Effexor XR and Serotonin Syndrome

[jmg72]

This is the first time I’ve posted, although I’ve read many of the discussion threads hoping to come across someone who has experienced something like what I am.  I’ve been on Effexor XR for at least a year and a half, maybe more.  For pretty much the entire time, I’ve been on 150mg (75mg in the morning, 75mg at night).  About 6 weeks ago, I started noticing that in the late afternoon, about 2 hours before the night dose, I’d get very mild “electric-shock” type feelings in the back of my head (I’ve experienced the severe version before when trying to go off of the drug).  They don’t interfere with my daily routines, but I couldn’t help thinking that it probably wasn’t a good sign.  When I’d take the evening dose of Effexor, the feeling would subside.  I finally saw my FNP last week and (as I feared), she suggested that we try increasing my dose and she gave me several “starter packs” (which include the 37.5mg capsules) so we could give that a try.



Last night, on a whim, I started reading through the info enclosed with the Effexor, hoping there might be something about long-term effects of Effexor XR (i.e., whether you can experience symptoms from being on it too long).  I came across a reference to serotonin syndrome, and after doing some research on the web, I figured I’d better ask someone how likely it is that I could have it, because I’ve been experiencing many of the symptoms described (the “electric shock” feelings, which could be described as lightheadedness, headaches that don’t respond to Advil, IBS (about 2 weeks now), occasional nausea, and, although I haven’t seen this anywhere, a stiff neck and pressure in my cheeks and behind the eyes, which could, of course, be a sinus thing and not at all related).  I’ve read that serotonin syndrome can range from mild to severe, so if I do have it, it would obviously still be a mild case.  My fear here is that if it is being caused by the Effexor, then increasing the dose is the last thing I should do.



Finally, if it is seriously unlikely that I do have serotonin syndrome, I’m still wondering whether there are negative effects caused by being on Effexor XR for too long.  Thank you very much for any information you can provide.

[Roger Gould, M.D.]

These symptoms are so hard to diagnose like this. yes it may be a serotonin effect or it may be not enough. Both could cause the same kind of symptoms.  The only way is to experiment.  In order to be perfectly safe,you might ask your doctor to experiment with lowering the dose first to see what happens.



There are no good data for very long term use, but you are certainly in the safe zone now.

[marie0895]

I have never heard of serotonin syndrome!! Really makes me wonder! i've been taking 150 mg of effexor xr for a year and half, and have had some strange side effects, much like feeling manic for about 4 hours after i take it. I get the shakes, my hands tremble and i feel so hyper sometimes i cant stand it!!! And this drug is supposed to help with depression. I dont get it. Where did you read about  serotonin syndrome? I am interested in reading about this.

[jmg72]

I initially came across serotonin syndrome under "Postmarketing Results" in the Effexor XR product insert (because I was trying to find some reference to long-term effects).  Since I hadn't heard of it either, I looked it up on the internet and found a brief description in Wikipedia and then went on to find some other articles elsewhere.  The info certainly made me nervous, which is why I posted a question -- I don't want to jump to conclusions or cause anyone else to either!  I will say, though, that I once experience symptoms like you're describing when I started Zoloft with too high of a dose...I went off of it not long after and switched to something else (don't remember what) before ending up with Effexor.

[jdtm]

When my friend suffered from Serotonin Syndrome it was because the dose was increased too quickly.  She had to endure withdrawal and then another SSRI was used.  This time the dose was kept low and increased very slowly.

[MISHI]

I WAS TAKING EFFEXOR FOR ALMOST 3 YEARS AND THOUGHT IT WASNT WORKING FOR THE LAST 3 MONTHS I GUESS I AM NOW DIAGNOSED AS BIPOLAR AND WONDER IF EFFEXOR PUT ME HERE I WAS ON 150MG MIND YOU I WAS DIAGNOSED THREE MONTHS AFTER THE BIRTH OF MY THIRD CHILD VERY HIGH STRESS I HACE THREE UNDER FIVE MAYBE YHIS IS NOT THE RIGHT PLACE TO POST THIS BUT EFFEXOR IS KNOWN TO CAUSE ANGER WHEN IT IS NOT WORKING I HAVE ALSO SUFFERED A TERRIBLE SKIN CONDITION AND HAVE NOT BEEN DIAGNOSED BUT AFTER EXTENSIVE RESEARCH I HAVE DIAGNOSED MYSELF AND HORMONES ARE A MAJOR PART IN MY PREDICAMENT GETTING SOMEONE TO BELIEVE YOU IS ANOTHER STORY ALSO HAS ANYONE THOUGHT THEY MAY HAVE A CALLING FROM THIR SPIRITUAL SIDE HEALING YOUR SOUL IS THE ONLY CURE FOR EVERYONE MEDITATION IS A GREAT HELP ANYWAY I PROBABLY SOUND LIKE A CRACKPOT BUT I WONDER HOW MANY PEOPLE GET DIAGNOSED WITH DEPPRSSION AND BIPOLAR WHO ARE REALLY GETTING THEIR CALLING WHICH IF DENIED THEY WILL NEVER GET BETER? WHY ELSE WOULD THE MENTALLY DISTURBED BE AFFECTED BY THE MOON SO MUCH THEY ARE SPIRITUALLY GUIDED THEY JUST DONT KNOW IT.

