Venlafaxine blues?

[Nay]

Can anyone give me info on Venlafaxine? I've been on it for nearly 12 months now, and I've had my ups and downs with it, like any meds. But I'm not sure if I need an increase, a change or a mix of meds now.

I've had a large period of feeling ok, but my mood can change so quickly. I have spoken to some of you about the possibility of having a personality disorder but not sure if my Dr would take me seriously on this. I'm feeling low, even though positive things surround me.

Any advice? X

[Leo]

I felt persistently low on Venlafaxine.

What dosage are you on?

[Nay]

I'm on 112.5mg a day, split into 2 in the morning and one at night.

I've not felt too bad on it, but it's the fast change in mood that's getting me. I can be really upbeat and postive one day and the second something happens my mood just drops so low. Maybe its just the way I am.

[SteveW]

 I haven't been able to reply your post on Venlafaxine, for obvious reasons. Your dose is very small, it goes up to 375 mg. If you haven't been able to talk it over with people I'd have a try.

[Nay]

Do you think I need an increase? The side effects getting on to them were awful.

[SteveW]

 What you do depends a lot on how you construct your depression. Depression comes in many sub types, the type you are starting to resemble is what I used to refer to as relapse/remit. This is where people experience a period of wellness and then for no apparent reason often they simply drop back into depression. The wellness can sometimes last a long time, I made 9 years at my best. But the underlying diseasse process hasn't disapppeared. If I remember this episode of depression is your 5th ? That still isnt enough to think about recurrent depression but it is starting to get there.
 
 But your situation is complex. You're living in a psychological and social world that is absolutely packed with depression triggers. You have done well with grief but it is way too early to even think that you might have overcome or transcended it. And just in case you may be starting to recover you have the idiot C.  to screw around with your mind on a daily basis. One of the major diagnostic books in psychiatry has what is refered as "The Grief Exclusion". It says don't diagnose major depressive disorder if the symptoms are better explined by grief. It favours heading in the direction of grief counselling.
 
 All I can do is say that my intuition tells me that you are suffering from Depression and Grief. But I have no way of proving that. But it does suggest that at least part of what youre experiencing is depression. This leads to the fundamental question which is, is your life and work being adversely affected. It seems like it is to me. So if I was your therapist I would be suggesting that you took more anti-depressants.

You have two real choices. The first is to increase your Venlafaxine. I would certainly describe your current dose as low. When I was taking Venlafaxine the more I took the more side effects I got. It never eased off but you might be different. The second is to use the Venlafaxine as the basis for a combination of two drugs. A combination of Venlafaxine and Mirtazepine is accepted by many as being as powerfully anti-depressant as it comes. In America this combination has the quaint nickname of "California Rocket Fuel" This is a bit over the top in the light of my experience.

A lot would depend on your GP. Many GP's would regard Venlafaxine and Mirtazepine as the province of specialist psychitrists, but not all would. More Venlafaxine shouldn't be too problematic. If I were you I would decide which option I found preferable and then set about persuading my GP to go along.

I hope things get better soon.

Love

Steve

[Nay]

I've been getting very bad migraines lately so need to see my GP anyway. I will have a chat and see what her attitude is. Sometimes I don't feel comfortable asking for am increase or a change. Especiallyas it took several attempts to change my meds in the first place. I'll see how it goes.

Thanks Steve