Shall I go up on venlafine ?

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Hi. I'm wondering if anyone can help me. I have been taking venlafaxine daily for 10 months. 75 mg in the morning and 37.5 evening. They have helped my anxiouty tremendously. My anxiouty was very high before. Afraid to leave the house and generally feeling very anxious through out the day with my confidence very low and unable to sleep. The dizziness was horrible. All this has subsided greatly. And although I do feel much better and am able to enjoy life fuller. I still have days when I feel anxiouty leaving the house and unsteady on my feet as I'm so self conscious. I still worry alot about my anxiouty becoming worse again. Having children this made my situation before very difficult. I'm usually happy but don't have much motivation. My kids are in full time school and I am looking for a job. Which is difficult working around my children when I eventually do. So as you can imagine I do have alot of spare time on my hands. I'm wondering if I need to go up or its just my situation. Thanks. Any advice is very much appreciated.

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  • Posted

    Hi Joanne,

    I've been on Effexor XR now for 14 years. I started out on 75mg but nothing worked for me until I was on and still on 450mg a day and 12 mg of Edronax a day, (happy pills), so your level could be higher or nearly right now.

    I not only had major depression but bad bad anxiety, but once the dose was right, it made my world a whole lot better. I'm trying to lower it now because I think I'm ready. I might have a broken, she left me marriage but I'm so much better and life is good. Just need a partner now.

    Hope it helps

    Warren G

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  • Posted

    Hi, actually it all sound great at this point. You have responded to your therapy progressively. Having goood and bad days is normal for everyone and especially magnified in people with anxiety disorders. Because when you are having a bad day it becomes intermingled with memory of how bad you were at your worst, fear of relapsing into how it was etc. You are still in early therapy. It is not medication that will retrain your brain into healthier patterns on its own. It is a matter of accumulating positive experience and more confidence with less fear of your past condition. Every little feat adds up slowly and your brain starts to rewire. So for instance, if you manage to leave the house and not fall apart a few times, a new route is formed in the brain over time. You feel more confident that the likelihood that you will be just fine is greater than that you won't be fine smile

    Therapy will therefore take some time and during this, medication will force a better balance in the brain that will make it easier for you to reach a more comfortable state eventually.

    Your situation is stressful, due to fresh memories of 'falling apart', children to look after, preparing for added responsibilities, getting used to not having 'me' time and feeling pulled in various directions. If you had more confidence and a healthier drive, you would balance better and feel more in charge. This will come.

    Your doctor is in the best position to judge whether you are stagnating or continue making gradual progress. Provided your doctor is a licensed psychiatrist and not just a GP. Generally, if no notable progress is made between visits, psychiatrists attempt a small increase to try boost things a little. What does your doctor say?

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    • Posted

      Thankyou for your reply. And it makes perfect sense as I do feel myself gaining more control in situations. I guess the fear is the worst problem I have, and in time hopefully like you have mentioned that will subside. The Internet doesn't help when I hear stories of people's medication not working anymore, I guess this is my biggest fear.

      I have not spoken to the doctor yet as I would prefer not to go up on my medication. I had a bad reaction in the past with sertraline. Because of this I tried to cope without medication through fear of further bad reactions. This only made my anxiouty worse in time.

      Thankyou again. Your reply has helped me alot. ?

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    • Posted

      Just know that you should not worry about upping your dose if needs be. It is better to go a little higher if deemed necessary since you are already on meds and get balanced out faster and more thoroughly, than undermanaging a condition for a prolonged period, which is what usually results in failures that you read about. In your case, the drug worked and if used correctly at optimal dosage it will continue to work. In that sense also, a dosage that is a notch higher than the first therapeutic level is usually a safer bet than staying on a smaller dose with partial results. With these disorders, the sooner they are countered and the sooner optimal dosage is discovered (and the longer the balance is held - typically minimum therapy should be no less than 4 years in total for moderate to severe cases), the easier the recovery and smaller the chance for relapse after therapy is over. Once the therapy is done, we pick a relatively calm period in our lives to start a very gradual taper. We hold each dose until long after any discomfort from the drop ceases and then cut next dose etc.

      Have you been sleeping well? Eating well? Normal digestion? Have you been able to laugh at a funny show or something you heard/saw?

      How brain retraining works normally is assessing your ability to cope with daily responsibilities and progressively figuring out better approaches to how you manage your tasks, emotions, needs, preferences. Diverting focus from negative beliefs/expectations to positive ones or proactive approaches that would better help you cope with any of the above where there is stagnation or fear. Finishing unfinished tasks (aids confidence and gives you a sense of accomplishment that are very motivating). Daring to do things you may have been avoiding (Starting very very small and working your way up - this is progressive desensitization). Finding pleasure in some personal and social activities - not necessarily the same ones you enjoyed before you developed anxiety disorder - you may have developed new interests since: play with various ideas. Being able to effectively express yourself and working to relieve or resolve any frustrating situations that may be holding you back. Generally getting creative about improving your quality of life, sense of well-being and overall balance of responsibilities, needs and wants. For the acceptance of each thing you can't change or don't have influence over, find one big or small thing you can actually change or do something about. Look at it as replacing faulty things in the house, servicing a car or something - whatever analogy works. You can actually adjust things to be more comfortable.  

      Hope this gives you some ideas on what you can or should expect from your therapy and how to optimize your recovery.

      Have an easy journey and don't worry about balancing it all in your life. One way or another you have done this all while falling apart so i am pretty sure you can while coming back together smile Perspective is everything! xxx

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    • Posted

      What you just said is very motivating and has really put things in a better perspective. I guess I have been spending more time thinking what if, rather than being positive and trying new ideas.

      I am definitely more my self. I'm able to enjoy life and laugh and do the things you have mentioned.

      Again thankyou. I will put your wise words into practice.

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