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Blahblah

No sadness/depression now, just can't get out of bed!!

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Since I've been on Effexor for 7 months, I've had zero emotional depressive symptoms (like the crying, sadness etc) negative ruminations have lessened, no anxiety whatsoever either...

Issue is, I've become more & more lethargic. I sleep a full 10 hours per night and then I cannot get out of bed. I'm not really tired, I just literally cannot get myself to do anything. I am super content just laying in bed for hours. I read crap online for hours, I often take 2 hour naps in afternoon. It pains me to take a shower & go outside. I procrastinate on work/everything... I avoid doing things I need to do just so i can lay in bed! No interest, motivation, pleasure in anything. How can I light a "fire under my ass" again? The same issue happens with other meds that work for depression, but then they cause this!

And no, my doc won't increase my Ritalin (which I have a tolerance to & it stopped working). She won't put me on any other stimulants which seem to be the only thing that help me in this state. Yes, I've tried Abilify add-on...not sure if I want to keep adding more meds or if there something better I can switch out in my situation?

Seems my choice is to either be emotionally depressed or a complete apathetic sloth!!! Any ideas?

 

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1 hour ago, Blahblah said:

 Seems my choice is to either be emotionally depressed or a complete apathetic sloth!!! Any ideas?

Since stimulants are off the table, my suggestion would be to ask your doc about possibly increasing your Effexor dosage....From what I have read, Effexor is more activating at higher doses.

According to drugs.com, the maximum dose for depressed outpatients is 225mg, but I have seen a few people here on even higher doses........Also, according to this dosage guide, severely depressed inpatients can be given up to 375mg:

https://www.drugs.com/dosage/venlafaxine.html#Usual_Adult_Dose_for_Depression

Edited by CrazyRedhead

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When you tried Abilify, did you take it all the way up to 15 mg? I believe that Abilify has not been given a fair trial unless taken up to higher doses provided akathisia is not a problem. Abilify only began to work for me once I hit 10 mg and 15 mg were better. At less than 10 mg, all I got from it was anxiety.

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I developed something similar on Zoloft and I actually started feeling more energy when I tapered down the Zoloft. I know you've already tried a lot of meds but maybe Effexor is just not a good fit and something else might work better in combo with abilify etc.? I don't know.

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I tried Abilify up to 10mg and I got the restless movement/foot/leg shaking thing. I also became an eating machine which is so not me, like waking up at night to go to the kitchen for snacks kind of hungry.

I suppose I could go up on Effexor, but at least with my experience with other antidepressants, at the higher dose, they are stronger and make you feel really numbed out, it's not an "activation" feeling that i ever get, it's a flatness & emotional blunting.

I feel like a stimulant would be the trick, but they are so regulated here. They do not even prescribe Dex or Adderall. Anyway, I get the feeling that with stimulants, you get used to the dose and then you need to either take longer breaks or continue to increase to get the same initial effect.

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@Blahblah, What about Provigil (modafinil),  or Nuvigil (armodafinil)?........They are wakefulness-promoting meds for people with excessive daytime sleepiness.

https://en.wikipedia.org/wiki/Modafinil     https://en.wikipedia.org/wiki/Armodafinil

Nuvigil has a longer half life than Provigil.......They are both controlled substances, but only class IV......Ritalin and Adderall are both class II (more highly regulated)......I don't know how your doc would feel about these, but it might be worth a try to ask.

Edited by CrazyRedhead

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How about Rexulti? It's like Abilify but supposedly with fewer side effects and specifically the appetite side effect is supposed to be less. I'm not joking when I say that when these meds work, they REALLY work and the difference is like night and day. I can't tell you the bliss I felt when Abilify started to work for me. It was not subtle at all. And yes it was bliss.

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Sorry you are feeling like this, I feel your pain.  Winter is hell for me, exactly as you are feeling now. 

I am taking Viibryd now after about 6 years on Lexapro.  I am still titrating on the Viibryd and completely off Lexapro, but it feels like the Viibryd has started to kick in.  It seems to be energizing and has lowered my anxiety.  I am getting out and doing something pretty much every day.

I also take Ritalin, it always gives me a boost, sorry it isn't working for you.

Someone in another post mentioned the extended release version of Ritalin might be something to try.

Wish I could help out more.  Do try to do something everyday, even if it is something quick, at least it will give you a sense of accomplishment.

