Has ven stopped working

Quote:

Originally Posted by Stronglady

Hiya, I've been on ven 75mg for approx 8 years.. Its been a life saver.
I was diagnosed severely anemic 6 months ago along with panic/anxiety returning the same time I've been going through the mill since.. although the anxiety is getting less and less.. I'm still contemplating upping my meds as I'm sick of the battle with anxiety..
Question is... anyone's meds just stopped working and how do you know or should I just still plod on with battling my anemia in the hope that once that's sorted, anxiety will disappear xx

Yes, antidepressants (ADs) can stop working and the SSRIs are more prone to quit than other AD classes (despite the claims, venlafaxine is really only a SSRI, not SNRI). Whether venlafaxine has permanently failed for you I can't say, however, given the stress you've been under it may be the dose is simply now inadequate and an increase will return the AD to full effectiveness.

ADs have no direct effect on anxiety (or depression) in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels, mostly of cortisol. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly. For a more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

The problem is when stress levels rise, as they have in your case, so do cortisol levels which may then inhibit neurogenesis more strongly than the med can stimulate it at the current dose.

75mg is only the usual minimum therapeutic dose. The recommended maximum is 375mg with most taking 100-225mg for optimum results (225mg is about the dose at which venlafaxine begins to inhibit noradrenaline, aka norepinephrine, reuptake so becoming a SNRI, albeit still only a weak one).