Venlafaxine increase

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Hi, I've just turned 18 and have been taking venlafaxine in many different combinations and doses for the last 6 months. For the last 2 months I've been taking 225mg XL prolonged release along with 3 other types of drugs. However, last tuesday it was increased to 300mg and since friday I've been feeling unbareingly low and helpless and had a slight relapse in symptoms. I'm starting uni and really cannot afford to go this down hill again but I'm finding it so hard to fight.

I just wanted to know if it could be the increase by 75mg which is causing my distress or whether it's likely to be unrelated?

Any ideas, opinions or personal experience would be massively appreciated as I feel so confused and upset about my mood dipping like this again. I know some days are better than others but the difference in my mood for the last 4 days has been massive and I don't know what to do.

Thank you so much for anyone who has read this and please please comment your ideas if you want to whatever they are!

Sorry for the massively long post I am just so confused at the moment!

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8 Replies

  • Posted

    An increase could well be eliciting a temporary worsening of symptoms and feel more like a relapse of sorts. However if this persists for more than 2 weeks or continues to worsen you must inform your prescribing doctor. Another thing to consider is the fact that you are about to start uni. This is a very big change and quite stressful. So it may well be a combination of adjustment to new dosage and a major life event. If only for the latter a bit of a relapse is justifiable and normal so don't fret too much. It will get better for sure.

    Having said that any increases should be minute, especially at your age. Perhaps you would have been better off increasing by 37.5 first, or at the very least taking 37.5 XL morning and 37.5 XL at noon to ease you onto this rather notable dosage of 300mg. You can discuss this with your doctor. Who is hopefully a licenced psychiatrist and not a GP (?).

    If you don't mind me asking, what condition are you prescribed this for at such dosage and what other drugs are combined with it? Manic depression? In case it is then it is understandable why you were upped by 75mg. Either way it will smooth out soon enough but if anything concerns you (say you feel like it is getting a bit out of hand or you start feeling very strange etc.) you should be able to get in touch with your care provider at any time hopefully? Are they available to you if you need to talk/consult? x

     

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    • Posted

      It is also worth mentioning that along with your major life event (starting uni) you are also at an age when hormones start to crash a bit following puberty. For predisposed individuals this also makes for a temporary worsening of symptoms. If it is any consolation. I also started therapy when I was about your age. Mine was for severe anxiety disorder (permanent state of fight or flight biggrin Therapy took a while but was successful ultimately. Wish you to feel better very soon.

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    • Posted

      I've been inpatient for the last 6 months and they tried everything they could think of and we finally found a combination which enabled me to be stable enough for discharge(as I was turning 18 and was very against going to adult ward).

      I currently take Lithium, Venlafaxine, Mirtazepine and Promethazine (no idea on spellings sorry) all in the evening for BPD(depression & stabilising mood), anxiety and PTSD.

      In the unit my consultant was medication mad and changed my meds so fast and to so many none of the other nurses knew what was going on so this is a relatively small change compared to what I had been doing however I was in a controlled environment so it was more understandable. Uni hasn't affected me that much I don't think as its really local so I'm living at home and it's not a very intense course as I needed more of a steady introduction back to education as I wasn't able to complete my A2 exams.

      I hope that's a bit more information..I'm just so worried this is me going back downhill.

      Oh, and no I don't have anyone to really contact as despite being discharged 2 months my new adult team still haven't given me a therapist, and I was only able to see a consultant after insisting so it was a one-off appt. They've been useless since I've been discharged but it was a surprise to everyone as we only had 2 days notice so I can't blame them.

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    • Posted

      I see you are minimizing your life changes, which is a shame. You may not realize it but you are at a turning point in your life. Why i think this is important is because you should feel relieved that there is a situational aspect to your worsening. Which suggests you are not going downhill, merely reacting to some major changes. You have been inpatient at a facility, where you had others do all the thinking for you, you are out now and frightened and you are about to start uni. It wouldn't really matter if uni were in your kitchen, you are taking on a new challenge. Anyone would find this a little overwhelming. Even if only subconsciously (as now you are mostly fixated on thoughts of whether or not you are coping) you are going through a lot of adjustments and a lot of challenges. You are also taking quite a coctail of medication, all of which interact to achieve a desired result. Any change in dosage of any of the meds are likely to set off some response. So again, I really think it is a combination of things adding up to some worsening of your symptoms and i think it is temporary.

