# Effexor XR vs Effexor



## AmZ (Oct 29, 2010)

I just got another months worth of Effexor so have 3 boxes of 28 tablets at 75mg each, so I take 3 in the morning each day.

I asked the pharmacist if the medication comes in a higher dosage per tablet, as I pay for each individual box, so now I'm on 3, it costs quite a bit of money per month. He said that there is also Effexor XR 150mg available. I was wondering if you can split these or how it works (for next month)? Obviously, I couldn't take 2 as that would be 300mg, and need 225mg, so is it possible to take the Effexor XR at 225mg? He said that this is the only other dosage available in the country. So either Effexor 75mg in a box of 28 tablets or Effexor XR 150mg (not sure how many in a box).

Also, the 225mg has been doing bad things for my stomach, as much water and as I drink and fibre and a balanced diet I have, nothing seems to help. I was thinking about maybe not taking all 3 pills at one go in the morning and maybe taking 2 and then one at lunch time or something. I think I remember Dr Baxter saying that it's OK to do this and people do this so as to avoid side effects such as these?

Thanks


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## defect (Oct 29, 2010)

I was on Effexor XR for 8 years and just got off of them, switched to Wellbutrin about 2 months ago.  
I'm not sure where you are, but here in BC it is available in 37.5 mg, 75 mg, and 150 mg.  The link below has info available about this medication.
EFFEXOR XR® (venlafaxine HCI)*—*Prescribing Information & Medication Guide
If you click on the link that says "prescribing information", you come to this page, Wyeth.com
and if you click "continue" you get a 52 page pdf file that I found quite informative about dosage, pharmacology, etc.

You can't split these pills as they are capsules with beads of medication inside.
If there is any advice I could offer it would be to seriously consider looking into other drugs that have less side effects and withdrawal symptoms.  Effexor has a discontinuation syndrome that is unique unto itself.  Google "head shivers" and you will get an idea of what I'm talking about.

Also, about the lorazepam, if that is what you are prescribed to help you sleep, I believe that is likely the reason for the numb body and alert mind thing.  It was probably prescribed to calm you down so you could try to get some sleep, but it is definitely not a sleep aid.  It is helpful for anxiety attacks, but will leave you groggy for sure if taken several minutes before bed, and should not be relied on for any length of time.  Now that you are having a less stressful past few days, you might want to check out other remedies to help you sleep, like mindful breathing techniques, yoga, etc.  In my extensive experience with drug use (and abuse) prescribed and otherwise, the less drugs you're on, the better chance you have of truly achieving wellness.  Hope this helps, good luck.


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## David Baxter PhD (Oct 29, 2010)

defect said:


> You can't split these pills as they are capsules with beads of medication inside.


 
XR stands for extended release. These are either capsules or coated tablets but either way they should not be split because doing so defeats the purpose of the extended release. For example, with tablets there is a coating which releases the drug slowly into the system. Breaking the tablet means you'd get the dose all at once.



defect said:


> If there is any advice I could offer it would be to seriously consider looking into other drugs that have less side effects and withdrawal symptoms. Effexor has a discontinuation syndrome that is unique unto itself. Google "head shivers" and you will get an idea of what I'm talking about.



Please review the *Forum Rules*: You cannot post statements to other members that countermands the recommendations of their physician.
While Effexor is known to produce discontinuation effects in some patients, this does not occur for many others. Additionally, Effexor is not "unique" in this respect: There are other medications that can potentially have similar discontinuation effects.
Googling something like "head shivers" only gives you half the story at best and anything you read will be based only anectdotal comments from those who had side-effects or discontinuation effects which they, rightly or wrongly, attribute to the medication. This is not evidence, not science. This is merely opinion. For example, you are prescribed a drug and experience flu-like symptoms. You persist for a few days to a week and the symptoms also persist. You decide to stop the medication and a few days later the symptoms subside. Was this the drug causing side-effdects? Or did you simply have a cold or flu, which over the course of about 10 days will subside on its own?



defect said:


> Also, about the lorazepam, if that is what you are prescribed to help you sleep, I believe that is likely the reason for the numb body and alert mind thing. It was probably prescribed to calm you down so you could try to get some sleep, but it is definitely not a sleep aid. It is helpful for anxiety attacks, but will leave you groggy for sure if taken several minutes before bed, and should not be relied on for any length of time.


 
Again, *you are not qualified to dispense medical advice* and *you cannot countermand the advice of a health professional who knows far more about the medical history of the patient than you.*


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## defect (Oct 30, 2010)

I apologize and did not intend to undermine any prescribed route of therapy.  I spoke from a place of personal experience and information.  I will restrict my opinion to more suitable threads.


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## Andy (Oct 30, 2010)

Your opinion is fine Defect. It's just that people are prescribed medicine for certain reasons that may be very different to what you may have been prescribed them for. Your welcome to talk about your experiences on medications but telling a person to switch medications or get off of medications, that is definitely not allowed. Leave that up to them and their prescribing doctor.

For example Lorazepam can be used as a sleep aid. In fact it's often one of the medications used in a hospital setting.
This as well. "the less drugs you're on, the better chance you have of truly achieving wellness." . You don't know how anyone would be off medication. If I were off medication, wellness would be the farthest thing from my mind. 

I don't want to sound like I am lecturing you, you just REALLY need to be careful with what you say regarding medications and follow the forum rules.


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## defect (Oct 31, 2010)

STP - I did not tell anyone to switch medications or get off of medications.  My intention was to suggest to obtain as much information as possible.
I was reprimanded already, and will keep my opinions to myself.
Thank you.


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## AmZ (Oct 31, 2010)

Thanks for the replies everyone.

All good Defect  It's OK.

If someone could let me know if it's possible to take the three 75mg a day pills at different times of the day so as to avoid side effects, that would be great. Since going up to the 225mg, my digestive system, shall we say, has been affected and it's like it all the time and very uncomfortable. Maybe it'd be better to take 2 in the morning and one later on in the day or something.

Thx.

---------- Post added at 01:50 PM ---------- Previous post was at 01:20 PM ----------

BTW, especially in the last week or so, but since a couple of weeks ago, I keep getting involuntary muscle twitching in my arms and legs, at least a few times every day. I will bring it up in the next meeting with the psychiatrist but I guess it's nothing that I need to worry about immediately if it's not causing me too much bother?


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## David Baxter PhD (Oct 31, 2010)

These are questions to ask your doctors, AmZ. 

Normally, it's not a big deal when you take the medications and whether or not you split them up, unless you're taking an extended release or slow release formulation. 

However, with your sleep issues, you might find that Effexor messes up your sleep if taken at night. 

Do you take the Effexor with food? If not, that may help. If you already take it with food, you might reconsider what foods you are having with the medication and stay away from things like milk.


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## AmZ (Oct 31, 2010)

> However, with your sleep issues, you might find that Effexor messes up your sleep if taken at night.


True.
It's messed up enough as it is!
I'll have to decide what to do about the sleep issue. I tried the new medication again and the same thing, didn't help at all.
I think that if I've been managing to function up until now on half the sleep or less than I normally have, then I'll just get on with it and not try out more medications. Kinda battling with this one, but will see how things go.



> Do you take the Effexor with food? If not, that may help. If you already take it with food, you might reconsider what foods you are having with the medication and stay away from things like milk.


Ah, good to know. I always have it with food and a lot of water in the morning, but recently I started having cereal with milk which I didn't do before. I either had it with cereal with soya milk or had bread or something else. Will soya milk be better you reckon? 

I know they are questions for my doctors really, but as you know, unfortunately just not the ideal and most accessible etc of doctors. I was just generally asking and hope I didn't over-step the mark. Was just wondering of the general possibilities of when to take the meds and general advice. 

Many thanks for the reply.


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## David Baxter PhD (Oct 31, 2010)

Possibly. Cow's milk isn't very easy for humans to digest so I generally advise cutting back or eliminating it if you have an unhappy digestive system until it settles down.


