Effexor/SNRI space cadet - does it go away?

[Blahblah]

I'm on 75mg Effexor (just under 2 weeks) and I feel incredibly spaced out. I don't feel at all depressed or any anxiety, just borderline numb and "not there." My mind is an empty void & ruminations gone, but I literally feel so detached, listless. I'm continuously zoning out during the day, and in conversation. I'm struggling to spell some words (something I'm usually very good at). I could just lay around and stare at the tv like a sloth. This is sooo not me.

I've had this same effect from other antidepressants (hence why I usually end up going off them). Is this effect dose-dependent?  Like, if I increase to 150mg will I feel less "tranced", more motivated or will this numbness & detachment increase even more so that I don't care about anything or anyone?? I thought the SNRI's were less likely to cause this?

[browri]

18 minutes ago, Blahblah said:

I'm on 75mg Effexor (just under 2 weeks) and I feel incredibly spaced out. I don't feel at all depressed or any anxiety, just borderline numb and "not there." My mind is an empty void & ruminations gone, but I literally feel so detached, listless. I'm continuously zoning out during the day, and in conversation. I'm struggling to spell some words (something I'm usually very good at). I could just lay around and stare at the tv like a sloth. This is sooo not me.

I've had this same effect from other antidepressants (hence why I usually end up going off them). Is this effect dose-dependent?  Like, if I increase to 150mg will I feel less "tranced", more motivated or will this numbness & detachment increase even more so that I don't care about anything or anyone?? I thought the SNRI's were less likely to cause this?

While I can't speak to the numbed/detached feeling, I can say that 150mg should be where the stimulation starts to pick up because that's when Effexor starts hitting norepinephrine. At 75mg, I would recommend you go up before you give up. But I would also say that if you take 150mg for a week or two and don't feel any more motivated or feel less motivated, then Effexor might not be for you. In which case, I would recommend Cymbalta which is much more stimulating. It affects norepinephrine about the same that it does serotonin, but I'm not sure how that will play with your Ritalin. Like if it will make you feel over-stimulated.

[Blahblah]

Thanks @browri I'll go up to 150mg before deciding. It's nice to have a break from the ruminating negative thoughts, Effexor has immediately obliterated my feelings, sad dysphoric moods and leftover anxiety. I'm just not sure I can deal with this numbed-out, flat, listless feeling longterm!

Anhedonia, lack of interest, lack of libido and lack of motivation/focus are all major (and seemingly treatment-resistant) features of my chronic depression so I don't want to take something that will just make these problems worse, you know? I was on Cymbalta YEARS ago (monotherapy by itself), so perhaps I will give that another shot if the Effexor is too mind-numbing...I like the fact that Cymbalta has a longer half-life and more effect with Norepinephrine. I don't think my issue is solely Serotonin because SSRIs just makes me want to lay in bed for hours while staring at the wall, eating snacks...

Were you ever on Cymbalta for very long?

[browri]

30 minutes ago, Blahblah said:

Thanks @browri I'll go up to 150mg before deciding. It's nice to have a break from the ruminating negative thoughts, Effexor has immediately obliterated my feelings, sad dysphoric moods and leftover anxiety. I'm just not sure I can deal with this numbed-out, flat, listless feeling longterm!

Anhedonia, lack of interest, lack of libido and lack of motivation/focus are all major (and seemingly treatment-resistant) features of my chronic depression so I don't want to take something that will just make these problems worse, you know? I was on Cymbalta YEARS ago (monotherapy by itself), so perhaps I will give that another shot if the Effexor is too mind-numbing...I like the fact that Cymbalta has a longer half-life and more effect with Norepinephrine. I don't think my issue is solely Serotonin because SSRIs just makes me want to lay in bed for hours while staring at the wall, eating snacks...

Were you ever on Cymbalta for very long?

Was on it for a fair amount of time. I would say at least 6-9 months. When I first started with SNRIs, I started with Pristiq at 50mg. Insurance changed. So I had to switch to generic Effexor XR and cut right over directly to 150mg. Wasn't a fun few days. However, when Effexor pooped out on me, I switched again, and we actually cut right from 150mg Effexor over to 60mg Cymbalta. We didn't even titrate. And unlike my experience going from Pristiq to Effexor, my mood actually switched to hypomania. Only I didn't realize it at the time because I thought I was unipolar at that point. Finally started seeing a psychiatrist again who immediately recognized from my records at the previous psychiatrist and the way I was behaving that I was in AD rapid cycling. I had been taking antidepressants for years and was constantly switching them because they would poop out in less than a year sometimes, and that's not tachyphylaxis, that's just plain old cycling. I also went to Cymbalta for the half-life reason. I mean I felt like Effexor had pooped out, but I was having difficulty always taking it at the same time every day and would experience withdrawal. So really my primary complaint when I went to see my gdoc was I wanted a longer half-life.

