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Raised Anxiety after starting Ven
Hi, been on the Mirt forum for some time as on 30mg per day. Recent problems got dr to start me on 75mg of Ven which I started last week so I'm 4 days on Ven now. Noticed that my Anxiety has been worse and I kind of feel wired, on edge only feeling calm come evening. Still on Mirt but I think the plan is to come off that once Ven gets into my system. I guess im asking in general, how long this raised anxiety lasts as I have a habit of panicking when it comes to med changes and have stopped taking them before due to startup side affects. Want to give this new drug a chance so is it like Mirt where it can take a month or so to start to work.
Thanks
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Maca44
I guess im asking in general, how long this raised anxiety lasts
Unfortunately, this is one of those how long is a piece of string questions which can only be answered with, it depends.
The problem is despite the common myths that serotonin is a *'feel good' neurotransmitter and ADs work by raising brain serotonin levels, the opposite is true in both cases. Serotonergic ADs like venlafaxine do trigger an immediate increase in synaptic and general brain serotonin levels from the very first dose which is what triggers most of the unpleasant side-effects. But after a few weeks they force a significant down-regulation of serotonin synthesis and expression in regions of the brain linked to anxiety and depression. However, the process can revert for a while following dose increases, though side-effects severity tends to be less each time.
*neurotransmitters don't have an intrinsic property, their action is determined by the receptors they bind to, not the neurotransmitter itself.
Quote:
have stopped taking them before due to startup side affects
Speak to the prescribing doctor if they become intolerable. There are ways of minimizing them with meds such as mirtazapine, the benzodiazepines (if you can get a script), or milder anxiolytics such a hydroxyzine, etc.
Quote:
Want to give this new drug a chance so is it like Mirt where it can take a month or so to start to work.
Most antidepressants take 4-12 weeks to kick-in from when a therapeutic dose is first taken. They work by stimulating the growth of new brain cells in the hippocampal regions of the brain and it is the new cells and the interconnections they forge which produces the therapeutic response, not the ADs directly. Mirtazapine appears to become effective sooner for anxiety because of the sedation. It is more a sedating antihistamine than antidepressant.
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
panic_down_under
Unfortunately, this is one of those how long is a piece of string questions which can only be answered with,
it depends.
The problem is despite the common myths that serotonin is a *'feel good' neurotransmitter and ADs work by raising brain serotonin levels, the opposite is true in both cases. Serotonergic ADs like venlafaxine do trigger an immediate increase in synaptic and general brain serotonin levels from the very first dose which is what triggers most of the unpleasant side-effects. But
after a few weeks they force a significant down-regulation of serotonin synthesis and expression in regions of the brain linked to anxiety and depression. However, the process can revert for a while following dose increases, though side-effects severity tends to be less each time.
*neurotransmitters don't have an intrinsic property, their action is determined by the receptors they bind to, not the neurotransmitter itself.
Speak to the prescribing doctor if they become intolerable. There are ways of minimizing them with meds such as mirtazapine, the benzodiazepines (if you can get a script), or milder anxiolytics such a hydroxyzine, etc.
Most antidepressants take 4-12 weeks to kick-in from when a therapeutic dose is first taken. They work by
stimulating the growth of new brain cells in the hippocampal regions of the brain and it is the new cells and the interconnections they forge which produces the therapeutic response, not the ADs directly. Mirtazapine appears to become effective sooner for anxiety because of the sedation. It is more a sedating antihistamine than antidepressant.
Hi, thanks for taking the time to explain things. I guess its just a case of putting up with it until it settles then I will know how long the piece of string was😀. Yes the Mirt never really worked great with my anxiety but did help with sleep and has helped over the last few years but I think a med change was long overdue as things have been getting worse over the last year. There is also the weight gain which isn't helping my confidence or health so its one of the things I hope to address once we start the Mirt reductions depending on how well the Ven works for me.