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## AmZ (Oct 31, 2010)

Ah, I was going to say also... I'm going to my family doctor tomorrow (rather than the psychologist) and will ask about the muscle twitching etc. I'm going to ask to check that all is OK with my blood pressure and ask to get blood tests done to also see if all is still OK. Did blood tests last 3 months ago or so and before I was on the medication and in general, think it's good anyway to just get a check up because I'm still not eating much so need to see if my levels of things are OK. (I do take multi-vitamins every day, but still).

Sometimes you just gotta take things in to your own hands! I don't want to overdo things, but don't see the harm in getting a check up. I asked the psychiatrist about this and after how long you need to do blood tests etc when on medication and she just said that I am 25, healthy and not overweight, a smoker, etc etc... so basically, 'don't need to'. 

Good idea, no?
I wonder if there is also anything specific I'll need to ask the doctor to check... Nothing has been done through my family doctor really and they don't even have on computer that I am on medication etc or the background of it.

---------- Post added at 05:11 PM ---------- Previous post was at 05:09 PM ----------




David Baxter said:


> Possibly. Cow's milk isn't very easy for humans to digest so I generally advise cutting back or eliminating it if you have an unhappy digestive system until it settles down.


 
Yeah, good thinking. That's why I stopped having pure milk actually, because I heard and also felt that milk a lot of the time doesn't go down that well! But then was concerned about not getting enough calcium, but I get enough I think anyway from cheese and dairy products. 

Will try changing that and see if it makes a difference. If not, then will just switch to toast and water or something which hopefully will be better


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## David Baxter PhD (Oct 31, 2010)

It's not just milk, it's dairy products in general (e.g., ice cream), although personally i don't find cheese to be a problem.

With the medications you're taking, you shouldn't need to worry about frequent blood tests.


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## AmZ (Oct 31, 2010)

> It's not just milk, it's dairy products in general (e.g., ice cream), although personally i don't find cheese to be a problem.


Gotcha, yeah. I'm like this too. I was lactose intolerant as a baby and sometimes still get stomach aches etc when I have a lot of dairy like cottage cheese or something... But yellow sliced cheese for example seems OK. Think I'll go back to the soya milk for sure 



> With the medications you're taking, you shouldn't need to worry about frequent blood tests.


Cool. Good to know. I think that it's even worth it like I say to check that all my vitamin and mineral levels are OK due to the months of not eating much.


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## AmZ (Nov 17, 2010)

Finally, I have 'Feeling Good' by David Burns! After the last one I bought from Amazon went missing in the mail, my therapist advised that I keep trying to get it so found it elsewhere.

I was reading just now about Effexor in the book and it states: "Venlafaxine has a short half-life - meaning that it leaves your body in a matter of hours. Therefore, you must take the medication two or three times a day to maintain an adequate level in your bloodstream".

I think we were talking about splitting the dosage up before and said that only in cases of having side effects, such as taking it at night and it causing sleep problems, that you can adjust when you take it or split it up... 
So sorry to bring it up again... But I was wondering if I should do as is being recommended so that I'm not taking all 3 (75mg tablets) in the morning together? 
If the psychiatrist decides to move me to 300mg, then I'll simply ask for the Effexor XR which my pharmacist has told me is available in 150mg, so that I can take 2 a day. The regular Effexor is only available in 75mgs.

Thanks.


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## Retired (Nov 17, 2010)

> I was wondering if I should do as is being recommended



I've come into this discussion late and having been away for a few weeks may have missed some details in other related discussions.

By "recommended" do you mean the instructions by the prescribing physician?  If so, what are those instructions for when you take your Effexor?

Based on what you've written, you currently are taking the original Effexor, and not Effexor XR, correct?

Because this medication has a short biologic half life (about 12 hours) does not mean the medication is completely eliminated from your bloodstream at that time.  There is another aspect to the kinetics of the medication called "steady state" whereby the amount eliminated is replaced by the amount ingested and steady state does not mean the levels are at 0 at the end of the 12 hour period.

Extended release offers the advantage of less frequent daily dosing, lessening the chance of forgetting to take the medication.

BTW as a further insight into why cows milk is difficult for humans to digest has to do with the whey cassein ratio of cows milk compared to human milk.  Cows milk has a 60/40 whey cassein ratio, whereas human milk is 82/18.  It's why babies are not given cows milk at birth because their kidneys are not fully developed and cannot digest the cows milk formulation.

Infant formula companies modify the whey cassein ration, making it resemble that of human milk, so babies can be given formula insteat of breast milk.

This, of course is a totally separate issue from lactose intolerance, which is a person's  inability to digest lactose due to the body's inability to produce lactase, the enzyme needed to digest lactose.


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## AmZ (Nov 17, 2010)

> I've come into this discussion late and having been away for a few weeks may have missed some details in other related discussions.


Hi Steve,
Yes, I noticed that you haven't been around for a while. Nice to see you back and hope that all is well.



> Based on what you've written, you currently are taking the original Effexor, and not Effexor XR, correct?


Yes. Original Effexor. 



> By "recommended" do you mean the instructions by the prescribing physician? If so, what are those instructions for when you take your Effexor?


I was referring to the quote from the 'Feeling Good' book which says that if you are on regular Effexor, that you should split the dosages up between 2-3 times daily.
The psychiatrist's instructions when I first started the Effexor was that it would probably be best to take it in the morning in case if I took it at night and it would cause sleep problems. However, I was on 75mg to start with for the first month, so was only one 75mg pill a day. Since then, they haven't given me any new or different advice as when to take the pills and have been on 3 x 75mg for 2 months now. They just said that it may cause some 'worse' stomach problems and more of a dry mouth on a higher dosage, wrote me the prescription, and that was it.

Thank you for the extra information concerning the short half-life, but that it doesn't mean it's eliminated totally after 12 hours. 

I am going to the psychiatrist on Sunday and will see where we go from now and ask about splitting the dosage. I have asked things in the past and they haven't taken the time to give me a real answer or provide information to me, even though I said that I am new to 'this' so don't know anything about taking this kind of medication. Anyway we'll see how it goes on Sunday. If things are still the same and I feel like I am needing to wean necessary and important information out of them, then I will see about going to another psychiatrist. I have found another in case, but need to check if I can go and if he speaks English also, etc, so watch this space 



> Extended release offers the advantage of less frequent daily dosing, lessening the chance of forgetting to take the medication.


Sounds definitely more ideal and convenient. The thing was that I am on 225mg and the XR available here only comes in 150mg capsules, so I couldn't split them so am left with the regular Effexor of 3 x 75mg tablets. If they decide to move my dosage up though, I will make sure to ask for the XR instead as I can then take 2 x 150mg a day, 300mg total. 

Interesting about the milk  !! 
I was actually lactose intolerant as a baby so couldn't have breast milk and was only on formula. Now cow's milk is an issue haha, but anyway...
Not sure what to do about this. I have to see about my diet and what I can change around. I often get a stomach ache if I have cows milk, i.e. milk with cereal. So then I switched to soya milk which was a lot better for me and I have a fair amount of other dairy which doesn't cause me the stomach problems, so that covered me calcium wise. Now I've been told today that I need to ideally cut out the soya milk altogether because of something else unrelated. So looks like the cereal is out of the window either way! I've been having porridge with soya milk each morning, 1 minute in the microwave and marvelous, but I guess I will now substitute the soya milk for water instead!


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## Retired (Nov 17, 2010)

Your doctor should have the conversion dosage schedule if it is decided to switch to the Extended release formulation.

BTW Effexor should be available in a 37.5 mg tablet in order to be able to divide a 75 mg daily dose.


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## AmZ (Nov 18, 2010)

> Your doctor should have the conversion dosage schedule if it is decided to switch to the Extended release formulation.


Conversion dosage schedule? The XR is not the same dosage equivalent - i.e. 300mg of 4 x 75mg tablets vs 2 x 150mg XR capsules? Or you are referring to something else? The 'schedule'? 



> BTW Effexor should be available in a 37.5 mg tablet in order to be able to divide a 75 mg daily dose.


The pharmacist said that there isn't. But the 75mg tablets can be split as they have a score line, so perhaps that's what we have here instead.

Thanks for the information Steve.


