My Experience Having Been Changed From Efexor To Venlalic..

Hi Stephanie,  you have my sympathies, I went through a similar horrible loop and it is frightening. In my caseit turned out that it was changing me from a 37.5 twice daily to 75 once a day regime that made it all go wrong. I thought it was. Effexorbut it wasn't. Back on my old doses and fine now. 

However, in your case it might be effe or. Generic drugs have a requirement to be the same as the original but there is a margin either wY for the quantity of the active ingredient. For most, this margin is fine and therefore it makes economic sense Togo for the cheaper generic. For others it doesn't work. 

If the doctor specifies Venlafaxine on the prescription, the chemist cannot give you Effexor as that is not within their contract and they would not get paid for the much greater price of Effexor.   So if you wanteffexor, you need to go and get your GP to specify it on the prescription and, if necessary ring the chemist to say so. My local boots was very helpful with this though this didn't turn out to be the problem. Effexor don't make 37.5 any longer so that was no longer an option. 

So if your GP won't help, then try one who will. You must have a drug that works and if the generic doesn't work then they have to give you something that does. 

You might try to ask for a trial back on Effexor to see if itis the problem. This way, both you and the gp can see if that is the cause of your current state or if there is some other underlying problem. 

Also, to, try taking someone else who is clear minded and assertive with you to the doc. I am pretty assertive but when I am low and a doctor is throwing excuses at you and making you feel it's all in your head, I can be put off. Very helpful to have some one next to you taking the doctor to task and insisting with you. 

My doctor was very helpful and did change the prescription despite the fact, in the end, it was a two dose approach I needed, not the one and the generic is ok for me.  Good luck and keep us posted. 

Good luck!  Your GP may argue with you on the basis that EFFEXORis much much more costly than the generic venlafaxine and so it makes economic sense to try to see if you can cope on the cheaper drug.  with cuts and everything, this is all the more important.

I'd love to go back on Effexor as I do think it's a better drug but they no longer make the 37.5 dose I needed twice a day and the 75 dose controlled release doenst work for me.  I'm better off with the two peaks a day at the time I am most vulnerable, morning and evening.  All the best, let others know how you got on.  You could try asking for a compromise position where you have a week on one and then a week on the other so you still cut the costs but you dont fall so low before the better drug comes in.  There may be medical reasons why this wont work though.

 

My gp listened and has agreed to let me have the brand I'm happier on even though that too is a generic venlafaxine apparently so I shouldn't notice any difference in reality.... I'm sure I do so we will see from here on in. The brand I have now is sunveniz xl as apposed to venlalic. So I'm hoping that in a week or so I can start rising up again from the pit I have sunken into the last couple weeks....watch this space!

