Getting on to effexor - your experiences

Hi Christine and Hannah,

I dug deeper into the pharmacolgy of effexor and this is the story: the drug is a racemic mixture or “racemate”. Basically it is composed of two similar but different molecules called stereoisomers –– one left-handed and the other right-handed. Think of your hands as the molecules. They are nearly identical but mirror images of each other so not quite identical. In Effexor one of the molecules has a greater effect on noradrenalin reuptake while the other molecule is more potent for serotonin reuptake. Both of them combined have a greater overall effect on serotonin than on noradrenalin.

Based on the above, any dose of effexor has an effect on both serotonin and noradrenalin but with a slightly greater effect on serotonin reuptake. Of course as the dose gets higher, so too does the total reuptake potential on both serotonin and noradrenalin.

Christine - while all of the SSRI type meds do the same thing – prevent serotonin reuptake – they are all different molecules and therfore have slightly different overall effects on how you feel, migraine-killing potential and so on.

Hannah - I suspect that you could have had a bad time any one of the other SSRIs too and I would not necessarily attribute this bad effect to effexor per se. It is equally also possible that another SNRI or SSRI would not cause such a bad reaction or even work! Cymbalta, for example, is apparently not very good for migraine control yet is an SNRI and has a much stronger effect on noradrenalin than effexor. Makes no sense apart from the fact that the active molecules are different.

[size=130]This about effexor withdrawal:[/size]

Symptoms reported included agitation, anorexia, anxiety, confusion, dry mouth, fatigue, paraesthesiae, vertigo, hypomania, nausea, vomiting, dizziness, convulsion, headache, diarrhoea, sleep disturbance, insomnia, somnolence, sweating and nervousness. Where such symptoms occurred, they were usually self limiting, but in a few patients lasted for several weeks.

Discontinuation effects were systematically studied in a long-term fixed dose trial for generalised anxiety disorder; 24 and 11% of patients recorded the appearance of at least three withdrawal symptoms on abrupt discontinuation from venlafaxine 150 or 75 mg once daily, respectively, compared with 3% for placebo. The most commonly reported withdrawal symptoms on abrupt discontinuation were nausea, vomiting, dizziness, lightheadedness and tinnitus from venlafaxine 150 mg once daily and dizziness from venlafaxine 75 mg once daily. Severe withdrawal reactions were observed in 1.3% of patients discontinuing from 75 mg once daily (no patients requiring further drug treatment).

There is also a report of a withdrawal syndrome, confirmed by two challenges in a 32 year old woman who had received venlafaxine 300 mg daily for eight months. It is therefore recommended that the dosage of Effexor-XR be tapered gradually and the patient monitored. The period required for discontinuation may depend on the dose, duration of therapy and the individual patient.

Scott 8)

Thanks for that Scott. I am especially interested in how these drugs work on what as I went blindly into trying one drug after another years ago, not only with bad side effects but then sarcasm from the docs when they didnt work for me. Sort of left on my own, which is OK if you try a drug and it doesnt work and then can come off it reasonably comfortably. Somebody wrote on here that effexor was causing withdrawal symptoms a year later. I have also read somewhere else this happened to someone. Probably on high doses for a long period before they came off but all the same, very worrying.

Anyway, I have felt for the last few weeks and especially the last few days, that I am coming off a drug anyway, and I am not. The last few weeks have seen longer and more severe vertigo attacks. I am waking most mornings feeling very sick and dizzy and then comes the migraine, now had a run of 5 days. Checked my diary and nothing different that I can see. So I dont see I have much to lose by giving one a try. Any thoughts on whether to go for Cymbalta or Effexor?? From what I have read, Cymbalta seems to cause worse insomnia that Effexor. I want something to help me sleep!!!
If I get worse insomnia than I have at the moment, (most nights sleeping only 3 to 4 hours) I wont even stay on it a week!
Thanks
Christine

— Begin quote from “cmoc”

I want something to help me sleep!!!
If I get worse insomnia than I have at the moment, (most nights sleeping only 3 to 4 hours) I wont even stay on it a week!

— End quote

Hi Christine,

I’ve been on Effexor 37.5 mg for a week. I had trouble sleeping the first two nights. Since then, I’ve been sleeping pretty well for me. However, Effexor makes me so tired that I am experiencing extreme fatigue during the day. I’ve been having to take a short nap in my car on my lunch break. I think a lot of people have the opposite response, so you’ll have to try it to know how it affects you.