Thanks again
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Re: Raised Anxiety after starting Ven
God this is hard going, day 7 on 75mg of Ven and still on 30mg of Mirt pm until dr tapers it down. Anxiety is pretty intense especially in the morning. I work in the afternoons for 4 hours and am worried I'm going to lose it and not be able to go in. I really hope this intense anxiety subsides soon I'm finding it hard to deal with and my gp is not the sort to dish out a sedative. If this goes on much longer I will need to think about stopping it. An advice would be much appreciated.
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Maca44
I really hope this intense anxiety subsides soon I'm finding it hard to deal with and my gp is not the sort to dish out a sedative. If this goes on much longer I will need to think about stopping it. An advice would be much appreciated.
You are probably very close to seeing a reduction in side-effects. They usual begin diminishing as plasma levels of the drug stabilize to a steady-state which should have occurred a couple of days ago so try and hang on a little longer if you can. While your GP might not be keen on prescribing a benzodiazepine (BZD), there shouldn't be an objection to trying hydroxyzine as it isn't habit forming (not that a few days on BZDs would be either).
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Re: Raised Anxiety after starting Ven
Thanks
It is so hard to keep calm even though I keep telling myself it will pass.
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Maca44
It is so hard to keep calm even though I keep telling myself it will pass.
Yes, it is hard. Try and distract yourself as much as possible. The first time I started on an antidepressant I rather stupidly demanded the dose be raised as quickly as possible as I wanted to speed up the process to protect my job. It was a horrendous experience, but one I got through by 'reading'. Actually, more just looking at the pages one word at a time without really comprehending what it was all about, but it got me through some very dark days. I've used the same strategy several times since with the same books when things became bleak while restarting, or switching ADs. I still have no idea what the books are about.
Another thing you can try to ease the heightened anxiety is a rudimentary form of acupuncture. Run your index finger down the back of an ear where it joins the skull until you find a hollow toward the bottom and apply firm pressure at that spot for a minute or so, though not to the point it is painful. Reapply as necessary. One ear is often more effective than the other, but this can change from day to day so you may need to experiment.
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Re: Raised Anxiety after starting Ven
It was so bad at work yesterday I had to take half of a Zopliclone to calm down, Its been a few years since my panic/anxiety has been that bad. The odd thing is I know its panic so im not thinking im dying because I know its panic but I still have that totally out of control panic feeling. The Zopliclone calmed me down but its not the best thing to use while out driving. I will try the ear pressure, thank you.
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Re: Raised Anxiety after starting Ven
Hi Maca.
How are you doing this morning? Panic down under has given you great advice, and I'm going to try the ear thing too!
Do you think the anxiety is about taking a new medicine? Or do you feel it's a side effect? Might be difficult to tell I guess. What strategies have you used before for panic? It's really good that you recognise it's just panic and you aren't dying, and you WILL get through it just fine.
I switched from citalopram to Ven and didn't have major side effects, just a couple of mild ones. That said, when I've done dose increases I've had side effects. First time I gave up and went back to original dose, but they do subside if you can stick with it.
Out of interest, what time do you take your Ven? And is it 75mg once a day (extended release) or twice daily (37.5 immediate release)?
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Dying_Swan
Hi Maca.
How are you doing this morning? Panic down under has given you great advice, and I'm going to try the ear thing too!
Do you think the anxiety is about taking a new medicine? Or do you feel it's a side effect? Might be difficult to tell I guess. What strategies have you used before for panic? It's really good that you recognise it's just panic and you aren't dying, and you WILL get through it just fine.
I switched from citalopram to Ven and didn't have major side effects, just a couple of mild ones. That said, when I've done dose increases I've had side effects. First time I gave up and went back to original dose, but they do subside if you can stick with it.
Out of interest, what time do you take your Ven? And is it 75mg once a day (extended release) or twice daily (37.5 immediate release)?
I take it am 75mg extended but can't eat am so just have it with coffee. I'm still on 30mg of Mirt pm so, yes I think its the meds causing the raised anxiety but also a little of my own startup/new med anxiety also. I have practiced mindfulness audio and deep breathing for years but when Im like I was yesterday I can't do anything but panic, also closing my eyes and meditating with headphones on while driving don't go well together 😀.
Still very early days its day 8 on Ven and I did sleep last night and evening was calm so that was good.