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## Retired (Nov 18, 2010)

> Conversion dosage schedule?



Sorry, my mistake...the dosages of both forms are the same for the original and the extended release and there is no conversion....senior moment here

Thank you for noticing.

Perhaps the dosage forms availability vary from one Country to another, or perhaps the pharmacist doesn't want to stock the lower dosage form; but if the 75 mg tab is scored, then it comes to the same thing.


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## AmZ (Nov 18, 2010)

> senior moment here


I'm certainly sure not, Steve 

Thanks for the reply.


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## AmZ (Nov 21, 2010)

Hi all,

Went to the psychiatrist this morning bright and early. Arrived and the secretary said that she'd just called and can't make it to work so couldn't see her! 
There was another psychiatrist there and the secretary asked if she could see me and she said OK. She just went to write out another prescription for another month without asking me anything asides from what I take and at which dosage so I said that I'd like if she had a minute to explain the situation. She said that 2 months is long enough to wait on the 225mg and was surprised that I hadn't been given the XR. Apparently there is a 75mg XR here but I'd been given the wrong info before. Anyway, I explained a little and she's said to go up to 300mg. So now I have 150mg XR x 2 a day to take. 
She was quite nice and showed some sympathy which was nice for once (!) and said that 4 months at trying the same med is a long time and that she'd like to help me out to sort it out as soon as possible. She said rather than waiting now another month for the next appointment, that I should give it just 2 weeks at 300mg and if I don't feel an improvement/help from it within this time then they'll either switch to another med or add something else.
I've asked the secretary to find out if she speaks English so maybe I can go to her the next time so we'll see about that.

Any news, views, advice?  Thx.


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## Retired (Nov 21, 2010)

It sounds as though you feel comfortable with this particular physician...are you thinking about switching to this doctor for your continuing care?  Is this doctor available to take you into her practice?



> the 225mg has been doing bad things for my stomach, as much water and as I drink and fibre and a balanced diet I have, nothing seems to help



Are you saying you are experiencing the side effect of constipation?  Constipation is a possible side effect of medications that affect certain neurotransmitters, affecting different people in varying amounts of severity.  Some meds have no effect on some, while others affect the same people severely with no predictable common factors.

Constipation with SSRI/SNRI's has less to do with the food you eat than with the effect of the neurotransmitters on the the body process called peristaltic action, the physiological action that produces the urge.

You should certainly report this to the prescribing doctor, because sometimes the doctor can recommend the use of certain laxatives or other remedial medications known to counteract the side effect.   Psychiatrists are usually pretty good at managing side effects of these types of medications because of their specialized understanding of the mechanisms of action of the meds and ways to deal with specific side effects.

So, your best course of action is to contact the doctor and explain the situation. Your doctor should be able to help with this.


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## AmZ (Nov 21, 2010)

> It sounds as though you feel comfortable with this particular physician...are you thinking about switching to this doctor for your continuing care? Is this doctor available to take you into her practice?


I'm looking in to it yes. I am not sure if she can take me and I asked the secretary to find out if her English is any better, because it's too difficult with the other one with the language. I can't explain enough as my vocab isn't that great when it comes to words like this that I've never used before! It's difficult enough in English to be honest - That's probably no surprise coming from me! So we'll see. If she can't take me, then I have another possible option that I found. But I don't want to keep switching psychiatrists. The secretary didn't call me back so I'll have to chase her up tomorrow and see if she asked.



> Are you saying you are experiencing the side effect of constipation? Constipation is a possible side effect of medications that affect certain neurotransmitters, affecting different people in varying amounts of severity.


Yes, since I went up to 225mg. I'm trying to make sure that I take the meds in the morning with certain food that will avoid this as much as possible, but it's pretty much a daily unpleasant thing that hasn't gone away in the last 2 months as much as I try to eat different things and always take the meds with a lot of water... I wonder what the 300mg XR will be like? I guess there is no difference? I have XR pills and not capsules. I hope it won't be worse! Hmm.



> You should certainly report this to the prescribing doctor, because sometimes the doctor can recommend the use of certain laxatives or other remedial medications known to counteract the side effect.


I was thinking of getting something yeah. I have some pills already that help but I don't want to take these on a daily basis all the time, as I don't think it's good to do that long term for my body. But I saw today in the pharmacy (but didn't have proper time to look) some different more 'natural' things like special powder that you add to drink (not sure what the ingredients were) which could help. I've been going to the same pharmacist to get my meds each month so he knows me now and seems helpful. Maybe I'll go in and ask him and see what he recommends first of all. I've kind of been coping with it most of the time and it's OK, but I don't think I should put up with it and try to find something to help. With a family history of stomach cancer and bad digestion (!) I think I will go tomorrow and investigate 

Thank you very much Steve.


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## AmZ (Nov 25, 2010)

Does anyone know which/if side effects could happen when moving to 300mg Effexor XR from 225mg Effexor?

I don't know if it's because I've been feeling a little worse the last few days or because of the dosage change, but for a few days now I can't fall asleep until 3am and then am waking up at 6.30-7am each day and can't seem to get back to sleep like I was managing to do before. I try to go back to sleep and I can hardly even lay there with my eyes closed and try, even though of course I am (still) tired.
I went up to 300mg on Monday. 

Thanks.


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## Retired (Nov 25, 2010)

Tell your doctor about it because it might be a function of the dosage increase in the way the medication is affecting adrenergic receptors in your brain chemistry.  Although the mechanism of action of Effexor is very specific to serotonin and norepinephrine, there might be some "spillover" to other neurotransmitters as the technology may not be perfect.  Therefore some people may experience some unwanted side effects at certain dosages.

It should also be said that many of these unwanted effects diminish with time as the body becomes acclimated to the new dosage, but your doctor would be the best authority to make those determinations beased on his/her clinical experience.

So, your best course of action is to let the prescribing doctor know the details of the sleep disruptions you are experiencing.


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## AmZ (Nov 25, 2010)

Thanks Steve.

I really can't say that I am feeling too good now. Therapy tonight was hmm, a sense of hopelessness there? My therapist said that we'll carry on therapy but the medication is of main importance now to sort out and without it, it's making things not 'workable' in therapy. Can't say that makes me feel too positive and it kind of sucks that my thought about tonight was that she's going to bring up the medication again and she did, and went as far to say that. She said she feels that strongly about it that it would be "unethical", "unprofessional" and "not right" that she would carry on therapy without getting this sorted out by a psychiatrist that we know we can trust and that is going to take care of me properly. 

The place I have been going to (with those 2 psychiatrists) called me back to say that the other psychiatrist can't see me as she has enough patients, so I am left with the one who doesn't ask hardly anything and doesn't speak English. So basically that place is out of the question to go back to. My therapist said that my only homework is to call up this other place that I found to see about it and already make an appointment for 1 1/2 weeks time (if it works out) so that I can go once I have been on the 300mg for 2 weeks, and if not working by then, then something will have to be done then and not wait any longer. 

Totally bad of me, but I can't bring myself so far to throw out the leftover alcohol. That was my other homework also actually, as I didn't throw it out after last session. I know it would be totally wrong to have a couple of drinks to get me off to sleep for more than 3 1/2 hours tonight and if I succeed in resisting the urge, I will be very proud of myself. Doesn't look like therapy is currently workable anyway and the therapist was just annoyed at the end and did her frustrated 'thing' which I can see which doesn't make me feel very positive now waiting around for the medication to be sorted out and she could only suggest throwing out the booze (but that's a good one) and deep breathing.

---------- Post added November 26th, 2010 at 12:52 AM ---------- Previous post was November 25th, 2010 at 08:09 PM ----------

No AmZs were harmed after the writing of this post. No booze, other substances or any other actions occurred such as had happened on two previous Thursday nights which involved other things.
AmZ just feels :nah::help:

Goodnight.


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## AmZ (Dec 12, 2010)

Hi everyone,

I had a question concerning side effects when taking Effexor at higher doses.

I've been on 300mg for about 3 weeks and since I started to feel better mid-late last week (and I can feel it helping a lot), I have had some side effects which I haven't had before (whilst taking it at 225mg for 2 months and 2 months before at a lower dosage). 