Hi - I'm new to this and only came across it because I was trying to find out if others were having problems being changed from Efexor venlafaxine to something cheaper.  Like you, I've been on 75mg slow release venlafaxine (always Efexor) for at least 10 years and about 18 months ago my GP's receptionist rang me to say that they were changing my prescription to a different brand of venlafaxine but not to worry as it was "identical".  It sure as hell wasn't!  I went from being a normal, rational, happy person on a very even keel to being prone to tearful outbursts at the drop of a hat, aggressive for no reason (then immediately afterwards tearful!) and generally not much fun to be around - not even on a lovely week's holiday in the sun, which turned into an absolute nightmare and so unfair on my husband.  I eventually put 2 + 2 together and realised that the new venlafaxine was far from "identical" and when I eventually saw my GP on return from my holiday she immediately agreed to put me back on Efexor which I've been happy on ever since.  I've had a bit of a blip over Christmas and New Year - but then I generally do at this time of year.  However, when I collected my repeat prescription a week ago I noticed that I had been given something called Venlablue XL - again supposedly 75mg prolonged-release capsules - but having been on them for a week now am experiencing exactly the same symptoms as you - low, irritable, with no drive to do anything or see anyone - all I want to do is stay in bed all day.  I thought that after my previous experience with "identical" tablets that weren't a success the pharmacist would have had the sense not to change my prescription again, but it seems not.  I had an appointment with my GP today and she said that I needed to double my current dose to help me get over my current problems.  I'm not sure whether she is aware of the change from Efexor to this Venlablue.  When I was with her this afternoon at around 4:30pm I broke down into a tearful gibbering wreck.  I took my so-called prolonged release capsule approximately 5 hours previously so don't think they can be prolonged release at all for me to get so low in such a short space of time!  My GP gave me another prescription which I left with the pharmacist because, quite honestly, I was in such a tearful state I was embarrassed and just wanted to leave asap.  I expect it will be for the Venlablue agains and I'm now wondering whether to speak to the pharmacist and see whether he will let me have Efexor again or have to make another appointment to see my GP - maybe I will see if I can telephone her instead.  In the meantime I hope you get on ok with the Sunveniz, but why oh why when something works for us can we not continue with it?!  Many years ago I was given some other anti depressant as an alternative (presumably again because of the cost of Efexor) which just left me like a walking zombie!  Never again do I wish to tinker with alternative meds all the time my existing ones are still in production - if it ain't broke, why fix it?!  As for the comments by doctor Paya - well, all I can say is I'm glad I'm not registered with him as I would have done as he wanted and saved him much needed funds by topping myself ages ago!  Never before have I read such harsh, unfeeling and unsympathetic attitude to mental illness - and from a GP, no less!  Who was his mentor - Harold Shipman?!

Sandra

I strongly advise you to go back to your GP and ask for Efexxor.  Ask to give it a go and see what happens.  Ultimately, it's not a big ask to give you 3 months worth to prove if it make a difference either way.

The reason they do it?  Pressure of finances.  You've seen it all over the news, they are really strapped for cash.  Yes it makes no sense: if it aint broke dont fix it.....but with what the government has done to the NHS, doctors are left with little choice but to try and cut costs everywhere.

For some, the alternative cheaper lookalikes work, not for others.  It's a risk they seem prepared to take but MOST GPs seem to let you return to the EFEXXOR if you are not getting on.

The drug formulations in the lookalikes are NOT identical.  They have to meet the active ingredient level to within a margin of the original either way (10% I seem to remember, but check as I may be wrong).  This means that for those who were fine on EFEXXOR but at the lower end of a dosage spectrum would then not be getting enough of the active drug if the lookalike had 10% less active ingredient.  For others, it would have little effect.

I had no choice as I function best on 37.5 twice a day not 75 CR.  EFEXXOR stopped making it.  I still think I was better off on the 37.5 EFEXXOR but if they dont make it, I have no choice.  The alternative drugs (and the chemist doesnt always give me the same one) leave me a bit borderline sometimes.  I fancy some brands are worse than others.

So, go back and ask and if not change GP.  Before you re-register with a new one, see if you can have a word over the phone or face to face to ensure you are changing to someone willing to listen!

Good luck

Dear Sandra

You could not be further from the truth.

Your comments are offensive and derogatory. To suggest I am unsympathetic and unfeeling is hurtful and simply not true. You obviously have a greater insight into your personal mental health but that does not mean others are unable to contribute to a meaningful debate.

Resorting to personal attacks is unfortunate and I realise that sharing views on this forum was a mistake on my part.

I genuinely hope you feel better, in fact I hope you are all able to resolve your health issues and find some degree of inner peace and happiness.

Good luck and best wishes

Well Paya

Perhaps you need to go back and re-read your threads.  I saw them when I first joined the discussion and decided to ignore them.  Partly because I already knew that what you said wasnt strictly accurateand partly because they seemed more focussed on costs than anything else.  Human costs matter too.

Of course these drugs are safefy tested! We know that! This is the UK and one would hope they were.  Our point is that they are not as effective.  Yes we know it is the same active ingredients BUT there can be a variation on the amount of it from the branded original.  This is a documented fact and most doctors will admit to knowing this.  

