Effexor sweating...over it!!! next...

[Blahblah]

Been on Effexor (again) 4 months. Went up to 225mg, but the lethargy and apathy was getting worse, along with excessive sweating. I'm typically someone that runs more cold (usually takes a lot for me to sweat at all!) So this is upsetting. I've started working out everyday and after the warm-up, sweat is pouring down my face & neck. Sweat towel makes no difference. I get out of class and it looks like I just stepped out of shower.

At moment I'm on 112mg and this sweating persists. Would going down to 75mg be better?? Anyone recommend something with the least amount of side effects (especially no weight gain or lethargy) I'm thinking maybe just screw it, and going on something easy/basic like low-dose Prozac (also makes me sort of apathetic, guess I can't escape that)

I cannot take Glycopyrrolate (anticholinergic drug that reduces saliva, sweating, etc) because it worsens my severe dry eye syndrome & blurry vision. Lamictal + Ritalin have been moderately helpful (for stabilization, slight motivation) but I need a bit more antidepressant boost to cover some intermittent labile/low moods.

[argh]

Anything that hits norepinepherine has the potential of making you sweat. I believe pristiq is now generic. Supposedly like effexor but with less side effects. It's a metabolite of effexor. Things that do hit serotonin via SRT tend to have a blunting effect.

wellbutrin had a sweating side effect for me, for about 4 months, then it went away. It hits norepinepherine quite hard. What were your issues on wellbutrin?

geodon, is said to be the most weight neutral of A/Ps. Worth a shot? (assuming your sig is correct). That was one of the options my pdoc gave me (along with lamotrigine and abilify) to stabilize my mood and bolster my AD. One of my conditions was for no/minimal weight gain as I do calisthenics, so weight gain without the corresponding muscle gain would wreck my shit. exercise is a cornerstone of keeping my moods in place.

[Blahblah]

Thanks @argh Good to know. Effexor is amazing for anxiety & severe depression, but most of the time I just feel so lazy & lethargic on it.

Exercise is the best for me also...I just need a bit more boost to keep it up everyday before I get sucked into avoiding it due to tiredness & apathy. Welbutrin I trialed twice. It did nothing but give me some sweating & horrible tinnitus...A/Ps I won't try, I just do horribly on those.

Which SSRI is the least sedating & least likely to cause weight gain? I'd stick to a low dose. (Celexa made me very lethargic) Had high hopes for Trintillex but that did absolutely nothing....

Seems most A/Ds cause weight gain in the long term...except SNRIs, Lexapro.... or Viibryd is another possibility i guess.

Edited August 2, 2019 by Blahblah

[argh]

3 minutes ago, Blahblah said:

Thanks @argh Good to know. Effexor is amazing for anxiety & severe depression, but most of the time I just feel so lazy & lethargic on it.

Exercise is the best for me also...I just need a bit more boost to keep it up everyday before I get sucked into avoiding it due to tiredness & apathy. Welbutrin I trialed twice. It did nothing but give me some sweating & horrible tinnitus...A/Ps I won't try, I just do horribly on those.

Which SSRI is the least sedating & least likely to cause weight gain? I'd stick to a low dose. (Celexa made me very lethargic) Had high hopes for Trintillex but that did absolutely nothing....

Id try pristiq first is effexor works so well..sort of.

im not too versed in trintellix or vibriid...not sure how those stack up.

There is another snri, fetzima, which has nearly a 1:1 ratio of serotonin and norepinephrine.

the double edged sword tends to be stimulating = sweating via norepinephrine.

potentially.

prozac might be a good choice too.

if you want to think ootb, as you respond well to an anticonvulsant..or at least one , you could try trileptal. Weight neutral. Related to tegretol, but without the need for blood tests. You might need genetic testing if east or south Asian before you begin.

https://www.ncbi.nlm.nih.gov/pubmed/3510572

ancient article but promising, references tegretol, but close enough potentially.

it may be slightly anticholenergic however is not as much as tegretol

[looking for answers]

@Blahblah  im sure its been asked before have u tried vyvanse instead of ritalin

[BrianOCD]

3 hours ago, Blahblah said:

Been on Effexor (again) 4 months. Went up to 225mg, but the lethargy and apathy was getting worse, along with excessive sweating. I'm typically someone that runs more cold (usually takes a lot for me to sweat at all!) So this is upsetting. I've started working out everyday and after the warm-up, sweat is pouring down my face & neck. Sweat towel makes no difference. I get out of class and it looks like I just stepped out of shower.

