Posted by em_kath on February 25, 2010, at 20:13:42
In reply to Effexor 225mg - what now?, posted by tensor on February 25, 2010, at 3:57:48
> I'm currently on 225mg Effexor xr for depression and been on this dose a couple of weeks. Side effects are not so bad. But I have no drive, motivation, interest or energy, am tired all the time. I have my own BP monitor at home, an automatic one, and my BP is about 120/78mmHg.
> Should I up the dosage, augment or switch?
Have you considered Wellbutrin? I had the same problems with motivation and energy along with my depression, and Wellbutrin was the first drug that was helpful for me after trying numerous other drugs, and it worked moderately well for several years. I added Effexor to the Wellbutrin when it seemed like the Wellbutrin wasn't as effective anymore, about a year ago. I gave up on it and switched to an MAOI somewhat prematurely, and I wish I had given it more time to work because the combination had potential (I have considered going off the MAOI and trying Wellbutrin/Effexor again). The Effexor helped with my anxiety while Wellbutrin helped more with sadness and anhedonia/tiredness. IMO It's a good combination because Effexor (as you may know) works on serotonin and norepinephrine, and Wellbutrin works on dopamine and norepinephrine. Low dopamine might be partly responsible for your lack of interest and motivation. In any case, if I were you I would try to augment, increase the dose of Effexor, or both, before completely switching, because the withdrawal effects of quitting Effexor can be difficult for some people and you should make sure you're getting the maximum possible benefit first. Your pdoc will probably want to wait a few more weeks before making any large changes to your meds. Good luck!
poster:em_kath
thread:937850
URL: http://www.dr-bob.org/babble/20100216/msgs/937899.html