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Avatar universal

Effexor XR and muscle twitch

I switched to Effexor XR about a year ago because Zoloft was not doing enough for my depression. I was and still am taking Wellbutrin XL to combat the sexual side effects. Shortly after I started Effexor my doctor also put me on Seroquel. So I have been on these 3 drugs for the past year. Last month my doctor suggested I up my dosage of Effexor from 150mg to 225 mg. I was hesitant about increasing my medication but she seemed to encourage it bc it was the winter months and I was experiencing mild SAD symptoms. After taking 225mg for about 5 days I went back to 150 mg bc I was waking up every morning at 5:30 feeling very jittery. My doctor said it was okay for me to go back to 150. But right when I was downing my dose I started to experience muscle twitches in my legs and torso. They happen quite frequently and only when my muscles are relaxed, such as sitting or lying down and especially before sleeping.  I told my doctor last week about it and she told me to stop taking Seroquel bc she has had some patients experience muscle twitching after several months of having been on Seroquel. I haven't taken Seroquel for 5 days now and the twitching has not stopped. So I just looked up Effexor and muscle twitches and found that several others have had this problem. Have you heard of this and if so is this permanent? I would like to wean off of Effexor because of this in addition to its strong addictiveness. The twitching is a big concern of mine. I am also curious about the underlying mechanism responsible for the strong withdrawal effects of Effexor. I am a neuroscience major and will be attending medical school this fall so please feel free to be as specific as possible as I really want to know why.

Thank you so much.
8 Responses
Avatar universal
Funny that you wrote that.  I am actually having a similar problem as I am weaning myself off Effexor right now.  I was on 225mg and have worked down to 37.5mg now because it didn't work great for me and it skyrocketed my blood pressure.  I am starting Prozac 20mg and decreasing the Effexor.  Here's the thing.  What do you mean by muscle twitches?  Are they involuntary?  Because I have voluntary muscle twitching that I just noticed as I began decreasing the effexor.  Mine is an uncontrollable feeling that I need to tighten my muscles.  I tighten them quickly, like a twitch to eliminate this feeling.  My mother has told me to stop doing it because I look like I have Tourettes syndrome.  It makes me crazy.  I am finishing nursing school and currently work in a hospital and am having a hard time doing procedures because I am constantly twiching my arms.  Ive probably done it 25 times since Ive been writing.  Let me know if this is similar bc I am curious too.  
Avatar universal

My muscle twitches are involuntary. If I'm relaxed my legs will just spasm at different spots very often. They are always strong enough to cause noticeable movement. It's a little scary. It happens all the time when I'm sitting in class, especially if I happen to be dozing off. I don't know it's going to happen. All of a sudden certain muscles in my leg will just twitch and it feels like when you have a knee jerk reflex. I haven't experienced voluntary twitching but I've heard of people having muscle tightness after stopping Effexor. Maybe that's what you're experiencing? Either way, I wish I'd known about how strong Effexor was before I started because I definitely would have tried other drugs. I'm going to discuss this with my doctor on Tuesday and talk about getting off Effexor. I hope you are able to resolve your twitching; I have total empathy for you. I'll let you know how the twitching goes when I start weaning off of it. And I hope everyone learns from all of these horrifying stories about withdrawal that you need to find out EVERYTHING about a drug before you start taking it. The consequences can sometimes be permanent. Isn't that what they say about suicide? A permanent solution to a temporary problem. Sadly, this may easily be applied to the few people who have worst-case withdrawal symptoms. PLEASE, DO YOUR RESEARCH!!!
Avatar universal
Could it be the Wellbutrin that is causing the twitching?
I'm also a neuorscience premed student..just recently went on seroquel..working up to a 550 mg dose, as the 50 mg only made me tired but didn't reduce hallucinations/delusions.

also went on wellbutrin, to reduce depressive symptoms and to quit smoking, managed to quit smoking but have been having some involuntary tics and I'm worried that it may be permanent or tardive dyskinesia from sero..but the numbers are low and its basically reallly rare and i'm told occurs more with older women using sero..

so..if its the wellbutrin then what to do?
is there something that can counter the muscle twicthing..i'm guessing its wellburtrins DA agonist activity..which incidentally should be countered by Sero's DA antagonism..but..maybe seroquel is antagonising different DA receptors than are being agonized by wellbutrin..
the effects of wellbutrin are great..when its working on the NE systems..but I'm guessing there's a problem with the nigrostriatal DA systems..and I'm worried since I want to be surgeon..can't afford permanent twicthes..I'll speak to my psychiatrist this week..and post..hopefully you guys have come up with somethin..