I’m actually considering a switch over to Zoloft because of the fatigue with Effexor and my fear of withdrawal symptoms if I have to come off. I’m trying to plan my med trials around a trip to Europe at the end of June. I took Zoloft in the 1990’s for depression. I stopped due to increase anxiety. I had withdrawal symptoms with it when I tried to quit cold-turkey, but I was able to taper off okay over a few weeks. I’m wondering if a low-dose trial of Zoloft will help with my MAV symptoms. Or, should I stick it with Effexor to see if the fatigue improves? This is all so frustrating and confusing!!!

Marci

Hi Christine,

I completely understand your reluctance to try Effexor and even though I keep saying it’s different for everyone and to take internet reports with a grain of salt, I was still putting off ever going near Effexor! The fear-mongering out there had a strong effect on me too. But, suprisingly, coming off of it was relatively easy –– much easier than Cipramil or Lexapro and even SJW. I am of the opinion that the degree of withdrawal that anyone will experience on Effexor has to do with three things: 1) the dose you’ve been on 2) the length of time used and 3) your own physiology. The first two are supported in the literature. If you’re going to try an SNRI, it makes the most sense to go with what has been proven in double-blind trials to work for migraine and is also supported by Hain –– Effexor. For some (Marci), Effexor actually causes drowsiness!

Marci, I don’t know what the story is with this med and tiredness, or whether it will go away but there is a warning about it on the MIMS website for doctors saying the following: “This product may cause drowsiness”. Is it the same sort of tiredness you had on 5HTP?

Paxil is definitely jacking me up and making me feel like a robot too. I still feel like the emotion has been sucked out of me. Not liking this at all but will tough it out. I keep having vivid heart-pounding dreams. :shock:

Scott

Hey Scott,

Are you still on 5 mg of Paxil? I’m going to start taking my dose tonight 12.5 mg. I can’t cut these up cause they are ER.
Do you feel less dizzy? What are the main side effects you are feeling?

Emma

— Begin quote from “scott”

Marci, I don’t know what the story is with this med and tiredness, or whether it will go away but there is a warning about it on the MIMS website for doctors saying the following: “This product may cause drowsiness”. Is it the same sort of tiredness you had on 5HTP?

— End quote

Sort of, but it is much worse. It makes me feel drained like I did in the beginning of this whole mess when all I wanted to do was sleep. I think part of the issue is the zonisamide I was taking until two weeks ago had all but eliminated my MAV-related fatigue. I think coming off of the zonisamide and then adding the Effexor may have given me a double-whammy of tired.

Hi Marci,

The drowsiness doesnt sound nice but at least you are sleeping at night. That has got to be a good thing. I experienced much of the same on amitryptiline. I slept well (the only thing that helps me sleep) but was hungover till 3 in the afternoon. Is there any information to say that this drowsiness gets better over time?

I think we have all been scared over the withdrawal side of things with the effexor, but as Scott says, we are all different. I did see some stuff on a migraine board where it was a lot more positive for effexor.

Scott, I dont know whether you read it, but they say that effexor raises cortisol. I know from tests that mine is very low, so this may be a good thing. I have a friend on hydrocortisone for 5 years (very low dose) and she was sleepy at the beginning of taking that and now she only gets a headache once every 3 weeks and is very well in between. She also has a lot more energy and her mood is always up. This may be just one of the ways in which it works on some of us, maybe those of us with too low cortisol levels through too much stress will feel better when it is raised. I think this has a knock on effect of raising blood sugar as well, again, I suffer with reactive hypoglycemia (proved at the hospital), so again, those of us with this problem, may feel better. As you can see, I am trying to look at the positives as opposed to the negatives. Its mad really, we are all happy to plunge in and take a risk on a drug, but none of us wants to be putting up with withdrawal side effects (especially vertigo, the one thing we are trying to treat most) for a long time, thats whats frightening us.
Christine

This seems to be a catchall thread for Effexor experiences, and I don’t really think I should start a whole new thread just for my own, so I guess I’ll post here…

I began Effexor yesterday. Took the 12.5-mg dose. I was kind of hoping I’d get the XR form, but I guess the good part is that I don’t have to deal with the capsule pills and the bead-counting.

No adverse effects that I’ve noticed. I thought I felt slightly nauseous earlier for a while, but I think I may have just been hungry. … Like I’ve said before, I used to take Zoloft at up to 100 mg, so I wasn’t too surprised by the lack of side effects with Effexor. Not sure if things will change when I go up to 25, 37.5, etc., but presumably not.

Anyway, I realized the doctor never said how long Effexor should take to work, or at what dosage people tend to begin seeing improvement … though I expect 12.5 isn’t high enough for anyone. If anyone has some answers (from firsthand experience or otherwise) about timing or dosage, I’d appreciate the info.

