Hi, all,
First of all I would like to say that I am quite sensitive to medications, but even so, have made it through start-up side effects and have been doing fine with Effexor XR (One week at 37.5 mg, then 75 mg since.) Now at 10 weeks in, my memory is finally coming back, not so apt to lose things or forget what I'm supposed to be doing, yay! This had been a real problem for me before, but I suspect a lot of it had to do with my untreated depression. I have been diagnosed with Seasonal Affective Disorder, which is a form of MDD. I expect to be kept at this dose for another couple of months and then titrated up for the winter. I imagine I will be on it year round, and am very hopeful of its working out for me long term. It is also prescribed for GAD and OCD and is useful for pain as well. Dosing can be adjusted to account for not only serotonin, but norepinephrine and some dopamine levels, and certain other medications can be added on if needed.
I realize that many people are given tablets, and then when it is felt that the dose is right for them, they may be given the extended release capsules to carry on with. I was fortunate in that my doctor had in mind what he wanted for me to try, and started me right off with the extended release form. I say this because by all accounts, this form has the least number of problems with the spiking of side effects that can occur with the standard release pills. For example, suddenly increased anxiety. You may want to ask your doctor for the extended release form from the start. Capsules are available as low as 37.5 mg.
Some people don't experience any start up side effects with Effexor/venlaxafine, or these are made less when they are crossed over from another medication. I started from "scratch", and as I say, I have experienced side effects from all meds, which I think is more common than not. This is what I found helpful.
IT IS CRITICAL TO TAKE THIS MED AT THE SAME TIME EVERY DAY. If you miss it, you will know all about it after a couple of hours. Eat and take it and you'll be fine again. I only had to do this once.
*Sleep disturbance - Pharmacist suggested I start by taking my dose in the morning, and only switching to evening if it created daytime sleepiness. I did, and it didn't.
*Constipation - hugely common. Pick up a gentle laxative and some dried prunes. There will be days when you need the laxative, days when you can get by with the prunes. It will go on for weeks, be prepared. Not the end of the world, just constipation.
*Nausea - Pharmacist said to take it with food. I take it after breakfast (not just a piece of toast, something substantial). And a full glass of water, sipped at slowly. On HERE I LEARNED: Eat even if you don't feel like it, lightly and often throughout the day, every couple of hours if possible. IT HELPS! This goes away for the most part, after the 3rd or 4th day. I manage any occasional queasy feelings with soda crackers and sometimes ginger ale. I find I still have to eat often throughout the day.
*Dry mouth - OMG, I thought I was dying of thirst! Carry water with you wherever you go. Also sugar-free hard candies to suck on or gum, which work when you are talking or away from your water bottle. Apparently it is "just" dry mouth, but our brains send a strong signal out that we are thirsty. This eases off eventually. You probably needed to drink more anyway!
*Muscle tonus - Not mentioned often, but it is the continuous and partial contraction of muscles. It affected my arm and leg muscles and gave me the sensation of knots-in-the-stomach. TIP FROM HERE. Taking a number of long, slow deep breaths in, long slow deep breaths out through my nose helped. This would always dissipate by bedtime. Went away at the end of the 4th week. This may be felt as increased anxiety for some, but for me it was just a physical thing.
*Foggy head - This is probably why I didn't get too excited, it was very hard to put two and two together, lol! Drove me nuts until I found out on here that it's normal to have this for the first few weeks. It gets better.
*Visual snow - Came with it. Like a constant visual fuzzyness. Sometimes euphemistically referred to as "lightheadedness". It goes away, be patient.
*Muscle weakness - Felt at the same time as the muscle tonus, it was a little debilitating. You may just want to sit around. Might get a bit of jelly legs getting in and out of vehicles. Take your time.
*A bit of a delay to starting your urine flow - With all the water in, water out, the added few seconds to have to release your bladder may not be a bad thing!
All of the above are *perfectly normal start up side effects* from Effexor/venlaxafine. Don't freak, don't panic. All normal. You may get some or none. You may also feel dizziness, sedation, sexual side effects such as delayed orgasm, unusual dreams (gotta love em, ha ha!), weight loss, sweating and tingling in extremities. Manageable. At least they were for me.
I know a month or so sounds like a very long time, but really, start-up side effects are to be expected with any of the meds we are going to be prescribed by a doctor. Be gentle with yourself. If you can, take some time off work. Lighten your schedule. Watch some movies. Pet your pets. Eat healthfully. DRINK lots of fluids. Avoid alcohol during this time. Make friends on here. Read success stories. Go for walks if you are able. Fresh air and sunshine do us good when they can be found.
IF YOU REALLY WANT OFF EFFEXOR: Please for God's sake don't cold turkey it and then come on here to "warn" everyone of the "hellish" withdrawal symptoms. Go see your doctor and get a discontinuation schedule going and follow it. Don't be a hero. It's a bad idea, and it doesn't work with any of these meds.
Thank you for your time, guys, and if any of this helps anyone I'm a happy girl. It was all of your support on here that got me through the start up (doctor hadn't said what to expect), and onward to success.
Namaste,
Marie
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