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Need Urgent Help! Ssri Or Snri


cma
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Hello everyone,

I need your advice. It's been 5 years since POTS symptoms started. My GP thinks that I have anxiety and depression. I don't feel depressed, but he thinks otherwise. The only reason I have anxiety, because I can't find a specialist, who could effectively treat this disorder. I live in Ireland and I haven't found a doctor, who knows much about POTS.

I had been tested for lyme disease, which was negative,MRI of my head and neck, nothing significant there either. My GP prescribed me effexor ( venlafaxine), but after reading reviews from people who tried it, I'm absolutely terrified to even try it. He told me that I might experience nausea, shakiness, sweating and even tachycardia ( which I already have!), but if I could stick with this med all those negative side effects would go away and I would feel better.

Could anyone tell which anti anxiety medication worked best for them. Should I ask for SSRI instead of SNRI?

I have a 3 month old at home and don't want to try messing with these kind of meds and want to find the one with the least possible side effects.

Thank you.

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Thank you for your answers.

jangle I would love to find another doctor, but there are not many to choose from. In fact he was the only one, who took me seriously enough and agreed to test for lyme disease and refer to me to have an MRI done. He told me that, if those test would be normal ( which he believed upfront that they would) I will have to trust him and try what he'll suggest. I agreed, but now I am feeling super anxious and can't force myself to take even one pill of Effexor.

Am I being ridiculous? I'm feeling quite bad enough and am scared that this medicine will make me feel even worse. On the other hand, sometimes I see others being anxious to try florinef, which for me had no side effects what so ever, but didn't help much either.

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corina, I don't want to ask my doctor to go look for information about POTS. I'm the only patient he has or probably will ever have with this disorder and I don't think he'd want to "waste" his time on educating himself about it. My philosophy is, if a doctor is really willing to help you, you won't have to ask him/her educate himself/herself about any disease, they'd do that by themselves.

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Hello everyone,

I need your advice. It's been 5 years since POTS symptoms started. My GP thinks that I have anxiety and depression. I don't feel depressed, but he thinks otherwise. The only reason I have anxiety, because I can't find a specialist, who could effectively treat this disorder. I live in Ireland and I haven't found a doctor, who knows much about POTS.

I had been tested for lyme disease, which was negative,MRI of my head and neck, nothing significant there either. My GP prescribed me effexor ( venlafaxine), but after reading reviews from people who tried it, I'm absolutely terrified to even try it. He told me that I might experience nausea, shakiness, sweating and even tachycardia ( which I already have!), but if I could stick with this med all those negative side effects would go away and I would feel better.

Could anyone tell which anti anxiety medication worked best for them. Should I ask for SSRI instead of SNRI?

I have a 3 month old at home and don't want to try messing with these kind of meds and want to find the one with the least possible side effects.

Thank you.

To reply on this. These medicines are not as scary as they seem. I was also very nervous to try ssri's/snri's out. I mean, super nervous. The thing you have to remember is about 70% of the population (this is what my Doc says) is probably on some form of SSRI !!!! These people take this stuff mindlessly with out even giving it a second thought. But our type of personality is prone to over thinking and freaking ourselves out, rightfully so as we do react more to meds. But this is a double edge sword as it stops us from sometimes getting the help we need.

What I can note is that once starting them your symptoms do flare a bit for about two weeks as your nervous system gets back in balance but don't be afraid of this!!! If your expecting it then there is nothing to fear. Now everyone is different of course but I would say 1-3 weeks is about average if you look at the online information.

Even if you give yourself a timeline where you say, okay if by such and such date this isn't helping then just taper off and thats that.

Obviously I'm not a doctor so this is all just my personal advice from being through what you are going through.

Effexor is one of the more heavy duty AD's so if you are really nervous maybe he can try something super benign like Prozac or something very easy to get off of like the Lexapro/Wellbutrin combo which covers all of the same neurotransmitters that Effexor does.

Again, I am no Doc!!! I hope this information is helpful from my own personal experience.

If this gives you any peace of mind i have been on and off, Zoloft, Lexapro, Prozac, Effexor, Wellbutrin, Celexa, and am now back at Lexapro! haha.

Of all this information that you take with you I think the most important is if you are aware that the start-up symptoms WILL go away its so much easier to not be too freaked out by starting one of these types of meds.

I'm wishing you the best!

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cma, I don't think you're being ridiculous for being concerned about trying a certain medication. I just went through this and in fact, the medicine I was prescribed I told the doctor that I wouldn't take it because it was said to increase heart rate and i didn't need further increase. He tried me on something else that i was just as scared to try. I did it for a few days and it made me feel poorly. I'm about to give it a second shot and hope it goes well. Good luck to you!!! I've tried Cymbalta and Lexapro. No negative side effects from either but no improvement in my condition so I quit them.

Keep us informed on your experience!

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I think it's hard for us to know which drug would be good for you without knowing all of your symptoms. It really is a decision that needs to be made between you and your dr. I know that's not so helpful when drs are clueless about POTS. If it were me though, all other things being equal, I would go with an SSRI over an SNRI. SSRIs are commonly used (and have been proven in studies) to treat POTS, so if you take one for anxiety, the added benefit could be that it helps your POTS. I would recommend going slowly with any new med you try - that helps ease in the side effects.

