Posted by europerep on October 13, 2013, at 8:55:58
In reply to 450mg Effexor - seems to be helping slightly. Q, posted by TriedEveryMedication on October 12, 2013, at 21:09:54
> me: ADD, depression, social phobia, some sort of ischemic lesion or something in my insula
>
> been taking 450mg of effexor for about 3 weeks (150mg for 6 months and then 300mg for a few weeks before)
>
> I think its helping slightly.Hi,
there is some scientific documentation, as well as anecdotal reports (such as mine) of patients going up to 600mg/day of venlafaxine (Effexor). I was on that dose for about a year and a half, without noticeable side effects (except for the first few weeks, but they quickly disappeared after that). So, if you are not having problems with side-effects or blood pressure, I wouldn't see a reason to not try out 525 mg/d.
If that fails, you can indeed try combination treatments. CYP2D6 metabolizes tricyclic antidepressants (TCAs), but it's by far not the only cytochrome doing that, and as far as I know not even the most important one for tricyclics (I think those are 1A2 and 3A4). So you may have have to start with low amounts of a TCA, but there's no reason you can't take them at all.
If you have problems with ADD as you say, an option might also be to add methylphenidate. Here one has to be careful with blood pressure though. But I took the combination without any problems, it just didn't really do anything for me. Before trying a stimulant, bupropion might be worth a try though.
I hope this helps...
ER
poster:europerep
thread:1052096
URL: http://www.dr-bob.org/babble/20130930/msgs/1052118.html