My Experience Having Been Changed From Efexor To Venlalic..

Treatment and medication
1

I have certainly noticed a difference having been given a different brand of venlafaxine. Apparently it is a new brand on the market that now does a 225mg extended release tablet with the same bioavailability as efexor. The brand i have been given is Venlalic XL and there is a very good website that shows how the new tablets work and how they are different to effexor. I am now onto my third extended release tablet so far after being on 225mg efexor xl for 5 weeks or so. Like the other posts on here i too experience a worsening with regards to concentration and the fog effect is simply awful. The only way i can best describe it is when you have a heavy night out on the booze and on top of this you have little or no sleep all rolled into one. My mood became as flat as a pancake upon starting these new tablets and i felt & still feel irritable, stressed, shaky and panicky late in the day. I'm not for one minute going to say that everyone else will experience this also as we are all different and some are more sensitive to side effects than others. It just seems to be that there is a pattern that relates to the changover from efexor to these other brands looking at some of the posts on here. I too felt much much better on efexor xl with a far better mood, less anxiety and more motivation etc..

The only side effect that i ever get with the efexor is an increase in heart rate not long after taking it each morning but this subsides an hour or so afterwards and is nowhere near as troublesome as this new brand. I would be much happier to be back on efexor & i'm sure my gran would be also as she has seen the changes in me regarding the transition. I feel so flat right now i just feel like going to sleep. This can't be right surely??

Would be greatful of any feedback.

Here is that site for those interested:

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(Sorry but Patient Admin have removed either a telephone number, an email address, a postal address and or web address, from this posting, as it is the policy of Patient UK not to publish these on this forum.)

2

hi, you mentioned a really good website to check out the new venlalic prescriptions... id like to check it out, do you have the address? about to be changed to itl...

3

its so annoying for this to change just as something i found really made me feel like a normal person again and able to deal with actully a lreally difficult situatuon atm, without feeling anything more than unhappy.

So, obv it's a bit worrying, i don't want to be depressed again no matter what, ever again! i couldnt seem to find any good medical things about the new drug at all... the only thing i could find mentioned there is slihgtly mote of the active ingrediated venlafaxine in it.

So any more references wouold be grate

4

This is too much to just be a coincidence. I have noticed almost the same changes since being switched to Venlalic and would swear it is due to the new drug despite being told there is no difference.

I am not normally one of those people who get paranoid about a medication just because it isn't the usual colour...etc, but with these tablets there is definitely a marked difference in effect. I constantly feel I could curl up and go to sleep almost anywhere and spend all day trying to fight it, often without success when I fall into a deep sleep without warning. I now have to be careful where I go and what I am doing; certainly can't drive at the moment. WEIRD!!

5

i have been on efxer for 9 years

now ive been told my surgery is changing my tablets 2 venlalic xl

because thet must be cheaper will let u know how they affect me

6

i have been changed from efexor to venlalic 225 mg recently to and all though my mood is much better i'm having terrible hot flushes so much so i thought i was hittin early mnenopause but only being 33 i think thats unlikely other unwanted effects are very sensitive skin itching and as i said hot flushes.

7

Hi All

I have also noticed the difference since been swopped over with no explanation, also extreame itcyness and small spots, the itcyness was driving me mad, so got an emergency appiontment with a psych i have never seen before, i told him i felt better on effexor dont sweat as much and about the irritation, could i be allergic to the coatings i asked, never heard of that, must be an allergy to venlafaxine, so after a difference in opinion he wanted to swop me to another anti de. I dont want to go on another anti de i just want to go back on effexor, and after a few heated moments he has agreed to put me back on effexor, but what a fight.

So to all of you out there not happy on venlalic stick to your guns and get what you know you feel better on.

8

just to add to above experience, i went for the presription, another battle with the pharmacy, eventually my gp came out to speake to the pharmacist, he told her she cannot have tabs venlilac she has an allergy to it \"oh that will be the way the compound is made up in the tabs\" so now i am back on effexor capsules, and they say there is no difference.

BTW there is also a generic capsule i was nearly fobbed off with, much cheaper i suspect because i am on 225 mg i have to take 150mg+75mg twice the cost.

9

Hi

I'm so glad I found this forum because I was wondering what was wrong with me, and why Venlalic wasn't working for me. I've been on Venlafaxine for about 5 years with very little side effects. I'm on a high dose (375mg) but it works for me and I'm able to work full-time and support myself. Just like you, I was told that the capsules were no longer available and was prescribed Venlalic XL instead.

