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Thread: Stick or go back?

  1. #1

    Question Stick or go back?

    My anxiety has blown up over covid and although i am already on a cocktail of drugs for it the phys team recommended going from my 112.7 of Venlafaxine SR to 75mg Venlafaxine SR and 10 Mg of Escitalopram (i am also on 450mg pregabalin). first few weeks i didn't really feel any effect but i am nearing the end of my 4th week and I am worse now than I was on the old venlafaxine dose. All the leaflets i read say that it should take about 2 to 4 weeks to feel its feel effect so not sure i should stick with it or just go back to my venlafaxine dose and re-evaluate once my baseline anxiety comes down a bit.

  2. #2
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    Re: Stick or go back?

    Quote Originally Posted by nedmcg View Post
    My anxiety has blown up over covid and although i am already on a cocktail of drugs for it the phys team recommended going from my 112.7 of Venlafaxine SR to 75mg Venlafaxine SR and 10 Mg of Escitalopram (i am also on 450mg pregabalin).
    Were you given an explanation for adding the escitalopram instead of simply increasing the venlafaxine dose? Are they maybe planning to switch you to escitalopram? Have you ever taken more than 112.7mg venlafaxine? If so what was the outcome?

    first few weeks i didn't really feel any effect but i am nearing the end of my 4th week and I am worse now than I was on the old venlafaxine dose. All the leaflets i read say that it should take about 2 to 4 weeks to feel its feel effect
    The 2-4 weeks claim is male bovine manure. Hardly anyone responds this quickly. Six to eight is more likely. Some require even longer.

    so not sure i should stick with it or just go back to my venlafaxine dose and re-evaluate once my baseline anxiety comes down a bit.
    Guess this depends on what the plan is. If the intention is simply to have you on 2 SSRIs - and despite what it says on the box venlafaxine is really only a SSRI having only a weak effect on noradrenaline (NA), aka norepinephrine, reuptake and then only at doses of ~200mg plus - I really don't see the point. Far better to be on one AD that works than taking low doses of two doing the same thing which probably won't. Polypharmacy, adding more and more meds in the hope of hitting some magic formula which solves all the patient's issues is an easy trap to fall into. My observation is it rarely works.
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