Today when I got on the bus to work, all of the noises around me sounded so loud, I couldn't take it. It wasn't an anxiety-type thing/feeling, I just felt super sensitive somehow. 
Also with other noises, even if they are not that loud, they really affect me. 
I also feel extremely relaxed and calm, but kind of verging on feeling a bit floaty and 'too good'. I wasn't feeling like this 6 months ago, let alone in my whole life, so is a bit weird to adjust to. I feel like I'm kind of 90% 'here' or something (it's not an unpleasant feeling like I've had before but is a bit peculiar). 
I know that it sounds a bit anxiety-like, but I'm a bit twitchy also and whilst I feel a hell of a lot less anxious and down, the hand counting (OCD) is still there and seems to be a little worse since I moved to 300mg. I actually didn't have it at all for a few weeks and in the last few days, it's returned.

So yeah, sensitivity to sound, feeling 'too good' (a bit numb and overly relaxed) and twitchyness/involuntary movements/OCD - I was wondering (and hoping) that I will either just get used to the way the medication feels and/or these are perhaps sounding like side-effects from the higher dosage that will eventually go off?

Glad to report that I'm still sleeping a lot better which has made a big difference. I'm still waking up once or twice (3am and/or 5am) but am going back to sleep and having a much better night sleep. My appetite has come back tenfold which I am not giving in to because I don't want to put on so much weight! But is a bit annoying to wake up at 5am with my stomach rumbling for food!

Thanks


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## Retired (Dec 12, 2010)

> all of the noises around me sounded so loud, I couldn't take it. It wasn't an anxiety-type thing/feeling, I just felt super sensitive somehow



AmZ,

From my understanding of Efx, I do not have sufficient clinical knowlege to give a useful opinion on what you experienced; however I would report it to the doctor and ask if this might be related to a side effect referred to as _psychomotor agitiation_.

Your doctor may consider modifying your prescription in that case.


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## AmZ (Dec 12, 2010)

Thanks Steve.

I'm going to the psychiatrist in a few days so will see how things go between now and then.

I still feel more (than ever) relaxed and calm, but did have a little panic attack on the bus this evening which came out of nowhere and came hard and fast... I've only had it happen 3 times or so before but this was the most intense. Luckily had it under control within a few minutes so glad I managed to calm myself down.

Tonight I started thinking about self-harming... Not thoughts of doing it, but I don't know where it came from, I just started to look up about it on the internet. I know that's not good and am trying to see where this all came from this evening.

I'm still glad to be feeling and sleeping better though now after quite a few days. It's been a long time coming and still have some way to go I know. But for now, it's a relief, regardless of my bad evening I've had today. I knew it was going to get tough again and have bad times again some time, so... On I go. 

Just at home now and trying my best not to get in this bad frame of mind and thinking.


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## David Baxter PhD (Dec 12, 2010)

AmZ said:


> I still feel more (than ever) relaxed and calm, but did have a little panic attack on the bus this evening which came out of nowhere and came hard and fast... I've only had it happen 3 times or so before but this was the most intense. Luckily had it under control within a few minutes so glad I managed to calm myself down.


 
No medication can entirely control anxiety and you wouldn't want any medication that could do that. The fact that you could bring it under control so quickly should be reassuring. The next step is to learn to identify the early (remote) antecedents so you can predict an attack and intervene before it even hits.



AmZ said:


> Tonight I started thinking about self-harming... Not thoughts of doing it, but I don't know where it came from, I just started to look up about it on the internet. I know that's not good and am trying to see where this all came from this evening.


 
I suspect it's part of your OCD by now, automatic and repetitive.


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## AmZ (Dec 13, 2010)

David Baxter said:


> No medication can entirely control anxiety and you wouldn't want any medication that could do that. The fact that you could bring it under control so quickly should be reassuring. The next step is to learn to identify the early (remote) antecedents so you can predict an attack and intervene before it even hits.


 
For sure. I agree that of course I wouldn't want the medication to stop and take away everything... Otherwise I'll never come off medication in my life. My mum never did seek any professional help in her life for her anxiety and depression and still has daily heart palpitations (because of anxiety) to this day.

It's good that I managed to control it quickly and I know how it started - I was on the bus coming back from work and was stuck in traffic all the way home in the dark with heavy storms and rain outside. The bus was all steamed up and the air was humid and moist which I can't say was helping things. The journey took 2 hours rather than 50 minutes it normally takes. I started the journey by thinking positively and started to read 'Feeling Good' and thought that it was good that I was feeling relaxed and can try instead to enjoy the journey and take it as an opportunity to read the book and just get on with it. Even though there were obvious things that weren't so pleasant about the situation, I was OK for the first few minutes, then I had a tiny thought of 'I want to get off the bus' 'but I can't get off because we are on the highway', and then just straight away my whole body had pins and needles and I started to sweat and heart rate/breathing started to speed up. I just straight away put my book away, put my coat over my face, closed my eyes and did deep breathing for a few minutes until I was OK again. 

Then luckily had an empty seat next to me so put my head down and slept for a while! 

I was more than 50% there and it started off as a good CBT test for me, but that negative thought crept in and attacked!



> I suspect it's part of your OCD by now, automatic and repetitive.


 
The therapist and I never linked it to the OCD really but can see other reasons as to why I have self-harmed or have the thoughts. I've maybe only thought about self-harm 6 times or so in the last 6 months and did it twice. I think there is definitely an element of what you say that must be true though as no doubt the obsessing about thoughts or urges I have make it worse and the release is the compulsion i.e. drinking, taking sleeping pills, self-harming. We haven't looked so much at all about the OCD yet really, so we'll see. Because it seems to show itself only in the hand counting thing and comes about from any anxiety I am feeling about anything, I guess we are more focusing on controlling the anxiety to start with and change the thinking there. Maybe there is something else to do with the hand counting, but it's not like I do it every time I feel anxious or is connected to a specific thought etc.


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## tasha (Dec 13, 2010)

AmZ, I was only on regular Effexor for a short period of time then switched to the XR, which I've been on for years now.  I can't really remember how I felt when I switched or when my dosage was increased, but I do remember there were some adjustments to get used to.  

You sound very intelligent and very attuned to the differences your experiencing both physically & emotionally and I personally think that's a good thing.  It's great that you're wanting to understand the "whys" and "whats" of your medications and your health issues.  I guess what I'm saying is you're being proactive and that's fantastic! :2thumbs:  I really hope you find a therapist that you're compatible with.  

You mentioned a tingling or a twitching, I believe.  From my own experience with Effexor-XR, I've experienced an "electric shock" sensation in my fingers if I've forgotten to take it, and I know others who have reported the same thing.  If that's what you were feeling, maybe the same sensation happens to some people when their dosage is increased (or decreased)... just a thought.  In my case, it's a reminder that I must have forgotten to take my pills that morning. :bonk:


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## David Baxter PhD (Dec 13, 2010)

AmZ said:


> The therapist and I never linked it to the OCD really but can see other reasons as to why I have self-harmed or have the thoughts. I've maybe only thought about self-harm 6 times or so in the last 6 months and did it twice. I think there is definitely an element of what you say that must be true though as no doubt the obsessing about thoughts or urges I have make it worse and the release is the compulsion i.e. drinking, taking sleeping pills, self-harming. We haven't looked so much at all about the OCD yet really, so we'll see. Because it seems to show itself only in the hand counting thing and comes about from any anxiety I am feeling about anything, I guess we are more focusing on controlling the anxiety to start with and change the thinking there. Maybe there is something else to do with the hand counting, but it's not like I do it every time I feel anxious or is connected to a specific thought etc.



First, it would be rare for OCD to manifest itself only in one form. Indeed, your posts here show evidence of several different but related OCD signs, in my opinion. Second, OCD pretty much always gets worse as anxiety and stress levels increase.


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## AmZ (Dec 13, 2010)

> AmZ, I was only on regular Effexor for a short period of time then switched to the XR, which I've been on for years now. I can't really remember how I felt when I switched or when my dosage was increased, but I do remember there were some adjustments to get used to.