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    • Posted

      Now, a major obstacle in your way is not having a firm support from the medical community. Because if you had a doctor to turn to you would likely feel a lot less afraid. You managed to see a consultant after insisting for a one-off appointment and it was this consultant who decided to up your venlafaxine if i am piecing it together correctly? Look, they had 2 days notice before you were discharged but this was 2 MONTHS ago. Anyone being given HALF the medication you are with half the diagnoses you have, absolutely needs to have a doctor closely monitoring, carefully evaluating and adjusting treatment. I don't know where you are and how it works but the first thing i think you should do and at the soonest is find someone who will listen and demand you be assigned someone to follow your case. This is no time for offhand interpretations at one-off visits of the kind of: well...she is feeling worse so i will just up this a bit and let someone else handle it. This is very irresponsible. Nobody should be upping anything except a doctor who is to follow your progress.  

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    • Posted

      Lastly, I would like to say you have obviously been through a lot at a young age. I can't even begin to imagine what happened to drive you to all the dark places you have already been to inside. But I do know that at your age you are especially vulnerable and that in time and given some sound assistance you can absolutely forget about going downhill again. Because you can draw strength from the fact that you have already been to some nasty places in your mind but you came out. And if you find yourself slipping up a little now, and i do insist it is consistent in change of dosage coupled with the changes that are occuring, take heart that you will easily find your way back up. Each time a little faster because you will have learned how to and you will stop fearing it too. Sending my best wishes. Apologies for long responses too smile I feel incredibly sad that anyone should be left wondering and guessing like this without having a good doctor to turn to. x

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    • Posted

      oh my gosh i am in shock, thank you so so SO much for you the time and effort you have put into your response! I can't even tell you how much this means to me, I literally posted on this site in desperation as I literally have nobody to call or any contact to any team and my care coordinated is horrible (also on holiday) and it was a one off psychiatric appointment so no one to turn to. Everything seems to have just gone to poo after fighting so hard inpatient to be out by turning 18.

      But I guess I'll just have to get through this dip like everything else and keep on fighting!

      Thank you ever so much again for your reply it really has helped and made me think maybe there are reasons for this and that it isn't just me getting ill once again! X

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    • Posted

      It certainly doesn't sound as if you are 'getting ill again'. Recovery from extreme stress is turbulent always. If it helps any, it is good for you to remember that you are on some sound and good quality medication. They won't let you slip back all the way to the bottom. They serve to support you while YOU make your way back up and realise that you can. They don't do it for you. It is all you. Medication does not change you per se. It helps keep you afloat while you learn to swim. That is all! And you already have a triumph under your belt to start building on. Desiring and then MANAGING to get out before turning 18 to avoid going to the adult facility. This is an achievement. You pulled that off and  can also make the day to day work. But use that persistance you have to make sure you demand the right care for you now. Because while you can do a lot on your own, it is not your job to do the guessing you are now forced to do. Someone with tons of experience should be working those meds to make sure everything is working as it should, to know what to add, what to deduce, when, and what to say to you when you need to hear it. This forum is excellent, with lots of people who are really very supportive. I have seen many forums but this is the only one i engaged on. Someone will always reach out.

      I am 38 years old, mother of two girls aged 11 and 3. I studied psychology but am a researcher by profession. I have been treated for heavy GAD for 12 years and completed therapy 3 years ago. I was hospitalized twice for GAD prior to commencing therapy. I was treated with Effexor (Venlafaxine) at 150mg initially alongside with alprazolam (xanax). During this time I have met so many people in therapy for various psychiatric conditions. I have seen a lot of success stories. Very few failures and those were always down to not following medical advice. I stuck around here because I noticed that not many people who complete therapy take the time to sit by those in the process. I was very lonely those 12 years. On these forums people are faceless but all have been through a lot and you can draw strength from that and feel less insecure about the future and your capabilities. Just the fact that you are reaching out means you are on your way already. Give us a shout when you need to and do let us know how you get on. x

       

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