As I said in an earlier post,the balance for some people therefore does not add up if the new drug doesnt quite deliver what they need in terms of dose.  Your point would only make sense if the active ingredients were of EXACTLY the same quality and quantity, but the fact is they are not and don't have to be within a margin.  And that margin, for some, can be crucial or all these very clearly sane people would not be reporting the findings above.  From reading the posts, all are pretty articulate.

I think it is a valid exercise trying to see if patients will be fine on the cheaper equivalent but not without due warning to the patient and close watching. The nature of depression is such that, once you start to slip, your ability to work out what is going on can fail you as you slide into the abyss. Additionally, you are faced with many doctors who just accept the drugs are identical and therefore humour you or build up the dose or send you off for therapies you didnt previously need.  They never stop to question the change they have made in your medication.  Many also treat every other complaint you have as depression linked/psychsomatic.  I got to the point with one doctor where I wondered if reporting an in-growing toe nail would solicit the usual doleful nodding expression of "there there dear".

When you have finally settled on a drug like Efexxor which has the benefit of letting patients feel pretty normal without undue numbing of emotions etc..., you need to be very careful about rocking the boat because it is absolutely terrifying.  You might be justified in trying the cheaper drugs on new patients but existing patients should make the experiment with extreme caution and close monitoring.  I think you need to be very careful when you say to people that they have to take responsibility for their own health.  This made me bristle.  We all do where we can, but when we are plunged back into a deep hole by a GP who changes a working medication for something less effective, it leaves us in a state of mind that makes it very difficult to "take responsibility".  That's the whole point of depression.  And I think it is this comment, to me, that categorically shows your fundamental lack of understanding of depression.  It comes from the same stable as those who tell you to pick yourself up and start a new hobby, take some exercise or meet up with friends...or worse "you don't need those happy pills".  If patients had the wherewithall to start a new hobby, do exercise or any of those great suggestions, they wouldn't be ill in the first place.  Depression has been described as an "illness of the will" and although there is a lot more to it than that, it is certainly a factor.  Why on earth a competent business woman like myself got reduced to being unable to pick up a ringing telephone, even when I knew it was my husband, is to do with will no longer functioning.  In that state, you can't take responsibility.

People often dont realise they are slipping back till it's to late to understand it could be the pills.  I was lucky in that having twice tried to come off Efexxor before trying to get pregnant and realised I couldnt do without it, I knew immediately when, after a move to a so called equivallent drug, I suddenly felt weird but even then it took me a while to put 2 and 2 together.

I'm sure you think you are sympathetic, but you are not empathetic.  Nor do you seem to have REALLY talked in depth to patients about how depression feels on a daily basis.  Doctors are busy and insufficiently trained in this area.  If you really understood, you entries would have been somewhat different.

But, though I believe you are probably genuine in your entries, you don't come over as having a real clue what it's like or you would not make some o the statements you make.

So I will only beg you to go get up close and personal with some depressed people.  It is VERY hard to understand for an outsider but not impossible.  I know you meant to be helpful but I'm afraid this is a case where the patients know better.

While I disagree, for the most part, with Paya, we should support him in contributing to the thread. The more professionals that engae in these discussions on forums the better. It gives us a chance to explain how we are effected, and him/her an opportunity to understand. 

Without getting too philosophical, mental illnesses and other mental states are essentially private experiences. This is what makes it so difficult for sufferers to convey to non-sufferers. A friend of mine recently took Venlafaxine for the first time last week. He had an adverse reaction that ended in him being sedated in hospital at 04:00am. I take Venlafaxine everyday, not suffering any of the side effects stated. My point being that inductive-based beliefs that x amount of patients are fine on the generic counterparts to a drug does not mean therefore all patients will be. This, to my knowledge, is the basis of the original argument made by Paya, when he/she said, "...In my experience i have not had one patient return saying they have had a problem. They would not have a marketing authorization in the UK without good safety data." 

Please don't leave the discussion, Paya. People can become very emotional in their responses in this forum because they are in a mental condition/state that dictates they be so. So please take this into consideration and try not to take things too personally.​

This is an article I came across the other week:

http://www.theguardian.com/science/2015/jan/05/serotonin-map-brain-antidepressants-mental-illnesses

thanks adam5!  Sounds promissing but a looooong way off.  It's good to share these articles though.  Thank you.

