Start up side effects advice needed

Hi Sarah, thanks for your reply, sorry to hear you are suffering too I too changed from citalopram to Venlafaxine. I doubt it's the withdrawal as I've been off citalopram for a month now and having the same issues as you where my head feels better but emotionally (in my stomach) I'm very raw and anxious and sad.

Hi James

I ve been told the cit can take up to 6 weeks to fully withdraw.

Who knows. All I know is I really don t like how I feel today.

Hi James

How are you feeling ?

Any improvement ?

I had a good day yesterday....not sure about today yet.

Hi

What dose are you on ?

Do you feel better than before you went on them ?

X

Hi Sarah,

I'm talking a total of 225mg of Venlafaxine daily.

37·5mg extended release in the morning. 37·5mg extended release

in the evening. 150mg regular release at night.

I'm going to talk to my GP when I see her this Thursday.

The days are difficult with anxiety and depression and I get headaches

pain in my shoulders and neck. I don't know whether it's the medication

or my anxiety, or both causing it.

Sometimes I feel slightly better, other times I feel worse. I don't know

what's going on to be truthful.

xx

Hi Purpldobermann

I am now on my 3rd day at 150mg. I found the first 2 weeks on 75mg really quite good but last week was hellish. Could be cit withdrawals ? Is it normal to go up and down like this ? Will it be 6 weeks on 150mg or from 75mg I might stabalise ?

It is really hard to judge which is to blame. However I dare assume that 150mg blast after only two weeks of 75mg will probably override cit withdrawal LOL so it will no longer make a difference which it is.

Also, whichever it is, you can expect notable ups and downs until medication peaks and yes it is normal considering the fact that you were doubled up quite fast while also withdrawing from another drug .

You should be able to reach good concentration already by week 6 total (from onset at 75mg therapeutic dose) and progressive but gradual improvement from that point. Even then, you will have blips and sometimes feel like you are taking a few steps back . These blips will slowly become lighter and further apart.

All that of course provided the medication works for you. Which it sounds like it has a good potential to judging by your positive response to 75mg.

If however, as mentioned, you continue to worsen, with new issues cropping up, talk to your doctor about mild tweaks of dosage, ideally in no more than 37.5 increments either way from this point.

The worst of ven adjustment should not take too long - perhaps another 2 weeks at the most.

Another thing to note is that once a medication begins to address certain brain responses, in people with a lot of tension as is typical of those with GAD, the first forced release of that tension does not feel much like relief at all. Instead can feel overwhelming and alien. That is repressed emotion that is largely subconscious. This is usually why it 'gets worse before it gets better'.

Hang in there, keep your wits about and get in touch with your doctor if you feel anything is off. You are in the best position to judge how much you can handle and how much you should be handling. Us here we can only go by what we deduce from what you say

But do let us know how it goes!

All the best!

Thanks for your full reply.

I was 5 days on 37.5 then 19 days on 75mg now 3 days in 150mg. Is that a fast titration up ? It is slower than my psychiatrist suggested.

I am hoping that the fact I felt better the first 2 weeks on 75 is a good sign and again I feel a bit better starting on 150. Better than last week. Still anxious and tearful.

Is body weakness a start up side effect ? I feel shaky and heavy limbs.

Yes, heavy limbs are. Shakiness is from tension and exhaustion (anxiety takes a lot out of us). Overall it is an adjustment issue. Shakiness is also normal for withdrawal from cit.

The 5 days on 37.5, followed by three  weeks at 75mg is fine (I just now realized this did not come from the original poster!). It is the jump straight to 150 from 75 that tends to cause some waves. There is a difference in how your brain is stimulated on 75 and how it is stimulated on 150mg. Nothing to worry about normally. Just needs a few days to start to even out. For me it lasted about 5 days for the worst or most violent reactions(once i was on 150 - but i never made the jump from 75 to 150 - we used 37.5 increments).

You mention a psychiatrist - how refreshing. Most people here are followed by GPs who are really bad at dosing and tweaking. I trust you are in capable hands. A psychiatrist is always better able to work with these drugs.

Thanks for all your replays they are very helpful, the good news is the the emotion has passed for me. However I have noticed that the tablets wear off quite quickly, say after about 5-6 hours and then my concentration starts to lapse and I start to drift off into worry again. I normally take 75mg at 9am then another 75mg at 9pm, I take the immediate release tablets. Once I take them I feel great,?Will this subside or because they have a short half life will I need to increase to keep a consistent amour of medication in me.

Well your reaction to immediate release tablets is actually a good thing. Good in that it proves they work for you. Ask your doctor to consider putting you on extended release tablets to prevent the ups and downs jerking your brain all the time. XR is justified in your case since it is clear the drug is working for you. Now you are ready to start evening out. All the best.

However, if the doctor (for whatever reason) decides to keep you on IR instead, you may be able to even out once concentration levels are high enough, i.e. after a few weeks.