Should I Start on Venlafaxine?

The length of my therapy is proportionate to the level of my disorder as well as the amount of time in inadequate therapy. Most people I know, who were functional, took no more than a total of 2-4 years for the entire process. I even know a couple who were done after about a year and a half (full process, therapy, maintenance and taper included) In case 8 years sounded scary to you.

Thank you so much for your response, I always appreciate reading what you have to say. I feel more encouraged now, it certainly seems like there's a bias here and it's nice to know where that bias comes from.

The duration is one of my bigger concerns. It's scary that going on this drug is such a commitment. What happens if it doesn't work for you? Or if you make strides in therapy? It seems like then you're already committed to Venlafaxine and have to endure at least another year of tapering off when you don't need it. Kind of sucks that it's not a drug you can easily try out.

Still, your success story gives me lots of hope. I'm glad it's worked out for you. I have a question - when you say therapy, are you referring to talk therapy? What kind of therapy was it?

Throughout the 12 years, well those fateful first 5...I have been to clinical psychologists for evaluations, to CBT, to psychoanalysis (something I do not recommend until one is stable enough to deal with crap that comes out...). Various therapists tried to warm me to talking...which was pretty stupid because I am so open. Some tried to get me thinking...which didn't really work because of all the noise in my head at the time. One tried hypnotherapy only i found him so agitating I couldn't actually go under. Eventually, after meeting my final doctor I was told that there is no need for 'therapy' other than stabilizing me with drugs. I was really offended. But over time, his matter-of-fact grounding and unobtrusive presence and stabilizing effects of the medication made it clear what he meant. I was perfectly capable of going through 'therapy' on my own. Did  not need a sounding board or retraining. Once drugs took hold I started picking myself up very naturally. He later elaborated that talk therapy is great in combo with meds for most. But that my case was purely psychiatric and that otherwise, psychologically i was actually sound. It no longer matters whether it was years of stress or repression that caused me to eventually cave and malfunction. Once I came to, after about 8 months on medication, it all started to resolve. So my therapy was purely chemical. My psychiatrist was there for occasional reassurance throughout the process. What works for some does not work for everyone. But I think it is safe to say that at the onset of chemical therapy for any advanced disturbances it is a good idea to just let it be and leave the digging and prodding of various therapies for 6 weeks into medication, i.e. after adjustment. Now that I am done with meds i have been toying with the idea of going back to psychoanalysis to dig around a little and get to know my subconscious driives a bit better - as a means of further growth and strengthening, not therapy per se...but after my initial experience I am a little wary LOL

If it doesn't work for you it will be painfully obvious pretty early on - the first 3 months or so. Even if it works at first and then plateaus, as it happens to many, the taper is not slow in these cases. You are taken off rather speedily, sometimes a bridge is given to help ease the worst of it, either in the shape of a different antidepressant like say Prozac OR with the addition of a temporary crutch like any of the diazepines - typically alprazolam (xanax - which works great at lowish but steady doses to see you through). The latter is tapered off as you start and stabilize on the new antidepressant your doctor chooses to try you on. Pretty straightforward actually. The comittment is notable for those for whom it works. not those for whom it does not.

Now, for once you are well, you will no longer care that your taper is painstakingly slow. Bear in mind that a relapse following premature or hasty discontinuation feels about 10 times worse than the original problem youu came with...and takes longer to treat. That in itself should be kept at the forefront of one's mind when 'enduring' a painstakingly slow taper following successful therapy. I think so anyway And i tried both. The relapse after my first arrogant hasty AND premature taper was pure hell. I never want to feel that way again if i can avoid it. The easy comfy long taper i had upon proper completion of therapy...walk in the park.

I think people about to embark on any kind of psychotropic therapies are so distrustful and wary of being 'ruled' by the drug. Over my  years of therapy, after escalating to psychosis, i remember getting increasingly agitated with those helpfully suggesting that fresh air, some exercise and a holiday (I can't afford) should help me feel better and not need drugs. Eventually I became mouthy and used to retort: I will cut meds once you get pneumonia and cure it with fresh air, exercise and a holiday. I was very sick. I had also just become a mother. Drugs I repeat do not change who you are. They give you a break, calm your brain's jitters down and give you space to regroup and ideally rebuild any faulty responses and coping mechanisms. If you have tried, really tried pulling through on your own, buut you continue to worsen and your quality of life is declining or non-existant...drugs are the least of your concerns.

