.

Never had a problem before in the sleep department, even when anxiety was really bad I always got to sleep ok and stayed asleep. This started about a week after starting keto so I don't know if it is to do with that maybe. I am staying asleep once I get there but it's taking between 1 and 2 hours to get to sleep.

Anxiety doesn't seem quite as bad today, still lingering there though but I haven't felt tearful like the last 2 days so fingers crossed it's on the out. As you said could just be a bad couple of days.

Ava x

[panic_down_under]

Never had a problem before in the sleep department, even when anxiety was really bad I always got to sleep ok and stayed asleep. This started about a week after starting keto so I don't know if it is to do with that maybe. I am staying asleep once I get there but it's taking between 1 and 2 hours to get to sleep.

I guess the keto diet may be a factor, but SSRI/SNRI induced insomnia is a common side-effect. An over-the-counter sleep supplement may help, Ava, as may Nytol tablets or liquid containing diphenhydramine, a sedating antihistamine (ask your pharmacist if there are any issues with the meds you're taking). If not ask your GP to prescribe something. A small dose of mirtazapine usually works. Being tired all the time is not good for your state of mind.

[Paradise10]

Thanks PDU, not keen on the Mirt idea as I already take the ven and nort so don't really want to add another one into the mix. Someone on my keto group suggested taking magnesium so I might try that.

Anxiety is a bit up and down at the minute, have gone back to my weekly planner from tomorrow as I had lapsed in doing this and I did like it before so will try that again and see if it helps. It's my body that feels tired and I have a bit of brain fog so maybe I need to be a bit more active as I am just sat at my desk all day in front of the computer. I have scheduled lots of dog walks and connecting with people on the phone and I will see how I go.

Again it is my mental health affected by how I feel physically, when I feel sluggish and heavy (like you are dragging your body around and things are a big effort) this is when the anxiety gets involved as I wonder why I feel like that and then get frustrated because a, I don't know why it's happening and b, it impacts the things I want to do. I still haven't googled though as I know that doesn't help. Health anxiety has been kicking in a bit too.

The joys...

Take care all, Ava x

[panic_down_under]

Someone on my keto group suggested taking magnesium so I might try that.

Magnesium might help with anxiety too, Ava.

[Paradise10]

I've had a great few months and now find myself back in blip-ville!!
I have been on keto the last 14 weeks and have lost nearly 2 and a half stone, had lots more energy and was happy.
Bam... woke up last Sunday feeling like someone was stabbing me, quick trip to A&E who said I have a kidney stone. Sent me on my way with half a pharmacy and said it should pass. I have been feeling crappy all week, tired, backache, intense nausea, no motivation, so with the nature of the beast, up pops my old pal anxiety!!

I have tried rationalizing it, that's not happening. I just keep telling myself I will feel better soon.
I know I am never going to go through my life not feeling unwell but every time I do anxiety seems to come as part of the package deal.

Venting on here helps me and keeping busy so I will go back to basics and hope this is just a blip and full on episode.

Ava.

[panic_down_under]

I've had a great few months and now find myself back in blip-ville!!
I have been on keto the last 14 weeks and have lost nearly 2 and a half stone, had lots more energy and was happy.
Bam...

That's great, Ava!! :)


woke up last Sunday feeling like someone was stabbing me, quick trip to A&E who said I have a kidney stone. Sent me on my way with half a pharmacy and said it should pass. I have been feeling crappy all week, tired, backache, intense nausea, no motivation, so with the nature of the beast, up pops my old pal anxiety!!

Not that surprising given the stress and the possible effect on the immune system. The meds may be contributing too.


I have tried rationalizing it, that's not happening. I just keep telling myself I will feel better soon.
I know I am never going to go through my life not feeling unwell but every time I do anxiety seems to come as part of the package deal.

Even people without anxiety disorders feel anxious and crappy at such times so just go with the flow. You're human and reacting as you should. Meds can do a lot, but they don't make us immune to the downs (or ups) of life, neither should they.


Venting on here helps me and keeping busy so I will go back to basics and hope this is just a blip and full on episode.

Vent away, Ava. It is included in the NMP package deal. :winks:

[Paradise10]

Bloody blip-ville, I'm back visiting it again and I'm really hoping it's not a long stay!

As usual my physical health is affecting my mental health. Been feeling a bit iffy the last week or 2 and I am now on antibiotics for a water infection. I feel like my whole body is made of lead and It's a huge effort to do anything. Also have my old pal brain fog back along with a low level headache I have had all week.

Same sort of symptoms that set me off every time. You could be your mortgage on it! I drove down to Swindon yesterday with my mum, my son and his girlfriend for the weekend as we are visiting my nans grave, I don't think the 6 hour drive yesterday did me any favours.

So the plan... well I have my planner back again and I've filled that out with activities, I've told my family I am struggling so I know I can chat to them, and I am back venting on my thread here. These things helped me last time I was in blip-ville so I'm telling myself they will help again. I have been here a couple of times before and I have helped myself without going back to the doctors and having a ven increase. Nice to know I can contact my doctor though if needed.

We are going shopping this morning, then visiting the grave this afternoon then going to dinner this evening, it seems I can't wait till bedtime at the minute though. My Google obsession is back so I'm making a promise right now not to Google symptoms as this helped before.

Let's hope the holiday in blip-ville is a short one!

Ava x

[panic_down_under]

Bloody blip-ville, I'm back visiting it again and I'm really hoping it's not a long stay!

As usual my physical health is affecting my mental health. Been feeling a bit iffy the last week or 2 and I am now on antibiotics for a water infection.

The blip has very likely been triggered by the infection, Ava. Anxiety disorders and depression are arguably the expression of an auto-immune system disorder (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002174/) disorder. Patients taking immune system boosting meds such as interferon (http://www.hepmag.com/articles/hepatitis_interferon_depression_2501_22378.shtml) to treat viral diseases and cancers are now often also routinely prescribed an AD because of this. Immune system proteins may also reduce the effectiveness (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337012/) of antidepressants.

See also:

Immune system may trigger anxiety in response to infection (https://www.medicalnewstoday.com/articles/immune-system-may-trigger-anxiety-in-response-to-infection)

Anxiety and inflammation: Is there a link? (https://www.medicalnewstoday.com/articles/anxiety-and-inflammation-is-there-a-link)

Is Depression An Infectious Disease? (https://www.popsci.com/depression-infectious-disease/)

Immune cells are behind the depression experienced in inflammation (https://liu.se/en/news-item/hjarnans-immuncell-ligger-bakom-nedstamdhet-vid-inflammation-)

Interferon-Related Depression: A Primer on Mechanisms, Treatment, and Prevention of a Common Clinical Problem (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050402/)

A Dialogue between the Immune System and Brain, Spoken in the Language of Serotonin (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547518/)


I don't think the 6 hour drive yesterday did me any favours.

I have recently being driving 8 hours a day twice a week so I feel your pain. :ohmy: Takes me a couple of days to get over it.

[Angiesuggs]

Hi Ava

I came across this thread by accident and got so involved with it I couldn't stop reading it. I made an account just to reply. I am on 75mg of Venlafaxine for nearly 6 weeks and so want this to work for me. I started off on Mirtazapine and have worked my way up to 45mg but my doctor wanted to add in Venlafaxine. I so want to stay on a low dose as this is all getting too much for me. I have only ever had 10mg of Citalopram which I had been on for 15 years. I had a few major life events that caused increased anxiety/depression back in June and for some reason the citalopram did not work??? they increased it but it made me so ill and I dont know why that it either. Had a quick change to the Mirt while reducing the Citalopram and all seemed good for a few weeks, then it went down hill. I have never suffered anything like this before and it is all new to me taking such medication. I read your thread and really want to know how you are getting on? xx

[Paradise10]

Hi Angie, thank you for taking the time to write a message, I have read other threads on here which helped me so much so I'm glad if maybe mine can help anyone even if it's just a little. Your story sounds similar to mine in places as I was also on citalopram but at 20mg and I had been on that dose and in a good place for years, I had some added stress and my doctor put me up to 30mg and I just couldn't tolerate it at all. That was when I switched to Ven. I had a bumpy ride getting on the ven but I stuck with it and on the whole i would say I am in a good place. As you will see from my thread I have had the odd blip along the way and i have managed to ride through these without an increase in medication, that's not to say I wouldn't increase if I thought I needed to. I know people say they want to be on the lowest dose but what's the point if that dose doesn't work for you? My doctor always said I should be on the lowest dose that works for me and I have always gone with that. I also have plans in place for when blips happen. My anxiety always stems from how I feel physically, so if I feel run down and over tired, or if i feel not well, then it triggers my anxiety. And as we know when anxiety gets involved I turn from a functioning member of society into a fruit-loop as I like to call myself.

Right now I am on the fast train to Blip-ville, I came down with flu last week and it totally knocked me off my feet, still not feeling right yet. You could literally set your watch by my anxiety turning up. Plan of action now in place. I told the husband and kids (they are all over 17) what's going on, I have my weekly planner out and filled in for the next week and here I am back on here as i find it really helps to get it all out. I set myself 2 weeks to try and manage it and I know if I need to at the end of the 2 weeks I will chat to my doctor re options re medication. Luckily my plans seem to hold and work so I haven't needed to speak with my doctor in quite some time.

I gave each increase at least 8 weeks so if you are on 75mg and after this time you still don't feel right then I would always suggest that you discuss this with your doctor. I always try and go with what my doctor suggests as I like to think they are trained in what they are doing, if you don't trust your doctor then get one you do trust. Luckily mine is fab.

Not forgetting I also get top notch service from the wonderful Panic Down Under (PDU) That man has given me untold help on here and is a legend!!

I'm always here for a chat so feel free to vent whenever.

Ava xx

[panic_down_under]

I came across this thread by accident and got so involved with it I couldn't stop reading it. I made an account just to reply.

:welcome: to NMP, Angie

Hope you don't mind me butting it.


I so want to stay on a low dose as this is all getting too much for me. I have only ever had 10mg of Citalopram which I had been on for 15 years. I had a few major life events that caused increased anxiety/depression back in June and for some reason the citalopram did not work???

While I understand the reluctance to take high doses of an antidepressant (AD) taking too little can often be a bad thing. ADs do not directly ease anxiety (or depression) in the way say aspirin does for headaches. These disorders are the emotional expression of a physical brain disorder, atrophy of parts (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045) of the two hippocampal regions of the brain caused by high brain stress hormone levels killing hippocampal brain cells and inhibiting the growth of new ones. ADs stimulate the growth of new cells (neurogenesis) and it is these new cells and the connections they form which produce the therapeutic response. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF (https://www.americanscientist.org/sites/americanscientist.org/files/20057610584_306.pdf)) and How antidepressant drugs act (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/).

The problem with low doses for most ADs is that plasma levels need to be high enough to saturate around 80% (https://pubmed.ncbi.nlm.nih.gov/15121647/) of the serotonin transporters to initiate neurogenesis and this must be a constant as interruptions may increase the risk of the med pooping-out. I suspect this is why the citalopram failed when you most needed it as the minimum recommended dose is 20mg. The recommended minimums are set with the ~80% occupancy rate in mind.


they increased it but it made me so ill and I dont know why that it either.

It is common for AD dose increases to produce significant side-effects for a few weeks. They would likely have soon diminished. It's possible that citalopram may have worked at a higher dose, but it's equally possible that it wouldn't have.


Had a quick change to the Mirt while reducing the Citalopram and all seemed good for a few weeks, then it went down hill.

Mirtazapine is more a very sedating antihistamine than antidepressant and mostly eases anxiety by sedation. It is actually more potent than some of the meds marketed as antihistamines. It seems to work well for some, but it is very prone to poop-out and the powerful carbohydrate cravings it often induces can become a real problem.

Ian

[Paradise10]

Afternoon my lovelies... Well the Big Bloody Blip as I am calling this one is defo in progress!

