Effexor, side effects, hypergraphia, help!

I will try to keep this brief.

56 yo male, current diagnoses MDD, severe, with psychotic features, and anxiety disorders. Began 150mg Effexor on 06/16, dosage increased to 225mg on 07/29.

I went through a large number of the most common side effects. Most of them have dissipated, with a few remaining: increased anxiety, nausea, a few others.

Rare side effect: hypergraphia. Frightened at first, came to enjoy it and get pleasure from it. Was able to 'control' for a couple of days but is out of hand again today.

Effexor has been a God-send in re depression. Good days/bad days 50/50. See doc this coming Friday, anticipating dosage increase to 300mg. Tremendous as mood elevator (with no mania) and treatment of morbid depression. I realize that I may become addicted for life but I prefer that to hospitalization for remainder of my life.

Looking for any advice on 'controlling' the hypergraphia? I just can't it seems. Anyone else have this disorder, caused by Effexor or not?

Also looking for advice on decreasing anxiety. I've been on Xanax since 1987, currently on 1mg tablet 4x daily. Effexor does not help but rather exacerbates. Suggestions?

Back to Effexor with two more questions: drugs.com monograph says that conventional tabs should be taken WITH FOOD – I have no instructions to do so. What do others do? Taken with food may decrease nausea?

And dosage – I take three (3) 75mg tabs at once in the morning. Same monograph suggests 2 to 3 times daily dosage. I have no instructions to do so. What do others do? I sleep very well but upon waking have 'craving' for Effexor. Should I take one 75mg tablet 3 times daily? I really should ask my doc – just found out about the food/dosage information 20 minutes ago. Please, if you can, let me know.

And if you've any suggestions for controlling hypergraphia, PLEASE respond.

Thanks,

Good heavens! Your doctor has given you non-extended-release Effexor and having you take it all at once?

I have taken both non-extended-release (3 times a day) and extended release (once per day.)

I would highly recommend the extended-release version. When I took the other type, I started having withdrawal symptoms (head zaps, tingling lips and fingertips, confusion) between doses after a few months.

Your doctor may have an explanation for why he/she is prescribing the Effexor this way. I would definitely ask. Taking the extended release version might get rid of the hypergraphia side effect, since you wouldn't be getting a huge dose of the drug in your system at once.

I took Effexor XR for about 5-6 years. You're right, it can work extremely well. Unfortunately, I had anxiety and insomnia problems from it and ended up having to take meds for those.

Some people prefer Pristiq for that reason. It's the evolved version of Effexor and is supposed to have fewer side effects. Desvenlafaxine - "Desvenlafaxine is a synthetic form of the major active metabolite of venlafaxine (sold under the brand names Effexor and Efexor)."

As far as the "addicted for life" part, it's not that bad. It just requires a very slow taper to get off it (often several months.) This can be avoided if you stay on a drug in the SNRI family.

When I stopped taking Effexor, I went straight to Cymbalta without any noticeable side effects. Other people on PC have written about going to a combo like an SSRI + Wellbutrin with some side effects but not too much misery.

It's when you stop it suddenly and don't replace it with another antidepressant that all hell breaks loose.

I don't know your age. I hope that your pdoc and regular doc will monitor your blood pressure while you're on Effexor. It can definitely increase it. Mine went from 120/80 to 130/80 when I first started taking Effexor and stayed there until after I had been taking it for about 5 years and then it jumped to 180/?. I was in my mid-40s then.

In spite of all the "watch out for this" things I've said, I'm so happy to hear that Effexor is helping you. The SNRI family of meds help me a lot, too.

Thanks so much for your reply! When I was first prescribed Effexor, it was a daily dosage of 150mg, two 75mg tablets, and the instructions just read "Take two tablets daily." When the dosage was increased, again with 75mg tablets, the instructions read "Take three tablets daily." So I took three tablets each morning before eating a thing. Yesterday, when I read the "2 to 3 times a day with food," I wigged out a bit. Had the instructions read "Take one tablet three times daily," then I would have had a better idea of what I should have been doing!

Today I began the day with a bowl of applesauce and took my meds 30 minutes later, taking ONE 75mg of Effexor. I put one tablet in my noon slot and one in my five pm slot. I don't know what to expect – less anxiety? An ability to control the hypergraphia (I don't want it to vanish!).

I have no idea why I was not put on the XR caps at the start. I'll ask doc Friday. It may have something to do with my insurance – I am mentally and physically disabled (I lost my legs) and I was in a nursing home from 2005-2012. Thanks to a state Medicaid waiver program I was able to get Medicaid, with many of the benefits, and use my monthly disability check for everyday things – paying rent, utilities, groceries, etc. I've been out for almost exactly three years and I'm proud to say that, in that time, I have reestablished my credit and my FICO score is in the low 800's (the amount of available credit that I have is ludicrous for someone with my low income – I have over $50K available credit on cards alone! How can the cc issuers possibly think that I could pay that back?). But I only have around $3,000 in debt. I'm a little proud of going from no credit for 13 years to exceptional credit!

Anyway...

I've been on different types of antidepressants since 1987 but Nardil was the only one that ever helped. I was hospitalized while on it and had to cease taking it because of the stroke or worse potential.

I do have a history of hypertension; I monitor my BP three times daily and my very highest recorded reading since taking the Effexor has been 121/75 with the highest pulse rate of 74. So it has not been a cause for exacerbated hypertension.

My sleep has been wonderful. After I've completed my nightly preparations, my head hits the pillow and, for about twenty minutes, I'm lulled to sleep by my auditory hallucinations. And I sleep a good 7 hours at least. Lately I wake up craving Effexor (a feeling that I equate with going through a 16 hour period with no Xanax) but I believe that will change. The non-XR tabs have a half life on 5 hours, I've read, while the XR capsules 11 hours.

Oh – I'm a 56 old male. This is my second diagnosis of severe MDD with psychotic features (and anxiety disorder) in 16 years. I was hospitalized for 17 months the first time and only responded to ECT. I have many physical and mental illnesses and I don't mind being on a life maintaining drug for the rest of my life. Effexor has worked wonders in the short time I've been taking it and if 'splitting' the time between doses helps with anxiety and nausea then I will be delighted.

As for Pristiq, I was on it for maybe 1 ½ years starting in 2010 or so? I don't recall that it had any effect at all. Now, knowing that it's just a synthetic version of Effexor and that it was the first SNRI that I had taken, I find it odd that I had no reaction to Pristiq.

I really need to give you accolades in verifying the dosing schedule! I'll see how this three times a day works. I will also ask my doc about the XR option. Maybe the standard tabs go to work more quickly? I was in very, very bad shape when I began the Effexor – I had been on Wellbutrin for 16 months prior to Effexor and it did nothing good or bad.

I'll let you know what my doc has to say on Friday. If, as expected, he increases the tabs to 300mg, I have four slots in my daily pillbox.

Thanks, again,