# Raised the dosage



## NicNak (Jan 23, 2009)

About two weeks ago, I started to feel some lows creeping back again.  I have a diagnosis of Chronic Depression that my doctor says is currently Acute.   Over the years I grown to kind of  learn the signs.

Two weeks ago, I assumed it was a bout of PMS, but now this week it has condtinued.  I feel almost paralized to move, all I want to do is sleep and I am bursting out crying for little things.

Yesterday I made a call to my Psychiatrist and asked if it would be ok if I raised my dosage of Effexor to the next step up.  I have been on high dosages before and many different coctails of meds.  He talked to me for a few minutes and I explained what was happening.  

He agreed it was best to try to raise it.  We had been briefly discussing this previously too.

I am currently on 150mg of Effexor and raised it another 37.5mg which is how the Effexor dosages come.

The side effects generally pass in a few days.  

I just wanted to stress the importants of contacting your doctor if there _any_ changes in symptoms.  The sooner the better.    Our doctors need to know these things and it is to our benefit that they do.  That is the only ways they can help us cope.  One should not feel they are trivial or they are making a big deal out of nothing.  Relapses can start with "small" symptoms and compound quickly.  (I know this from experience)  

By telling our doctor, we can usually hault the downward spiral.

I feel like my head is a paper weight today, but that is what happens with me.  I am just going to take it easier for a couple days until the "dopeyness" subsides.  Even with the first dosage, the depression side of things has the edge off.  They physical symptom I can handle fine


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## Jazzey (Jan 23, 2009)

I'm sorry to hear that you are going through this, but really happy that you talked to your Dr. about it and that you're being pro-active.  :hug:


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## David Baxter PhD (Jan 23, 2009)

Good reminder, Nic. 

And even at 187.5 mgs, that's really not a high dose for Effexor - many people are at 300 mg - so if need be it could be raised again.


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## Into The Light (Jan 23, 2009)

you are taking very good care of yourself, nicnak. if it were me, i'm not sure i would have done what you have, simple because of how my mind works when i get into that state. kudos to you!


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## Halo (Jan 23, 2009)

Good job, NicNak :2thumbs:  You really took charge in this situation and are looking after yourself.  That's awesome to see


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## NicNak (Jan 23, 2009)

David Baxter said:


> Good reminder, Nic.
> 
> And even at 187.5 mgs, that's really not a high dose for Effexor - many people are at 300 mg - so if need be it could be raised again.




We tried to raise it to 300mg at one point, but I had a difficult time handling the dosage.  At that point the doctor suggested gradually lowering it to see if maybe it was a case of too high of a dosage that was making me feel bad.  

We lowered it and monitored each dosage level lowering and I got to 187.5 but almost felt too good.  I was almost euphoric all the time.  So he suggested taking back to 150mg.  

For a while I was ok on that, but since having to go off work it has been a discussion about weather to try to raise it back to 187.5 again.  

Another reminder too, I guess would be to try to be patient.  I always try to keep it in the back of my mind that I have gone through this before and was able to find comfort.  It just sometimes takes time to re-tweak the dosage or medications.

Thank you everyone for your kind words.  I hope sharing this helps others to get help when they start to feel changes of symptoms and catch it before it gets really bad and know that there is usually a solution to take the edge off the rough times we feel.

:flowers:


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## prayerbear (Jan 23, 2009)

I am glad this is working for you! Has your depression finally lifted? There is one thing to be careful about-you mentioned euphoria at a higher dose. Is there a history of bipolar in your family? b/c antidepressants can lift a person into a manic state. I denied being bipolar for years until I started taking antidepressants and my mood went skyhigh!
 Please talk to your doctor about this! I can't stand extreme moods!

                                                               prayerbear


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## NicNak (Jan 23, 2009)

prayerbear said:


> I am glad this is working for you! Has your depression finally lifted?



The edge is off of the depression, if that makes sense, but it will take a few weeks before the full effects show.



> There is one thing to be careful about-you mentioned euphoria at a higher dose. Is there a history of bipolar in your family? b/c antidepressants can lift a person into a manic state.



For sure! That euphoric mood was with a previous experience when my Psychiatrist wanted to try lowering the meds to see if that would help, after we attempted to raise it to 300mg with little effect mentally, but many physical side effects.

As we were lowering it, he monitored me at each dosage decrease.  

When I reached the 187.5 level before, I felt euphoric.  So he suggested lowering it to 150mg.

I had to stop working in September due to the Depression and Anxiety.   Since that time, my Psychiatrist and I have been going over the pros and cons of raising it back.   Since I am in a "slump" now it shouldn't cause the same euphoric effect as before.




> I denied being bipolar for years until I started taking antidepressants and my mood went skyhigh!



I see a Psychiatrist on a regular basis.  I have asked him if I do have Bipolar, but he says no, but my diagnosis is complex.   

I have had various degrees of Depression, OCD and Panic attacks now for close to 14 years.  



> Please talk to your doctor about this! I can't stand extreme moods!



I always tell my doctors, not to worry Prayerbear :support:  I never keep anything from them.

I phoned him yesterday to discuss this raise of meds.  I am in good hands, I appreciate your concern. :hug:  

I just wanted to post to let people know, when there is changes in symptoms, it is important to tell our doctors so they can help us manage them.

Thank you Prayerbear :hug:


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## David Baxter PhD (Jan 24, 2009)

NicNak said:


> We tried to raise it to 300mg at one point, but I had a difficult time handling the dosage.  At that point the doctor suggested gradually lowering it to see if maybe it was a case of too high of a dosage that was making me feel bad.
> 
> We lowered it and monitored each dosage level lowering and I got to 187.5 but almost felt too good.  I was almost euphoric all the time.  So he suggested taking back to 150mg.



I didn't mean to imply that you *should* be at 300 mg. You're absolutely correct: For some people that is overkill.

I think the best advice is to titrate to the lowest dose that manages your symptoms and change it only when your symptoms seem to be increasing in severity. In other words, I think the strategy that you and your doctor are taking is spot on. :2thumbs:


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## NicNak (Jan 24, 2009)

David Baxter said:


> I didn't mean to imply that you *should* be at 300 mg. You're absolutely correct: For some people that is overkill.
> 
> I think the best advice is to titrate to the lowest dose that manages your symptoms and change it only when your symptoms seem to be increasing in severity. In other words, I think the strategy that you and your doctor are taking is spot on. :2thumbs:




Thank you very much Dr Baxter.  That means a lot to me


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## amastie (Jan 24, 2009)

NicNak said:


> ..the depression side of things has the edge off.  They physical symptom I can handle fine


I'm so sorry that you've been through this difficult time and so glad that you  had the presence of mind to contact your dr. 
Glad to know that the depression is easing a little    :hug:   :flowers:


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