![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by AnneL on May 20, 2001, at 12:59:52
Been on Effexor since March. On 150 for two weeks. Depression symptoms have improved, but it is such a struggle to get up and on the move! I am by nature a get up and go person (probably very OCD-type tendencies-usually everything I set my mind to is way over the top, details, details!) Is this lack of energy and a "this can wait 'till later" attitude what is known as "Apathy"? Because if it is, then I have an excellent case of it. When I first started Effexor I had to really cut down my caffeine intake due to start-up anxiety/agitation, now that that is not an issue my caffeine intake has gone way up again. I realize now that for the last few years I unconsciously chose this stimulant because it took away the "blahs". Either this blah feeling (apathy) is either a known side effect of Effexor or I am still
depressed. Caffeine helps, but it is not a steady state and yesterday I overdid the caffeine bit until I was overly caffeinated- jittery, irritable and just felt nauseated! My internist suggested adding Wellbutrin SR 150 mg. daily and backing down my Effexor to 75 mg. daily. I don't know why backing down the Effexor to 75 mg. is such an issue. And he didn't say (and more importantly I did not ask) when do I take the Wellbutrin? With the Effexor at the same time? I need some help with this ladies and gentlemen. Thank you for your time. AnneL
Posted by Cam W. on May 20, 2001, at 13:54:31
In reply to Ideas Folks? Effexor induced apathy/tiredness?, posted by AnneL on May 20, 2001, at 12:59:52
Anne - The Effexor XR™ (venlafaxine - I am assuming that you are taking XR form or should be) should be taken later in the day and Wellbutrin SR™ (bupropion) should be taken in the morning.
It really doesn't matter when you take the Effexor, normally, but if it is making you tired, take the Effexor an hour or two before bed. If this keeps you awake, then take it a couple of hours earlier, yet.
I have found that as I increased my Effexor XR from 150mg to 225mg I got more energy, but was still dragging my butt. My dosage was increase to 262.5mg (added a 37.5mg capsule, daily) a week ago and I know have much more energy. When I see my doc in a couple of weeks I am going to ask to have the dose increased to 300mg to see if I can get my energy level back to some sort of normal.
You could ask your internist about increasing the Effexor XR to 225mg to see if your energy returns. The norepinephrine-reuptake blocking effects of Effexor, which increases noradrenergic neurotransmission and thus can give you more energy and interst. This is just a thought, but overall you would only pay one dispensing fee instead of two.
Hope that this is of some help - Cam
Posted by AnneL on May 20, 2001, at 17:06:54
In reply to Re: Ideas Folks? Effexor induced apathy/tiredness? » AnneL, posted by Cam W. on May 20, 2001, at 13:54:31
> Thanks, Cam. I really appreciate your thoughtful response. I will speak with my doctor about upping my dose. I could also try taking it near bedtime as well. I am also taking Klonopin 1 mg. at night because I had a lot of trouble with start-up side effects which included extreme agitation and anxiety which would set off a panic response in the middle of the night. I'am pretty sure that I can start tapering off of the Klonopin (slowly) now that I no longer have any of the agitating start-up side effects. Plus, the Klonopin makes it difficult to just spring out of bed in the morning (takes about a 1/2 hr plus a cup of coffee to clear the fog). Is it possible that I what I am experiencing (lack of energy, etc) is a result of the Klonopin taken at night? It just occurred to me that perhaps the Klonopin may be partly responsible. . . Thanks, Anne
Posted by Cam W. on May 20, 2001, at 19:30:14
In reply to Re: Ideas Folks? Effexor induced apathy/tiredness? » Cam W., posted by AnneL on May 20, 2001, at 17:06:54
Anne - The Klonopin™ (clonazepam) is one of the intermediate to long acting benzodiazepines. Therefore it could be contributing to the morning "hangover effect" and the tiredness. This would be additive to the tiredness and lethargy caused by the depression and by the Effexor XR. I wouldn't blame the tiredness all on the Klonodin, though it is a contributing factor. - Cam
Posted by SalArmy4me on May 20, 2001, at 23:45:35
In reply to Ideas Folks? Effexor induced apathy/tiredness?, posted by AnneL on May 20, 2001, at 12:59:52
You should really see a psychiatrist in addition to the internist, because the internist may not know too much about newer medications used to fight apathy.
Posted by AnneL on May 21, 2001, at 21:39:12
In reply to Re: Ideas Folks? Effexor induced apathy/tiredness? » AnneL, posted by SalArmy4me on May 20, 2001, at 23:45:35
> You should really see a psychiatrist in addition to the internist, because the internist may not know too much about newer medications used to fight apathy.
Sal, thanks. I agree with you entirely. I have an appt. with pdoc next week. Internist suggested Wellbutrin 150 mg. along with reducing Effexor 150 mg. to 75 mg. Reducing Effexor does not sound right. If anything, I think I need to work my way up to 225 mg. What are your thoughts about increasing, decreasing and/or adding Wellbutrin? Thanks in advance, AnneL
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.