[Blahblah]

@browri What were your main symptoms of AD rapid cycling? Just curious, hypomania/mixed cycling is so different for everyone, it doesn't always look like typical mania. I've had episodes of rapidly cycling moods, but it always presents as dysphoria + anxiety at the same time which I don't think is the same thing as Bipolar cycling.

[browri]

14 minutes ago, Blahblah said:

@browri What were your main symptoms of AD rapid cycling? Just curious, hypomania/mixed cycling is so different for everyone, it doesn't always look like typical mania. I've had episodes of rapidly cycling moods, but it always presents as dysphoria + anxiety at the same time which I don't think is the same thing as Bipolar cycling.

I could literally be in a melancholic, semi-catatonic depression for a day or two and then snap out of it and be positively brilliant for a stretch of several days to a few weeks which would inevitably terminate in another depressive episode. But the depressive episodes would be far too short to be considered an MDD episode. I've only had one depressive episode in my life that could have been classified as MDD if the rest of my psychiatric history wasn't considered. And at that point I wasn't taking any medication.

On the flip-side of rapid cycling, my mixed states are usually surrounded around racing/intrusive/obsessive thoughts. I become very antisocial and introverted at the exclusion of pretty much everything around me. Irritable and reactive to most people who approach me. I'm pretty much useless at work because my inner monologue is too distracting for me to get anything done. I get anxious and depressed when this happens too. It's very rarely anymore that I get full hypomania with euphoria or rapidly cycle. But until Depakote, my mixed states were fairly common.

Edited November 20, 2017 by browri

[BrianOCD]

On 11/20/2017 at 11:24 AM, Blahblah said:

I'm on 75mg Effexor (just under 2 weeks) and I feel incredibly spaced out. I don't feel at all depressed or any anxiety, just borderline numb and "not there." My mind is an empty void & ruminations gone, but I literally feel so detached, listless. I'm continuously zoning out during the day, and in conversation. I'm struggling to spell some words (something I'm usually very good at). I could just lay around and stare at the tv like a sloth. This is sooo not me.

I've had this same effect from other antidepressants (hence why I usually end up going off them). Is this effect dose-dependent?  Like, if I increase to 150mg will I feel less "tranced", more motivated or will this numbness & detachment increase even more so that I don't care about anything or anyone?? I thought the SNRI's were less likely to cause this?

I guess this is standard for the first few weeks on any medication, cause I'm starting wellbutrin and feel the exact same way.

I feel like I'm just watching a movie of everything going on in front of me.

[mikl_pls]

5 hours ago, BrianOCD said:

I feel like I'm just watching a movie of everything going on in front of me.

This is derealization (I believe); nevertheless, it's a dissociative symptom. This could potentially be serious. You might want to get with your pdoc about this.

[BrianOCD]

58 minutes ago, mikl_pls said:

This is derealization (I believe); nevertheless, it's a dissociative symptom. This could potentially be serious. You might want to get with your pdoc about this.

Nah, in this case I know the difference, believe me I've had derealization before.

I'm saying my day to day life feels movie-like because I feel like I'm in a different body/different personality, ontop of having trouble finding stability with meds.

[mikl_pls]

12 hours ago, BrianOCD said:

Nah, in this case I know the difference, believe me I've had derealization before.

I'm saying my day to day life feels movie-like because I feel like I'm in a different body/different personality, ontop of having trouble finding stability with meds.

Oh, I see.

[Blahblah]

I'm still feeling very detached/spacey on the Effexor. It is super calming - I can see it would do WONDERS for anyone with anxiety & the worried ruminations. yet, It is flattening all my emotions though, like I'm removed in my own bubble, disinterested, just going through the motions. My pdoc does not want to increase until I see her in a couple weeks.

[browri]

On 11/26/2017 at 3:09 AM, Blahblah said:

I'm still feeling very detached/spacey on the Effexor. It is super calming - I can see it would do WONDERS for anyone with anxiety & the worried ruminations. yet, It is flattening all my emotions though, like I'm removed in my own bubble, disinterested, just going through the motions. My pdoc does not want to increase until I see her in a couple weeks.

150mg of Effexor might enervate you a bit and might cut through the flattening effect. I felt that way on Prozac at 10mg and 20mg but 40mg was a real kicker and was quite different from my experience with Prozac at the lower doses. Also consider switching to desvenlafaxine and you might tolerate it better. My cousin started with desvenlafaxine when it was still only available as brand Pristiq and she tried the generic Effexor XR but couldn't tolerate it. It was a totally different experience for her from Pristiq. I know my experience between Pristiq and Effexor was slightly different as well.

