Venlafaxine

I think the best advice would be to speak to your GP, it might be that they prescribe something additional for you to take in the morning at least short term. They know you best. There could be many reasons for you to wake up shaking, even low blood sugar if you aren't eating much. Anxiety makes you overthink everything. Perhaps write a little list of what you are most worried about and speak to your GP so you don't have to worry about forgetting anything.

Please please do not try to adjust/decrease/increase the dose without medical support.

Being able to notice small pockets of calm in your day is huge, that's really positive.

When you say shaking, what do you mean by that? I found I was wobbly, trembly in the mornings but not with anxiety, just a bit foggy wobbly, but then Ive been like that most of my life to be honest. Its not so bad now

Oh yes that awful morning anxiety. I would just recognise it for what it is, morning and anticipatory anxiety and know that it wears off throughout the day.

I am taking 267.5mg venlafaxine & 40mg propanalol up to 3 times daily, I absolutely know about it if I miss either. I suspect your morning jitters are down to the timing of your dose and would advise a conversation with your dr about both that, and something else to take the immediate edge of the acute anxiety.
This is the first combination to have worked for me, but it’s taken months to reach the right dose. I’m approaching a year and I would say it’s only in the last 2-3 months I feel properly settled.

Yes, it’s taken a long time. On the higher doses, it would feel effective quite quickly then seem to lose effectiveness, so we would increase again.
Most days I only take one propanalol, but it’s good to know the option is there for more if required.
I try to take mine in the morning, a consistent time of day is really important but I’m not fantastic at that tbh as my routine varies. If I forget, I get very jittery as the day goes on, and if I completely miss a dose the next day is very difficult and I feel extremely jittery / somewhat manic.

Yes, and depression. Anxiety is not gone but a whole lot better where I can enjoy my life

I was told by my GP that the anxiety side might take longer to settle, and it did, went from having a nervous breakdown, extreme elevated anxiety due to prolonged difficult life circumstances to pretty normal emotions. I do wonder if your dose is enough though. I did manage on 75mg once it kicked in, it was about 8 weeks in I'd say before I started to think I felt more normal. I think adding another 37.5 dose might be an approach given bodies are different and your anxiety is pretty embedded.

I get that you are worried about coming off the drug, and I agree it's not one where it's easy to miss a dose although all that happens to me is I get tingling lips and face and feel a bit odd, but there are lots of protocols on how to taper very gradually, I mean over months or years. Many GP's don't know about these or how to taper this drug so it's worth looking at those. I'm tapering off and then I've stopped at times where stress has risen again and I'm happy I'll be able to get off it again.

I would go on it again though if I ever get in that non-functioning state again, it does seem to work every effectively and I like knowing it is out there, if that makes sense.

I hope this or something else works for you, I think this will work as it gives your body a bit of time and space to start calming itself down, and you can use other things (nature, meditation, adjust life) once that's been achieved but it's so hard to do that when your adrenaline has been running high for so long. I'd also recommend Self-Help for your Nerves by Claire Weekes, very old but full of great wisdom of how to live with anxiety. You can get the audiobook and hear her lovely old-fashioned Australian Queen's English accent speaking to you.

I do get what you mean about the “what if” of coming off it. Being truthful, I try not to think about that.
I have a problem with anxiety right now, and that needs addressed. If the medication creates another problem in the future, I’ll deal with it then. I was always very much of the mindset that I wanted to be on minimum doses (of any medication) and definitely didn’t want long term dependency. However my brain and body have other other ideas, and this is a need whether temporary or long term.
I know it’s easy to say to push the thoughts away, especially given the problem is with anxiety, but on balance I will take the peace now and take a risk on the future.

Yes, the sweating got much better, I was also sweating with stress and anxiety around that time and used to get sweeping feelings of being hot and flustered and occasionally sick. Venlafaxine is good once it settles for this, and also is sometimes used off-label for the menopause if someone can't go on HRT as it deals with night sweats.

I think fighting to stay on a lower dose if you need a higher dose is probably a bit daft, you need to have a prolonged period of no or little anxiety to reset your brain and body away from this permanent jangling of nerves and that takes a while, I think it's better to have that time fully medicated, because you can always drop down again. I found I was fine at 75mg after a couple of months but would have added another half again if it hadn't been fully working, I don't see the point in half treating yourself. Good luck with it all, it's always a journey!

The sweating does seem to adjust, it is weird! I have not had problems with menopause symptoms though since the getting used to it period about two years ago.

I think do whatever is kindest to yourself, you have suffered enough so far.

Sorry to hear this. These meds work brilliantly for my anxiety and depression but I take 225mg! I was on citalopram for years and then switched to these which work so much better for me. Hang in there - maybe increase the dose? I went private to psychiatrist who put me on that dosage x