Can Anybody Answer This??

[McBlonde]

Started Effexor XR 37.5 on the 11th. By the second day, waking up at night feeling dread, with that awful feeling that something was wrong was completely gone. No more adrenaline surges or waking up with dread. I remember saying on the way back home from Florida.... I feel happy. Eliminated all my IBS issues and fibro pain.

But, within a few days, I noticed my resting heart rate had dropped from the high 70s - 80s down to the 50s, but my standing heart rate continued to be over 125. By 1 week, I noticed that the fatigue had set in... Extreme fatigue. I felt dull... apathetic and unable to get up and do anything. Started having carbo cravings

What part of Effexor XR eliminates the adrenaline surges, sense of dread, IBS and Fibro pain.

What part of Effexor causes the fatigue?

Edited July 25, 2012 by corina
enlarged the text

[abbyw]

Well, its an SNRI - so it is affecting serotonin and norepinephrine levels, which may explain the IBS as well as the POTS. The gut has lots of serotonin receptors. It almost seems like you may be on too high a dose. It usually takes weeks to feel the full effects, and you felt them immediately, and then had poorer results later on.

Also, the time of day you take it may be affecting the fatigue. It is something you have to play around with. Good Luck!

[McBlonde]

Thanks for answering. I had taken 75 mg of Effexor for years and got off of it last Feb (got off meds for testing). That's when I noticed that my worst symptom of severe fatigue went away, but after about 4 months the sudden surges of adrenaline and dread just about overtook me! I wasn't positive it was being off the Effexor that made the fatigue & I was at a point where I HAD to do something, so I started the 37.5 xr. It is like I was on too high a dose isn't it? I stopped it again. Now I'm not as fatigued (and I'm typing on the forum again, BUT the adrenaline surges and despair are creeping back. There is not a dose smaller than 37.5 is there? I don't get what about that small amount would cause fatigue??

[Debbie Rose]

There are plenty of other medications that are SNRI's that can help so talk to your doctor about options

[McBlonde]

There are plenty of other medications that are SNRI's that can help so talk to your doctor about options

I DO have a call into him, but I was hoping some knowledgeable person on the board would have some ideas AND I have previously tried every single one of the SSRIs through the years and not been able to tolerate. Besides, posting it here might ring a bell with someone else that has had severe fatigue and never one thought it could be related to an SNRI!

[McBlonde]

Well, 5 days and still no call back from my doctor. I wish there were websites that you could go on that could answer questions like this.

[abbyw]

Funny, I was just thinking of switching TO Effexor because of the weight gain and fatigue on Lexapro.

[McBlonde]

Abby, prior to going off Effexor in February, I had taken it for a long time. Unlike all the other anti-depressants that I tried, I lost weight on Effexor. In most people, I think Effexor XR is one of those that actually gives you energy.

It appears to me that the side effects I described above seem like the dose is too high now. (More sensative to drugs now)

I wonder what would happen if I took the Effexor at night? I wish they had a child's dosage. I wish we still had a pharmacist on this board!

It seems like such a simple question for people that know what a drug has in it and how it works. I am beyond frustrated at not knowing what to do.

[sue1234]

Can't you go talk to your pharmacist where you get your prescriptions from? I have great small-town pharmacists that have answered all my questions over the years.

[McBlonde]

Talked to the pharmacists ..... They say the response sounds like the dose of Effexor 37.5 is too large (for me). Their suggestion was that I tried either (1) Taking the Effexor XR 37.5 at night Or switching to regular Effexor so that it can be filled at baby doses.

Any opinions on that?

[sue1234]

Oh, definitely baby doses!! Then you could titrate as needed.

[McBlonde]

I wonder if you take the regular Effexor and not the Effexor XR if you get those crashes like you can get with regular, not time released, Adderal? Come to think of it, when I took the 15 mg of Adderal, it ALSO made me feel dull, apathetic and unable to find the energy to get up and do anything. Does Adderal & Effexor XR have any of the same properties?

PS... I must be the only person in the world that responds to Adderall like that, since it's so popular with the college crowd, lol!

[sue1234]

I hope someone chimes in that has taken them, as I haven't tried an SSRI or an SNRI since the 1990s, when the the first ones were coming out. I remember when Prozac came out, I tried it and felt awful. The doctor tried a few more (Paxil, Wellbutrin) and all made me feel worse than not taking anything. So, I never tried any of them again in the last 15 years or so.

[Guest headhunter030]

Effexor was absolutely terrible for me. Everybody is different. Paxil was great for me...stopped adrenaline surges and helped be sleep better. But it is very important to realize that I think we need to start on low doses of these meds and they take at least 4 weeks before you feel better, and you will feel worse at first.

Edit: On Paxil it is impossible not to gain 10-20 lbs.

[brethor9]

I am the same as Sue...I went through a year of crap before I was diagnosed where I tried every single anti-depressant out there.....I had paradoxical reactions to all of them....the stimulants knocked me out (McBlonde; you are not the only one .....) and all the other ones made me squirrely or feel a hundred times worse....so I gave up on all of them. Even the beta blocker is a constant battle as the effects to my system change one day to the next.....my best luck has been with lorazepam so I just stick to taking it...helps with my mast cell issues, digestive upset, sleep...etc..

