Switching meds

[maxandmolly]

I have been on prozac, on & off, for the better part of the last five years. And that was after a couple years of thinking I didn't need it (had taken it for a couple years at that point).
So, when I went to the doctor last week he asked if I needed a refill, I told him actually, I don't think it's working anymore. Instead of helping me be un-depressed, I feel, like....disengaged from my feelings. Like things that should make me cry, don't. Like my life is over there, and I'm sitting over here stone faced.
So he gave me two month's worth of Effexor XR samples. Told me to finish my current prozac then switch. So I started taking the new stuff on Saturday, and I have felt weird ever since then. He had said I might be a little hyper, but this is bounce off the walls restless, hand shaking, weird. Almost like being high but not quite. Like I'm running on high instead of low.
Is this common, either for switching meds, or for this particular med?

[ejs]

What type of doctor switched your meds? You should have been weaned off of the Prozac instead of stopping it immediately. You can go through withdrawals with Prozac, which might be what you're experiencing. Prozac and Effexor have different ingredients.

I'd consider getting a new doctor. Sorry you're having medication reactions.

[berry]

I agree with previous poster, that you should have been weaned off of your Prozac, unless you were on an unusually low dose.

Is your gp prescribing this, or do you have a psychiatrist?

You also should be going on the new medication gradually. Starting out with a lower dose, seeing how it works for a few weeks, then it should potentially be adjusted.

Forgot to add, it is hard to say if new meds are causing this or if it is being caused by going off the prozac.

I was on Wellbutrin for a while and they said it might make me energetic, excitable, at first I was hyper & bouncing off the walls, like on a permanent caffeine buzz. Once I was on it for a few weeks these side effects disappeared.

But I would call your doctor if you are worried at all.

[maxandmolly]

I was on 20mg of prozac- a fairly low dose. The effexor starts with a half dose for a week, then a full dose after that.
Any other time I have been out of prozac (between refilss, no $$, whatever), the symptoms did not start coming back for several week- about as long as it takes to feel the positive benefits of it, too.

[maxandmolly]

It's really the jitters and twitching that are bugging me, and I've never had that reaction coming off prozac before, so I'm pretty sure the effexor is to blame. But, how long will it last?

[BTB]

Hi MaxAndMolly -

So your last day taking Prozac was Friday, and first day on Effexor was Saturday?

If I've got that right, I don't think you're experiencing Prozac withdrawal (from the little I know about how you're feeling). :) There is a Prozac withdrawal syndrome, but the half-life of fluoxetine is about 4 days, that of norfluoxetine (Prozac's active metabolite) is even longer... you might feel withdrawal, but not this early. I don't think at this stage your plasma concentration would've dipped enough to leave you with withdrawal symptoms.

What you're describing is, however, common when starting venlafaxine (aka effexor). Patients can feel nervous, edgy, or like they're bouncing off the walls. If it's bad enough to interfere with normal daily functioning (concentrating at work, getting things accomplished at home, etc) let your doc know about it. It's important to monitor response when med switching, so don't feel like you're bothering him/her! That's what docs are there for.

The worst of it is usually over after 2 weeks. I know that sounds like a really long time, but 3 days are already done. :)

[maxandmolly]

Thanks so much, BTB. I think as long as I know it's normal, I can deal. It's just worse than he had described, so I was starting to wonder if I was having a bad reaction or something.
And as much as I would love to blame the med switch for not getting anything done at work, well.....we see where I'm spending my work time, right? ;)

[KarenS]

DH takes Effexor-XR and the twitching and "wired" feeling are definitely normal for going on the drug or when you raise the dose. It took DH a few days to get past those symptoms when he first started taking the Effexor and again when the Dr. raised his dose.

Karen

[meggiedarlin]

I take Effexor and don't have any side effects at all, but then again, everyone is different.

[maxandmolly]

It's gotten much, much better. The jittery bouncing off the walls feeling went away after the second week, the shakes too.
I really don't think I've had any withdrawal from the prozac. To be honest, I think it stopped working long before I realized it. It's been the last week and a half or so, starting to feel a bit better, that I realized just how rotten I really was feeling.