Spent half the night coughing and finally got some sleep when I propped my pillows up and nodded off sat up, really struggled to get myself going this morning, luckily I only have to commute the dining room for work as we are still working from home due to covid! Normal symptoms going on that would set my anxiety off such as feeling tired, body feels like lead, can't be bothered, everything is an effort kind of stuff, then add in the cough, the headache, and the inability to blow my nose because it's blocked then I have the perfect ingredients for a blip! I had quite a few cold and flu tablets last week so I am wondering if they could have affected my ven? Feel very flat at the minute and my motivation has really run off somewhere!

I tried to have a rational chat with myself earlier and did the whole what would you tell someone else exercise.... I came to the conclusion that I would tell someone else that they clearly have a bug such as a cold or flu and just over a week of having it isn't that long and the symptoms sound normal. I would tell them not to stress, to rest up as I am sure they will be back up and at it fairly soon. Sounds about right doesn't it? Did I believe myself? No, of course not! I know it's more than likely right and it's what anyone would likely say to me. But me, well I'm not a rational human being when anxiety take over. That I do know! Oh and of course, rather than it being a cold or flu I have to analyse every ache and pain that comes with it and decide it could be something else or something sinister. I seem to like a side of HA with my regular anxiety on occasion.

The outcome of all this.... I'm going to give it till the end of this week and reassess the situation. I'm going to keep writing when I need to, I'm going to keep as busy as I can while feeling pants and I am going to keep talking and challenging my thoughts. I am also going to tell myself that I have blipped through many blips previously and always come through it.

Most importantly though, I am going to eat chocolate cake and custard as that's all I fancy eating and my mum is delivering it.... (I may be a grown up with my own kids but I will always be a mammas girl.)

Take care all. Ava x

[panic_down_under]

I had quite a few cold and flu tablets last week so I am wondering if they could have affected my ven?

Maybe, Ava. But another likely candidate is the infection. Both anxiety and depression are arguably symptoms of an auto-immune disease (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002174/) and they often worsen when the immune system is in overdrive. This is so common that patients taking immune system boosting meds such as interferon (http://www.hepmag.com/articles/hepatitis_interferon_depression_2501_22378.shtml) to treat viral diseases and cancers are now often also routinely prescribed an AD to dampen this response. Immune system proteins may also reduce the effectiveness (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337012/) of antidepressants.

See also:



Immune system may trigger anxiety in response to infection (https://www.medicalnewstoday.com/articles/immune-system-may-trigger-anxiety-in-response-to-infection)

Is Depression An Infectious Disease? (https://www.popsci.com/depression-infectious-disease/)

Immune cells are behind the depression experienced in inflammation (https://liu.se/en/news-item/hjarnans-immuncell-ligger-bakom-nedstamdhet-vid-inflammation-)

[Paradise10]

Morning all.... It's not been a great couple of days. My HA has been at the forefront of my mind a good 90% of the time and it has kind of taken over. It's all about physical symptoms, how they are affecting my life at that particular time and what they may mean longer term and then the questions what should I do about them, are they anxiety or something else and how do I get rid of them? I guess somewhere in all that there should maybe be a trip to the doctors but the thought of even picking up the phone to them seems something I am not capable of. Crazy isn't it that I actually work in sales and I come across as the most confident person on the planet yet the thought of calling the doctors and trying to sort my health out stops me in fear.

I guess my HA is slightly different in some cases to others in that I don't actively go looking for symptoms when I don't have any, and when I do get them I tend to try and ignore them and hope they go away rather than go to the doctors. I have also gotten really good at not googling symptoms, I learned a while ago not to trust Dr Google and that has been a great thing. It's when the symptoms stick around for a while that it starts to cause me problems.

From a health point of view I am not in the best physical shape to start with, I am 46, a fair bit overweight, I smoked for most of my life but switched to vaping a couple of years ago and with me having an office based job my exercise level is really low. This all most likely makes me a prime candidate for all sorts.
The symptoms I am having at the moment are...

I feel exhausted most of the time and most things are a huge effort as my body feels like lead and heavy. I have no energy.
I also feel like I cant take in enough air sometimes when I breath, like I can't take a deep enough breath. I also can't breath through my nose.
I am also getting aches in my left breast area in like a c shape around the outside, this aches also radiates into my back, this gets worse as the day goes on.

Being the trained medical professional that I am.. (Haha.) I have diagnosed myself with lung cancer. (My nan died from this a couple of years ago and this has preyed on my mind a lot since then.) I keep comparing my symptoms with how she was. I haven't googled anything about lung cancer and this is the first time I have voiced this fear outside my own head. It's just been in there for the last couple of years bouncing around whenever these symptoms come forward.

Wow, I've said it! I have also gone online and booked an appointment to see a doctor for next Friday, I didn't realise you could book an appointment without speaking to anyone. How I am going to get this out of my head and articulated to a doctor I have never met before is beyond me at the present moment, but I guess I have a week to figure that out! Now I have booked the appointment I kind of want to go right now and not have to wait as that is creating a whole bucket full of anxiety in itself.

Ok so my CBT activity planner that I did is telling me I have to update my journal... (Check) and also start getting the Xmas decs out the loft for this mornings tasks so I better get cracking.

It's been a long post this morning but I feel like I have gotten quite a bit out there so I will catch up with you all soon.

Take care, Ava x

[panic_down_under]

How I am going to get this out of my head and articulated to a doctor I have never met before is beyond me at the present moment

Write down what you want to say, just a one or two sentence prompt as a reminder, more if there are more than one factor to a topic and don't forget to take it with you.


The symptoms I am having at the moment are...

I feel exhausted most of the time and most things are a huge effort as my body feels like lead and heavy. I have no energy.
I also feel like I cant take in enough air sometimes when I breath, like I can't take a deep enough breath. I also can't breath through my nose.
I am also getting aches in my left breast area in like a c shape around the outside, this aches also radiates into my back, this gets worse as the day goes on.

These all probably come to down to a lack of fitness and being overweight, Ava. The best thing you can do is get some exercise. Works wonders to anxiety too. You don't have to run a marathon on day one. Just walk 50 feet from your front door and back again. Keep 'rinsing and repeating' 4-5 days a week while slowly extending the distance. Also consider cutting back on the amount of carbohydrates you're eating, especially sugar (and sugar substitutes are nearly as bad). No need to go full evangelical keto, but try avoiding anything that contains more than 4-5% carbs.


Being the trained medical professional that I am.. (Haha.) I have diagnosed myself with lung cancer. (My nan died from this a couple of years ago and this has preyed on my mind a lot since then.)

I doubt you have lung cancer, but consider having an x-ray every 2-3 years from age 50. I had multiple risk factors for lung cancer and that's what saved me. The second or third one picked up the nodule when it was only 10-12mm diameter which made it easy to excise with little risk of having spread. Still cost me half a lung though. By the time symptoms start it is often already far to late which is why only about 12-15% are still alive 5 years after diagnosis. Radiation and chemo can slow it down, but they don't cure that often.

[Paradise10]

Thanks PDU, I will write it all down and take that with me. As you say it is most likely the weight and lack of exercise, as for the carbs I am off my food a bit a the minute so that might help.

So, anxiety is still high and pretty constant at the moment, but I am doing my best to keep busy. Yesterday me and the other half had a right good tidy through the house and clear out, we then put all the christmas decs and the tree up, went to the tip, then went out for a drive around the city looking at all the Christmas Lights. I was completely exhausted when we finished at 8.30pm. We watched a film and then went to sleep. Today I have been pottering around at home, doing a bit of house work. We are going to my parents in an hour or so for Sunday Dinner. Then I will take the dog for a walk when we get back so I can start getting some exercise.

I am off work next week so I think it will be a bit of a challenge as I use work as a distraction but I have accounted for this on my weekly planner so fingers crossed this helps. I read a quote the other week which I really like so I have printed it off and stuck it above my desk. It says... 'Nothing diminishes anxiety faster, than taking action.' I also try to accept or ignore my anxiety as much as possible and just get on.

Ok well that is it for today, take care all. Ava x

[Paradise10]

Morning all, well it's only 8.05 and it's a bad one already. Anxiety has been raging since I woke at 7am.
As per usual, something such as feeling unwell sets all this off and then the anxiety takes over so that it becomes the main problem. I am now in the stage where the anxiety is pretty much 24/7 in some form and I hate it.

Yesterday I got up and took my son to work, then popped out to get a few bits I needed. I then pottered about at home before picking my dad up from work at 1pm and I spent the afternoon at my parents house. Last night I made tea and watched some TV with the husband.

I downloaded a book from the NHS website which is CBT Self Help, started reading that last night too so I will pick this up later today.

I am taking the dog to Wakefield shortly for his operation and mum is coming with me for the drive so that should fill out a few hours. I just hate it when anxiety is this consuming.

I will update more later... Ava x

[Paradise10]

Morning campers, this blip has really taken hold, I'm not sure that it is a blip, it feels like a full on relapse at the moment! I am literally having anxiety 24/7 at quite a high rate, this then peaks into an almost panic attack at certain thoughts. Doesn't seem to be going into a panic attack but it's really not nice feeling like this all day.
It's literally zapping most of my energy.

Yesterday I got up and took my son to work, then went and picked my mum up so we could take the dog to Wakefield for his operation. Took about an hour to get there and I struggled on the drive, once we had dropped the dog off we went for a walk around a nearby garden centre and I felt myself just rushing round and wanting to get out of there. Drove home and I went out to do a few chores like get some tea and take a parcel back, I then went to my parents for a few hours until I picked my son up from work at 5. I came home, did tea, had a bath and watched some TV with my husband. Was really just waiting till I could go to bed. Bed is the only place I can calm myself down.

I am going back to my parents today to put their tree up as I am off work this week. I have also made a promise to myself that today I will tell them everything that is going on, I haven't told any of my family about my health anxiety, they just think that I have my anxiety back. I guess I haven't told them as I am scared to speak about it, I promise I am going to do it and just can't get the words out. Just like I haven't been able to go to the doctors about it. After reading a little of my cbt book I have come to the conclusion that that is keeping a lot of the fear going as I am scared. I am going to speak about this today somehow. I will speak to my parents today and my husband tonight and tell them everything.

I have been readying my CBT book on my kindle but I ordered a hard copy which is coming today. I am keen to start it but I am still reading the first part of the book and I haven't got to that bit yet. I am keen not to increase my medication but I will do if needed.

Well I think that's it for this morning.

I hope anyone reading this is well. Take care. Ava x

[Paradise10]

Morning all, another day on the anxiety train!
Well the anxiety has most certainly moved in for the duration... Joy!! It's literally 24/7.
I would say the anxiety has settled at an 8 for most of the day and then peaks at a ten due to certain thoughts.
I have received my CBT Self Help book and had a read through and I have also scheduled in my first session for tomorrow afternoon. My mum is going to be my therapy buddy/therapist. You have to schedule sessions and do agendas for the sessions, you also have to set goals and do homework between the sessions. Sounds quite complicated but I am sure it will become a bit easier as I go along. I am also at the doctors tomorrow about the pains in my side so fingers crossed he will put my mind at rest a bit. I have a water infection again now, tested this morning so I wonder if that has been making me feel rubbish. I seem to get them all the time.

Going to have to breath through today as I am at the hairdressers at 10.30 this morning and then I have to pick the dog up from the vets at 2.30 which is about an hour away as he has had surgery. I have redone my weekly planner and scheduled in daily exercise which will be new for me, nothing strenuous just a walk round the block each day, and one day a walk to my parents which is about a mile and a half away. I have also scheduled in an online quiz with friends Saturday night.

This is really hard but I am determined to try this before I ask for a medication review as it seems every year I am having to increase the dose. I do wonder how effective the ven actually is for me as I never had to do this on Citalopram and then ven has never really improved my mood.

Oh well another day! Take care all. Ava x

That's about all for now

[panic_down_under]

This is really hard but I am determined to try this before I ask for a medication review as it seems every year I am having to increase the dose. I do wonder how effective the ven actually is for me as I never had to do this on Citalopram and then ven has never really improved my mood.

It might be that venlafaxine is not the right med for you, Ava, but it could also be that the dose has been inadequate all along too. It only begins to function as a SNRI at doses around 225mg/day, albeit being still only a weak noradrenaline/norepinephrine reuptake inhibitor.