Avatar universal
I discontinued Effexor a few years ago, after having taken it for a year and a half or so. I experienced a lot of muscle twitching while on it, though I don't remember when I started to notice it. I don't remember if it was before or after I started to decrease my doses. The highest dose I took was 225mg. A while after I'd been free of the drug and was still experiencing the twitching, I asked a doctor about it, who said that they should go away after a while. I don't think she really knew, though. I still have them to this day, and although they're not as frequent overall as they used to be, sometimes they are very frequent. As you said, they happen a lot more when I'm relaxed or falling asleep. I get them all over my body, but most often in my hands, then arms and legs. It's annoying sometimes, mostly because of the reactions I get from people when my leg suddenly spazes out on me or something, but I could have much worse residual symptoms.

Also, if you haven't gotten off the Effexor yet, I wish you the best of luck. My doctors didn't warn me at all about the effects or addictiveness of the drug (and they also gave it to me when I was 12 or 13, and it's only supposed to be for patients 18 and older), so I found out the hard way how troublesome it can be to discontinue it. Purportedly, Effexor withdrawals are worse than Heroin withdrawals. I've never taken Heroin, but I do remember lying in bed for two weeks feeling like I was dying while I weened off of the last low dose of Effexor. This was my second attempt at quitting; the first time I got so sick that I wasn't able to do it. The second time I got sicker, but I knew I had to go through with it. It's hard, but it can be done. I really hope the best for you, and anyone else dealing with the same thing.
585414 tn?1288944902
There are two issues here and they must be seperated. The first is extra-pyramidal side effects such as akathesia and dystonia. Those are nothing to be concerned about and you can take a side effect pill for that. SSRI's commonly cause that. The second is tardive dyskinesia (which I have in advanced forms but I had akathesia before so I know what it is). There are no clinically confirmed cases of SSRI's causing tardive dyskinesia (which is permanent) but they can easily cause akathesia. Its hard for me to tell the two apart by description so it could easily be akathesia but tardive dyskinesia should be ruled out, considering that you took Seroquel (all antipsychotics can cause it except for Clozaril and the antipsychotics in development such as the one I am on glycine, a glutamate antagonist in Phase II FDA study, a new class of antipsychotic that promotes a fuller recovery and will not cause tardive dyskinesia or diabetes). The only anti-depressent that's of concern for tardive dyskinesia is Tradazone. Almost all other anti-depressents do not cause it. The best thing is to look at this clinically accurate website "patient education tardive dyskinesia" and if you took or are taking a medication on the list (and remember the list says "some of these medications may be neccessary") have your psychiatrist refer you to a movement disorders specialist to be tested for that (and there is treatment to mitigate it) and in addition you could post the question in the neurology forum.
   That would not apply to anyone who only took an SSRI anti-depressent but as for the original poster you have to distinguish between extra-pyramidal side effects (which the Effexor can cause) and tardive dyskinesia (which it can't but Seroquel can). If the movements worsen when you take the Effexor and then mitigate during the day as it wears off that's one thing but if they are random and uncontrollable and never stop then that's of concern. Don't make any changes without speaking to your psychiatrist. But do speak to your psychiatrist about it. And if its akathesia there are many medications that help with it or if you want to know more about the wide variety of anti-depressents and their options google "Depression Central".
   And if you are a neuroscience major look up my Wikipedia entries on "glycine as a novel antipsychotic agent" and "tardive psychosis". I did both and they had the approval of my provider and clinical studies will be published on me in a psychiatric journal as I am under study for both. PM me if you want more details.
Avatar universal
Effexor causes involuntary muscle twitching.  I've never heard that about Seroquil, but I don't know that much about it.  I got Serotonin Syndrome while on Effexor XR and some other drugs.  It started with muscle twitching.  My psychologist insisted I could control it -- I could not!  He also insisted that despite having being diagnosed with Serotonin Syndrome and hospitalized for it -- my limbs were flailing all over the place and muscles were clenching and twitching everywhere and I was extremely dizzy.  My pych took me to the psychiatric emergency room.  I was released and the next day his supervisor saw me and ran me down to the medical emergency room where they took me seriously.  