[ShelbyMay]

Glad to hear you're feeling better. I had a similar reaction when my Celexa stopped working and my doctor put me on Effexor. I hated it, so she then put me on Zoloft. I was very happy with that for a long time (although I am now off my meds completely).

[maxandmolly]

Off meds completely is great!
I seriously doubt I'll ever reach that place in life- every time I have rtied to get off meds, it just gets ugly.

[maxandmolly]

So, I went off the Effexor around New Year's this year due to lack of funds. I now have much better insurance, and went back on it at 75mg. After a few months, the doctor and I decided that it wasn't a strong enough dose. So he upped me to 150mg. I expected to go through the side effects like last year all over again. Instead, I've found myself suddenly overly emotional. I've been through a lot this year, and an awful lot recently, but this crying at the drop of a hat thing has never been me.
Is it possible that the excessive weepy-ness is due to the double dose?

[Rose]

I found that effexor made me all around emotional and moody no matter the dose. I was on 150mg, and was told you need to be on a high dose of it for it to work. I think the next dose would be 300, or 375 but I went to my Doctor and told her I wanted to wean off of it before Thanksgiving. It didn't help me, and going off it was worse.

[maxandmolly]

Yeah, when I had to go off it lasst year due to $$$ woes, it was like, the worst experience EVER. I got angry, totally irrational, nuts. Nearly ran someone down in a parking lot.
I have an appointment to see my doctor Wednesday, guess I'll talk to him about it then. Starting to run out of options, though. Propzac, Paxil, Effexor, think I've tried Zoloft before too......

[maxandmolly]

I ended up going off it too. I went to my doctor with another issue and told him it wasn't working. He agreed to switch me to Elavil-it worked for my mom before she had a bad interaction with another med-but said if that didn't work he wanted me to see a shrink, I was beyond his capabilities as a primary care doc.
So he wrote me a taper-down scrip. I looked at it, decided it was too agressive, and decided to go slower with my existing tablets instead of filling his for the CR ones, which would have been a full $25 brand name co-pay. I was at 150, he wanted me to go to 75 right away for a week, then 37.5 for a week while starting the Elavil.
Instead I opted to go to 75 in the morning, 37.5 at night for a week, 37.5 both morning & night (75mg total for a week) which I am in the middle of now. Then I will do the 37.5 in the morning for a week while starting the Elavil. And I still may see a shrink and/or therapist anyway.

[AmandaLeigh]

I used to work in the mental health field, and have always been opposed to anyone besides a psychiatrist prescribing psychotropic medications. I've found that many general doctors do not fully understand the differnt pathways that the psychotropic medications use to foster an improvement in symptoms or that many are intended for only short term use in conjunction with therapy. When starting any new psychotropic med, you should be evaluated within 2 weeks for any adverse side effects and to adjust dosage and then every 2-3 months after that.

[maxandmolly]

I'm only in the first couple days of the Elavil but appear to be doing ok so far. I ended up starting it before dropping to the 37.5 of Effexor because I wasn't sleeping well and it's supposed to help with that. There was a bunch of stuff going on in my life affecting the lack of sleep, too. I continued to not sleep well, even with the Elavil, until I got out of the situation I was in. Last night-first night out of the nightmare sitch-I slept like the dead.
No side effects so far, but I've been told to expect the standard dry mouth you get with any/all anti-depressants.

[Rose]

How are you doing going off the effexor this time M&M? I hope you're doing OK. Even though I tapered and had a switched to a new med it was still horrible. I am just now starting to feel better, three months later.

[maxandmolly]

You know, I really have been totally ok. Yesterday was my first day at 37.5mg-down from 150mg when I started tapering down two weeks ago. I haven't had ANY of the problems I had last time. Even with massive amounts of stress, my personal life blowing apart, being homeless, having one of my childhood (er, teenage) pets being put to sleep.....it's weird, but I've been totally ok.
Been on the Elavil about almost a week now.