[Carrie L]

After having been on Welbutrin for a year for depression and having decent results a HMFNP, Mental Health Family Nurse Practioner , and I decided to try some other meds to treat my newly diagnosed ADD. I play the piano each day for about 1 hour and this is the best place for me to see if I am in balance. We 1st tried Zoloft, which worked well for 2 days and then my music notes appeared to stack on top of each other. We also tried a Welbutrin, Adderall, Lexapro combo I thought might work. Even though it makes me wide awake late at night, I was now able to get up easily in the morning ( otherwise it is a struggle). After 3 months it dawns on me bruising on my thighs and arms have been appearing since I started these drugs.  My MHFNP informed me I must stop the Lexapro as this sometimes happens.  Then the Welbutrin Adderal combo (now w/o Lexapro) made me so aggitated, my kids were saying mommy your mean.

So I stopped all those meds and my MHFNP suggested I start Effexor XR at 37.5 mg 1st week and 75 mg 2nd week and to return to see how things were going.After 2 weeks I'm back in her office saying I have painful bloating and gas, drowsiness and shortness of breath. She asked me when the shortness of breath started and I advised her that it started when I started the Effexor XR. She checked her palm pilot for side effects and said there was not data showing shortness of breath as a side effect and ended up sending me home with a prescription for Effexor XR 150mg.  I went home and typed in EFFEXOR and shortness of breath and thank God I did because there were many sites addressing this issue. I called my MHFNP back on Friday to try and advise her I saw this on the internet. I was unable to speak with her Friday but based on the information I saw online I did not take the Effexor 150mg. I've been off the Effexor for almost 1 week now and my shortness of breath is not completely gone and I have been having that mild electric-shock feeling others are describing. I describe and compare it to an old TV with static going accross it, like after the stations have signed off. It has also been difficult to drive.  I have to really concentrate when driving as it is still affecting my reaction time and focus. I was so concerned that something might happen to me that I made my 5 !/2 year old memorize our home phone number and taught him how to dial our number on my cell phone. That static feel makes me feel like I might not make it to finish daily errands like grocery shopping. I told my son, now if you see mommy laying on the ground and can't talk to you and looks like she needs help while she's grocery shopping I want you to call daddy.  This is after the starter doses and 2 weeks!!!  I'm glad I didn't increase my dose! Oh to boot, my HMFNP calles her Effexor drug rep about my case and her rep tells her no one has reported shortness of breath and that the are going to report mine and that it will be the first one reported.Hmm what is wrong with this? It's all over the internet. Also, why doesn't the Effexor information paper in the Effexor sample box address shortness of breath as a side effect? They say it's an allergy? Not! It's a side effect, just like the static tv feeling that perpetuates on and off throughout the day now. Has anyone had this feeling and then had it stop after 1 week?

[sandratarium]

I've just stopped taking Effexor XR 7 days ago....and it's been the worst seven days of my life. I started off taking 150mg for about 2 years and have been tapering off the last couple of months, down to 75mg, 37.5mg, then cold turkey.

I am so mad at my shrink for not ever informing me of the horrible side effects I was someday going to face. I have been experiencing nausea, vomiting, uncontrollable crying, body sweats, hot/cold spells, severe headaches, diahrrea, mood swings, body aches and my hands and feet turned bright red and itch like a mother...and that's just what I can name off the top of my head. Which still is not all there. I can barely focus enough to come to work and driving is extremely scary. I don't know whether I'm coming or going. Please, if anybody is going through this or has already gone through this. How long do these withdrawal symptoms last?? I am trying so hard not to go pop another pill just to make all this go away.

[Julia Ann]

I thought I was going to lose my mind and still wonder.  I was on Effexor XR 75 mg. for 18 mo's +.   Effexor's recommendation is 6 -8 months max. (My doc told me after the fact)  I am very sensitive to meds. Maybe that is why even the low dose got me so

hard.  I tapered off then quit.  The day I started tapering off the symptoms began. Horrible, closest thing to death I have experienced.  Head shocks, stomache spasms, inner thigh spasms, severe short term memory loss, confusion, dizziness, (shouldnt have been driving)CRYING, sobbing every hour on the hour, suicide thoughts, screaming at other drivers, MAD!! (not me at all)..and so on...this went on for two weeks steady, then started to taper off BUT....still cry every day...feel like I have lost my mind in a sense.  I am unable to work with my Insurance as I am so confused.  Cant add/subtract right now.  Scared...HOPING IT WILL GET BETTER....  Went to Psychiatrist and she said I have rapid cycling bi polar. Hey, I am 57 years old and never had that ****.  So I just got it after Effexor.  We should sue this company.  My life is poo poo from it.  I wonder how many people are in prison from taking this stuff and getting out of control.  I am a serious christian woman who smiles and is kind to all. Or I was.  The other month a nice policeman tried to give me a ticket.  I said awful things to him and when he was finished told him, "I hope you die." (what scared me is I didnt care what happened to me) Come on, not me in the least way...What I did frightened me very much.  I am over that part of the EVIL EFFEXOR thank God....But something has happened to me from it.  Any hope?  I dont think I am bi polar/rapid cycling.  I think I am still in withdrawal. I am in the fourth week of withdrawal.  Any hope would be appreciated.

[keeponkeepingon]

I have been on Effexor XR 150mg, for a year now. In the beginning I had the electric shock feeling. About six months ago, I forgot to re-fill my prescription, and was off for a couple of days. My daughter was auditioning for a play and didn't get the part she wanted (this has happened before, never has bothered me) I COMPLETELY LOST IT. The director of the play, not only got an earfull, I was screaming at him, at the top of my lungs. The day before this happened, my husband and daughter kept asking if I was o.k., cause I was sweating profusely, snapping at them, not rational at all. As, soon as I went back on, I wa fine again, although for a few days I felt that electric shock thing going on.



So, I broke my neck a few years ago, and have chronic acute pain. On Effexor Xr I do relatively well, that's why I'm on it, it's not only for depression, but they also use it for people like me who have chonic severe acute pain, I guess the electrodes are the same in the brain as depression