18 days in of Venlafaxin - help!

[panic_down_under]

If it is withdrawal, how long do the severe withdrawal symptoms last? 3-4 days is what I have read.

It would be impossible to predict even if it was the only med you were taking. Given the dose and the length of time you've been on diazepam it shouldn't take long, but everyone reacts differently.

I'm also conscious that my mind has gone into negative overdrive regarding my impending 3 day trip to Austria. It's meant to be pleasurable!!

I suspect psychology is at least partly responsible for what you're going through.

Doc has prescribed me promethazine to take to lower anxiety as and when I need it. Never heard of it but I know it has sedative properties

It is a very sedating antihistamine which also eases nausea and vomiting.

[DanJ1971]

Quick question that I hope someone can answer please.
Briefly, I’m still not right, despite having some longer periods of feeling much better before and during Christmas period. GP thinks it is to do with original symptoms returning plus also the diazepam reduction I’ve been following has given me severe withdrawal symptoms (perhaps I reduced too quickly, I may be quite sensitive to it even at a low dose of 2mg and I have had to increase back to 5mg recently just to be able to function.)
I’m about to get help through an addiction centre for the diazepam. I feel incredibly anxious a lot of the time (evening is always better), so I need something to ease this and the panic I feel. Depression has kicked in quite badly too - not much motivation. So, not in a good space at all.

The venlafaxin has been increased from 150mg to 225mg.
Can I expect bad side effects during the 1st few weeks of this, or should these be much reduced/negligible as I’ve been on the meds for 15 weeks already. I assume side effects will be less severe.
Does this increase have positive effect quicker as a result of being on them for a while? I assume not.
Thanks for any advice

[Sparkle1984]

It's a positive sign that you had some better days over Christmas. How was your trip to Austria, by the way?

How long is it since you increased your dose? I suspect that may be why you're feeling rough again.

[DanJ1971]

Hi, I managed to get to Austria by increasing my dose of diazepam a small amount for a few days. Whilst I was there, I was mostly ok. Lovely place to visit. Got back 23rd Dec and felt ok for about a week.
Then took a drop in diazepam and I was overwhelmed with severe anxiety and other symptoms. I’ve never ever felt so bad with such extreme symptoms without any respite, for about 12 days. Had to increase my diazepam to 5mg 5 days ago as was in crisis. Started higher dose of venlafaxin yesterday, so the symptoms I had/still have to a lesser degree were nothing to do with the venlafaxin.
Prior to this latest increase, I’d been on 150mg for 10 weeks. Thanks

[panic_down_under]

GP thinks it is to do with original symptoms returning plus also the diazepam reduction I've been following has given me severe withdrawal symptoms (perhaps I reduced too quickly, I may be quite sensitive to it even at a low dose of 2mg and I have had to increase back to 5mg recently just to be able to function.)
I'm about to get help through an addiction centre for the diazepam.

I suspect most of it is withdrawal symptoms, but the diazepam may be inhibiting the venlafaxine too.

I feel incredibly anxious a lot of the time (evening is always better), so I need something to ease this and the panic I feel. Depression has kicked in quite badly too - not much motivation. So, not in a good space at all.

This may be an indication of the effectiveness of the AD being blocked by diazepam to some extent.

The venlafaxin has been increased from 150mg to 225mg.
Can I expect bad side effects during the 1st few weeks of this, or should these be much reduced/negligible as I've been on the meds for 15 weeks already. I assume side effects will be less severe.

In theory they should be less severe because the dose change is smaller in percentage terms, but that's not guaranteed, especially with what else is happening.

Does this increase have positive effect quicker as a result of being on them for a while? I assume not.
Thanks for any advice

It might have produced quicker results if the dose increase were the only change, but with all you're coping with atm this isn't certain.

Then took a drop in diazepam and I was overwhelmed with severe anxiety and other symptoms.

How soon after you reduced the dose did the anxiety begin to spike, what was the dose and by how much did you reduce it?

