Having second thoughts about med

So this is ~day 107. I have been on verapamil for 42 days, or 6 weeks to the day. I’ve been on the 180-mg dose for the last 11 days (of 42).

And … I don’t feel a bit different. Not even slightly. Improvement is absolutely zero. I said I wanted to tough it out on verap. for a full 8 weeks, but I’m having second thoughts about continuing it for another 2 weeks. I’m not sure I want to risk wasting 2 weeks feeling the same when another medicine could be helping.

A number of people here, including Nance, said it took up to 8 weeks to really “get going” on verap., but … they didn’t they feel at least a little better by the 6-week point? … If change is nil after 42 days, can I assume that verap. probably isn’t going to suddenly start becoming effective?

Anyway, I have an unfilled prescription for Effexor here. Begins at 12.5 and titrates up. What does everyone think … begin having a go at the Effexor? Or give the verap. a little more time?

And to those of you who’ve found success with Effexor (especially where other medicines didn’t work): How long were you on it before you began feeling some improvement?

George - All doctors I have seen, excluding Dr. Hain, considered 180mg to still be a low dose. I’m not sure which doctor to believe. But, going with the consensus, you can still increase the med quite a bit.

Lisa – Unfortunately, unless I completely ignore the doctor’s instructions and start making up my own dosage levels, Dr. Cherchi said 180 mg should be the limit. Even at 120 mg it caused a decent drop in BP and pulse, and I think he feels 180 is the highest safe-point.

Besides, he felt that I should have seen improvement even at 120 mg. He didn’t think 180 was likely to produce any different result, and I also am suspecting that going up won’t work.

So I’m still trying to figure out what to do. I do keep in mind that Hain recommends Effexor particularly for the “visual dependence symptom,” which I think is what I have. I used to take an SSRI (sertraline) and did OK on it, at 100 mg, so I wonder if I should probably be able to handle an SNRI without problems.

Obviously, I’m more than a little unsure what to do.


Just thought I would say I’m at the same point as you - 6 weeks in and no major improvement. I have had a few days where I have felt better, but it doesnt seemed to have had the desired effect. I’m on 240mg - thats what Dr Hain’s site said the maximum is. I’m actually seeing Cherchi & Hain in August so I will keep on it till then. I have been self treating myself with Verapamil so I could be wrong.



George and Luke,

I am in a similar situation. I have been on 120 mg for 3 weeks and in the process of upping it to 240 mg. As Lisa said, many Drs go up to 360-480 mg, depending on whether you are having adverse effects. I have had no positive results yet, and actually have been dizzier since beginning the titration up to 240 mg - I also am fighting off a head cold so that may be increasing my dizziness and it may have nothing to do with increasing the Verapamil. I plan to take it to 240 mg and remain there for two weeks and see how I feel. I have been through Effexor and Nortriptyline and want to give this one a full shot. Adding an SSRI or switching out to Topamax may be next for me.

Good luck.


Nance has given me a pretty compelling story in favor of keeping on it the full 8 weeks, which I may try to do. That would be 11 or 12 more days. (Of course, I haven’t had any “gradual” improvement yet, but…)

The doctor wants me to phase out verap. and begin Effexor so that, if I show improvement, they’ll know for sure which drug did it (i.e., going from verap. to verap. + Effexor and then getting better would make it hard to tell which drug did what). I’m not so sure I want to, as verap. + Effexor seems more likely to work, but I guess I’d better not go against what they’re saying.

Luke – you’re seeing Hain/Cherchi in August? Isn’t that an awfully long time to be stuck with verapamil? If there was some way you could get in to them sooner, it might well be worth it.

Hi George

Yes it is a long time, but its the earliest I could get there as I’m travelling in Asia at the moment. I’m really 50/50 about keeping on Verap as I haven’t been to the toilet in a week now, and these bouts of constipation are driving me nuts combined with the fact I’m not having any accumulative improvement in symptoms. I may drop down to 120 mg to see if it makes any difference from the 240 mg.

I’ve been on 240 mg for 7 weeks, so I might as well keep going for another week.


Hey Luke,

One week without a poop is not good at all. I can’t believe how constipating that stuff is. Are you able to try and crank up your fibre intake? Can you score a box of All-Bran? That stuff should do something … you could also put some flaxseed oil on the cereal.

Scott 8)

Hello Mate

I’ve been on laxatives for 4 days as well! I’m actually going to dump Verap. Its been nearly 8 weeks…and even if it did help me out I couldn’t hack the constant constipation. Hain says its very constipating stuff.

So Verapamil trial comes to an end. Bizzarely today is the best day I have had in 10, but its prob just a random good stretch.

Next stop Effexor…what dosages does it come in? Is it like rocket fuel like Lexapro? Urgghh.

Luke -

Try and score some 37.5 mg caps … then start by taking a third. You have to pour all the beads out everywhere. A pain really but that’s the way it goes.

I’m feeling really bloody weird at the moment. I don’t know if it’s Effexor come down or Paxil but I feel like I don’t want to talk or see anyone. Head feels like a foot ball too. Not a good feeling. Even my GF is wondering what’s up with me. :?



When I was on Verapamil I was also constipated. I took magnesium 750mg per day which didn’t help the constipation much. I then added Miralax which was a lifesaver. It takes a few days to work but it was a miracle for me.


I would stay away from laxatives in the traditional sense and try adding lots of SOLUBLE fiber to your diet (slowly). Note I say soluble - this is different than the typical fiber found in most things. You can find it in special high fiber oatmeal, etc (just read the ingredients) or by using Benefiber mix. You have to make sure to drink lots of water with it though. Miralax is good too but you really shouldn’t use it for more than 1-2 weeks.

Hey Scott

Sorry you are feeling so weird. Thanks for the advice on Effexor. I was going to ask - if the Effexor was helping you keep you ahead above level and you felt half decent - why did you stop it? Maybe a few more months and you cold have levelled out?

Anyhow - good luck with Paxil.

I’m off Verapamil as of today - can’t be doing with living on laxatives. In the end you have to balance out benefit vs side effects, and not being able to go to the toilet makes me feel rough (I used to be a 2 a day lad!).

I will score some Effexor when back in Bangkok on Saturday. I’m starting to feel like a junkie with the amount of pharmacies I am visiting asking for random drugs! They say ‘whats that for Sir - depression or high blood pressure?’ “No, no, I suffer from an uncommon form of dizziness to which nobody really knows how to fix except to turn you into a human guinea pig!”


— Begin quote from “Dizzyrascal”

… if the Effexor was helping you keep you ahead above level and you felt half decent - why did you stop it? Maybe a few more months and you cold have levelled out?

— End quote

Unfortunately, when I started to inrease the dose to something useful, the agitation kicked in and stayed constant. Worse was the weird pains it was causing – endless back spasms and sore heels. I couldn’t walk for the first 20 minutes in the morning! Just wasn’t a smooth drug at all. I’m more optimistic about Paxil thus far.

Bugger about Verapamil but at least you can rule it out. Perhaps you’ll do better with a serotonergic med like Effexor given the results you had with Piz.

Scott 8)