[Paradise10]

Thanks PDU, I think you are more than likely right, it is one or the other and I know I will need to make a decision re my meds at some point soon.

Not been a good couple of days at all. I would say my anxiety is constant at the moment at about an 8-9 all day, then ramps up into a panic attack multiple times a day dependant on my thoughts and feelings. It really isn't a nice place to be. I am getting tired as it's exhausting doing this all day, didn't sleep that great either last night.
Went to see the doctor yesterday morning, wasn't my regular doctor though. I told him about my anxiety, told him about the aches around my breast and in my side. Also told him my fear of what it was. He has arranged some blood tests for next Wednesday and also referred me for a chest x-ray which he said would take 2-3 weeks. This sent my anxiety through the roof. I was that freaked out I forgot to mention my water infection. I came home and emailed them and they have sent a prescription for antibiotics to the chemist for my uti, and I have also asked for a private referral for the x-ray as the private hospital said they would be able to do most likely Tuesday next week. Which is much better than 2-3 weeks. Spent the rest of the day in a never ending panic attack.
I told the doctor I was trying self help cbt for my anxiety, but now I am questioning that as the anxiety is really bad. I really just want it to stop.

NHS CBT is February, maybe I should pay private as I'm not sure I am doing it right on my own.

Not taken any diazepam even though I have 7 or 8, really not sure what to do for the best. Maybe I just need to get on these antibiotics for a couple of days and get this x-ray out the way then I might be able to manage? Even Tuesday seems forever away to wait when I am feeling like this.

Today me and my husband are going to get my antibiotics then he suggested we get some board games while we are out and play those this afternoon and watch a film tonight. I really hope today is a better day.

take care all, Ava x

[panic_down_under]

Not taken any diazepam even though I have 7 or 8, really not sure what to do for the best.

If you need to take them then please do so, Ava. White-knuckling through anxiety is counterproductive as it reinforces the anxiety. Also talk to your GP about this as there are alternatives.

[Paradise10]

Thank you pdu, I know you are right re the diazepam. What do you mean by alternatives?

[Paradise10]

Morning all and welcome to todays update.

Anxiety is still quite high but I managed to stop myself going into a full on panic twice yesterday so I am taking that as a win. Had some tears when I woke up yesterday morning but I got dressed and had a tidy round with my husband, we then went out to pick up my antibiotics and get some shopping. We came home and wrapped some Christmas presents and then I took a walk to the supermarket to pick up some board games we had ordered. I am trying to make sure I get out for a walk everyday. We played a board game while the football was on and then we went online for a quiz that was arranged with some friends. Anxiety was slightly lower last night. I am learning that you can't run away from full on panic which is what I always do, you just have to sit there and expand your stomach and breath through it until it subsides. Problem is I am having so many thoughts that are peaking my anxiety, it's like I am having to do this all day and it's exhausting.

I am still looking for reasons why I feel like I can't be bothered and dragging my body around, this tends to start the anxiety spiral off each morning. I hate feeling sluggish, this is one of my main fears. If I feel like I just want to lay on the sofa and sleep, I get anxious. I think it's because this isn't something you should be doing during the day. There is stuff to be doing and me feeling like that gets in the way. Doing things shouldn't be such an effort. I just want to get up and get on with stuff like everyone else. I think this is why I start looking for other reasons why I feel like that. I have the X-Ray and blood tests next week so I guess if they all come back clear then I just have to put it down to anxiety and being overweight and make more of an effort to sort these.

I think I am looking forward to going back to work tomorrow for the structure, I wont be looking for things to do to fill my time as I will have work. Today is ironing and making mince pies, will get a walk in later too.

Till tomorrow, Ava x

[panic_down_under]

Thank you pdu, I know you are right re the diazepam. What do you mean by alternatives?

Your GP is likely to only consider pregabalin (Lyrica) and mirtazapine. Pregabalin achieves the same result as BZDs, but via a different route. Like the BZDs dependence may become an issue, but this develops much more slowly so it is unlikely to become a problem in the short time you're probably going to need it. Mirtazapine calms anxiety by sedation.

[Paradise10]

Thanks PDU, I think I would rather stick with just the ven as I am already on Nort as well as the ven. Or i would rather come of both of them and maybe try a new med or increase the ven. I'm only on 150 so I guess I have scope to move up more.

Yesterday was a hard one but after my tears yesterday morning I had a tidy round then I did some ironing and then wrapped some Xmas presents. Got a bit wound up at tea time so went round to visit my parents for an hour. Last night the husband finished wrapping and i sat on the sofa and half watched some TV. Felt calmish, or the calmest I have felt the last few days.

Back at work this morning, Anxiety has been really high this morning, and I have had a couple of panic attacks but I breathed through both of them and carried on working. Anxiety is a nightmare as I have been for a wee about 9 times. I read through this whole thread earlier and what amazed me was that this time last year when I increased it was for the exact same reasons. same symptoms exactly. The ache around the left breast, the tight chest in the middle and bra feeling too tight, wanting to burp all the time, low energy, things being an effort. I have a chest x-ray at 3.30 today and they said they will have the results back with my doctor by tomorrow afternoon, this has increased my anxiety since they rang earlier but I know I need to do it even though it will be a nightmare till the results come back. The things I put myself through.

Ok till later guys. Ava x

[Paradise10]

My anxiety is literally through the roof.... It's been like this for about an hour now and I just cant calm down. I know it's because I have the xray in half hour but the worst part is having to wait until tomorrow for the results.

This is so horrible, I haven't felt this scared in a long time. I am crying writing this.

[Paradise10]

Morning all...

Well I went for my xray yesterday afternoon, I was in a bit of a state but the man that did my xray was lovely. He took one picture of my chest and then said.... All I can say is that is there was anything on here of concern I would have to take another picture and I don't need to take anymore pictures. I was so grateful as he didn't need to do that. He did mention something about my ribs but I didn't take that in as I was to relieved about the other things. I still need to call my doctors after 2pm today though for the results he said.

Me and the husband popped to the shops and my anxiety settled a bit, still had a really tight chest and felt a bit breathless but anxiety wasn't too bad. Came home and did some pottering around then we settled down to watch TV, anxiety was fairly quiet and it was quite a calm evening although I felt completely wiped out.

Slept fine and woke this morning to..... Yep anxiety. Not about the lung cancer. I totally believe the test results. Just my anxiety in general...
Anxiety because I feel anxious
Anxiety because I feel sluggish and want to sleep
Anxiety because I am lugging myself around and everything is an effort.

Have blood tests tomorrow, so will see what they say, I am not overly worried about these as at least they will tell me if I am feeling this way just because of anxiety and it closes another what if question. I am still on with my weekly planner and today I have a lady coming this morning to do my nails this morning, this afternoon I am wrapping some Christmas Presents (This working from home helps sometimes lol) and tonight I have my daily walk and then a film with my husband. I am still rating each task with how I feel. I am also doing my CBT homework or challenging my scary thoughts and coming up with other alternatives for them. My next CBY session is Friday. I am doing this with my mum as it's a self help book but you can have someone help you as your therapist, I did the first session on my own but my mum said she would help with the others. I am going to try this approach until after Christmas when I will assess how I am feeling and if I need to go back to doctors and look at my medication.

Am also still eating good, husband ordered a takeaway last night and I had chicken, salad and a pitta bread. Much healthier than what I would have had.

Till later, Ava x

[panic_down_under]

99.9% of the time the anticipation of potential bad news is far worse than the actuality. An anxious mind in full flight when given something to focus on can be truly terrifying on many levels. :sad:

[Paradise10]

Very true PDU, I went for my x-ray on Monday afternoon and I was so lucky as I got the most amazing man who was taking my x-rays. I burst out crying before he had even started. He stood me in front of the machine very quickly and took the X-Ray, had a look at it and said, "i'm not allowed to give you results but I will say don't worry what you have been worrying about," he then went on to say that if he saw anything suspicious like that he would need to take a side x-ray and he wouldn't be doing one of those. I could have hugged him. He also said to call my doctors for the results on Tuesday afternoon and then something about my ribs but I was that focused on that it wasn't lung cancer that I didn't hear what he said about my ribs. I need to try my doctors after 2pm for the results as I called them yesterday and they said they wasn't back. I also have blood tests today at 1.30.

My anxiety has been reduced since Monday evening without a doubt, I still have it but I would say it is just there bubbling away all day rather than peaking in panic attacks throughout the day. I would say it has dropped from a 10 to a 6, which has helped.

With regards to symptoms at the moment I am experiencing...
Anxiety at about a 6.
Tired and dragging myself around.
My bra feels too tight in the middle and I have been getting really breathless, and also pains around my left breast and back, and wanting to burp constantly.

Surprisingly I took a rennie this morning which I haven't done since last year and my breathing feels easier and my chest not as tight. I guess it could all be gas, crazy that it could make you feel like that. I will see how I go with this over the next few days.

My step daughter is coming this afternoon and then my son and his girlfriend are coming tonight as they fly to Spain on Friday for Christmas, so we are having a family night.

That's is for now, Ava x

[Paradise10]

Morning all, another day on this scary journey that I would really rather not be on.

So, Yesterday... Bit of a mixed bag really, started the day shaky as normal with the anxiety just bubbling away, did some work and got a few bits done at home. Went for my blood test at half 1 and I was ok. Had to park the car quite a bit away from the doctors and I was fine walking round there. Got home and did some more work and sorted some bits for secret santa today and coped with the background anxiety fine. I went to pick my son up from work at 5pm and I felt really strange on the way there, couldn't describe it if I tried but it was really scary. This spiked my anxiety quite a bit, it ramped up to a 95 but I didn't go into a full on panic attack. This feeling went about 8pm but I felt really unsettled after that and I was just left feeling unwell and tired.

I think I have figured out why I don't like feeling unwell, it's the uncertainty of not knowing what is happening to me. I have never dealt well with uncertainty most of my life, I have to know one way or another even if it's nothing major. So if I feel ill and it's quite non descript I feel like I have to know what is going on.

Still waiting on the X-Ray results from my doctor and also had my blood done yesterday and they said to call Friday afternoon for results. At least I will know on Friday that maybe everything that is going on is just anxiety. I would really like to go work from my parents during the day but the dog has just had an operation on his leg and is not allowed to run around and they have a dog so mine would run around like crazy there so I have to stay at home. I am going to meet my team at lunch time today in a pub car park to swap our secret santa gifts, it's about an hour away so will get me out for a couple of hours. Also have a few online meetings. My planner said hair and makeup this morning which I have done, been a bit lax on it the last few days, also haven't been writing down and challenging my thoughts so I really need to make an effort with that today.

Catch up soon. Ava x

[Paradise10]

Morning my lovelies, so used to starting out with what day I am on that its quite weird not to. Just another day on the anxiety merry go round, I really would like to get off now though.

Yesterday was same as really, anxiety all day and evening only letting up when I went to bed. I am so ready to get off the train now! So yesterday I went to meet my work team at lunch to swap gifts, bit would up and anxiety on the drive and while I was there. Came back and tried to keep busy with work. Finished work and went for my walk, I even jogged a few lampposts then came home and watched TV with the husband. Anxiety went quiet about 11pm. Slept through and I am now sat in the garage car park waiting for them to open as my car has its mot. I have my 2nd cbt session tonight with mum. So will update more later as I am on my phone.

[Paradise10]

Anxiety was less yesterday than it has been, although I was really tired as it took me ages to get to sleep the night before so I only got about 6 hours. I was OK at the garage minimal anxiety while I was waiting for my car. It picked up in the afternoon though as the tiredness kicked in. I picked my son up from work at tea time, then I took the dog out for a long walk. Came in and watched some TV with the family and fell asleep about 11. What I notice I am doing though is tensing up a lot, sometimes I notice that my shoulders are up round my ears and I am pulling my stomach and chest muscles in. I am relaxing into the anxiety though and I am also changing my thoughts to more positive ones afterwards, so hopefully this will have some effect soon.

