HomeAnswersPsychiatrydepressionIs my rapid mood change a side effect of high dose Venlafaxine?

With alteration in dosage of Venlafaxine, I started feeling anxious, depressed and insomnia. Please help.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ashok Kumar

Medically reviewed by

Dr. Vinodhini J.

Published At July 11, 2020
Reviewed AtDecember 21, 2023

Patient's Query

Hello doctor,

I have been diagnosed with major depression and I have been taking Venlafaxine for the last three years. I was stable on the dose of 150 mg, so I decided to wean off the drug last year. However, I got a relapse and my family doctor upped my dose to 150 mg again, and further to 225 mg when 150 mg was not doing much for me. My depression lifted in mid-May. But, after just three weeks, I started feeling anxious and depressed with distressing thoughts and got severe insomnia. It lasted for a week, then I got better suddenly. After another week, I am having another episode and feeling really low. I have been unable to sleep for four nights in a row. I just wanted to ask if this rapid mood cycling, that too without any stressful event, could be a side effect of the higher dose of Venlafaxine, or is it that the drug is not working for me anymore, and I need to switch over to another antidepressant?

Answered by Dr. Ashok Kumar

Hello,

Welcome to icliniq.com.

I read your query and understand your concerns.

First of all, I like to inform you that the most acceptable explanation about your current situation is based on fact that often recurrent depression needs more intensive care in compare to the first episode of depression. It can be stated that we often need a higher dose of medication for the second and further episodes of depression in comparision to the first episode. On similar lines, there is a possibility that there is an inadequate response with the Venlafaxine. I also feel that your doctor took the right decision by increasing the dose of the Venlafaxine. I also like to make it clear that this is not rapid cycling as mentioned in your query and the anxiety and nervousness are probably due to inadequate response.

Since 225 mg is also not doing the assigned job I feel we have three options at this stage.

1. Increase further to 300 mg (maximum dose) provided there are no intolerable side effects.

2. Change to different antidepressants.

3. Augment with some other medications such as low dose antipsychotics or Lithium or any other suitable medication.

I hope this helps.

Patient's Query

Thank you doctor,

I will discuss this information with my family doctor now.

Answered by Dr. Ashok Kumar

Hello,

Welcome back to icliniq.com.

I will be glad to answer anything related to mental health and health if there are any questions. You can post me if there is a need for opinion or second opinion.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ashok Kumar
Dr. Ashok Kumar

Geriatrics

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