Thanks for letting me know about your experiences. It's great to hear.
I noticed a difference today with the sound sensitivity and morning weird feelings being a lot lot less so am hoping that it is just adjustments that I will get used to over time.

Thank you for the such kind words Tasha - That's really nice of you to say so  I need a bit of a 'lift me up'  right now so that helps!



> their dosage is increased (or decreased)... just a thought. In my case, it's a reminder that I must have forgotten to take my pills that morning.


Hehe - Yeah, I'm trying my best to not forget to take etc. So far, so good, in 4 1/2 months I haven't forgotten to take my medication once and have taken it every morning within the same 3 hours of each day. I heard all about those brain zaps and all kinds of things that aren't too pleasant when missing a dose so am keeping that in the front of my mind!



> First, it would be rare for OCD to manifest itself only in one form. Indeed, your posts here show evidence of several different but related OCD signs, in my opinion. Second, OCD pretty much always gets worse as anxiety and stress levels increase.


Agreed. Has just been a bit unexpected that having 5 days or so feeling much calmer and relaxed, and generally, have had less anxiety to deal with, that the OCD has been worse. I brought it up in therapy tonight and well, there are so many other things that we need to work on, that this is something that is the least of my worries (in a way) so this will be dealt with in the near future I hope.

I'd appreciate if anyone is around on the forum now or later, to offer me some advice about something. It's not like a mega urgent thing and I seem to pretty much have it under control so I don't think I'm going to do anything... But just need to get some advice and vent and welcome anyone's thoughts about the situation.
Therapy tonight was extremely uncomfortable. More than in any session I've had. The therapist asked me to do a narrative about something, then and there and straight away blood rushed to my head, I went bright red and totally tensed up and went mega awkward. I felt like an idiot to be frank and have lots of feelings about it all. I'm embarrassed at generally ' being me'  and specifically being in this situation and being totally awkward and not being able to do something quite as simple as this, sitting in front of just one person. We talked about it and then I'm even more upset that it just brings more of my many issues out, more and more on the list that we need to address and have so much to work on. I feel totally messed up and am overwhelmed at just being me, again. So now it's all come out about me and my social anxiety basically. I'm not necessarily using it as a term of diagnosis, but regardless, it's something that I've always had problems with. Whenever I am in a group of people, say at a lecture, whether it's 5 people or 50, I find it extremely difficult to be the one asking a question or making a comment in front of people. In the past, I've forced myself to do it a couple of times and went bright red and the same thing happened basically and it was horrible. Hence, why I am always the quiet one and 95% of the time, the only one who says nothing at all in front of the class (was like that all throughout school etc, up until now). If I'm in a room full of people at an event for example, and everyone is mixing and talking with other people, then I have no(t much of a problem really) going up to one person and talking to them. It's just times where the focus is on me and maybe when it's more of an improvised or scripted/talk type thing that I've most of my life avoided doing these things. It was right at the end of therapy when this happened so my time was up and I just had to hold my emotions in because I knew the next patient was waiting. The therapist urged me to tell me what I was thinking and I just said that I am very embarrassed and upset. She asked what I was upset about or who. I said ' me'. So now I have to email her a thought log of all of this and like I say, it's another thing on the list that upsets me, the way that I am and something else to work on.

My body was aching as soon as I got up from the chair and I wanted to carry on crying because I feel a general self-dislike, frustration and general upsetness (I know that's not a word, but it works) about everything. I started thinking about the evening ahead and my self-destructive behavior options and was thinking that I'm going to do something and don't care if I do. Luckily 30 minutes in to my walk, I got to the stage of telling myself the cons of doing so and now feel like I'm not and don't want to do something... Then I think, 'ahh, just a tiny glass of alcohol', just to relax me a bit and numb out a bit... Then I think no and keep doing so. Because I can't go on like this.

Thanks. I v much appreciate it.


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## David Baxter PhD (Dec 13, 2010)

> Agreed. Has just been a bit unexpected that having 5 days or so feeling much calmer and relaxed, and generally, have had less anxiety to deal with, that the OCD has been worse. I brought it up in therapy tonight and well, there are so many other things that we need to work on, that this is something that is the least of my worries (in a way) so this will be dealt with in the near future I hope.


 
Well, your memory for how you have been feeling even a few days ago isn't very accurate. But even apart from that, think of OCD as an anxiety-based disorder where the thoughts/obsessions represent worries and anxieties and the behaviors/compulsions represent a defense against the anxiety.OCD intensifies when stress and anxiety increase, but to the extent that the OCD is successful in reducing anxiety you might sometimes see OCD up with subjective anxiety down. It doesn't really mean there is less anxiety, just that it has been transformed.

If you understand OCD this way, it's not different from the other issues at all. They are all interlinked.


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## AmZ (Dec 13, 2010)

> Well, your memory for how you have been feeling even a few days ago isn't very accurate.


I appreciate your reply Dr Baxter. I am being accurate here however. I started to sleep well from last Wednesday which has continued since then. I posted late Wednesday night (in my time zone) with some concerns I had but Thursday onwards after sleeping good on Wednesday I've been feeling very different like I've never felt pretty much, let alone in the last 6 months. 
Shame something has clicked in me tonight though during/after therapy but I'm working on it as we speak. My heart keeps racing a bit even though I'm in bed and am usually very relaxed and have no anxiety (before mid-last week also). I hope that I'll be able to stop it before I go to sleep because from past experiences, the anxiety etc carries over in to my dreams and causes me a bad night sleep if I go to bed like this.



> ...think of OCD as an anxiety-based disorder where the thoughts/obsessions represent worries and anxieties and the behaviors/compulsions represent a defense against the anxiety.OCD intensifies when stress and anxiety increase, but to the extent that the OCD is successful in reducing anxiety you might sometimes see OCD up with subjective anxiety down. It doesn't really mean there is less anxiety, just that it has been transformed. If you understand OCD this way, it's not different from the other issues at all. They are all interlinked.


Thank you for that. It definitely helps me to have more of an understanding of how these things are interlinked for sure.


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## Daniel (Dec 13, 2010)

AMZ said:
			
		

> I posted late Wednesday night (in my time zone) with some concerns I  had


That's one way to put it 



			
				AMZ said:
			
		

> I've never thought like this before, it's never gone 'this far'....
> 
> ...if we can just 'assume' here that I have been feeling worse and at the  worst that I have ever felt before in the last 2 weeks, then that would  be a good start.
> 
> http://forum.psychlinks.ca/members-only-private/25086-i-feel-like-i-simply-just-dont-care.html


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## AmZ (Dec 13, 2010)

Daniel said:


> That's one way to put it


 
Lol. Are you guys out to get me or what!?
I don't even know why we're going off on this tangent here... So, I posted on the 8th that I was feeling v bad but slept 8 hours that night and 7-8 hours each night since then, compared to 3-5 hours in the last 6 months. On the 9th I woke up feeling very calm and relaxed and have felt like this since also with, I know, a bit of a difficult night last night (but I controlled within 3 minutes the start of a panic attack) and you guys and I know full well that medication doesn't take everything away... so why are you trying to prove me wrong here? You're trying to say that I am disillusioned somehow or? What advice are you trying to give me?


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## Daniel (Dec 13, 2010)

I was hoping you would provide the clarification.   You said on Wednesday night that I wasn't taking you seriously. And tonight you are saying you were just posting with concerns.

---------- Post added at 08:23 PM ---------- Previous post was at 06:05 PM ----------




> You're trying to say that I am disillusioned somehow or? What advice are  you trying to give me?


My point isn't primarily about what you posted last week but about what you have been posting for months.   I read over some of your old posts.  You seem to use the word "worst" and "worse" a lot -- which is the point I was making before about "awfulizing" and the recurring themes in your posts. Awfulizing also keeps OCD going: http://forum.psychlinks.ca/obsessiv...5-key-cognitive-errors-in-ocd.html#post175547

And, of course, acceptance (a.k.a. "high frustration tolerance") is the opposite of awfulizing.