And by the way, I agree with your earlier comments to Paya.  I think the drug reactions do depend on the person.  I was initially put on Prozac by a doctor who decided I was depressed (I didn't think so, I thought I felt exhausted and a bit distant after 11 months of being a new mum, being woken at night, breast feeding for all that time, travelling abroad to introduce daughter to parents etc...) I wasn't even at the GPs to discuss me but for my daughter's innoculations!!!!! I left the the surgery puzzled but, not knowing better, took the drug.  Given no warnings on the drug's possible side effects, I was, within two days, wondering whether to jump off a second floor balcony with or without my baby.  I managed to get myself downstairs and call a friend (husband was away on business). Long story short, I turned out to SEVERELY not get on with that drug and it took 10 days to detox under hospital supervision.  I wouldnt return for further help till 2 years later.  I know it was the drug as I had not really felt any extreme feelings of depression beforehand, just a bit jaded. I felt as if I was tripping on Prozac and it was very very frightening.  Venlafaxine for me was a doddle.  Took it, it worked. So again, good points made by adam5.

So I also support adam5's plea to Paya not to leave the thread.  It is emotional indeed, he is right.  It's emotional because of the illness (though I would not consider myself ill at all these days so none of what I said in my post was fuelled by that) but also because of the way one can be treated by GPs due to either ignorance or, in some cases, the idea that you can shake yourself out of it makes you very angry, in my case on behalf of others now since I am lucky to be totally functional on venlafaxine.  But I also found out the hard way the perils of messing with my drugs for financial reasons.

You see it's all very well trying these things out to save some money and I realise it has to happen across the spectrum of people on regular drugs but the knock on effects of getting it wrong with mental illness are huge.   It's not just the individual you affect, it's the entire family.  The partners.....those who are still there (I was told by Mind many years ago that depression is a relationship breaker, others are negatively altered for ever), the children and any other dependants on that person.  The rebuild time if the experiment goes wrong can be lengthy.  You can't necessarily just pop back onto the right pills and all is well overnight.  Sometimes going back doesnt work so well.  Sometimes people can be hospitalised before it's discovered that the problem was just a change to a cheaper less effective formulation of the drug.  By this time, the effect on the patient and their confidence is HUGE.  The time it takes to climb out of depression's dark hole and feel you are not going back there can be years.  So a small experiment to save cash, could set you back years, cost you a job, destroy relationships, upset kids and cost you a lot to help hold the fort while you try and get back on an even keel. When I had the Prozac debacle, someone even questioned my fitness to care for my child.  I was terrified they would take her from me.  And that was caused by the drug.  Mercifully, there was an uproar from all those who knew me and knew that the care I took of my child was meticulous, plus the consultant was livid and said I was a totally mentally competent person and I should never have been medicated so strongly and without due care and supervision. He refused to tret me until I found another GP and sent the first one "an advisory letter".  

All this to show what messing with people and these drugs can lead to more than just someone feeling not quite right.  So in the balance, I do think that if it ain't broke, you should not fix it....and certainly not without very very close supervision.

I am of course writing from my experience but also having read up an awful lot of stuff and spend quite sometime with professionals and other sufferers discussing it.  My GP is excellent at understanding where people are with depression, perhaps because someone near her has been there.

I did not want Paya to take things personally but, adam5, I am not "in a mental condition/state that dictates they be so".  To all intents and purposes, I have felt like myself for  years bar the glitch when they changed my medicine.  But I am very defensive when people make what appear to be statements based on little real understanding of the illness mostly because it's all gone on for long enough at too many peole's expense.  When you are not well, statements saying patients "should take responsibility" sound very ill informed and high handed.

As I said before, this is not an attack on Paya, I do agree that it is useful and necessary to have doctors involved in these discussions but it needs to be a discussion of equals where both sides are there to learn and understand and support.  So Paya, do stay tuned but also try to get some understanding of how patients feel, what they experience and how they are treated in the system.  Also how doctor's decisions can have huge effects on these types of patients and changes should be avoided or only done under very close supervision and with the knowledge that generic drugs are not fully equivalent (that is documented).