I am going to Leeds this morning with my husband and two friends for the weekend to get some last minute Xmas bits and look round the Xmas Market so I best go get ready.

Ava x

[Paradise10]

Morning all, well it's Monday morning so back at work.

It's quite strange as the journey I am on to address my blip without increasing my medication seems to be following the same path as when I have increased my medication previously. I started off with really high anxiety 24/7 with panic attacks thrown in throughout the day, this is when it is this bad that I increase my medication as it's truly horrible. What normally happens is my anxiety increases for a while, then the panic attacks stop and I just get anxiety all day, then the anxiety slowly starts to decrease in severity, it then changes to a frustration and wound up feeling and I go through a really sluggish cant be bothered phase and then I start to come right. This seems to be what is happening. This time I read a cbt self help guide and made a commitment to follow it for a minimum of 6 sessions which is when it said i should start to notice a change. I committed to do what it said so I relaxed into the panic and anxiety and when I had the scary thoughts I started to change them, such as 'What if I stay like this' I would then follow that with 'I have been here many times before and always come through it.' This was really difficult at first but I have continued doing it and it is becoming easier. My anxiety has lessened a lot over this week and this weekend it hasn't really been there at all, I have however felt like I was dragging myself around and I have felt really flat. The last two evenings though I have felt close as back to normal. I have really pushed myself though in that I went to Leeds and walked round the shops on Saturday and then went out for a meal with friends in the evening, then Sunday again went round the shops and then took the dog out when I got home and watched tv with my husband. The mornings are the hardest and it seems to get easier as the day goes on.

Well that's it for now, I have my planner done for this week and I will stick to it, keep eating healthy and drinking enough, get daily exercise and also keep changing the thoughts.

Catch up soon. Ava x

[Angiesuggs]

:welcome: to NMP, Angie

Hope you don't mind me butting it.



While I understand the reluctance to take high doses of an antidepressant (AD) taking too little can often be a bad thing. ADs do not directly ease anxiety (or depression) in the way say aspirin does for headaches. These disorders are the emotional expression of a physical brain disorder, atrophy of parts (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045) of the two hippocampal regions of the brain caused by high brain stress hormone levels killing hippocampal brain cells and inhibiting the growth of new ones. ADs stimulate the growth of new cells (neurogenesis) and it is these new cells and the connections they form which produce the therapeutic response. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF (https://www.americanscientist.org/sites/americanscientist.org/files/20057610584_306.pdf)) and How antidepressant drugs act (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/).

The problem with low doses for most ADs is that plasma levels need to be high enough to saturate around 80% (https://pubmed.ncbi.nlm.nih.gov/15121647/) of the serotonin transporters to initiate neurogenesis and this must be a constant as interruptions may increase the risk of the med pooping-out. I suspect this is why the citalopram failed when you most needed it as the minimum recommended dose is 20mg. The recommended minimums are set with the ~80% occupancy rate in mind.



It is common for AD dose increases to produce significant side-effects for a few weeks. They would likely have soon diminished. It's possible that citalopram may have worked at a higher dose, but it's equally possible that it wouldn't have.



Mirtazapine is more a very sedating antihistamine than antidepressant and mostly eases anxiety by sedation. It is actually more potent than some of the meds marketed as antihistamines. It seems to work well for some, but it is very prone to poop-out and the powerful carbohydrate cravings it often induces can become a real problem.

Ian


Hi Ian and Ava

Sorry for the late reply as I didn't know you had responded. I really appreciate the information and I am reading your other posts to get updated. I would love to carry on this conversation. I stuck with the 75mg up until two weeks ago when ,y doctor put me up to 112.5. I was doing really well on the 75 and each day seemed to get better. I managed well in work and could do most of the things I previously struggled with like shopping and socialising. I started the 112.5 and had a little headache and off my food but that was normal. I took the 75mg at 6am before leaving for work and the 37.5 at my lunch break at 12 noon. I couldn't take it all in one go as I couldn't eat enough at 6am not to feel sick. I thought I was doing great as not had any anxiety or low mood for a few weeks. But for some reason the last few days gave not been great and today of all days I have had bouts of anxiety. I got afraid that I was going backwards. I always have a fear of going back to what happened in the summer when I was a complete mess. Rationally I know this can't be as the Ven has been working really well for me. Am I right in thinking the increase will not have had much effect as yet? I appreciate your advice xx

[panic_down_under]

Rationally I know this can't be as the Ven has been working really well for me.

Welcome back :)

It could still be a response to the dose increase. The most immediate effect when first taking SSRIs/SNRIs, or raising their dose is an increase in serotonin synthesis and expression. Despite the common myth serotonin is not a 'feel good' neurotransmitter. It is anything but as anyone who has had their anxiety levels shoot into the stratosphere in the weeks after first taking these meds will testify. Often this begins within a few hours to a couple of days, but some experience a delayed response and this might be what is happening to you now.

However, it could also be caused by other factors such as higher than usual stress because of the holidays, or a placebo response which has been more responsible for the improvement than than the med has now ended with the med not yet contributing much.


Am I right in thinking the increase will not have had much effect as yet

Yes, you are. It will likely take at least a month for the higher dose to have an effect. I wouldn't read too much into the last few days. Setbacks are quite common at the beginning. It can often be a case of one step forward then two or more back. All part of the rich tapestry of life on ADs. :meh:

[Angiesuggs]

Hi Panic down under - Ian

Thank you so much for your response. I have only ever been on one AD and that was citalopram as previously said which worked amazing for 15 years. Maybe I was on it too long, I don’t know. I did forget to add that my dose of citalopram was increased about 4 years ago to 20mg again without any issues and I bobbed along quite happily until June this year. After losing my dog and about half a dozen other life factors my exterior cracked and my dose was upped to 30mg which I thought would work happily again but it didn’t so it was upped to 40mg which made me worse each day and I couldn’t even leave my bedroom. My doctor changed me to Mirt 15mg which I thought I was cured as felt so good. But it didn’t last long so was upped to 30mg. I paid to see a psychiatrist (Prof Tahir). Who upped my dose to 45mg and on review a few weeks later as I wasn’t making enough progress told my GP to add in Ven to dose as my GP advised but only up to 150mg max due to serotonin syndrome. I have been on Ven at 75 for 10 weeks and 112.5 the last two weeks. I do not have much experience with AD’s at all. So glad I found this thread. Ava’s blog is amazing and your comments are so informative. I feel very lucky to have met you both. Am I right in saying these tablets will take a while longer to work their magic? I just want to be me again. Thanks in advance.

Angie 🤗

[panic_down_under]

I have only ever been on one AD and that was citalopram as previously said which worked amazing for 15 years. Maybe I was on it too long, I don’t know. I did forget to add that my dose of citalopram was increased about 4 years ago to 20mg again without any issues and I bobbed along quite happily until June this year.

After losing my dog and about half a dozen other life factors my exterior cracked and my dose was upped to 30mg which I thought would work happily again but it didn’t so it was upped to 40mg which made me worse each day and I couldn’t even leave my bedroom.

One significant life event can be enough to trigger an anxiety disorder and/or depression. Half a dozen in succession will push many over the edge.

As per my reply to your initial post, Angie, I suspect a contributing factor to the citalopram failing to work when you needed it the most was the length of time you were on only 10mg which is a sub therapeutic for most.


I paid to see a psychiatrist (Prof Tahir). Who upped my dose to 45mg and on review a few weeks later as I wasn’t making enough progress told my GP to add in Ven to dose as my GP advised but only up to 150mg max due to serotonin syndrome.

Was there any mention of weaning off mirtazapine in the near future? Imho, there's no point taking an AD that isn't working, but all too often I see reports here of doctors just adding more and more meds in the vain hope of striking some magic combination that works. It rarely does from what I've observed. Polypharmacy is sometimes necessary, but not that often and it should be among the last options tried, not one of the first, imho.

There is zero chance of serotonin syndrome from taking both mirtazapine and venlafaxine even at their respective recommended maximum doses of 45mg and 375mg/day, despite the NHS Guidance (PDF (https://www.sussexpartnership.nhs.uk/sites/default/files/documents/antidepressant_guidelines_for_use_in_adults_-_jan_20_0.pdf)) claiming there is. It is wrong. This isn't my opinion, but that of one of the two leading SS/ST experts, Dr Ken Gillman (http://scholar.google.com.au/citations?user=ea6KeD0AAAAJ&hl=en) who used to spend a large part of his semi retirement trying to correct this misinformation until the futility of it all became overwhelming (he details some of it here (https://psychotropical.com/serotonin-toxicity-and-5-ht3-antagonists/)):


"As I have pointed out before, drugs like bupropion and mirtazapine, that have no significant serotonergic activity, are no more likely to cause ST than is vitamin C. This scenario has already been enacted, over a decade, with the antidepressant mirtazapine, which was claimed, erroneously, to have serotonergic activity. Many poor quality case reports of ST with mirtazapine were published. This probably led to misdirected treatment of overdoses, some of which may have caused morbidity. It took several reviews to correct this error and establish that mirtazapine cannot cause ST"

PK Gillman, 2010 PDF (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550296/pdf/13181_2010_Article_84.pdf). See also: A systematic review of the serotonergic effects of mirtazapine in humans (https://onlinelibrary.wiley.com/doi/abs/10.1002/hup.750)

And lest there still be doubt, the other leading expert, Prof Ian M. Whyte (https://orcid.org/0000-0001-7693-3948), whose team at the Hunter Toxicology group wrote the SS/ST diagnostic criteria now used world wide to diagnose SS, agrees (note: 5-HT=serotonin):


"In some cases this has led to reports of serotonin toxicity for drugs that, from well-defined receptor binding studies, are unlikely to cause increased levels of CNS 5-HT. Important examples include the 5-HT2A receptor antagonist olanzapine and the 5-HT receptor antagonist mirtazapine."

Dunkley EJC, et al, (2003), The Hunter Serotonin Toxicity Criteria (https://doi.org/10.1093/qjmed/hcg109), QJM, Sept, vol 96(9):635–642

Moreover, mirtazapine is a serotonin 5-HT2a receptor antagonist (blocker) which can prevent (https://www.ncbi.nlm.nih.gov/pubmed/20655983) the spike in body temperature which does the damage in SS/ST although in humans the recommended treatments (http://www.psychotropical.com/treatment-of-serotonin-toxicity) are the more potent 5-HT2a antagonists cyproheptadine and chlorpromazine.


I have been on Ven at 75 for 10 weeks and 112.5 the last two weeks.

...Am I right in saying these tablets will take a while longer to work their magic?

I'm afraid so, Angie. These disorders are often a long time in the brewing and they can take a while to bring under control. But if one AD worked for such a long time then there is a very high probability that another will be just as effective. Unfortunately, it can sometimes take time to find the right one. :sad:

[Angiesuggs]

Hi Ian

Thank you so much for your informative reply. It’s so nice to meet someone that can give you answers to many questions. My doctor wants me on both meds for 9 months then see how I am. I have always had trouble sleeping so the Mirt is a godsend for that. I am lucky as well as I have not had any carb cravings or put on any weight. I have gone the other way and struggle to eat at times. But I have weight to lose so not so bothered by it. I would like just to be on 15mgs cor Mirt for sleep as the lower dose is more sedating. I am still reading the other articles you sent and they are so interesting.

I find it hard to remember when I started Citalopram how long it took to work and for me to move on. I know your brain blocks out stuff that it deems isn’t essential to remember. It must have taken sometime as these things don’t work overnight.

I feel a lot better today so hoping things are starting to work. I always get a headache and upset tummy for a while when they are increased.

My sister lives in Australia 🤗

Hope you had a good day

Angela 😊

[panic_down_under]

I feel a lot better today so hoping things are starting to work. I always get a headache and upset tummy for a while when they are increased.

Serotonin isn't just a brain neurotransmitter, Angela. It has many roles in the body including in the regulation of blood vessel tone, constriction and dilation and serotonergic ADs can affect that function for a while when first taking them and after dose increases which can trigger headaches. The usual pain killers should be effective, however, if you need to take them for more than a couple of days in succession then paracetamol, aka acetaminophen, is the preffered option as the NSAIDs such as aspirin and ibuprofen are also blood 'thinners'.

