Posted by ed_uk2010 on July 14, 2018, at 7:18:55
In reply to Re: Switching from Abililfy to Saphris. » ed_uk2010, posted by SLS on July 12, 2018, at 14:40:31
>I'm guessing that the Effexor has made it worse temporarily. There is a trill in my voice and my hands are shaky.
I think that could easily happen if you increase Effexor too rapidly. I do think the anxiety would respond to lorazepam or diazepam though.
I do believe venlafaxine is a good antidepressant, although hardly first-line with the high incidence of withdrawal symtoms and initial nausea etc. Although higher dose are more effective for a subset, I must admit I'm unconvinced by the usefulness of ultra high doses vs licensed doses - especially since the approved maximum dose is already very high. Increasing beyond the approved dosage range often seems to cause more fatigue rather than more efficacy. I think it's probably more useful to wait longer (on 75mg/day in moderate depression and 150-225mg in severe depression), rather than ramping it up to 300-375mg too fast. I think people usually have fewer adverse effects and comparable response by doing this. Less initial agitation, nausea, tiredness etc.
Oh, and you may find this interesting. Perhaps it is why duloxetine isn't a very good antidepressant compared to venlafaxine!
https://www.ncbi.nlm.nih.gov/pubmed/26437230
poster:ed_uk2010
thread:1098631
URL: http://www.dr-bob.org/babble/20180521/msgs/1099568.html