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Re: Raised Anxiety after starting Ven
Hi Maca, I am on day 3 of cross tapering 10mg escitalopram and 75mg Venlafaxine and like yourself I take 30mg Mirtazapine at night. Next week my psychiatrist is going to increase me to 150mg and stop the escitalopram. She says that at 75mg venlafaxine acts as an SSRI but it starts to affect the Noradrenaline transmitter at higher doses and this is better for anxiety. Maybe you will get a better effect if you increase again? It’s a scary thought I know (I also have a small supply of diazepam to take in case the anxiety gets really bad.)
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Re: Raised Anxiety after starting Ven
Yes I will see what dr says on next visit on Tuesday.
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Jo79
Hi Maca, I am on day 3 of cross tapering 10mg escitalopram and 75mg Venlafaxine and like yourself I take 30mg Mirtazapine at night. Next week my psychiatrist is going to increase me to 150mg and stop the escitalopram. She says that at 75mg venlafaxine acts as an SSRI but it starts to affect the Noradrenaline transmitter at higher doses and this is better for anxiety. Maybe you will get a better effect if you increase again? It’s a scary thought I know (I also have a small supply of diazepam to take in case the anxiety gets really bad.)
Keep posting on how your getting on, I think me raised anxiety is getting better after it went sky high @ about day 3 on Ven. Could be me being anxious about med changes but I do believe the med is a factor.
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Re: Raised Anxiety after starting Ven
So glad you had a better day. Fingers crossed you're through the worst of the side effects now. I totally understand not feeling able to control the panic when it gets like that. Have you tried the "sigh breath"? I can't remember the exact procedure but can look it up, but basically you force yourself to sigh and I think the theory is that it helps to regulate your O2/Co2 levels. Another thing I sometimes find is that when I'm anxious about a situation, I subconsciously tense a lot of muscles, and so sometimes consciously relaxing them again can help.
75mg XR in the morning sounds a good plan. Do you find the "on edge" feeling improves after you take your dose in the morning?
Hope you're feeling ok today.
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Dying_Swan
So glad you had a better day. Fingers crossed you're through the worst of the side effects now. I totally understand not feeling able to control the panic when it gets like that. Have you tried the "sigh breath"? I can't remember the exact procedure but can look it up, but basically you force yourself to sigh and I think the theory is that it helps to regulate your O2/Co2 levels. Another thing I sometimes find is that when I'm anxious about a situation, I subconsciously tense a lot of muscles, and so sometimes consciously relaxing them again can help.
75mg XR in the morning sounds a good plan. Do you find the "on edge" feeling improves after you take your dose in the morning?
Hope you're feeling ok today.
At the moment the on edge/anxiety is in the morning and lasts until about an hour or so after I start work at 2pm. I didn't sleep well last night woke up in a panic so sat in summer room with my cat until it went so knackered today. I do a breathing exercise where you breath in for a count of 4 hold 4 breath out 4 and repeat. Problem is that when I'm really out of control anxious nothing helps I just let it run its course.
Can't say I feel better but I'm not feeling worse so that's a + i suppose.
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Re: Raised Anxiety after starting Ven
I'm sorry you had a rough night. Cat cuddles are always soothing :) Yes, when panic takes hold it's really hard to remember the strategies. It's positive though that you recognise it for what it is and just let it go.
When do you go back to the GP? Are they going to reduce or just stop your mirtazapine?
I hope you're having a good day today
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Re: Raised Anxiety after starting Ven
Hi, yes I often look at my cats and wish I could relax like they can they have mastered the art.
Today not so bad so far and did sleep so feel refreshed. I think the idea is to reduce then stop the Mirt but I am going to suggest we might try a low dose of Mirt pm to help with sleep. I do have Zopliclone but that's not great long term also when my panic was so bad the other day I took half a Zop to calm down I was working at the time stuck in Southampton in the van so had to pull over and get things under control, that panic was very intense.
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Re: Raised Anxiety after starting Ven
The panic/anxiety attacks are still intense but do not last long so I am hoping things are starting to settle down. Have been sleeping but not deeply but do not feel tired in the day so must be getting sleep. Have been able to get off my bum and do some garden work all be it just a little but still something.
