Psycho-Babble Medication Thread 701176

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effexor--would a lower dose work just as well?

Posted by fluff on November 7, 2006, at 7:55:49

I can't find any information on this on the Internet, and my GP doesn't know the answer, either. I've been on Effexor XR 150mg for 3 years for anxiety disorder; it's worked wonderfully. I know that I need to stay on meds for life, but, if possible, I would like to lower my dose of Effexor because of weight gain. I was put on 150mg by my GP because it's the average dose of what people take. Is it worth trying to go on a lower maintenance dose? Has anyone had success doing this? My biggest fear is that I will go down in dose, feel lousy again and then not respond when I go back up to 150 (sound like an anxiety disorder type of thinking?!). Any thoughts or experience with this? Thanks in advance! fluff

 

Re: effexor--would a lower dose work just as well?

Posted by Racer on November 7, 2006, at 10:08:41

In reply to effexor--would a lower dose work just as well?, posted by fluff on November 7, 2006, at 7:55:49

Effexor is a weird drug. At the lowest doses, it affects serotonin; at moderate doses, it also affects norepinephrine; and at the highest doses, it adds in dopamine. So, what sort of drug it is really depends on what dose you're taking. Someone here will know the dose thresholds for the various effects, which should give you an idea of whether a lower dose will work.

The bad news is that the weight gain may not be dose dependent. Lowering the dose may not help. There are alternatives, like trying Topomax, although I wouldn't ask a GP about it. Adding Wellbutrin might help, although it wouldn't be likely to help your anxiety. Glucophage is being used a little for weight gain.

Good luck!

 

Re: effexor--would a lower dose work just as well?

Posted by ed_uk on November 7, 2006, at 13:40:56

In reply to effexor--would a lower dose work just as well?, posted by fluff on November 7, 2006, at 7:55:49

>effexor--would a lower dose work just as well?

Maybe, maybe not. You could try going down to 112.5mg/day for a few weeks then 75mg/day if all goes well. 75mg is often sufficient for GAD. In fact, clinical trials suggested no advantage of higher doses.

Unfortunately, as Racer said, the weight gain might not be dose-dependent.

Ed

 

Re: effexor--would a lower dose work just as well?

Posted by fluff on November 7, 2006, at 17:26:03

In reply to Re: effexor--would a lower dose work just as well?, posted by ed_uk on November 7, 2006, at 13:40:56

Both of your responses are interesting! I definitely didn't know that weight gain might not be dose dependent. And, although a friend told me that people with anxiety often respond to lower doses of SSRIs than those with depression, I could never find anything in print about it.
I don't know if my thinking about this is right, but even if I don't lose the weight by going to a lower dose, I would still like to take a smaller dose (if possible) since I intend to stay on it for the long haul. Thanks!

 

Re: effexor--would a lower dose work just as well? » fluff

Posted by ed_uk on November 7, 2006, at 17:37:16

In reply to Re: effexor--would a lower dose work just as well?, posted by fluff on November 7, 2006, at 17:26:03

>And, although a friend told me that people with anxiety often respond to lower doses of SSRIs than those with depression, I could never find anything in print about it.

In the treatment of Generalised Anxiety Disorder and Social Anxiety Disorder, 75mg Effexor XR is the 'standard dose'. Higher doses may be needed to treat severe depression. Effexor is not normally chosen to treat OCD, but if it was, a high dose would probably be necessary in most patients.

Regards

Ed

 

Re: effexor--would a lower dose work just as well?

Posted by fluff on November 8, 2006, at 6:52:01

In reply to Re: effexor--would a lower dose work just as well? » fluff, posted by ed_uk on November 7, 2006, at 17:37:16

Thanks, Ed. This gives me some encouragement to give it a try. fluff

 

Re: effexor--would a lower dose work just as well?

Posted by Johnathan on November 12, 2006, at 19:00:06

In reply to Re: effexor--would a lower dose work just as well?, posted by fluff on November 8, 2006, at 6:52:01

Fluff, I was wondering if you went to a lower dose and if so was it ok for you? My wife went from 150 to 75 with a few days of confusion and a incident of crying but otherwise has adjusted well. I think she would be better with the 150 dose. I see her as a little hectic trying to do too much but that may just be her. I would like to see a 100Mg capsul for her but not sure why they have the 75Mg only. I wish you luck with your dose reduction. Johnathan

 

Re: effexor--would a lower dose work just as well?

Posted by fluff on November 13, 2006, at 16:03:38

In reply to Re: effexor--would a lower dose work just as well?, posted by Johnathan on November 12, 2006, at 19:00:06

Hi Jonathan,
So far, I've chickened out on lowering my dose. I did try once, a year ago, before I knew that having a few days of crying was a pretty normal response to lowering the dose; as soon as that happened to me, I got scared and went back to 150 and stayed there.
Right now, aside from the mild weight gain and lack of sexual desire, I feel very good and am thinking that maybe I should "leave well enough alone." That's why I was wondering what experiences other people had with trying lower maintenance doses. So far, it seems like it's just trial-and-error. Best, fluff


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