18 days in of Venlafaxin - help!

[panic_down_under]

I'm now on 150mg per day and I take it before bedtime.

When did you begin taking 150mg? If recently this probably accounts for the increased anxiety/panic.

[DanJ1971]

Started yesterday, increased anxiety came 3 days before- out of the blue sadly

[panic_down_under]

When did you begin taking 150mg? If recently this probably accounts for the increased anxiety/panic.

Then the increase was most likely because the med hasn't kicked-in yet. It is still early days

[DanJ1971]

So, now on day 47, 11 of those on the double dose of 150mg. No improvement in fact last week my anxiety was increasing and because I have been taking Lorazepam for about 8 weeks now, the doctor added 50mg pregablin to the mix, to reduce the anxiety.
Since last Thursday, I’ve been steadily feeling worse, very tearful at times, very low mood and high anxiety. Today, the doctor said to stop the pregablin in case it was interacting in some way.
Could the pregablin cause this or are other factors contributing?
This suffering is all rather relentless, but I’m still confident that the Venlafaxin will work in the end. But please can it work soon as losing hope slowly

[panic_down_under]

So, now on day 47, 11 of those on the double dose of 150mg. No improvement in fact last week my anxiety was increasing

Upping an AD dose will often increase anxiety levels for a while. Doubling the dose in one hit isn't ideal.

and because I have been taking Lorazepam for about 8 weeks now, the doctor added 50mg pregablin to the mix, to reduce the anxiety.

So you're taking both lorazepam and pregabalin? I don't see the point, but if it works then okay. The one advantage of pregabalin is it doesn't have the same negative impact on hippocampal neurogenesis as the BZDs. It may even speed up cell maturation a little.

Today, the doctor said to stop the pregablin in case it was interacting in some way.
Could the pregablin cause this or are other factors contributing?

I think it is more likely to be due to the venlafaxine dose increase, imo. You will soon know whether pregabalin is the culprit because it has a short half-life, around 6 hours, so it should be completely out of your system within 30 hours. If nothing changes within 2-3 days then it probably wasn't the problem.

This suffering is all rather relentless, but I'm still confident that the Venlafaxin will work in the end. But please can it work soon as losing hope slowly

Unfortunately, there is no way of speeding it up and as you've been on ADs before it is likely to take a little longer for the venlafaxine to kick-in.

[DanJ1971]

Update
Day 54 since starting on 75mg, day 17 on double dose 150mg of Venlafaxin.
A week since my last post and a lot has happened and I’ll try and explain.
My symptoms got worse culminating in an awful experience on Friday afternoon (it’s Sunday today).
My doctor, last Monday, had restricted me to half a Lorazepam tablet per day, but I was having to take one tablet basically to have any effect.
On Friday I was desperately trying not to take a tablet but I did eventually give in as I was having a severe panic/anxiety nowhere is safe attack. Truly horrible.
The doctor prescribed me diazepam, 4mg am and 4mg pm instead of the lorazepam. I have taken it yesterday and today as prescribed and not touched the lorazepam. I’ve had some very anxious moments in the last 2 days but managed to stick to the plan.
I had been taking the lorazepam for around 8 weeks, as and when needed, and averaging somewhere between half and one tablet a day. I had noticed that it was having less effect in the last 2 weeks.
I’m wondering if my symptoms of the last week were caused by lorazepams tendency to be more volatile and cause ups and downs due to its properties, or the side effects of the double dose of venlafaxin, or perhaps a combination of both.
If it’s the lorazepam, then I may now be in some kind of withdrawal from that, although the diazepam has now replaced it so hopefully my symptoms should soon stop.
The next challenge is to taper off the diazepam assuming I cope with the new regime.
One thing is certain and it was not the pregablin making me feel worse (I only took this for 5 days as per note last week).

Ho hum, what a rollercoaster, but I still have to believe that the venlafaxin will start to work soon.

[panic_down_under]

I’m wondering if my symptoms of the last week were caused by lorazepams tendency to be more volatile and cause ups and downs due to its properties, or the side effects of the double dose of venlafaxin, or perhaps a combination of both.

It's mostly from the venlafaxine dose increase, imo. A 37.5mg increase for a week would have been kinder.

[DanJ1971]

Update.
Now on day 74 since starting venlafaxin on 75mg and day 38 since doubling the dose to 150mg.
Tapering off diazepam slowly and have been on 2mg A.M and 1mg evening since Wednesday (today is Sunday).
Started feeling much better from the end of November (day 58/ day 21 on double dose), for about 2 weeks.
I have found tapering off the diazepam quite easy and there have been times when I completely forgot I had to take it although I have not missed a dose.
Then suddenly on Friday i had a bad panic attack and I’ve been feeling low and very anxious ever since. I also have shivers (but not like flu symptoms).
I’m asking myself if this is diazepam withdrawal, venlafaxin side effects still, a return of original symptoms, or a worry I have about going to Austria on Friday for 3 days for a family break which involves flying and potentially feeling unwell in a foreign country.

[panic_down_under]

I'm asking myself if this is diazepam withdrawal, venlafaxin side effects still, a return of original symptoms, or a worry I have about going to Austria on Friday for 3 days for a family break which involves flying and potentially feeling unwell in a foreign country.

Unfortunately, there's no way of knowing. It could one of these, a combination of 2 or more, or simply happenstance.

[DanJ1971]

Yes agreed, impossible to know!
I ended up in A&E last night as I was feeling so awful. When I described my symptoms they said it sounded like withdrawal (I’ve only been taking them for 3 weeks starting at 8mg a day split 4mg a.m and p.m and lowering every 6 days).
If it is withdrawal, how long do the severe withdrawal symptoms last? 3-4 days is what I have read.
I’ve been told to stay on current level which is 2mg/1mg until I settle down.
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!!
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