I sure hope this works. If it gets rid of the visual dependence/sensitivity and lightheadedness (which may be one and the same; I’m not quite sure), I’ll pretty much feel 100%. Heck, if that goes, I don’t think I’ll even care much any more if I get a regular old (non-migrainous) headache now and again.

Ok, so it’s twenty days now since I stopped this.

I oscillate wildly between thinking this is a migraine attack and then thinking this is still the drug withdrawal. What confuses me is that the symptoms I’m experiencing, although they are somewhat familiar, simply don’t mimic other relapses I have had. I have this horrible pressure bearing down on the right side of my head, pressure in to my right ear when it is at its worst and a horrible feeling of wearing the wrong glasses prescription, which I haven’t really had since I got vestibular neuritis seven years ago prior to the vestibular migraine kicking in. Apart from the odd occasion, I also no longer generally experience vertigo and have been with this. I generally experience severe brainfog, photophobia and lightheadedness.

The fact remains that aside from severe photophobia i was doing ok before this drug and then all manner of horror has descended on me since taking it and especially since stopping it.

It’s true that I might have had a bad time withdrawing from any SSRI or SRNI, although from reading the countless people on the net talking about effexor withdrawal, it doesn’t seem to add up that it’s meant to only be people who have been on high doses for a long time who suffer withdrawal. There seemed to be countless people who took less than 75mg who had a bad time. Then again, (and forgive me if I’m wrong or there is anyone I am unaware of) but I seem to be the only person on the board having major issues post effexor, so who knows. Based just on that I’d say most people will probably be ok and I might be just have drawn the short effexor straw. Frankly at this point I’d just like to know what the hell is happening to me and how long it’s going to last.

I was feeling better yesterday and of course was full of hope that this might be passing only to be really bad again this evening. It is so tiring and I am so sick of it and having to work is just awful.

All I can say is it is better than it was when I initially came off, but I was so bad I’ve merely gone from very grim to less grim.

I want to take my dizzy head back to the shop and trade it for something else. I wouldn’t be greedy, I’d fully accept that I have to put up with something but I’d swap it for a bad knee or maybe a bad elbow. You know if they promised I’d never have brainfog ever again I’d take both the knee and elbow problem, and what the hell, maybe even an ingrowing toenail. I’m a generous sort.

H

— Begin quote from “Hannah”

I want to take my dizzy head back to the shop and trade it for something else. I wouldn’t be greedy, I’d fully accept that I have to put up with something but I’d swap it for a bad knee or maybe a bad elbow. You know if they promised I’d never have brainfog ever again I’d take both the knee and elbow problem, and what the hell, maybe even an ingrowing toenail. I’m a generous sort.

— End quote

:lol:

I’m glad to see you still have your sense of humor! Hang in there.

Guess I have to take back some of what I said earlier…

This is only day 3 of Effexor, but today and yesterday, I think it’s made me somewhat more lightheaded. Sitting at the computer or lying down (to watch TV, or whatever) isn’t as effective at relieving the lightheadedness, last 2 days.

Stunning to me that just 12.5 mg – a small amount – of an SNRI can have any noticeable side-effect.

I know some others on here had a rough start with Effexor but got used to it… how long does that usually take to acclimate? (Hopefully, adding 12.5 mg every 7 days doesn’t just goof it up again…)

— Begin quote from “georgekoch”

Guess I have to take back some of what I said earlier…

This is only day 3 of Effexor, but today and yesterday, I think it’s made me somewhat more lightheaded. Sitting at the computer or lying down (to watch TV, or whatever) isn’t as effective at relieving the lightheadedness, last 2 days.

Stunning to me that just 12.5 mg – a small amount – of an SNRI can have any noticeable side-effect.

I know some others on here had a rough start with Effexor but got used to it… how long does that usually take to acclimate? (Hopefully, adding 12.5 mg every 7 days doesn’t just goof it up again…)

— End quote

I too would like to know how long it takes and at what dosage is needed to get full benefits from the Effexor. I’m day 28 now at 37.5mg and sill experiencing lightheadedness/spaciness, teeth grinding, in additional to my usual horrible symptoms, and today it feels like my head might explode at any moment. My mood hasn’t improved (i was hoping for that side effect…) and I’m still not noticing any improvement with my dizziness or other issues. I saw a GP who wants me to get up to 150mg of Effexor!?! He is concerned about my depression. Well no wonder doc, I haven’t been able to function normally in three years, can’t work, totally unproductive, i’m wasting my life away, of course I’m going to get upset when discussing my situation with you doc. Grrrr… OK, sorry for the rant.