The most serotonergic organ of the body isn't the brain, it is only a minor user, but the gut which makes about 50 times more serotonin than the brain. As with the blood vessels, SSRIs and other serotonergic ADs can impact its function for a while when first taken, or after dose increases. The enteric nervous system (http://www.scientificamerican.com/article/gut-second-brain/), the mini brain which controls the gut is also a significant force in anxiety and depression.


My sister lives in Australia 🤗

Oh, the poor thing! :ohmy: Whatever did she do to deserve that? :winks:

[Angiesuggs]

Hi Ian

Your msgs are so interesting I look forward to them. I am also hoping Ava comes back in soon as I really would love to know how she is getting on.

I don’t know that many people on Ven but those I do know are on 150mg and swear by it. Is that the optimum dose? I was told it’s the therapeutic dose? Not sure how right that is having not had much experience with these types of medication. Today is better again so hoping things are slowly picking up for me. It’s about 2 and half weeks on 112.5 so do you think this could be the start of improvement? I know it will be a few weeks yet for full benefits. I think the NHS information is a little optimistic as they say 4 to 6 weeks for improvement but I am sure people take much longer.

My sister emigrated 15 years ago to Perth well just outside. Near a place called Joondalup.

Angie 😊

[panic_down_under]

I don’t know that many people on Ven but those I do know are on 150mg and swear by it. Is that the optimum dose? I was told it’s the therapeutic dose?

The therapeutic dose range is 75-225mg (up to 375mg in an inpatient setting) with most taking 100-150mg. At doses below about 225mg it acts only as a SSRI and is still only a weak noradrenaline/norepinephrine reuptake inhibitor even at the maximum 375mg. How much you'll need to get optimum results is something only time will tell.


It’s about 2 and half weeks on 112.5 so do you think this could be the start of improvement? I know it will be a few weeks yet for full benefits. I think the NHS information is a little optimistic as they say 4 to 6 weeks for improvement but I am sure people take much longer.

ADs typically kick-in from between 4-12 weeks with most beginning to see benefits at around 6 weeks (ADs work by boosting the growth of brain cells which create the therapeutic response and they take about 7 weeks to grow to maturity though they may begin to make a difference a little earlier). However, as this is not your first time on ADs kick-in may take a little longer.


My sister emigrated 15 years ago to Perth well just outside. Near a place called Joondalup.

I grew up in WA north of Kalgoorlie. Ran away as soon as I finished high school.

[Angiesuggs]

Hi Ian

Your information is always so interesting. How will it take longer to work if you have been on AD’s before? I am sure when I went on citalopram that it didn’t take this long to achieve a steady state but then again I have difficulty remembering that time.

I joined an online group on FB for Venlafaxine and lots of the people on there are on 150mg. Why is it called an SNRI when it isn’t really? The lady who runs the group says it is an SNRI at 150mg but reading your comments it can’t be so. Is Mirtazipine a good AD?

I only ask as I don’t know anyone on both only me are what I read In the medical reports in work. I was worried that I was a failure as things weren’t working for me and I will be like this forever.

I Know the “California rocket fuel” combo is supposed to be quite good. I am so hoping in another week or so I will feel more like the old happy me again.

My sister has been to Kalgoorlie a few times.

Angela 🤗

[Paradise10]

Hi both, firstly I hope you had a lovely Xmas. Angela you sound like you are starting to get somewhere, hang in there, the ven at 150mg took a good 8 weeks to start to work for me. I also have family in Australia, mainly Adelade (if that's how you spell it) I went to visit once but I was only 9 so have limited memories, i do remember my mum not wanting to come home though... haha.

Christmas was fairly decent for me considering I am still in blipville and have chosen to not increase my ven at this time. The last day or two have been a bit of a struggle though as I seem to have replaced a lot of the anxiety with tension. I am waking up with blinding headaches and my shoulders spend most of the time around my ears. My cbt has helped a bit in when I do have the anxiety I tell myself that my body is falsely telling me there is danger when there isn't any. I have a bit of a mantra that is 'there is no danger' then I carry on with what I was doing. I am also facing my scary thoughts by writing them down and then writing a more balanced thought next to them. It's not easy but it is getting easier. I am also keeping to my weekly planner and rating how I feel. My husband has bought me a candle making kit and some cross stitch for hobbies to do. I am looking forward to being back at work tomorrow even though it is from home, just for the structure. I am also picking up my cbt next week with my mum as my helper so will be having weekly sessions with her, we didn't do it as much over Christmas. My youngest son (17) is being a total nightmare at the minute too and it's causing so much stress. I feel like I either have him shouting at me about my husband or my husband shouting at me about him, either way it's not fun.

My husbands parents are arriving shortly to visit so I best go get ready.

Will update more tomorrow.

Ava x

[Paradise10]

Your information is always so interesting. How will it take longer to work if you have been on AD’s before? I am sure when I went on citalopram that it didn’t take this long to achieve a steady state but then again I have difficulty remembering that time.

(Just a note Angela, Cit always took about 2 weeks to work for me whereas ven has taken a lot longer, keep at it)

[Angiesuggs]

Hi Ava

It’s so good to hear from you. I feel as if I have know you forever after reading your blog. I so hope you don’t mind me butting in 😊. Thank you so much for the advice regarding the Ven. I have been 89 days in total and 20 days at 112.5. I keep a journal only o we the last few years that’s why I know the dates lol. I thought before Christmas that I was doing fantastic as never even thought of the anxiety/depression so I don’t know why it decided to some back. It’s not no where near as bad as it was before Ven but it’s that stomach drop thing I hate. So hoping that the increase will work soon. You said it didn’t really start to work for you until 8 weeks so just short of 12 weeks now. I am so gutted the Citalopram did not work it had been my constant for many years. Last time I was I. Australia I wanted to go to Adelaide but it was too expensive to get there. Maybe in the future I will get there one day. So glad your Christmas went ok. Sorry about your soon. I assume teenage years? Went through it with my daughter but she is a delight now and it does pass.

Angie 🤗

[Angiesuggs]

Sorry Ava May I ask, do you take one 150mg capsule in the morning or two 75 capsules? Xx

[Paradise10]

Hi Angie, I just take one 150mg dose in the morning, I am also on 30mg Nortryptline before bed, this was mainly to help with the tension but I am not sure that it helps really.

It's really nice to hear you say you feel like you know me from my journal, it's nice to know it has maybe helped someone, I often read back through it and it shows me how far I have come. Re the cit it was also my go-to med and I have been off and on it many times over the years. I was gutted when I couldn't tolerate the 30mg dose, it sent me hyper then really really low, I stuck with it for 8 weeks but it became unbearable. Ven has helped with my anxiety no doubt but I don't think it has ever lifted my mood as well like cit did.

It's been better being back at work today (never thought I would say that) but the structure helps. Anxiety is slightly less than yesterday but still very unsettled. I am going to give it till the end of Jan and if I am not improving on my own I will talk to my doctor about next steps.

Take care, Ava x

[Angiesuggs]

Hi Ava

Your journal has helped me loads. I don’t know many people on this med, 4 at most. I keep bothering them all the time asking questions, I bet they think I am stalking them 😂. I could not tolerate cut at 30mg or even 40mg made me very ill. I take 45mg of Mirt at night. I have a really good sleep now from it. I was hoping it would work it’s own but it didn’t so also started on the Ven. Today has been a much better day hardly any anxiety so hoping the new higher dose has maybe started to work?? I am not an expert on this med so I don’t know. With the cit you knew where you were with it. I take 75mg at 6.15am before I leave for work. I can only eat a biscuit at that time so as you do need to eat to take it I have the other 37.5 at lunchtime. So still getting the full 112.5 in 24 hours. My GP is reviewing me on 18th January so will see how I am. Most people say you need 150mg as it’s the lowest therapeutic dose?? I joined a FB group and most are on 150mg. I am not back to work until 4th. I too like the structure of the working day. I look forward to reading your updates. So glad I found this page.

Take care Angie 😊

[panic_down_under]

How will it take longer to work if you have been on AD’s before?

I don't know, but it often does.


Why is it called an SNRI when it isn’t really?

I'm guessing mostly marketing. I doubt they'd be allowed to call it a SNRI if they were seeking regulatory approval for it now.


The lady who runs the group says it is an SNRI at 150mg but reading your comments it can’t be so.

It only begins to block noradrenaline/norepinephrine reuptake transporters at 150-200mg, but even then only weakly.


Is Mirtazipine a good AD?

It is mostly only a sedating antihistamine. Not a true AD.


...Most people say you need 150mg as it’s the lowest therapeutic dose??

The therapeutic dose range for healthy adults is 75-225mg (up to 375mg for hospital inpatients). This applies to both immediate and slow-release formulations.

[Paradise10]

Hi all and happy new years eve!

Mixed bag the last couple of days and just confirmed today I have another water infection. The doctor has prescribed some stronger antibiotics and said I need to go back next week if it still hasn't gone. I think this is the same one from before Christmas that is still there.
Anxiety is still there bubbling away all day at about a 5, or it settles to that uncomfortable feeling in my tummy that makes you think something is wrong but you don't know what. It's all very frustration. Still having a lot of tension and getting the headaches which is from the tension too.

Just waiting to go to my friends for a New Year party, don't really want to go but it's on my planner and I know it will do me good so I am going. We have all got negative PCR tests so that's good. Getting frustrated waiting to go though as we should have left at 3.30 but as usual my husband isn't ready and then he stresses me out last minute asking for stuff to be ironed ect... He is currently singing on kareoke with his daughter like we have all the time in the world, I have come here to update so I am not just sat waiting otherwise I will get stressed. We also have to drop the dog off before we leave and my friend lives about an hour away, we are going to be really late. We are going to pick a new bed up tomorrow and a new hallway unit so I will update more when i get home.

I hope you all have a great New Year.

Ava x

[Angiesuggs]

Hi both

Happy New Year. Thanks Ian for answering my questions. I just need to know useless things. Hope you did t mind.

Ava hope your party goes well and you are able to enjoy it.

I have been fine today again. I am truly hoping that the increase is beginning to work.

Sending love
Angie 🥰

[Angiesuggs]

Hi Ava

I would love to know how you are getting on?

Angela 😘

[Paradise10]

Hi all, been getting on really well, my cbt has been going good and i was getting back into a good place, then...... Covid!

My son had it, then the other half, then last Friday I tested positive. I was ok over the weekend, had a bad headache, all bunged up and sinus pain, but nothing to bad. Then yesterday I started feeling strange and then my anxiety made an appearance and it hasn't gone since. I am really struggling as I have anxiety but just don't have the energy to deal with it. Had tears today which is unlike me. I have been trying to explain the strange feeling to my partner as this is the feeling that is scaring me but it's hard to explain although I will try...

I don't feel tired in that I need to close my eyes and sleep but you know that feeling when you cant concentrate on anything and you could just stare at the wall, I feel out of it like my mind is wading through a fog, my eyes feel heavy but not tired if that makes sense? I also feel quite low with it and I just want to cry. This is the feeling that is really scaring me. It's like I could blink and clear it. Usually I can do a bit of work and my anxiety will fade but it's like I cant even get my brain into work, it's just too much effort. I don't even know what to tell myself about this to make myself feel better.

I really hope it goes. Ava x

[Angiesuggs]

Hi Ava

It is so good to hear from you. I am really sorry that you have Covid. I hope you feel better soon

With your work do you get some time off if your have it or do you have to carry on working?

I am unsure of the feelings you are experiencing. Do you think it’s all related to Covid and not your anxiety? Covid produces many weird symptoms in people

Can I ask how long you were on 112.5 before you went up? I am sure things are starting to improve so I re-read your blog as I find it so helpful. As I said I feel that I have known you for years. I am sure PDU will be able to help as his messages are so informative and interesting.

