venlafaxine increase side effects

[MyNameIsTerry]

Thats the problem with these meds Nicola, there is a fair bit of guesswork involved.

I think there has to come a point where it becomes a matter that the side effects are unusual and at that point its either going to be a reduction or moving to another. Thats the reality of it I guess and the way I looked at it when it was driving me mad was that if I stuck it out a little bit longer, at least I don't have to take a chance on something (and any side effects that brings).

The fact you are having some better periods is good. Mine was just non stop but far worse earlier in the day which matches my pattern of anxiety anyway. I know that Ven is less intense per mg compared to Duloxetine so maybe that explains why mine was constant but quick and yours is less constant but taking a bit longer?

If it just doesn't stop, then there is an issue to make a decision on but you are not there yet and still have a chance this will break and you can get back to where you were before on this dose. The increased anxiety and recent trauma will certainly make you more conscious of things on top of it all as well and this tends to feed the cycle (I'm not saying you could deal with that in a CBT way because I think when we go through this, its often beyond that rational method and we need it to calm down first).

Since my most distressing side effect occurred upon waking for 2 hours, I found Diazepam would mitigate that a fair bit and I wasn't left with as much residual anxiety afterwards. If you can identify when its at its worst, use the Diazepam to get through that if needed and if you feel able to, go without at other times.

[pulisa]

Excellent advice from Terry as usual. My only concern would be that ven is an absolute nightmare to get off so you don't want to be taking too high a dose if this is not suiting you. I think prolonged side effects from a dose increase with no reasonable benefit is unacceptable. Most doctors are completely unaware of how difficult ven is to manage and they whack the dose up thinking it will be easy to cut back if any problems occur.

I hope things settle down for you really soon, Nicola.

[MyNameIsTerry]

I agree pulisa. I've always resisted increases because I was concerned about the withdrawal issue, especially if you have to switch meds which must be a horrible situation for a month or two.

An example of this can be seen on the Pregabalin board where Avasmummy has been struggling badly and now her dose has been slightly reduced, she is experiencing less issues.

If increasing doesn't work, maybe combining would help as thats what she is trying next and I've seen people say it works for them on other threads.

I often wonder about the suitability of GP's in prescribing any of these meds. My GP told me once that he won't go behind standard doses without a referral to a specialist which he won't do for me for therapy (I would have to kick him for that but I've decided to go elsewhere for things thesedays) so he would be blocking changes to medication. Silly situation and only serves to prove the inexperience of an experienced GP!

I hate all this guinea pig stuff, they have no clue how badly this spikes it all. Roll on the electrostimulus treatments that are in research!

[pmrob1]

Hello people just looking for some advice. I had to start taking venlafaxine for anxiety on the 12th January. The initial dose was 75mg but when I went back to the gp's on Wed he thought it was best to increase the dose to 150mg per day. I have hardly been sleeping since starting on the venlafaxine is this likely to subside in time. Also I have been advised by a friend who is a mental health nurse that I should be taking the meds in a morning. Do people agree with that?

[nicola1980]

Hi i would recommend you take your venlafaxine in the morning if your on the slow release tablets as they can interfere with your sleep. Hope you coping ok on them XX

---------- Post added at 08:48 ---------- Previous post was at 08:41 ----------

Well yesterday my anxiety was unbearable again, I just didn't know what to do with myself so I phoned my out of hours doctor and 3 hours later a Gp called me back!! I was quite surprised he knew alot about ven as many Gps don't but he said it is def the increase causing my heightened anxiety and it's very typical of ven to cause this, he said so many people throw the towel in after 2 weeks as they just can't cope with all the side effects especially the heightened anxiety, he said he sees all his patients he starts or increases meds on in 2 weeks to check their managing the side effects ok. He told me to try and hang on in there for a bit longer if I can and all side effects usually diminish before 4 week's!! XX

[MyNameIsTerry]

Yeah, NICE actually have this in their guidance for treating depression:

1.5.2.4 When prescribing drugs other than SSRIs, take the following into account:

The increased likelihood of the person stopping treatment because of side effects (and the consequent need to increase the dose gradually) with venlafaxine, duloxetine and TCAs.

