Effexor XR increase: Update-Added Escitalopram now High BP

[lazer]

So I had my med check yesterday and due to some ongoing agitation, mood swings, ect... the dr upped my Effexor XR from 75mg to 150mg. So I took the higher dose this morning. I am now feeling hotter than normal, sweaty, some confusion and disorientation, and feel very on the edge like I'm ready to have a breakdown. But then in a way, it's weird, I feel calm.

Anyone else experience these type of side effects when raising the Effexor XR dosage? Should I be concerned or keep with this dosage hoping the side effects go away? Not sure what to think right now but I certainly feel crappier all and all today.

Started the 75mg initial dose back in February. Was on Prozac for an extended period of time before that and it just seemed to not work that well for my depression anymore along with contributing to my insomnia.

[Maxie]

I use Effexor XR and I like it but I find you have to be fairly regimented in the time you take it, etc so I think that doubling the dose will take you a while to get accustomed to. I hope it gets better for you. Good luck and keep us posted.

[lazer]

I use Effexor XR and I like it but I find you have to be fairly regimented in the time you take it, etc so I think that doubling the dose will take you a while to get accustomed to. I hope it gets better for you. Good luck and keep us posted.

Thanks Maxie. I did just reach the nurse at the prescribing doctor's office and described what I was feeling to her. She said these are common side effects but it was up to me how much I wanted to put up with and if I felt like toughing it out in hopes they would ease. The way I'm feeling today, I just don't think I can tolerate taking that chance so I told her I want the Dr to consider switching me (once again... ) to something else. I'm to go back to my 75mg dosage tmrw morning and she is to call me back sometime tmrw. I'm about burned out on all these pills and attempts to find the right one.

[VikingGnome]

Did your doc explain to you about Effexor withdrawals? I've been on Effexor for a couple of years. I ran out of my RX before my disability check got here so was without Effexor for about 5 days. It was the most horrible experience I have ever experienced. Withdrawals from Effexor are notoriously horrible. You have to go off VERY GRADUALLY, maybe over 6 months. I'm in the process of getting off for good. I don't want to be on a medication that causes such misery if you miss a couple of days. My doctor never told me about that when he put me on it. Wish I had known because I would not have agreed to take it.

[ems]

You are having a reaction to the Effexor. I'm glad you decided to go back to 75mg. As VG said, Effexor is hell to get off of and you have to go very slowly. The same is true for all anti depressants, but some are worse than others to get off of. What is suggested on the AD sites is to drop 10% of your current dose every 3 - 6 weeks, either by using the liquid form or cutting and then weighing the pills.

Read VG's post again. What he is saying is unfortunately the truth. I hope you start feeling better very quickly.

[lazer]

You are having a reaction to the Effexor. I'm glad you decided to go back to 75mg. As VG said, Effexor is hell to get off of and you have to go very slowly. The same is true for all anti depressants, but some are worse than others to get off of. What is suggested on the AD sites is to drop 10% of your current dose every 3 - 6 weeks, either by using the liquid form or cutting and then weighing the pills.

Read VG's post again. What he is saying is unfortunately the truth. I hope you start feeling better very quickly.

Yea this is not good at all. My 15 minute drive home from work, I forgot to turn on the road to stop at the gas station then I almost took the wrong ramp which would have headed me into Ohio... Now I'm at home trying to relax on the couch and after getting up to make something to eat, I was dizzy for about 10 seconds. But here is the strange thing. Looking back, I was actually once on Effexor and 150mg around the time of my separation 5 years ago and it had been working alright then but with the trauma of the divorce upcoming at the time, we switched off to something else thinking it wasn't working as well but oh yea, I do remember the terrible withdrawal. Head felt like it had bees buzzing around in it, general body aches, nausea... all sorts of problems. Why I even gave this another chance is beyond me right now.

[BlackSpinner]

I am shocked that they doubled the dosage just like that. My daughter's doctor increased her very gradually for just that reason.

