Is it safe to increase my venlafaxine

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So I went to the doctors today because I've felt my depression getting worse. I asked the doctor if I could increase my venlafaxine from 225mg to 300mg. His response was that he didn't know if it was safe to do so as I'm also on 45mg mirtazapine and 7.5mg olanzapine. He then said he has no experience in this kind of medication so to wait for my next phych appointment, he then followed saying but if you feel you need to up your Meds till your next phych appointment do so. This confused me as prior he said he wasn't sure if it was safe. Needless to say I left the doctors confused. Does any of you kind people know if it is safe to up my venlafaxine to 300mg as I'm not sure I can wait till my next phych appointment. Thanks in advance.

Leanne

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  • Posted

    Hello, i did my own increases of ven within the limits my pysc gave me. Im on 225mg of ven. I dont think a gp is allowed to pescribe above 225mg, it has to be done by a pysc, as its is regarded as the max dose for most people. People on here have said that 300mg works very well for them, and if admitted to hospital, think they can go even higher. You need to wait for your pyscs assessment, especially as you are taking mirt as well. I was a little blasee about my own increases, but even i wouldnt go over 225mg without a pyscs approval. How long until your next pysc approval?
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    • Posted

      Thanks for replying nigel. My next phych appointment is in 5 days but I'm struggling at the moment with intrusive thoughts which is making me depressed. I'm hoping an increase will help with the thoughts so I can get back on the recovery track.

      Leanne

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  • Posted

    Hi Leanne. I have the same feeling as Nigel. 300mg of Venlafaxine is quite a high dose. I have been on that size of dose last year and I got very bad anxiety and worsening insomnia too. I hope you don't have long to wait to see your psychiatrist as without doubt he/she will be the one to advise you best. I know this is difficult for you when you're feeling unwell. The psychiatrist will help you get the best balance of venlafaxine/mirt. Or may have other meds which could help you. Do you have plenty of support from CPN's when you're feeling like this? Also, are you able to get plenty of sleep? It's really helpful to have this forum to comment on as I think it gives support from people going through the same thing. Hope you get to see your psych very soon. Jackie x

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  • Posted

    There are different maximum limits for xr and ir. Generally 225 is the max for xr and it would have to be a psych that increased you. You are on alot of heavy meds i would wait to see the psych. I was on those 3 meds together and it was really foggy and sedating. You must have quite a few side effects ?
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    • Posted

      Hi sarah, thanks for replying. Not got any side effects anymore although when I first started out I was very sedated and yes had lots of other side effects... I've been on all Meds about 9 month now so I was doing well until recently.

      Leanne

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    • Posted

      That's a short period of time to be put on so many psych meds.  The concern is that all increase serotonin, so you are at higher risk of serotonin syndrome by upping any one of them. That is dangerous to do on your own.  Now, the other thing is that the nervous system responds to artificially elevated serotonin by modifying itself to bring levels back to homeostasis. It sounds like you have reached tolerance withdrawal status rather quickly, but to which one?  You are in an arms race with the meds.  Dosages keep being raised and then the body opposes those levels and adapts until finally you are on the highest levels of all and still reaching tolerance.  Now you are on massive amounts of meds that are no longer working, called treatment-resistant depression.  Where to go from there?  You then have a huge amount to come off of to then try something else, and that means withdrawal in the coming off process of a cocktail.  Worse yet is to have yet another drug added to the mix that isn't working!

      Before you raise Ven even further, you might discuss with your doctor what the plan is because it would be better to come off ones NOW that are pooping out rather than go higher, have them poop out again and then have farther to go to come off!  Since you are on a cocktail already you don't don't know which one has really pooped out!  What was the progression of getting on these meds?  Which came first?

      I'm hazarding a guess that Mirtazapine came second after the first one caused insomnia.  That is the classic progression:  One drug causes side effects that a second drug is added to treat, and so on and so forth.  Better would be to recognize the first one wasn't well tolerated and to gradually switch over to a different one.  The polydrugging/cocktail approach can be devastating.

      I'm not wanting to freak you out, Leanne, but the problem is we patients are so trusting as to be led into these situations by our doctors and only later do we learn what has really happened, yet we find ourselves in a position of trying to come off these meds somehow but failing because it is so very difficult.  Been there.  I'm in the process of slowly tapering off of Ven and Mirtazapine.

      Much can be learned on the web.  There are drug info sites that can tell you about each you are on, the side effects, etc. and then interaction checkers.  If you do a search for interaction checker you will find it easily enough. 

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    • Posted

      Hi Betsy thanks for your reply. I was first started on the mirt but because it wasn't working alone they added the venlafaxine. The olanzapine came about because I had a massive breakdown and thought I was going crazy... they gave it me to calm me down and to help the anxiety. I hope I haven't reached tolerance and it is just a simple increase that's needed to even me out.

      Leanne

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    • Posted

      Leanne just a word of warning. I ended up on 4 psych drugs.....am now on 3 and soon to be 2. It is a dangerous game adding more drugs or continuously increasing dose. The combo you are on now at those doses is pretty strong. If you are feeling unwell i would suggest this meds combo is not working for you. I would talk to your psych about what is going on. At some point you may want to come off and it won t be easy....i know. Have you tried talking therapies or meditation. Psych drugs can only do so much you need to help them by making changes to your lifestyle.
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  • Posted

    Hi Leanne. I have taken 300 mg venlafaxine and 15 mg mirtazapine for 3 years now. My psych weaned me off olanzapine within 3 months. These meds work great for me, but I have never taken a higher dose of mirtazapine than 15 mg, and I no longer take olanzapine. I think it would be wise to talk to your psych before adjusting your dosage. Good luck.
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    • Posted

      Hi Leanne. Although I'm Bipolar 2 I was given venlafaxine on it's own and got really awful intrusive thoughts. My psychiatrist is balancing me on quetiapine and after 7 days the thoughts are gone and anxiety lessening. I'll have to be weaned off ven as I'm not supposed to be getting it as it can turn hypomania into extreme anxiety. You could maybe ask your psychiatrist if it would be suitable for you to get quetiapine? For me it has been a godsend. Hang in there. We're all thinking about you. Jackie x

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    • Posted

      Hi I'm on venlafaxine 75mg twice a day now came off the mitrazapine now I'm struggling too sleep I think it's because I came off the mitrazapine xxx

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