Failed on venlafaxine, desperate to find something to work

[PastaLaFeasta]

I started venlafaxine on Wednesday, just one 37.5mg and took two thu, fri, sat - one in the morning and another evening. I had awful nausea, stomach cramps, jaw clenching so bad I've bitten the inside of my cheeks and tongue plus it gave me headaches and pain in the jaw. I also had restless legs, well body really, even my tongue was fidgety. I couldn't sleep sat night/early Sunday feeling awful, like I was going to puke, jaw so painful and dizzy, I touched my head and it didn't feel like me if that makes sense. It became untolerable. I felt a little yuck yesterday but today I've been so nauseous I haven't eaten. I thought the symptoms would pass but they just ramped up over the four days. I feel bad for giving up but couldn't cope with it - I have two smalls to care for.

Is there any medication which won't do this? I've tried sertraline which was worse and citalopram which was ok but the jaw clenching got to me with constant headaches, plus suicide ideation constantly. I presume I'm particularly sensitive to serotonin and need a different approach. I took a low dose of nortripiline and was ok aside from tiredness, has anyone had the full dose and had success? I'm feeling very desperate. I read how venlafaxine helped others and feel so hopeless that it's not an option for me. I was prescribed, but never got, duloxetine - any success on that? I've been offered mirtazapine but worry these drugs will just lay me low for a couple of weeks and the side effects not ease, nevermind it actually work. The jaw clenching is the worst and never stopped after months on lower dose citalopram. Desipramine sounded ok but I can't see any one online discussing it or whether it's even available in the UK. I asked for Wellbutrin once and was corrected that it was only for smoking cessation.

[captaincake]

I tried venlafaxine thinking it would be a miracle after 'failing' on paroxetine and sertraline. I was SO disappointed when the same happened with the venlafaxine I spiralled. Escitalopram has saved my life but isn't working as much as I need it to. Moving to mirtazapine has been an option but after what happened with the previous 3 it's been decided to leave it as it is.

[NotAJammyDodger]

How awful for you. Sounds like a complete nightmare .

Are you still seeing your GP or a psychiatrist?

(It used to be the NICE guidance (4+ years ago) that if your GP has tried two different types of ADs from the same class, and a couple from two different types of classes (e.g, SSRI, SNRI) the GP should consider referral to secondary services.)

A Pdoc is better placed to know all the possible drugs types, and give you more options. If you aren't seeing one, can you ask your GP for a referral?

[Butterchunks]

Sorry you are having such a rubbish time. I have been through over a dozen different antidepressants over the past 15 years or so, since I was a teenager. I won't list them all but have personally always found tricyclics to be most effective and to have the fewest side effect and least withdrawal symptoms. SARIs and SNRIs have always had too many uncomfortable side effects (jaw clenching, sleep proplems, sexual problems, weight gain, shock sensations etc).

I am currently on amitriptyline (as it is safe during pregnancy) and have had no unpleasant side effects. It massively helps with my ability to sleep but when in the past I have had it in higher dosages it has made me tired during the day. Another tricyclic I have had (and stayed on for years) was lofepramine, this had a less sedating effect but was still helpful for mood etc. The only side effect was slight ichiness for a day or two, and constipation but the latter was easily dealt with).

Don't give up yet, there are plenty of different meds to try. Maybe try to get a referral to speak to a Psychiatrist who can help you find the right medication or combination.

[slushie]

I was put on venlafaxine and it made me so sick I lost a stone in the 9 days I took it.
After that I tried mirtazipine. I found the side effects ok (apart from drowsiness but I took it in the eve) it helped my mood but not enought.
I'm now on duloxetine I've been on it for 2 months and feel like a different person. Side effects I've had have been quesyness but that's eased now and a decreased appetite. Honestly I felt like I'd never find the right medication but now i have its like a new lease of life.
Are you under the gp or a mental health team?

[NanaNina]

Trouble is all these meds work differently on different people just to cause us more confusion, so it isn't a great deal of help to know what someone else found beneficial. Incidentally Venlafaxine is an SNRI not SRRI but don't really know what that means! I couldn't cope with it either but others talk of it in glowing terms.