My daughter also quit cold turkey due to monetary reasons (she didn't tell me until after) It was hell according to her but since she wasn't working and school was finished she figured she could tough it out. Since her thyroid meds were working well for her she didn't really need them anymore.

[portiemom]

About the only thing I can add, and I have been on a bunch of different antidepressants including effexor, which is hard to wean off of, I was put on cymbalta, it works great, and after years on it I had to get off of it due to $. If you think effexor is bad, DON'T EVER TRY CYMBALTA...........took two painful attempts and finally with augmented meds.(dr. supplied so not cost) the three months it took were awful. I hope you get the treatment you need, but whatever you do avoid Cymbalta.

[Matty332]

Oh man,

If you look at all my starting posts here on CPAP community, I was experiencing activation syndrome from my Zoloft being doubled and the whole time I thought it was my CPAP treatment and that I had obesity hypo ventilation syndrome and I was a mess. My OSA did play a factor but it was mainly the Zoloft. It is my understanding that you can still get activation syndrome in rare cases on SRNI as well as SSRI. Those symptoms *may* be the start of activation syndrome or just normal side effects. I felt all those things at the start when my dose was doubled and then came the slightly psychotic bizarre racing thoughts and thought disorder, confusion and sometimes disorientation, anxiety and random sound bites of conversations I had heard earlier repeating in my mind. I basically had a mixed episode - depression mixed with hypomania. That calm you talked about - I had this twisted fake euphoria over all those symptoms as well and my mood went up and down, I felt better at night from 8pm to midnight. Not a fun time I can assure you. I went through it for two months because I trusted my psych, when I should of trusted my gut instinct. I have a new psych now. It was the scariest period of my life and you can see all the posts I made trying to find out if it was the CPAP. Go see another doctor about it in my advice and if they take you off it - for the love of god taper off slowly over a month or two do not stop it abruptly. These drugs are known to increase the risk of suicidal idolation when going off cold turkey. In even rarer situations people even go postal but I won't go into that.

You did the right thing by deciding to go back to 75mg. If you don't feel better ask to try something else, just because you had a bad reaction to one SNRI or SSRI doesn't mean you will on the others. If you have bad reactions on all of them it is likely that you have undiagnosed bipolar disorder. What are you considering trying next? If you don't mind me asking are you on the meds to treat only depression?

[lazer]

Oh man,

If you look at all my starting posts here on CPAP community, I was experiencing activation syndrome from my Zoloft being doubled and the whole time I thought it was my CPAP treatment and that I had obesity hypo ventilation syndrome and I was a mess. My OSA did play a factor but it was mainly the Zoloft. It is my understanding that you can still get activation syndrome in rare cases on SRNI as well as SSRI. Those symptoms *may* be the start of activation syndrome or just normal side effects. I felt all those things at the start when my dose was doubled and then came the slightly psychotic bizarre racing thoughts and thought disorder, confusion and sometimes disorientation, anxiety and random sound bites of conversations I had heard earlier repeating in my mind. I basically had a mixed episode - depression mixed with hypomania. That calm you talked about - I had this twisted fake euphoria over all those symptoms as well and my mood went up and down, I felt better at night from 8pm to midnight. Not a fun time I can assure you. I went through it for two months because I trusted my psych, when I should of trusted my gut instinct. I have a new psych now. It was the scariest period of my life and you can see all the posts I made trying to find out if it was the CPAP. Go see another doctor about it in my advice and if they take you off it - for the love of god taper off slowly over a month or two do not stop it abruptly. These drugs are known to increase the risk of suicidal idolation when going off cold turkey. In even rarer situations people even go postal but I won't go into that.

You did the right thing by deciding to go back to 75mg. If you don't feel better ask to try something else, just because you had a bad reaction to one SNRI or SSRI doesn't mean you will on the others. If you have bad reactions on all of them it is likely that you have undiagnosed bipolar disorder. What are you considering trying next? If you don't mind me asking are you on the meds to treat only depression?

