Back to neuro in 2 weeks, some advice on effexor and sympthons

Hi folks, I’m due back to my neuro in early sept to let him know how I’m doing on effexor and map next steps. I’m living with chronic migraine, imbalance, sensitive scalp, lightheadedness, ear fullness, ear ringing and occasional deep ear pain, occasional echo sounds when i raise my voice etc for two years now. I attempted everything including vrt for a year and hrt! So the jump onto meds was a big decision but one I felt ready for.

I started venlaflaxine late April and as I’m med sensitive, its taken me a long time to get to 37.5mgs, in fact I’m only on my 4th week at this dose, every titration up was noted by my body eg increase in headaches, bowel activity but after a bit it settled.

Overall in the last two months, I can see an improvement in my daily pain and can see in my calendar where I have had ten days of pain free days so I’m very pleased with that.

My concern is no real let up in vestibular sympthons, to be honest its been a physical few months with kids at home from school so I’m wondering if I’m paying a price on vestibular front or if doubting this med can help with vest issues.

At the neuros, he said we’d talk nerve block in sept but I think I want to give this med more time, I’m only on the venf 4 weeks so I’d like to give it the 3 months. He also told me I can go up to 75mg which will take me a long time to do as I’m med sensitive. I know I’m putting all my eggs in once basket with this med but I’m clinging on to the pattern of the pain free days, just worried it won’t work on vest issues esp the imbalance which is my primary issue along with pain. Do you think I should ask him about vestibular suppressants?

Thanks for reading, have had a few wobbly days so questioning everything this morning and bit anxious about it all.


Sounds to me as if you are doing pretty well everything taken into consideration. Being med sensitive, increased activity with school holidays and so on. From my own exp (on Propranolol not Effexor) for 18 months) and all I’ve read everywhere the imbalance/rocking/dizziness seems about the last symptom to go. If the drug you are on is improving some other symptoms, ie pain, it’s working I’d say. Just hasn’t reached the imbalance etc which is really when you think about it ‘just’ another MAV symptom if indeed the main one for some or even the only! Think it easiest to keep it simple. I’d be same as you stick with just one drug until you are sure you’ve got everything you can from it. Obviously sensible to go with what the neurologist suggests when you see him/her (although I’d prefer to finish the 3 months first too) but you seem to be doing well to me. You have to bear in mind MAV is chronic, it’s a migraine variant balance disorder and it can be very persistent. I’ve had it on and off nearly 15 years so think I can safely confirm that!

Powers that be say vestibular suppressants prevent the brain compensating so ask away but wouldn’t imagine he/she would encourage use of them certainly outside very acute onset attacks.

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Hi Helen, really appreciate your reply and input and the reassurance that I’m on a decent path forward, I’m giving this med time and the imbalance too, some days make it hard to stay sane and rational so blessed this forum exists with people who experience this and reach out. Thanks again x

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On the vestibular suppressant front, I find them useful as a rescue med. Effexor has been good to me, side effects notwithstanding. Sometimes, and increasingly less, I need a mild vestibular suppressant like half a Meclizine. They’re worth it for those breakthrough days. And, personally, I’m counting the days until school starts again and I can get back to a more ordered routine.