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Effexor Xr 450 Mg Dose


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#1 sg2028

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Posted 15 May 2008 - 01:16 PM

Wondering if anyone's been on 450 mg of Effexor XR before. Any experiences? I haven't had too many side effects at 375, mainly my hands shaking, decrease in appetite and the predictable nausea if I don't take it with food. Wondering what, if anything, will pop up with 450 mg....
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#2 In_Remission_Andywankanobi

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Posted 02 June 2008 - 03:22 PM

Hello..
I'm a 24 year old university student..I have been on Effexor for about 10 months now, and had peaked @ the recommended max of 300mg/day...I recently upped it to 450(4 days ago)...so far, nothing to report in the negative...hands do shake some, and lack of appetite, and I have always gone with 2-3 hours of sleep(pre medication as well)...other than that it seems to be a positive change...but as you probably know, mental medication should and will be different for everyone, so just pay close attention to how it effects your system...

Andrew

#3 Pillboxfox

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Posted 03 June 2008 - 05:06 PM

Wow... 450mg of Effexor XR is a huge dose. I don't know how your bodies can handle it. My body starts to flip out at 150mg, effective dose being 75. And what a hell it was to quit. If you ever have to quit it, go VERY slowly.

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#4 sg2028

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Posted 30 June 2008 - 07:39 PM

I've had success with effexor xr 375 mg/day (side effects: weight loss, nausea if taken without food, insomnia which was effectively countered with ambien) before: once for about 10 months, once for about a year, but this time around, wasn't having success. after trying augmentation with a couple of drugs, pushed the effexor up to 450/mg. had great results - unfortunately, those great results quickly turned to hypomania (i've never had a hypomanic or manic episode before). stopped sleeping almost entirely (1-2 hours per day, in spurts), increased movement, quickened speech (and thoughts), huge increase in energy.... dr advocated lowering the dose but i wanted to stay on it - i felt better, and that's what was important to me - but we both watched as the hypomanic symptoms quickly continued increasing in intensity and ended up decreasing it.

so much for my short-lived 450/mg success....:mad:

related question: can medication-induced hypomania turn to full-blown mania?
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#5 Lost In Space

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Posted 02 July 2008 - 08:41 AM

http://www.crazymeds...?showtopic=2033

SG,

I ranted a lot on the above thread in regards to my husband's high dose daily Effexor dose (450mgs, also). He is taking three (or four?) other medications along with the Effexor. I think the problems began though .. when his doctor pushed him up to the 450mgs of Effexor. The other medications followed because of big time RLS (because of Effexor .. and then the Ambien , because of high dose Effexor and then the provigil, cause he was so tired the next day because of Mirapex .. which was diagnosed because of Effexor related RLS .. ) I guess you get my drift .. right? :mad:

IMO, it's been a horrendous vicious circle

Of course .. I am on the outside, looking in .. so this is just my perspective ..

And based on that, I would want to (very loudly) beg you NOT to continue on this high dose. It takes a while for "side effects" to become noticeable ..
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#6 rebnej

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Posted 02 July 2008 - 03:44 PM

http://www.crazymeds...?showtopic=2033
And based on that, I would want to (very loudly) beg you NOT to continue on this high dose.


I don't know - I wouldn't want to discourage even a very high dose if that's what was recommended. Yes, the side effects can be awful. But, assuming the doctor is reasonably responsible, such a high dose would not be prescribed in the absence of severe depression. And anyone who has been to that really deep, dark place can tell you that they would gladly suffer a few side effects to get out of that hole.

Incidentally, although an above-poster is correct that 75 mg is "effective," it's effective only on seratonin receptors. The drug can also work on norepinephrine and dopamine at higher doses (to get to dopamine you have to be taking a minimum of around 300 mg, and some folks will require more.)

All that said, I know it sucks to watch someone you love suffer, but one look around this forum and you'll see that poly-pharm is the norm, and it takes a while to get meds right.

Edited by rebnej, 02 July 2008 - 03:45 PM.

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#7 Lost In Space

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Posted 04 July 2008 - 07:09 AM

"I don't know - I wouldn't want to discourage even a very high dose if that's what was recommended. Yes, the side effects can be awful. But, assuming the doctor is reasonably responsible, such a high dose would not be prescribed in the absence of severe depression. And anyone who has been to that really deep, dark place can tell you that they would gladly suffer a few side effects to get out of that hole."

I guess I have pretty much taken "Drs." off my list of "unquestioned" respected individuals. In my parents era 50's - 70's, the doctor would diagnose and prescribe and those of that era (rarely) ever questioned.

In my own personal situation, I have discovered (more natural) ways to heal myself. An endo dr. told me that if I didn't follow his recommendation for burning out my thyroid (RAI) .. that I would die. I am alive and doing much better than the "protocol" that he had me on. That was 10 years ago.

In my husband's situation .. well this dr. appears to be ONLY prescribing ALL of the (IMO) horrible meds and pushing him out the door. There are many drs. out there that ARE NOT "reasonably responsible". My husband's included. In my opinion, he is just doing what is easiest for him. Definitely not what is best for my husband's situation.

