Start up side effects advice needed

Sorry for the late reply Ann, the start up side effects were pretty strong with these. I had everything that was listed. Drowsiness at start, heightened anxiety, then depression and spells of crying and I don't suffer with depression, I have GAD. My stomach felt emotionally vulnerable. I had the sweats and migraines plus many more. Most antidepressants make your worse before better. I've been on 150mg for nealry 3 weeks, The strong side effects lasted for about 2 weeks but then I felt that things were changing. I've had 4 days were I felt things weren't that bad, I had motivation to do things ish and signs of not worrying and spells of my confidence and happiness returning until today that is. It hasn't been terrible today just heightened anxiety and low motivation but I know it just the tablets levelling out. Tomorrow will be different. Hope this helps

Hi thanks so much for reply.  I can deal with symptoms except the heightened anxiety, the diazepam doesnt touch it.  Anything else would help it till it goes?

Hi Ann, have you tried mindfulness to help you through until the tablets kick in? How long have you been on the tabs for now and at what dose? The heightened anxiety is a pain but it will subside. Just think to yourself it's only the tablets. I'm at 3 weeks tomorrow and today was another good day for me in comparison to the last 3 weeks. I'm not fully 100% and I may need to increase again but I've seen a big improvement.

Diazepam did not touch it for me either. My psychiatrist put me on alprazolam (xanax) three times per day for a few weeks to aid in adjustment to venlafaxine before slowly phasing it out. After the first few days on them I began levelling out nicely and once it was phased out i never looked back. He insisted that steady levels would help kick-start therapy and I have not regretted it. I remember doubting him at the time but he really helped pull me through.

rationalizing through the roughest patches helped somewhat. Saying that it is only adjustment disturbances and not worsening as my doctor reassured me regularly. Another helpful thing he said was to not sit through anxiety spikes, but do something tactile and automated like washing up, repotting plants, gardening, cleaning. This helped through all major attacks. Helped the brain unwind in minutes. I was pleasently surprised. Normally I would just sit and wait for spikes to pass or cry but redirecting brain and body did really work. x

Yeah I've been having the same. I was feeling so good yesterday daytime, I woke up with more energy and then all of a sudden boom! My anxiety came over me yesterday evening and today I've woken up with less energy and heightened anxiety like I'm starting all over again. I know it's just the tablets levelling and your right you just need to keep your mind occupied as best as you can. You do start questioning things due to the anxiety and thinking it's not working but I know I have to give it 6 weeks before I can fully asses if I need to increase again. I'm on the immediate release tabs also.

I m the same. Up and down all over the place. One minute calm then anxious then crying but do feel better overall. I m on day 17 on 150....nearly 6 weeks since I started on 37.5.

I do have a poorly baby so that won t be helping and as I have to hold him all day it is hard to use distraction techniques.

I ve heard people say it can be 3 months. I see my psychiatrist in 2 weeks and I think she will want to put it up but I d rather give it 6 to 8 weeks on this dose.

I don't remember if I asked before, but how old is your baby sarah24378? Any condition aggravated by post-partum issues can take longer to respond to treatment.

Within 2 weeks it should be clear enough whether you have made gradual progress. Most psychiatrists will, in early therapy, attemp to push the dose up even at a dose that seems to be working, to assess whether they need to go higher or not. If the dose is too high you will know (different kind of sensation) and they will fall back to last comfortable dose. I want to say 'trust the process' but knowing how anxiety feels and how trusting anxiety sufferers are...I am laughing out loud as I am toying with the phrase !!!

I hope your baby gets better soon and that it is just a transient issue for him/her and also for you! x

 

My son is 1 on sunday. His illness will pass.

I do have pnd. So do you think I should go up in 2 weeks ?

Your doctor is a psychiatrist (thankfully not a GP) and only for that reason  I would say that if he/she wants to bump it up a little more I would not be aversive to the idea. By this time you would have been on it for 4 weeks at 150mg.

I remember mine upped dose before I was ok with the idea but my system reacted to it over the course of the week so he calmly pushed it back down to 150 and it was smooth sailing from that point pretty much.

What I do know for certain is that the later that treatment is started with PND the longer it takes to reign in.