Hope that clarifies things.

Hi!  Sorry to be so long getting back to you, but it's been a rocky few days most going downhill despite taking double the dose of the Venlablue - firstly one in the morning and one at night (as I struggle most mornings to want to get up) and then two in one go which I did yesterday as per my GP's instructions.  I called in to the pharmacy (which is located within my doctor's surgery) to pick up the prescription to allow me to continue to take two Venlafaxine per day.  Before I signed for them I asked to see what brand they were - they were yet another brand in a purple box (I can't recall the name as I was so dismayed they weren't Efexxor). I aske to speak to the pharmacist who insisted they were exactly the same as Efexxor, so I explained to him the problems I had been having and he went on to explain that he has no control over what he is sent as he only puts in the order and the wholesalers send him whatever they have at the time.  To be honest I find this very hard to believe!  He explained to me that Efexxor are 10 times more expensive at £2 a pill than their generic equivalent and that they lose money by ordering in Efexxor.  I did say to him that I appreciated that the NHS wasn't a bottomless pit but there really was a difference between the generic pills and Efexxor.  He patiently told me that they had to be the same in order to get the licence to distribute them.  Feeling like I was banging my head against a brick wall as he clearly wasn't taking on board anything I was saying I started to get upset which seemed to grab his attention!  He told me that the only way I would specifically get Efexxor was if my GP particularly requested it on my prescription and that he would have a word with her and get her to telephone me. Needless to say no-one rang me back yesterday at all so it looks like I will have to ring them on Monday.  Even on a double dose of the Venlablue I was getting emotionally wobbly again by 4:30pm after speaking to a friend of mine who has also been on anti depressants for several years.  By the time I met my husband for a drink an hour or so later I was a sobbing heap which I eventually managed to bring under control but it was bubbling away underneath all evening and got the better of me briefly a couple of times.  It seems to me that the Venlablue is either as much use as a chocolate fire guard or maybe I'm supposed to give it more time to adjust to it.  I refused the new brand the pharmacist had given me as I really wasn't prepared to play russian roulette with my mental health just so they can save a few quid on their budget.  I worked full time for the same employer for 34 years ever since I left school but was made redundant last March due to his retirement. I've only ever had two minor operations on the NHS and never had children so haven't been a burden on the system (not that I'm saying people who have children are a burden, before anyone jumps on me for that one!) or taken anything out of it my entire working life, so now I need a more expensive drug than others have I feel I deserve it.  Fortunately, I don't think there will be a problem with my GP prescribing me Efexxor as she's extremely sympathetic and remembers everything I tell her and I don't think it's because she Makes copies notes - she just obviously cares about doing her job properly.  I never feel rushed or pressurised to hurry up when I see her, unlike others GP's I experienced within the same practice.  It's a pity that when prospective GP's take their exams that they aren't asked pertinent questions about how they would deal with people with possible mental health problems.  Perhaps in years to come this will become standard as part of their training - let's hope so. That said, I've also read that anti depressants are being issued to 1 in 4 people now, so maybe they've gone too much the other way, or maybe it's just an easy option.  I note that you are better on 37.5mg Efexxor twice a day.  I was also prescribed this dosage of Venlafaxine (not Efexxor) to be taken in addition to my 75mg modified release Efexxor to help me cope with difficult days if I thought I was going to have one and after I was made redundant - my GP trusted my judgement for me to decide as and when I needed to take them.  I've never been prescribed Efexxor 37.5mg Venlafaxine but generic ones, usually by a company called Teva.  To be honest, these seem to be more effective for me at the moment than the Venlablue, but I'm getting so fed up with being generally ok for maybe a day and then plunged into the depths the next day.  My husband doesn't understand at all (I think a lot of people who have never suffered with depression or have been close and fully empathised with someone who has find it hard to comprehend) and just he keeps asking me what's wrong and why I'm unhappy.  It's not about being happy - I get this empty feeling when I'm so down - does that make sense?  Some people have even said to me "what have you got to be depressed about?" when I had my good, well paid job, a nice car, lovely home, etc. and you then feel guilty about being depressed when there's so many others in the world who have virtually nothing but still manage not to get depressed.  The only things I find pleasure in are my two cats, my garden birds, wildlife in general and the birds and squirrels I feed where I work part time two half days a week.  Oh, and shopping for things I probably don't really need which has caused me to run up £10,000 on my credit cards which my husband has only recently found out about, which didn't please him. I can't decide whether I'm a shopoholic by nature or whether my depression contributes to my shopping addiction.  My GP suggested counselling and/or CBT.  I've done counselling on several occasions - all of which were a complete waste of time.  They're just paid to sit and listen to you drone on about your past (which I prefer to keep buried and forget about anyway) which can't be changed so doesn't help.  My husband says I spend too much time dwelling on the past instead of looking to the future.  This isn't true - I gave him an instance about my past which upset me greatly at an event we were at in December.  Some things just trigger off memories or events in your past whether you want to forget them or not.  So I think I'm going to give the CBT a go and see if it helps.  I think this, combined with getting back on the Efexxor might put me back on the right track - here's hoping! 

