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Bye bye Nort, hello Effexor???

Today to my surprised I saw the other neurologist that works in the same office as my regular neuro, I rescheduled this appt and apparently the person who did it made a mistake, they asked me if I wanted to stay and see the other one and that my dr would come in later on or to wait about 2 hours for my regular dr. I said what’s there to freaking lose and went with the other/new dr. Loved her!!! I actually think I’m going to stay with her. Seemed more knowledge about migraines at least and more compassionate.

Here’s the deal, I mentioned before in one of panicking posts that since I started nort a week and some days ago I noticed high heart rate, we are talking 108-118 resting heart rate measured by my Apple Watch, I never thought it was that accurate anyway and blamed it on the increased dosage …today when they took my vitals the nurse asked me if I had taken the stares and how long I was in the waiting area. I said I took the elevator and was sitting for about 10 min before being called in, she said my heart rate was at 138, she waited another 10 min and when she measured my pulse it was at 130, not much difference …apparently she went and told the dr and they put me on the monitor for the rest of the appt & my heart rate never went lower than 118.

While taking to the dr she asked me to go on the log data of my watch and it showed that my heart rate definitely increased in the past 8 days, sometimes with measurements of 190 beats per minute, she said the watch is decently accurate to her knowledge and this was definitely a no.

Anyway after talking for a long time and mentioning how anxious this is making me and all that she mentioned Effexor (without me mentioning like I had to with the other neuro last time) and said that if it works it could be like killing two birds with one stone but that it can take up to 6 weeks to see benefits so for the mean time she prescribed Hydroxyzine (knowing as vistaril or Atarax) and said that for something like benzos I would have to see a psychiatrist.
So her plan is to make me go back to 10mg of nort for a few days to see if the heart rate thing gets better and wear off of it at the same time and then jump onto the effexor XR wagon.

I have mixed emotions about this, effexor was the one I wanted from the beginning and not did the neuro or the neuro-too took me seriously, they decided to make me go on other things and now I feel like that’s wasted time and increased symptoms for nothing. It would have been great to start Effexor before when we were still on summer break but now my daughters start school Monday and I’ll be starting new meds around the same time smh. Plus nort is definitely working for the headaches so it’s kinda bitter sweet stopping it.

I did a search here on the Hydroxyzine and didn’t find much, does anyone have experience with it?

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what dosage of Effexor ?

37.5mg venlafaxine ER …already opened a capsule just in case I decide to start lower, have 30 something little beads but I’m gonna need my husbands help for that cause vision isn’t too trustworthy lately

I don’t remember anyone on here mentioning Atarax recently but if you use the Search facility there are five/six references there. It’s an antihistamine which is used to treat anxiety. Not surprised you were told you would need a psychiatrist to obtain benzos. They are so addictive. Here in the UK they are very much out of favour, much frowned upon, and rarely prescribed. If I asked my doctor for ‘something for anxiety’ she’d offer Citalopram which of course you have to take daily. Propranolol is used here for anxiety as one off, performers tend to use it I believe. Valium is another treated much like benzos here.

Can’t agree with you there. Doctors generally prefer to try the tricyclic antidepressants, ie Nori first because they have an established proven record and they are much easier to come off in the future than SNRI’s like Venlafaxine. Timing, with the school holidays, may be inconvenient but trialling Nori wasn’t a waste of time. It very much looks like you are unable to tolerate it because of the increased heart rate so now you know that, it is eliminated from your future options. Annoying but hardly a waste of time.

Most people start Venlafaxine low and slow. As per the attached. Helen

http://dizziness-and-balance.com/disorders/central/migraine/treatments/venlafaxine.html

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Thank you Helen for always putting things into a better perspective, you are right, at least I tried even after being so scared of it …I forgot to mention she gave me a prescription for meclizine as well, I mentioned that it sometimes helps specially when I have to go out and that I’ve been doing the over the counter version …she said if it helps me to take it as needed for now at least until we find the right meds for me

Yep. Very plucky to keep going with it. Not easy. Meclizine’s another one we don’t get these days. Actually UK Doctors just don’t expect people to anxious about things like MAV. My doctor would be amazed to hear me say vertigo scared me. I was offered two tiny valium for the night before my MRI to ensure I slept. I’m so med sensitive I didn’t dare take them cos I would have overslept. Valium knocks me out like GA would for hours and hours but it was a nice thought. You should find the Venlafaxine will help with the anxiety so then you might not need anything else. I do hope it helps you. Helen

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I’ve felt like that too after trying multiple medications, but sounds like you made some headway with Nort, so that’s good. I remember thinking that changing my meds was going to throw me back to the beginning, but it doesn’t. The improvement in headaches you’ve had on Nort should stick with you for the most part. That was my experience with Verapamil and Topiramate.

