Venlafaxine

[somedayillbesaturdaynite]

I am prescribed 150mg twice daily, morning and eve, prolonged release capsules.

I cannot bear to eat in the morning and have noticed that taking them on an empty stomach seems to induce some sort of low blood sugar- I go shaky and light-headed- and I only go back to normal after eating. I am wondering if it's possible just to take the 300mg (whole daily dose) in one go on the evening?

You need to ask a doctor that question.

Thanks, I will be seeing my GP later in the month (earliest I could get an appointment). In the mean time I am hoping some other people on the same might have some experiences they may share.

Can you not call and leave a message, send a fax or an email? For a simple question like when you must take your meds? Sorry I don't understand how the system works in the UK but you should really not have to wait weeks with a question about side effects and when to take meds.

How long have you been on the Venlaxafine? I cannot remember what dosage I was on, but I took it in the morning. You're supposed to take it with food afaik.

Ring your GP again and get a telephone appt

I was on venlefaxine about 10 years ago and was really sensitive to the side effects, but they did ease after a few weeks and were better once on the capsules.

how long have you been on the capsules at this dose?

I am no medical expert but it may just be the side effects of the medicine, not reallyrelated to you eating but just that yea eat at around the time the side effect would wear off - when i first started on them I would get palpitations 20 minutes after, feel dizzy and shaky and vomit an hour after. you really could set your clock by it.
Once I was on the capsules for a bit it settled down completely. (just got left with excessive yawning and excessive sweating as my lasting side effects, nice! -I was unlucky though, most people get away with a lot less)

I could tell if i forgot to take one though, literally an hour or so late and I would feel funny in the head, sick and dizzy. I used to keep a few in my wallet in case that happened after having to leave work to go home and take one a couple of times.
I would not recommend taking 300 at night as an alternative without consulting your gp, it might really screw up your sleep/dreams and I have no idea what effects it would have on your liver etc to take that much at once.

Good luck!

Are you definitely taking the extended release not immediate release tablets? I've not been on venlafaxine for a while so things may have changed, but I thought the extended release tablets were designed for once a day dosing; i switched from twice a day immediate release to once a day prolonged release for similar reasons to what you have described. I don't have an up to date BNF at home, but have had a quick look in my 2010 one and it supports this.
However, don't go by this and change the timings yourself...your doctor may well have a good reason for having prescribed it this way! I would suggest that you phone the surgery and ask for a telephone appointment. They are often easier to get on the same day and this is something you could probably discuss as well over the phone as you could face to face.

I'm on 375mg extended release and was told by my Psych years ago to take them in the evening to avoid the side effects, still do it and they're still as effective

Sorry if this is long and/or I miss anything, or my waffle just doesn't make sense. I appreciate everyone's input, I don't know anyone in RL who takes this.

I could get a more urgent appointment but it would be with a locum and this doesn't work with my anxiety issues. I struggle to speak to ANYONE on the phone, and have ATOS soon so I need the appointment with my normal doctor for more than just this.

I have been on V for about 5 years +, taking the immediate release, which is the one that seems to cause this sudden dip. I have in the past put it down to other things, like drinking redbull but slowly over time have eliminated everything except the V causing it. It's not like the withdrawal (eg the brain freezes for a brief moment every few mins) but like a big drop in sugars (I am not diabetic) and only eating actual food stops it (eg a sugary drink doesn't work) I've had this side effect as long as I have been on them.

The pharmacy has been unable to get the tablets and have been issuing Efexor XL instead. The XL instructions say to take after food which I hadn't heard of before, and the doseage is as before- 2 tablets twice a day. I am yet to start them as taking remaining older tablets. This has made me wonder about taking the XLs in one dose (at night) instead as a possible solution.