There are plenty of options. If you are uncomfortable about venlafaxine in particular, raise your concerns with your doctor. There are many other drugs as well. Citalopram is pretty good for depression and anxiety too. I find it less potent but definitely worthy of mention. plenty of others too.

It's interesting that the drug seemed to have solved the problem by itself without the addition of therapy or anything else. My plan was to take some medication for a temporary boost while my therapy, which is pretty psychoanalytically oriented, comes more into effect. I also have my graduate program which adds another layer of psychological stress. I'm training to become a therapist and it's quite difficult learning about depressive symptoms and the potential underlying unconscious causes.

The first few months of the drug are kinda scary. Seems like if it doesn't work, your life is kinda hellish for a while until you can find a drug that's more stabilizing.

With the taper - definitely I plan on following instructions pretty closely. I've read more than enough anecdotes to sway me away from going cold turkey.

Another thing I'm realizing is it's so hard to discern how depressed I am. I read all these stories like yours and am not sure how much the depression affects my life. If I start taking the drug, will everything just seem clearer?

That seems to be the nature of depression - it's so ingrained in my personality, it's hard to notice it and do something about it. No to mention I feel such strong opposition. What if I take it and become someone else? What if it messes me up for a few months and affects my performance at school? What if I could get by without taking it?

I know I've got a fair amount of anxiety at play, too. Certainly would be nice to have that cooled down a bit, too...

"My plan was to take some medication for a temporary boost while my therapy" - Absolutely! I only mentioned it because you asked. My case is not comparable. I had monster GAD without many regular depressive symptoms except the sense of dread my case was labelled "purely psychiatric". Most people are in fact encouraged to follow some psychotherapy while on medication for best results. I was too until it was obvious it was only making things worse. I would just experiment a little with different therapy approaches to see what works best.

Your life on the wrong drug or dosage is only as bad as your condition...ok plus some adjustment disturbances

You are training to become a therapist!? That's awesome. Perhaps through your studies you will be liberated of the uncertainties you are feeling. You have plenty of time to try something, fail, try something else.

If I understood correctly then, your most prominent symptoms are depressive (lethargy, de-motivation, inertia?) with some anxiety that you describe as feeling of dread? How is your sleep? And have you had blood tests recently? Just to rule out any anemia, thyroid dysfunction, mineral imbalances first etc.

haha "If I start taking the drug, will everything just seem clearer"...well...not sure about "everything". But what will become clearer is whether it works or not and perhaps also whether you need it or not.

Gauging how depressed you are (and may I add - while at the same time digging with psychoanalysis to establish why you may be depressed is difficult for most. Especially if they don't have someone there to see/point out the difference between how they were when "well" as opposed to "unwell"... And then there is the change that takes place as we grow older that sometimes, if we were not paying attention, makes it difficult for us to identify and comprehend this older version of ourselves that comes with own needs....well...lots to discover...you get the idea. That all leaves you to pretty much guess if this is your "normal" or not. By rule though, if you are feeling very demotivated/inert and you want to accomplish more but can't - it is enough to make you look for ways to find your best path for growth. Be it therapy, medication or getting really upset with yourself to push those limits that are somehow imposed upon you by your mind.

There is no scientific, exact solution. Even medicine as a field is not always an exact science. You are a unique individual and your wellbeing, growth and progress depends on you. Great responsibility, one that is imposed on us by birth. Coping mechanisms and skills however are not always delivered alongside our bodies and minds...Unfair, but for those up for the challenge it can be liberating getting those components to cooperate and collaborate. Leave no stone unturned is what i suggest! And take yourself lightly. Laugh at yourself. It is all a process. And your current predicament is surmountable. EVEN if your entire life these responses have been engraved by your psyche or your environment, resulting in you feeling that it is 'so ingrained in your personality'. Sure, I mean...make room for the quirks of your personality, but see what you have there to work with that will make you feel more comfortable with that personality

Do let us know how it goes. Whatever path/s you embark on!

