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Question: Hello, I have been taking Viibryd for 3 weeks now for anxiety after my Effexor xr seemed to not be working as well. I have been on Effexor for 8 yrs. the last week I cannot sleep and am now itching terribly. I had 7 hrs of sleep in 2 days and work 10-12 hour days. Also I am much more anxious and nervous than usual. What should I do?
Brief Answer:
tell dosage and get tests
Detailed Answer:
Hello,
Viibryd can take upto 6-8 weeks to show good results, at a dose if 40mg daily.
if you have had good response to effexor for 8 yrs, you could have gone for increasing its dosage ( if there was a scope) and waited to see if that works. the past history of good response also gives hope that even this time you will settle with good response.
Viibryd is likely to start show some results by three weeks, if not then you should go for some blood tests- TSH, Sr. b12 levels.
i have seen that patients of anxiety have very good response to pregabalin when added to the existing regimn in case of poor or partial response to drugs. This even takes care of sleep as well.
so, if you can tell me the doses you had in past and taking now and if you have tests results already done, one can try to be specific about which approach to treatment is best for you.
Do not worry, it is common to see sudden relapse in several patients who were otherwise donig fine for a long time. You will be fine soon.
hope the reply is useful for you.
wish you good luck.
Dr. Manisha Gopal
MD Psychiatry
tell dosage and get tests
Detailed Answer:
Hello,
Viibryd can take upto 6-8 weeks to show good results, at a dose if 40mg daily.
if you have had good response to effexor for 8 yrs, you could have gone for increasing its dosage ( if there was a scope) and waited to see if that works. the past history of good response also gives hope that even this time you will settle with good response.
Viibryd is likely to start show some results by three weeks, if not then you should go for some blood tests- TSH, Sr. b12 levels.
i have seen that patients of anxiety have very good response to pregabalin when added to the existing regimn in case of poor or partial response to drugs. This even takes care of sleep as well.
so, if you can tell me the doses you had in past and taking now and if you have tests results already done, one can try to be specific about which approach to treatment is best for you.
Do not worry, it is common to see sudden relapse in several patients who were otherwise donig fine for a long time. You will be fine soon.
hope the reply is useful for you.
wish you good luck.
Dr. Manisha Gopal
MD Psychiatry
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am now still on 20 mg of viibryd and have been afraid to go to the 40 mg amt because of the issues i have been having. I was on 75 mg of effexor for a very long time and tapered down to 37.5 a couple years back. My goal was to get off completely and sipplement w excercise because my anxiety had improved. After my unexpected emergency gallbladder surgery, it got worse and i had crying spells for a couple months and my dr changed it. I can handle everything but the manicky feeling on occasion, the sleepiness, and the itching and naseau is sporatic. I had b12 tested a year Ago and am now getting tested becausei my ultrasound showed fatty liver before surgery. Waiting to hear those results but think all is ok with bloodwork. Always have had perfect bloodwork, hormnes normal, etc. through wellness progrAm at work. Thanks for giving me hope. I just wnt the restlessness to stop. Do you think some can be from effexor withdrawAls? Would you recommend going back? Please excuse my grammar as i usually dont type on my ipad.Thanks again
Brief Answer:
you can re-start effexor, it will work.
Detailed Answer:
Hello,
Now I can see why you developed the sudden relapse- it was due to unexpected gall bladder surgery. First of all, let me tell you that gall bladder operation is amongst the most commonly performed operations now a days (even in developing nations).
usually the patients are of young age, somewhere in early thirties or even in late twenties. It is almost become a routine day care procedure with laproscopic technique. The results are excellent and there is hardly any complication after the surgery and one is able to eat and digest nominal amount of fat in day to day life.
So, please try to accept this fact that it was OK to undergo this surgery and significant number of cases have to undergo this operation in short sapn of time (i.e. Sudden diagnosis).
So, it was nothing major to be fearul of. OK
Now, regarding drugs. You kept well with very low or just starting dose of vanalafaxine, so I would recommend that you may shift back to it and taper and stop viibryd ( it is anyway not working and you dont want to hike the dose). Effexor ( venalafaxine ) is a very good and effective molecule for any youngster who can tolerate it. It is safe also. I would say that you should discuss this probability with your treating team and go back to effexor.
Regarding fatty liver, it can be due to gall stones or raised cholesterol. You must try to restrict the amount of oil in food (make it 1/4 of what you use in any meal) and try to increase exercise and stop using junk food. The food like pizza or burgers or any such preparation has significant amount of oil. Even something like usual bread has it. So, best way to reduce its consumption is to read the ingerdients of wahtever to are going to eat. Increase the salad and sprouts in diet, take enough water and continue to exercise. Im sure that you will get well very soon.
Do get the tests repeated and see if there is soemthing to take care of.
All the best.
Please feel free to ask more quetions for clarification.
Dr. Manisha Gopal
MD Psychiatry
you can re-start effexor, it will work.
Detailed Answer:
Hello,
Now I can see why you developed the sudden relapse- it was due to unexpected gall bladder surgery. First of all, let me tell you that gall bladder operation is amongst the most commonly performed operations now a days (even in developing nations).
usually the patients are of young age, somewhere in early thirties or even in late twenties. It is almost become a routine day care procedure with laproscopic technique. The results are excellent and there is hardly any complication after the surgery and one is able to eat and digest nominal amount of fat in day to day life.
So, please try to accept this fact that it was OK to undergo this surgery and significant number of cases have to undergo this operation in short sapn of time (i.e. Sudden diagnosis).
So, it was nothing major to be fearul of. OK
Now, regarding drugs. You kept well with very low or just starting dose of vanalafaxine, so I would recommend that you may shift back to it and taper and stop viibryd ( it is anyway not working and you dont want to hike the dose). Effexor ( venalafaxine ) is a very good and effective molecule for any youngster who can tolerate it. It is safe also. I would say that you should discuss this probability with your treating team and go back to effexor.
Regarding fatty liver, it can be due to gall stones or raised cholesterol. You must try to restrict the amount of oil in food (make it 1/4 of what you use in any meal) and try to increase exercise and stop using junk food. The food like pizza or burgers or any such preparation has significant amount of oil. Even something like usual bread has it. So, best way to reduce its consumption is to read the ingerdients of wahtever to are going to eat. Increase the salad and sprouts in diet, take enough water and continue to exercise. Im sure that you will get well very soon.
Do get the tests repeated and see if there is soemthing to take care of.
All the best.
Please feel free to ask more quetions for clarification.
Dr. Manisha Gopal
MD Psychiatry
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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