[McBlonde]

Yep. I went through them all, too, starting in the 1990s. None of them worked right on me except the Effexor XR back then... I gained 30 lbs in 30 days on Cymbalta and I bought a house I don't like on Prozac. The Effexor XR on the otherhand, was great! I lost weight and kept it off...... so, I don't know why now I'm suddenly sensitive to such a small dose. I take Klonopin at night, but it does nothing for the adrenaline surges for me... If I wasn't having those and now the feelings of despair coming back, I wouldn't even think about taking an anti-depressant again.... but this crying at the drop of a hat or the insane over response to the slightest stressor is starting to take me to despair again, so I feel like I have to do something. That week when the Effexor was working (before it built up too much) was great. I remember it fondly.

[brethor9]

McBlonde....like you I have way over-reactive responses to the dumbest things sometimes.....have you tried any beta blockers just in a tiny dose? they can help block the adrenaline and IMHO are a little more user friendly than the anti-depressants.....also if your dr allows you can take only when you are going through a bad episode. Magnesium is good for relaxing also. Its the adrenaline surges that are making you react with the crying and feelings of despair so try to remember that (its not the same as psychological anxiety although I am sure we are all stressed out with this illness) its a physical repercussion of your autonomic system not being balanced. Just out of curiosity the last time you were on Effexor did you have POTS? that might be the difference for why the med has changed in how it affects you? maybe since then your system is just a little more deregulated? what meds are you taking right now?

[sue1234]

Yes, if you are having the bad emotions, I can see where you need to find one that works. The emotions I had back in the 90s have gone. But, if they came back I would start the round again on trying to find one that helped.

Hope you didn't have to stick with the bum house too many years!

[McBlonde]

Hahaha Sue! Thanks for making me laugh today!! The GOOD news is that it's a very nice house. The BAD news is that it is nothing, nowhere near my taste & we bought it in 2003 and with housing being what it is now, well, here I am with no exit strategy possible, lol! LOL, so many worst things but I do laugh whenever I hear the word Prozac because that's what I think about ....this house!

Brethor9 Yes, you are right. I didn't have the POTS portion of dysautonomia. At the time I had the low BP, orthostatic hypotension and fainting part going on....

Back in 2010, when the cardiologist said POTS, my heart rate was over 165 and he insisted I take 5 mg of Bystolic. It did lower my HR, but after 2 weeks I had bad fatigue and something not depression, but like it.... I don't know how to describe that feeling but it was bad. They lowered the dose to 2.5 but that didn't help. My guess is because I have periods of my BP dropping 40 or 50 points when standing, BB probably aren't the right thing for me. Maybe I need the HR increase to compensate when on occasion my BP drops so drastically. I don't know. The more I know, the more confused I am getting.

Right now I take 1.25 Levoxyl .1 Florinef in AM and 1mg of Klonopin with 25 mg of Trazadone at night.

[brethor9]

yeah I hear you.....sometimes I wonder how much more damage I am causing to the system by trialling and tweaking drugs all the time I tried about 10 different betas before I hit on one that isnt bad in a very tiny dose (bisoprolol) I take 1.25 mg on an as needed basis mostly. I find if I take it everyday I get the same feelings you describe (feeling of being sucked through the floor or I am moving through mud or something and I get really ****** mood wise lol)....it probably builds up in the system. I dont take it on days that my pressure is low or I compensate with an extra dose of florinef.....its such a balancing act isnt it? I really wish one of these treatments would hit and stick

[McBlonde]

THAT is an AWESOME description of how I feel when I take a beta blocker!! Wow..."being sucked through the floor (or wishing I would, lol)

[brethor9]

lol you are right it is a horrible, alien sensation isnt it??.....I tried to describe it to many Dr;s prior to finding my POTS specialist....as soon as I explained it to him he smiled and said I know exactly what you are describing...the dose is too high and you are dilating too much causing even more pooling....weird right?? they put us on meds to stop the tachy but they also cause more pooling and low BP....sometimes I want to be put into a medical induced coma where they can just reboot the system and I would wake up cured

[McBlonde]

EXACTLY! Oh for the "good ole days" when I just had orthostatic hypotension & would faint and then get up and go my merry way!

[Lemons2lemonade]

My Citalopram behaved similarly. Perhaps your appetite is increasing because you are feeling better and are able to eat Carbs

[jangle]

Unfortunately it is poorly understood what levels of serotonin as well as norepinephrine need to be to be "symptom free" which is one of the reasons why doctors don't test these neurotransmitters. The nervous system is quite complex, so we can only intelligently describe general trends. The SNRI you're taking inhibits serotonin reuptake as well as norepinephrine reuptake. Now it has been documented that norepinephrine reuptake inhibition causes POTS in healthy volunteers and that POTS patients have naturally low levels of norepinephrine reuptake. So that part of your medicine is likely to exacerbate your POTS symptoms. However, the serotonin part of the medicine might be what explains the beneficial effects of reducing your adrenaline surges as well as the fibro pain. There probably is something else going on because if this were the case then one would logically just switch you to a SSRI which has more specificity to serotonin receptors than norepinephrine receptors and that might work it might not I'm not sure.

You have to understand we're not dealing with the gall bladder, skin, hair, or intestines. We're talking about the nervous system, the most complicated system on Earth. Even super computers do not reach the complexity of the biological nervous system. There is no way we will be able to provide precise answers, we can only talk generally and qualitatively.