If there is any SSRI with a half life shorter than paxil....its Effexor.
If there is any SSRI with worse withdrawal symptoms.....its Effexor.
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Effexor's pros and cons:
Pros: If anything is going to cure the deepest, blackest depression,
it's Effexor (venlafaxine hydrochloride). Perhaps Effexor (venlafaxine
hydrochloride) in combination with an antipsychotic, but for deep,
despairing clinical depression that is going to respond to the
standard tweaking of the popular neurotransmitters, Effexor
(venlafaxine hydrochloride) pulls people out of the abyss.
Cons: The absolute worst discontinuation syndrome of an
antidepressant. Effexor (venlafaxine hydrochloride) is a medication
people utterly loathe to have taken. It is not uncommon for someone to
change doctors during or immediately after Effexor (venlafaxine
hydrochloride) discontinuation.
Effexor's Typical Side Effects: The usual for SSRIs and SNRIs -
headache, nausea, dry mouth, sweating, sleepiness or insomnia, and
diarrhea or constipation, weight gain, loss of libido and a host of
other sexual dysfunctions. Most everything but the weight gain and
sexual dysfunctions usually goes away within a couple of weeks.
Although some women will notice that the sexual side effects will
diminish above 200-225mg a day when the norepinephrine kicks in. Maybe.
For tips on how to cope with these side effects, please see our side
effects page.
Effexor's Not So Common Side Effects: Increased or lowered blood
pressure, sweating, farting, anorexia, twitching, shock-like sensations.
These may or may not happen to you don't, so don't be surprised one
way or the other.
Effexor's Freaky Rare Side Effects: Alcohol intolerance and alcohol
abuse. So Effexor (venlafaxine hydrochloride) is going to be just the
thing to talk about at AA meetings. Someone's reflexes increased and
someone else's breasts got bigger, proving that there is no pleasing
some people. Someone else's hair changed color and, really, no Revlon
was involved. But the most disturbing freaky rare side effect with
Effexor (venlafaxine hydrochloride) is what Wyeth disingenuously calls
"withdrawal syndrome," that once you acclimate to Effexor (venlafaxine
hydrochloride) you are basically hooked for life. The discontinuation
syndrome never goes away if you try to stop. For someone with unipolar
depression that's a pain in the ass, but something you might be able
to work around barring any really adverse side effects, but for
someone who is bipolar you can be royally screwed because Effexor
(venlafaxine hydrochloride) can really aggravate mania and especially
rapid cycling.
I've been getting a few e-mails and reading a few reports about how
Effexor has caused Effexor users, as well as friends and relatives
using the med to really hit the booze, so alcohol abuse may not be
that rare a side effect after all. Best guess to date on that - Paul
of Leeds (in the U.K.) posits that Effexor's broad spectrum use of
liver enzymes probably interferes with alcohol clearance and
tolerance, thus leading to the type of alcoholism that affects people
without the proper enzymes to effectively metabolize alcohol. Between
that and the way Effexor works your liver, you're probably better off
giving up booze entirely if you're taking this med.
You aren't going to get these. I promise. Although I make no
promises about the alcohol abuse.
Interesting Stuff Your Doctor Probably Won't Tell You: Few, if any
doctors, will discuss the possibility that Effexor (venlafaxine
hydrochloride) could become a permanent part of your life, whether you
like the results of Effexor (venlafaxine hydrochloride) or not.
Granted that is a very rare adverse effect, but it does happen. It's
hard enough to get them to discuss SSRI discontinuation syndrome., let
alone get them to admit that Effexor's symptoms are the absolute worst
and the longest lasting of all serotonergic drugs. The
discontinuation from Paxil (paroxetine) is bad enough, it's much, much
worse with Effexor (venlafaxine hydrochloride).
And the way Effexor (venlafaxine hydrochloride) works on
neurotransmitters is very complicated. Your doctor may or may not
explain this to you. Here's how it works: First it starts to work on
your serotonin. Then somewhere around 200 mg a day it starts to work
on norepinephrine. Then around 300 mg a day it starts to work on your
dopamine. Mileage will vary for each individual, and there's no
guarantee on getting all that much dopamine action.
