Venlafaxine
Posted , 2 users are following.
Hi all, I've suffered from anxiety and depression on and off for 23 years and currently in my 6th relapse which has been worst so far.
The anti depressant I have found the best for me is Venlefaxine however 3 years ago I was taken off it as I'd reached the highest dose and wasn't getting better and switched to a tricyclic clamipramine and Olanzapine.
Following a bit of a dip in my mood I was switched to Brintellex and continued with Olanzapine, anyhow I didn't improve although my anxiety disorder was under control and caused little if any problems my psychiatrist took me off Olanzapine and with a couple of bad decisions with work my anxiety kicked in.
I was put on Quietiapine but that hasn't done anything so my new psychiatrist has suggested I go back on Venlefaxine as I've had a good 3 year break from it, has anyone else been put back on an anti depressant they had previously maxed out on? My psychiatrist has said that AD's don't just stop working and he assures me it will start to work for me.
Ven has gotten me out of periods of anxiety and depression before and with little or no side effects as I recall so what experiences have others had with this AD?
Im hoping it will help me again, my therapeutic dose is 150mg.
Any advise, words of wisdom, experiences especially good ones will be welcomed.
cheers Neil
0 likes, 4 replies
johnkov Aspinan
Posted
I feel like you did not provide enough information to answer the question. Anxiety and depression are rarely treated with antipsychotics as most psychiatrist believe that the associated risks (weight gain, elevated prolactine levels, tardive dyskinesia) outweight the potential benefits of such therapy. Was there any other reason for using olanzapine? Delusions? Intrusive thoughts? Abnormal thinking patterns? If you did not have any of these symptoms – were other potential ways of treatment explored (tricyclic antidepressants, MAO inhibitors) prior to antipsychotics?
Regarding venlafaxine, the maximum daily dosage is 225 mg, but at this dose it is not selective anymore, which means that it affects the reuptake of all three monoamines (serotonin, noradrenaline, dopamine). Considering this unique dopaminergic action, I can see how a psychiatrist could be tempted to try an antipsychotic (which affects dopamine receptors). Whether this was a good thing to do – I cannot tell, but there is a clear difference between the reuptake inhibition (venlafaxine) and being a receptor antagonist (antipsychotics).
Will venlafaxine work for you again? Only time can tell. However, I can see no reason why it should not work. Some patients have been using this drug for many years with great success, it should make no difference whether you took it previously or not.
Aspinan johnkov
Posted
Hi Johnkov, what a great reply, thank you so much! I suffer from classic GAD with depression, nothing more complicated as that really.
The psychiatrist had bumped me up to 325mg of Ven but didn't really give me an explanation as to why he'd put me on Olanzapine also, one of the symptoms I was displaying was a pre occupation that I had to leave my wife to get better, i as very ill and as I wasn't getting better so he switched my AD to Clomipramine and after a few weeks I noticed an improvement.
My new psychiatrist wants me off Quietiapine which I was put on a couple of months ago rather than change AD's despite me wanting to change AD and wants me back on Ven which I'm happy to do as I have some confidence in given its previous success.
Thanks again for the rely it's very much appreciated.
Neil
Aspinan
Posted
I've also a hunch Johnkov that my new psychiatrist will put me on 37.5mg twice a day to start with when the NICE guidelines for anxiety state 75mg once a day.
I'll take this up with him if necessary as I'm sick of my recovery being prejudiced by them, for example when I started Quietiapine the guidelines stated starting at 50mg and working up to the therapeutic dose of 200 over a period of a week but they only titrated me over 6 weeks even though I pointed the above out, I could have been back on venlafaxine weeks ago.
I spoke to my care coordinator and asked whether it was a good idea to start titrating down on my current AD ready to start Ven but she said no so I'll be annoyed if I have to start to do that starting Friday! I've already decided I'll halve my dose tomorrow as I'm not going to be messed about.
johnkov Aspinan
Posted
However, if (and this is a big if) venlafaxine did not work, I would recommend trying tricyclic antidepressants (e.g. amitriptyline) or MAO inhibitors (phenelzine) prior to antipsychotics... If your psychiatrist tells you that antipsychotics are good for GAD/depression... well... see another psychiatrist.