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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by The_Resistance on March 28, 2005, at 5:20:31
High everyone
I recently increased my dose of Effexor XL to 225mgs.
This intially gave me improved energy and mood, unfortunatly this effect has now faded.I've increased my dose to to 300mgs, but I just feel tired
I'm so frustrated I'm tempted to just start weaning myself off strait away
How long is a fair trial for high dose Effexor?
Should I stay on 225-300mg for three weeks or four?
Should I just stop?
Posted by Bill LL on March 28, 2005, at 9:38:00
In reply to Effexor XL, how long is a fair trial?, posted by The_Resistance on March 28, 2005, at 5:20:31
I think that 3 weeks is the minimum amount of time that you need to give it a try at the higher dose. Try drinking a lot of caffeinated tea. That helps me with energy.
The drug that I take, Cymbalta, is similar to Effexor in that it affects both serotonin and norepinephrine. If Effexor doesn't work out, you might want to try Cymbalta. It makes me tired, but not as tired as I had been on the Lexapro/ Strattera combo that I was previously on.
> High everyone
>
> I recently increased my dose of Effexor XL to 225mgs.
> This intially gave me improved energy and mood, unfortunatly this effect has now faded.
>
> I've increased my dose to to 300mgs, but I just feel tired
>
> I'm so frustrated I'm tempted to just start weaning myself off strait away
>
> How long is a fair trial for high dose Effexor?
> Should I stay on 225-300mg for three weeks or four?
> Should I just stop?
Posted by SLS on March 28, 2005, at 9:41:26
In reply to Effexor XL, how long is a fair trial?, posted by The_Resistance on March 28, 2005, at 5:20:31
> High everyone
>
> I recently increased my dose of Effexor XL to 225mgs.
> This intially gave me improved energy and mood, unfortunatly this effect has now faded.
>
> I've increased my dose to to 300mgs, but I just feel tired
>
> I'm so frustrated I'm tempted to just start weaning myself off strait away
>
> How long is a fair trial for high dose Effexor?
> Should I stay on 225-300mg for three weeks or four?
> Should I just stop?You've already invested so much time with this drug, I would be inclined to fully explore its potential to help you. Hopefully, the sedation at 300mg will pass. 4 weeks seems reasonable to identify whether or not there is a trend towards improvement.
If you decide to discontinue Effexor, do not do so abruptly ("cold-turkey"). The withdrawal syndrome can be very intense if you stop the drug all at once. You are much better off tapering the drug slowly and perhaps begin an SSRI as you are discontinuing the Effexor. If you want to discontinue Effexor without replacing it with an SSRI, take a look at the Psycho-Babble Withdrawal board to find suggestions for how to go through the discontinuation process with minimal withdrawal effects.
Good luck.
- Scott
Posted by SLS on March 28, 2005, at 9:47:16
In reply to Re: Effexor XL, how long is a fair trial?, posted by Bill LL on March 28, 2005, at 9:38:00
> I think that 3 weeks is the minimum amount of time that you need to give it a try at the higher dose.
I agree with this. What do you think the maximum time period should be? I've seen quite a few people say that they didn't experience an improvement for at least 6 weeks.
I guess the more patient one can be with each drug, the better the chances are of finding one that works. This would be particularly relevant if one has already failed to respond to previous drug trials.
- Scott
Posted by ed_uk on March 28, 2005, at 10:11:43
In reply to Re: Effexor XL, how long is a fair trial? » Bill LL, posted by SLS on March 28, 2005, at 9:47:16
Hi Scott!
>What do you think the maximum time period should be? (on a high dose)
I'd say 6-8 weeks for depression. 8 weeks for anxiety. 12 weeks for SSRIs in OCD.
Ed.
Posted by Racer on March 28, 2005, at 10:50:25
In reply to Effexor XL, how long is a fair trial?, posted by The_Resistance on March 28, 2005, at 5:20:31
> High everyone
>
> I recently increased my dose of Effexor XL to 225mgs.
> This intially gave me improved energy and mood, unfortunatly this effect has now faded.
>
> I've increased my dose to to 300mgs, but I just feel tired
>
> I'm so frustrated I'm tempted to just start weaning myself off strait away
>
> How long is a fair trial for high dose Effexor?
> Should I stay on 225-300mg for three weeks or four?
> Should I just stop?The minimum should be about four to six weeks -- AT THE SAME DOSE! Changing the dose within that time period will make things worse rather than better.
I just read something about this very subject in one of the journals -- dunno which one, I found it via Medscape and just read -- which told doctors that they do more harm than good by making dosage adjustments within that initial window, and then it takes longer to see if a medication will work for a patient or not. If you can be patient, and wait out that initial period to give the drug a chance to work for you, you may find that you get good results in the end.
What does your doctor say, by the way? Or are you making these adjustments on your own?
Posted by The_Resistance on March 28, 2005, at 12:38:03
In reply to Re: Effexor XL, how long is a fair trial? » The_Resistance, posted by Racer on March 28, 2005, at 10:50:25
Thanks for the input everyone
Your support means a lot to me!
I'll try and clarify a few things.
I have been taking 150mgs of Effexor since 25 of November 2004.
I upped the dose to 225mgs in January because I was quite depressed, but went back down to 150 when I ran out of 75mg capsules.
A few weeks after going back to 150mgs I became very depressed again, so I went to my GP and asked for a dose increase.To be honest I know Effexor alone is not going to be the answer for me. It does seem to help my depression somewhat at 225mgs.
However it doesn't help my Social Anxiety or my ADD/Apathy type symptoms.Unfortunately it’s very difficult to get social anxiety or ADD treated effectively in the UK.
UK docs are very reluctant to prescribe Benzos and MAOIs, and it’s all but impossible to get stimsI'm going to see my NHS Pdoc on the 7 of April. I don't really trust him so I think I will stay on the Effexor and see what he offers, I can always accept if it’s good.
I'm sorry if what I'm doing sounds mendacious and deceitful, but to put things in perspective I find him quite difficult to deal with. He is very distant, when I told him I was taking Dexedrine he implied I was addicted, although there was nothing to suggest I was.
Don’t really know what to do :(
Posted by Bill LL on March 29, 2005, at 10:11:44
In reply to Re: Effexor XL, how long is a fair trial? » Bill LL, posted by SLS on March 28, 2005, at 9:47:16
I tend to be too inpatient. But I have also read a lot of posts suggesting that patience can pay off when starting new drugs, or increasing a dose.
> > I think that 3 weeks is the minimum amount of time that you need to give it a try at the higher dose.
>
> I agree with this. What do you think the maximum time period should be? I've seen quite a few people say that they didn't experience an improvement for at least 6 weeks.
>
> I guess the more patient one can be with each drug, the better the chances are of finding one that works. This would be particularly relevant if one has already failed to respond to previous drug trials.
>
>
> - Scott
>
This is the end of the thread.
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