Almost immediately, I started to experience horrible digestion problems - bloating, sore stomach, indigestion, constipation, and wind. All very uncomfortable. I started playing around with my diet to see if that helped, but it didn't. Worse though, I was feeling depressed!

Eventually I worked out that the digestive problems had started at the time I'd started taking Venlalic. I checked the ingredients and noticed that there was a warning about lactose, got on the internet and discovered I was displaying signs of lactose intolerance. Then I searched on the internet for Venlalic and found this forum and all your posts describing your problems with this drug.

I have since been to the doctor and he has re-prescribed capsules. He told me that he is issued with a drug tariff every month by the health trust. This tariff can vary greatly from month to month. At the moment, if he prescribes Venlalic, he gets recompensed £36 for each prescription, and the drug only costs him £1.33. How ridiculous! He was happy to stick 2 fingers up at them and prescribe the capsules because he's fed up of his patients' views being ignored. His advice to those who can't get the capsules prescribed - tell your doctor you think you're lactose intolerant ie allergic to the tablet form of Venlafaxine. Then they can't argue!

So, I hope you all manage to get back on the capsules as I have - and I hope this advice proves useful. Good luck!

10

Just seen this thread. Yes there are significant cost differences with tablet formulations of venlafaxine as opposed to the capsules this is an issue in the NHS drug tariff. Whilst the NHS will always try to support all patients i don't think it's too much to ask for patients to try alternatives which are pharmaceutically equivalent in terms of active ingredient. There is no bottomless pit of funding and we all need to take some ownership of how our Health service is used. - Believeit your GP that 'sticks two fingers' up at the NHS is spending tax payers money in effect by prescribing in this way others will do without. Its a pretty disgusting attitude when you consider the issues facing the NHS

All i would ask you to consider is some balance and consideration of others. The tablet formulations have been well researched and there is a wealth of data about them. In my experience i have not had one patient return saying they have had a problem. They would not have a marketing authorization in the UK without good safety data.

11

Hi Paya, all I can say to you is that quite clearly you have never suffered with depression. I understand the problems that the NHS is having and you are right that its not a bottomless pit. However when taking Venlafaxine at the 150mg per day and then being made to swop to venlalic but at a higher dose because you just dont feel as well as you did on venlafaxine, the monetary cost is very small. Also if by taking the venlafaxine it means that the patient is able to support himself by working for a living surely this is so much better than having to go on sick leave. I whole heartedly support those that have managed to discuss with thier Drs. how much better they were doing on the right drug. After all even cancer patience have had to fight for drugs that would give them a proper quality of life. Also we are not talking about the safety data of these tablets but whether they work for you. It could be that your patiences may feel that you are not the listening sort, hence no complaints. Docs are not always right, I can vouch for that.

12

Hello ratbag

Interesting view, no i have not suffered from depression but i have not suffered the majority of the illness that i manage. You do not need to have suffered an illness to be able to empathise. If you follow you argument through you would only be treated by a clinician that had suffered depression!!

You quote 'right drug' it is the right drug simply a branded equivalent. The active ingredient is the same it would not have a product license if it did not comply to the same rigorous testing.

I appreciate your comment about going back to work and having a positive impact on society - this should be encouraged regardless. I'm a great believer in people helping themselves and working is a great way of doing this, unless a particular place of work was the cause of the problems!

You have a very limited understanding of the NHS. Some high profile cancer therapies have been in the news and funding has been an issue. Thousands of patients are treated every day with drugs that may have quite limited clinical efficacy. The new cancer drugs fund has helped and all NHS organisations have funding routes that will allow for individual funding of unique cases. These are looked at carefully on merit.

But that is exactly the point i make, if we were to use NHS funds more effectively we would not need to make some of these very difficult decisions. You have been given your treatment all be it a branded equivalent. May be you should be considering those that have more difficulty getting funding given the fact that you agree there is no bottomless pit.

As a sufferer of depression you have insight into your treatment - i would ask that you consider the wider implications. What about the generic prescribing in diabetes or heart disease. Similar changes are made in these areas and patients do return saying they want a branded version of their cholesterol tablet because it suits them better. Given that if we did this for one patient it would not be fair to deny others the same options, this would be a completely unaffordable and irresponsible prescribing strategy. We would need significant cut backs elsewhere in the service or increased funding, which is not going to happen.

I do listen ( i would not be responding to you if i didn't!) but i admit that i encourage all my patients to take some ownership of their health and wellbeing where this is possible. Improving your quality of liife must be a shared responsibilty.

I agree doctors are not always right nobody would suggest otherwise. If we could fund everything for everybody we would do so but that is not the reality.

