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Which drug do you feel is better tolerated and most effective?

Duloxetine or Venlafaxine?

Same drug class, the only difference of any note that I've seen is that Duloxetine is prettier!

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Duloxetine is more N than effexor, which is more S until you get to super high doses. 

 

I've only taken Duloxetine of the two though. 

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Venlafaxine was more effective in higher doses for me than duloxetine was, but it had WAY more and more severe side effects than duloxetine. In addition to the innumerable highly problematic side effects (which started as low as 75-150 mg) that got worse as the dose went up, the dose kept needing to be raised rather rapidly, as it would very quickly lose its effectiveness, and wound up at a pretty dang high dose of 450 mg, which was hell coming off of.

Duloxetine was nice, but I wound up requiring 120 mg (max dose) which my pdoc refused to give me for the longest time. Once on it, I was doing very well, but she suddenly halved me dose to 60 mg for no reason, and I not only crashed through the floor but suffered withdrawal symptoms.

Overall, duloxetine has the best balance of tolerability vs efficacy, but don't be surprised if 60 mg isn't enough for you if you're treatment resistant. Also don't be surprised if your pdoc refuses to prescribe above 60 mg, because it is said that there is no proven additional benefit for patients of doses above 60 mg, and they take this for face value very often, not considering that some people do benefit from 120 mg, and some even require 240 mg (the highest dose studied in clinical trials).

I wouldn't waste my time with desvenlafaxine or Fetzima if it's SNRIs you're looking into.

Are you looking at getting off the tranylcypromine?

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I took Venlafaxine with no side effects but it didn’t work for me so I had to go off it. Going off it was a nightmare though. I was given a schedule to taper down and even that was too fast. I ended up having to open the capsule and take one single granule more out each night in order to avoid feeling like I was violently sick. It took many weeks to finally be off it completely. 

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i really liked venlafaxine. i took 225 mg for a few years. it was great for anxiety for me, but it was somewhat sedating and not the best for depression. anxiety was my main issue, so i didn't mind being a bit sedated. apparently most people find it activating, though, so YMMV. it also made me a bit dizzy upon standing up in the first couple months, but that went away with time. when i came off of it to try clomipramine, i actually had almost no withdrawal effects besides an increase in anxiety that i attributed to a reoccurance of symptoms. 

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On 3/19/2020 at 3:03 AM, Simba Cub said:

Which drug do you feel is better tolerated and most effective?

Duloxetine or Venlafaxine?

Same drug class, the only difference of any note that I've seen is that Duloxetine is prettier!

I've been on and off Duloxetine 3 times and on Venlafaxine once.

Duloxetine is more energizing and feels different from all SSRIs. Venlafaxine felt like an SSRI for the most part (up to 225mg).

No side effects from either, but Duloxetine gave me no withdrawal symptoms... Venlafaxine is a whole different story.

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Posted (edited)

Venlaflaxine made me weirdly agitated.  I tolerated duloxetine a lot better and got some kind of pain relieving effect off of it.  

Edited by Banana Smurf

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