With the previous (instant release?) tablets that would have been impossible because of the immediate withdrawal if I was a couple of hours late taking them. For years I have only eaten once a day, it started with being LP to 2 under-2yo's and is something I have tried to break in the past but unsuccessfully. (I have digestive problems anyway: IBS, hiatus hernia, GERD and recently had gallbladder taken out, and can only eat when I know I will be at home and near to a loo for several hours after) So if I was able to switch to once a day it would solve that problem.

Also, just a thought, but has your GP referred you to a community MH team? some GPs are ace at helping you manage depression/anxiety and really know their stuff, but others not so much. Might be worth asking for a referral if you think it might be right for you

Thanks Foody I will ask when I see her. I did a fair few years ago but was having a good day when I saw psych nurse for a 1st appointment and as is the nature of this burden it is hard to imagine how bad it gets when you're 'ok'

I know, its a bloody nightmare! you just want to take the good days and run with them!

you sound very much like I did on the Venlefaxine, the standard release tablets I was on at the start were hell for weeks and when I did eventually mange to stop taking them the reducing slowely took months as I got all the side effects from the start again, and had the wierd electric shock head thing for about 6 months after that! not what you need when are supposed to be 'better'.

To clarify are you on tablets or capsules?

this is the info from the BNF (British Medical Formulary) on the effexor XL - it really does read as though they should be taken once a day - could you manage going into your pharmacy and speaking 1:1 with a pharmacist? most now have a private consultaion room.

Again, pls dont change anything without checking first, but this is the info from the BNF

Efexor® XL (Pfizer) Prescription only medicine

Capsules, m/r, venlafaxine (as hydrochloride) 75 mg (peach), net price 28-cap pack = £22.08; 150 mg (orange), 28-cap pack = £36.81. Label: 3, 21, 25, counselling, driving

Dose depression, adult over 18 years, 75 mg once daily, increased if necessary at intervals of at least 2 weeks; max. 375 mg once daily; child under 18 years not recommended (see Depressive Illness in Children and Adolescents)
Note

Faster dose titration may be necessary in some patients

Generalised anxiety disorder, adult over 18 years, 75 mg once daily, increased if necessary at intervals of at least 2 weeks; max. 225 mg once daily

Social anxiety disorder, adult over 18 years, recommended dose 75 mg once daily (no evidence of greater efficacy at higher doses); dose may be increased at intervals of at least 2 weeks; max. 225 mg once daily

That is a brilliant idea about the pharmacist, thank you !!!

Almost out of old tablets (not prolonged) and will be taking Efexor 75mg "prolonged release capsules hard" (total 300mg daily so just under their max for single daily dose). I hope I don't get withdrawal changing, ended up in A&E just from the withdrawal when hernia was too bad to swallow them for nearly a week

Good luck!

Hey there!

I totally understand where you’re coming from—I'm also on Venlafaxine, and I get mine from the same place: topsup24.com. I’ve been taking 150mg twice a day, just like you—once in the morning and once in the evening. It’s the prolonged-release version, and honestly, it’s made such a positive difference for me. My mood has become more stable, and that constant, heavy emotional fog I used to have has really lifted. I feel more balanced and functional in my daily life, even during stressful periods.

That said, I’ve had similar issues with morning nausea and just not wanting to eat. Taking Venlafaxine on an empty stomach can definitely make me feel shaky or dizzy—probably a blood sugar dip, like you mentioned. What’s helped me is having even a small snack or a smoothie right before taking it in the morning—something easy to get down, like a banana or a protein shake. I asked my doctor about taking the full 300mg in the evening instead, and she advised against it. Since it’s a prolonged-release capsule, the idea is to keep the medication levels steady throughout the day. Taking it all at once might mess with that balance and could increase side effects like insomnia or agitation at night.

Still, I’d definitely recommend speaking to your doctor about how you're feeling—they might be able to adjust your timing or suggest a slow-release version that works differently. Hang in there, you're not alone in this 💛

@Abbyy its kind of you to share your experience however the thread is over 11 years old. I hope the drug continues its positive effect for you