Venlaflaxine (Effexor)...immediate or extended, your advice pls

Morning all,
So I’m now up to a tablet and a half of the venf tablet (approx 56mg). I’m two weeks at this dose and noticing an extra kick eg head feels muzzy etc…after taking it within 2 to 3 hours, it passes OK and I get on with my day.
My dilemma is that the plan is to go up to 112.5 even 150 by February (am med sens) so wondering if immediate release now the best way forward? I’m not sure my body could take high dose together first thing in the morning via tablet.
Should I consider switching to extended release or am I over thinking the impact of the immediate release at higher doses?
If I switched, would there be any negative impact?
Thanks a mill

Hi Elaine.

Just talking generally here. I don’t take Effexor but the design of extended release is exactly that. It doesn’t mean you get the whole lot into bloodstream at once. The little beads break down gradually to spread the dose evenly over the 24 hours. That applies to all extended release tablets of any drug. So you wouldn’t be taking a high dose all at once.

That said I’d say ‘better the devil you know’. I’ve read, on here and elsewhere, about people switching and finding the other type - whichever way it was they switched - didn’t suit them as well as the one that they started with. Depends really, try to think it through on the ‘if it ain’t broke, don’t fix it’ principle.

I had same dilemma with Propranolol. I have to take pills three times daily which could be a pain whereas the XR is only once a day. I’ve actually read the more often daily plp hv to take pills the higher the rate of non-compliance. All I say to that is, if they were ill enough, they’d comply. They are only being asked to swallow a few pills, how hard is that, not climb Everest! As I very med sensitive didn’t take me long to decide to just stick with immediate release. Helen

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I prefer the XR. The half life of Effexor is 10 hours. I could tell when it wore off in the evening.

150? Woof. Hain caps out at 75mg for MAV. Those higher doses are for depression.

Thanks Helen. I had a good chat with my pharmacist this morning and she said pros and cons to switching, to chew it over before I rush into a decision. The reason I went to tablet was to break it into quarters, she said she would not advise breaking capsule either as it impacts the release mechanism, I knew even cutting the tablet has an impact potentially. I’ll stick with immediate until I get to 75mg then review.

Hi Emily, can I ask what does half life mean?
Some evenings by 5pm, on a bad day I can feel the pain creep back in.
Woof as right, my plan is to get to 75mg and sit on it for about 8 weeks, I may go to 112.5mg but after that will review. The thoughts of any higher freaks me out but one day at a time. Will keep an open mind on the xr as I move up. Thanks a mill

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I’m hesitant to go up to 50 mg.

Half life means your body has metabolized and eliminated 1/2 of the med in 10 hours. I need XR because it was too much in the morning and too little in the evening.

Thanks for that, I’m still new to these meds so learning as I go everyday and with every move up too on dosage

I’m geeky. I learn everything I can as fast as I can, much like my buddy Vigs (@GetBetter). Gives me a sense of having more agency in my life.