Take care of yourself

Angie 😘

[panic_down_under]

you know that feeling when you cant concentrate on anything and you could just stare at the wall, I feel out of it like my mind is wading through a fog, my eyes feel heavy but not tired if that makes sense? I also feel quite low with it and I just want to cry.

An immune system in overdrive may trigger or worsen anxiety and depression, Ava. In several respects, anxiety and depression are the symptoms of an immune system disorder (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3002174/). Patients taking immune system boosting meds such as interferon (http://www.hepmag.com/articles/hepatitis_interferon_depression_2501_22378.shtml) to treat viral diseases and cancers are now often also routinely prescribed an AD because of this. Immune system proteins may also reduce the effectiveness (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337012/) of antidepressants. One of the brain regions most affected is the hippocampus with, among other things, regulates memory hence the concentration issues.

You should begin feeling better as the infection eases.

See also:

Immune system may trigger anxiety in response to infection (https://www.medicalnewstoday.com/articles/immune-system-may-trigger-anxiety-in-response-to-infection)

Is Depression An Infectious Disease? (https://www.popsci.com/depression-infectious-disease/)

Anxiety and inflammation: Is there a link? (https://www.medicalnewstoday.com/articles/anxiety-and-inflammation-is-there-a-link)

Immune cells are behind the depression experienced in inflammation (https://liu.se/en/news-item/hjarnans-immuncell-ligger-bakom-nedstamdhet-vid-inflammation-)

[Paradise10]

Hi both, Angie I was on 112mg for a few months before I increased, I have always tried to give each increase 6-8 weeks. Are you thinking of increasing? I thought you were doing well? With regards to work, we are working from home still at the moment, I haven't worked this week and my boss has been amazing.

Ian, thank you. You would think I would see this but it's like I never can when I am poorly.

Today is day 7 of testing positive and I tested this morning and I am still positive, bit frustrating as my son and partner were only positive for 5-6 days. I don't do well when I feel under the weather as that is my trigger for anxiety so I guess it was just a matter of time. Also I can't go and see my mum as that's where I go when my anxiety is bad. Still up and down with the anxiety but I guess that is to be expected while I still feel rubbish and testing positive.

Oh well, I guess another chance to practice my cbt skills!!

Here is to tomorrow and fingers crossed being negative.

Take care all, Ava x

[Angiesuggs]

Hi Ava

I am starting to feel the benefits of the 112.5mg now. The only thing that hasn’t come back for me at the moment is the contentment or your happiness with each day. It’s hard to explain. Like looking forward to something which may seem trivial. It I was always content doing. I will try and explain a bit more. On a Saturday I do my housework which seems boring but I really enjoy doing it. Then I would shower and sit down and light a candle and watch some tv. At the moment I don’t have that looking forward thing. Not sure if your get what I mean. My energy has come back and I sleep and eat well. So there are changes being made. I think when I get that contentment with my life back I know I will be on my way. My doctor is ringing me on 9th Feb for a catch up and that will be 9 weeks on this dose. I am hoping I won’t need to go to the 150mg but I want to be complete. If your get my meaning

So sorry you are still not feeling well. I hope today you test negative. Please let me know.

Much love
Angie 😘

[Paradise10]

Hi Angie, I know exactly what you mean. I think for me the best way to explain things is the Ven has always helped with my anxiety and I have got on with things again but I never felt like the light bulb in my head was switched back on. The best thing to do is tell your doctor this on the 9th of Feb and see what they suggest. I always try to be honest with my doctor and then go with what they suggest. I notice you are England too, where abouts in the country are you? Are you married? Kids? Just being nosey now haha.

So I tested positive again today, it is starting to get me down now and it's really messing with my anxiety. I have redone my planner this morning for the rest of this week and next week, just easy stuff, no walking the dog etc as i'm not allowed out yet and I must make sure I am drinking more water and eating healthy, I think because I have been unwell we have been living off takeaways which isn't good. I will also go back to work on Monday as the structure does me good. I keep having to tell myself I have a reason for feeling rubbish but it just doesn't seem to be helping at the moment.

Catch up soon, Ava x

[Angiesuggs]

Hi Ava

I live next to England in Wales 🏴󠁧󠁢󠁷󠁬󠁳󠁿 really. Actually Swansea all my life. I am married for 32 years to Michael and have one child Emily who is 27 and lives in Chipping Sodbury with her partner. I have two dogs a German Shepherd called Zeta and a mini Yorkie pup called Daisy. I have worked since 1986 at the DVLA Medical Section. Issuing driving licences to people with medical conditions. So that is basically me.

I am hoping by the time I speak to my doctor I will have improved to the extent I won’t need to increase. Each day has been getting better since I passed the 6 weeks mark. Today has been the best by far. I even went and had a look around the shops and enjoyed it.

I know what you mean by the light bulb. I was so happy in my small dose of citalopram and never thought it would fail me when I needed it. It’s taken a long time to get where I am today. Was off work 4 months and I am never off sick. Last time was 14 years ago. Been back at it now 4 months. It’s been hard while you wait for the meds to work. I was 9 weeks on 75mg and after discussions with my doctor she upped it to 112.5 which I have been on just over 6 weeks.

I hope your feel much better tomorrow

Sending love

Angie 😘

[Paradise10]

Hi Angie, you really sound like you are getting somewhere now and this is great news, let's hope by your docs appointment you will be even better. I am up in Hull so quite a distance from you, I have been to Wales a few times though and it's a lovely place.

So still testing positive for Covid but I have been in isolation 10 days now so according to the government website I am allowed out again now. I am assuming that I am not infectious anymore but it seems strange that I can test positive but go out...

I reached kind of rock bottom yesterday and spent a lot of the day in tears and anxiety through the roof, I nearly took a diazepam... Should this still be happening while I am taking 150mg of Ven and 30mg of nort? Makes me wonder if they are even working seeing as the amount of blips I seem to be having. I kind of don't want to fail on this med though as after the cit stopped working so successfully for me after all those years I tried Cymbalta with no joy and then sertraline with no joy and now this... They have helped to an extent but never like the citalopram did and the weight gain has been scary daft.

After yesterday the action plan has come out again, I have my weekly planner and today was, Morning - Phone chat with mum. Afternoon - Craft and walk the dog. Tonight - Wash hair and look at holidays with my husband. I've just got back from walking the dog and it was tough going. The anxiety is there bubbling away and peaking at certain thoughts, it's like I am waiting for it to go into a full on panic but it hasn't yet today, I am shattered though and I am dragging myself around.

I did get myself out of the last blip though so I am going to try this again and if no better then I will have to make an appointment with my doctor to discuss my medication.

Till tomorrow, take care. Ava x

[Angiesuggs]

Hi Ava

I have been up as far as Cleethorpes where my sister in law used to live. But not been to Hull

I am sorry that you are still not feeling right. I am not sure of the Covid rules as they are different in Wales. Let’s hope Covid passes soon and you will test negative.

I didn’t know you had tried those other meds as well. I was put on Mirtazipine when the Citalopram failed as I wasn’t sleeping and had lost a lot of weight. I paid to see a Psychiatrist a Prof Tahir in Cardiff via Zoom. I didn’t have to but I wanted the best advice and it wasn’t an option for me on the NHS. He recommended Venlafaxine and Mirtazipine combo. So my GP took advice from him. Looking back I can see the difference since starting the Ven. The jury for me is still out on the Mirtazipine and maybe when I have reached where I want to be I will lower that dose. It does help me sleep well which I am grateful for as I get up so early for work. I have not been the best today. Not bad but not like I have been the last few days. I suppose it’s still a bit up and down in the early days. It’s been so long since I started and AD I can’t remember how it goes.

How long in total have your been on the Ven? It’s does scare me as it’s a drug that is very difficult to get off so I of kinda wiling it to work as I would t know where to go if it doesn’t work.
What was wrong with the other medications? Did they just not work at all? I have only ever been on Cit and the ones I am on now.

We are going to a friends for food tonight so maybe that is why I feel a little bit all over the place. I never feel as if I look forward to things. So maybe going to 150mg will solve that? I don’t know? I have a few friends on 150mg and they are doing really well and get on good with it. I have one friend who is on 375mg and has been for 20 plus years so it must work.

Hoping you have a good weekend

Much love

Angie 😘

[Paradise10]

Hi all, Angie I hope you had a good night once you got there, I find I am like that beforehand but usually enjoy things when I get there. The sertraline and the cymbalta helped with the anxiety but left me feeling very flat, nothing as ever helped my anxiety and mood like citalopram did. Maybe I need a higher dose of ven or a different med, that's a chat with my doctor though I guess. I'm pretty sure if my medication was working for me as it should I wouldn't be having blips every few weeks.

Well I tested negative today at last so that's a positive. :-) I hope the rest starts to improve now. Did everything on my planner yesterday, it wasn't an easy day but no tears so that's a start. I still fell bunged up in my head and throat and still very breathless from not much activity but I will see how I go. I am going to keep on with my planner and recording thoughts and also keep talking to my family and I will review on Friday if I need to make a appointment for a chat with my doctor.

Going to drop the dog off with my mum soon and then head to pick my daughter up (and see her new puppy) before we head out to watch my son play rugby this afternoon. Back at work tomorrow too which should help fill my time, although I might work from my parents house for a few days next week as they only live 5 mins away.

I hope you all have a lovey day, take care. Ava x

[Angiesuggs]

Hi Ava

So glad you tested negative today. I bet that is a big weight off your mind. Maybe your do need a higher dose possibly just a small increase and that will solve your problems.

I agree with you on the Citalopram front. It worked so well for me for many years even at the small doses I was on. I was always happy and enjoyed life. I still don’t know to this day why it failed me when I went up to 30mgs and made me really poorly?

When I look back over the last few months on Ven I can see the progress I have made. But it’s just not enough for me. I did think about ringing my doctor next week and just go up to 150mg. But I may not get to speak to her and I would like to give it a good go at 112.5. It is only 2 weeks until I speak to her so I am sure I can wait until then.

I did have a good time when I got to my friends. We haven’t had food over friends since Covid hit. We were home just after 11pm. The latest I have been out in a long while.

I hope you enjoy your day today at your daughters and that you son has a good game of rugby.

Sending love

Angie 😘

[Paradise10]

Hi Angie, I know exactly how you mean about the cit as that is what happened to me, worked perfectly and then stopped and I couldn't tolerate the 30mg. Strange how we are so similar. I also know what you mean about that last bit, the looking forward to things as that's how I have been on the 150mg, not that final bit of contentment and getting excited about things again. That is what I think has been missing for me. Maybe I do need an increase, the thought of increasing scares me to be honest though.

Yesterday wasn't great to be honest, had a bit of a panic attack at rugby but I went outside for 10 minutes and breathed then came back in and watched the rest. Anxiety settled about 6pm but I had a banging headache and was really wiped out. Back at work today at my parents house but my boss has said just dip in and out when I want for the next few days which is helpful. I am getting my nails done this afternoon and then I need to take the dog to Wakefield tomorrow for a check up with his surgeon after his surgery just before Christmas. This morning was really hard, I felt all bunged up and hot with no energy but I made myself do my hair and makeup before my dad picked me up as it was on my planner.

I hope you are doing well.

Ava x

[Angiesuggs]

Hi Ava

Sorry for the late response. I did type a msg but it wouldnÂ’t send and logged me out so had to do it again.

Sorry about your panic attack and I hope your are feeling better now. Maybe your need a small increase in Ven perhaps ring your doctor today.

I really miss citalopram and I get upset when I think why it didnÂ’t work for me. Silly I know. I hate taking this medication and again I donÂ’t know why bcos I took the citalopram each day.

Yesterday was my best day for ages. Going into week 7 on the increase. I know with you it took about 8 weeks to see a difference.

Sending love

Angie 😘

[Paradise10]

Hi Angie, you are most likely right re needing an increase but I'm really scared to increase again as I know it will make me worse for a while. I want to be able to do this myself if I can.
Yesterday was a bit better than Sunday, went to my parents in the morning and did some work there on and off then went to get my nails done yesterday afternoon. Husband then came with me to walk the dog last night then we watched TV. Anxiety bubbled away all day and peaked here and there due to certain thoughts but I am trying to face those thoughts and challenge them and relax into the anxiety. I feel it could spill over into full on panic but it didn't yesterday so that's a plus.