I know it is scary to try a medicine, but just think it may help you. Try not to read the stuff on the internet because everyone's experience is mixed. Rememeber, even if some meds have side effects, all of these medicines help some of us and you'll never know until you try. Unfortunately, it is just a long road with POTS. I hope you feel better soon!

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Cma,

I find your concerns totally reasonable. I did pretty bad on the smallest dose of citalopram (lexapro) but that doesn't mean you should experience side effects as well.

Best of luck, whatever you decide.

I'm sorry I can't be of much help.

Alex

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Hi,

I was on Lexapro for 10 months and just switched to Effexor, so I am probably in a good position to help. Of course, everyone responds differently.

Weaning up to each of them was the hardest part. It definitely increased my anxiety and the feelings of jitteriness for the first few weeks. The first 2 weeks were the worst, and then I gradually started getting used to the Lexapro. By 6 weeks, most of my POTS symptoms were better. I had to take a benzo to calm my system down in those first two weeks, but I got through it. I just switched around a month ago because of the weight gain on Lexapro, I gained 22 pounds in 10 months. I was also worried about the Effexor, but switching to it wasn't as horrible as I thought. I read up a lot on it, and most people are able to wean if necessary. If your POTS is debilitating, I would say that it is worth the few weeks of side effects in order to get your life back. I am around 85-90% better than without meds, and most of the side effects improve over time.

Good Luck!

Abby

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There is a girl that has been on this site that is from Ireland - she is really trying to promote awareness in Ireland. (She even did a radio interview - there.) I can't remember her name (It started with an L) - I do remember that her blog was something like ---fainting goat or something. I guess goats faint - like with dysautonomia too. You might do an internet search for dysautonomia and Ireland. I bet she could help you find doctors there. I've visited there and it's not so big like here in the States, so you might could travel to get to some docs that are more aware of POTS.

I agree with the others - we really can't predict how your body will respond --neither can the doctors. It's all trial and error - but, we have to get past the fears to find help.
Issie

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The "L" Issie gave, reminded me of the name of the Irish member, it is Lette. She did a topic which was called: I'll be on the radio talking about Dysautonomia Awareness. When you go to her profile page you can find the topics and posts she wrote, maybe they can be of help to you!

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Thank you issie and corina for your help. I've actually contacted Lette a while ago and she told me the name of the specialist that she's seeing. I asked my GP to refer me to him, but the waiting time is 18months! Until then I need to do something to get relief from some of my symptoms.

abbyw, thank you for your input. What kind of side effects have you experienced when you switched to Effexor? Has it increased your heart rate?

I don't faint and am able to do some stuff at home, like light cleaning, cooking and taking care of my lil one, which sometimes I find exhausting, but healthy moms report feeling exhausting with new babies, so I don't expect to be full of energy. My main symptoms that are driving me nuts is brain fog, fatigue and feeling lightheaded, sometimes I'm feeling tachy while standing, but not always. I am not sure, if these kind of symptoms are worthy to start messing with SNRI or SSRI meds.

yogini, you are so right that I should stay away from reading all the stuff on the internet, but I just can't help it :) I was prescribed a very small dose for the first week, so maybe I should stop freaking out. My GP didn't mention for some reason that Effexor is one of the most addictive SNRI's out there, and I definitely don't want to be on something for good.

yogini and corina, I see that you are on Paxil. Are you experiencing any side effects from it?

Thanks everyone for your input.

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Hi cma,

When I started Effexor, I was switching from Lexapro so it is hard to know if I was feeling my POTS symptoms, withdrawal from Lexapro, or side effects from Effexor !

I was feeling wired and jittery and dizzy - just plain yuck! But when I increased the Effexor, I started doing much better. I started at 37.5 twice daily, added another 1/2 a pill to each dose after a week, and I just went up to 75mg. Now I feel almost normal again. At the beginning I had difficulty urinating (sorry if that's TMI) , nothing too bad, and I have had increased sweating. But the urinating issue is almost all gone now. I have read that the other symptoms improve as well.

As with everything else, too much internet research can be a bad thing! Sometimes it is better not to know the horrible things others have gone through.

I understand your hesitance to take the medicine plunge. I know for me it was very helpful. My theory was that if it was too bad, I could always wean and then be back where I started.

My thoughts are with you!

Abby

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Actually I do not (at least not that I'm aware of or was). I've tried to come off of it about a few times (very slowly and undersuervision of my doc) but it turned out I can't do without it. Meaning that when I'm off it my hr shoots up up on standing again and I'm very dizzy. So we decided that it has to be part of my daily regimen. I'm happy with that as it makes me much more functional!

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  • 3 weeks later...

Hi Cma,

I just wanted to know if you are in the north or south of Ireland? When I initially became ill I went to a really good doctor in Belfast. He carried out a tilt test and diagnosed my condition. He tried me on several medicines before I found one that worked (Florinef, Midrodrine, Betablocker and then SSRI). He seemed to know alot about the condition. Later on once I improved he transferred me to a cardiologist as he was closer to where I lived. If you want I could look up his details for you?

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