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## AmZ (Dec 14, 2010)

Daniel said:


> I was hoping you would provide the clarification. You said on Wednesday night that I wasn't taking you seriously. And tonight you are saying you were just posting with concerns. My point isn't primarily about what you posted last week but about what you have been posting for months. I read over some of your old posts... which is the point I was making before about "awfulizing" and the recurring themes in your posts.


Thanks for the reply.

I agree with you that I am guilty of many bad ways of thinking which don't help things in the least. That's what I am trying to work on so I hope that I will improve within time. It's all a learning process. On the other hand, even though I post a lot here and it may appear like I'm saying everything, that's not the case. I'm not trying to awfulize my life and situation here, I'm just saying that there is also an element of not being able to understand a person fully and know everything by me writing and you reading on a forum like this. If we take both things in to account then I think we'll be just about straight 

BTW, tonight (last night) I was just posting with concerns. I didn't say that I was feeling awful again or anything like last week. I said that I'm happy about the medication helping me stay a lot more calm and relaxed in general and sleeping better, but that the session was difficult because it brought up another issue of mine (social anxiety) which was very embarrassing and difficult to deal with in therapy (last night). I could hardly look at my therapist and make eye contact with her for more than a second without awkwardly looking away all the time. I've been like this since I started to see her but last night was very difficult because of the situation of her asking me to do the narrative.

I didn't say it last night, but in general, I feel rather overwhelmed with everything and feel like there is so much to work on. Adding on now that my job that I've had for over 3 years is in a bad way, I'm trying to find another job that pays enough for me to pay my rent, bills, living, etc. Generally, I am trying, and have been trying for many years, to find some direction in life and it's bringing me now to a place where I've been in a good place in this job and got promotions etc along the way, without having any educational background (but it doesn't really require it) and have been very lucky. Now I am looking for jobs and they're all asking for a degree, etc, or are minimum wage and are shift work and not nice jobs - So it's difficult now because I know that I can't regret the past but I wish I had studied (finished) something at university and had a direction to go in. Anyway, so, yea, a bit difficult and I am trying to use the situation to make positive changes and look at other possibilities, but it's either a problem because I am not fluent in the language here and/or don't/can't get any financial support whether it be from family or money from the government because you can only use your benefits within 3 years of coming here and I've been here for 4 years. Now, at the age of 25, I really want to find something in life that interests me work-wise, it's not all about the money, as long as it pays enough to cover the necessities of what I need, then it's OK... Just have been searching for a long time and haven't found anything, and now am searching with the knowledge that I'd better find something before I get to a place where I can't pay my bills at the end of the month.

Sorry I went off on a little ramble. I know that the social anxiety thing and work issue has caused me more anxiety over the last 2 days, but I'm still a lot more calm than I have been before and feel OK - I'm eager to make the positive changes that I need to, but like I say, it's feeling a little overwhelming right now so I'm trying to break everything down into smaller parts and work on one thing at a time.


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## Yuray (Dec 14, 2010)

> I can't regret the past but I wish I had studied (finished) something at university and had a direction to go in.


Does this mean you have _some _university?
Is a community college an option, or a trade school?



> I am not fluent in the language here


After four years there, are you somewhat competent with the language, and are courses available to help you improve on it?


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## CarlaMarie (Dec 14, 2010)

Hi,
I would like to share some of my experience. I have been on effexor for many years now with lots of experience on and off it (one of the many ways I self harmed). I know what it feels like to go through the increase in dose and I relate to the syptoms your having. I am stable on my meds now and have been for awhile. I found a bunch of the weird stuff went away. Like my eye would tingle and stuff like that. I take 2 180 of effexor in the morning and at night I take trazadone. I still have my complex PTSD and have panic attacks and all that but I keep getting better. It seems like your struggling but doing the right thing. Persistance is what worked for me.


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## AmZ (Dec 14, 2010)

Hi guys,

Wow, stressful day and it's still going on. Not good timing and a very uncomfortable situation indeed. They've just fired 17 people out of 27 of us... Me and another 9 people are still safe for now, depending on how the company does over the coming couple of weeks. 



Yuray said:


> Does this mean you have _some _university?
> Is a community college an option, or a trade school??


We had to choose at the age of 15 what subjects we wanted to take which then leads on to university. In my opinion, that's a very young age to choose, but that's the way it works in the UK. I chose art, because it was just a hobby and something I enjoyed at the time but knew it wasn't going to be a career. Anyway, I did 2 years extra after high school and then a 1 year art diploma and got in to a 3 year degree course. I did one year of it and didn't like it and didn't want to be in England, so moved here. So now been here for 4 years. Nothing I did at university or in school goes towards anything here as the minimum they recognize is a bachelors degree. I did an 18 week web design course since coming here which ended up to be a waste of time as I'd already self-taught myself everything they had taught us already. There are basically no courses offered here asides from degrees (which I can't afford for starters and other problems, like the language and past education they don't recognize) and the college course I did in web design is no way enough experience to go in to the job field with. I look all the time for new things that are maybe available, but there isn't anything. 
To be honest, I've been more successful in doing things by myself, but it's not reliable enough to earn a full time salary which I need. I started an affiliate website about 3 years ago (from knowing nothing about SEO or web design) and after about 8 months, I taught myself everything and built it and then for about a year was earning a steady monthly amount of money ranging from $250-$2000 so I earned several thousand Dollars or so from it within a year or so. My dream would to be self-employed like this but like I say, it's not really reliable enough. I've since started working back on the website because I know that the more time I put in it, the more money I make back from it and I've only made a couple of hundred every 2 or 3 months in the last year since I stopped working on it.  



Yuray said:


> After four years there, are you somewhat competent with the language, and are courses available to help you improve on it?


My mistake was coming here and since doing so, in working and studying only in English as there is quite a lot available in English and it often has worked out better being from the same background (new immigrants) as other English speakers from other countries. I'm competent on a conversational/daily-use level of the language but my vocab is a big problem. I looked in to studying again for 5 months, but they cost a lot of money and is minimum twice a week and nothing has fitted in with my 3 day fixed work schedule.



> Hi,
> I would like to share some of my experience. I have been on effexor for many years now with lots of experience on and off it (one of the many ways I self harmed). I know what it feels like to go through the increase in dose and I relate to the syptoms your having. I am stable on my meds now and have been for awhile. I found a bunch of the weird stuff went away. Like my eye would tingle and stuff like that. I take 2 180 of effexor in the morning and at night I take trazadone. I still have my complex PTSD and have panic attacks and all that but I keep getting better. It seems like your struggling but doing the right thing. Persistance is what worked for me.


Thank you very much for the reply 
I'm very glad to hear that you are in the process of getting better - Genuinely nice to hear good stories like this!
I've had persistence and patience and it seems to be like that's worked for me in the end also... I've been on 300mg XR for err, 3 weeks and a bit, and felt a big change mid-last week. I've since been a lot more calm and balanced out. Things have been pretty stressful the last couple of days though, but I must say, still, at least physically I've stayed quite calm and I also have noticed a big difference in intrusive/unpleasant thoughts I normally have. For sure, my sleep has improved a hell of a lot also, and I'm now sleeping at least double the amount each night than I was sleeping in the last 6 months. So... Things are looking up... Let's hope everything else starts to work out whatever may be... All a bit up in the air and feeling lost and overwhelmed but hope to speak with my therapist and we can sort out a plan to go by.
What is the trazadone for? For sleeping? Did you not find the Effexor helped with your sleep? I heard that in some cases, it can cause insomnia or sleep problems and maybe doesn't help out with that side of things. I know the feeling about the weird side effects! I really think that I've had a few of those also that weren't related to anxiety, like my muscles twitching when I'm sitting or laying still... I've never had that in 6 months of having the anxiety, so pretty sure that's no coincidence that it only happened in the same week that I went up to 300mg Effexor etc...

Right, it's time to leave work now for the day!

Me and one woman are here that are 'safe' and all of our work buddies are packing their stuff up to leave so it's not an easy situation to be in!!!


