Effexor - do I really want to do this?

[Sixstringkate]

So my Dr just put me on Effexor (the generic, twice a day kind. 35.7mg ea. It's the only one my crap-ass insurance would cover.) After freaking myself out by reading the PI novel that came with it, I went online to check things out and got even more freaked out. Is it really horrible? Or is it really worth it? Paxil & Celexa don't work for me anymore, and my Dr wanted to put me on an SNRI. I've got panic attacks, general anxiety, circular thinking, obsessive behaviors (although I've gotten through those with counseling) minor manic upswings, significantly depressive moments, and periods of extreme self doubt and loathing. Good times. Never suicidal. But not having a good time of it.

Also, in the completely unimportant and vain end of things, did you gain or loose weight? I gave birth to twins 18 months ago and just recently got my weight under control. I wouldn't NOT take it if it was going to make me gain weight, but I want to be prepared :*(

-Six

[lilymu]

For me, Effexor is the only thing that helps w/ depression. It does come at a price though. You will be addicted to it, withdrawls are horrible, and it doesn't work for everyone.

That being said, it is a Godsend if it does work.

For me, the weight gain was minimal <5 lbs.

Just my experience, I'mm also a mom of twins.

[Sixstringkate]

Yay! Another twin mama! Everyone's reaction is always "well of course you're having trouble, you have twin toddlers!" but it's been going on for waaaaay before the twins. It's petty and a bit selfish, but just for once I wish someone would say what a great job I'm doing holding it together in the face of the craziness that is my life. I really suppressed how bad things were getting until I had trouble self-inflicting that I couldn't hide from my husband. Not the healthiest way to deal, but the kids come first. I know you have to take care of yourself in order to take care of them, but there's no time to even THINK let alone self diagnose. There - vent over. I feel a little better now

[Damik]

Effexor is defiantly a YMMV drug. I know some people who it totally saved their lives and I know other people who had a really rough time on it. I have heard of people who have become addicted to it. I was lucky I didn't when I was on it.

I had a bad reaction to it myself.

I hope it works for you, though.

[jt07]

Effexor is a perfectly good antidepressant. There is a 2009 meta study here: http://www.isbp.org.il/up/article_files/9668495.pdf that shows it to be one of the more effective antidepressants.

I personally didn't have any trouble coming off of it. It, like almost all AD's, simply didn't work for me.

[Sixstringkate]

Soooo, basically it's a crap-shoot? I guess there is no easy answer to any of this. I'll take my chances and get started tomorrow.

[Damik]

I thought the whole medi-go-round was a crap shoot. But it is worth it when you find the right combo.

[jt07]

Soooo, basically it's a crap-shoot? I guess there is no easy answer to any of this. I'll take my chances and get started tomorrow.

In a way it's a crap-shoot. There is no way to tell which AD you will respond to in advance. But the meta study that I posted shows that Effexor (venlafaxine) is in the top 3 in terms of efficacy. That is just one study so it's methodology could be called into question. But that study is fairly accurate in terms of my experience (I respond to mirtazapine and citalopram).

[malachite]

Effexor worked pretty well for me for awhile, but it raised my blood pressure and I had to go off it.

[Velvet Elvis]

The only thing you have to worry about with it is missing doses since you're on the IR. If you're late by a few hours on the dose, you might feel it.

[Anna]

Effexor is a very effective AD, but if you have manic upswings you want to make sure you are on an effective mood stabilizer as well, in case it causes your mood to shoot too far upward. And a rescue plan as you will pretty much HAVE to come off it rather slowly.

Anna

[chimpmaster]

Good luck with the effexor. It is a drug with a great reputation for success where other drugs, particularly ssris have failed. Keep in mind there is a wide dosage variation, and your dr can increase the dose quite a bit if necessary. Due to the potential side effects of coming off the medication I strongly advise that you stick with for a good 5-6 weeks at least. Has your dr prescribed a benzo for the iniital period?

[jt07]

I forgot to mention, my doctor told me that Effexor hits different neurotransmitters at different dosages which translates to it behaving somewhat like a different med at different dosages. Don't be surprised if you doctor would substantially increase your dose if you don't respond to 75 mg. It's just the way Effexor is and why it has such a wide therapeutic dosage range.

[Calypte]

I was on Effexor for about a year (300 mg eventually). It wasn't very effective for me unfortunately, but no horror stories to tell either. I don't think it caused me to gain weight (depression did, however). The PI sheet will list every odd thing that happened to anyone during Effexor trials -- it's unlikely to happen to you. And of course the internet tends to select for people who have had really bad experiences. Withdrawing from Effexor tends to suck, but taking it slowly and having a benzo or Benadryl on hand can help get you through it when/if that time comes.

Also, to add to what JT is saying, most SSRIs do not show a dose-response curve in clinical trials (i.e. increasing the dose beyond the intended therapeutic dose doesn't have an average effect [it may work for individuals here and there, though, but on average the effect is not significant]), but Effexor does get more and more effective as you increase the dose. This is because at low doses, Effexor is essentially an SSRI. By about 187.5 - 225 mg per day, it starts hitting norepinephrine receptors, and at 300 - 375 mg per day you may also be getting some dopamine action. So don't despair if it doesn't work well for you at 75 mg.

[Sixstringkate]

Thanks for the details! I took my first one this morning and, even though I know I won't feel anything for a while, I'm excited and nervous. Mainly because I'm also easing off Paxil at the same time. I've barely been on it for a month and a half, but going off it the first time SUCKED. I would loose feeling in my face and hands, and I felt like I was walking about a foot below where the floor actually was. Of course, no one told me not to go cold-turkey, and I ended up literally hiding under the covers, disoriented, and getting seriously dehydrated. I probably should have been in the hospital. Fun stuff. I know it won't be anything near that bad this time, but I'm still worrying. Cause that's what I do

[rowen]

One thing that I've noticed about drugs that have been on the market long enough to have a generic is that their PI sheets get a bit lengthy. I assume this is due to the large amount of data we have on the drug. Whenever a new adverse reaction comes up, it is required that it be added to the PI sheet. Any new data on the drug, really, goes on the PI sheet. The PI sheet for Effexor when it was brand new was probably a lot different than the PI sheet for Effexor now.

I take Effexor, and I have been taking it for obsessive thinking for two years. It has not caused me to gain or lose weight. I initially had nightmares, but those went away. Some headaches and nausea when first starting up. All of that abated quickly. I don't currently have any side effects from it. I do have very wicked withdrawal symptoms from it, so I take two XR capsules daily as opposed to one. That seems to keep the withdrawal at bay.

I will say that because I have Bipolar Disorder and because I have strange reactions to antidepressants, Effexor does not help my depression. It tends to make my mood cycle, so I take another drug to help keep my mood stable. I really don't know what sort of mood I'll get with Effexor. It could be depressed, or it could be hypomanic. Fun stuff.

Overall, I like Effexor and I'm glad I take it. Would recommend it to people.