Mirtazapine Vs Venlafaxine

[prosperoliver]

Hi, I joined this group about 6 months ago but haven't posted since.

My addictions person suggested I change/add my antideppressant from Mirtazpaine to Venlafaxine, to cause less anxiety.

Been doing very well with CBT/DBT but still incredibly anxious and paranoid.

I meet with my psychologist once a week and my group once a week. I look well to them but I lie, even still.

Thanks for any advice

Oliver

[samsung]

Venlafaxine (effexor) is a really really good antidepressant for some people.. you can have a try on it.

if the first on is not working... go for this one...

but you need to be under observation when leaving one drug and taking the next one..

please keep postin oliver..

[Vorpalblade]

hi Oliver, i take venlafaxine, and apart from suffering huge side effects it is actually working very well for me

[pip]

OMG,

Ok I will try to answer this without the pharmacological knowledge I have - cos it will dement you.

It depends on your dx.

There that was easy!

If mildy depressed, I would go for low dose venlafaxine - but a low dose venlafaxine is basically an SSRI(eg Fluoxitine). -So if you can tolerate that is just as good.Only at higher doses does it work as an SNRI - but then you get the bad side effects.(they are bad, I've tried).

Mirtazapine has the sleep inducing quality - but it also promotes weight gain. - but you don't get the side effects of an SSRI eg,nausea,loss of libido,hypotension(dizzyness).

Hard question really.

If you have BPD - then I think the FDA (American Food and Drug regulators) have said to keep clear of venlafaxine.

So it really all depends on your dx.

Another thing to bear in mind is that GPs (most) know nothing of BPD and just want you to go away.

Venlafaxine is (was) the only AD liscenced for GAD (General Anxiety Disorder) - hence why your doc may have thought about it.

Sorry, I have't answered your question, but it does depend on your dx.

OK, just read your dx on your profile - its only my opinion, but i would stay away from venlafaxine.

Are you on other medications?

Do you have side effects from mirtazepine?

There are other medications for anxiety - I would opt for them.

The above is only my opinion - sorry it was rambling and at least I stayed away from receptor sites and how they work.

The above probably doesn't help - sorry.

With all patients, it is trial and error anyway.

I think you should try something else for anxiety - if you are in therapy then maybe you can work out what is causing it and work on that?

OK I will be quiet.

At least you have learned not to ask me about drugs!

Pip

x

[Eva*]

Hi Oliver,

I don't know what to make of the risks of Venlafaxine.I'm on it for a few months now (150mg a day, I am diagnosed with GAD by my current pdoc and NOT bpd by the way), I'm not suffering from side effects and my mood has lifted a bit. Just very small steps forward but it's a difference. I used to feel like in a horror film when under people before and had to concentrate on the fact that they're not Zombies very hard not to freak out. That has gone completely.

I've heard about the problems about it now though and I guess it would be worth trying something else first. If it's mainly anxiety you're suffering from you could ask your doc about this: (copied from Wikipedia my choice of source for the day)

Buspirone (brand-names Ansial®, Ansiced®, Anxiron®, Axoren®, Bespar®, BuSpar®, Buspimen®, Buspinol®, Buspisal®, Narol®) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam.

It shows no potential for addiction compared to other drugs commonly prescribed for anxiety, especially benzodiazepine medications. The development of tolerance has not been noticed. Cross-tolerance to benzodiazepines, barbiturates and alcohol does not exist. Furthermore, it is non-sedating.

I've taken it in the past and it seemed to work whenever I started on it but there was a lot of confusion about it. When I went to my new p doc she said that she has seen successes with it and let me choose if I wanted to give it a real try with a high enough dose or if I wanted something else. I chose to try something else. Maybe I was stupid seeing that I now ended up with venlafaxine which is said to be very hard to withdraw from... But on the other hand I've left the house voluntarily a few times since I started taking it!

One more thing (I know this is horribly long as it is, sorry) I think you should really try to be honest with your therapist and in your group. They can't help you if you act and you don't have to make them feel like they have succeeded when they haven't. It's not good for either one of you. Just try and be honest. For your own sake.

Best wishes

Eva

[pip]

Eva,

You are getting as bad as me with your drug replies.

150mg of venlafaxine isn't too bad and it is lisceced for GAD.

I would stick with it.

When yyou come to withdraw, it will be done slowly - make sure of that!

Hows your Scots coming alaine (along)

Pip

x

[Eva*]

I'll stick to it as long as it helps. I was horribly scared that my pdoc would take me off them when I told her I think it might have sent me into rapid cycling (like every other ssri that had effect on my before at all sent me into (hypo)mania) but she upped the mood stabilizers and it seems to be okay now.