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Re: Raised Anxiety after starting Ven
Hey Maca. That sounds positive and well done for sticking it out. I think managing to get with some things like gardening is a great thing to do. I find it quite therapeutic and satisfying. I'm sorry you're still having panic attacks, but it sounds like you're getting through them. I don't know much about zopiclone - took it briefly many years ago and remember getting an awful taste in my mouth, and then the GP refused to prescribe them, so that was that. I would say it's definitely worth chatting to your GP about carrying on with a small dose of mirtazapine if your sleep is still difficult.
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Dying_Swan
Hey Maca. That sounds positive and well done for sticking it out. I think managing to get with some things like gardening is a great thing to do. I find it quite therapeutic and satisfying. I'm sorry you're still having panic attacks, but it sounds like you're getting through them. I don't know much about zopiclone - took it briefly many years ago and remember getting an awful taste in my mouth, and then the GP refused to prescribe them, so that was that. I would say it's definitely worth chatting to your GP about carrying on with a small dose of mirtazapine if your sleep is still difficult.
Hi Dying Swan,
Yes the Zopliclone sedates me and I take one before bed. But I do have a problem as I really shouldn't be taking half in the day when really in panic mode but they do sedate me and stop the panic. My GP knows about this and that is why we are working towards a slow reduction of Zop in the hope that the Ven starts to work. The Zop should only be taken for a few days really simply because you can become addicted to it as I have. Still on the bright side, at least I have managed to get some work done today.
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Re: Raised Anxiety after starting Ven
That's good that you've managed to get some bits done. Do you take the zopiclone every night or just as and when? I'm not sure if it's the same as benzos where you get tolerant to it and need more for the same effect? I'm really hoping that's not the case for mirtazapine but I presume not. I can see why taking the zopiclone during panic isn't necessarily ideal, especially if you're at work or driving etc, so well done for being open with your GP so that you can figure things out together. Good luck for your appointment tomorrow, and I hope today is a good day
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Re: Raised Anxiety after starting Ven
Yes the Zop does need more of a dose the more you take it thats why they only prescribe short term so im well and truly hooked. I take one every night but take half in day if panic is severe. Mirt is not the same you wont need more its always been consistent for me.
Dreading work today as I was up at 5am in a panic so not looking forward to work.
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Re: Raised Anxiety after starting Ven
Just got back from GP's and she has been great. Going down on Mirt to 15mg then the plan is to go up with Ven to 150mg in 2 weeks with a view of coming off the Mirt. We are going to tackle the Zopliclone once I'm stable. Its was nice to be listened to as i am not keen on GP's due to bad experiences in the past.
Hope thing are on the up.
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Re: Raised Anxiety after starting Ven
Great to hear that you've found a GP you feel you can work with, and that you have a plan in place. I hope your day at work yesterday wasn't too bad and you're starting to feel better on the Ven :)
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Re: Raised Anxiety after starting Ven
Yes although I'm still getting panic attacks, I do feel they are shorter and my mind is dwelling on them less so I hope that is the Ven beginning to work.
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Re: Raised Anxiety after starting Ven
Still pushing on with new meds so now the Mirt is down to 15mg at night and Ven still at 75mg. Sleep is poor I keep having to get up and go downstairs as I wake feeling disturbed/anxious, not sure what that's about. I get so tired fighting anxiety all the time I guess you all know what that's like, just waiting for relief.
DR wanted me upto 150mg on wednesday but I said I wanted to take it slow but perhaps I should have taken her advise. Wife is on holiday with my daughter and my sons away all weekend so I'm panicking being on my own, I used to love time to myself but now, when alone, my mind just turns on itself and I feel crap. Hope things will change soon.
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Re: Raised Anxiety after starting Ven
Hey Maca. Maybe the lower dose of mirtazapine will help with sleep? When I increased from 75 to 150 Ven, I did it slower than the doc wanted and did a week at 112.5mg. You could ask about that maybe?
