[Nike007]

I was on Effexor Xr at 75mg for 4 months or so and then I became depressed again, and my dose has now been increased to the max dose of 225mg, and I still want to sleep all day and eat sugary foods and feel so sad. I know Effexor xr is suppose to be a fast acting drug, as i felt the effects in like 4 days or so. I've been at 225mg for a week. I see my pdoc next week, and I wonder if I need to change or if I need to add something? A doctor I saw, whom I think is just a family doctor, said I may need another med on top of this, but the pdoc didn't say anything about this. I'm really stressed, as I need to study for my finals this week as they are next week and don't have motivation to do so and I just feel awful. Any suggestions I guess?

[*Laurie*]

Hi Nike007, I feel so bad for you because I know how terrible it is when a medication doesn't work. Unfortunately, the only advice I have to offer is for you to speak with your pdoc (not your family doctor). You don't have to wait until next week - call your pdoc as soon as possible. If no one returns your call within the day, call again. Tell your pdoc how unwell you're feeling and ask if you should try a different med, or add another one.

Best of luck to you.

[Nike007]

Originally Posted by *Laurie*

Hi Nike007, I feel so bad for you because I know how terrible it is when a medication doesn't work. Unfortunately, the only advice I have to offer is for you to speak with your pdoc (not your family doctor). You don't have to wait until next week - call your pdoc as soon as possible. If no one returns your call within the day, call again. Tell your pdoc how unwell you're feeling and ask if you should try a different med, or add another one.

Best of luck to you.

I wish I could call my pdoc and reschedule, but she's associated with my university, and is only in on Mondays, which is tomorrow here, and she most likely is filled up and you are even suppose to call 48 hours in advance to cancel. My Mondays are quite hectic already, so I can only go between a certain time or else I'm missing class, and that is happening enough as is (missing classes). And that time is most likely already full. I can try to look up the number to call tomorrow between classes. I really hate phones though... A lot of anxiety. I know the worse response I can get is saying that I just have to wait, which is what I already suspect though.

I'm just stressed about it, as I've already tried 4 anti-depressants with either relapse/recurrence or bad side effects.

[marcoleap]

I would try to call tomorrow. It sounds like you're anxious about it, but it might be worth feeling that anxiety in order to get an earlier appointment. If you responded to the Effexor, your pdoc might try augmenting with another drug, such as lithium, aripiprazole, bupropion, etc. There are a number of good options for people who have a partial response to AD like Effexor. You might also consider making an appointment with a therapist--perhaps you got more depressed after the initial response to Effexor because something happened or school is particularly stressful, and a therapist might be able to help with that. Most well-designed studies show that the combination of medication and therapy is the best treatment for depression. Hang in there.

[Nike007]

Originally Posted by marcoleap

I would try to call tomorrow. It sounds like you're anxious about it, but it might be worth feeling that anxiety in order to get an earlier appointment. If you responded to the Effexor, your pdoc might try augmenting with another drug, such as lithium, aripiprazole, bupropion, etc. There are a number of good options for people who have a partial response to AD like Effexor. You might also consider making an appointment with a therapist--perhaps you got more depressed after the initial response to Effexor because something happened or school is particularly stressful, and a therapist might be able to help with that. Most well-designed studies show that the combination of medication and therapy is the best treatment for depression. Hang in there.

Yes I do see a psychologist for therapy at the moment. I'm seeing him on Wednesday.

Effexor works well for my anxiety, as if I'm not on it, i get stress headaches almost daily and they're painful and I can't do much when I have them, and I currently don't get them. I feel less anxious overall, but still really depressed. I couldn't sleep last night, even with melatonin, and had an hour and a half of sleep. I have classes pretty much all day from 8-4 today. I really want to nap, but am afraid people will judge me...

Anyways, I'll look around to see if I can make an appointment. My only fear about adding medication is with weight gain, as depression makes me gain weight because I crave sugars and eat more. And I have insulin resistance because of another medication condition so...

[marcoleap]

I understand your concern about weight gain. I am concerned about that as well. My pdoc recently added aripiprazole to my sertraline for depression, and I have not gained any substantial weight in 5 months--probably 1 or 2 lbs. My appetite is better, but I believe that's because my depression is lifting more fully. You should try to exercise regularly--it will help with the depression/anxiety and make it less likely that you'll gain weight. Keep in mind that SSRI and SNRI can also cause weight gain.

[marcoleap]

You must be really tired. I remember being in graduate school and sleeping for only a few hours every night. It's terrible. The only problem with napping is that it throws off your sleep schedule and makes it even harder to fall asleep at night. I wouldn't worry too much about what people think if you take a nap--if I remember correctly, college students are always taking naps. Glad to hear you're seeing a therapist. Keep up the good work and hang in there. It sounds like you're doing all the right things. Sending good thoughts your way.

[still_crazy]

hi. I don't have lots of advice on the drugs...wellbutrin is sometimes added to effexor, remeron (sedating, but helps depression and anxiety), various 'atypical' tranquilizers, and now and then, stimulants.

i just hope you can get the care you need, when you need it.

[Nike007]

Originally Posted by marcoleap

I understand your concern about weight gain. I am concerned about that as well. My pdoc recently added aripiprazole to my sertraline for depression, and I have not gained any substantial weight in 5 months--probably 1 or 2 lbs. My appetite is better, but I believe that's because my depression is lifting more fully. You should try to exercise regularly--it will help with the depression/anxiety and make it less likely that you'll gain weight. Keep in mind that SSRI and SNRI can also cause weight gain.

Yes, I used to go to the gym every morning before school, but I've been so tired and just want to sleep, so i haven't been going. My weight has increased mainly because of depression, so once I am better, I tend to eat better and don't have strong cravings.

[Nike007]

I probably will have to stop Effexor XR. I have hypertension now (bp is 151/91) and a high resting pulse of about 110... My blood pressure about pulse were fine before Effexor XR. I'm already at risk for conditions like diabetes and cardiac disease because of PCOS so I will see what the pdoc thinks. I didn't get to see her today. I'll have to wait until next week...

[marcoleap]

Sorry to hear that. Maybe a different AD or AD plus AP regimen will work for you. I hope you have a close friend or family member that you can look to for support right now. It's good that you are seeing a therapist regularly. I admire your stamina. Hang in there and keep us posted.

[Nike007]

Originally Posted by marcoleap

Sorry to hear that. Maybe a different AD or AD plus AP regimen will work for you. I hope you have a close friend or family member that you can look to for support right now. It's good that you are seeing a therapist regularly. I admire your stamina. Hang in there and keep us posted.

Thanks. I don't currently have a close friend and am not that close to my family. But I'll just keep holding on...