Venlafaxine finally some results, but a dilema and some questions

Hi,

​It has taken 11.5 months for Venlafaxine to show signs of working. I have not had a depressive episode or significant side effects since the end of October, and I can honestly say that "something" (Venlafaxine?) has managed to successfully mask or remove my depression and anxiety. The last time I broke down and cried was in August and the last time I felt rock bottom was 29th October.

​However, I have noticed that I have put weight back on even though I am exercising regularly. This is not so bad, but the worst thing for me is that I have ED caused most probably by the venlafaxine. Having a "sexual dysfunction" may be the price to pay to be rid of depression, but it is a high price to pay. I wonder if anyone out there has had this horrible side effect and was it enough for them to get off venlafaxine. One possible way is to take a drug to combat the side effects of venlafaxine, such as taking Viagra, but this option does not always work, and I have had mixed results. I will definitely come off my 225mg very very slowly (I am taking modified release capsules). Additionally, does anyone know if Venlafaxine messes with your cholesterol? I have noticed while in the gym on the running machine, my peak heart rate can go as high as 190 bpm. Some people have told me that this is high and it should really be around 160 bpm. I am reasonably fit, but after now feeling 80% better from depression, I have now focussed more on other aspects of Venlafaxine which trouble me.

​Any advice, knoweldge or your experiences would be invaluable.

Regards,

Ricky.

Hi Ricky, 

Yes, ven will impact your health negatively over time.  I have the female equivalent of ED and have had for the entire 20 years of being on ADs.  Just search around the web and you will find tons of people with this problem.  I have heard that 80% of SSRI/SNRI takers have sexual side effects.

Ven is also one of the hardest to get off of, with horrific protracted WD if you come off too quickly.  There often will be a honeymoon period where you feel fantastic for the first two months off, but then the wheels come off the bus and this can go on for months and even years for some. 

The doctors won't acknowledge this.  Search for Complex Withdrawal Model by David Healy to read a nice synopsis.

Doctors have us come off way too steep and too fast.  10% of the previous dose per month is the recommended taper schedule and even that doesn't guarantee the wheels won't come off the bus months out. 

Since you are doing well with your depression and are taking the extended release version, you could do the bead-counting method.  I'm assuming yours has the little beads inside the capsule.  Open three or more capsules and count how many beads each has.  Hopefully they are pretty close to the same, though I've read that the manufacturer is allowed as much as +/- 10%!  Once you know the average number, you can start removing 10% of the beads each month.  Journal your symptoms so that you can see if you have any mild WD symptoms and how many days from the cut they occur, and how long they last.  This will allow you to determine how often you can cut.  You want to stabilize well after the symptoms, and never cut when you are still having any, as this will only cause more instability.

This should go well until you get down to 37.5 mg, which is the minimum effective dose.  At that point, your serotonin receptors are still 80% occupied (the top occupancy with higher doses only being about 90%).  Once you start cutting into that 80%, the likelihood of WD symptoms increases, so if you have cheated and reduced by more up to this point, you better slow down to 10%!  Occupancy drops precipitously with small dosage drops at this point.

Since the brain has remodelled in response to the drug's action, taking away drug causes imbalance of neurotransmitters, and until the brain adapts and remodels to these changes, WD symptoms can occur.  The goal is to make cuts so small that the brain hardly notices, is able to adapt without too much imbalance, and WD symptoms remain tolerable so you are funcitonal.

Meanwhile, I would have a visit with your doctor to check out your heart funciton.  I do know of someone on another AD that had to come off because of heart arrhythmia.  He is suffering bad WD because he HAD to come off, no two choices.

I will add that withdrawal includes symptoms that appear like the original depression but aren't, yet doctors will say you have relapsed and throw you back on meds.  Reinstatement can help alleviate withdrawal symptoms, which is what is really happening, but often people will be thrown on new drugs (which can't cover up WD from the one you came off), including benzos and anti-psychotics because their WD makes them appear bi-polar!  It can get ugly fast!

I hope this helps, Ricky.  More than you probably wanted to know.

Hi Ricky.

Whilst on venlofaxine (225 for 4 years) i too had these problems. Loss of sex drive, high cholesterol, high blood pressure and i put on 4 stone in weight. As i weaned off all these things slowly returned to normal and now 10 weeks after stopping all are completely normal and once again am back to 14 stone.

Ian

Venlafaxine does increase heart rate, but I think the effects are supposed to reduce once the increase in dose has stabilised. GPs do an annual cholestorol test if you are on venlafaxine long term so I think that is a known problem. For me there are no negative sexual affects (I'm female). My interest seems to increase on venlafaxine, probably because it cures the depression. Not aware of significant weight gain either, but I think I've been very fortunate. Everybody is different. Hope you find something that suits you.