Is there something you could do whilst your wife is away to take your mind off things? Maybe listen to some relaxation exercises? Puzzle book? Something mindless but which switches your focus.
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Re: Raised Anxiety after starting Ven
Yes I'm going to hammer mindfulness AP this weekend. Isn't it funny, years back I couldn't wait for the weekend to come and couldn't wait fb or work to end, now its the other way round.
If you couldn't find the humor in it you would go mad.
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Re: Raised Anxiety after starting Ven
Mindfulness sounds like a great plan. Yes, humour is super important. I have a close friend who has anxiety problems and we often laugh out loud about things we've worried about. Do you have someone you can talk to about how you're feeling? Wishing you a happy and hopefully relaxing weekend.
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Re: Raised Anxiety after starting Ven
Yes I have an emergency mate, she also suffers but has done well on meds. Feel drained today and sick of intense health anxiety, its been with me since a very young age but I can cope with a few days of it but not this just wish they would prescribe a benzo to shut my head up and give me a break.
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Re: Raised Anxiety after starting Ven
Really glad you have someone to turn to. Will they not give you any benzos? I know they aren't the long term answer but understand the feeling of needing a break from it. You're doing so well though and it's still early days. I hope you manage to sleep ok and are feeling brighter tomorrow
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Dying_Swan
Really glad you have someone to turn to. Will they not give you any benzos? I know they aren't the long term answer but understand the feeling of needing a break from it. You're doing so well though and it's still early days. I hope you manage to sleep ok and are feeling brighter tomorrow
No benzo is not a thing my gp would give but I'm using up my supply of Zop so have needed to order more online. I had to take one at work Friday just to stop the panic then i got home late took 2 and was asleep by 9pm but up at 12 in a panic so its now 3am and I'm not tired. My friend does not have benzo so im stuck. Just starting to regret this med change now as i didn't think I would be feeling this bad.
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Re: Raised Anxiety after starting Ven
Oh no, I'm sorry you had a bad night. When are you next seeing your GP? I wonder if it might be worth going back sooner to explain how you're feeling?
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Re: Raised Anxiety after starting Ven
On the 6th, problem is she is booked up and I really only want to see her as the others can't handle my HA she is very good with it, treats me with kid gloves. I will just have to wait it out but not really sure she can do anything more.
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Re: Raised Anxiety after starting Ven
God this is getting tiring, asleep at 10pm after calming down after bath the awake at 12 feeling agitated went downstairs sat for a while. Back sleep up at 3am,same again agitated, then had light disturbed sleep until 6am when I had to get up as I was panicky. Its been like this for a few days/nights now. Does this never let up.
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Re: Raised Anxiety after starting Ven
It's horrible Maca. That's how I was for weeks until the mirtazapine. Is this still happening despite the zopiclone? What happens if you stay in bed and don't get up?
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Re: Raised Anxiety after starting Ven
Quote:
Originally Posted by
Dying_Swan
It's horrible Maca. That's how I was for weeks until the mirtazapine. Is this still happening despite the zopiclone? What happens if you stay in bed and don't get up?
Been taking 1 Zop later in evening @ 9pm. If I stated in bed I will just toss and turn and get all wound up, I just need to go downstairs and site until I've calmed down. The Zop relaxes me so I drift off in a lovely sleepy state until the agitation starts. I have given up trying to control it now I just don't have the mental energy anymore.
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Re: Raised Anxiety after starting Ven
This sleep pattern is really weird, 9pm take 1 Zop, wake at 12 get up wired, go back to bed wake 3am get up wired, go to bed light in & out sleep till 4.30am then up for day. Don't feel tired in day at all, really weird.
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Re: Raised Anxiety after starting Ven
That does sound tough, although I guess it's good you're not feeling tired in the day at least. I wonder what would happen if you changed it slightly and took the zopiclone either earlier or later?
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Re: Raised Anxiety after starting Ven
Yes might try taking it later but think best option is to reduce I have got to remember I'm still on 15mg Mirt 75mg Ven and Zop so they may all be fighting it out with each other. Mood is slightly better less negative so ready for the Ven increase.