[DanJ1971]

2-3 days after my dose reduction is when I started to feel awful, and the symptoms peaked over the next 10 days or so. They did not subside after this period which is why the gp thinks it’s original symptoms returning- is it possible the diazepam withdrawal phase caused a depressive episode and they have merged into one long horrible episode?
The dose was 3mg and I dropped to 2mg. A&E said this drop was too much (33%) and it needs to be more like a 15% drop each time. A&E increased my dose to 3mg (I was ok on that).
As I’ve said in my earlier post I’ve since had to go back to 5mg (last 5 days basically).
My motivation is so low, my anxiety is high and am feeling thoroughly exhausted and losing hope.
Would pregablin affect the Venlafaxin at all in the same way diazepam does? I took Pregablin 6 years ago for maybe 8 months and that definitely helped. I keep mentioning this to the doctors but they don’t want to prescribe it for me (at least not now).
I now have a diazepam dependency it seems so I’m speaking with an addiction service tomorrow.
I just want the anxiety to drop to a comfortable level which it was recently for 2 longer periods. I really thought I was recovering well. I’m very aware that I must not take more diazepam but recently I’ve had no choice. I’ve been in crisis really.

[panic_down_under]

2-3 days after my dose reduction is when I started to feel awful, and the symptoms peaked over the next 10 days or so. They did not subside after this period which is why the gp thinks it's original symptoms returning-

He's in a better position to determine this, but the timing suggests withdrawal is at least contributing and might be the main driver. The recent venlafaxine dose increase is likely also having an impact.

is it possible the diazepam withdrawal phase caused a depressive episode and they have merged into one long horrible episode?

Withdrawal, plus to some extent the negative effect on venlafaxine efficacy.

The dose was 3mg and I dropped to 2mg. A&E said this drop was too much (33%) and it needs to be more like a 15% drop each time.

I wouldn't reduce the dose by more than 10% at 2-3 week intervals. This will be a slow process.

As I've said in my earlier post I've since had to go back to 5mg (last 5 days basically).
My motivation is so low, my anxiety is high and am feeling thoroughly exhausted and losing hope.

Situations only become hopeless when we give up.

Would pregablin affect the Venlafaxin at all in the same way diazepam does? I took Pregablin 6 years ago for maybe 8 months and that definitely helped. I keep mentioning this to the doctors but they don't want to prescribe it for me (at least not now).

Pregabalin has the opposite effect. It enhances neurogenesis and accelerates maturation of new brain cells in the hippocampi.

Chronic pregabalin treatment decreases excitability of dentate gyrus and accelerates maturation of adult-born granule cells

Effect of gabapentin on neurogenesis in hippocampal dentate gyrus of adult rats with co-disease of chronic pain and depression (Pregabalin is a more refined version of gabapentin)

I'm very aware that I must not take more diazepam but recently I've had no choice. I've been in crisis really.

I suggest you ask your GP for a referral to a psychiatrist if possible.

PS:

I managed to get to Austria...Lovely place to visit.

Glad you had a good time. I'm half Austrian and in line of succession to the Austria-Hungary throne. I just need to put out contracts on the 7-8 million ahead of me and it'll all be mine!

[DanJ1971]

Thanks as always for the replies!
I’m only on day 4 of venlafaxin increase so the symptoms I was feeling could not have been down to this increase.
I do feel better for increasing the diazepam , but I’m very conscious of the fact that I need to withdraw again.
I’ve suggested pregablin to my case worker so will see what they say after their meeting on Wednesday with the psychiatrist.
I’ll definitely take the diazepam withdrawal nice and steady and listen to my body now that I know what to look for.
I may get venlafaxin side effects in the next 3 weeks or so, but at least I know they are temporary.
I’m trying so hard to stay positive and have managed this to some extent in the last few days. Positive mindset goes a long way- but obviously not easily done!

[panic_down_under]

I'm trying so hard to stay positive and have managed this to some extent in the last few days. Positive mindset goes a long way- but obviously not easily done!

As someone once said a journey of a thousand miles starts with one step. These disorders are often years in the making and there is nothing easy about getting on top of them whether with meds, therapy, or both.

Just take each day as it comes and don't despair on the bad days. They are as much part of the recovery process as the good days.

[DanJ1971]

I’m now 5 weeks since the last venlafaxin dose increase to 225mg. I’m still taking 5mg of diazepam and have had issues tapering, so go back to the previous dose.
My latest situation is that I feel REALLY strange, weird, on edge, very low, and my head is all over the place. It’s an impossible feeling to describe but it’s making me suicidal, frankly. Have been like this for 4 days and no sign of easing. Previous week or so I was up and down and not feeling right.
I know it’s impossible to say but I’m wondering if this is venlafaxin making me feel like this and the dose is now too high?
Or, just another brutal phase of symptoms that will pass.
Or perhaps it’s the diazepam, and my mind is craving more.
Either way I’m calling doctor first thing tomorrow (Monday) and calling a private psychiatrist for assessment.
I cannot go on feeling like this and I can’t see a way through. It’s just horrible.