Back on Venlaxafine.

[KK77]

SV - I know you're really struggling here but you're trying too hard to cope on your own IMO. My original point was that if you're having all these awful side effects now, then doubling the dose could become intolerable. And I agree with Marie that you're in a difficult situation because this isn't a med you can simply stop without careful tapering. I would definitely ring your doctor tomorrow and ask for advice re delaying the increase till this dose has at least somewhat stabilised.

[spamvicious]

I had a good nights sleep last night so that's helped. I know I'm gonna get side effects with either dose and I know that 150mg works for me so it makes sense to start that dose in a couple of days rather than waiting and being on 75mg longer and it probably not do anything for me or help the anxiety anyway.

[SADnomore]

Okay, if you are going to do that though, I would still encourage you strongly to ask for the extended release capsules and take in the morning (after food). The food is needed to offset nausea side effect, more than just a biscuit or a piece of toast, something substantial. This will also help prevent sleep interference from the ven.

I've been on the extended release from the start. I have no doubt that this form reduces side effects, but it seems I'm sensitive to side effects and need to just ride them out. I sat tight through the start-up phase eating small meals and snacking regularly, keeping my water bottle filled and at my elbow, and curling up with a blanket and taking it easy (tv, this forum, etc.) There are lots of good threads on venlaxafine, very informative and encouraging, and that's mostly what I read. I hope that you have this time to be gentle with yourself, too, and wish you much luck in any case!

Marie

[spamvicious]

I've already been given the tablets I have to take which are the standard release ones. 75mg twice a day etc. I won't be able to get a new prescription from the psychiatrist over the phone so I'll just have to take them as they were prescribed. I was on these ones before and was ok, I think I'm just so sensitive to the side effects now as I'm already so anxious. When I tried ven the first time I didn't suffer any side effects as I was stable when I changed over etc so now it's just playing on the anxiety that is already there.

[KK77]

The extended-release capsules are milder on side effects because they release the drug far more slowly, thus also easier re missed doses. This was a question you asked previously SpamV, so don't know why you're suddenly being so dismissive.

Good luck with increasing your dose but your obstructive attitude will not help matters.

[spamvicious]

Sorry I didn't mean to be dismissive, I just mean the situation I'm in at the moment being away from home and staying with family means it would be hard for me to get a change in prescription right now. I'm going to call my psych today and discuss what you guys have said about whether to stay on 75mg for a bit or trying to get a prescription for the extended release tablets.

I really appreciate all the support you guys have given me, it's just hard I'm trying to follow the plan I was given and I'm feeling so much worse panic wise than I have in weeks. I'm barely eating as I just can't face it.

[valatpaws]

Hi
I can sympathise with you as I am going through the same at the mo. Thought I could cope on a low dose of venlafaxine and orbited straight into mega anxiety. I have gone back up to my original dose and have been there for a week. The mornings are like a death sentence and the days not much better. Wish I had known the implications of withdrawal. The anxiety is like dying inside and getting help from this site is a godsend.hang in there we will get there.im told it's just time

[spamvicious]

Val that's exactly how I feel like I'm so scared that my heart is going to stop. I spoke to my psychiatrist yesterday and she said there is no evidence of the extended release tablets are more effective than the standard release ones so wouldn't change the prescription. She said it will get worse so in the mean time I have to take 1mg lorazepam 4 time a day. Before I was on 1 or 2 a day but now I have to take all 4 until the venlafaxine kicks in. I hope in a week or 2 at most .

[SADnomore]

Hi, again! Maybe once you are being monitored and cared for moreso by your gp, you could see about switching to the extended release capsules, it is just a suggestion, and of course, up to you. The reason we all have suggested switching to the extended release is not because it would "work" better, but rather because the side effects may be lessened due to the slow release of smaller amounts over the day, as opposed to immediate release, twice daily. Plus it is easier to remember the one capsule taken with breakfast than two different doses each day as time goes on. At any rate, no doubt being ramped up so fast to 150 will naturally have you feeling side effects exponentially. My heart goes out to you. We are all glad to help in any way we can, so you can be successful again with the drug that has helped you before (and lots of us here too!)

Rightly or wrongly, it seems as though our doctors don't give very much consideration to side effects as they weigh out benefits of medications and dosing and timing. Unfortunately, patient compliance often falls victim to side effects, no matter how much the patient wants to stay the course. As some have put it, maybe if the doctors actually had to take the drugs themselves for a bit, they would give them more regard and plan for them better! If you are still finding that the lorazepam is not helping enough, maybe have a chat with your doctor(s) about some propranolol for your physical symptoms that can help to slow you down a little without the woozies (and potential for addiction).

Most likely your pdoc is trying to get you ramped up to 150 asap because of heightened concern for your wellbeing. She clearly believes that it is imperative for you to become stabilized as fast as possible, even if it means having to weather a storm of side effects right now. She may be worried that there isn't time to lose, and we all have to respect that. I know we appreciate your resolve to follow her instructions and to get feeling better.

I can relate very much to your breathing symptoms. For me, I felt they were tied to a strong feeling of knots in the stomach that took my breath away! If you have a heating pad, you might try bundling it inside a towel and sitting with it against your chest and abdomen for a bit, that helped me a lot. The gut is filled with serotonin receptor cells, and these are what are being triggered and this may be felt in a physical way. (Put very simplistically, there is another "end" to the receptor which will shut down production of serotonin in response to the other end no longer uptaking it, (due to the ven). We experience this loss of serotonin as a spiking in anxiety. For myself, it was mainly felt as physical tension, and the heat and slow deep breathing helped a lot.) Over time, the cell becomes desensitized to the continued blocking response, and serotonin production begins again. This is when the side effects ease off, and we start to feel the benefits of its increase.

Many people note that at 150 mg, venlaxafine begins to block the reuptake of norepinephrine, so that more of this neurochemical is also made available to the system, with a similar temporary spike in anxiety to be gotten through first. (My pharmacist however says that the dose at which this occurs varies from person to person.) Then too, after a time, this temporary spike in anxiety abates and benefits begin to be felt from the rise in norepinephrine.

I don't know if you find this explanation reassuring, or boring (lol!), but hopefully you can take faith in the fact that relief is around the corner. Do keep reaching out, try to hang on, and see what other encouragement you can find on the site regarding venlaxafine. Do you plan/hope to stay on it long-term?

Marie
p.s. Good for you Val for accepting you need to go back to your original dose, and yes, absolutely, time and patience will pay off. Atta girl! Same advice off to you with hugs!

[spamvicious]

Tomorrow is the 7th day back on 150mg and I'm already feeling a lot better. I'm still getting chest pains and heart jolts but not the mental anxiety that goes with it. Here's hoping I'm finally back on track