I can’t remember, did you try or were you offered Propanolol? Seems like it would be a decent med to try for your MAV and racing heart stuff. I still use propanolol for situations where I think my anxiety might be worse and it definitely helps. It’s also not habit forming like benzos, I would consider trying them for anxiety before Benzos, but anyways sounds like your health care team is on top of it.

Anyways, its great that you will get on with Effexor, has such a good reputation on here, I’m sure you will do great!

Thanks Erik. I really do hope this is the magic med for me.

They didn’t offer propanolol, i didn’t ask specifically for benzos either but I did have them in mind …i questioned her about anything that could help with the anxiety/panic I feel on my worse days or at night (my symptoms seem to increase towards the end of the day) and her first choice was the hydroxyzine which is an antihistamine and told me that anything else would require a visit to the psychiatrist…I told her I would try her choice first since I don’t have a history of anxiety or depression, to be honest I think that as long as I manage to find a good medication for the MAV the anxiety part will get better as well …but I always wanted Effexor in the first place because of the anxiety part too

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That’s the best attitude. I applaud you. Keep life as uncomplicated as possible. That way you know where you are. One drug at a time. Give it time to work. Try Relaxation Techniques etc. Anything natural.

Propranolol is supposed to be good for short term anxiety and can be taken as emergency for that but needs daily fir migraine prevention and dosing is different. I think many doctors avoid it in younger people because it slows the heart rare and indeed over time slows people up making exercise etc difficult and of course it is designed to alter heart rhythms etc. That’s its purpose in life really. Helen

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So thrilled for you Diana and proud of you too! Keep fighting the fight, you will prevail :sparkling_heart: We learn alot about ourselves and our condition with the hard times we endure. Praying Effexor is the right med for you my friend! :pray:t3:

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Thank you @Naejohn …I’m hopeful, idk if it’s the anxiety part of Effexor but that’s the one I always wanted to try so I’m happy. The only thing making me nervous is the chaos of back to school routine and starting a new medication and the possible increase in symptoms but I’m praying we manage well.

:kissing_heart::kissing_heart:

Thank you Helen …I’ve always felt very strong minded about how easily this drs blame everything on anxiety and are so easy to put you on meds for it …i once told my general dr that i was having a hard time with insomnia (after they took out one of my ovaries and hormones were all over …so there was a reason for it) and she told me I was anxious and prescribed ZOLOFT and then put in my medical history that I had generalized anxiety …went to another dr who prescribed trazodone to sleep while the body finished regulating the hormone & anesthesia thing and the “anxiety” went away after 2 weeks.

Hi Diana, i’m glad you found a neuro who you love. We have yet to find a neuro that we really truly love. During our neuro-otologist visit he recommended that we try venlafaxine (rather than ami) but since we already started on amitriptyline we didn’t want to change so soon. I did how ever take the prescription and his suggestions on how to microdose it. He also recommended the generic brand TEVA (??) if possible (I’m based in USA though).

I hope it works for you. This will likely be our next go to if ami fails, so I’ll be watching with great interest (although, I pray we can just stay on ami :pray::pray::pray::pray::pray::pray::pray::pray::pray::pray::pray:)

:revolving_hearts:

Well @Bebop I’m glad that’s the bran he recommended because those are the ones I got, it says TEVA USA on the manufacturer space …that’s good to know.

Thank you so much for the good wishes, I’ll keep you posted for sure …what are his instructions on the microdosing? Mine said to start at 37.5mg but I think at least on the sensitivity aspect we know better than them lol …I opened one of the capsules and I they are full of little beads

These were his instructions:

1st week: Dump out all the granules except 2, put 2 granules back in the capsule and take the capsule whole with just 2 granules
2nd week: double dose (4 granules)
3rd week: double dose (8 granules)
4th week: double dose (16 granules)
5th week inc by 10 granules (26 granules)
Continue to increase at a rate of 10 granules per week until you get to whole capsule

If you cannot tolerate increase, go back to last dose
If you want to conserve some of the extra granules rather than throwing them away you can buy vegetarian capsules size #1 or #2 on amazon

Good luck! :pray::pray::pray: I pray that we will soon see some better days

:revolving_hearts:

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This is so helpful @Bebop …thank you so much. I was thinking about swallowing the granules without the capsule to not waste any :joy::joy: thank God I asked

Really not sure about that one but isn’t the actual capsule involved in the time release process of the XR system itself? Could be wrong but that’s what I thought. Removing it from the capsule means you got the entire lot in one dose instead of spreading it? Experts always say not to split any XR capsules but I know Dr Hain’s Venlafaxine recommendations of thirds. It’s detailed on this thread in a link. Helen

Hi Helen, for capsules typically it is the granules themselves that are time released (venlafaxine and cymbalta are both formulated this way - you want to make sure that the beads themselves are not tampered with or crushed). Tablets typically are coated and cannot be split/crushed (therefore, venlafaxine ER tablets cannot be crushed/split).