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gonamath

Effexor 6 Weeks On-My Experience

69 posts in this topic

Posted (edited)

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For those people who are just starting Effexor, I hope this helps you out. Overall, it has been a positive experience.

I went to my first Psychiatrist 6 weeks ago. I complained of lack of motivation, loss of hope, loss of clarity in purpose and I am also dealing with a mother who is in Dementia- End of life facility.Also, I complained about the never ending voices of family members telling me I was worthless. I am 47, recovering alcoholic -11 years sober. AA pushed the non meds-work the steps approach which left me depressed and guilt ridden walking into the doctors office. I had waited as long as I could and tried everything including 4 years of talk and cbt therapy. Nothing worked.

Psychiatrist evaluated me for an hour and then suggested I start on Effexor, "It's the fasted acting medicine and I have had success with many patients" ....she didn't and still hasn't revealed her diagnosis, "I don't want you to be labeled". She has referred me to a CBT therapist , but agreed with me that after 4 years of therapy not working , it would be ok to,see how the meds do.

Dosage:

Week 1: 37.5 mg 1x per day

Week 2 : 75 mg 1x per day

Week 3-6 : 112.5 1x per day

Met with Dr after 2 weeks . Very short visit, 15 minutes. She confirmed my diagnosis , agreed meds were working and boosted dose up to 112.5. She told me 112.5 would be my max dose. She would not give reason for that.

Mental effect:

First 72 hours immediate postive effect on anxiety and voices. All the negative thoughts lost their 'edge' and sort of smoothed out. I didn't go deep Into the black hole anymore. My situation did not change but these postive mental improvements were easy for me to see. These positive effects have continued thru the 6 weeks.

By week 3 I started to notice cognitve improvement. Focus, concentration, task completion, math problems, reading and memory all came back to functioning levels. This also increased my self esteem. This has continued thru week 6.

The one area I could use a boost is a moderate but yet nagging social phobia, particularly meeting new people. This is an area I will talk to my Dr about next week. I just haven't seen improvement with social phobia. I can build myself up and knock others down to "get thru it" , but I know this isn't healthy.

Side effects:

I had loose bowel movement once per day for the first few weeks. Oddly, it occurred only in the morning and only once per day. It started to clear 4-5 days after the last med increase.

Each time meds were increased, I would de be ' dragging' (seemingly tired but yet still able to function) for 4-5 days. Oddly, I wld feel this 'dragging' in the morning but then go have an amazing workout. The key for me on this was to ' push thru it' . I would feel tired and then crank out 2-3 hours of solid work.

Sleep was no problem, although I do find myself waking up 4-5 hours after going to bed......then i would use the bathroom or just roll over ....most of the times I would get another 2-3 hours.

Currently, the only side affect I am still trying to figure out is the at times feeling like I am 'dragging' . This could just be the new reality ? As mentioned, I am having success just busting thru it the best I can.

Good example of the effects:

I have a sad but useful example for this. My mother is in end of life facility for dementia. The call could come in tommorow or in 6 months. She basically is a vegetable waiting to die. I use this example because it was there pre med and hasn't changed a bit post meds.so,,what has the medication done ?

Pre med I was burdened with guilt and shame that I was not able to help her. Also I was starting to become overwhelmed with fear of her facing death. It was crippling situation for me. A very heavy burden.

Post meds, all the negatives like guilt, shame, fear have departed. They have been replaced by me using cbt exercises , journaling and prayer.....seemingly very healthy and I am able to deal with her situation much better ! .....it's rather amazing.

Cost-I have no insurance !

Using Apple Ap R/x cost for generic is under $30 per month ! 150mg pill , using R/x is $14 if I get my dosage increased.

Discounted dr visit is $96 per session, but she said she would be lenient with visits if I am doing ok ! Hopefully 1x every three months.

After I get up and running with program, cost for a year on Effexor + Dr visits will be under $475 per year.

Questions for you:

Has anyone also been told they will be maxed out at 112.5mg ? Seems strange doc would say this at week 2 visit. Is there something hat happens at 150mg ?

Why wouldnt doc give me my diagnosis ? I asked and she said " I don't want you labelled" .....I will ask her again next week. Anybody similar ?

