Paroxetine and then Venlafaxine, but still feeling awful

Hi all,

I am here looking for advice. First, I apologize for my English, it's not my first language. Second, I know I might be repeating stuff you have read many times, so maybe writing this is more of a way to help myself than adding valuable info to your experiences.

My first encounter with panic attacks, GAD and secondary depression was in 2014 (25 y.o. back then). Since then, I have been treated with paroxetine (Paxil in the US I guess), in 6/8-months spells at moderate dosage (10mg-20mg) with excellent results. I was on and off P, each time relapsing 4-5 months after quitting, each time going back to P and coming out of it (with no symptoms left) in 2-3 weeks.

After quitting P in November 2017, I relapsed last June. So, following my psychiatrist's advice, I went back to P as usual. After one month at 20mg I was having no relief, so we decided to move up to 30mg. After a week at 30mg, I fell into bad depression (like really bad, contemplating putting an end to it for real for the first time in my life). Doctor got scared and changed me to Venlafaxine (Effexor XR) 75mg.

In a couple of days the panic attacks had weaned, anxiety was there but manageable: chest pain got worse but mentally I felt more at ease. By the end of the 1st week I was feeling sad (like bursting into tears for no reason) but not depressed, I was thinking more clearly and thought I was on the right track.

At the end of week 2, I had a couple of bad days (high anxiety and depressive brain fog) and doctor upped me to 112.5mg (75 + 37.5). Once again, I felt better in a couple of days and by the end of week 3 I was almost normal, except for some mild anxiety in the morning and some low mood in the evening. Then I got worse again, with increased anxiety and depression coming back, although not at the same depth as when I had changed meds.

So doctor upped me to 150mg (75+75). I've been there for 6 days now and feel no change. There are times at day when I feel that the thing is manageable, especially between 10am and 5pm. But mornings and evenings are bad. Anxiety comes and goes, and while it's weaker than it had been before starting P, it still hits hard at times. But the depression, although I can get up and go to work, never goes away. My ability to do anything is really low now.

Doctor says I should stay at 150mg and see what happens. But considering the period on P and this one on V, it's almost three months now I haven't been able to life my life (well, any life to be honest).

I really want to live my life, but I also cannot accept being in this state of things. I don't have a family of my own, nor a partner at the moment. But I have many things to do, wonderful parents and brother, amazing friends who are caring for me as if they were family (like visiting every single day after work, taking me out to dinner, being patient when I cry about how my existence is meaningless with this illness). I love my job, and it makes me sad that I cannot give even 20% of what I used to, even though colleagues see me struggling and do everything they can to make it easier for me (they don't know I have mental health issues, but they see I'm not ok).

I am terribly sorry for the long post, today I'm having a bad day and the most frustrating thing is that each day I hope to wake up and realize that that's the first day of a recovery, rather than the nth day of being ill.

Thanks to anyone who reads this and also to previous posters, I found reading your experiences extremely comforting.

Hi, I am exactly the same... can’t shift my depression, been on Sertaline for a month, then Mirtazapine and I was only getting worse so now 2.5 weeks on Venlafaxine (2 wks on 75) and 2 days on 150. I felt a bit better on Monday but now upping a dose and I feel depressed. I am also getting impatient because I can’t live normal life. I think each dose takes a least a couple of weeks to settle. Hopefully one day I wake up less depressed. I think it’s early days for us on 150. Depression sucks!

Hi, I am exactly the same... can’t shift my depression, been on Sertaline for a month, then Mirtazapine and I was only getting worse so now 2.5 weeks on Venlafaxine (2 wks on 75) and 2 days on 150. I felt a bit better on Monday but now upping a dose and I feel depressed. I am also getting impatient because I can’t live normal life. I think each dose takes a least a couple of weeks to settle. Hopefully one day I wake up less depressed. I think it’s early days for us on 150. Depression sucks!

You need too give it longer more time it worked for me I seen a massive improvement on 150mg within 4 weeks xx

Hello 🤗 A friendly hug to you firstly.

I am now going to put my HR Advisor hat on and ask if you can do something really brave. I would like to ask if you can approach you boss or if not, HR to discuss how you are right now. It is fantastic that you are continuing to work but by your own admission you are struggling. Please speak to them as this will ease any anxiety you have about underperforming at work. I would hate for them to misunderstand your situation.

As for venlafaxine, well as I am sure you have been told already, it not only takes time to get into your system but also takes time to find its level.

