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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by tensor on February 25, 2010, at 3:57:48
Hi,
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?Thanks for *any* ideas!
Regards,
Mattias
Posted by Viking on February 25, 2010, at 9:14:52
In reply to Effexor 225mg - what now?, posted by tensor on February 25, 2010, at 3:57:48
The best med I have ever tried when it comes to drive and motivation is a low dose Abilify (2mg). I have only tried it together with Prozac, but it will probably work with Effexor too.
You may increase the dose of Effexor. That will make it more noradrenergic and may boost energy.
Anyway, you should take the med for at least 6 weeks before you decide if it works or not.
Posted by polarbear206 on February 25, 2010, at 10:05:06
In reply to Effexor 225mg - what now?, posted by tensor on February 25, 2010, at 3:57:48
> Hi,
>
> 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?
>
> Thanks for *any* ideas!
>
> Regards,
> MattiasI usually can't go lower than 300mg or I feel like that, esp in the winter months. You get the NE surge on higher doses.
Posted by conundrum on February 25, 2010, at 10:07:43
In reply to Effexor 225mg - what now?, posted by tensor on February 25, 2010, at 3:57:48
I guess an important question to ask in whether to stop it or not is: "Is it helping?"
If you are being relieved of the painful symptoms of depression it might be worth it to stay on it awhile longer. If its helping you can always augment. Also you probably should give it 6 months at this dose as well. Also it depends on how many other drugs you've tried first and if they've helped. If you haven't tried many you might want to take the time to find something less blunting, if you've tried many drugs and this is helping with sadness and anxiety then it might be worth it to stay on it and augment.
Posted by Phillipa on February 25, 2010, at 10:53:32
In reply to Re: Effexor 225mg - what now? » tensor, posted by conundrum on February 25, 2010, at 10:07:43
Hi Mattias I'd say are you functioning better are you getting out working socializing. Important. Some become shuts ins and others work and function well with depression. Phillipa
Posted by tensor on February 25, 2010, at 12:31:46
In reply to Re: Effexor 225mg - what now? » tensor, posted by Viking on February 25, 2010, at 9:14:52
> The best med I have ever tried when it comes to drive and motivation is a low dose Abilify (2mg). I have only tried it together with Prozac, but it will probably work with Effexor too.
>
> You may increase the dose of Effexor. That will make it more noradrenergic and may boost energy.
>
> Anyway, you should take the med for at least 6 weeks before you decide if it works or not.
>I've been thinking of Abilify and maybe it's time to give it a try. But I would like to get some improvement from Effexor first, i.e. a partial response, now it's just fatigue.
All in all I have been taking Effexor about a month and I don't feel any noradrenergic effects./Mattias
Posted by tensor on February 25, 2010, at 12:34:04
In reply to Re: Effexor 225mg - what now?, posted by polarbear206 on February 25, 2010, at 10:05:06
> > Hi,
> >
> > 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?
> >
> > Thanks for *any* ideas!
> >
> > Regards,
> > Mattias
>
> I usually can't go lower than 300mg or I feel like that, esp in the winter months. You get the NE surge on higher doses.Interesting, this encourages me to call my pdoc tomorrow, how high have you gone? XR?
/Mattias
Posted by tensor on February 25, 2010, at 12:36:52
In reply to Re: Effexor 225mg - what now?, posted by Phillipa on February 25, 2010, at 10:53:32
> Hi Mattias I'd say are you functioning better are you getting out working socializing. Important. Some become shuts ins and others work and function well with depression. Phillipa
Hi,
no I do not work and I'm not getting out much, don't want to socialize either. Basically I'm just moving back and forth between the bed and the sofa.
/Mattias
Posted by Phillipa on February 25, 2010, at 19:56:12
In reply to Re: Effexor 225mg - what now? » Phillipa, posted by tensor on February 25, 2010, at 12:36:52
That's not good was hoping you were doing better. Phillipa
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!
Posted by tensor on February 26, 2010, at 5:41:47
In reply to Effexor 225mg - what now?, posted by tensor on February 25, 2010, at 3:57:48
Ok, spoke with my pdoc, I'm upping the dosage to 300mg immediately.
/Mattias
Posted by polarbear206 on February 26, 2010, at 15:03:18
In reply to Re: Effexor 225mg - what now?, posted by tensor on February 26, 2010, at 5:41:47
> Ok, spoke with my pdoc, I'm upping the dosage to 300mg immediately.
>
> /MattiasI hope this will do the trick. I never went past 300mg, Some people need higher and go up to 450mg. Glad you talked with your doctor. Good luck.
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