I’m going to wait for my referral to neurologist before changing a thing.

Crystal

When scouting around looking for info when I was on this, I got the impression that docs tend to think it takes 3 to 4 weeks to get past the side effects and experience the benefits. Noticing what other people have said re anti depressants on here, there is often a mention of feeling worse for around that amount of time before they feel better.

I bailed at three weeks on effexor so don’t know if I would have experienced any improvement. I sympathise. All you are experiencing is what I went through. I definitely wouldn’t go up on the drug unless the SE’s have stabilised.
Again from what I have read, people seem to do best who allow their brain to get used to the drug before hitting it with some more. I know there are theories that sometimes more of the drug will help when less of it causes problems, but it’s a bit of a risk to try that.

H

Totally fed up this evening. Just gutted that I ever took effexor. Who knows if it just triggered a massive migraine attack or whether this is still fall out from withdrawal. I’m past caring. All I know is I was doing ok, long periods dizzy free before I took it and now I have been struggling for four and half weeks with unrelenting symptoms. Not to mention the three weeks before that of feeling worse on it.

I am better than I was, just gutted that I am back to an existence where I feel grateful for feeling somewhat less dizzy on any given day because other days are so bad.

I have been working in a high pressure job through all of this and frankly at times it’s barely tolerable.

I remembered that as well as getting instant aura on citalopram, I even got dizzier on 5HTP, clearly drugs that manipulate serotonin in any way are a total no no for me. Even pizotifen, a serotonin antagonist was a disaster for different reasons.

If I’m stuck like this for centuries I will be kicking myself for the same amount of time that I ever downed any effexor. It’s so gruesome knowing I would almost certainly be ok right now if it wasn’t for that damn drug. I know regret is futile but the consequences of taking it are so life altering, avoiding regret is fairly impossible.

Hannah, after I read your story when you first came off effexor, I went through tons of stuff on people withdrawing from these drugs and the 6 week mark seemed the most popular for when they got back to normal. I know some were longer and some shorter, but this one came up time and time again, so I hope it wont be long for you now.
Christine

Hi Christine,

Thanks for that, you’ve cheered me up. I also read a load of withdrawal stories. I had convinced myself that three weeks seemed the most popular time to recover, but frankly I was so dizzy when I read them I don’t think I was in a fit state to really judge.

I seem to get most despondent when I show some improvement and then slide backwards, which is what happened last night/this morning.

Where are you up to with your drug decisions? Are you trying Effexor? I realise it’s a bit ironic my asking having doom-mongered my head off about Effexor. I should stress that whatever conclusions you have come/came to about what to do, I have a terrible track record with drug trials. As a neuro said to me recently - I am hyper sensitive to drugs.

I also just remembered that nearer the beginning of this whole ordeal I went on notriptyline and that was when the true vertigo started having never had it before, just dizziness. It’s sort of all falling into place that the serotonin altering drugs really don’t help me in fact they make me worse.

H

Hi Hannah,

I am not on anything at the moment. Have been putting off going over to the GP, even though the letter is in from the neuro saying I can try effexor, cymbalta or trial verapamil again. I simply don’t know which one to go for. I think I have been put off the effexor for the time being.

Like you, I am very med sensitive. Years ago I went through propranolol, tynelol, atenolol, epilem, gabapentin, flunarazine, verapamil, prothiaden, amitriptyline, imipramine, nortriptyline, lorifipramine, trazadone, seroxat, cypramil and sandomigran.
Could tolerate propranolol but not above 40 mg; amitriptyline not over 10 mg. I managed a while on sandomigran and prothiaden. Gave up for 15 years and just took painkillers. Now I want to try again but it seems that for every success with a drug there are far more failures. I have been printing off the successes (before the success post at the top) to see what works the most!!

Hope you are feeling a bit better today.
Christine

Hi Christine,

That’s an impressive list of drugs, I have to take my hat off to you for your resilience. I think doctors rarely acknowledge how hard it is to keep putting yourself through the drugs wringer. Probably because they don’t have to deal with the fall out if it goes wrong. At the last count I think I’d tried seven. I also got fed up with it all and had the neuro letter re effexor waiting at my doctor for about 7 months before I did anything about it. Wish I’d left it there frankly.

I was thinking of verapamil at some point but have definitely lost my enthusiasm for drug trials. Although the state I am currently in I might be lured into trying again in a desperate attempt to get some relief. I am worse today but my period is due so I figured I was in for some trouble.

What gets me most about this illness is how much time it forces you to waste time as you sit around feeling terrible avoiding stuff. Have work I have to do today at my computer and am snailing around wishing I could do anything else.

H