[BrianOCD]

Effexor is so good when you've been on it for months, but the startup is one of the hardest imo...Although I don't have a big history of drugs, I know the startup to Effexor was pretty damn bad.  Nausea, felt worse for a week or so...

I can tolerate 75mg and 300mg...but when I was on 150mg it made me too jittery and restless.  But many people take 150mg no problem...

[BrianOCD]

On 11/20/2017 at 11:24 AM, Blahblah said:

I'm on 75mg Effexor (just under 2 weeks) and I feel incredibly spaced out. I don't feel at all depressed or any anxiety, just borderline numb and "not there." My mind is an empty void & ruminations gone, but I literally feel so detached, listless. I'm continuously zoning out during the day, and in conversation. I'm struggling to spell some words (something I'm usually very good at). I could just lay around and stare at the tv like a sloth. This is sooo not me.

I've had this same effect from other antidepressants (hence why I usually end up going off them). Is this effect dose-dependent?  Like, if I increase to 150mg will I feel less "tranced", more motivated or will this numbness & detachment increase even more so that I don't care about anything or anyone?? I thought the SNRI's were less likely to cause this?

Hey how are you doing on Effexor Blah?  Working for you?
I recently went up on mine too, and seem to be feeling a bit more calm and collected.

[Blahblah]

I still feel the same really...spaced out but super calm and chilled out. I don't see my pdoc for a week, so I'm still only on 75mg. I will try 150mg first before giving up, but I don't know if I like feeling this daze. I feel more sluggish/tired like I need a nap after lunch (and then I don't want to get up) which I don't like.

So it definitely gets rid of intense emotions, but yeah, I don't know if I necessarily feel "better. " I'm also constipated like hell which sucks.

[BrianOCD]

I guess for me, not feeling anxious and depressed, I'd take the spacey feeling over it.

I can tell you it doesn't last forever, took 300mg effexor for 7 years or so and felt fine once you adjust to it.

[Blahblah]

That makes sense. I haven't really had anxiety issues, just depression (and more of the anhedonic, apathy type which never seems to be helped by meds).

So it's a catch-22...Effexor does help get rid of the intense emotions, but then I struggle even more with the lack of motivation/interest/pleasure and become so apathetic & lazy that it's almost just as bad...I stop caring about anything. Then there is the issue of once you start Effexor, it's near impossible to ever come off of it - it's like your brain never goes back to baseline and needs the drug even more.

Do you plan to go up to 300mg again?

[BrianOCD]

17 hours ago, Blahblah said:

That makes sense. I haven't really had anxiety issues, just depression (and more of the anhedonic, apathy type which never seems to be helped by meds).

So it's a catch-22...Effexor does help get rid of the intense emotions, but then I struggle even more with the lack of motivation/interest/pleasure and become so apathetic & lazy that it's almost just as bad...I stop caring about anything. Then there is the issue of once you start Effexor, it's near impossible to ever come off of it - it's like your brain never goes back to baseline and needs the drug even more.

Do you plan to go up to 300mg again?

Probably, I felt better right away taking more Effexor.

I think Effexor is addicting, real addicting.  That's one part that's shitty.

Does anyone else here get that "dread feeling" in the stomach, first few weeks on ADs?

Edited December 8, 2017 by BrianOCD

[Blahblah]

Yeah it sucks that the withdrawal is so terrible.

I know exactly what you mean by the dread feeling.... I haven't had that in a long time, but I remember, it was like an awful anxious/hypervigilant type feeling in the pit of my stomach that would happen immediately when I woke up in the morning. Sometimes it felt like a nervous paranoid feeling when I arrived at work, i would feel overwhelmingly self-conscious, like everyone was watching me.

[BrianOCD]

18 hours ago, Blahblah said:

Yeah it sucks that the withdrawal is so terrible.

I know exactly what you mean by the dread feeling.... I haven't had that in a long time, but I remember, it was like an awful anxious/hypervigilant type feeling in the pit of my stomach that would happen immediately when I woke up in the morning. Sometimes it felt like a nervous paranoid feeling when I arrived at work, i would feel overwhelmingly self-conscious, like everyone was watching me.

Is there a name for it?  Or is it just anxiety?

[Blahblah]

@BrianOCD I haven't had that symptom in years..but yes, I believe it was some sort of anxiety,  but not extreme. Like more of an undercurrent of constant nervousness when your nervous system is over aroused or overstimulated...It was tolerable but annoying and I think it was mainly a start-up symptom that I eventually got used to and it went away gradually.