Well, all that is to say that yes Effexor causes muscle twitching, clenching, tics and it is known for that.  You may want to switch to another medication.  The symptoms will most likely go away once the Effexor is out of your system.  But Effexor also has a reknown horrible withdrawal syndrome, so make sure you discontinue the drug under the supervision of a good psychiatrist who knows what they are doing (if you can find one).
Avatar universal
I was put on Wellbutrin then added Zoloft. Zoloft seemed to bring me down too much, so my dr switched me to Effexor. Now after taking it, I experience a LOT of big twitches and sometimes involuntary moaning while trying to fall asleep. I've been very tired and have to lay down often throughout the day. I zone out a lot as well, so I don't drive outside my home area, I usually have someone else drive if available. Exerting any kind of energy wipes me out and makes me feel faint. Walking seems to be an exercise even. I wake up tense and shaky. I take the Effexor at night and I feel like I'm more tired around bedtime than I used to be, so that would be an improvement I guess. The dry mouth.. Omg it's so bad, sometimes I wake up because I can't breathe because it feels like my throat is stuck together. At first I thought the Effexor was more of an upper compared to the Zoloft, but now I'm getting a lot more depressive symptoms almost like its overriding the Wellbutrin. I took 75 dosage for a week, then been at 150 the last two. I have a dr app today and I'm wondering if she will switch me off or maybe up the Wellbutrin..? And I've heard about some people's experiences with withdrawal from the Effexor... They had to do it very slowly, even to the point of opening the capsules and counting the little beads all the way down to taking one bead every other day, otherwise they still had withdrawal symptoms. I am not looking forward to that part but I don't think I want to be on the Effexor anymore. I hope this kinda helped knowing what I've experienced.
You should make this a new post, as you have a current problem -- this post is 8 years old.  But you are right, Effexor is a bit of an "upper"and a bit of a "downer."  Wellbutrin is very much an "upper."  Now, this is in terms of how stimulating antidepressants are, not in terms of taking speed, obviously.  But you buried the lead -- why was anything added to the Wellbutrin?  Was it working pretty well but just not well enough?  Or was it not working well at all?  Because if it wasn't working well at all, adding anything to it won't make it work any better.  You add, called augmentation, to something that's working but could be working better, not to something that isn't working well at all.  You stop taking something that doesn't work, tapering off, and then you try something else.  You don't say, so we don't know.  Zoloft targets serotonin, and ssris can be very sedating.  This often becomes easier to deal with once the drug takes effect, which takes from 4-6 weeks, but side effects start right away.  For others the sedation just doesn't go away.  It's a very individual thing.  Effexor targets both serotonin and norepinephrine.  The latter is basically adrenaline, so it can be very stimulating.  Both wellbutrin and snris such as Effexor are so stimulating for some they make them very anxious and sleepless, but for others, the serotonin effect of the snris predominates and they get the sedation.  Because you're mixing meds, the effect could be the new drugs you've tried or it could be your system doesn't take easily to combining a bunch of drugs.  No way to know, really, it's all trial and error.  As for quitting Effexor, if you've only been on it a short time it shouldn't be much of a problem -- if it's only been 3 weeks it isn't working yet, it's just messing with your neurotransmitters.  But do taper off slowly no matter what.  By the way, Zoloft is no picnic either, although by far the worst for the most people are Effexor and Paxil.  But they can all be hard to stop for some people.  Always best to play it safe.  But again, if a drug doesn't work and you haven't been on it a long time, you probably won't have a big problem.  And again, all this might be not the Effexor or the Zoloft but the combination of drugs.
I have a few issues and the Wellbutrin tackles one part of the brain while the others tackle a different part.
The Wellbutrin helped with my physical pain and fatigue. I actually had some energy for a chunk of the day. But I still had anxiety problems. I've been on the Wellbutrin for almost 3 months now. The Zoloft was an attempt to help the anxiety, but after like 4 weeks I think? My dr took me off them and tried Effexor because the Zoloft was making it hard to do anything, too sedative. The Effexor has been wreaking havoc and I'm tapering off of that now. Moving on to BuSpar now... The transition definitely sucks. Today was the first day I had the low dose of BuSpar and lowered the Effexor. I spent the day in bed lol
The Effexor made me feel moody and sad and depressed, which those were not my problem symptoms to begin with and it felt like it just took over the Wellbutrin.
Buspar is now sometimes used along with an antidepressant, but it isn't a very effective drug in clinical trials.  One thing to keep in mind, and this is true for Buspar as well, is that even Wellbutrin targets serotonin some.  Taking several drugs at the same time that target the same neurotransmitter can overload the circuits.  With serotonin it's called serotonin syndrome, but it is quite rare.  Just wanted you to know about it.  I'm not sure about what's actually going on with you -- as far as I know, the only approved use for Wellbutrin is depression.  It's not used for anxiety much because it can cause it as it's so stimulating.  Sometimes it's added to an ssri, which along with the tricyclics are the main antidepressants used for anxiety, when there is a weight gain or sexual problem to mitigate that side effect.  The only antidepressant I'm aware of that is approved for pain control is Cymbalta, and that would imply other snris do that as well, but you have to be aware of possible liver problems and the difficulty of stopping them.  You get to decide, but if pain is a problem, what's the cause of the pain?  If fatigue is a problem, what's the cause of that?  There are many things that might cause them, none of which antidepressants, especially wellbutrin, treat.  They tamp down, but don't cure, mental illness.  You do need to treat what you have or else you're just using drugs for their side effects.  Something to consider, and it might lead you to get more thorough medical examination if you haven't already done that to keep trying to find if you've got something physiological going on, because if you do, again, antidepressant won't treat it and something else might.  A second opinion on your drugs might also benefit you and shed more light on this.  Whatever you do, best of luck and a speedy recovery.
Avatar universal
Hi, did the shake go away with time??

