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Augmenting 187 of Effexor with 10mg of Lexapro - surely a recipe for disaster?

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Hi all,

Went to my pyschiatrist today. The last few weeks have been stressful and I have felt that Effexor is not doing the job it is supposed to be doing (felt that for most of the almost 2 years on it tbh). On top of all that, I am starting a new job next week (teaching, which I love!). 

My pysch suggested that I titrate from Effexor to Lexapro by taking 10mg of Lexapro while still taking 187.5 of Effexor - I nearly went "What the f**k!". I would imagine that would knock you 10 ways sideways or has anyone done this? 

We settled that we leave it a week before deciding to either go up to 225 or down to 150. I feel that I need to come off it at least. I feel that there's a tendency to just pump people with drugs from pyschs rather than look at more meaningful answers. 

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Hi @StoniumFrog -- It's been a while.

Usually, adding another anti depressant, would, mean tapering the dose of the first down a bit. As far as I know (haven't been on Venlafaxine for years now) the max dose is 225mg. So you are on the upper end of the safe prescribable dose.

I used 150mg of Venlafaxine with 45mg Mirtazapine.

For that combo, that was the max safe prescribable dose, as taking one med, has a side effect profile and adding another med will increase the profile.

Not by increasing the risk of rare side effects, but just adding to the frequency and maybe amount of side effects.

It is though, unusual that Escitalopram has been recommended, as they both have a "stimulating" effect, in that, not sedative.

I would suggest, looking at sedative meds like Trazodone for example, and seeing what your psychiatrist says.


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Hey @Tungsten Aromatics - Seemingly it's 450mg over here in Ireland and by f**k, I am going nowhere near that! I'm not going anywhere near Mirtazpine or Seroquel (I could only tolerate 1.25mg of Mirt). 

It just seems that I am getting a grasp of what needs to be done personally, but the physical side effects of Effexor (headaches, limbs sore, etc) are too much at times. Of course there's the bigger issue of me giving myself a hard time all the time and being a procrastinating perfectionist. I just need to learn to take it easy on myeslf and enjoy a bit of life rather than take it so seriously. Like right now - I need a nap 😉 

I'm just so frightened of going from one med to another ... as we all are. 

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@Natasha1 - There was no way I was going on that combination ... if I was to have any chance of waking up in the morning and functioning properly.

Having a stressful time of it at the mo and I think getting the job (the frustration of searching on top of the fear that would I be able to work at all). It is physical mostly at the moment, with headaches and sore limbs. Every few weeks it's that and it is tiring. 

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For me the Effexor gives me tremors and it wakes me up at 7:30 a.m. everyday to take it if I don't take it even an hour before or after I will go through withdrawals that really freaks me out. But it does help 80% of my anxiety. And I have extreme severe anxiety. I want to get on Lexapro but some people say that Lexapro only helps 40% of the anxiety and right now I have a big trigger going on so I'm afraid to go on Lexapro right now.

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