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Low dose venlafaxine basically an SSRI?

Posted by NKP on August 8, 2021, at 15:52:17

I've read that venlafaxine, at doses lower than 225 mg/day, works essentially like an SSRI. A meaningful dopaminergic effect only kicks in at very high doses. That being the case, is there any point to using venlafaxine, rather than an SSRI, at doses lower than 225 mg/day?

Here's a case report of a patient who became psychotic when using venlafaxine at a dose of 150 mg/day.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802382/

The probable cause for this psychosis was an increase in dopamine. Does this not contradict the claim that venlafaxine is basically an SSRI at these doses?

Context
++++++

Previously I was taking sertraline 50 mg/day and flupenthixol 0.5 mg/day. My mood was fine but my functioning was very poor (extreme lack of motivation). This medication was being prescribed through my family doctor.

I finally went to see a psychiatrist a few weeks back after my wife threatened to divorce me if I didn't see a psychiatrist *and* abide by his treatment (I have a tendency to consult with Dr Google). He took me off the sertraline and flupenthixol, and replaced it with 75 mg/day venlafaxine.

I notice no real difference except perhaps I feel a bit more energetic. My wife however claims that my mood has substantially improved.

I don't really know what to do because my functioning is very poor.

The psychiatrist said that future options would be to increase the dose of venlafaxine, and if that didn't work, to consider augmenting with quetiapine or lamotrigine.

Do you think that this might improve my functioning?


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poster:NKP thread:1116313
URL: http://www.dr-bob.org/babble/20210723/msgs/1116313.html