Edited by gonamath

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Posted

Hi there, sorry to hear about your mum. Yeah the non diagnosis thing rang a bell with me. I also realised that I have never seen an official diagnosis from my pdoc. The only thing that came close to it was a handwritten script where there was a note in the 'reason' field. Well OK, I guess the fact that he keeps talking about my 'severe' depression means I'm...severely depressed? Don't know. Originally I came to seek help for my ADD really and since then he is trying to figure out how much of my ADD is ADD and how much depression.

Makes all sense but the thing is I feel a little bit like hanging in the air. I don't like labels either and I think a lot of people hide behind theirs but then again I have a concerned family and close friends to report what's going on with me. Also some less concerned people may have to be informed about aspects of my state like work colleagues, bosses etc. For that, it would be useful to give them something to be happy with i.e. an 'official' diagnosis. Actually, at this point I would like to raise the question how other people are diagosed. Do they get a piece of paper with the condition? A note in their file? What exactly makes one diagnosed?

Regarding the dosing...hmmm... in my logic it could make a difference if someone is a 350kg sumo wrestler or a 45Kg ballerina. There are also various approved max doses for different conditions. I.e. Anxiety max dose might be 150mg whereas depression could be 300mg. My hunch is that your pdoc has an idea about your condition and doses accordingly.

There is nothing special happening at 150mg. Some people are over the moon on 75mg or less and others have no effect on 375mg. It really depends.

The only thing that seems to be kind of agreed on is that it is supposed to start working on norephedrine in mid doses (150-225mg) and mildly on dopamine around 300-375mg. Dopamine is every pdocs problem child as it may react with existing addictive and manic tendencies. Maybe that's her concern?

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Posted

Thanks bluesbrother, you offered great insight.I have an appointment on Friday with my pdoc, you have given me some ammunition for my meeting. I'm going to ask her for the diagnosis at the end of our meeting.

* I believe your idea on 'dosage range' (for me max dose 112.5) fits 'diagnosis' makes sense. Addiction background must also figure into dosage as well.

* I had a sense her focus was more on anxiety and isolation over depression. Although, I now believe my biggest issue could be the Social Phobia. Which I think also plays Ito anxiety as well.

It seems like there are two sides to getting a diagnosis. The negative side, as you mentioned, is we walk around and hide behind label. We also get labelled by society ? Potential negative. The other side, number 2 is much more positive. We can become educated about our condition. Seek information on alternative treatment plans and discuss strategy with pdoc. We can come to a forum like this one and say I was diagnosed with this, anybody else like me ?

Thanks again, I'll follow up after pdoc appointment.

tattered likes this

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Posted

Ah I'll be having my next one on Friday too. Let's see what's in it this this?

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Posted

I wanted to say that I'm sorry to hear about your mom as well. Keep us posted about your doctor's visit. :)

Phoenix1 likes this

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Posted

Thank you Tattered, you are very kind. Means a lot.

Ok, now for follow up with Doctor ---saw her this morning:

*She revealed my diagnosis- Dr quote: "It was clear to me, after my evaluation of you, that you suffer from major depression. There is accompanying anxiety, but not strong enough to categorize as a disorder. The fact you have been sober 11 years and still suffer rules out the possibility that the decade long alcohol abuse was the cause.You are clinically depressed. Most likely you became depressed in your teens and used alcohol as a medicine , per se. It is a chemical imbalance in the brain." End of quote

*'in terms of dosage, She will keep me on 112.5mg for the next 2 months. Dr quote: "I like to be conservative on dosage. It can take up to 6 months to feel the effects. The optimal dosage (statistically) for Effexor is 150mg. We will consider it in 2 months time. You could continue to see postive effects of the drug for the next several months".

*The key to success is CBT therapy , medication .

I felt better after getting diagnosis from her and I liked her plan .

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Posted

It sounds like a great plan & one I hope works for you. In the meantime, I am here for support. I'm new to this medication and all AD so I don't have a lot of experience but I do with supporting people. :) And I've had anxiety my whole life.

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Posted

Just wanted to add that this week (7-8) has probably been my 'best' on Effexor. Continued, slight drop off in daytime drowsiness week to week. More of a regular sleep pattern (6-7 hrs works for me, maybe 1x per week I have made it 7-8). This is a definite improvement for me versus pre-effexor.

I wish I didn't have to do the work though...CBT drills and meditation. No way around it....I just can't do it alone on the med only.

