Another on mixing Effexor XR, xanax, and Sotalol (beta blocker)

[TwilightStar]

I have been taking beta blockers for my heart condition for 17 years, and recently switched from tenormin to sotalol. I'm also taking effexor xr (300 mg 2x/day) and xanax (.5 mg 2x day). All of this for my GAD, tension, and depression

I've been having panic attacks recently, having checked with my cardio to make sure it wasn't heart related. I was doing so well for almost a year, but lately I think I may be tolerant of my xanax...I've heard that is a possibility. If you still have problems, I would suggest upping the effexor first (most commonly) but in the future you may need to switch to higher doses of xanax. I wouldn't recommend upping the beta blocker (although with these panic attacks it would be nice!!! I've got an implantible defibrillator that is gonna shock me because I'm having panic attacks!! hehe)

Just something to keep in mind--these benzo...s (sp?) create dependence and tolerance; and depending on your doc they might not really care: They just don't want you to become an "addict." I'm fighting my doc to change my xanax to something stronger, it's been 2 1/2 years on it.

Best of luck to you! You're on the right path in my opinion!

[MarkP]

That's a fairly high dose of venlafaxine (Effexor).

One of the big problems with those extended release tablets is that its hard to taper the medication down, to see if, for instance, lowering the dose brings the anxiety and the need for the other medications under control.

Maybe you could get some of the 150mg XR tablets, and try 300mg for one of your doses, and 150mg for the other dose?

So personally, my suggestion would be to look towards a dose reduction down, not up on the venlafaxine, if you are having feelings of panic. And switch to a longer-acting benzodiazepine as well. Even lorazepam 1mg B.I.D. would be better than the Xanax, or even switching to diazepam, bromazepam, or temazepam. Venlafaxine is quite closely related to stimulants, while benzos are essentially downers, so taking both essentially is medicating the side effects of one med, with another, and vice versa, with the development of tolerance.

[SashaSue]

I'm not really clear on the question in this post, but have to say, 600mg is a huge dose of Effexor. If you need that much for symptom relief, I'd say it's time to think about changing to a different AD. I'm really surprised your pdoc would even let you go up that high.