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## David Baxter PhD (Dec 14, 2010)

> We had to choose at the age of 15 what subjects we wanted to take which then leads on to university. In my opinion, that's a very young age to choose, but that's the way it works in the UK.


 
Thirty to forty years ago, children in England were streamed at age 11 for their future academic streams. In that context, 15 is a huge improvement.


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## AmZ (Dec 14, 2010)

David Baxter said:


> Thirty to forty years ago, children in England were streamed at age 11 for their future academic streams. In that context, 15 is a huge improvement.


 
Yep, I guess so! Can't deny that!
But I can't count how many people I knew went to university because of pressure put on them by society in general and or/parents and jobs always asking for at least a BA, even if it's not related to the job you are going for! My friends went and had 3 miserable years or 3 party years studying things like law, and hated it all along, and didn't even use it in the end or jewelry degrees and did nothing for 3 years and just partied all the time! So yeah, after a year of me being the only one pretty much turning up to the studio and wanting to be learning and doing something, I quit! Again, I maybe wish that I would have chosen something more focussed such as graphic design or something with computers as it's more in demand... But hmm, really not so much I can do now! I know it's not good to have regrets, so am trying to work out my future from today onwards  Searching gets exhausting though!


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## Yuray (Dec 14, 2010)

> I'm competent on a conversational/daily-use level of the language but my vocab is a big problem.





> But hmm, really not so much I can do now!


Budokan Israel - Ulpan, scholarships for Hebrew Ulpan
Learn Hebrew Online - Write or Speak in Hebrew Language Exchange
TAF - Welfare and Social Services Projects
In most regions of Canada, there are free night classes at local schools for immigrants to learn and improve English. Maybe contact Tel Aviv school boards.


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## AmZ (Dec 14, 2010)

Thanks Yuray, that's really nice of you to have taken the time to find these links for me! I'll definitely be looking in to them. Much appreciated.

I'm off for a semi-misbehaving but relaxing evening... Take away sushi and hmm, well, a Coke and some liquor goes well with that. And a movie. Unfortunately an ice cream or some other 'treat' doesn't quite do it for me! Maybe I'll find something else in life that will fill the place of a nice couple of drinks to relax with and enjoy. I'll be good with my limits. Promise. I know I shouldn't drink at all and I'm calm and relaxed anyway, so why bother? It's just enjoyable I guess.

---------- Post added at 10:44 PM ---------- Previous post was at 08:38 PM ----------

Haha.


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## Yuray (Dec 14, 2010)

> Haha.


What do you mean?


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## AmZ (Dec 14, 2010)

Sorry Yuray. I'm just being an ass. Everything is laughable right now. Better than the alternative, I guess.


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## Yuray (Dec 14, 2010)

Being an ass is not always better than alternatives. Alternatives are choices, and you are only seeing bad ones.

Earlier you alluded to coke and liquor, and said you know you shouldn't drink, but were going to anyhow, and were going to limit yourself, and that drinking is enjoyable. You said you wanted a "void" to be replaced with something other than booze, and you would desire that. 

If you drank tonight, even maintaining limits, the escape from reality is short lived, and generally leaves one in the same boat when the effects wear off, and being an ass sometimes. Drinking is not an alternative, it's a mistake while on medication. 

Basically, you told us you were 'going to be bad', and told us 'but not too bad'. In a situation like that, should someone be chastised for being bad, or praised for not being too bad? Something to look up is Effexor vs Liquor.
MyTherapy Discussion Forums - alcohol cravings w/ Effexor?
Risks of Drinking Alcohol While on Effexor | eHow.com


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## AmZ (Dec 15, 2010)

Thanks Yuray.

I was saying that the choice about laughing at everything was better than an alternate at the time such as getting worked up and anxious about everything. Excuse me for still being an ass though 

Well, I have voids yes, lots of them. I do still enjoy a couple of drinks though and stuck to that last night. I guess that I'd like to be able to get to the stage of both having things in my life that make me naturally happy and also have a couple of drinks a couple of times a month because I don't see the harm in that - But I know that drinking by myself is not really good, so I'll try to stick to it when I am around people in the future. For now, I know I should just forget about it completely. I woke up with my eyes swollen this morning which I never have, and I am guessing, that even though I wasn't drunk, it was probably because of the medication and drink together - My stomach was hurting also an hour or so after I drank and during the night. Anyway, we all learn our lessons. I still can't say that it wasn't enjoyable though. Now I try it do it by doing other things like going to the gym etc, but nothing for me is the same than drinking and stuff or taking some sleeping pills.


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## Yuray (Dec 15, 2010)

> I still can't say that it wasn't enjoyable though


Which part gave you the most enjoyment: the drinking alone, swollen eyes, or sore stomach?


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## AmZ (Dec 15, 2010)

Yuray said:


> Which part gave you the most enjoyment: the drinking alone, swollen eyes, or sore stomach?


The effect of the alcohol... Regardless of whether I was by myself or not. Things are more entertaining and seem better through the liquor-tinted-glasses. Lucky I was never a crying-sad drunk. Or maybe I should wish that I was one, then nothing would be good about it.

Anyway, I'm still embarrassed about therapy and just want to run away to be honest and never face her again. I didn't manage to do anything social or any new things this week so failed on that. My mood doesn't feel lifted at all, I just feel physically more relaxed and calm since last week. 

Psychiatrist in the morning. I'm just going to say for now that my medication is working and leave it at that and see how things go. The other psychiatrist said about taking Endronax also, but to be honest here, I don't think any medication will make me feel that much better so I don't want to take more medication than I'm already taking. 

Just need to sort out *every* part of my darn life out somehow. :rofl::rofl::rofl:

---------- Post added at 10:25 PM ---------- Previous post was at 10:00 PM ----------

I don't want to take any more of people's time here, at least for now, so thank you for everything. 

I'll sort things out one way or another.

C'est la vie.


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## CarlaMarie (Dec 15, 2010)

You are telling my story. You are where I was at five years ago and I have to tell you there is so much hope. I drank for the same reasons you drink and a warning about the effect of alcohol with my medication would have not deterred me from drinking. I too drank for the effect produced by alcohol. Alcohol was my best friend and I couldn't stop sure I could for days, sometimes weeks but I would miss the sense of ease and comfort I felt and sure enough I would pick up again no matter what the consequences. Until finally I was sick of it. Sick of the way my life was going. With alcoholism our problems pile up and are difficult to solve. Until I got sober I could not solve my problems. I got stable on my med and sobered up by going to 12 Step meetings. It was then I could address my all my problems and find solution.


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## Yuray (Dec 15, 2010)

> I don't want to take any more of people's time here,


We volunteer here to _have_ our time taken up. Sometimes, it's satisfying, and other times challenging, but never considered as 'time being taken up'. Sometimes our responses challenge the person posting, and the challenge is given in a positive way to incite thought or introspection. It can be a way of realigning the crux of what needs to be addressed or further investigated, and bring the topic back to a point where progress can be made. There are times when people posting feel threatened, or attacked, by a 'challenge'. Its hard sometimes to sift through extraneous information to see what is really happening, or being said. 

Psychlinks is a forum where people participate, take what they can, offer what they can, and then drift on. We offer what we can, and at times it's not to the liking of someone looking for information, but it's given with sincerity, and good intent.

Your participation here has been stimulating to many, appreciated by many, and has puzzled many. I hope your leave of absence is short.


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## David Baxter PhD (Dec 15, 2010)

AmZ said:
			
		

> Psychiatrist in the morning. I'm just going to say for now that my medication is working and leave it at that and see how things go


 
Not advisable unless it's true. Health professionals cannot assist you if you withhold information from them.


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## AmZ (Dec 16, 2010)

CarlaMarie said:


> You are telling my story. You are where I was at five years ago and I have to tell you there is so much hope. I drank for the same reasons you drink and a warning about the effect of alcohol with my medication would have not deterred me from drinking. I too drank for the effect produced by alcohol...I got stable on my med and sobered up by going to 12 Step meetings. It was then I could address my all my problems and find solution.