Even if I'm still very avoidant, I get on with less tranquilizers and less eating binges and go out at least at times or call friends...

Scots is still very fragmentary, just found "Shift yer erse, wee man!" I'll try to work that into a conversation with my bf's parents

Sorry, Oliver, if we highjacked your thread a wee bit.

That's it for the now. Speak yous later x

[pip]

Eva, sorry for being a pain.

Venlafaxine is not an SSRI, it is an SNRI.

This means that it works on noradrenaline as well as serotonin.

It works 80% on serotonin and so the noradrenaline only kicks in at high doses. Thats when the side effects also kick in.

In studies for depressed patients maast (most) ADs have the same efficacy.

I believe venlafaxine has the GAD liscence as it was coming to the end of its patent and so the company (Wyeth in UK) would lose money cos the drug would become generic and anyone could make it.

Wyeth have the GAD liscence cos they are the only company to have done the trials.

Please excuse my cynicism, but I am right.

I would still stick with venlafaxine.

The above is just an aside.

Please excuse me

Pip

x

[Eva*]

What is a high dose of venlafaxine? I take it 150mg is normal more or less, so it works almost like a ssri? right? or not?

I'm sure cynicism doesn't go amiss with drugs companies and their ways to get money, although I do see that they need some money for research of course (my sis works in pharmatheutical research for HIV and cancer drugs). But they still make shedloads (is that a correct expression?) of money.

[pip]

They do make shedloads.

Are you on venlafaxine XL or the other?

When you get upto the 300s then worry.

I know the companies do need money for research and development

- but they waste a heck of alot of it too.

Thankfully they wasted loads on me!

Infact this is/was a pharma co. computer!

Pip

x

[Eva*]

Well, my sister has to travel to hospitals in different parts of the country and so she has a company car. Which she is allowed to use in private on company expenses... Good for her but not exactly neccessary for research or for anyone needing medical treatment.

Oh and she recently had to fly to Miami for a two day course!

[pip]

Eva,

I have been all over the world with pharma companies.

I had a brand new posh car for 8 years (Diff ones)

I had a huge salary and bonus and daily allowance and expenses of £30,000

God I miss it!

[Eva*]

I definitely study the wrong thing! lol

[realscape]

Hi Oliver

My psychiatrist is also the local expert on pharmaceuticals and is the consultant on substances addictions and the whole lot for my London borough. I don't like him but he seems to have a firm grasp on the effects of legal and non legal chemicals.

I asked him to prescribe me Venlafaxine because I heard it can give you a bit of a buzz, a bit of a lift in mood, and make you feel a bit more energetic. Being a junkie at heart that appealed to me. Mirtazapine did not appeal to me, especially since it is well known for weight gain.

Unfortunately, the psychiatrist, who seems to be the expert in his field, has refused me Venlafaxine because he says it will exaccerbate my paranoia and anxiety and it is highly addictive too with bad withdrawal symptoms. He says it isn't suited to my dx. Worse yet, he has prescribed me Mirtazapine.

I have spoken to enough people to know that Mirtazapine is surely gonna make me gain weight. So I'm not taking it until I loose to my target weight and then I'll consider it. I was very disappointed not to get Venlafaxine because I heard it supresses appetite and everything. But he won't give it. I trust that he did that for valid reasons, and that venlafaxine is not the best thing for anxiety. It might not be the best thing for you.

[Eva*]

But venlafaxine says it's against GAD and social phobia!

[pip]

An SSRI is best to repress appetite eg fluoxitine.

Appetite is not affected by venlafaxine.

Pip

x

[kitkat]

hi oliver,

ive been on many meds for years but finally they put me on venlafaxine and i was on it for a good few years of 225mg then it seemed to stop working and recently ive been put on mirtazapine, the transition between the 2 was hell, i think i came off it way too quickly (the effexor) and had really bad withdrawls, but now ive been on mirtazapine maybe a month now and already ive been putting on loadsa weight and im really not happy bout it and i swear its just adding to my depression. but follow ur docs advice. my shrink told me that in her opinion no meds is very sucessful in treating bpd and its all therapy etc but dont come off the meds too quick and btw welcome it took me months to start posting i was too scared lol

kitkat

[Faerielight]

hi oliver,

ive been on many meds for years but finally they put me on venlafaxine and i was on it for a good few years of 225mg then it seemed to stop working and recently ive been put on mirtazapine, the transition between the 2 was hell, i think i came off it way too quickly (the effexor) and had really bad withdrawls, but now ive been on mirtazapine maybe a month now and already ive been putting on loadsa weight and im really not happy bout it and i swear its just adding to my depression. but follow ur docs advice. my shrink told me that in her opinion no meds is very sucessful in treating bpd and its all therapy etc but dont come off the meds too quick and btw welcome it took me months to start posting i was too scared lol

kitkat

iv been on 45 mg mirtazipine for a year and it had helped hugely with anxiety and sleep but i've put on 2 stone which has been horrible.. the drug makes me eat for england!! i am trying to diet and have lost half a stone through healthy eating and lots of excersize, but it is a struggle. i think u have to work out if you are prepared to gain weight on it. other than that it is a good antidepressant. good luck with everything, hugs ivy xx

[pip]

Sorry Guys,

me again.