My condition worsened rather notably after delivery and within 2 months I had psychotic episodes for the first (and hopefully last) time in my life. PND is a monster. I had anxiety before this but it was a walk in the park compared to what I went through after having my first child. People think of PND as post-natal blues. Mine were no blues. There were no blues at all bar immediately after delivery. It was terrible. I had my 2nd child after finishing treatment and although I was told I should do a preventive course of venlafaxine after delivery because my chances for another episode were huge (like 50-75%) ... nothing happenned at all. It went perfectly the second time around. I was relieved to say the least LOL.

I also had a anxiety prior to pregnancy but nothing like this. My anxiety was untreated then when I fell pregnant I became I'll very fast. I was immediately given a psychiatrist and had a CPN. They tried some meds that were safe in pregnancy but they did not really help....maybe the low dose of mirtazapine to sleep. I was very unwell and under crisis team a lot due to suicidal ideation....never been depressed before and anxiety I did not know was possible. After I had my son I was better than expected and did not need to go to a mother and baby unit. They increased the mirtazapine. At about 5 months I deteriorated and they tried adding in citalopram. I got worse over the next 5 months and ended up at a and e as I did not feel safe. It was at this point I was changed to ven. So have had treatment from pregnancy but not been effective. I also have had therapy but that did not help.

PND is a life threatening illness. I really hope the ven will help. Feel cautiously optimistic but still quite unwell a year out. I hope in the end I will be better than before as my anxiety will be treated whereas it was not prior to PND.

I'm sorry to hear you are suffering with a difficult time also. I'm also going to give it 6 weeks before seeing about increasing and I've been taking 150mg for 3 weeks. My anxiety is worried more about the side effects of increasing to be honest. I don't want to go through hell again but if I have to then I have to. My anxiety tends to move to my head where its difficult to concentrate and I have head pressure, then it will go to my body where my stomach will feel very nervous and raw and my heart rate will increase then It might go for a while altogether. Not sure if your having then same?

Yes much the same. I get dizzy and head pressure then start to panic. I am worse if I go out. My head does feel clearer at times though.

What a rough ride you've been on Sarah. I can imagine how you are reeling from it all now and how much you need to see the light at the end of it.  

I take it bloodwork was regularly checked throughout this ordeal and you have no notable imbalances either in terms of iron/anaemia or thyroid dysfunction btw?

Venlafaxine is a potent medicine. The only question is how well it will mix with your unique chemistry. Are you still taking mit? Are they planning on phasing it out once ven kicks in?

Notable ups and downs that you describe are very normal in the first 3-4 months of optimal dosage. However the intensity should be gradually but unmistakeably lessening over this period or the frequency of crises should become more widely spaced. One or the other and ideally both but let's not push it. Maybe you could make a note of this - perhaps like a journal where you just score the crises and duration on a scale or something?

For balance I remember very vividly the first day I sort of emerged from the state. It was about 6 months after starting ven when i woke up one morning and felt truly ok, looked at my child (who for a change was not crying to be immediately tended to and realized the danger I presented for her is somehow gone and the danger i presented to myself was also gone. I was so relieved and filled with optimism that day. Ups and downs persisted for a while after that but much milder and further apart until i reached a good equilibrium sometime around the two year mark, setting a good base for healing. It took another two years for all my abnormal anxiety symptoms to completely disappear (minor details) and then I was in maintenance for 2 years followed by a 2 year taper. Hope this helps offer some hope and also an idea of the timescale. Note that I was treated within 2 months of onset of PND and the first drug worked. So your timeline sounds regular considering that citalopram did not sit well with you and you lost time there. I was lucky in that sense. I wish you a fast turnaround and easier days ahead. Sending love

 

Thanks for you reply.

It is very unfortunate the citalopram lost time. Despite that I feel I am very slowely recovering from this nightmare. Yesterday afternoon I felt almost normal. The morning are the worst.

I do plan on tapering the mirt as i am on 45mg and I think that is making the mornings worse. I would like to get to 15mg initially. I also take 10mg of diazepam which will need tapering.

I have heard with pnd especially severe cases it can take longer for meds to work. As you can imagine I am scared of the anxiety a lot and very hypervigilant.

I am not anemic but have low thyroid.

I do score my days out of 10 so I have a record but with all tbe meds changes it does not tell me much as yet.