I'm taking the dog for his check up this morning then spending the afternoon with my mum so fingers crossed it's an OK day.

It's good you had a good day and fingers crossed you will keep on improving over the next week or 2.

Take care, Ava xx

[Angiesuggs]

Hi Ava

i know what you mean by being afraid to increase. I caught your blog when you first went up to 150mg. How long have you been on the Ven in total? I have only been 9 weeks at 75 and now 7 weeks at 112.5. I found for me when I increased I had a week of anxiety around week 5 then it calmed down. Today I still don’t have the contentment or looking forward still waiting for that to come back. It’s my mothers 80th birthday so we are all going to hers this afternoon. Normally I would be bouncing with joy but I am not. I wish that part of me would come back then I won’t be thinking about going to 150mg.

Your anxiety seems to be a lot worse than mine. When I look back I can see how far I have come but still want to be me again! I hope you don’t mind me butting in on your blog. I love hearing how you are getting on and I hope you don’t have to go up a dose. But it is no good suffering, if you need to then do it.

hope you have a good day

Angie ��

[Paradise10]

Well it looks like I have no choice but to increase, it has gotten to the point where I am just struggling to function. The anxiety and agitation is just off the charts, I can't sit still, I have been in tears again all morning and I keep waking in the night. I am back staying with my parents at the moment as they are about during the day. I had to resort to a diazepam about an hour ago and it's barely taken the edge off. It is just 24/7 and I can't cope. I have just put an online message through to my doctor so will see what they suggest but I imagine it will be an increase. Will keep my thread updated as usual.

Take care Ava x

[Paradise10]

So just a quick update, i get mental health cover through my work health insurance. I have had an assessment and they have recommended cbt done via video call which I should get within a few days. I have also been on the phone with my doctor and he has increased my venlafaxine from 150mg to 225mg. He has said to take an extra 37.5 for 2 weeks then take the full extra 75mg after that. He has also prescribed me 28 diazepam and I can take these up to 3 times a day if needed. He did mention addiction of the diazepam but anyone who has read this full thread will know I really hate taking them and only use in a dire emergency.

I have told my boss I am increasing my medication and she has been amazing and told me to take time out when I need it for walks or just to chill. I am really lucky there, and working from home really helps. I am still at my parents and they said they will make sure I eat and get a walk eveyday.

I am not going to lie I am totally petrified of doing this but I can't stay like this.

Tomorrow will be day 1..... Gulp!!

Ava x

[Paradise10]

Ok, It's day one from the increase from 150mg up to 187mg and I took the increased dose at 9.30 this morning after I had forced some breakfast down.

At the moment I have 24/7 anxiety and a shed load of agitation so that's the main reason for the increase, I am also hoping at this higher dose it helps to get me more back to myself as I have felt all the other doses have helped the anxiety but I've never had that energy and excitement for life back. I wouldn't say I was depressed but I never got excited for things like nights out, weekends away, Christmas ect. The only way I can explain it is that it feels like a light switch in my head that has been dimmed and I would like the switch turning back up to bright, I don't know if that's maybe mild depression? I have never addressed that though as once i get stable with the anxiety i never want to increase more as i really don't want to go through all that again that increasing brings.

I am petrified that this increase wont work for my anxiety but I have to keep telling myself that any med I have taken has always helped my anxiety, the citalopram helped with my anxiety and my lightbulb went back to bright. The Cymbalta and Sertraline both helped with my anxiety but not my lightbulb.

I am still working at the moment as I can work from home and I am staying at my parents house at the moment as they are usually about during the day so I am not on my own. Might sleep at home at the weekend though with my husband as both me and my 17 year old son are here so we've left him home alone.

The side effects from the increase usually start to hit around day 4 but I will deal with that when I get there. I know this is going to be tough but the plan is to go out for a walk everyday maybe twice, keep working and eating, venting my feelings on here and take the diazepam if needed without a fight. (Not needed one today yet so that's good.)

I have to pick my son up from his driving lesson soon so that will get me out for a while.

Ian thank you for answering my questions, you have always been such a help to me.

Angie how are you doing now?

Till later, Ava x

[Paradise10]

Morning all... Tablets taken and it is now day 2 on this increase journey.

I am so glad I keep this thread as I have been reading through when I started it when I was increasing from 112.5mg to 150mg and it is all for the exactly the same reasons.

The ache around my left breast and top of the left side of my chest and numb feeling in left arm and the heavy feeling behind and between my eyes that makes me feel like my lightbulb is switched off. As usual the ven helps with the anxiety but those symptoms persist afterwards and although I have no anxiety I still keep thinking about them constantly and trying to push them away. Then after a few months the anxiety comes back. It tells me I must get these issues sorted or I will keep doing this. I just go round and round about what they could be, after my last blip in November I don't think it is Lung Cancer anymore as I had an x-ray and that was clear which I believe 100% also had blood tests which were fine too. So of course now I know it's not that I start moving onto other things it could be... Never stops.

So yesterday was manageable and no diazepam needed and no tears. I worked from home and did a lot of pacing between work. I picked my son up from his driving lesson at 11am then I took the dog out about 4pm. Cooked tea for my parents and son which I only managed half of and then watched some tv while looking at ven success stories online. I have not googled my symptoms though and I am determined not to. I also read my own thread through a couple of times.

I have an online appointment with a psychiatrist tomorrow evening at 8pm which has been arranged through my insurance and I am waiting for the CBT appointment to come through as well.

The plan is to get to 100% this time and not just 80% like previous as it just leaves me open to blips every couple of months and I don't want to keep doing this. I want the old me back!!

Got my partner coming here for tea tonight and a few meetings today, will also get a walk in with the dog.

Day 2, let's do this!

Ava x

[Angiesuggs]

Hi Ava

Really sorry I have not been on here been having difficulty logging in from my phone. It keeps logging me out when I type a message and when I get home I keep forgetting to go back on.

Really sorry you have to go up a dose but it maybe the best decision you have ever made. You have struggled for sometime and like you said you have never had that light switch moment where you have been totally happy.

I have been doing ok on my 112.5 but am I really totally me? I am unsure about this. I have a call with my GP tomorrow just a check up chat so do I go to the 150mg or do I stay and see what happens and if the interest in my life totally comes back? Maybe you can advise me?

I hope your appt goes well today. When I saw my Cons he said Ven is the best medication.

Sending love

Angie xx

[Paradise10]

Hi Angie, glad to hear you have been getting on OK, I think the best thing on your phone review tomorrow is to tell your doctor exactly how you are feeling and see what he says, he might say give it more time or he might suggest an increase. I always like to think they know better than we do so I go with what they say. It's hard for me to advise as up to now my interest is the same as yours. I'm planning to ask the phych on my appointment tonight so I will see what he says. I have also had my CBT come through so I have a video appointment with her today at 3.30 as well. Busy day and I am pretty much back to back meetings with work too.

Today is day 3 on my increase and nothing major to report, no side effects as of yet which is good. Got through work ok yesterday, can't sit too long at the laptop as I have to get up and walk about a bit and I struggle to concentrate and get lost in work. My partner came to my parents for dinner last night and then I just watched some TV until I went to bed about 10.30. Woke a couple of times in the night but went straight back to sleep. Woke with a banging headache this morning and I was dripping in sweat (how nice) Headache cleared on it's own though. Need to go eat a biscuit so I can take my ven now and get ready for my meetings.

Angie let me know how you get on with your docs chat.

Speak soon Ava xx

[Angiesuggs]

Hi Ava

I think the sweating is a side effect of the Ven? I have heard quite a few people say that. I have done a CBT course and I really enjoyed it. I did it with the Mental Health Community at first then I paid and did 7, 1 hour sessions with a lovely lady called Dr Tracey Vick. She said last week that she doesn't want to see me anymore as she feels that I am doing really well on my own. I never had negative thoughts much as I am always a happy person and a glass half full king of girl. But it was good to learn how your mind affects your feelings. I think my doctor will discharge me tomorrow as well. I am probably back to almost myself. I have plenty of energy and I can do most things but there is still that small bit of me missing. The bit where I liked going away with the girls and looked forward to going to our caravan. I will def discuss this with my doctor tomorrow. She may say give it a little longer and it will come back or the other way she could say well go up to 150mg and see how you get on. I just don't like the side effects mainly for me the increase in anxiety at about weeks 3 and then weeks 5/6. I will let you know what happens anyway.

Hope you have a good day, and speak soon

Angie

[Paradise10]

Hi, well day 4 on this increase journey and it's going OK. No side effects to report as yet apart from maybe headaches but I was having them before so that might not be the ven and also constantly want to burp as I feel I have something stuck in the middle of my chest.

Busy day yesterday, Had a lot of work meetings which I coped OK with, I then went and worked from home by myself from 3pm as I had my first video CBT session. The lady doing it is really nice and we went through everything that has been happening, she then set me some homework, I have to fill in an activity tracker for the next week which monitors what I do and how I feel about it then I have another session next Thursday. I also had a video assessment with a phychiatrist and he asked loads of questions. He said I defo had anxiety (which I obviously knew) but that I also had some depression, I queried this as I said I didn't feel low but he explained that depression isn't just feeling low or hopeless, depression can be a loss of interest in doing things and a loss of pleasure in doing things which I did say I felt like so I found that quite eye opening as it looks like the tablets have been fixing the anxiety but not the depression. He then suggested a plan which I agreed to as I trusted him. He has said to stay on the increase of 187.5mg for 2 weeks as planned then go up to 225mg. He has also told me to stop the nortryptline by dropping 10mg per week as that's not a good combination to augment the ven. He wants to see me again in 6 weeks to assess as he said there is scope to go further on ven if needed or to add something else in. He said he is also writing to my doctor telling them to send me for an ecg as everyone should have one after starting on venlafaxine. I am pleased I now have someone looking after my medication rather than different doctors at my surgery.

I am working today then we have my step daughter visiting tonight with the puppy to watch the rugby.

Angie how did your telephone appointment go with your doctor? I hope you are feeling ok?

Take care all, Ava x

[Angiesuggs]

Hi Ava

So glad to hear your appointments went well. I really enjoyed my CBT and she also used to give me homework to do. It does sound similar to yours. When I saw a psychiatrist I was already on 45mg of Mirtazapine and he added in the Ven and said it was the best combination. You may have that added to your Ven, it gives you such a good sleep the best I have ever had. My appt is tonight with my GP, so I will let you know how it goes. At the moment I am feeling ok, its been 9 weeks on the 112.5mg so not sure how long I should wait to maybe up or not? I know these tablets take much longer to work as Ian has said and I have heard it from someone else on a Facebook group that I joined. Maybe tonight I will discuss with my doctor about staying another 4 weeks and if I still feel not quite there I can ring and they will put them up for me. Hoping my body will be used to them then and I wont get too much side effects.

Speak soon

Angie xx

[Paradise10]

Hi Angie, my Phych did say each increase should be 3 months so if you have done 9 on the 112.5 maybe ask for a review in another 3 weeks and if you still feel the same try the 150mg.

Don't settle if you are not right as I have done this so many times and it just comes back.

He didn't say what he would add in so I will go with whatever he says if I need to, fingers crossed the 225mg works on it's own. I am glad to be getting off the nortryptline though as I didn't think it was doing anything.

Re side effects I don't think you can ever know, I am usually much worse than I am by day 4 (touch wood lol) I have been really bad at this point on the other increases so you never know xx

[Angiesuggs]

Hi Ava

thats good to know about the increase. Is that to give your body time to get used to the meds and for them to work? My GP did ring me and I said that most things have come back for me but I am still not totally myself. My Surgery isn’t a fan of putting up your meds it’s always a battle as to why you think you need to increase. She seemed happy that 112.5 was ok for the moment and I said can I ring in day 4 weeks if I feel I am still not myself? She did question as to why I wanted to go to 150mg? So I think I will just keep some notes of my feelings and in 4 weeks ring and go up if I feel I am not there yet

I hope that’s the right thing to do it will be a little over 12 weeks then. So glad you don’t have any side effects at the moment. Maybe your body is getting used to this medication and you will up your dose without any issues. Fingers crossed for you.

sending love

Angie xx

[Paradise10]

Hi All...