Poor you!  Things are not good at the moment.

Looking at your points.  The chemist is right, he can only give you what is on the script and if it's a generic script, he can't give you EFEXXOR as he won't get paid for it.  If the GP specifies it on the prescription, then he can.  So it is paramount that you get your GP to write EFEXXOR on the script.  And yes, most of them do get what the wholesaler sends...usually the cheapest.

Yes, personally I do get on better on two doses of 37.5 than one controlled release of 75 a day.  So when EFEXXOR stopped making the 37.5, I was stuffed.  I tried the 75 controlled release in both EFEXXOR and generic.  I didnt rate Venlalic at all.  Ultimatelly I dont get on with control release because I dont need the support all day.  So it was back to 37.5 twice daily.  I seem to be OK on the TEVA but none have been as good for me as the original EFEXXOR 37.5.

The reason I think I do better that way is because, when I was depressed, it tended to hit mornings and wear off as the day went on.  Taking non control release gives me a big boost first thing.  As I tend to be a bit of night owl, I take my second dose very late at night...between midnight and 2am so the drug is at it's highest dose through the night and boosted 5-6 hours later when I wake up.  In other words, I'm heavily weighted for the morning.

That's how it works for me and, although I was originally dosed at double that, after only a few years I cut down to half and have been OK.  I guess I'm lucky.

As for your husband, it is very very hard for him to understand.  Again, I'm lucky in that my husband went through a period of depression in his early 20s and even though it was not for very long, he does have an idea of what it's about and he is the sort of person who would try and read up on it anyway to try and understand.  It's hard to say to somebody that you wake up in the morning and, for some inexplicable reason, after an instant of feeling vaguely normal, the cloud descends for no reason you can put your finger on.  The piece of metal down the middle of your chest that makes you feel strong and upright suddenly buckles with extreme "metal fatigue" and you find yourself feeling weak, vulnerable,distant from everything, hopeless, and ashamed of not pulling your weight whilst unable to make yourself do so.  So guilt plays a part to.  I used to describe it as if I woke up and someone instantly injected me with a serum, like a bad trip (as I imagine it would be ).

You should NEVER EVER take any notice of the things people say.  They simply don't understand and you should treat them with the contempt they deserve.  They wouldn't turn round to a person with a broken leg and tell them to get on with walking faster, or suggest to a person with diabetes that they dont "need that insulin".  It's total bull and says more about their ignorance and/or fear of facing what is happening than it says about you.