Don't worry about showering.  As the late George Carlin said, "you don't always need a shower, all you need to do is concentrate on the 4 major areas, armpits, asshole, crotch and teeth." :)

I hope you get well soon..

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On 5/23/2018 at 6:19 AM, Blahblah said:

Seems my choice is to either be emotionally depressed or a complete apathetic sloth!!! Any ideas?

 

 

Anhedonia — lack of pleasure or inability to enjoy everyday things — is pretty common with major depression, even when being actively treated and some symptoms resign. I know it's definitely something I struggle with a lot of the time. I also took Effexor XR at one point for a couple of years, going as high as 300mg, but never saw much improvement beyond when I first started taking it, regardless of dosage. I can manage, but I wouldn't say I feel great (or even good some days).

Eventually though, largely due to a return of depressive symptoms triggered by life stuff, my PDOC and I decided to switch off of Effexor and try something else. He gave me a lot of freedom to research and make my own decisions, so initially, I tried modafinil (Provigil) because I figured it'd be easier to add than take away; plus, it's not a stimulant, which I personally would rather avoid, if at all humanly possible. But, ultimately, it didn't do much, if anything, even at the max dosage (400mg/day), so I came off of it.

Ended up on duloxetine (Cymbalta) because it was another SNRI and I wasn't sure if I wanted to quit SNRI's all together yet (worried what it would do if I came off the NRI portion of the drug and went with something else, like an SSRI, that doesn't affect norepinephrine receptors). As it stands right now, I'm on 80mg and I feel mostly okay. My PDOC said the ceiling for the drug is 120mg/day. I've thought about increasing it, mostly to see if I'd get any benefit at a higher dose, but I'm also afraid it won't do anything and I might have to find another drug again.

Long story short: you still have quite a bit of Effexor to play with (the highest dose I've seen is 425mg/day), if you're so inclined; you could try modafinil like I did (assuming your doctor is open to it and you can afford it if it's not covered by insurance) or a different SNRI entirely. There are newer, novel anti-depressants that might do some good, but I don't know much about them and probably wouldn't try them anyway 'cause they're still patented and expensive af. Beyond that, there are tricyclics that sometimes affect both serotonin and norepinephrine, but they're also notoriously bad in regards to side effect profile; plus, I don't know your history, but your doc might be reluctant to try them because they're very cardio-toxic when used in an OD attempt.

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On 5/23/2018 at 5:19 AM, Blahblah said:

Since I've been on Effexor for 7 months, I've had zero emotional depressive symptoms (like the crying, sadness etc) negative ruminations have lessened, no anxiety whatsoever either...

Issue is, I've become more & more lethargic. I sleep a full 10 hours per night and then I cannot get out of bed. I'm not really tired, I just literally cannot get myself to do anything. I am super content just laying in bed for hours. I read crap online for hours, I often take 2 hour naps in afternoon. It pains me to take a shower & go outside. I procrastinate on work/everything... I avoid doing things I need to do just so i can lay in bed! No interest, motivation, pleasure in anything. How can I light a "fire under my ass" again? The same issue happens with other meds that work for depression, but then they cause this!

And no, my doc won't increase my Ritalin (which I have a tolerance to & it stopped working). She won't put me on any other stimulants which seem to be the only thing that help me in this state. Yes, I've tried Abilify add-on...not sure if I want to keep adding more meds or if there something better I can switch out in my situation?

Seems my choice is to either be emotionally depressed or a complete apathetic sloth!!! Any ideas?

 

Have you tried taking a break from the Ritalin? It can work wonders. Just a week off and it may work as well as it used to. It did for me. Worth a shot. 

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Yeah, I've taken short breaks on & off of it...It seems it always eventually sort of "poops out" quite quickly again. I've been completely off it for over a month now, so perhaps I can try it again.

What dose are you on and what schedule do you use? (like: On 2 months, off 1 month and so forth?) If I just take breaks on weekends, it doesn't seem to be a long enough break.

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I’m on Adderall, and I typically take weekends off and during the week when there is nothing needing done where it’s necessary . I can’t remember now, have you taken Adderall in the past?

Edited by DammitJanet
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@Blahblah I'm so glad to see your post! I've been feeling the same lately. Thought we had my Rx mix at a good stable place finally (and for several months now), but about 4 weeks ago, things started to come apart at the edges. The house is a disaster. I sleep 'til noon and stay up 'til 3 AM. One day last week, I was so out of it I missed my weekly checkin with academic advisor _and_ my therapy appointment. Time to make an appointment with the pdoc...

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