Effexor durability over years?

[Icy_rose88]

Hey guys, I've been on Effexor XR 150 mg for around 8-10ish years and I have the issue that i either feel like it isn't working anymore, or maybe i am just way more depressed? I talked to my doctor about changing it, possibly. She didn't want to change it yet though,(Against my request) so she added another 75mg to take every day so now I'm at 225mg a day and i have been since February 6th(roughly) but I still don't feel a difference. So I guess my questions are, where do i go from here? And do you guys think that the medication doesn't work after so many years or is it just me? 

[mikl_pls]

Trying to go up to 225 mg makes sense as it is the max approved dose and it is also the dose at which you start to get the benefit of the dual serotonergic + noradrenergic reuptake inhibition. But if after this long you haven't felt anything, you have a few options at hand.

1. You can go beyond 225 mg, usually up to 375-450 mg max, or even up to 600 mg with very close supervision by your doctor.

2. You can switch to something else—I would recommend giving Cymbalta a try as you have migraines and Cymbalta tends to work well for migraine prevention.

3. You can augment with something like high-dose Remeron (30-45 mg), an atypical antipsychotic like low-dose Abilify (2-5 mg) or Rexulti (0.5-2 mg), or perhaps even Lamictal.

Remeron + Effexor is a very common combination; they make a very synergistic pair in boosting both serotonin and norepinephrine. Effexor begins to affect dopamine reuptake inhibition at super-high doses (usually 375 mg and above). Abilify and Rexulti are both approved for the use of adjunctive treatment with an established antidepressant for major depressive disorder. Lamictal is an anticonvulsant mood stabilizer typically used for acute bipolar major depressive episodes, but can be used in treatment-resistant unipolar depressive episodes. There's also always "good old" low-dose lithium, but that's something you generally want to avoid if possible due to the side effects it can cause.

[Prycejosh1987]

On 7/21/2019 at 10:54 PM, Icy_rose88 said:

Hey guys, I've been on Effexor XR 150 mg for around 8-10ish years and I have the issue that i either feel like it isn't working anymore, or maybe i am just way more depressed? I talked to my doctor about changing it, possibly. She didn't want to change it yet though,(Against my request) so she added another 75mg to take every day so now I'm at 225mg a day and i have been since February 6th(roughly) but I still don't feel a difference. So I guess my questions are, where do i go from here? And do you guys think that the medication doesn't work after so many years or is it just me? 

I think you should have the doctor prescribe you something more effective. Some medications works better on some than on others. Going up to high on the dosage is never a good idea.