Incidentally, if the dr. is not paying attention or does not really care .. what happens to an individual who has been prescribed a cocktail that is slowly killing him? This person .. being so badly affected, cannot see the meds as being the crux of the problem??? My husband is convinced that he is on the last resort "silver bullet" .. so constantly just tells psychiatrist that all is fine ... while he continues all of his destructive behaviors, that did not appear .. by the way, until AFTER he had been on the new(er) medication regimen for a while.

It is very sad ..
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#8 notfred

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Posted 04 July 2008 - 07:31 AM

Wondering if anyone's been on 450 mg of Effexor XR before. Any experiences? I haven't had too many side effects at 375, mainly my hands shaking, decrease in appetite and the predictable nausea if I don't take it with food. Wondering what, if anything, will pop up with 450 mg....



Try it. That is the only way to know. You can always stop it. Others war stories are of little predictive value on your results. I did well for about a decade on the higher doses, 300-450 mgs.
Effexor had minor withdrawal effects for me and few side effect in general.

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#9 sg2028

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Posted 05 July 2008 - 07:52 PM

thanks for the replies. notfred, i definitely agree with you. i had success for several years at 375 mg, with the side effects being ones i was more then willing to accept in terms of the remarkable payoff in mood. that's why we figured trying 450 mg was a good option.

i guess my initial post wasn't that clear - i did go up to the 450 dose, but after about a month it did become pretty evident that there had been some sort of switch to hypomania. :mad: honestly, my doctor caught it; from my perspective, i was just feeling better, and i was reluctant to drop the dose back down. i did end up going back to the 375. i suppose i'm just curious about what could have happened - ie, anti-depressant induced hypomania have turned to mania?

lostinspace, if you are unhappy with your husband's doctor, maybe get a second opinion. i have to agree with rebnej that poly-pharm is unfortunately the norm and it does, unfortunately, take a while - sometimes quite a while - to find something that works.

I don't know - I wouldn't want to discourage even a very high dose if that's what was recommended. Yes, the side effects can be awful. But, assuming the doctor is reasonably responsible, such a high dose would not be prescribed in the absence of severe depression. And anyone who has been to that really deep, dark place can tell you that they would gladly suffer a few side effects to get out of that hole.


rebnej, i could not agree with you more.
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#10 rebnej

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Posted 11 July 2008 - 03:13 AM

I guess I have pretty much taken "Drs." off my list of "unquestioned" respected individuals.


Just wanted to point out that I didn't mean to suggest that a doctor should not be questioned. That's why I added the "reasonably responsible" qualifier. If the doctor does not appear to be, a second opinion is in order.

That said, one bad situation should not be universalized to apply to all situations. Many have had success on high doses of Effexor -- many have not. I, like sg2028, suffered hypomania when I went up on Effexor: I ended up having to get off Effexor entirely because even when the dose was lowered I was still manic. But that doesn't mean everyone will have the same experience.

BTW, Lost In Space, I read your post about your husband's experience with Effexor and drinking. My sister had the same experience on 150 mg of Effexor -- as well as a truly terrifying sleep disorder (Effexor and alcohol together can cause rare sleep disorders). I didn't have those problems on the same dose of Effexor.

Your husband's doctor should not have laughed off your concerns -- and it does seem that Effexor was not the right drug for your husband -- but I still think that there are situations in which high doses of Effexor are warranted.

Edited by rebnej, 11 July 2008 - 03:22 AM.

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#11 Jerod Poore

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Posted 11 July 2008 - 10:42 AM

I used to think that anything above 375mg a day was insanely high.

However I've since learned that about 1-2% of the population has multiple copies of the genes responsible for the various CYP450 enzymes. As such they metabolize medications at an accelerated rate and need higher dosages of medications and/or need to take them more often than most people.

Unlike people who are poor metabolizers, there isn't yet an affordable test that someone can take to see if they are an ultra-rapid metabolizer. One can only infer it from experience with other medications.
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#12 Lost In Space

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Posted 11 July 2008 - 10:49 AM

Yes, I know .. I guess. This whole situation has soured me terribly. In all of my searchings, I have found so many negative stories about Effexor .. well, it makes it very easy for me to focus on just that. I apologize for making "my" (husband's) story sound like an absolute. Of course that can't be.

Would you mind elaborating more about the terrifying sleep disorder? When I google the different terms, I'm not really finding anything .. ?

Thanks much,
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#13 rebnej

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Posted 11 July 2008 - 02:40 PM

Would you mind elaborating more about the terrifying sleep disorder?


We're not exactly sure of the exact diagnosis, but the the pathologist and psychologist limited it to either a "parasomnia" (in the same category as sleepwalking) called REM Sleep Behavior Disorder or RBD (characterized by violent outbursts during sleep, often injuring the patient or another) or a rare form of sleep terrors in which the patient acts out his/her nightmares and believes they're awake. RBD patients are usually men over 50 or anyone who combines alcohol with certain drugs including Effexor. Sleep terrors are often triggered by alcohol in combination with drugs such as Effexor.

A good book on the subject is Sleep: The Mysteries, the Problems, and the Solutions by Carlos H. Schenck, M.D., who was one of the first experts on the subject of sleep disorders. There are also a few New York Times articles on the subject (search for "RBD" or "Sleep Behavior Disorder" on the NYT website).
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