Venlafaxine - scared to start

[Pierrederesistance]

I'm due to begin Venlafaxine next month. 50mg initially.

I'm absolutely terrified of the side effects of starting. Mostly:

Nausea - this and actual vomiting are part of my bipolar anyway, so I have a (probably) disproportionate fear.

Dizziness - terrified of fainting.

Palpitations - this is another big one as my health anxiety often focuses on heart issues and I have quite a high rate anyway.

I've tried lots of other meds and can't take a lot of others due to existing health issues, so this is pretty much my last chance.

I think I can deal with the depression, I can't remember a time I didn't have it, but I would so love to be free of the completely debilitating health anxiety.

I'm not sure what I'm looking for as some people will love it, some will have had awful experiences - I'm taking time to be gentle with myself when I start it, but the idea of the side effects is making me question it all. If it wasn't for the chance it might help the health anxiety, I wouldn't be trying it.

I have an incredibly supportive partner and adult kids, a great GP, and a useless psychiatrist 🤷

That's very interesting. I have bipolar as well and lots of other things - I did find quetiapine good years ago but another health issue has been uncovered since then and I should never have been on it in the first place 🤷

High resting heartbeat terrifies me - it goes up with breathing exercises or any sort of calming attempt. Do you find that too?

All the women in my family are the same - low BP high pulse.
I once had labyrinthitis and my resting heart rate was 140 going up to 180 with gentle movement.

I have had several ecgs recently due to persistent poor health. I developed liver issues and severe fatigue in late pregnancy a year ago, one of the things they were worried about was whether there was something cardiac going on. Still unsure, my resting heart rate was 120ish in pregnancy and in 2 of the ECGs but I have since had them with it under 100 so they are happy for now - no prolonged qt either. It could well be long term quetiapine use i guess, I've been on it since 2012.

When things are good quetiapine is all I need but in recent year when depression hits it doesn't shift. I had a bad episode in 2020/21 after having my daughter and had treatment resistant severe depression with psychosis and spent 10 weeks in a mother and baby unit. It took 2 years from the start of the episode to feeling like me again. I ended up on high doses of quetiapine, lithium and mirtazapine and a bit of lamotrigine too. I have had depression this time again but moderate- severe and no psychosis but it is now heading towards being treatment resistant again. I'm trying to avoid going back on lithium as whilst it was helpful for my mood it also came with debilitating physical side effects and my physical health is trashed as it is...

I avoid breathing exercises to be honest. There are some deep set issues that life has a thin protective cover over. Any form of breathing or relaxation exercises is like tearing off the cover and pouring alcohol in an open wound. They are thinking that the avoidance of dealing with this is contributing towards the difficult depression and me being able to accept and engage with help and support. I am in the process of being referred for psychodynamic therapy to hopefully treat this and the underlying depression. I did compassion focussed therapy last time and I found that highly distressing and sent my mind and body into threat mode.

The mind and body is a weird thing.

There is a living with bipolar thread here with a few of us managing life and the ups and downs of bipolar if you want to join us

Hi @Pierrederesistanceive got Schizoaffective disorder, bipolar type. I take quetiapine 450mg a day as well as the Venlafaxine. But I have been quite paranoid on & off so my psychiatrist may need to increase the dose of quetiapine, not sure yet.
I was taking Aripiprazole 30mg a day until last September but it just didn’t control the psychotic symptoms anymore and I had regular highs & lows so I had to slowly come off the Aripiprazole and start the quetiapine, then increase the dose of that. I was off work for 6 months because of getting used to all the side effects. I do find quetiapine a bit too sedating though.

It's a wonder drug for me. I will never come off it, it just keeps me steady.

I had naseau at first but that stopped after a bit. I have to take it in the morning or I can't sleep and if I miss a dose I feel drunk.