Effexor's Dosage and How to Take Effexor: Effexor (venlafaxine
hydrochloride) comes in immediate and extended release flavors,
although hardly anyone takes the immediate release form anymore. Just
be sure to check your prescription for that XR to make sure you are
getting the extended release form. For the XR flavor, you start at
37.5 to 75mg a day, taken with food, at either breakfast or dinner,
depending on if you're apt to get wired or tired. Once you get the
wired/tired issue straightened out, you take the med all at once at
the same time every day. If you start at 37.5mg you can move up to
75mg after a week. As with any antidepressant, it takes a month to
feel any positive effect, so give it a month. Seriously, don't move up
above 75mg a day for at least a month. You'll know if it's going to do
anything then. If you feel nothing, give up and take a much easier
discontinuation. After that you can move up in 37.5-75 mg increments,
allowing at least a week between each increase until you reach the
maximum of 375mg a day for the most severely depressed of patients.
The older immediate release version is pretty much the same, except
that the dose is divided into two or three doses a day.
Days to Reach a Steady State: Three days.
When you're fully saturated with the medication and less prone to
peaks and valleys of effects. You still might have peaks of effect
after taking many meds, but with a lot of the meds you'll have fewer
valleys after this point. In theory anyway.
How Long Effexor Takes to Work: Up to one month.
Effexor's Half-Life & Average Time to Clear Out of Your System:
Effexor (venlafaxine hydrochloride) does the double metabolism trick,
so its half-lives are 3-7 hours and 9-13 hours. That means the
combined half-life is anywhere from 12-20 hours, so it takes anywhere
from two to five days to clear out of your system. This is a huge
part of why Effexor's discontinuation syndrome is so harsh. No popular
SSRI does the double metabolism, and the half-lives of each metabolism
is so bloody short. So while you clean out of one metabolite, you
still have another one in your system. Your body is completely
confused! Wyeth states in the pharmacokinetics section that there's
only one active metabolite worth mentioning. Who the hell knows about
other metabolites and what part they play in Effexor's discontinuation
syndrome, or how long you should take in stepping down your dosage!
How to Stop Taking Effexor: Your doctor should be recommending that
you reduce your dosage by 37.5mg a day every week if you need to stop
taking it, if not more slowly than that. ; For more information,
please see the page on how to safely stop taking these crazy meds. ;
You shouldn't be doing it any faster than that unless it's an
emergency. Yes, that means if you've maxed out at 375mg a day it'll
take 10 weeks to get off of Effexor (venlafaxine hydrochloride).
Believe me, it's better that way. Also, once you get down to that
last 37.5mg a day, ask your doctor for a Prozac (fluoxetine)
prescription or samples. Generic fluoxetine will even do. 10mg a day
is all you need. ; Even with the proper discontinuation stopping the
last 37.5mg can be hellish. Taking two weeks worth of Prozac
(fluoxetine) will make the discontinuation a lot easier. So when
you're off of Effexor and you cannot function, get on the Prozac for a
week or two, then stop taking the Prozac. You'll find you'll have
either no discontinuation syndrome, or it won't be nearly as bad.
If you've worked your way up to a particular dosage, it's usually best
to spend this many days at the next lowest dosage before going down
the next lowest dosage before that and so forth. This is the least
sucky way to avoid problems when stopping any psychiatric medication.
Presuming you have the option of slowly tapering off them.
Comments: This is a multiple reuptake inhibitor, acting sort of as
both an SSRI and NRI, so be sure to read up on all three classes of
meds, as those pages will cover a lot of stuff common to all meds
similar to Effexor (venlafaxine hydrochloride).
Everybody hates their meds because of the costs and the side effects,
but people just loathe Effexor (venlafaxine hydrochloride) because the
discontinuation can be so harsh; it's the med everyone wishes they
never took. Yes, people will change doctors because some doctor had
the nerve to punish them with Effexor (venlafaxine hydrochloride). Yet
for many people it is a godsend, because the combination of serotonin,
norepinephrine and dopamine reuptake is literally just what the doctor
ordered for the darkest of depressions. Of course Effexor (venlafaxine
hydrochloride) has to be complicated about it, it can't just work on
everything all at once from the beginning. Oh, no. First it starts to
work on your serotonin. Then somewhere around 200 mg a day it starts |