13

hiya Paya, cheesygrin

i assume from your post you are a doctor, thank you for finding the time to post on here and i wish more doctors would, the points you make are clearly all valid.

but may i suggest that mental health issues maybe be treated differently as psychosomatic factors can and do play a bigger roll in the severity of mental health issues as against 'physical diseases' , after all were not talking about cancer 'super-drugs' with super-drug prices here, in comparison we are talking pennies, obviously each case should be judged on its own merit, lets face it placebo effect is very powerfull, but heh, if it works for an extra minimal cost, so what ??

my personal opinion is that GPs (no disrespect intended) in the majority do treat mental health illnesses as they would a physical illness, with respect, its a whole different ball game, even the government in the last couple of days have acknowledged the fact that GPs in general sadly can not even recognise early indications of mental health illnesses when presented to them, this is hardly surprising when doctors training contains such a minute amount of time contributed to psychiatric illnesses, at least (if the goverment is to be believed) this aspect may now be going to be addressed and not before time too.

cheers,

Ken ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ cheesygrin

14

Thanks Ken

You make an important point and i would agree mental illness is a very different ball game although we are often criticised for forgetting the physical aspects of illness for this patient group. I guess you can’t win!

I'm not sure i will be taking advice from the government about managing mental illness!

These patients do require a multidisciplinary approach and i think your right practitioners in general practice may well be under skilled.

Each patient group will always shout for their personal needs, we saw this with the intense lobbying of dementia groups in response treatment guidelines. I would support patients / public raising their concerns. It’s important to hear views and disagree if necessary.

Psychosomatic factors probably are a greater factor in this patient group but i would disagree that we should treat them so differently. Some of the issues we have in addressing mental illness is that we segregate individuals and suggest a particular group should be treated more sensitively, maybe this is part of the problem? I don’t mean to sound harsh but stigmatising a group and suggesting they should be treated differently may compound issues.

In terms of expenditure Ken with all due respect it is significant and we all have a responsibility to be careful with tax payers money...its not pennies!. Governments like to talk about choice in the NHS - it’s a vote winner after all but in reality the economics will always be a consideration.

In this instance we are not even suggesting a different active ingredient simply a change in the way the formulation looks. Given the issues the NHS faces personally i don’t think it’s too much to ask. Any savings should be put back into the service and maybe even more supportive therapies could be commissioned.

Kind Regards

15

hiya Paya,

im sorry and im not trying to pick a fight or be obtuse but i dont see how treating a certain patient group more sensitively stigmatises that group, are children or the elderly stigmatised because they are, or should be treated with more sensitivity, care and empathy, i dont think so ???

you make a very valid point about once a patient has a history of mental health problems, when they present with physical type symptoms, they tend to be, dare i say it, patronised, given a pat on the head and sent on their way, i have decades of being told its 'just your mind playing nasty tricks on you, its the depression etc etc', well guess what, i recently moved and registered with a new surgery, i chose a doctor that has an interest in psychiatric matters and after having extensive tests (still on going), for my 'imaginary' aches, pains, chronic fatigue, skin problems etc etc the list goes on are real, its now apparent that i have auto immune system problems, arthritic problems, PMR was suspected at one point 8)

still, working as a team, my doctor and i will eventually get to the bottom of the problem, the sad thing is that psychiatrists are the biggest offenders for ignoring physical symptoms sad

oh sorry for hijacking your thread and going off at a tangent Marcus, but i think its really enlightening to hear the views of a doctor on these matters, once again i thank you for taking the time to do so Paya .

cheers,

Ken ~~~~~~~~~~~~~~~~~~~~~~

16

Although standards and testing differ from our denizens across the pond, I thought this article might be of interest.

management.fortune.cnn.com/2013/01/10/generic-drugs-quality/?iid=SF_F_River

17

Thanks Adam for the link to the article on how the FDA are now approaching generic drugs, and tightening regulations over testing with particular reference to the time it takes for drugs to be absorbed into the blood.

Very interesting that the FDA has been forced to reconsider, and hopefully ultimately good news for the UK which does tend to follow FDA guidelines.

I had no idea of the prevalence of generic drugs - 80% are used in the USA - but I can understand the logic when there are such huge cost savings to be gained by doing so. Shame on the manufacturers of the original drugs - surely they can find a way to ensure their drugs continue to be used (volume must lower production prices?), instead of allowing a lesser quality generic to take its place?