From what I understand effexor is a reuptake inhibitor of serotonin, neuroephidrine and at larger dose it also inhibits the reuptake of dopamine. ( which mean it block the reabsorption of theses molecules in the pre synapse  of your brain.)

225mg seems to be the largest dose you can take since the MAO molecule block the reabsorption of serotonin, neuroephidrine and dopamine for good, that means prescribing a larger dose than 225mg is useless.

Dopamine is responsible for motor skills and mood management.

Is it possible your doctor damaged your post synapse receptors by prescribing you a heavy dose of effexor??

If your problem wasn't a deficiency in dopamine, serotonin and neuroephidrine, I think this could be the case.

Your sending all theses molecule to the post synaptic receptor and blocking the rebsobtion of these molecule. I believe this can cause damage to your receptor since they are not suppose to absorbe all the released molecules from just one side.

Here is a quick draw to explain what I mean :


"Quick note damaging your serotonin receptor which is located on the same synapse as serotonin receptor is what we can call  parkinson related disease make your own research on the subject, it is scary."

"Essential tremor is another one, but the explanation of this one is far from well understood. From what I understand it is damage to the thalamus section of the brain and turn out 37% of theses diagnostic turned out to be parkinson."

"Also their is Dystonia who can be caused by heavy dose of SSRI but this disease does not seems to be well understood by doctor either... They say it is damage to the basal ganglia but their really isn't a clear explanation as to why SSRI can cause damage their at least I did not find any."

We actually are in the same boat, I took effexor at 225mg for a year and when I stopped the used of this drug I started to have uncontrollable spasms in the head and overall body. It is scary...

This seems like the best explanation to me.

Since your not blocking the reabsorption of theses molecules anymore these molecule are now reabsorbed in the pre synapse and have a harder time being absorbe by the post synapse receptor if damaged. which could potentially disrupt their normal behaviour.