Do you have this now? Maybe it's because the Effexor isn't quite at the right blood level.

Edited December 10, 2017 by Blahblah

[BrianOCD]

16 hours ago, Blahblah said:

@BrianOCD I haven't had that symptom in years..but yes, I believe it was some sort of anxiety,  but not extreme. Like more of an undercurrent of constant nervousness when your nervous system is over aroused or overstimulated...It was tolerable but annoying and I think it was mainly a start-up symptom that I eventually got used to and it went away gradually.

Do you have this now? Maybe it's because the Effexor isn't quite at the right blood level.

ya unfortunately I've had this for about 4 weeks, going up on both wellbutrin and effexor...

I have Ativan on hand, but I prefer not to take it for obvious reasons...If I take it one night, I feel like I have to take it again the next so I save it for panic attacks instead....

It's lessening now, the jitters or whatever, but unfortunately my depression isn't going anywhere 

[BrianOCD]

On 12/10/2017 at 4:13 AM, Blahblah said:

@BrianOCD I haven't had that symptom in years..but yes, I believe it was some sort of anxiety,  but not extreme. Like more of an undercurrent of constant nervousness when your nervous system is over aroused or overstimulated...It was tolerable but annoying and I think it was mainly a start-up symptom that I eventually got used to and it went away gradually.

Do you have this now? Maybe it's because the Effexor isn't quite at the right blood level.

Hey how are you doing?  Wondering where you're at now?

I'm in space cadet mode myself, 6 days from 150mg to 225mg...

Did the spaciness go away or are you still struggling?  Is Effexor working for you yet?

[Blahblah]

Thanks for asking. Doing pretty well actually, but it's because I was away on holiday (beach) for 3 weeks. My mood was great and now that I'm back home in the cold, daily routine I'm becoming grumpy, which is normal I suppose.

I am now at 112mg Effexor and will increase this week after my appt. I'm still a bit spaced out, but I've experienced that most antidepressants do that to some extent, they mute down your intense emotions so you feel more mellow. Not getting too many side effects after increasing except for typical dry mouth, nausea, some sweating, restless legs...Sounds like it is helping you since you've gone back up on dosage?

[BrianOCD]

2 hours ago, Blahblah said:

Thanks for asking. Doing pretty well actually, but it's because I was away on holiday (beach) for 3 weeks. My mood was great and now that I'm back home in the cold, daily routine I'm becoming grumpy, which is normal I suppose.

I am now at 112mg Effexor and will increase this week after my appt. I'm still a bit spaced out, but I've experienced that most antidepressants do that to some extent, they mute down your intense emotions so you feel more mellow. Not getting too many side effects after increasing except for typical dry mouth, nausea, some sweating, restless legs...Sounds like it is helping you since you've gone back up on dosage?

I may have to go much higher, but it's having the effect of calming my thoughts/worry/ruminations...That alone helps a lot in rebuffering my serotonin and other chemicals depleted...

I've gotten a lot of nausea, some insomnia, and ya the dry mouth is brutal.

I've been on every dosage of Effexor up to 300mg...I hope it works for you...I also found it to be much more effective for both depression/anxiety at 225+ so you got a lot of room.  =)

Edited January 11, 2018 by BrianOCD

[Blahblah]

Yes, I agree. My main problem is depression, low mood/motivation and CONSTANT negative ruminations. The same worrisome thoughts about hypothetical "worse case life scenarios" are paralyzing sometimes. I feel like I am mellowing out and they are becoming manageable.

One thing, I'm also intentionally trying to incorporate more Mindfulness into everyday - I check in with myself and notice how I am breathing (if it's shallow, if I feel tense) and I start to try to relax my breathing and forcefully shift my thoughts to more positive (or at least neutral) things. Observe things around me without judging. It usually feels like I'm "faking it" but in combination with the meds, I think it's helping at the moment.

I'll admit, I feel really wary and scared about getting addicted to Effexor and never being able to go off it.  After all these years (and doctor visits) I still feel ashamed that I am dependent on drugs to feel better...like I'm weak and pathetic because of this. Like, I have no legitimate reason to be this depressed, etc. I must learn to accept it and realize that MI is like any other chronic disease. But by tracking my mood every week (and looking at old journal entries), perhaps I can prove to myself that it is helping and I need to stay on it.

[BrianOCD]

When you went up on Effexor, did you have any days with the agitated feeling in your gut?  I think it's agitation...