Are you in secondary care (have regular oversight by psychiatrist? and CPN maybe) If not I think you need to ask GP to refer you. I've never found the right combination yet..........but I'm old so that's one of the reasons. Not trying to nit pic but you aren't sensitive to serotonin (as that's a chemical in the brain) but maybe sensitive to SSRIs that raise serotonin levels. The other thing of course is that medics don't know how these drugs work and it's all trial and error even with psychiatrists because of their individual effectiveness (or lack of)....

If you've stopped the Venlafaxine you need to go on to something else and as you've tried so many I hope you can get to see a psychiatrist soon.

[PastaLaFeasta]

Thanks for the replies, it helps to know I'm not the only one to not have found these drugs lifechanging especially if something has helped in the end - particularly the duloxetine and tricyclics which help pain - I took amitripline and couldn't wake up but nortripiline is similar and not quite so bad so an option, I just didn't take enough to know if it would help my depression. I've had depression and suicidal thoughts since childhood but didn't face up to it until motherhood. I've coped without drugs but it would be lovely to have a break from it and feel ok, especially when so down I'm struggling to function, like recently. And I need to rebuilt my life as its eroded away so much over the last three or four years.

NanaNina (actually my Nana's name so feels strange to type) - I did mean more sensitive to the increase, I know it is used in the body like digestion which explains the bad tummy on them. I weirdly read the website for the book Potatoes not Prozac and it recommends eating a potato before bed to increase serotonin. The bigger the odd dreams etc the bigger the reaction to the supposed serotonin increase, which in turn is in an indication of a bigger depletion in the chemical - you have to start off with a smaller potato if this happens and build up over time. No idea if the science is correct (sounds a little mad in fact) but if so those with the lowest serotonin levels would have the biggest reactions (or side effects) to starting antiDs. Wishful thinking maybe, I was wondering if building slowly would work or just prolong it not being effective and the side effects starting once it was an effective dose - which happened with citalopram and the jaw clenching :(

Or I find something with lower impact on serotonin and higher on other helpful chemicals (noradrenaline and dopamine?) Or do I try the potato, although I actually feel too depressed to try it.

I was offered an appointment with someone to discuss medication but declined at that time, it was possibly a psychiatrist but via the counselling service. It's a low level service and I'm more complex so I've exhausted it and been discharged, but I'm not bad enough for community mental health so only have the GP. I booked in for a few weeks time so can ask about a referral then, although I struggle to trust health professionals (for good reason) so worry I'll get another duff drug and no support when it goes wrong. I can't get anymore counselling etc from the NHS but could go private, although I didn't feel better for it, my scores on the questionnaires were just as bad at the end as the start. CBT was too surface level and failed too. So drugs and 'kicking myself up the arse' (if ever possible) is all I have.

Luckily I'm feeling more normal aside from slight queasiness this morning so no withdrawal effects. Although I could do with losing a stone. I also managed to get out and see people which helps.

[Minisoksmakehardwork]

Venlafaxine has been great for me. It's in a class of its own apparently. I don't really understand it but after feeling absolutely dreadful on mirtazapine - like I was drunk/stoned permanently from the first tablet, I welcomed the change.

What is your dose? You said one 37.5, but that you'd taken 2 tablets? Are you taking what's prescribed or more as that might make a difference to your toleration, especially as you can start on a low dose and increase (I started on 75mg which thankfully is helping me).

[Bluebell66]

So sorry you're struggling Pasta. Having tried and failed with many different medications including fluoxetine, seroxat, Sertraline, citalopram, I always go back to Flupentixol. It's the only AD I can take without suffering any side effects. I just can't tolerate any of the new SSRIs, the side effects are unbearable. The GPs don't prescribe Flupentixol anymore, as it's one of the older ADs. My GP is happy to prescribe it for me though, as it's clear I can't tolerate anything else. Due to the loss of my DH, my DS has just had to go onto medication for extreme anxiety and depression following the loss of his Dad. The GP prescribed Sertraline for him, but the side effects were so severe, I asked if he too could try Flupentixol. He did, and my DS is really noticing a significant improvement, with no side effects. The new drugs are not always better than the older ones. HTH and good luck.