Venlafaxine Changes

LOL who is prescribing this to you? 300 divided by 2 is 150. This is the dose you are actually receiving and meant to be receiving unless they want to up in which case this is not really how you do it. You can try to ask them to drop to 150 mg XL and up only if needed. I am really surprised at how this is being handled. XL is taken 1 time per day at the peak dose of your previous regimen...which was 150 mg if total you took was 300 mg immediate release in a day. At the most they can give you 150mg and top it off midday with immediate release boost of 37.5 or 75 IF they want to test your dosage reactions. Good luck.

Thankyou for this information, I take it that what you are saying is: 150mg of Extended release is the equivalent of 300mg of the 75mg immediate release tablets. ? That is why we feel terrible, we are overdosed ? I have just called pharmacy and they say the dose is correct. However, the 75 mg immediate release are back in stock ! The pharmacy said they go by what the GP prescribes. Well , the GP's and pharmacys are both getting it wrong then ! I have read far too many cases of people feeling awful because of the switch to XL ! We All can't be wrong ! I don't know how you know about the correct doses between the Two medications, but it makes complete sense to me now. I came Very close to losing a friend because of my odd, out of character, behaviour. I was unaware of what I was being like until it dawned on me that I was either Up or Really depressed . The same way I was when I forgot to take Any of my 75mg tablets for about 2 weeks because of life changing events. Didn't realise I wasn't taking them..long story . However, I'm not going through This again. Going to plan with GP to come off Venlafaxine. It's not the 1st time this medication has Vanished. Thank you again.

According to the prescription advice from manufacturers' your GP is correct. Experience showed otherwise. While it would be unfair to say we are looking at a double-up, it still amounts to more than what you have been getting. How I know is based on personal experience. The same was done to me until my psychiatrist decided to use common sense and switch me to 75mg xr after 2x75mg IR. after a week or two of that he pushed up using IR (adding another 37.5 IR to ease me into more appropriate doses for my case. I had ZERO issues this way. Getting the full force of 75 mg over the first 12-15 hours cannot possibly equal 37.5 peak at 5-6 hours. and then topping it off with another 37.5 at night again does not make 75. It remains 37.5 magnitude because the drug is so readily absorbed (small amount) and so readily excreted via the renal system. The premise that 75XR equals to two times 37.5 IR is mathematically inaccurate. AGAIN, not double but not far enough from double so as to not cause a (temporary, at least) overload. 

You can even out on your prescribed levels with some patience. But the wisest course of action if you are not managing is first to try a lower dose with your doctor to see how you feel rather than replacing with a new agent now and messing up your chemistry even more.

Thank I took that advice. Pushed thru a pushy receptionist that would only reiterate what 1st doctor had said. Wld listen 2 how I was feeling....mentally & physically. So glad 2 say normal prescription has been given & taken...thank u again. 

Glad you got help. I was bit scared to call cos of Receptionists attitude in past. This time I got a nice one and I'm getting new precription. I am definately seeing GP about coming off this now. Not the 1st time supply has vanished. Plus the side effects of forgetting to take them are Awful! I noticed I forgot them when there was a Change in my life routine. Dont know why really, but when I forgot 1 or 2 tablets, I forgot completely for 1 to 2 weeks and it's bad. So, whatever you do, set an alarm, if you dont already, to make sure you take your tablets. Ive now done that. Take care.

Woops, I missed this comment. You were told to ride-out the side effects? That's not good advice. No the XL is not for me either. Something isnt right about it..whether it's overdose.. or whatever else it could be.but it does make sense that it probably is that.

Mmmm, no chance 😊 going back to IR tablets then going to ask to reduce and stop the Bleeping things..forgetting them was bad enough and put myself on a strict Remember-it list + alarm to remind me. Then they go and stop supplies. Now my friends think I'm..for want of a better..non PC word ..think I'm Crazy because of erratic behaviour etc.. I want off it and I'm going to do it in new year, with Doctors help of course.

Hi, it has taken my befuddled brain a while to fully understand how I could be over dosed. I worked it out this way. 300 mg a day = 12.50 per hour Max!

XL 150 mg over 24 hours = 6.25 per hour . But I was given 2 tablets to take 12 hours apart Therefore after 12 hours it becomes 12.50 mg per hour 12 hours later it becomes 18.75mg per hour ! Which is Far more than the Max 12.50 for 300mg an hour on XL ! I assume therefore, this is what you meant ? No wonder people have been feeling so awful ! I see how potentially dangerous that way of changing from IR to XL could be now. Not been thought through by Doctors. Thank you again for pointing this out. I will be pointing it out to the Doctor .

Lol close yes. Plus The elimination rate is different for XL. Slower. When you take two separate doses of XL you make it even worse because it is not designed to be taken that way. After about 3 days, when you reach steady concentration level you begin to actually overdose due to that combination of factors. Immediate release punches at peak after about 6 hours depending on your metabolic rate. So when you take your second dose you simply restart the process from close to baseline back up to peak at 150. XL peaks at 150 mg concentration but it does so after 15 hours on average. You take one more you are going to be over 300mg by the end of the 24 hours. Not double but certainly more than 75mg again largely depending on your metabolism.

Doctors go by pharmacologist (and manufacturer) advice. And this kind of switch to 'equal' dose is doable. But usually not well tolerated. I was confused with the study that justified this. They found better results on extended release compared to control groups of 'equal' dose immediate release and a placebo group. Then I realized that extended release did better in the long run because dose was higher and because the release was steadier. But that does not mean everyone needs a higher dose when switching from immediate release. The difference for me when psychiatrist recognised overdose and adjusted was astounding. He used immediate release top-ups to my XL as dosage tests and tweaks and then adjusted my XL prescription once consolidated. A world of difference...