I had a chat with my friendly local pharmacist yesterday and he suggested splitting the dose would give more prolonged relief, whereas taking 75mg all at once would probably cover around 2/3 of the day. So today am taking 37.5mg twice daily. Thanks.
3 posts were merged into an existing topic: Has Amitryptline saved me? (Kirstyās Diary)
Iāll be overly specific ā hopefully the details help. Itās been a while though, so my memory of this might not be perfect.
I failed my first trial of Venlafaxine really early on ā I think it was the second med I trialed. Tried ātitratingā by splitting a 37.5mg pill in half, and after a few days at that dose, had raging tinnitus, crazy anxiety, worst VM symptoms. That coupled with reading the worst Effexor stories on the internet made me give up pretty quick.
Fast forward several months trialing several other meds that didnāt work for various reasons, I asked the neuro what my best shot would be: effexor.
Second time, I titrated up by starting at 5 out of 100 beads, and adding 2-3 beads a day, pausing when I felt migrainey (which was often). Far less anxiety, far less tinnitus. Still some night terrors and insomnia. I paused at 37.5mg for a while, no real relief in VM (I was pretty chronic back then), so I kept going up, same method. Got to 75mg, then realized I was having some āgood daysā, which really meant, I no longer felt swaying/motion sensitivity, and I could start to tolerate supermarkets. I paused here for several weeks, and remembered thinking āoh, shit, this feeling of āyeah Iām not that worried about stuff anymoreā must be how normal people liveā. I never thought of myself as anxious prior to VM, but I was, and it was good to feel happy and a bit more care free.
I decided to go up again to 112, same method. I got a lot of relief there. About 80%, which again just meant I was having more good days, almost symptom free. I stopped here, and added other meds, which got me to 90% or so, which is where I am today after 3 years.
Effexor helped me the most. Botox and Nurtec after that. Symptoms change over the years, good days get clearer, bad days get a little less bad.
Hereās the thing about 90%. Itās good enough that you decide to get lazy. Iām pretty sure I can get to 98%, but I donāt, because that coffee tastes too good, and I just want to watch one more Youtube video despite being awake 3 hours past bedtime, and damn that chocolate cake tastes nice. Sometimes I have a real bad week, and those āswayingā symptoms reappear, and that shit scares me straightā¦ for a little while anyway.
Trust the data. Effexor is effective. Itāll suck for weeks while your brain gets used to it, but it does get much, much better once it kicks in.
good luck!
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Hi Sonny
Thank you so much for your very detailed account of your story. I am so very pleased to hear youāve had such success with Effexor 
it gives me some hope that things will get better and that one day I may even be well enough to start working again - any amount of relief is welcome right now. I have a way to go in terms of your dose as Iām still only at 37.5mg and I agree with stopping if it feels too much and waiting until things settle further. Some days I feel like itās hopeless and that Iām always going to be too unwell to live a normal life again 
so your post has encouraged me to have some more hope. I am on 75mg of Ami and that worked for me for a while but it doesnāt seem to be helping like it did anymore 
Thank you again for your post.
Glad to hear youāre well 
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for everyone that is on effexor, how is your interest in things and overall level of focus/work output?
iām currently on sertraline, and while it hasnt really done a whole lot for my vertigo, its made me considerably less anxious and worried about my health, so at least it has some benefit.
my only complaint about sertraline is that it tends to take away my drive/focus and ambition. does effexor give you this āeverything is going to be okay feelingā or is it more focusing?
i dont think i can deal with the satiated feeling that sertraline gives me any longer. hopefully effexor is better for restoring drive/interest in things
Iāve only been on Effexor for a few weeks but already Iāve seen massive improvements in mood, energy, sleep, optimism. Also noticed my Fibromyalgia aches and pains are less. Iām making mental plans for the future whereas before Iād lost interest, just getting through the day was challenge enough. Iām just hoping it works as well for MAV but that will take time.
Do you think I should push to start with Venlafaxine or Nort? Iām interested in Nort mostly because I sleep like absolute sh**, but Venlafaxine seems to be the gold-standard for treating this.
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Itās the current fashion (just like the diagnoses! :D)
Amitriptyline was once the gold standard, then Nort.
Amitriptyline would be even better for prioritising sleep than Nort (but I vaguely recall you tried Ami?)
EDIT: found I think Melatonin is really helping me - #7 by sheepdog_lord
So yeah, consider Amitriptyline too.
i havent tried any of them, actually. just CGRP drugs, which are very in-fashion in america, and Topamax for a few weeks. I feel like the first doctor that I saw just skipped over all the tried and true drugs and went straight for the new ones.
Venlafaxine is very in-fashion in America. Here it is definitely the āgold standardā, and providers are more against Nort and Ami because of the cardiac side effects.
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Nort can be sedating although not as bad as Amitriptyline. Some users, particularly in the early stages of taking it can find it makes them very tired and sluggish the next day. I tried both of them, didnt get on with either. Both gave me the shakes and Nort gave me heart palpitations and headaches, not migraines. It was helpful for sleeping but nothing else. I felt no improvement even at 30mg.
Venlafaxine conversely can cause insomnia although Iāve not found that to be the case. The trick is to take it early in the day if you find its an issue. Some people find it makes them more tired. Its so indvidual.
Obviously we cant advise on medical matters here but I dont regret starting it and wish Iād tried it months ago instead of wasting time messing about with other meds.
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I have problems with sleep induction, and pretty heavy depersonalization/derealization so Iām leaning towards Nort or Ami so I can get my sleep under control. I lay awake every night until very late and feel horrible the next morning
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Then either might be a good choice for you. I took both years ago for Fibromyalgia sleep related issues and pain. I learnt to take them early evening so they had kicked in by bed time and also so I wasnāt too tired to wake up the next day.
As I said you might feel a bit like youāre walking through treacle initially but this should wear off as you get used to them. And if you dont get on with them they are pretty easy to stop. I got to 30mg of Nort and just stopped it cold turkey. With no ill effects. Good luck.
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update: iām going on effexor because, quite honestly, I canāt wait another second to get on a proper drug. I honestly feel completely medically mismanaged for being placed on Sertraline before an actual good and proper migraine drug. Got the NP to call in the prescription today, so Iām going for it.
I hate having to basically manage my own care, but if the doctors are too busy for me, I feel like I have no choice.
Agreed, I had to get the OK to start Venlafaxine from my Neurologist after I suggested it. Its not a primary care drug for migraine in the UK and Iād already tried 2 of the 3 drugs our GPās can prescribe. Its pretty ridiculous that patients have to suggest treatments themselves but we are where we are. It was seeing the positive reviews on this site that spurred me to to try it. Hope it helps.
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Iām doing 37.5 and uptapering by 1/3 capsule per week. I have high hopes. Finally some evidence-based medicine!
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How long did it take yall to notice pretty consistent benefits from this? Took my first dose earlier today and felt really good (almost completely dizzy-free), and then crashed hard a few hours ago in a full blown attack?
seems to suggest im on the right track with this, but has to get into my system a little more?
Iām seeing some benefit now. Been on it nearly 4 weeks. However Iāve been told it will be a few months before it will fully work.
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18 posts were split to a new topic: Comparison of Venlafaxine and Amitriptyline
I started 9 January but titrated up slowly. Started on 12.5mg week one, 25mg week 2 and 37.5mg week 3. Iām now on 75mg since last week as 37.5mg didnt seem to be helping. Iāve seen improvements since last week. Iām laid up with cough/cold right now which can impede progress. Iām hoping I dont need to go up any higher. And I need to give it a decent interval to work. Iām also being good with potential food triggers as well. So no caffeine or cheese.
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