Effexor against depression, good or bad choice?

Hello,

I have been suffering from depression and anxiety for a long time and due to bad health and other circumstances it's getting worse. That is why I made an attempt with Celexa 20mg for 1 month but after 1 month I didn't feel anything and my psychiatrist said then we have to try something new.
He made a few suggestions like Parnate but I don't want to go on a MAOI because of the food restrictions and dangerous interactions. And then he suggested Effexor. I should start with 75mg and then increase to 225mg. But I read so many negative things about Effexor withdrawal that I'm scared of this. He said to me it doesn't cause addiction but from what I read it's a real pain in the ass when you want to get off it. This scares me. I already feel bad. What if I go on it and it doesn't help and then I even get more problems getting off it?
I really don't know what to do. Shall I just take it or should I insist on a different med? But since Celexa didn't work how likely is it that other SSRI would work?

I also wonder how does Effexor work at doses below 225mg? Is it like a normal SSRI in lower doses?

Personally,I have no been on Effexor before, but I would ask my doctor to start me on the lowest dose possible.
And ask your doctor if they feel that it would actually help you, and it might help to ask them if it's helped for other people.

I was on 20mg of Celexa too, and it just increased my suicidal thoughts. After I stopped taking my medication (on my own, without doctor's help) I learned that other people had the exact same problem with Celexa, and none of them were helped by it at all.

I think with most SSRIs, they all generally have the same withdrawal symptoms and side effects, but if there are any in specific that you worry about, you could talk to your doctor, and ask for a list of specifics about Effexor.
Hope that helps a little bit!

Hi, this sounds very discouraging. I had no problem stopping celexa but it also didnt help.

What if all SSRI simply suck and at best dont make you worse? Then there isn't much hope for depressed people who can't overcome their depression through therapy or other means.

I think the big focus is, SSRIs mostly help if the depression really is caused by chemical imbalance. That's why it helps to have a good doctor, and make sure to ask a lot of questions!

I don't think all SSRIs suck (and we can't even say that they do, especially since you've just tried one!), or that they don't work. I think each work in a unique way, but the problem is, finding what needs to be helped. Celexa only works for just clinical depression in general. If there are underlying issues that are causing the depression, or other mental health issues causing the depression, I don't think Celexa would help for that person. If that makes sense. Hence, why I stress talking with your doctor, or asking to see a psychiatrist might help.

And there are pretty much going to be side effects and withdrawal symptoms for any psychiatric medication, I don't think there is any way to avoid it. But most of the time, once you are able to find the medication that suits your needs, it helps.

There are a number of antidepressants out there which are not SSRIs. However, they seem to be the ones most frequently offered to anyone with depression as the side effects are generally less than some of the other antidepressant types such as the older tricyclics and they are considered to be safer to use.

My personal view is that SSRI's suck, because I've never been able to stay on one longer than 3 days because they make me so violently ill, however, I know of other people that they have worked really well for, so everyone is different. I have in the past had some level of success with other types of antidepressants- mirtazapine and moclobemide namely. But I've gotten to a point of refusing SSRIs because they just don't agree with me for some reason.

I was on Effexor for I think somewhere between 6 and 12 months, and it had some effect from about 150mg, but it wasn't quite working for me as well as it could be, so they kept bumping up the dose. I ended up on about 300mg from memory, and it triggered a hypomanic episode. I don't really remember coming off it (but I'm pretty sure it was done very gradually), I just remember the hypomania and being a bit annoyed that they'd taken me off something that made me feel so good. I became over-confident, aggressive and agumentative- but it felt good being able to tell someone to stick it and not care. So if I'd had major effects of coming off the stuff it probably would have stuck in my mind. At the time I had an undiagnosed physical condition which stopped me absorbing the meds properly, so maybe it would have worked at a lower dose better if that had not been part of the problem. I reacted violently when we tried to reintroduce it again.

I'd say give it a go, it might just be the right one for you. I know how much bravery it takes to start on a new one and feel for you though.

Hi,

it's really hard to decide what to take. I also thought about moclobemid but I heard that it's not as strong as regular MAOI and I dont want to take a MAOI even though I heard good things but the food restrictions are too scary for me. I'd be in fear 24/7 of eating something wrong.

The TCA have more side effects especially people who have problems with the heart have to be careful with TCA.

What also worries me is that I heard that when you take SSRI your brain adapts to it and simply becomes less sensitive to serotonine which means that the brain always tries to get back in balance which would mean that sooner or later the SSRI dont work anymore and when you stop taking it then you have even lower serotonine levels or at least a lower sensibility to serotonine.

I also cannot really afford to try 100 different meds until I find the right one. I am in a situation where I must be productive and focus on studying but my depression is hindering me. that's the reason for taking an AD in the first place because I have to be able to work and learn. Taking ADs which make me feel worse or tired all day wouldn't help me. What if I go on an AD and it works but the suddenly doesn't work anymore? That's scary.

Hi Samx

Moclobemide is not quite in the same category as the other MAOIs- it works slightly differently and doesn't have the food restrictions like the others do. I was on it for at least 18 months and it worked quite well. I eventually stopped taking it because there were some side effects that were really bothering me, and some of my issues had come back in full force triggering a relapse, and it was decided to try out something else. For a long time I had been fine with it though. I have re-tried it since, but it just didn't agree with my system this time around. I have become extremely sensitive to antidepressants, and doctors are starting to wonder whether they are having that effect because I have something other than depression and that it's not the chemical imbalance for depression that needs treatment, that I need something else entirely.

I agree that the TCA's can have more side effects, but they do work for some people. As far as the good effects suddenly stopping, it would be more likely that might happen gradually, and sometimes it just means that the dose needs to be increased a bit. I have had it with some I've been on- where I've been taking a really low dose and getting the desired effect but later having to have the dose increased a bit.

It can be a little bit of trial and error with meds, it is for anyone on medication, but hopefully you get results from the first one you try. Some of the side effects only last a short time, and with things like the drowsiness, sometimes it is better to take them before bed- I've found that some that cause drowsiness, that's an effect that only lasts for a while until my body gets used to it.

Best thing to do it discuss it with your doctor to work out what is best for you.

The problem is that somehow every psychiatrist recommends a different med. I don't know who to trust. We also never talked much about side effects it was always like side effects arent a big deal but if people become addicted to effexor and have to count pellets then I think this is very disturbing.
Also the side effects like brain zaps and other things are worrying. I even read that one person urinated in her bed at night because due to the effexor she didn't wake up anymore when she had a full bladder.

Everybody reacts differently, so while one person had brain zaps with it, not everyone does. Personally I had few side effects from it other than feeling a bit drowsy when I first started on it, my bigger problem with effexor was that it just wasn't the most effective med for me, in that it wasn't working at a lower dose, and when we had to bump it right up it made me hypomanic. But I was on a pretty high dose of it when I reached hypomanic. So try to remember that the reaction you have (which for you maybe it's just the right one and you may not get many side effects at all) may be entirely different to that of someone else.

Each doctor/psychiatrist is going to have a slightly different preferred plan of action for working out which med to use, depending on what meds are available at the time, or what type of depression you have, and what your past reactions have been.

there are always going to be horror stories about rare reactions to any drugs. you have to take them with a grain of salt. I experienced brain zaps when withdrawing from Pristiq which is basically a newer version of Effexor and it wasn't pleasant but it wasn't debilitating. it's trial and error. no way of getting around that. everybody reacts differently. you don't know until you try.