I also have these occasional little bursts of serotonin (not every day) every once in awhile for about 20-30 minutes and its awesome...very mild, but nice. Usually hey occur after a very healthy meal.

Also, still,seeing a nice drop in sugar cravings.....for now ! ...we will see on that one.

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Posted

Sounds like you're doing great gonamath. :) It keeps me full of hope.

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Posted

ive been on Effexor xr 75 mg feel like the depression has lifted a bit but my anxiety and panic r still very much there do you think if my doc raises the dose it would get better? I was on 150 mg for 10 yrs until it stopped workinga year and a half ago

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Posted

Hi Crystallee,

I was told the 'optimal' dosage for Effexor is 150mg. Everyone is different, some need much less and some need more. Here is my Doctors dosage and noted strategy :

I was on 37.5 mg for week 1

I went up to 75 mg for weeks 2,3 and 4

I met with Doctor at this point and reported postive feedback and limited side effects. She then upped the dosage.

I went to 112.5 mg for weeks 5,6,7,8,9

I met with Doctor and reported postive feedback and limited side effects . She decided to remain on the conservative side and not increase dosage at this time.I meet with her again at week 12 to see how I'm doing.

Crystallee, I would ask your doctor what his strategy is ? It you were on 150mg for 10 years why would he think 75mg wold work ? It seems your strategy would most likely be to see how you do on 150mg again and then most likely go up ??

Hope this gives you some tips for your doctor. Good luck.m

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Posted

Update on side effects:

*I have increase in underarm perspiration during the day.In situations where there might be some nervousness (speech) , I am seeing a 30-40% increase in perspiration. Temps have begun to rise here, but still this is 'ridiculous'.....more research to follow on this one .

thats it for now ..

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Posted

I haven't experienced the sweats that people speak of on Effexor but maybe it's because of the low dose I am on?

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Posted

thanks

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Posted

Hi,

I thought I would update:

* I started with a CBT therapist last week. Strictly CBT, possibly some EMDR. Seeking weekly progress through exercises like Daily Thought Record, etc. This will be my first male therapist (same age too), so we will see if a male influence/input will help. I told him talk therapy did nothing for me. I want weekly exercises and interaction and coaching.

*I have a 'gut' feeling that Effexor is a medication that demands action (to be most effective) and change. In other words , I have to really want to change and get healthy for it to be most effective. If I act and think the same way I did before Effexor (no action) , I'm not sure how effective it will be ?. That is the reasoning behind going full force with CBT. Effexor can provide a 'boost' to my actions, but its not a crane capable of lifting a sulking me off the floor ?

* I may have over reacted on the perspiration issue, not quite sure. I know it's rather personal, but thought I would mention it. I do rather prefer feeling "fresh" throughout the day. A little more testing is needed.

* I am convinced I am breathing better. My workouts are much more productive and fulfilling. I occasional get a 'super high' on my long runs. I felt invincible this morning.

* One of the exercises this week was to 'observe' how other people react to me (strangers). So I sat in the park for about :30 minutes and observed. It was a beautiful day, so I just chilled out. One of the things that stood out were the warm smiles. So many people walked by me and gave me a nice warm smile......I had never noticed that before. Not flirtatious, just a 'have a nice day' smile. ....

* I see no reason to request a dosage above my current 112.5. It's time for me to do some of the work instead of relying to heavily on the med.

How is everyone else doing ???

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Posted

Sounds like you are doing fantastic. I for one and getting things done because of the Effexor, I had no will before it. I also have some talk theraphy coming up but I want to get settled on my Effexor dose before I even go there. :)

Thanks for the update. :)

gonamath likes this

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Posted

I had my 3rd CBT therapy session today. So far so good. It's much different than talk therapy. We have been focusing in on my daily thoughts-perceptions-then actions. I clearly have a lot of negative perceptions which start the domino effect . Here is what I'm currently working on:

*"I don't need to be perfect" . This is a big one that points to the need for approval from others rather than just focusing on what I want and need to make me happy. This is big negative pressure. So I have been practticing to get this turned around.

*"Mind reading what people's thoughts are" . For example, a grumpy person at work may not respond to me by saying Good morning. If I'm mind reading I may perceive this as a negative, assuming that the person may have a problem with me. This is another negative that can start the domino.....leading to negative pressure.