Not sure what you mean by "damaging" the dopamine receptor.  Effexor blocks the reuptake of norepinephrine and serotonin.  Because brain neurotransmitters are in balance in a normal brain, and people who have anxiety and depression do not have abnormal brains in any way we can see -- there is no evidence they have any different amount of these neurotransmitters than anyone else -- large dosages have a relatively mild effect on dopamine but not by blocking its reuptake, as I understand it, but by affecting it.  I'm just not sure about that damage part.  Antidepressants taken over a long period of time are thought to alter the brain's ability to function without medication, which is a kind of damage, I suppose, but not one you can physically see.  In the end, you're right, high doses of this drug can affect dopamine no matter how it's happening, but this is, again, a very old post and I'm not sure if the people on here are still around.  I'm sorry about your lasting problems -- did you taper off the medication as slowly as you needed to or were you rushed or did you quit abruptly?  This is one of the most difficult meds to stop taking and can have long-term consequences, so it has to be stopped very carefully, something many docs don't do.  I hope the original poster is still around to offer help.

I did try  to taper of the medication slowly.

Actually my doctor stopped following me at the time I tried to stop this medication by myself.

Anyway, the result is still the same I still have uncontrollable twitch and I noticed really bad mood swing  & anxiety problems I can't seem to control.

I went to see another doctor he taught my spams was the result of a psychoses so he prescribed me some siroquel. This just made my movement disorder worst.

So I stopped going to the doctor and I try to live my life as healty as possible... Its a serious condition...
Are you seeing psychiatrists or regular docs?  If the latter, this is what happens, they don't actually study a whole lot about this stuff.  Psychosis is reflected in mood disorders, not shaking.  Don't get that at all, and most anti-psychotics affect dopamine so the risk of getting shaking is higher.  But when a med causes this, it generally goes away when you stop taking the med.  Withdrawal, on the other hand, can last forever if you don't go off the drug the proper way that suits you and you're unlucky.  It's uncommon, but it happens -- it happened to me.  I think the specialist to see would be a neurologist, though I have no idea if they can help you or not, assuming your twitch is not related to stopping the drug too quickly.  The reason I think that might be the problem is, first, almost everyone has a very hard time stopping Effexor and too many do a taper that is on a schedule set by a doctor for everyone when it needs to be tailored to suit the individual, as we react differently.  The other reason is the really bad mood swings and anxiety -- if this is materially different from what you were experiencing that drove you to take the drug in the first place, and it started when you stopped taking the drug, it's most likely withdrawal.
By the way, this won't help the mood problems any, but taking antidepressants often causes nerve and muscle problems.  It's often a problem with its effect on the absorption of magnesium.  Have you ever tried supplementing with some magnesium citrate or taureate?  Might help.
Nope lol but I will give it a try for sure lol !! Thank you for the infos.

I will try to keep the peoples who stumble on this thread updated if it does work !  

If it doesn't work then I suggest peoples with similar diseases to just kill your self you were not meant to live with this in the first place and you will be miserable for the years to come.

No doctor will ever testify in court on the cause of the problem, unless you give them 10 000$ for a medical expertise supervised by a lawyer (I tried to sue him)  but hey, if this does happen to you, you won't be able to pay this expense trust me lol.

On another note, my doc told me this thing is probably degenerative.

So yeahh, if you never did cocaine before might be the time for you to give it a try. What do you have to lose (your job maybe???) Do you still have a job???!!. If you do, what kind of job is this???

Please let me know lol


I'll leave you on this.

But seriously thank you for the infos! I will definitely give it a try lol

When you sue a doctor for malpractice, the hard part is finding a good lawyer, because these cases are seldom won.  Very hard to prove.  But you're wrong about the cost of an expert witness -- tort cases like this are generally handled on a contingency fee basis by lawyers, meaning you only pay if you win.  But that's another reason it's very hard to get a lawyer for these types of cases because, again, medicine is such an inexact endeavor it is difficult to prove negligence.  Remember this next time you hear conservatives tell you the price of medical care is because of the high cost to docs of losing malpractice cases -- very few are lost or even brought.  The ones that are tend to be pretty egregious and obvious.
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