18

Hi All

Just to add to the discussion as you guys really helped me. I have been on Effexor for 15 years (after getting post natal depression which wasn't treated for ages....long boring story). It worked well for me. Initially on 75mg twice a day, I slowly reduced it over a few years to 37.5 twice a day. This was not the controlled release type. All was well till 7 weeks ago when I went for a new script and the GP said I could now take a single dose of controlled release once-a-day which would be easier and more straightforward. I wasn't fazed by this and thought nothing of it.

I carried on but then my bowels became unpredictable, and I found that I was sleepy all the time. This got worse till I was really only getting up to do anything I needed to do like the school run and homework supervision etc.. With the winter we have had, I assumed it was long dark days etc and still didn't put two and two together. Then I started to feel a bit depressed. It slowly got worse. Eventually, just before a week away, I had a sudden thought about the drugs and found this thread as well as a number of others. It became instantly clear what the problem was.

Whilst relieved that there was a reason, I found during my week away, that the depression continued to snowballed till I was back to that awful shaky tearful state, yet nothing in my life had changed. I couldn't have pinned it on anything. So the returning depression was gradual and then gained momentum. I guess Effexor was slowly clearing from my system, leaving me on the less effective drug.

On my return, I called the GP, terrified I would be refused Effexor but I wasn't. She reissued my repeat immediately and the chemist was also brilliant and has ordered Effexor to arrive overnight. It will take a while to build up again and I hope it works as well as it used to. It's a shock to feel like this again after 15 yrs of normal life and people who know me (but didn't ever know I was on anti-depressants) are absolutely floored by this quivering tearful me.

I took ages to rebuild confidence and see depression as a thing of the past and trust I need never go back there. This has really put a spanner in the works and given my confidence a massive jolt.

The FDA link was really helpful. My GP admitted there was a lot of this in the press in the UK too.

She's a good doctor and I don't think she as aware of the implications. If my script hadn't changed to controlled release none of this need have happened.

All this has left me feeling very exposed. I now feel I need to be much more knowledgeable and stand up for what I need and not allow things to be changed.

For anyone talking about cuts....we all understand cuts but they have to be made in the right places. If the result is turning stable patients back into wrecks, the costs go up again as we are sent off to see specialists, therapists etc...Its a case of not spoiling the ship for a hay'worth of Effexor. Yes a costly drug but not as costly as consultants and therapist, GP time to put it right; to say nothing of the devastation it causes to family life.

Hope this helps others too. C

19

Spot on, mcah, and everyone else who's posted similar: it makes no sense for cash-strapped NHS Commissioning Groups to save a few pounds on generics if they mess up mental health patients' finely-balanced brain chemistry. They know - as we do - the awful consequences that can follow. They are expensive in every sense.

I am afraid I found Paya's (GP?) take on the matter misguided, if well-meant. Anyone who has any real, close-up experience of things like severe depression will tell you how terrifying it is. We're talking the mind, here - the body's central control system. When people's meds let them down in this realm they don't just feel bad, or even awful - they can spiral down to suicidal in quite a short time. I have sympathy for people with any chronic illness and - like many probably on this blog - I put my hand in my pocket for all sorts of charities. What I would like to see, however - not least from doctors such as Paya - is an appreciation of how much people with MH problems do manage on their own. And how very little we are asking in seeking the best form of what are all essentially inexpensive drugs to help us manage.

20

Like several other contributors i too am relieved to have found this forum. I had been living a 'normal' life on Effexor for many years . I returned from 17 years abroad, set up home, saw my two sons through Uni and marriage , sadly nursed my parents and mother in law through terminal illnesses , became a Magistrate...a fairly tumultuous period all coped with. Two yeras ago my prescription was changed, I had a two different kinds of venlafaxine from India and one form Poland as my local chemist has had to 'cut costs' ,I began to feel not well. I asked for them to be changed and despite chemist trying to assure me they were the same I did get cahnges, but never back to Effexor.

And here is the rub. i am an intelligent person, I do take responsibility for my health Dr Paya but I began to distrust myself and my symptoms. I conceded the point about saving costs, used CBT, but still couldn't pull round from this sleepy , foggy , world i had entered. So taking responsibility i had my heart checked, my colon checked, my oespahgus checked,my bloods checked (several times) for liver, for kidneys, for thyroid, ALL at the expense of the NHS. I also put up with a series of doctors telling me or hinting that at 65 it was the menopause , or maybe the post menopause , ormaybe that I was 12 lbs over their ideal weight.  Have I made myself clear?

Yes this could be all in my mind but I am no longer certain I know what is being put in my brain and that makes life very unpleasant. I am a grandmother now and have had days when I cannot be bothered to pick up my little grandson...nice one..I think not .