Venlafaxine 225mg

[WithanAnotE]

I have recurrent depression.
Been increased from 150mg Venlafaxine XR (an SNRI) to 225mg by Pdoc. Up to 150mg it works like an SSRI targeting Serotonin. Above 150mg it is reported to act more like a Tricyclic (TCA) action but targeting Serotonin and norepinephrine.

Anyone else at this dose and how did it work for you?

I found a huge difference between the two doses; 150mg didn't help but 225mg did.

Definite improvement for me overall mood wise (though it did take a couple of months to notice the difference). However I am more tired at this dose than 150mg.

Yes, I came down to 300mg several years ago. Was on 450mg and was more functional at that dose, but tiredness & wooziness were worse. I'm wondering whether to try reducing it to 225mg but did it last winter and was in a right old state. So maybe not yet.

I also have Mirtazapine at night - reduced from 30mg to 15mg. About ten years ago, Venlafaxine + Mirtazapine was accidentally found to be something of a miracle combination for many; it facilitated my reduction in meds. This news hasn't filtered through to GPs and counsellors yet, so could be worth bearing in mind if your new dose doesn't cut it for you.

I'm on 225mg Venlafaxine M/R daily - it took 3 months to work properly so you have to be patient - but it's definitely been worth it & i recommend trying it!

I still get short depressive periods (& feel suicidal at times) for an hour or a few hours during mood swings (got BPD). Often this happens daily; but as soon as the depressive period passes off i feel ok, like i was never depressed.
Like today; i feel very happy & lively.

If you have epilepsy - be aware that Venlafaxine lowers the seizure threshold - that's the one side effect that is a problem for me - i don't get full tonic-clonic seizures thanks to my epilepsy meds, but it's not fully controlled. So i get very short absence, myoclonic & deja vu seizures daily; & those seizures contribute to memory loss which is frustrating...

Oh yes & best to avoid alcohol, even 1 glass of wine stops Venlafaxine being effective for me for up to 2 days later.
You may feel hungrier so snack on apples / Ryvita & jam - nothing fattening.

I'm happy to put up with less controlled epilepsy though as it means not getting the horrible depression i had; just would not wish bad depression on anyone.
Good luck, you definitely should try it - i don't remember any other side effects but you may get drowsy etc for a while - but hopefully that will wear off after few weeks.

I am on 150 mg Ven (XR) and don't think it's doing enough for my depression (which has hideous anxiety as most crippling element) so about to ask for increase to 225. Does it help sleep more at the higher doses? I am having horrid insomnia too (early waking) so feel completely shattered everyday. Might have to request sleeping tablets for that if the higher Ven does not work for this.

FedUp - heartened to hear of your success with this dose. Hope same true for Withan.

I use 225 venla. I take quitiepene in the evening which really helps with sleep.

Venlaflaxine has been miraculous for me ( as a warning though a missed dose can leave you feeling v odd)

I'm on 330 ven and don't sleep hardly at all but overall it has helped my depression and prevented me from having to take ?eroquel which I hate

Ginger - wow. I don't know how you cope with no sleep. I feel like an absolute zombie. Yet still horribly anxious. it's a bad combination! Can you get 330 ven on extended release? I started on non extended release ven and had hideous side effects which vanished as soon as i switched to XR.

Perry - thanks for the advice. can you take quitepene long term? A friend recommended zopiclone but said it's really only for 2 weeks so if this doesn't "reset your sleep patterns" where do you go next? I guess I should not knock it till I've tried it as it may be just the ticket.

Just got used to it and luckily the high dose of ven keeps me from going too high although I am always a bit high from so little sleep have to get on with it as i am a single parent with no family near hence why not taking the ?eroquel (quitiapine) because I can't function at all then, I really hope you start to feel better soon and Yes the 330 is the long release

ive just gone up to 225 from 150 too My doctor wants to try me on that for a month to see if it gives me a lift, then back down.
im sick of it all

Zopiclone worked like knock out drops for me
Took it and 20 mins later I was dead to the world BUT 4 hrs later I was completely awake. I was getting 4 hrs anyway and so thought the Z didn't really add anything
Quitipine gives me 7-8 hrs but I'm v out of it during that time. It's also an anti d afaik and less addictive than zopiclone

Wrt sleeping at night: I've got Zolpidem for occasional use and the Mirtazapine makes me sleepy. But you can now get Melatonin in the UK, which is the hormone your body produces to regulate sleep. I had it in hospital, it's very gentle and effective. It comes with all the usual warnings about extended use but, if you're concerned about using tranquilisers, could be worth requesting a trial prescription. It's also a brilliant antioxidant.

