Hi, I started venlafaxine slow release 2.5 weeks ago. A week on 37.5mg and the last 10 days 75mg but I'm feeling worse. Mornings are really bad, I have no energy, just want to lay down. I feel like I can't be bothered to do anything. I've been suffering with depression and anxiety for 7 months now. I'm also on 30mg mirtazapine at night which I've been taking for 6 weeks. Any help or advice would be really grateful. I feel like I'm never going to get better x
Hi
I'm sorry to hear how your feeling but I know exactly what you mean. I have been on antidepressants for 32 years and nothing ever worked so was put on venalfaxine as a last resort as its supposed to work when all else fails but it turned our to be a nightmare drug for me so now have come off it after a very long taper as you can just stop taking it without tapering down. Anyway I'm not taking anything now and will never use antidepressants again as they just don't help me in fact they have made me worse over the years. I'm not saying this is the same for everyone and they may well work for you. I'm just one of the unfortunate people that are medication resistant so I just have to try and deal with it without drugs from now on
Thank you for replying. How do you cope everyday? It's been 7 months for me and I'm finding it unbearable.
The way I cope is to try and keep it in the day and not think about tomorrow until it comes if that makes any sense to you. I think a lot of our problem is that our heads can trick us into thinking that we will always feel like this that why I keep it in the day and say to myself oh well I feel like crap today but maybe tomorrow will be better. I spent so long just giving in to this illness and ended up not doing anything but laying around at home all the time waiting for it to pass but I learnt that it just don't work like that. What I do now is try to get out of the house everyday and just do normal simple things like go to the shops or just drive somewhere and I find that it helps because it takes me out off myself and gives me other things to think about apart from how bad I feel in myself and also if breaks the day up a bit. I have found that the more I just don't do anything the more I don't want to do anything so I have broken that cycle and it does help
I know exactly what you mean. I've had a minor cold this week which seems to have zapped the little energy that I had so I've been at home all week. It makes me much more self absorbed and inward focussed. At this time of the day, when I'm feeling a bit better, I say to myself, tomorrow you need to go out and do things, even if you don't feel like it, then the morning comes, I feel awful, and Groundhog Day starts again. I do swim twice a week normally and volunteer at a charity shop once a week but the mornings are so dreadful for me it's hard to get moving. Does living with it get easier or is it just that your learn to cope better?
I think that with me I have suffered for all my adult life with this and tryed all the meds and counciling over the years and its has not helped me at all. I think that maybe I have learnt to cope with it because I have no other choice to be honest. I have noticed that since I stopped all the meds I am having some days when I feel not to bad. To be honest I really think that the meds have been the problem and not the cure for me. I have done a great deal of reasurch into this and it seems to be very common and I have read that a very high % of people make a full recovery when they have been off the meds for a while. There is a lot of stuff about all this on the net so it's worth having a look.
Hi
Venlafaxine is really a good drug and a good dose should be atleast above 150mg/day.At Doses below 150mg/day its just like an SSRI.It works usually after 4-5 weeks but its advisable to wait atleast 8 weeks to see its substantial response.Mirtazepine can be discontinued later as mostly venlafaxine is enough.
Thank you so much. I'm seeing my psychiatrist tomorrow who will probably increase the dose to 150mg. I thought that already having mirtazapine in my system, the venlafaxine would work more quickly?
Hi
Nope.Duration for onset of action wil b the same but Mirtazepine is a good augmentation to venlafaxine when venla alone is not working.But I m mostly conscious about pts weight so I mostly avoid medications which can increase the weight and thats the major limitation of mirtazepine making it a poor choice for maintenance treatment.For someone who is underweight or having insomnia its a good choice.But mirtazepine is special in one context as it has no or minimal sexual side effects and sometimes it partially reverses venlafaxine induce sexual dysfunction.
and yes the morning lethargy might be because of mirtazepine
Thank you again. One more question, does augmentation work better when taking the venlafaxne first and then adding Mirtazapine rather than the other way round?
Well I don't know the exact answer but in my understanding mirtzepine is an add on drug so 99 % its the 2nd drug and actua the order doesn't matter.Sometimes its not the mirtazepine augmentation but delayed onset of action of venlafaxine is responsible for improvement. So its possible that majority of benefit is due to venla. Only.still its well studied augmentation strategy.