Venlafaxine and Ven ER

[Tims]

Hi

For me duloxeteine didn't seem to do much except increase anxiety if anything, and like you I stuck to 30 mg. To be honest I wasn't sure why the doc put me on this med. I had previously been on Paxil for quite a long time and it did a great job with the anxiety, but then I decided I wanted to come off all meds so I stopped them gradually. After a few months I ended up back with the doc and he suggested cymbalta due to low side effects.
I've now only started venlafaxine as I thought it would be an easier transition than back to another ssri.
I must say, so far so good, much better results for anxiety than duloxeteine/cymbalta, which is strange because they are both so similar I.e the nonrephenerine.
How long have you been on the duloxeteine and how was you're experience on the citalopram and Sertraline ? I've heard good things about both in regards to anxiety. I'm going to see how it goes with the Ven, but the test will come if and when I need to up from 75mg.

Regards
Tims

[MyNameIsTerry]

I'm glad you are getting better results. Given how quickly Duloxetine starts to work on norepinephrine, I wonder whether it's just too harsh for some of us. It's a ratio of effect and Ven has a much lower one than Duloxetine.

I've been on Duloxetine for maybe 4 years and I can't say it has been much help, if any. In fact, I still have side effects from it. Sadly, I trusted my GP who completely disagrees on this but as I've improved over the years due to working on my anxiety I have noticed patterns that point towards something to do with the med e.g. adrenaline spikes for several days and there are no triggering events to be found. These "blips" come about every 7-10 days and last for 3-4 days but initially they went on for weeks at a time hence why I couldn't see a pattern in there. However, the year after going on these was far worse than the one when I relapsed and I never had all the OCD before, which took me years to reduce.

Citalopram was much better. It was hard starting but part of this was again my GP who told me the side affects were only going to be "some sweating and loose bowel" so when I was not sleeping at all, unable to eat but very hungry, extremely low and in tears, etc he called in the Crisis Team. All I needed was some help with my sleep and within a couple of days I felt a lot better about the side effects and coped. My numpty GP told me to take Zopiclone daily, which the Crisis Team told me was incorrect in their follow up and after 30 days I had become tolerant to the stuff and had to withdraw which mucked my sleep up for months.

However, after I got through that (most of which could have been avoided if my GP had a clue), it did start to really help. I did need a bit of motivation to get back into work but within 6 months I had my confidence back and was working in a very stressful environment. I only ended up relapsing because my GP was pushing for withdrawal and with not having any help to understand about anxiety, I trusted my GP back then, I hadn't resolved the issues underneath. But I have to say it was much better than this experience and didn't bring all the nasty problems this med has with OCD that were never there before.

I've never tried anything else but there are plenty of people on here taking Citalopram or Sertraline who will be able to tell you how well it has worked for them.

Your GP sounds like he doesn't know much about SNRI's. NICE guidelines state GP's should tell people more about SSRI/SNRI's and which ones are associated with greater side effects when starting. I don't think they know much about this though and it's so individual anyway but I would have thought switching SSRI to SSRI would be preferable over moving to a dual system med like a SNRI. Also, Ven & Paroxetine are the two most difficult to withdraw from and GP's are supposed to explain this. I guess your GP wanted to avoid Paxil for that reason but I find it strange he then opts for Ven. Guidance I have read has been to try something again if it worked before but my GP just said "this one if more for anxiety" which just proves to me again that his knowledge is very poor. Usually SSRI's are switched to other SSRI's and I think it would have been better for me to try Citalopram again or something like Sertraline and it's really my GP's ignorance that has put me in this situation.

[Tims]

My past experiences with gp's or psychs hasn't been great either, so I like to do as much of my own research as possible now. I definitely would have insisted on an ssri rather than cymbalta if I could go back. I'm surprised and also not surprised about you're gp prescribing zopiclone daily, and this is another reason why I will never solely rely on any single docs advice again.
I can see why Ven would be difficult to stop, with its short half life and quite fast onset, the instant release in particular.
Overall I totally agree with what some have said this on forum about keeping dosages to a minimum wherever you can with all psych meds. The more effective a drug is for you the harder it will be to stop.

[MyNameIsTerry]

I never used to be like that but after talking to people on here and starting to learn about anxiety and my meds I now do take more control of treatment.

There is a lot of NHS prescribing information online so you can see what your GP's are supposed to be doing. I read these for information when I see people having problems with the GP's in case they can be useful to prove them wrong.

For instance, in this Walsall NHS doc you can clearly see Ven is a 3rd stage antidepressant:

https://lifestyle.walsallhealthcare....n%20adults.pdf

That might be why your GP has decided on Ven but something that bothers me about this type of advice is that sometimes we just don't seem suited to certain meds and rather than advance people up the chain, why not try others in the same class & level as sometimes people then start to respond?