I wonder, with regards to your emotions, is it possible for you to undertake counselling? It may be helpful if you can talk through your feelings? I don't know if you have done this before but I found it very helpful in relation to my circumstances. I know you have the support of friends but you may find counselling a good addition to support if friends and family as it's a different relationship and approach.

Don't be afraid to go back to your GP if you need to.

🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗🤗

Are you still on 150 Karen? Have you been on it long?

Yes about 6 weeks now. I'm doing ok on it xx

That’s great! Was your depression really bad? I don’t Enjoy anything, I am flat, No emotions, can’t cry...

Everything you've said I've been there I hot so bad mental health crisis team was called I felt I was existing not living a life. I felt a burden too my family all I did was feel hopeless n cried cried cried constantly felt I couldn't go on much longer I was absolutely at breaking point. During this I was exactly the same going too work but really struggling anyway long story short I'm getting better on venlafaxine it had too be upped but u must tell your doctor if u not feeling great again I also had too get diazapam for a short time too calm me down. I was terrible not wanting too take it thinking I've only heard of people who abuse drugs taking this. But I did end up taking it for a short time and it defo helped me I was off it for 6 weeks last night was the first night I took another 1 with a sleeping tablet too sleep because my anxiety was so bad. Not taking them all the time just when I feel I'm struggling. You will get through this your not alone . Xxxxx

You will get there too takes a good 4 weeks for it too work. Everyone's different might take shorter or longer but u will get there do not be afraid too phone your doctor if u not getting any better they might just need upped xxx

I just sent u another message above yeah I was really bad xxx

Did u get my message x

Joanna, thank you for the nice words and advice.

Concerning work-related stuff, I omitted details in the original post. My direct supervisors know I've been going through a difficult health situation (I took a week off in July just before switching meds as I couldn't do anything at all those days). They will not misunderstand the situation and in fact they have been very supportive of me these weeks. I am not getting anxious because I am expected to be more productive. I am getting disappointed with myself mostly, and I want to get back to being productive simply because that's who I am, and I miss being who I am!

Also, I did not mention (the post was already long enough) I had CBT sessions right after my first experience with anxiety/depression. I am not sure to what extent that helped, as the meds were super effective the first time and I was back on track before CBT could actually work. It certainly was not effective in preventing relapsed. Also, my psychiatrists believes my illness has a prevalently biological component (no particular traumas / unresolved issues), although I was undergoing a stressful period when they first emerged. But not when I relapsed. In fact, relapses have so far occurred at times when I was doing quite fine in my life.

Hi Karen, I got your message. Thanks a lot for your support. I apologize for the late reply.

I also took anti-anxiety medication when I started taking paroxetine, and again when I started taking venlafaxine. Most doctors in the EU (I understand that's not as common in the US) will prescribe benzodiazepines along with anti-depressants for a short period of time, just as long as the effects of the latter cannot yet be perceived. You shouldn't be afraid of taking whatever your doctor prescribes, as long as you're following their instructions. It's true people may get a benzo addiction, but people also get addicted to pain killers, and there's certainly nothing wrong in taking pain killers under medical supervision when you're in pain.

You say "I am also getting impatient because I can’t live normal life". I feel the same. I think it's a good sign that we haven't given up on living our lives as they were before!

How long did u take the anti anxiety medication I'm on 75mg twice a day of venlafaxine n 2 nites ago I started taking one 5mg of diazapam just at night with a sleeping tablet. Because I couldn't sleep I'd get anxious n because I was scared too take sleeping tablet in case I got addicted I didn't take my sleeping tablet. Vicious circle but now I know until my sleep returns I need too sleep so the anxiety will go. I only get anxious when I don't sleep. Hope this makes sense sometimes I think I'm going daft xx

Hi Karen, I took the anti-anxiety medication for about two weeks since starting V at 75mg. Then I started to gradually reduce the dosage and now I have not been taking anything but V for two weeks. But my experience does not matter much: you really have to ask your GP or psychiatrist about times and dosages. As long as you follow their instructions, you should feel safe about taking medication. But do follow their instructions and ask for their advice if you feel something is not working properly. Hope to be helpful. Let me know how things are developing for you. Hugs.

I never took any anti anxiety last night only my sleeping tablet I'm waiting on my referral too mental health it's been put through as urgent I will defo let u no how I get on. I'm just watching what I'm doing n taking things day by day xxx

How are you doing on 150 Karen? Has your mood started to improve? Have done 3 wks on Ven, 1 week on 150. I feel very calm but my mood is still flat.

I just slowly felt a little stronger n better every day. My only problem now is not sleeping great xxx