Venlafaxine 7th week update

Treatment and medication
1

Hi,

first of all thanks to all those who replied to my previous post and gave me helpful advice.

I am here to share with you an update on my condition. I am now entering the 8th week on Venlafaxine. I have been on 75mg for 2 weeks, 112.5mg for another 2 weeks and currently at 150mg for about 4 weeks.

I am being treated for anxiety and panic with secondary depressive episodes, starting in June. Before switching to Venlafaxine, I have been on Paroxetine for 5 weeks, but it didn't work (and actually worsened the panic situation and the depressive side of my condition). I had been using Paroxetine successfully in several spells since 2014.

As I explained in a previous post, Venlafaxine almsot immediately reduced anxiety/panic while it seems to have triggered (or at least to have been ineffective in preventing) depressive episodes. Since week 5, these bouts of depression had turned into moments of deep, but more "natural" sadness. A similar feeling has been reported by other users as well.

By week 6 I was feeling generally better and though I was on the way to recovering just like the other times when I was on Paroxetine. The symptom I have the hardest time dealing with is anxiety and panic attacks, and those were gone, so I felt much more confident in my ability to tackle the remaining symptoms with the help of therapy and without changes in medication.

Unfortunately everything crumbled down last weekend (6.5 weeks). I began having episodes of increased and perceptible hearbeat. At first they weren't so bad, but my anxiety returned predominant on Sunday and yesterday has been the worst day since several weeks.

My mood is very low and I feel like the steps forwards I though I was making are just lost now. I really cannot stand the idea of another change in meds. My psychiatrist agrees and says I should keep on taking Venlafaxine and wait for it to stabilize. At the moment, though, I feel completely hopeless. I cannot function properly, but neither do I want to be at home doing nothing, because I fear that the suicidal thoughts I have been having in July and early August are more likely to come back if I just lay in bed on my own. Apart from my illness, I am satisfied with my life and believe that all things that do not work at the moment can be fixed with the help of my therapist. I am terribly scared that this illness will take push me over the edge, because that's really not what I want.

I am sorry to put you through yet another negative post. Thanks for understanding.

2

Hello, 

I'm sorry you are going through such a rough patch.  When did you first start antidepressants and what were the complaints for which you were being treated?  You said you had been using Paroxetine successfully for spells since 2014.  Does that mean you started/stopped/started? This last time you tried it for five weeks but it didn't work?

I don't think this is your illness but a situation created by the medication switches and dosage changes.  Stopping/starting/swapping meds sensitizes the nervous system to further changes.  When you stopped the paroxetine, when did illness return such that you began again?  Did it work right away when you started it again?

3

Hi Betsy,

thanks for your reply. Yes, you got everything right.

I first used Paroxetine at the end of 2014, after my problems first appared. They started as panic attacks, which then turned into generalized anxiety and depressive episodes, though doctors said I did not realy have major depression, because the depressive feelings came and went during the day, not necessarily with a "morning worse then better" pattern.

The first time I took Paroxetine I recovered in about 2/3 weeks, and in 5/6 weeks at 20mg/day I was even better than I had been before my panic attacks began. Then, always under my psychiatrist's instructions, I gradually suspended Paroxetine at the end of 2015. Two months later I was back with the same symptoms and again took Paroxetine (20mg) and felt good almost immediately (say 1.5 weeks).

Long story short I was told to suspend medication again after 6/8 months. Then I relapsed and took Paroxetine again. This cycle occurred 3 times, and each time the medication worked perfectly, so that I was symptom-free in 2/3 weeks at most. Then each time I stopped taking Paroxetine (which, I repeat, always did following the doctors' instructions), I was OK for a few months then back again in the same situation.

Unfortunately the trick did not work this summer. I had last suspended Paroxetine in November 2017, was fine until the end of May (so that is 7 months without medication), then went through some stress at work (but nothing serious, not enough to "justify" a new crisis) and panic/anxiety returned. I went back to Paroxetine but after 5 weeks (mid July) I was even worse, with recurrent depressive episodes. These have been deeper than I had ever experienced before. That is why I was switched to Venlafaxine. I have the impression that my psychiatrist is uncertain about what to do, but I got a second and a third opinion, and everyone agrees that switching to Venlafaxine has been the right choice. I just don't see an end to this situation right now.

Thank you again for your help.

4

Hi. I've been where you are right now and currently an having anxiety issues again. First, you sound very optimistic about your treatment. That's good! I think what you might be experiencing is what we call a "blip.". Sometimes these blips last a few dys to a week or more. But don't get discouraged. I'm in the tail end of a blip of two weeks. Not fun, I know.

I've been in ven for close to 17 years. I had great luck with it up until a year ago when the generic I was taking was discontinued and substituted with something that didn't work. So I'm on brand only now.

We had a major life event last year that triggered worse anxiety, and my dosage was recently increased from 75 to 150. It's been about 4 weeks on the higher dose and my anxiety increased just a bit, which correlates with the blip... Now that I think about it. Yesterday I had a check up with my PCP and she said to give the new dose another 2-4 weeks to feel the full benefit. So yeah, the waiting game.

But there are definitely things you can do to busy dopamine and serotonin in the brain. All you have to do is Google it. Surprisingly, food is an excellent way to do this. But more than anything, VIGOROUS EXERCISE! I know, who wants to do that, but it truly works. I was walking 3 miles 5 days a week and I definitely felt better. But then the life event happened and I found myself crippled with anxiety.

Hang in there. Be patient with yourself. Most important thing you can do is to stay active and exercise. I pray and go to church regularly and that helps so much.

God bless you

5

If you feel your depression is really bad maybe increasing to 225 would help. I am 6 weeks into treatment and have been 2 weeks on 75, then 3 weeks on 150 and now 2 days on 225 as my depression has been severe. My doc said to wait another 3 weeks and we will review the situation. I am getting impatient and just want to feel myself again. All the best!

6

Sorry to hear this. I’m similar to you but I’m 4 weeks in and had good/bad spells. I cannot work at present due to the way I feel but I always get up, showered, try to go to shops for a bit (usually supermarket) then come back and do housework to keep me busy. My anxiety is worse in the morning/daytime and by 5pm I feel normal with no anxiety. But next day it’s back again. I’m like you - had enough and just want to feel better