Thanks Matty and to everyone posting their comments. You've pretty much hit is spot on. I'm glad I didn't go with keeping to the upped dosage more than that 1st day yesterday. I just went back to the 75mg this morning. I was screwed up all day yesterday and it finally started to ease up at night enough to get some good rest and once I put on my mask, I really started to settle down. Another benefit I'm noticing with CPAP, it's sorta setting that clock off that it's "Time for sleep" each night when I start it up so my insomnia seems to be improving also post-Cpap.

But anyhow, back to this topic. The nurse called me back this morning and had talked to my doctor about my reaction and side-effects going from the 75mg to 150mg yesterday. He suggested I keep with the Effexor and he could prescribe a 37.5mg to add to the 75mg... (Now I'm asking myself, why did we jump to the double dose if this option was available in the first place... ) Anyhow, I told her that I have decided I ultimately want to switch to something different because I don't even want to chance having this reaction again in the future on the Effexor AND that I do remember how hard it is coming off of it which I will still have to go through BUT at a higher dose, would likely even be worse.

To answer your question at the end of your post Matty: I'm also on low dose Xanax (.25mg x 3 per day) and 1mg at night for sleep. And I'm on Neurontin 300mg up to 4x per day but I usually just take it 3x, also for anxiety. So the SNRI or SSRI is pretty much added strictly for my on and off depression symptoms.

I've done a little research and there are 3 that I am considering suggesting to my phsyc doctor: Paxil (I don't think I ever tried it), Lexapro (I was on this a while back and it actually worked well for me but switched off of it due to the cost being a Tier2 Formularly with no Generic available it costs about $30 per month opposed to $8 for generics...), Zoloft (I think I tried this in the past and can't really remember how it worked or why I switched off of it), Celexa (Same - Remember trying it but for some reason ended up on Prozac...)

I am basically looking for something that won't promote weight gain, insomnia, suppress REM sleep, not leave me screwed up with multiple side effects as the Effexor at the higher dose did, and obviously help me feel better and not depressed. So once again, the search is on....

[RandyJ]

You might want to look into Lexapro again... I heard there was a generic version out...

Are you doing at least 30 mins to an hour a day of intense exercise? Usually these drugs ramp up your nervous system so much that it really helps to use some of that energy, and it will cut down naturally on the feeling of agitation.

[Suzjohnson]

I would suggest a big NO to Paxil. My husband is trying to wean himself off of it and it's a bear. Going to take months. His withdrawal symptoms sound much like yours. He's decided depression is easier than withdrawal.

Suz

[lazer]

You might want to look into Lexapro again... I heard there was a generic version out...

Are you doing at least 30 mins to an hour a day of intense exercise? Usually these drugs ramp up your nervous system so much that it really helps to use some of that energy, and it will cut down naturally on the feeling of agitation.

Thanks for the feedback. I'm leaning towards the Lexapro at this time. I actually did get some good exercise in all of last week doing various outdoor projects and other than sore muscles, I did feel a bit better emotionally so I will have to work something into my schedule on a regular basis.

Thanks Suz for the heads-up on Paxil.

[VikingGnome]

Lexapro has the no effects on sleep architecture so is a good choice. Unfortunately, my Medicare Part D has it has a Tier 4 drug so my copay would be $80 per month. Yikes.

[lazer]

Lexapro has the no effects on sleep architecture so is a good choice. Unfortunately, my Medicare Part D has it has a Tier 4 drug so my copay would be $80 per month. Yikes.

Just did a little research on this and according to my plan, a "generic" equivelant comes up as escitalopram oxalate. Assuming this is correct and actually available, I do believe I will be talking to the doctor about this.

VikingGnome, You should check with your plan and/or pharmacy and see if this may be the case for you. I would think your plan would cover the generic at a much lower cost. I know mine does.