Just back and I've got a repeat prescription for 150 Ven and to take 5mg Olanzapine at night to give me sleep and reduce the anxiety. Then next step is apparently to increase to 225 Ven and give that time to take effect before reducing/stopping the olanzapine in a few months time. It feels like a plan. I'm just praying it works.

Garlic Interested in the melatonin being available, thanks. I didn't know about that.
Dinah - hope the 225 works for you.
Perry - hope the olanzapine works like the quitipine for sleep though a bit worried won't wake if the children do (have 3 young ones).

Hope you start feeling a bit easier soon, Serial.

Thanks Garlic. I do feel a bit better so guess the tablets work quickly. I hate the thought of being on them though - but it is preferable to be on tablets than to live with such anxiety. The thoughts are all still there though I don't have quite the same reactions in my body which is a relief. Though life with all the thoughts still there doesn't seem bearable. I worry that now I've had the thoughts - and for a quite a long time- they'll always be there. Anxiety is a horrid horrid thing.

It really is. You seem to know what the thoughts are, which is pretty good actually. Have you done any CBT to help you get used to querying those thoughts?
Might feel a bit too scary while you wait for the meds to work, but perhaps you could have a go on the Mood Gym - it's for depression really - to get used to it :)

Thanks Garlic. Yes I know what the thoughts are - is that good? I did some group CBT for depression and then a few sessions for GAD but even the counsellors said I didn't really fit either category very well. They hinted it might be more trauma related (I had a number of "life events" last year and a shocking health (mis)diagnosis). sadly though I think having had some talking treatment I'm now at the bottom of the list for any further help. I'm going to try the Mood Gym -thanks so much for the link.
I'm finding I'm absolutely exhausted still despite getting a good night's sleep since starting the Olanzapine. Hope this is just start up effects and wears off in another day or two!

Hope you're having an okay time weekend. Are your meds fully working for you?

Thx all!
I did quickly notice a difference when increased from 75 to 150mg a year ago but not noticed any real improvement as of yet, but only a few weeks in on the higher dose. Am totally dog tired ATT at the mo. No energy at all. (Nearly feel asleep during a work meeting too.) Immediate short term memory is really poor - as in go upstairs to get something but then can't remember what! And early morning waking has started again.....

Seeing pdoc tomorrow so shall see what transpires!

Hi WithanE - hope your appt with your pdoc goes well. sorry to hear about the early waking. that's a real pain isn't it.

Thanks SerialHousemover,
In true psychiatrist style he said, "We should give it another week and then you ought to come back to me then. Hmm, yes."

Awesome!

don't know if anyone's still watching this thread but be interested to hear how it's going. I'm now 6 days in to increased venlafaxine dose (225) and shattered all the time.

WithanAnotE if you're still around, how is the higher dose going for you? does the absolute exhaustion ever end??

Hey :)

I'm on Venlafaxine 225mg (Efexor XL). After reading your comments I realised I have been experiencing a lot of the same things but hadn't thought to blame it on the AD's! I've definitely been way more tired on this dose than I was before & am also finding that I'm having more down spells than I was before. However, on the lower dose - I think it was 175mg - I found myself feeling good - being "up" as I call it but still not to the level I was before I got ill. I seemed to stay at this "up" level though, didn't get any better & didn't get any worse. My psych then decided to up the tablets but if anything I think they're even less effective!

Sorry it's long!

Victoriaa x

Hi Serial
My Psych added Mirtazapine 15mg rising to 30mg. Really, really helped with my sleeps. Am sleeping pretty normally and regularly for the first time in years, which means I wake up pretty refreshed. I do get quite tired though towards late afternoon, but def. not exhausted. However, I now work out daily at the gym (as I am on sick leave) which boosts my energy levels so not sure how I will be when I go back to work etc. Hope you can stick with it a little longer and see if the tiredness goes. I think the combo of the two ADs is now working well for me, rather than just taking only the venlafaxine.

I was on a mega dose of venlafaxine years ago. I can't say it helped but then none of the anti D's did as my depression wasn't chemical in origin. My only reason for posting is to say be aware that if you do come off them from a high dose the withdrawal symptoms are awful. Equivalent to benzodiazepine and lasting for 6 months. If they work for you then great. Its just something to be aware of.

Ps: My Psych did say that the higher 225mg venlafaxine dose does act on Serotonin AND norepinephrine (aka noradrenaline) - apparently a good thing! But might also explain why the dose increase to 225mg has more noticable side effects for some?????