Just a quick update, day 4 saw some different side effect hit, about 7pm I went completely spaced out, it was OK though I just watched TV and went to bed about 11. Woke up yesterday the same but it wore off quite quickly. I got ready and went into town to get some wool and knitting Needles as my mum taught me the other day then went to Asda and did a shop, came home cooked tea and then watched TV with my hubby and step daughter. No high anxiety at all, just low level under the surface stuff. Went to bed about midnight.

Woke up this morning day 6, again no mad anxiety or agitation. Had to force some food down for my tablets though. We are going to see friends this afternoon as we are all going on holiday together in April so we are going to book it.

This isn't like any other increase, I'm normally climbing the walls by now so not sure what's going on, I do seem to have more energy though so fingers crossed that continues.

Angie good idea about writing down how you feel, that way you will have a record for your doctor if you need it. It's wrong they have opinions like that, you know best how you feel so push if you think you need to increase.

Right I am off to do day 6.

Take care. Ava xx

[Angiesuggs]

HI Ava

You do sound as if you are making really good progress. Maybe even 187.5 is enough to keep everything at bay. I had a really bad day yesterday not sure why? I thought I was doing ok and getting back to normal. The anxiety was there maybe not as bad as it was months ago before I started Ven. Did you have days like that?

I have got up this morning and not so bad but feel not like I have been the last few weeks. I am hoping its just the settling in period still.

Have a good day

Angie

[Paradise10]

Hi Angie, all part of the settling in process. I had the odd bad day here and there in the early days or the odd couple of days. It should all level out as you go forward. We all have bad days even when not on medication.

I do seem to be doing OK on this increase, my energy levels have improved, that happened in the first few days so fingers crossed it progresses.

Ava xx

[Angiesuggs]

Hi Ava

i am so glad that things are going well for you. It seems to be that this increase has not caused too many issues as I know you were really scared of going up a dose. Did your book your holiday? It’s also amazing that you can think about going away now without worrying too much.

Did you do ok on 112.5 before you went up to the 150?

take care

Angie xx

[Paradise10]

No not booked the holiday yet but been to the travel agents tonight and thinking of Egypt.

With regards to my dose I went to 112mg and things leveled out at 8 weeks. I always think of 12 weeks as the max to try a dose and then to increase, although this time I'm doing 187 for another week then going to 225 re the psychs instructions, also reduced the nortryptline yesterday.

Another so so day today which is day 8, no crazy anxiety, just waiting for something to happen now I guess although I know it's too early.

Keep plodding on.

Ava xx

[Angiesuggs]

Hi Ava

You see to be doing really well I am so pleased for you. I have been to Egypt many years ago now and loved it.

Just to update you I rang my GP yesterday and had a few tears which is not like me. I asked to go to the 150mg which she gladly advised so it was the battle I was expecting. Most people I know are on 150mg and are doing really well so I hope this is the case for me.

I am also hoping it kicks in much sooner but this maybe wishful thinking. Reading past post from you on here you seemed to do well on 150mg for sometime?

Are you more relaxed about taking this higher dose now? Sometimes I still have a hang up about taking medication. When I took citalopram I never classed it as an antidepressant I was just something I took each day and never thought about it.

I have a really hang up about taking these meds and I don't know why? If they keep the anxiety/depression at bay and I can really enjoy my life why would I feel awkward about taking them?

Well anyway, hope you have a good day and that you feel things improving soon

With love

Angie xx

[Paradise10]

Hi Angie, I am doing OK. No anxiety really at all and a little extra energy which is good. Day 11 for me now and I go up to 225mg next Tuesday. Also dropped 10mg off the nortryptline earlier this week and no effects at all from that. Just a waiting game now.

I really hope the 150mg is the little boost you need for that final part to come back, you have given the 112mg a good amount of time so this could be the last little bit you need. I was OK for quite a while at 150mg so fingers crossed you will be too.

It might be you feel this way about the venlafaxine as it's not working 100% yet and when it does you might think about it the same way as cit. I do know what you mean though as I was the same but then I felt 100% on them and I haven't got to that level yet on the ven.

We will both get there.

Ava xx

[Angiesuggs]

Hi Ava

So lovely to hear from you and that you are doing so well. I bet you can’t believe how seem less this transition has been. I really hope and have my fingers crossed that the 225mg will be the same. Can’t believe it’s been nearly two weeks since you started the increase. That time has gone quickly.

I am hoping I just need that tiny bit more to put all the jigsaw pieces together and get my whole life back. I think I only need that last shove and I also have my fingers crossed that this will work. Know so many people on 150mg that do really well and have been on them for years.

Not sure how long in total you have been on these? For me it’s only been 4 months. I just crave my old life back when I could do anything and go anywhere without thinking (obvs before Covid)

Haven’t heard from Ian in a while I hope he is well. Such an interesting man and so informative.

wishing you well on this windy weekend.

Angie xx

[Paradise10]

Hi all, well I have done the 2 weeks of the increased dose of 187.5mg and I am now on day 3 of 225. I have also dropped the nort to 20mg and go down to 10mg next Tuesday.

The first week of the 187 I had a few spacey moments, my anxiety reduced and my energy also increased, towards the end of week 2 the increased energy went and I started getting some headaches. The first few days on the 225mg the headaches have been quite constant and I have also felt quick sicky even though I make sure I take my tablets with food. I have also felt a bit agitated and restless but no crazy anxiety. I have my next Phych appointment in 4 weeks when I will have been on this dose for 4 weeks and I will be off the nort by then as well. Not needed any diazepam at all so far either which is great. Am finding I could eat everything in sight though which isn't good.

I have my third cbt session this afternoon, not to sure on this yet as for the last 2 weeks I have been recording everything that I do in 2 hour blocks and then rating my emotion next to each one, mine is full of either frustration or flat... I do make myself do a lot though. Not noticed any lift in mood yet though. Maybe too early.

Angie how are you getting on with the 150mg? I hope you are doing well.

Take care all, Ava x

[Paradise10]

So today is day 7 on 225mg of ven, I would say up to now day 5 was the worst, I felt really sick all day to the point of whenever I moved I felt like I was going to throw up. Wasn't nice. Since then I would say the main side effects have been headaches, they are pretty much constant at the moment and I also have some jaw ache, and nausea. The side effects seem to become more noticeable in the afternoons and then wear off early evening. I was expecting much worse but I have no increase in anxiety at all. Winner winner chicken dinner. (I just need them to work now.)

I am dropping the nort tomorrow by another 10mg so that will leave me just on 10mg of that which I will stop in another week or 2. I am due to see the phych in 3 weeks and by then I will have been on this dose for 4 weeks.

Well that's it for now. Ava x

[Paradise10]

Day 8 on 225mg and the headaches and nausea are really quite bad at the moment. I think I could have shares in paracetamol and Rennie at the moment. Also still feel quite sluggish but that could be down to feeling rubbish with the other side effects going on. I really hope these pass soon as it's quite difficult working when your head is banging and you feel like you are going to throw up all day. apart from these side effects nothing major to report really.

I drop down to 10mg of nort tonight for a week or 2 then stop that completely. I know it's far too early to expect anything but I would settle for getting rid of the headaches and nausea at the moment.

Ava x

[Angiesuggs]

Hi Ava

Sorry not been in touch, I think it's just because my life has been so busy. I am not sure what has happened but since starting the 150mg I have been feeling great. I don't want to jinx this but 2 weeks down the line and no issues at all. I do have saw as you jaw pain but only on the right side. I wake in the morning and feel as if someone has punched me. It wears off during the day but comes back again each morning. If thats the only side effect then I can deal with it.

I have been doing more and going out. Went to the cinema last night, been out for food as well with no issues. I so hope this is it for me now. Not sure if its the 112.5 finally kicking in or the 150 starting to improve things. I know with Ven that time is the essence so I do hope say in another 6/8 weeks I will be much better again.

I still don't like the issue of taking these tablets and can't seem to get passed that even though I took Cit for years. But I am sure it will become part of my routine soon enough. So glad you are doing well with minimum side effects. I do get the headaches as well but not as bad now.

I so hope this continues for both of us.

With love
Angie xx

[Paradise10]

I'm so pleased things are going well for you Angie, fingers crossed this is the dose for you. x

So day 10 for me on the 225mg and the last 5 days haven't been good at all. The main things I am experiencing at the moment are...

Severe nausea that starts about 3-4 hours after I take my ven in the morning and lasts until I go to sleep.
Headaches, mainly between and around my eyes and my jaw feels a little sore, think I am clenching.
My muscles ache, and they are really fatigued when I go to use them. Again I think I am tensing them up.
Fatigued in general.
Disturbed sleep.
A little anxiety back.

I called my doctor yesterday to ask for some anti-sickness tablets as I know people have been prescribed them but he told me he wanted to see me. I went into the doctors and he said the things I was experiencing were because I have too much Venlafaxine in my system and he wanted me to drop back down to the 187mg. This really confused me as I thought these were all just side effects that would improve in the next week or so. I told him this and he said he didn't think that was likely. I said it would be a shame when I have done 9 days on this dose to drop down and he reluctantly gave me some anti-sickness tablets but told me that I couldn't have them for any more than a week and only to use when the nausea was extreme as they would make me feel drunk. He also made a note on my file that said I had gone against his wishes to drop the dose down.

This all really confused me and made me feel really bad and then I started questioning if maybe the dose is too high. My family said to stay on the 225mg dose and to email the phych so I emailed him yesterday afternoon. No reply as yet and I am due to take the next dose again now and I am scared. I just feel so conflicted on what I should be doing. I am going to take the 225mg today though and hope the phych messages me back today.

I need to go and pick the anti sickness up from the chemist so I will go in my lunch hour today and take one this afternoon if it gets bad again.

My parents are flying off on holiday today for a week so I can't even go around there to work... Oh well onwards as usual.

Ava x

[Paradise10]

So today is 5 days reduced back down to the 187.gmg after the phych said to drop back down. The nausea has lessened, still there slightly but not nearly as bad.

Not sure how long I have been on these in total now, I think it is 4 weeks.

Up to now...

Anxiety is reduced from when I started.
The muscles in my arms, legs, face and chest are all tensing up, I am pretty sure this is involuntary and not me doing it, when they do release they are sore and very weak and I also think this is causing the headaches. This is the main problem at the moment. I also had this at lower doses and I don't think it fully went away so if it is still here in 2 weeks when I see the phych I will have to mention it as it is making my body exhausted and weak. It is also taking me ages to get to sleep at night.

That it is for the moment.

Ava x

[Angiesuggs]

Hi Ava

I am so sorry things have not gone to plan for you. Do you think the dose of 187 will be the dose you stick at? Did reducing back down go ok as sometimes maybe that can give you some withdrawal symptoms similar to side effects.

Things this week haven't been too great. That sinking feeling has come back but not as bad and the ability to look forward to things and feel I want to enjoy them has not been there. Hope you understand what I mean?? I know its only 21 days on the 150mg so probably only now they are getting into my system that's why I am experiencing some side effects now I think. Not sure about you but this wears me down at times as I just want to get on with my life as it used to be. You read good and bad reviews wherever you go for every medication not just AD's. But this med is supposed to be the best and is prescribed by many Psych's over anything else.

I am now also putting on weight quite rapidly so am having to start to watch what I eat and limit my calorie intake. I hope these feelings are just due to the rise in the dose and will settle soon and I can enjoy my life without food haha. I know quite a few friends on 150mg and they are doing so well.

I can't help but compare to Cit when I felt well all the time obvs until they stopped working. I know Cit would not have worked straight away for me so I must have gone through some process. I know comparing isn't going to do me any good.

Hope the last few days have been good for you Ava. I do think about you a lot.

Much love

Angie