how do I recover my medication mess...?
December 19, 2008 6:28 PM   Subscribe

I'm supposed to be taking 300mg Effexor XR every day. Except I've been so grumblingly ill this last week and a half that I've not bothered. What's the best way to get myself back up to speed? Impact load or slow tapering? And how slow...?
posted by anonymous to Health & Fitness (13 answers total)
You should ask your doctor, not us.
posted by Chocolate Pickle at 6:35 PM on December 19, 2008 [1 favorite]

Effexor has notorious withdrawal symptoms. I'm on Effexor and start to feel markedly bad within a couple of hours of a missed dosed. Having said that, I'd guess that your illness over the last ten days is actually at least partly withdrawal and I would go right back to the prescribed dosage.

IANAD and of course this advice should be taken with a grain of salt. But -- I'm on Effexor and it is what I would do.
posted by kate blank at 6:38 PM on December 19, 2008

The time my Rx ran out and I went four days without, y effexor (regular, not XR) withdrawals just about did me in. It was hideous cocktail of physical and emotional misery. When I got the pills refilled, I just started up normally. Within a day or two it was back into my system and I felt basically human again. I believe my doctor just told me to just start taking them again as per usual. But, indeed, its not a bad idea to talk to your own doc.
posted by mostlymartha at 6:51 PM on December 19, 2008

If getting in touch with your Dr. is a problem, call your pharmacist. They're usually very helpful.
posted by mattholomew at 6:57 PM on December 19, 2008 [1 favorite]

nthing the talk to your doctor (or, if that's not possible, your pharmacist) suggestions.

missing just one dose of Effexor does strange things to me.
posted by gursky at 7:05 PM on December 19, 2008

I'd call your doc right away to see how best to get back up to your full dose...300 mg is a substantial amount to go off cold turkey. I concur w/ kate blank that some of your illness symptoms could be linked to being off effexor...I have odd symptoms within hours of missing a dose and they get worse as each hour goes by...If I were in your situation I'd start to go up again slowly i.e. 75 mg for 2 or 3 days, then 150, etc. IANAD, and my best advice would be to talk w/ yours, or whomever is on call for her/him over this weekend. Going off any SSRI also risks it not working for you again when you resume use so neglecting to take it is risky on many levels. I speak from experience. ; )
posted by mumstheword at 7:15 PM on December 19, 2008

Personally, I would prefer to call the pharmacist over my doctor. They're generally way more straightforward when it comes to drugs, and they're totally willing to call your doctor's office on your behalf.

You may want to grab some Dramamine or ask your doctor to prescribe an anti-nausea med. I wish I'd had this idea when I was quitting Effexor cold turkey. I was sick for something like six weeks.

Hope you feel better soon!
posted by giraffe at 7:44 PM on December 19, 2008

My real advice is that you should ask your pharmacist/doctor. Just a quick phone call should suffice - if your Dr isn't in, the staff nurse can certainly give you some pretty good advice.

Anyhow, my crackpot advice is that for the first day or two, take half in the evening and half at night and then go back to taking the full dose whenever it is that you take it. So you get the full thing but you're not loading your system all at once.

I take Effexor and I FEAR going without it. The withdrawals are apocalyptically awful.
posted by grapefruitmoon at 8:45 PM on December 19, 2008

If you are unable to contact your doctor, you may also check with your insurance. They may have a 24 hour health info line that could give some basic advice on this, but, like everyone else, I would advise that you MUST contact your doctor about this. (If I could make that must blink and spin around, I would. It is that important.)
posted by slavlin at 8:59 PM on December 19, 2008

I wouldn't be keen to slam my body with 300mg of Effexor straight off. 150mg for a couple of days would be better and would be enough to get rid of withdrawal symtoms. If, after the first dose, the side effects are too severe, taper up from 75mg.
posted by sarahw at 10:29 PM on December 19, 2008

Yes, talk to your doctor. Personally, I prefer a specialist to a GP when it comes to psychiatric meds, so for the long-term I'd recommend shopping around for a good shrink, if you have health insurance. You want to find someone you trust, someone you feel good talking to about your health. I really like mine, even if he is a bit of a reefer-madness fuddy duddy about marijuana.
posted by flotson at 11:13 PM on December 19, 2008

Nthing doctor.

Also, not to preach to you, but if you're serious about actually using this medication, it really must be an every day thing.
posted by TypographicalError at 4:57 AM on December 20, 2008

I used to work as a pharmacy tech. If you live in the USA I would advise you to speak with the pharmacist at the store that filled your script, because according the 1990 OBRA, you have the right to get information about the medication you are taking and to get counseling concerning the medication from your pharmacist. It's the law!!! However the effexor XR website recommends "It's best to take Effexor XR at about the same time every day. However, if you miss a dose of Effexor XR, it can be taken later that day. Don't try to "make up" for the missed dose by taking 2 doses the next day. You should never increase or decrease your daily dose without consulting your health care professional"

Since you've skipped about 10 days of doses you should talk to the prescribing Doctor about what happened, at least call the nurse who can get the info for you. It takes about 2 weeks for you medication to work and if you missed that much time you may need something that is fast acting if your condition requires it.

I was prescribed Pristiq for depression/ GAD and Xanax for my anxiety attacks ; when I miss out my body knows it and it takes awhile to feeling right again. I took Prozac at one time thinking it may be PMDD but by the time it was built up into a serum, I got pretty sick from it and had to allow time for the medication to clear out. After it did, I really missed taking something for GAD because I had to take xanax more often . I really don't like taking it too often since it can be habit forming (it's a schedule IV controlled substance which means it has the potential for addiction and abuse by those who take it) I was taking xanax daily after I stopped Prozac when as before I was only taking it twice a week at most when i was on Pristiq.

If you are having a tough time remembering to take it, you should really pick a time of the day you know you will keep that is in your routine, like when you get up to pee in the morning and brush your teeth you also take your medication. Also if you aren't feeling that the medication has been effective or makes you ill you should talk to the prescribing Dr, because in order for a script to be effective you should take it:) Studies have shown there are things that keep patients from taking meds, like side effects, cost, emotional issues (embarrassment of the condition etc) daily routine and that taking care of those issues also help the patient remain on their prescription therapy. My doctor has been totally awesome, helping me with getting samples and a discount card for a few months since pristiq is a new med and not on the preferred drug tier yet. Also there are discount programs drug companies run for their drugs that help with medication costs too.
posted by agentsarahjane at 7:32 AM on December 20, 2008

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