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Effexor at night or in the morning??

JohnBoy2000

JohnBoy2000

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May 11, 2016
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I used to be on lexapro, and if I took it morning, I would stay in bed all day.

So I've been taking effexor at night, but have heard it can be more effective in the am, and does not carry the fatiguing side effect of lexapro.

So am or pm for effexor?
 
Oh yes, for me (es)citalopram was very stimulating and restlessness inducing too, besides that it is just a SSRI w/o norepinephrine activity. Read once that it increases uptake of dopamine, but don't know whether this is true.

Venlafaxine, being a SNRI (and a phenethylamine), has a stimulating component too but for me it's much better, and it works from day 1 on, something other ADs don't do but this is individually different.

But to your question, definitively in the morning.
 
palmanita said:
Oh yes, for me (es)citalopram was very stimulating and restlessness inducing too, besides that it is just a SSRI w/o norepinephrine activity. Read once that it increases uptake of dopamine, but don't know whether this is true.

Venlafaxine, being a SNRI (and a phenethylamine), has a stimulating component too but for me it's much better, and it works from day 1 on, something other ADs don't do but this is individually different.

But to your question, definitively in the morning.
Click to expand...

no no.

i said lexapro made me sleepy, not activated.

would that imply that effexor might have a similar effect, and thus I should take it at night?

I've just gone from 150 to 225, a dose where noradreneline comes into play, so thus it may be more activating than at 150mg?
 
Sorry, read it wrong. The sleepiness is a reaction that is more rare but happens too (obviously) ... they call it "paradoxical reaction".

Do you get sleepy some hours after taking the Effexor, when plasma levels rise? This is so individual, probably you just have to try. For me personally Effexor (150mg) was less, or better said more comfortably stimulating than citalopram what surprised me. Things might get nice when you add a dopamine agonist as proposed in the other thread, never tried this but could imagine that with the noradrenaline repute inhibition together with dopamine agonism you could get a profile not unlike e.g. methylphenidate.
 
Actually, after you have been on Effexor for a period of time you will reach what they call steady state. Meaning that the level of medication in your system is always at a rather consistent level if you take it every 24 hours. If you don't, there will be peaks and troughs of the level of medication in your body. This can cause you to be tired or feel more energy after taking a medication. The biggest reason doctors will tell patients to take Effexor at night is so they sleep through any nausea they may experience when first starting the medication. I was a drug rep and sold Effexor for a number of years.
 
I might be wrong but in practice I think with most medications plasma levels won't be really steady. This would require a very powerful mechanism for slow, extended release. Few pills actually have such one (Concerta comes to my mind, minus the initial IR dose), and one would have to take them strictly at the same time of day, having one pill lasting 8 hours for example, then one at 7 a.m., the next at 3 p.m. and the last at 11 p.m.

I do even feel the effects of my buprenorphine dosages (at morning, 8 a.m. and at afternoon, maybe 3 p.m.) when it's supposed to have a half life of 24-36 hours, and I'm on it for at least 8 weeks now.

Venlafaxine is relatively short acting (5h or so), the ER formula would need to last for 19 hours for a constant level what it probably doesn't, or one dose at morning and one in the evening.
 
Effexor is an "activating" SSRI, a la prozac, zoloft. The next line of even more "activating" (i.e. 'stimulating') would be SNRIs that are otherwise indicated for ADD but in cases of unusually unresponsive major depressive disorder they sometimes use Strattera. Celexa, Lexapro, Paxil, are more 'bi-polar' (not activating) anti-depressants and sometimes are taken at night; the others, usu. indicated for morning.

I do know that zoloft (sertraline) is activating for me, but some who take it, esp. at a large dose to begin, sleep it away; a lot to do with the body 're-seting' your system. The same can be said even for meth-amphetamine abuse, where large amounts can immediately put one to sleep ('over-amping')

the several week indicated period to 'get used' to the drug and reach peak consistent blood-serum levels will likely get the desired "activating" effect from Effexor. This is why they say it can take several weeks to notice a difference (I noticed a definite stimulation my very first 7mg dose of Zoloft, personally)
 
I switched to the morning.

