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Effexor XR - Input please


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Hi All,

I started on Effexor XR 12 days ago. I took 37.5mg for 10 days, then moved to 75mg starting yesterday. So far, I've experienced the usual side effects of adjusting to a new med, plus some that are typical of Effexor (sweating, nausea, appetite loss). Now, the questions...

  1. The SE's calmed down about a week after my first dose. Then some came back yesterday when I bumped up the dose to 75mg. Is this typical with Effexor? Should I expect a mini-repeat each time my dosage increases?

  2. About a week ago, I was shopping somewhere and swore that my ankles (yes, just my ankles) felt cold. It started again last night, so I know I wasn't imagining things. Anyone else have this side effect? WTF would cause that? ;)

  3. For the first 3-4 days after my first dose, I felt really good mentally. I would even get really "smiley" for a few hours. When I say "smiley", I mean grinning for no reason whatsoever and feeling contented. This went away, and now it almost seems to be coming back with the dosage increase. What is this? I thought it took weeks or months to get a positive effect from ADs, yet this makes me suspect my seratonin is already being tinkered with. Something similar happened when I took my very first dose of Lexapro (also my first dose of an AD, ever)...except it lasted for about 6 hours and it was far more euphoric. Thoughts?

  4. Finally, I've done my homework on Effexor and about a million different sources state that it doesn't do anything with norepinephrine until 200mg+ per day. My pdoc says we're aiming for 150mg...which confuses me because the whole reason I'm on Effexor is because neither Lexapro or Prozac did a damned thing for me. It's obvious to both of us that I need help with more than seratonin. So, I question her about this and she tells me that how Effexor works on the different neurotransmitters is "like a pie chart that changes with the dosages". Meaning: the lower the dose, the smaller the norepinephrine slice/the higher the dose, the bigger the norepinephrine slice. I trust my pdoc, but I can't find information anywhere that supports this. I can't help being anal, and wanting to see this in writing somewhere. From my point of view, why take an AD that is infamous for yucky SE's and difficult withdrawal if we're only going to work on a transmitter that we can hit using a much more "tolerable" drug? Luckily, she is open to bumping up the dosage beyond 150mg if it doesn't work. I just wonder why the fuck we're aiming for that in the first place when I can find no evidence of said "pie chart". :) What do you guys think?
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Hi Tek,

Welcome to CB ;)

I'm currently on 75mg of Effexor-XR but I went up to 300mg at one point. For every dose increase, I had a week or so of "settling in"; likewise for every step down.

I hope that is helpful for you. If not, can I please direct you to some of the other threads on Effexor-XR. I think you'll find, if you have a bit of a poke around in these parts you'll find that there are quite a few that deal with all sorts of side effects and dose changes and weirdness.

Good luck with it.

Bern :)

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I have had very good luck with Effexor, and no side effects. But everyone is different. I am currently on 225mg daily, and I did notice a big difference when we went from 150mg to 225mg. I have OCD, and the increased dosage really did help my intrusive thoughts, they are almost gone right now. Probably because of the norepinephrine thing.

The only drawback is the discontinuation effects, but I figure I'll worry about that later, because right now I have no intention of going off of it, it's the only reason I'm functioning right now.

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Hi, tek,

1. Yes, but probably briefer and less noticeable as you become more accustomed to the drug over time.

2. Effexor can do weird stuff to internal temperature regulation. Sweating is another common side effect. I had a similar sensation when I started Effexor, getting chills at odd times, when I really shouldn't have been feeling cold. That happened mostly during the first few months and then leveled off.

3. Some (fortunate) people get the early euphoric response when taking a new AD. Sadly, it doesn't last.

4. Wait and see. It's all a crapshoot anyway. If a couple of months at 150 mgs isn't doing the job, try the 225 dose. I've never read about the pie chart concept either.

Good luck. Effexor can be a wonder drug. I hope it works for you.

Greeny

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  • 1 month later...
Guest Guest_mackatlaw_*

I know the mere mention of Effexor scares most people away, but I also know that many of you have taken it. Please reply! ;)

I've been on 37.5, the starter kit, for five days now. It's doing something positive, I think, but I'm still having withdrawal from the 40 mg Lexapro I was on. The Lexapro worked for the depression and tendency to obsess and get stuck, but made it almost impossible to reach ejaculation, much less orgasm, without extreme efforts. (And I'm a 32-year-old male in good condition.) It also made me tired a lot with occasional lapses in memory (so I wrioe stuff down even more than usual). When I told the doctor about the sexual side effect, she immediately got concerned, possibly as that means I would have difficulty sticking with Lexapro for a long period of time. I've been on it six months or more. Previously I was on Celexa, and before that, a host of others. I'm an attorney, so I need to be as mentally sharp as possible. Being frequently tired is livable, though makes me disgusted.

I have major depression and ADHD. I'm currently taking 5 Abilify (for mood stability), 20-30 mg Adderall a day for the ADHD, and the 37.5 Effexor which should be going up to 75 soon. I'll try to get my doctor to prescribe the half-strength 37's so I can take the doses twice a day; I find the ride to be somewhat smoother. I should probably be on something other than mediation at night to help me relax, but since we're switching SSRI's, I'm reluctant to ask for a benzodiapine at the moment.

So no hard data on the Effexor yet, but I'm very hopeful. I've tried most of the other antidepressants and like you, have done a lot of research on them. I'm still searching for the most uplifting drug with the least negative side effects. I'll keep following this thread and will post as I have information to add.

Mack

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(This time, logged in and not as a guest.)

I have similar concerns about the pie chart problem of serotonin, norepinephrine, and dopamine. On the other hand, there would be a large difference in no norep-receptors being hit at under 200, and between a small but significant amount being hit below 200. I don't know either. I do know that too much norepinephrine makes my heart race like I'm working out, but a little might be very helpful. I'm also on a similar dosing course as you and for what sounds like similar reasons.

Mack

www.livejournal.com/~mackatlaw

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have you tried wellbutrin? I'm rather fond of the wellbutrin + SSRI combo. That hits all three major transmitter types. The wellbutrin typically counters the sedating effect of any other med you might be on while the SSRI counters any anxiety that might be caused by the wellbutrin. It helps with ADD as well. Adding Strattera to the mix is also an option if you take the dose up slowly.

If you're not taking Omega-3, give it a try for a couple months. It does help with both ADD and mood stability.

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I've only had a couple of noticeable side effects with effexor. I've been up and down on it over the years depending on where my mood was at. Of course, originally using the starter pack of 37.5mg. I've been on as low as 75 mg up to 375 mg. Currently I'm on 300 mg. I have had more hand tremors the higher the dose and maybe a little spacier. I hear it's a bitch to get off of, but I'm not ready for that yet.

I'm also on wellbutrin 300 mg (as others have mentioned) from 150 mg up to 450 mg depending on the mood.

I don't know which one works better, but I've been on both for a long time. And as suggested by VE, I have been taking omega 3 oil daily for the past couple of months. (Not to mention bucketloads of other stuff).

Oreo

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