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Chocolate Heartache

Venlafaxine in Bipolar

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I didn't know whether to put this in the med section or the Bipolar section, because it's about how the two react, so I used the one with the most traffic. If this is wrong, can a smart person move it for me please?

I'm wondering whether anyone here has experience with Venlafaxine in Bipolar disorder? I've always had a fairly antidepressant-heavy cocktail, but two days ago I switched from escitalopram 20mg to venlafaxine (alongside carbamazapine, quetiapine, and a whole bunch of physical meds) and I feel... wrong. Like I'm full of twisty creepy things, and I'm sort of alternating between wanting to curl up still in the dark with my eyes closed and wanting to run around like a hamster on a wheel. Lots of panic attacks, bigger and scarier than my 'normal' PTSD-related panic attacks, which are themselves fairly weighty. I've tried lots of totally illogical things that don't help, like hiding in the bottom of the wardrobe, and (TW): I'm having rather unhelpful thoughts about cutting myself open to let the twisty things out. I can sort of stand back a bit and see that that's insane, but there's another part of me that thinks it'd help, and I don't think it's the same bit of me as usually self-harms. On the plus side, I've also done more housework in the last 24 hours than I had in the last four months. I had a gradually-increasing-but-functional hypomania through October and November, a really horrible peak with mixed features in December, then a depressive crash in January which has trailed on long enough for my pdoc to want to switch meds again.

The patient information leaflet and the BNF were relatively unhelpful, and some other resources suggested that venlafaxine shouldn't be used in Bipolar. That said, psychiatrists fairly frequently prescribe things they're not supposed to, because that's how psychiatry works, and I don't know whether it's a relative contraindication or a total contraindication, because the resources weren't that helpful (my best psych texts are all piled up in my office at that job I haven't been going to.)

Has anyone here tried venlafaxine, and how did you get on with it? I'm trying to work out whether these are normal side effects that'll subside, or the beginning of an unpleasant episode that's going to get worse. I've put a call in to the Crisis team, and they're going to pop in to see me tomorrow, but I'd rather not go into hospital if I don't have to, although I was in recently and I'll go if they think it's really necessary.

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I had a very unusual side effect from Effexor: I got so suicidal that I said goodbye to my children, laid down in the middle of my living room floor, and cried for hours. This happened less than a week after I started. I called the pdoc and we stopped the med immediately.

I've never had a reaction like that to a pmed since, including other ADs.

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You need some help, asap Chocolate.

The full of twisty, creepy things is absolutly unbearable.

Don't wait!

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Oh yeah , definitely put a call in to the pdoc. I take 300mg of the stuff just fine. But we all react differently to each med.

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It sounds like what happens sometimes when you mix antidepressants and bipolar disorder.

You should call your pdoc.

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Sounds like a mixed state or dysphoric mania... I agree that you should call your pdoc and explain everything you've posted here. It seems venlafaxine may not agree with you in a very serious way.

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I have taken venlafaxine for almost 3 years. I don't have many side effects from the drug, but I am also not real fond of it either. The only time that I have ever seen any kind of effect from it was in the month or two immediately after a dose change. After that the med just poops out on me.

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I got manic when I took it. It was when I was first diagnosed and I didn't know what was going on. All I knew was that my doctor told me to call him "if it started working too quickly". I was on and off it inside of a week.

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Good on you for calling your crisis team. These are not the kind of side-effects that you can/ should continue to put up with.

I did have a (for me) rather bad/ intense bout of hypomania brought on by switching off Effexor (Venlafaxine) & onto its cousin Pristiq (Desvenlafaxine), but I wasn't on any form of mood stabiliser at the time either.

I was on Effexor XR (Venlafaxine) 75mgs for several years (was diagnosed with bipolar for some of those years) then moved on to Pristiq (Desvenlafaxine) 50mgs because the Shrink thought it might help better with my anxiety issues. I'm odd in that I mostly react really well to the base level of medication, & have crappy reactions to the higher doses, of anything.

My current cocktail is Pristiq (Desvenlafaxine) 50mg AM & Seroquel XR (Quetaipine) 100mg PM.

These days, I'm fine on Desvenlafaxine, but I certainly notice if I miss a dose. I still have the occasional bout of hypo-mania, but never as bad as that one when I was switching from Venlafaxine to Desvenlafaxine.

I also notice if I take it at night, I get restless legs & find it harder to fall asleep.

Hope you get some good advice from your crisis team, keep us updated :)

Thinking of you

Chiaroscuro

edited cause I can't spell

Edited by Chiaroscuro

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Been up to the hospital and been seen by a relatively clueless junior doctor with no more experience than I have - perfectly lovely bloke, but not a psychiatrist yet. So I'm on the ward, still being given the Venlafaxine because he didn't want to overrule my pdoc, and on massive doses of AP to cancel it out (the logic defies me really) and waiting to see a grownup doctor tomorrow. I still have twisty creepy things and I still haven't slept. Ick.

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Am glad you're in hosp. Hope u get a better answer from the Drs tomorrow :)

Thinking of you

Chiaroscuro

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