Posted by Racer on January 10, 2008, at 14:40:29
In reply to Effexor - How long is sufficiant?, posted by De on January 10, 2008, at 12:23:39
The general rule is that it takes four to six weeks at an adequate dose to see benefits from a medication, with full response taking about eight weeks. On the other hand, you were on Effexor, apparently successfully, at a lower dose for some time, so I would expect you to get an idea of whether it was going to work by about four weeks at an increased dose. So, I'd give it an additional two to three weeks before looking at alternatives.
Adding Zoloft, though, raises the risk of serotonin syndrome. I wouldn't think of it as a combo, for that reason. If your doctor thinks it's OK, maybe I'm being too cautious, but it's not an option I'd vote for.
There are two basic choices with medication which isn't working: switch, or augment. For augmentation of Effexor, I'd look at Remeron, Wellbutrin, or maybe one of the old tricyclics. Wellbutrin has the benefit of potentially increasing energy, although it can also increase anxiety if you're susceptible to that. Remeron can be helpful for sleep, and the combination of Effexor and Remeron is quite popular these days.
What's best for you really depends on what symptoms you're trying to target, and how tolerable you find the medications. Often side effects are a big part of choosing medications, since tolerability is so important in treatment.
I hope that helps.
poster:Racer
thread:805553
URL: http://www.dr-bob.org/babble/20080105/msgs/805570.html