18 days in of Venlafaxin - help!

[matthew1977]

Sending hopeful thoughts, DanJ1971. Try to stay grounded and get the help you need and deserve. A professional will say whether it could be the meds but meantime keep company with your support network – friends, family, forums – and keep us posted?

[panic_down_under]

Either way I'm calling doctor first thing tomorrow (Monday) and calling a private psychiatrist for assessment.

I think this is a very good idea.

[DanJ1971]

Thanks both

[DanJ1971]

Quick update. Spoke to private psychiatrist on Tuesday. He increased my diazepam from 5mg to 8mg. He says I’m having a depressive episode due to the problems I’m having coming off the diazepam. So, now I’m on a higher dose I should calm down, build up some confidence, do more things and the depression will lift. After I’ve been “well” for maybe two months, I can then start to wean off the diazepam slowly.
I do feel better already, although low mood in periods during the day, as well as peaks of anxiety still. But so far, an improvement.

Meanwhile, the NHS GP has increased my mirtazapine from 15mg to 30mg. Took my first increase last night, but wondered what effects I might feel on a higher dose?

[panic_down_under]

the NHS GP has increased my mirtazapine from 15mg to 30mg. Took my first increase last night, but wondered what effects I might feel on a higher dose?

It might be more sedating for a short while. Sedatives like mirtazapine tend to become less sedating as the dose increases, but can have the reverse effect initially. However, as with everything about psych meds, YMMV. Their only predictability is their unpredictability.

[DanJ1971]

The saga continues…
Was feeling well for 2 weeks approximately after the increase of diazepam from 5mg to 8 mg 4 weeks ago.
Then, last Friday, I felt something wasn’t right, I felt low and the anxiety spiralled.
Felt dreadful and demoralised.
Increased my diazepam to 10mg on Monday (it’s now Thursday) and also started on 50mg pregablin.
My main question is;
How long before the pregablin starts to work?
But so many other things going on in my head - my private psychiatrist says increasing the diazepam is perfectly safe and I will at some point just naturally not need it and I can come off it. I have to trust him don’t I? It goes against what the NHS are telling me.
Can the pregablin help with the diazepam withdrawal?
I’m on 225mg of venlafaxin with an option to increase to 300 mg.
I’m heavily medicated and it just seems to be a never ending cycle of adding more until something sticks.
I’m really trying hard in terms of keeping busy (when I can), I do yoga, swimming, football, meditation, CBT, mindfulness, walking, sauna/cold water treatment so it all seems so unlucky.
I feel I’m due some good fortune to get to staying well.

[panic_down_under]

How long before the pregablin starts to work?

Fairly quickly, typically within a week to 2-3 weeks. But I doubt 50mg will make a significant difference. Most need to take 150-450mg, a few need the maximum 600mg.

my private psychiatrist says increasing the diazepam is perfectly safe and I will at some point just naturally not need it and I can come off it. I have to trust him don't I? It goes against what the NHS are telling me.

I agree with the NHS. (If I posted what I really think I'd probably get banned, and/or your screen would melt!!!)

Can the pregablin help with the diazepam withdrawal?

Yes, but if taken for long periods dependency becomes an issue too.

I'm on 225mg of venlafaxin with an option to increase to 300 mg.

If I've added it up right it is 9 weeks since you increased the dose to 225mg? If there is no change in the next fortnight increasing to 300mg should be considered, however, see below.

I'm heavily medicated and it just seems to be a never ending cycle of adding more until something sticks.

I'm not convinced this is doing you any favours. Polypharmacy has become a scourge. It rarely works. Going back to basics is likely the better option.

In addition to venlafaxine, diazepam and pregabalin are you also still taking promethazine and mirtazapine and if so, at what doses? Anything else, including supplements, herbal remedies (legal or not), etc?

I'm really trying hard in terms of keeping busy (when I can), I do yoga, swimming, football, meditation, CBT, mindfulness, walking, sauna/cold water treatment so it all seems so unlucky.
I feel I'm due some good fortune to get to staying well.

Unfortunately, the fates more often hinder than help, ime.

[DanJ1971]

Thanks PDU,
The current list is:
Venlafaxin 225mg (in my 10th week at this dose)
Mirtazapine 30mg (in my 5th week at this dose)
Diazepam 12mg
Pregablin now 100mg (day 5 of pregablin, I was told to increase to 100mg yesterday by the gp)
I also take magnesium and B complex supplements but I don’t always remember to take these.
That’s it.
No alcohol at present, no recreational drugs. Healthy diet.

I took pregablin 7 years ago along with lorazepam when needed and it helped me. I was able to come off the lorazepam and then the pregablin with minimal fuss, from memory. I’m hoping the same thing can happen and I’ll then just be on venlafaxin and mirtazapine. Psychiatrist did say perhaps to reduce the mirtazapine back to 15mg.
Have started CBT sessions.
Not a lot more I can do

[panic_down_under]

The current list is:
Venlafaxin 225mg (in my 10th week at this dose)
Mirtazapine 30mg (in my 5th week at this dose)
Diazepam 12mg
Pregablin now 100mg (day 5 of pregablin, I was told to increase to 100mg yesterday by the gp)

Is the mirtazapine mainly for insomnia, or a sedative to keep you calm until the venlafaxine kicks-in?

That's a lot of diazepam. Hopefully, the pregabalin is reducing some of the adverse impact diazepam has on antidepressant effectiveness.

I took pregablin 7 years ago along with lorazepam when needed and it helped me.
I was able to come off the lorazepam and then the pregablin with minimal fuss, from memory.

Fingers crossed it is just as effective this time because the sooner you can get off diazepam the better, imo.

I'm hoping the same thing can happen and I'll then just be on venlafaxin and mirtazapine. Psychiatrist did say perhaps to reduce the mirtazapine back to 15mg.

If it's mainly for insomnia then that will probably be a good thing. Sedating antihistamines like mirtazapine usually become less sedating as the dose increases, although YMMV.

Have started CBT sessions.

Good!

[DanJ1971]

Mirtazapine was originally introduced back in May last year, and helps with sleep. When I started taking it I felt calmer and happier very quickly. Start dose was 15mg.
The diazepam has crept up over last few weeks (through the private psychiatrist). I REALLY don’t want to take it at all, hence the introduction of pregablin.
Today, high anxiety and feeling spaced out, low mood and some tears. I’m guessing this is the pregablin starting and it will pass soon.
I’m trying to keep busy though it’s a nice day here in Surrey, UK, so gardening this afternoon