That feeling like you're about to cry but dont actually cry, happens when you go up on virtually all SSRIs....I have a hard time placing the feeling...it's like a burning feeling in your gut that hangs around...If you take a deep relaxing breath it goes away for a few seconds...could be roped in with anxiety too I suppose but the feeling is different.

Does anyone know what the official name for this is?  Is it the "jitters" everyone decribes?

Edited January 14, 2018 by BrianOCD

[Blahblah]

I haven't had that feeling so far...my side effects are mainly nausea, dry mouth, headache, spaciness.....but I think i know what you mean.

Is it a feeling of increased Adrenalin perhaps? I imagine the feeling you get when you need to give a presentation and your stomach is a bit in knots and you feel a bit nervous/wired, your throat gets dry, heart rate increases etc?

[BrianOCD]

I think maybe it's the noradrenaline since I'm on the higher dosage...Not sure, but it happens after I take the pill for a few hours...Uncomfortable.  The further I get away from the pill, the better I feel.  I woke up today and felt great until I took the pill.

But ya that's how I feel, dry throat, high heart rate, lil wired...

Edited January 15, 2018 by BrianOCD

[Blahblah]

Yes - i think you are correct. I just met with my pdoc to discuss increasing, but since I've been feeling pretty ok/good baseline the last month (much less ruminations/negative dips), she said to stay at 112mg for now. I still wonder if going to 150mg would make me feel even better? Maybe you could go lower on your dose (if you are feeling a bit anxious?) Is there a reason you are at such a high dose?

I've read that the higher the dose, the more noradrenalin (or norepinephrine) effects you have. Here is some interesting stuff from Wikipedia:

The general function of norepinephrine is to mobilize the brain and body for action. Norepinephrine release is lowest during sleep, rises during wakefulness, and reaches much higher levels during situations of stress or danger, in the so-called fight-or-flight response. In the brain, norepinephrine increases arousal and alertness, promotes vigilance, enhances formation and retrieval of memory, and focuses attention; it also increases restlessness and anxiety. In the rest of the body, norepinephrine increases heart rate and blood pressure, triggers the release of glucose from energy stores, increases blood flow to skeletal muscle, reduces blood flow to the gastrointestinal system, and inhibits voiding of the bladder and gastrointestinal motility.

[BrianOCD]

Well I was on 300mg for years.

I wasn't getting much of a response under 225...I'm thinking about even going higher as I'm starting to feel good finally.

I managed to lessen some of those side effects by taking the Effexor with some food.

I'm glad to hear you're feeling pretty good...if you decide you need more of a kick, the higher dosage seems to do that, but be ready for those jitters.

[Blahblah]

Interesting. So was it pretty early on you ramped up to 225mg? Or did the dosage slowly creep up over time?

I think I might've spoke to soon, I had a bit of a sad mood crash today - managed to pull myself out fairly quickly, but it was upsetting to experience intense symptoms out of the blue, when I've been coasting pretty well the last month. Seems my moods are hair-trigger sensitive at times. I may try to go up to 150mg.

[BrianOCD]

What do you mean early on?  I recently went up to 225mg bout 2 weeks ago and am starting to finally cool out a bit.

I'd say if you could handle the side effects then going up is good for the depression, it's just the anxiety gets a bit haywire until you're adjusted...

[Blahblah]

That's good news: sounds like you are doing much better - are you still symptomatic (depression/anxiety or insomnia)?

By early on, I mean did you titrate up/increase every 2 weeks because it had no effect at all at the lower doses --  or was the increase very gradual over the course of several years? I had very noticeable effect from 75mg. Mainly spaciness (no anxiety)  I was really zoning out, head totally blank in the clouds. I feel like it's definitely mellowing me out and I am ruminating less, when I get upset it doesn't last for days. It feels neither activating nor sedating, I have more of an emotional buffer which is good. i just don't want to zombie-out.

So I guess it is working....? question is whether I decide to increase. I usually try to take the lowest possible dose of meds to try to avoid side effects and poop out...+  more sweating, constipation...etc...etc

[BrianOCD]

I went from 75mg to 150mg for about a month.  And then up to 225mg for 2 weeks, where I'm at now.

Thankfully I'm getting good sleep, but my depression and anxiety are still breaking through.  I've had some better mornings though recently.   I've been on effexor for 8 years or so, so I wouldn't be surprised if it's wearing out a bit.  I hope not though, I don't think I can handle another med change.

I wouldn't go up unless you're absolutely sure it's not working at the current dosage, which it sounds like it's having an effect.  

I've noticed taking Effexor the changes can be months apart too, you might feel even better in another 2 weeks on your current dosage.  For me anyways, I feel like once the ruminations are under control, things sort of balance themselves out.

Edited January 19, 2018 by BrianOCD