Difference is, ironically, night and day.

Waaaaay more energy, sleeping better, feeling so much better.

A good improvement.

Now it's a matter of seeing to what degree the symptoms become alleviated in their entirety - or whether it's necessary to consider a med from the tricyclic group.
 
I had upped my dose to 300mg, but, different from 225, found it fatigue inducing.

Perhaps returning to a night time dose would remedy this, cause effexor has impacted my symptoms, just not as much as I'd like.

Is it common or uncommon to go as high as 300mg??
 
Also, sexual dysfunction had been alleviated after 4 weeks of 225, but upping it to 300 made it plain impossible all over again, but worse than initially.

Would one expect that to level out after a month or so?

Thing was, after two weeks on 225, that side effect began to wain.
On 300, after 3 weeks, it just seemed to be getting worse.

Higher doses do seem to make me drowsy, like lexapro 20mg, would leave me stoned all day.
10mg I could handle.

45mg mirtazipine was fine.
But 60mg and I'm like the walking dead.
 
Yeah, venlafaxine is a weak stimulant and is regarded and a SNDRI. I can never take this shit at night. First time I took Effexor XR I got majorly stimulated withing 5 minutes, pupils dilated, heart rate elevated, and all that.

If you are taking XR, do not split the dose. If you are taking IR, it NEEDS to be split anyway. You should be taking it at least twice a day. It's a TID med...

Yes, it is quite common to go above 300mg for the IR version, but the XR is generally kept at 225-300. I honestly don't know many doctors that are willing to go above the recommended 225 though, for some reason...
 
I've never come across a GP that goes above 225.
Consultants seem to think it's licensed to 375 though - and I recently got moved to the executive consultant for my region, who said he has put people up to 600mg in the past.

I tried augmenting my 225 with 75 at night.
Didn't feel great.

Yesterday I just waited the whole day before dosing, at which time there were some strobe lights going off in my head, and dosed the full 300mg at 10pm.

Woke up at 4:30, wide awake, and not feeling too bad really - so I'll go a few days on this dose and see how it plays out.

I went three weeks at 300mgs before, but in the morning, and it definitely fatigued me and there was a regression.
Fingers crossed at night plays out better cause, if not, it's on to the tricyclics...
 
I bumped up to 300mg on friday evening.

Sat I was like a steam roller.
Sunday I went strong until about 4pm.

I from that point, until now, I have never felt so smashed in my life.

I had a good nights sleep last night, probably the best in quite a while.

300mg morning, definitely slowed me down.

Now at night - I'll give it another week, see what happens.
 
Back to 225 cause I was zombie like on 300.

For those of you who are more of an authority on neuroscience, is there any possibility that, despite the zombie inducing effect at 300mg, that 375 mg could actually go well?
i.e. be activating?

As I titrated up initially, it became more activating.

i.e. 75, to 150, and 225 was like, a legit stimulant.

Then 300 - first day, rocket fuel, second day, crash, third day and onwards, totally deflated energy wise.

Would there be any argument to be made for experimenting with a dose of 375mg??
 
There actually is a good possibility, but JohnBoy2000, you are taking IR right?

But based on the way it's been going, it's safe to say it might continue, but if you can keep it, try the 375mg for a couple days if you can to get through all the serotonin hell, as I am pretty sure that is what is going on.
 
theGirlWithBlueHair said:
There actually is a good possibility, but JohnBoy2000, you are taking IR right?

But based on the way it's been going, it's safe to say it might continue, but if you can keep it, try the 375mg for a couple days if you can to get through all the serotonin hell, as I am pretty sure that is what is going on.
Click to expand...

No - IR isn't available here.
Taking XL.

The serotonin hell?
I would like to try the 375, but if it's anything like 300, it's gonna set me back at least 2 weeks, cause just 4 days at 300 and I was stoned for a full two weeks after.
I'm just getting right now.

So can you expound on serotonin hell, and why that is something to consider in this instance??
 
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