At moment I'm on 112mg and this sweating persists. Would going down to 75mg be better?? Anyone recommend something with the least amount of side effects (especially no weight gain or lethargy) I'm thinking maybe just screw it, and going on something easy/basic like low-dose Prozac (also makes me sort of apathetic, guess I can't escape that)

I cannot take Glycopyrrolate (anticholinergic drug that reduces saliva, sweating, etc) because it worsens my severe dry eye syndrome & blurry vision. Lamictal + Ritalin have been moderately helpful (for stabilization, slight motivation) but I need a bit more antidepressant boost to cover some intermittent labile/low moods. 

I've had this issue in the past with both Lexapro and Effexor, interestingly not anymore, I've often wondered if the sweating is a sign that's it's working.

The best thing I can say is do what you're already doing, running and exercising, cause you'll feel cooler the rest of the day.

[Melancholya]

I've always found myself sweatier after taking SSRIs. This might sound like a dumb suggestion and you've possibly already considered it but I use a "clinical strength" antiperspirant / deodorant. I still sweat but not as much, it helps a lot. And hopefully this side effect will improve for you in time. 

Edit: SORRY I realise a deodorant doesn't help with sweating in places other than your armpits!!! 

Edited August 2, 2019 by Melancholya

[mikl_pls]

I noticed recently after getting up to the full 80 mg of Prozac that I was sweating uncontrollably. I've always had hyperhidrosis, but this made it, as you described, like I just got out of a shower after any slight exertion in the hot sun, and even indoors I was sweating profusely for no reason.

SSRIs and SNRIs both can cause this.

There is one medicine I know of that isn't an anticholinergic that may be used off-label for hyperhidrosis induced by antidepressants, and that is terazosin (Hytrin). Starting out at the lowest dose possible is advisable because it is an α1-adrenergic blocker and can cause hypotension, especially orthostatic, and may even cause syncope upon standing.

Come to think of it, clonidine (Catapress) I believe is also used for hyperhidrosis, but it can be slightly depressogenic...

Cyproheptadine (Periactin) I believe may also be used, come to think of it, but it is significantly anticholinergic, and you may not wish to take that.

Beta-blockers aren't as effective for hyperhidrosis, but have been used...

If you switch to an SSRI and stay at a low dose, ideally you shouldn't have sweating problems. Also, if you go below 150 mg Effexor, it is practically just an SSRI with a lot of side effects.

I agree with trying Pristiq as @argh said it might have less side effects than Effexor. Fetzima is actually more like a 3:1 ratio for norepinephrine reuptake inhibition vs serotonin reuptake inhibition: in low doses it's predominantly noradrenergic, and in high doses it recruits more serotonin reuptake inhibition. Milnacipran (Savella in the US) has closer to a 1:1 ratio though, which is the racemic version of levomilnacipran (Fetzima).

Low-dose Prozac and possibly Zoloft may be good for you. They're generally considered to be the most weight-neutral relatively modern antidepressants. Viibryd I would say is a good option too, but if you have a predisposition to having a sensitive GI tract, you will be looking at serious GI symptoms, especially diarrhea, so I've read. Personally, I didn't have any problems like that. Slow titration may be the key to successfully taking Viibryd: the titration packs give you 1 week of 10 mg and 1 week of 20 mg (used to have 40 mg in them but they don't anymore). You can then go up to 40 mg, the target dose, if you feel you need it, but 20 mg suffices for some people. Having multiple titration packs to take more than one week of 10 mg and 20 mg before going up to 40 mg may help with the GI side effects.

The tricyclic antidepressants desipramine (Norpramin), nortriptyline (Pamelor), and protriptyline (Vivactil), while being predominantly noradrenergic, are all weight neutral options (especially desipramine). A little desipramine goes a long way IME (50 mg being sufficient with no real benefits beyond 100 mg, with a max dose of 300 mg), but protriptyline at half the max dose (30 mg/day) and nortriptyline at its max dose of 150 mg/day didn't do much for me to speak of. Also, protriptyline is mightily anticholinergic, so that one may be a no-go for you.

Also, the SARI antidepressant nefazodone (Serzone), which may not be super potent and does have a black box warning about liver damage (though Cymbalta has one too I believe), may be a good option temporarily anyway. It is a triple reuptake inhibitor (moderate to weak), and also a 5-HT2A antagonist, 5-HT1A partial agonist, and α2 antagonist. This likely won't cause much sweating, but I can't attest for its efficacy on depression as I only took it for 1 month at a low dose.

