Restarting venlafaxine(effexor) made me more panicky and headache

Hello. I've read your inquiry. I'm a retired medical professional and try to provide assistance here as time permits.

Realize that Effexor is an SNRI, or Serotonin Norepinephrine Reuptake Inhibitor, more generally prescribed to treat clinical depression. Of considerable importance here, the norepinephrine component can also be thought of as the equivalent of noradrenaline. Norepinephrine is the most common neurotransmitter of the sympathetic nervous system and, in particular, is responsible for its role in the body's fight-or-flight response. This response is the main driving force that underlies Panic Disorder.

Realize that Effexor is a brand name for venlafaxine hydrochloride, also used to treat low blood pressure.

The point that I wish to make here is that if you suffer from Panic Disorder then using an SNRI is not typically recommended for several reasons. While increasing the onset of panic episodes, it can also elevate blood pressure, which is of particular concern if patients already suffer from either primary hypertension or paroxysmal hypertension as it relates to spikes in blood pressure that are related to panic episodes.

While my intent here is not to challenge the decisions by your physician, it is vitally necessary to determine whether use of Effexor is resulting in rather dramatic elevations in blood pressure that may potentially be responsible for some of the symptoms you describe. In any instance, I would suggest that you promptly contact the prescribing physician to determine whether this medication is resulting in both exacerbation of your panic episodes, which is quite likely, and to measure your blood pressure to make certain that it is not producing any remarkable elevations.

Lustral is a brand name for Sertraline, an SSRI medication that unlike Effexor is a Selective Serotonin Reuptake Inhibitor. It is most typically used to treat variants of clinical depression. While the manufacturer of these particular medications also make the claim that certain SSRI medications are effective in treatment of Panic Disorder, the evidence is both mixed and quite limited in the number of studies being used to support such claims. In general, realize that SSRI and SNRI medications produce an up-regulation of the neurotransmitter serotonin and in the instance of SNRIs, also produces an up-regulation of norepinephrine. The increase of these neurotransmitters is designed to elevate mood and energy that generally makes a person feel good.

While the up-regulation of mood and stimulation in general is the proper direction to proceed in persons with clinical depression, it is very often the wrong direction for patients with generalized chronic anxiety and Panic Disorder that most benefit from medications that calm, rather than stimulate, the nervous system. The combination of Lustral and Effexor would generally be of particular concern in patients with Panic Disorder. I see no mention in your post that you suffer from any variant of clinical depression.

I'd also like for you to describe your OCD and whether it was clinically diagnosed by a specialist. I ask because in all instance of actual OCD the presence of a compulsion must be present that suppresses the obsession and it is the compulsion, the the obsession, that causes patients to seek treatment because the compulsion interferes with daily social and/or occupational function. In other words, can your describe your obsession and consequently the compulsion that you are experiencing? Doing so would better help me to understand whether, purely in my opinion, whether you are actually suffering from OCD or alternatively whether the intense ruminations that accompany significant generalized anxiety and Panic Disorder are possibly being misinterpreted as a component of OCD.

Again, my discussion of your medications is not intended to challenge your physician's treatment plan but merely to provide you with information such that you can discuss it with your doctor, along with the troublesome side-effects being described, in order to obtain positive effects in the absence of detrimental side-effects. It is also quite common for medications in this class to require change until the right type of medication provides the intended relief in the absence of any negative impact.

Hope this provides help.

Best regards