Hi Purpledobermann,

I'm wondering about your comment about Effexor plateauing- how common is that? I'm entering my 4th week and feeling a little better but am worried what I will do if this med doesn't work. Lexapro pooped out on me. I always had the impression Effexor was highly effective for most. I did take it 3 years ago and it did work for me after about 1 1/2 months (after working and pooping out the 1st week and then the 2nd week) Id really appreciate any insight!!! Thank you!

I don't think it is as common with Venlafaxine as with many others actually. If it fits someone, i.e. if positive results are seen after adjustment period, 6 weeks or so, and consistent, though usually slow, progress is noted, then it tends to work rather well long-term. And by long term i am referring to prolonged therapy in excess of 5 years. It is a very good medication. If it starts to poop out, often a single dosage adjustment brings it right back into action. It is different for everyone, but there is something about Ven that is unmistakeably persistent . Out of interest, what dosage has been attempted for your adjustment now? And what dosage were you on 3 years ago? And what has it been prescribed for? Clinical depression, GAD or other?

Purpledobermann,

Thanks so much for your response!im being prescribed 150 for MDD(which mainly presents as major anxiety for me). I was on 75 for a week then moved up to 150. I'm now in my 4th week of 150 and have noticed improvement over the past few days. Less anxiety and feeling like crap. Better sleep. Still have waves of anxiety and feeling awful but better. 3years ago I was prescribed it forge same thing with a different doctor and she would increase my dose each week-!ended up at 225. My doc now wants to give 150 4weeks before moving up. Thanks for any insight. Hope you r well!

...be grateful for the new doctor. 4 weeks between shifts is definitely better. Effexor takes its time and patience is a must. I do hope you continue to feel better slowly but surely. Apologies for being nosey, but what happenned 3 years ago? Why did you stop? I mean therapy for any advanced level of depression or anxiety must take longer than 2 years. At least 4 actually. 

Hi my dose started with 75mg and stayed that way throughout until I wanted to finish then I only had 37.5mg for 4 weeks. My condition was anxiety depression

3 years ago I was being treated for MDD after my lexapro pooped out-doc added Effexor. She kept increasing to 225and about 1 month later I felt better. She never stopped the lexapro so I was on both. I was scared of effexors discontinuation syndrome so I weaned off that instead of the lexapro. It was weird because I was ok for almost 3 years with just the lexapro until it pooped out again now. So now I'm hoping the Effexor will work again! Thanks for sharing what u know about this stuff. It's so

Oops

So helpful

This answer has helped me so much. I've resisted drugs for over a year thinking I can get better myself. I've finally accepted I need them and am just up to 225 of ven

Hi Anne. Some people can get better on their own. My psychiatrist says everyone can eventually. But there comes a point when it makes no sense to keep struggling. You do not lose your power by taking drugs. In fact it is your inner system that facilitates recovery and not the drugs themselves. Drugs are a temporary crutch, a stabilizing agent. They force some balance in the brain's responses while you re-learn how to cope and pick up the pieces. We are lucky to have the option. Watching myself escalate from just being a little high-strung, to GAD to constant state of panic and finally psychosis...well....I am grateful to have had the option of taking the drug. In a different time, I would probably have been labelled as crazy and locked up somewhere. Now I am a mother of two, have a carreer and enjoy life. As a bonus I also have a much better set of coping skills and mechanisms for the messier parts of that life. And I am no longer afraid of everything. More self-aware and better able to look after myself and my loved ones. In a weird twist, you see, medication helped me regain a sense of control, while I expected it to render me useless and feeling weak. It is all about perspective. And some luck - luck in finding a good medication that works for you. Because there are no guarantees. 225 is notable. Depression or depression-anxiety? I hope the dosing up was gradual. Hope you feel well. x 

I was actually prescribed ven for 20 years by my GP on a repeat prescription, I'm angry about been left on it and for the past year have been trying different meds, I have depression, anxiety and ADHD so it gets confusing

oh my....I hate GPs prescribing psychotropics...with a passion. They can cut it with straightforward therapies but anything more complex ... people should really steer clear of them and be followed by a psychiatrist. What a mess. 20 years on any agent is enough for you to not really know what your 'normal' is like. And for any new doctor to have a tough time determining. Well....besides venlafaxine are you given any sedatives as well?

No but I take Buspar for anxiety, it doesn't seem to do much really, also take Concerta for ADHD but can't see it helping much. Fed up now after a year and you're right I don't know what my normal is