[Blahblah]

17 hours ago, looking for answers said:

@Blahblah  im sure its been asked before have u tried vyvanse instead of ritalin

Its not available where I live 😞 I think it sounds great for what I'm looking for...

16 hours ago, Melancholya said:

Edit: SORRY I realise a deodorant doesn't help with sweating in places other than your armpits!!! 

My deodorant (strong one) works really well...but yeah my issue is sweating elsewhere...mainly during workouts (and summertime) but even day to day, I get the thigh/wet underwear sweat thing, then damp jeans all day - so not pleasant!!!! 🥵

@mikl_pls Thanks for all the suggestions! I'll first try lowering Effexor to 75mg, and see if due to less NE, that will help. Or try Pristiq since it's supposedly so similar, less side effects.

Then I'd look into Viibryd (if available here) my GI system isn't sensitive, so usually no issue there. Never tried that.

Then probably low-dose Prozac (Zoloft was awful for me years ago). Hopefully 20mg wouldn't cause weight gain or tiredness?

I've tried Pamelor, and generally like to avoid Tricyclics...heavy on side effects and sedation.

Serzone my pdocs don't prescribe anymore for some reason - maybe due to Black Box??

I'm also wary about taking yet another med (to control the sweating), I know 3 meds doesn't seem like a lot, but between that and all my supplements/vitamins, sometimes a PRN...that would be just too much for me.

BTW @BrianOCD I see you've just switched from Effexor to Pristiq. Could you keep me posted how that goes for you? I know everyone is affected differently, but I'm curious if it's just as effective similar feeling, with less side effects (or maybe there are different side effects?) Also curious about half-life in case of missed dose, if it's smoother than Effexor?

 

 

 

Edited August 3, 2019 by Blahblah

[Melancholya]

4 hours ago, Blahblah said:

Then probably low-dose Prozac (Zoloft was awful for me years ago). Hopefully 20mg wouldn't cause weight gain or tiredness?

Fwiw, I tolerated prozac the best out of all the SSRIs I have tried. My weight was unchanged even when I was going out drinking every weekend, then I went to university and put weight on, but I really believe that was due to lifestyle and food changes. I was however very tired back then. Ymmv. 

[BrianOCD]

5 hours ago, Blahblah said:

BTW @BrianOCD I see you've just switched from Effexor to Pristiq. Could you keep me posted how that goes for you? I know everyone is affected differently, but I'm curious if it's just as effective similar feeling, with less side effects (or maybe there are different side effects?) Also curious about half-life in case of missed dose, if it's smoother than Effexor?

 

 

 

ya I'll make a post in Antidepressants with updates

[mikl_pls]

13 hours ago, Blahblah said:

Its not available where I live 😞 I think it sounds great for what I'm looking for...

You have dextroamphetamine available where you are, right? Do they have extended release dextroamphetamine spansules?

13 hours ago, Blahblah said:

Thanks for all the suggestions! I'll first try lowering Effexor to 75mg, and see if due to less NE, that will help. Or try Pristiq since it's supposedly so similar, less side effects.

Then I'd look into Viibryd (if available here) my GI system isn't sensitive, so usually no issue there. Never tried that.

Then probably low-dose Prozac (Zoloft was awful for me years ago). Hopefully 20mg wouldn't cause weight gain or tiredness?

I've tried Pamelor, and generally like to avoid Tricyclics...heavy on side effects and sedation.

Sure thing!  That all sounds like a plan to me! Nah, you shouldn't get any weight gain from Prozac 20 mg. If anything, probably some mild weight loss in the beginning.

But the blunted affect thing is something to factor in your antidepressant choice. Viibryd didn't cause weight gain for me, but it did for a friend of mine.

My problem with Viibryd is that it didn't feel strong enough, like I needed higher than the max dose. That was my only issue with it.

I'd be willing to bet that 50-100 mg desipramine wouldn't have much in the way of side effects, but everyone's different.

13 hours ago, Blahblah said:

Serzone my pdocs don't prescribe anymore for some reason - maybe due to Black Box??

I'm not surprised... I think my pdoc is the only one in this part of the country who would ever prescribe it.

13 hours ago, Blahblah said:

I'm also wary about taking yet another med (to control the sweating), I know 3 meds doesn't seem like a lot, but between that and all my supplements/vitamins, sometimes a PRN...that would be just too much for me.

I gotcha, and I respect that. Hytrin I think would be something you'd have to take all the time anyway, if I'm not mistaken.