It is nothing to do with what you have etc...but I understand that people say that.  I had a therapist say to me: "You came to me with a problem...the problem's gone.  You've got a nice house, a great husband, lovely daughter, horses, I'm not sure what you are doing here".  For info, the problem was I was pregnant again, the hormones had thrown me back into depression and I wasn't sure whether to go ahead with it.  What she meant by the problem's gone was that I had a miscarriage that week.  So that was all ok then.  NOT.  Thankfully I walked out of there, in shock, and straight into a good friend who called her close friend who was a very senior and able therapist.  She called me and proposed a meeting mainly to tell me the first therapist was totally out of order.  I went for a few sessions before she told me I was sane, tough and had handled things amazingly well and that this was down to a hormonal problem as a result of childbirth (she had been a psychiatric nurse in the past and also helped set up the modern psycho-therapy training courses, wrote and corrected the exams etc...she knew her onions and she was right).  It was after that and thanks to her I returned to the doctor and got put on Efexxor and never looked back until the glitch when my pills were changed.  All ok now.

So, all this to say that many of us have been there and you must remember that there is a lot of poor understanding and support out there BUT there are some excellent therapists.  If you can find it in you, go and interview some.  Make a preliminary appointment with each one and go and see whether you click with them as a person.  You don't want someone who asks the odd question and sits poker faced while you talk on the other side of the room.  You want someone warm who communicates with you and you feel confident to be with.  It's always hard leaving after your time if you are in the flow but they do have other patients. But there are human beings out there who can show genuine empathy, dont set themselves up as Mr/Mrs Sanity and make you feel like a freek.  There are also many approaches to psycho-therapy and some therapists are trained in different approaches.  Just explain how you want to work and ask if they can do that.  Some can include CBT as part of your therapy.  To have the choice, it does tend to mean you have to pay, but you will know immediately when you feel comfortable with someone.

You should expect to cry a lot, especially at first and to wonder if it isn't making things worse.  You do need to rake over the past a bit but stick with it.  The answers don't always come through the door you expect them to.  There isn't always a hallelujah moment.  It is a process and it takes as long as it takes.  Be patient with yourself.  But it's crucial you find the right person.  Go in there.  explain what you've done before, why it didn't suit you, how you would have preferred it and ask how they would approach it.  Don't expect to be told it will take 6 weeks or 12 weeks, go with it.  And allow them time to get to know you and you them.  Sometimes therapists make conjectures about why you do things....if you dont agree, say so nicely as you would to anyone else: No that's not how I feel, it's more like......They are humans trying to help you and not faultless.  A good therapist won't take offence which is why going to try it up front and see how you feel after an hour is important.

Events in your past do trigger bad memories.  What therapy does is let the arrows of the past fall short.  By that I mean, when something triggers the hurt, whereas in the past, the arrow would hit straight home and knock you for six, therapy helps you see those arrows coming and they no longer hit the target but fall short so you can see them there clearly in front of you for what they are.....usually somebody else's failing, not yours.  So whilst you can't stop the triggers, you can learn to stop them hitting the target.  It works, honest.

As far as your pleasures, it is quite usual to enjoy the company of your cats and the garden.  I think many people feel like that.  Animals don't question us, don't make us feel guilty, don't judge us and don't put on pressure....unless they want food!  As for nature, that too is soothing and there is some evidence that the colours of nature are therapeutic.  You might try spending some time outside and potter in the garden.  If you have enough drive, you could volunteer in a national trust garden or to work in animal rescue a few hours a week.  The other thing that is great for depression is horse riding.  It totally absorbs you mentally, emotionally (horses work on heart) and give you some much needed exercise.  So if animals and plants help you feel good and you can find it in yourself to go and get involved with them, draw on that strength.  It'll also keep you away from the shops.

On the subject of the shops...cut up that credit card!  This is just adding pressure to yourself through guilt and ultimately will piss your husband off big time and you are smart enough to know all those purchases won't make you feel any better.

I'm no doctor or therapist but I can share some of what I've learned along the way and hope it is useful to you.  I hope he Efexxor does provide the solution but, if not, don't despair or give up on therapy.  Just find the right person.  If you need help to do that, ask someone you trust to come with you.  As I don't know you, I hope I haven't said anything untoward, if so, I apologise in advance.

Good luck Sandra.  You seem determined to fix it and that is a very very good start.  Keep us posted if you want to.