That says to me that the side effects can be worse which must be due to the norepinephrine issue.

I don't think you would be looking at the normal 4 week side effect window on a dosage increase, I thought the 4 weeks was normally when you first start? Side effects are expected but I would have thought to a lower level as compared to a fresh start on them.

Part of me wonders whether its because of the norepinephrine element and that your system needs to adjust to it again as opposed to the increase serotonin element but I would really hope it to be a shorter side effect window.

I really feel for you Nicola and I wish I could help because I remember when I went through this, I never want to feel like that again. I just held on to the the fact it would break but it was an unbearable experience.

[nicola1980]

Thanks Terry im sure it's because the norepinephrine has kicked in as I've now gone over 150mg, the doctor told me when you increase you basically start from scratch again with these meds that's why the side effects can be so severe. I'm literally hanging in there by the skin of my teeth at the min altho again last night I felt alot calmer and I was suffering awful chest pains due to panic before I increased which was so bad I was convinced I was having a heart attack and they have gone and I've not had a full blown panic attack since the increase either so are they good points? It's just this constant unbearable anxiety that doesn't seem to ease off until about 7pm...well it has for the last few nights anyway!! XX

[pmrob1]

Hello friends I was initially prescribed the 75mg slow release as two doses one in a morning and one in the evening. I have since been told by my friend who is a mental health nurse to take both doses in the morning as it is like taking 1 150mg dose. I have now done this for two days and it initially makes me feel quite sick and very shaky but by dinner time the sickness and shaking wears off. Just waiting for my sleep to improve and then hopefully on the long road to recovery. I hope that everyone has a good week and will be checking in over the next few weeks.

[MyNameIsTerry]

I think there is an old saying that works for some of this "one pain lessens another". I have times where I notice my anxiety increases and my sciatica seems to disappear. I wonder whether its because of how our minds are using so much focus on the greater perceived threat or issue?

So, maybe this current problem has snapped you out of the other one. That doesn't mean that when the side effects subside, the old problem comes back. Besides, sometimes a break in symptoms can mean they go because our brain has broken the connection as it kills off old connections in time if we don't use them.

It could be that the medication is in some way working to resolve that problem though.

Can you get some exercise to see if it lessens it? Its all due to the increased adrenaline in your system so it might help it metabolise. I know its hard and it might not do much or anything with it being an artificial issue but it might be worth a try if you can do something gentle, even some walking around your house for a bit.

I know what you mean, I would struggle to sit down for about 6 hours. I would be standing around in the kitchen watching TV from the doorway or watching the birds in my back garden because I just didn't want to sit down as I found it harder being scrunched up on a settee and I found the symptoms always worsened when I stopped.

It was a horrible experience and part of me wished my GP would be given some of them so he could see how difficult it is so he appreciated that being told its just side effects and they will go was not very helpful and maybe he would think about it a bit more before shouting "Next!".

pmrob1 - the nausea thing is pretty standard on antidepressants. I've always found I get this for a couple of days and then it moves onto different symptoms. When I started Duloxetine, I was sitting in the bathroom within 20 minutes for about half an hour. It was the same with Citalopram. No one ever told me about SSRI's and I wasn't on here (solely worked with my GP) and was taking Citalopram in the evening which resulted in a lot of insomnia, a referral to the crisis team and Zopiclone to counteract the issue. I wish I was on here back then! Sleep was fine on Duloxetine strangely despite taking in the evening and if anything I slept better! Hope you have a good week and get some decent sleep...its so important when going through all this.

[pmrob1]

thanks for the reply terry i hope the side effects dissipate soon as they are not very nice hopefully the insomnia will sort its self out over the next few weeks.