Thank you CarlaMarie  and a big well done for the hard work you have put in. I know that I need to quit whilst I am ahead. I've only drank about 4 times in the last 6 months since this started, but I know that it's one time too many really, because 1. I am on meds and shouldn't drink and 2. When I have drank, it's not a social/special event type thing, it's drinking by myself in order to escape from things. I have a lot of urges all the time and I gave in eventually with the alcohol and have managed to resist getting some weed, so now hopefully I'll stop all of it.



Yuray said:


> We volunteer here to _have_ our time taken up. Sometimes, it's satisfying, and other times challenging, but never considered as 'time being taken up'... Your participation here has been stimulating to many, appreciated by many, and has puzzled many. I hope your leave of absence is short.


Thank you Yuray. I appreciate your words and of course, everyone's time in posting back and trying to help. I feel a bit like a lost cause right now so was feeling bad about bothering others also. 



David Baxter said:


> Not advisable unless it's true. Health professionals cannot assist you if you withhold information from them.


 Thanks Dr Baxter. Yeah, I know. I guess that I'm too cautious either way to say if it's working enough or not enough - I keep telling myself that I know the medication can't take all or even a lot of the feelings away and certainly can't solve my problems, so was maybe thinking I need to do the balancing act of therapy vs medication and both working together more... As you are aware, the therapist put a lot of emphasis on the medication, here we spoke about not relying on the medication etc etc... In the end, I know it's not. I also don't want to take more meds really, but I know that I need to if I need to!

I went to the psychiatrist today. I explained what has been going on and she understood. She has put me on Lamictal alongside the Effexor.
I said that even though I can feel a difference physically, in being more relaxed and calm and sleeping better, I don't feel an improvement in my mood being lifted asides from a little feeling here and there, like for a few minutes or an hour or two a day, and then my mood goes way down again. She said that this medication should balance my mood out, but will possibly take some weeks until I get to the right dosage.
I'm either feeling 'OK' or anything below that, going up and down below that line. At least if I can be feeling OK and be able to do more than basic functioning, then I can go and be able to do new and different things which should make me happier and more content over time, so that's the plan. 

I'll be OK 

Thanks everyone.


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## Retired (Dec 16, 2010)

> I feel a bit like a lost cause right now so was feeling bad about bothering others also.



As has been said, there is never a bother here, and everyone has bad days along with the good days.  Psychlinks is a support forum where you can feel comfortable in expressing your frustrations and concerns without fear of being judged.

Stick around..things usually get better!


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## David Baxter PhD (Dec 16, 2010)

AmZ said:
			
		

> I went to the psychiatrist today. I explained what has been going on and she understood. She has put me on Lamictal alongside the Effexor.


 
That may help to stabilize all the ups and downs you've been experiencing.


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## AmZ (Dec 16, 2010)

Thank you Steve and Dr Baxter.

I know this sounds so stupid, but I'm going to have a drink tonight. I really don't care about having a drink and don't see a reason not to to be honest... At least right now anyway. Nothing else is going on, most things are up in the air and I just want to have a nice enjoyable evening. I have no other options or anything right now that could be instead of this. I want to have a drink.

Therapy was canceled tonight 1 hour before the session whilst I was coming back from work in another city on the bus. I'm not drinking because of that, but I probably wouldn't have drank if I had therapy as I'd get home very late. It's another week down in my life so I may as well try enjoy some of the week and chill out. Like I say, no other options. And this is something I find to be the most enjoyable right now and nothing else comes close. This isn't something, however, that I want to carry on doing, I know it's not a 'hobby or 'interest' that I want to do often at all. And I know it sounds stupid for me to say that, but I do genuinely want to find good things in other places of life and things to do, and people, etc... I failed this week to do so, so I hope that next week will be a new week.


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## David Baxter PhD (Dec 16, 2010)

You're insistence on "no other options" is both puzzling and concerning. There are lots of other options.


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## AmZ (Dec 16, 2010)

David Baxter said:


> You're insistence on "no other options" is both puzzling and concerning. There are lots of other options.


 
It's 8.45pm on a Thursday night. I treated myself to some Chinese take-away, and of course, with that I get my once-a-week treat of a Coke. And I have a movie to watch. But I guess it's just not good enough for me and I had to put some tipple in my Coke.

I have at least nobody I can do anything with, so means doing something by myself. And I can't think of anything I want to do at 9pm by myself.


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## David Baxter PhD (Dec 16, 2010)

You're rationalizing. I hope you understand that.


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## AmZ (Dec 16, 2010)

Yeah.

---------- Post added at 08:56 PM ---------- Previous post was at 08:51 PM ----------

It's OK. I'm not drinking. Just plain Coke and am going to enjoy my evening with no alcohol.

---------- Post added at 11:17 PM ---------- Previous post was at 08:56 PM ----------

Just wanted to say that I feel good for not drinking tonight.

Good(natural-ish [just Effexor!])night(sleep).
Goodnight 

TY ty.


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## Retired (Dec 16, 2010)

> Just wanted to say that I feel good for not drinking tonight



Glad to hear you came to a sound conclusion.  It's progress one step at a time.


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## CarlaMarie (Dec 16, 2010)

You know AA is everywhere they should have a hotline number or you even could find a directory on-line for your area. It is a we program and you don't have to do it alone. It is a day at a time. Way to go! You got through a day and you really wanted to drink. That is all you have to do. Get through a day. My suggestion is to try a meeting. You can just check one out. It will make it much easier. The first step is to admit your powerless over alcohol, your life is unmanagable (acceptance takes time). It's was hard for me to get that I was out of control with alcohol/drugs or any substace that altered my mood I wanted to rely on them to cope and I would go through cycles and end up hitting a wall. I thought it was me that caused the problems and if I could just fix me the problems would go away. I don't have that power. That is the unmanagability. My life was unmagable. I was a dog chasing my tail. When I went to AA I found amazing people who act, think, and feel just like me. Here is the kicker. They laughed,, smiled, and had hope. I had it all backwards. The twelve steps rock.


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## Yuray (Dec 17, 2010)

Given the amount you drink, which is not a heck of a lot, it doesn't sound as though alcohol is a problem, but an escape. The problem is resorting to drinking as an option. It may escaslate, it may not, but as an option, its a better choice than getting high or self injuring as long as it is moderate. If it exceeds moderate, you are only adding to that heap of rubbish, and your heap is already large enough.


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## CarlaMarie (Dec 17, 2010)

Thank goodness Alcoholism is a self-diagnoised disease. I apologize for stepping on anyones toes. I don't know you, your history or the truth about your drinking or drugging. I suggested try a meeting and shared my experience. I heard the pain in your writing, the isolation, and the lonliness. My bad. I wish you well.


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## AmZ (Dec 18, 2010)

No need to apologize CarlaMarie 

Of course, your intentions were _only_ good and there is no harm in you offering your advice based on the limited information that either you or anyone else has on the forum. 

For now, things are under control enough that the drinking is not a large concern for me. But I am well aware that it's something that I have to look out for because it of course has the potential to become a much larger problem. I hope that once I am feeling better in general, that my urges to drink alone to escape will dissipate.

I'm sure it will make you feel better if I told you something that my therapist said to me CarlaMarie - A couple of weeks ago, after I drank last, I went in to therapy and told her that I'd drank again to escape etc etc. And even her response was "of course, the use of alcohol in order to escape is not an ideal thing to be doing, but if it's something that you don't do too often that it affects your daily life, and you find it a good way of winding down, then it's OK". Lucky I even realized then that this is not the route of thinking that I need to take and told her that for me, it needs to be a _no-no_ to do even that because it can easily get out of control. 

Concerning other drugs, I used to smoke marijuana as a teenager quite a bit over the space of several years, but the last time I smoked was about 2 years ago now. Lucky I since got rid of those 2 'stoner-friends'  I've had lots of urges in the last several months to get some, but haven't. For that I can be thankful to people on this forum who advised me against doing so.


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## CarlaMarie (Dec 18, 2010)

No, your not like me...darn. It would of been a great support group. I love it. You either are or your not. You don't need to go there (using it to escape or medicate your feelings). It's a vertex. Keep on...keeping on.:2thumbs:


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