Zispin is renound for weight gain - sorry.

It does help you sleep

Maintenance dose is 30mg

Side effects dont increase with dose

Pip

x

[realscape]

Well. I don't think I'll be taking my mirtazapine prescription EVER.

[pip]

I wouldn't either

(and I worked for the company that makes it - so I know more.......)

Don't take venlafaxine either - it is no good for BPD.

Pip

x

[ZareliMan]

Eva, sorry for being a pain.

Venlafaxine is not an SSRI, it is an SNRI.

This means that it works on noradrenaline as well as serotonin.

It works 80% on serotonin and so the noradrenaline only kicks in at high doses. Thats when the side effects also kick in.

In studies for depressed patients maast (most) ADs have the same efficacy.

I believe venlafaxine has the GAD liscence as it was coming to the end of its patent and so the company (Wyeth in UK) would lose money cos the drug would become generic and anyone could make it.

Wyeth have the GAD liscence cos they are the only company to have done the trials.

Please excuse my cynicism, but I am right.

I would still stick with venlafaxine.

The above is just an aside.

Please excuse me

Pip

x

Is an SSRI and an SNRI, very powerful medication.

As well I wouldn't reccomend SSRI's for BPD people since they just mess with your mood changes and won't make any good changes at all.

I took Venlafaxine for 10 months and my BPD had gone worse, so I stopped and I feel a lot better now.

Just try not to use medications for everything since there's no known medication that would help you for BPD.

[molly]

Ive been on 300mg of the effexor venalafaxine, Ive found it quite good compared to the other what I call 'baby' anti-depressants, but my psych told me venalafaxine is the last chance saloon, its a drug they only really give when all else fails as its so dangerous. If you do go on it, beware if you forget one dose you feel dizzy, 2 or more and you feel like youre dying, stomach cramps, diarhhoea, dizziness, confusion, Ive never known anything like it, so DONT run out over the weekends!!!!!

Molly xxx

[Eva*]

Zareliman,

I think you shouldn't make such generalizations. SSRI's seem to have helped some people here, so have mood stabilizers or even tranquilizers when things are getting tough.

I don't want to come across as someone worshipping drugs but they've helped me out of deep holes in the past and venlafaxine and lamotrigine seem to be helping me right now.

It's great if you cope without meds, but that they didn't help you doesn't mean no drug will ever help anyone with bpd. There's no drug against BPD yet but against depression or anxiety or mood swings.

Molly,

Sounds scary!!!! I'll make sure I never run out. I'm only taking 150mg a day though, maybe it's not that very bad then. Don't dare saying it might!

My pdoc actually told me that venlafaxine is still one of the meds that don't have too many side effects compared to their effect. But she did say that it was one step down in that scale from escitalopram. Well, anything that helps! I'm not coming off it yet so why worry now.

Eva

[aylaah]

There are a lot of mixed reports about venlafaxine. I am on it and have been for about 3 months now. I take 150mg once a day. For me it works. I haven't had any real side effects other than it initially making me very tired (so I took it at night while that lasted) for about 2 weeks, and then quite awake (moved it to morning) for another couple. It's evened off and I don't even notice when I take it now, so I take it around dinner (supposed to take it with food).

I find it keeps my moods very stable. I haven't had a rage since I started it, which is really obvious. I was given this one as direct treatment for depression, not BPD, and for anxiety. I scored a 28 on my depression test which indicated mild-moderate. It certainly works on more than the issues I went to the doctor for!

However there is a bit of controversy about withdrawals coming off it, from what I have seen this is one of the big issues with it. My mother had a psych tell her to tell me (as they do, lol she's a nurse) to find something else because of it. So not everyone it seems is keen to prescribe it, this psych wouldn't. But I've also read about ways to help getting off it (including using prozac to cover up the physical withdrawals) because it has a short half life it can be severe (so its out of your system really quickly).

But yeah, all I can really say is that you need to see how it is for you. Some people have no effects coming off it, others have horrible ones, like with any other medication.

At the moment it works for me though.