Help with Venlafaxine dosage

Hi All,

My first post to this forum. I have had had anxiety since 2005 following my diagnosis with MS. Since that time I have had numerous anxiety episodes and have treated them with Venlafaxine 75mg for a 6-8 week period. I have kept myself on a low dose 37.5mg since 2011. I have had a strange year where I developed anxiety after catching Covid - once in Dec 2021 and then in March 2022. Both times I treated the anxiety in the same way by going up to Venlafaxine 75 and waiting for things to improve which they did.

I stayed on Venlafaxine 75mg after my March 2022 attack, however in early May I suffered what could have been a mild MS relapse or a migraine (hard to tell the difference with my particular version of MS). I have since suffered with acute anxiety - seemingly much higher than on previous occasions. I was already on what I thought was a therapeutic dose of 75mg so was surprised to have anxiety. After 10 days my GP upped my dose to 112.5 which I stayed on for 2 weeks. The anxiety didn't get any better in this time, if anything it got worse. I was then suggested to go to 150mg which I have been on for a week. My anxiety is now at its peak and doesn't look like going down any time soon. I take 0.5mg Lorazepam once a day to try and quell the morning anxiety but whilst previously it worked really well it's now just about taking the edge off.

My question is two fold:

1. Do I stick on this dosage (150) for longer even though it seems to be increasing my anxiety and doing little else or do I titrate down to 75mg which is a level I can tolerate and wait it out?
2. Does this instance seem as is Venlafaxine has stopped working for me and do I need to look at an alternative?

Appreciate all the help I can get here. I am trying to get an appointment to see a psychiatrist but I am hoping I might get some wisdom from the good folk here.

Thank you.

0 likes, 0 replies