Adding Venlafaxine to Mirtazapine
Hi I've been hanging out in the Mirtazapine forum until now, but yesterday I saw a psychiatrist for the first time and she has decided to add Venlafaxine to my medication. I'm currently on 45mg Mirt and for three days she said to take 37.5mg Ven, then after 3 days to go down to 30mg Mirt and take 75mg Ven.
To be honest I'm terrified, terrified of possible side effects, of it not working and being stuck in this anxious/depressed state and terrified that I'm going to ruin Christmas for my three kids....
So I guess I'm here for a bit of moral support and to ask if there is a best time to take Venlafaxine or if it doesn't really matter...and if anyone has any positive experience that might help morale but I realise most people come here because they've had a tough time.
Thanks all x
Re: Adding Venlafaxine to Mirtazapine
Hi I successfully take ven for my anxiety and it has helped me tremendously so I would definitely recommend you give it a go, the mirt/ven combo is supposed to be very effective so you might not need to go as high as me just on the ven, I take 187.5mg slow release once a day, I take mine in the morning but try and take it with food as it can make you feel a bit nauseous to start with, I always used to have a biscuit then take it as I don't eat breakfast. As for side effects you might feel slightly nauseous, I felt quite tired and my pupils dilated too which freaked me out but it's very common and soon settled, you might notice your anxiety heightened slightly but as your not going above the 150mg dose where it kicks starts more transmitters this should be bearable. I hope this helps XX
Re: Adding Venlafaxine to Mirtazapine
Thanks Nicola.
Two days in and I'm not sure I can do this...anxiety increasing and I've got nothing left...just want to die. This is so hard.
Re: Adding Venlafaxine to Mirtazapine
Stay in contact with the people on here and they will help you through this. Nicola will tell you how she had a very hard time in her last adjustment but people were here to support her through it.
Just take it one day at a time. Don't think about anything except getting to tomorrow and think to yourself "anyday now it will break and reduce". Thinking this got me through 8-10 days of the worst hell I've ever had by miles when I started Duloxetine.
It may be helpful if your GP can give you some Diazepam as you go through this. Whilst it will still be very hard, it can really help to have a couple of hours of relief. I did this the last 2 days by taking one when I woke as the adrenaline rushes were unbearable, I felt like my chest was going to burst, I wanted to sprint a marathon (think the lift scene in the film Crank).
Re: Adding Venlafaxine to Mirtazapine
Hi the Ven will take a few days to settle and you should be fine, especially at that dose.
Il be interested in hearing how you get on with Ven/mirtazapine combo as I think il be doing the same shortly. I would like to take it in the day if poss and not rely on it as a sleeping aid, however it seems to be very sedating according to other folks experiences. Have you been on the mirt long, and when do you take it?
Tims
Re: Adding Venlafaxine to Mirtazapine
Something that might be worth talking about on here is which version you use. I've seen how people say they struggled more on the standard version than the XR. This makes total sense to me because the XR has a similiar half life to Sertraline but the standard is very short and it makes me wonder whether this has a significant impact because I just can't see how you can keep it stable as it's heading out of your blood plasma so quickly each day and a couple of doses spread out just wouldn't keep it up to the higher levels you would experience on the XR.
Re: Adding Venlafaxine to Mirtazapine
Thanks Terry, I really appreciate your messages so much. I've taken some diazepam which has helped a bit...and yes I think I might have to keep sending sos messages out on here.
Interesting point about the slow release - I'd wondered the same about the short half life, seems a bit crazy. I'm currently on the standard version, I'm guessing they're cheaper?
And Tims, yes I'll keep you posted. I've been taking Mirt for just 12 weeks. To be honest it has been great for helping me sleep and maybe slightly taking the edge off the anxiety but I've still been feeling pretty terrible. I take it approx 10pm because of the sedation. When I started on the lower dose I was really knocked out but that passed after a couple of weeks. I still think it's helping me sleep at 45mg (highest dose) but other people tend to find it stops sedating at 30/45mg.
Is there a reason you want to take it in the day? It might be tricky to stay awake to start with if you do.
---------- Post added at 12:58 ---------- Previous post was at 12:56 ----------
Ps Terry sounds like your mornings are pretty rough right now. Hope they settle soon for you.
Re: Adding Venlafaxine to Mirtazapine
Pricewise a years treatment on 75mg of standard is £17.94 or for XR it is £287.04.
So, it's a no brainer for a GP - unless you press them for it, they won't offer it. :winks:
Don't you find it interesting how cheap it is? So, that £8.20 we pay that we are told is a "subsidised prescription charge" would cost you far far more over a year than this. So, they make a profit. And if you think it's the logistics & dispensing, just look up your meds on the online pharmacies who will sell them to you on private prescription from a doctor and the prices tend to be the same which shows it's pure profit to the NHS. The NICE guidelines for GAD even state to use Sertraline "off label" as the first line drug because it's cheaper, not better! Lovely.
This is my night time, my days are upside down. Part of my OCD I'm afraid.
Re: Adding Venlafaxine to Mirtazapine
You can do this, I had an awful time earlier this year increasing my dose, my anxiety rocketed to a level I'd never experienced and don't want too again and I very nearly gave up and if it wasn't for the support on here I think I would have but now I'm so pleased I saw it thro as I'm so much better. Yes Diaz is a godsend when your starting up and increasing, I was taking it daily to help me and it did take the edge off. I was started off on the standard release then when my dose got higher I asked for the slow release, the slow release is alot more expensive hence why you don't get automatically prescribed it but I do feel you get a smoother ride on it but most people are started off on the standard release, when you increase to 75mg take 37.5mg 12 hours apart twice a day XX
Re: Adding Venlafaxine to Mirtazapine
Thank you so much Nicola...honestly the kindness of people like you and Terry taking the time to help really amazes me...thank you both.
Tomorrow I have to reduce Mirt from 45 to 30mg as well as increasing to 75mg Ven, I think the diazepam will need to be at the ready, I'm honestly dreading it.
And Terry, if this is your night time it doesn't look like you're getting much sleep, hope you get some rest soon.
Joy (my real name...a bit ironic in the circumstances)