*"Avoidance" . I am often guilty of avoiding things where I perceive the outcome to be negative. I may not go for that job promotion because I don't think I deserve it ....causing me to Avoid going for it. It has a llot to do with mind reading and perfection .....unhealthy avoidance seems like a good alternative but again it can lead to negative thought pattern and isolation.,

CBT therapy appears to be like exercising the mind ...trying to identify negative patterns and then changing them.,Easier said then done, but I am hopeful. To me this is so much more helpful then telling my life story again to a talk therapist ...I just never got anything out of talk therapy and telling someone how my weekend went with nothing to work after they say "times up"

My Dr said there are new studies confirming the success of Effexor + CBT + Meditation (much greater) versu just Effexor by itself. This confirms my initial thought when I mentioned that Effexor seemd to be an "action" medication. Sort of a double edge sword.

Still at 112.5 mg Venlafaxine.....I see psychiatrist next Friday.

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Posted

I had Appointment with Psychiatrist on Wednesday.

We both agreed to up dosage to 150 mg. I will report back over the next few days if any side effects kick in.

*He highlighted the need to get outdoors and absorb sunshine. Yes, sunscreen but get out into the the sunshine.Not only to be active, but to simply absorb the sun in a healthy way.

Admittedly, I was running very early in the morning and being 'careful' in the sun due to fears of cancer. The key is a good sun screen on body when needed, but gotta get out .

*He told me to get 'laid', get 'sun', get healthy diet......not kidding on the first one (sorry if it offends anyone). There is no comparison between a close relationship and having coffee in a busy cafe. We all need intimacy, I have been out of one for 6 months...time to start looking for another one. I told him that Effexor seems to be more effective with healthier diet, he approved.

Note on Effexor withdrawal:

Per my Doctor, "right here, right now there is absolutely no reason to go through horrible Effexor withdrawal symptoms. There is now a standardized 'tapering' schedule that takes 3-4 months. Other drugs can be brought into the picture if necessary, but the internet is full of "unsupervised" cold turkey stoppage of Effexor. This is the patient causing his or her own harm "

If you are coming off of Effexor, please seek medical attention. There is no need for the internet reported cold turkey withdrawal issues.

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Posted

This sounds great gonamath. :) I'm glad to see such a great update. Did he say why you needed an increase? If I recall correctly, he was not going above 112. 5 mg?

Eating healthy is very important and also getting real Vit D from the sunshine. I've been doing that as well.

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Posted

Hi Tattered, welcome back ! I missed your posting .....I was hoping you we're doing ok.

We both decided to give 150mg a try ....I still feel like I'm battling some chronic negative negative thinking ...

The gameplan is to see if it helps, if not we will go back to 112.5 and maybe add something else.....no rush , I will give this a go for 60 days.

tattered likes this

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Posted

Hi Tattered, welcome back ! I missed your posting .....I was hoping you we're doing ok.

We both decided to give 150mg a try ....I still feel like I'm battling some chronic negative negative thinking ...

The gameplan is to see if it helps, if not we will go back to 112.5 and maybe add something else.....no rush , I will give this a go for 60 days.

I'm here! :) I plan on staying here if not for support, to give support. I get those thoughts too, it's sure not easy. I hope it works for you. I've thought on the combo stuff myself, I'm not close minded to it. ;)

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Update. I have been on 150 mg for a week or so. Absolutely no negative side effects, actually feel a little "calmer" overall. A friend commented last night .." You seem much calmer" .

Definitely calmer but then I have great workouts and am able to read several articles in NYT without losing focus.

I have also been getting at least 20-30 minutes in the sun ( with facial sunblock) which also seems to have a calming effect. One strange thing is coffee. I don't seem to get that coffee rush in the morning....rather odd.

I know, I know only day 6 ......lets see how I do next t week.

How is everyone else doing ????

tattered likes this

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Posted

2 weeks on 150mg, no side effects . Easiest of the dosage increases so far. I believe I have cleared the hump and will stay on this level indefinitely.Feeling pretty good.

On a side note Dr mentioned adding Wellbutrin to Effexor if motivation was an issue. Evidently Wellbutrin will get you up and moving. No need for me, but thought I would mention it.

tattered likes this

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Posted

Yup, Wellbutrin will do that. :)

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Tattered, I'm going to send you a pm .....I'm worried about you.

tattered likes this

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