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What Causes Suicidal Thoughts After Increasing The Dosage Of Effexor XR?

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Posted on Mon, 23 Nov 2015
Question: I was on effexor xr for 11 yrs. It stopped giving its beneficial effects i stopped it in august to try another med but it have me adverse effects. I have now started effexor xr about 2 weeks ago. i went from 75mg to 150 mg 4 days ago and again seem to have increased suicidal thoughts . Will these go away ? or should I lower the dose ? my main question is when people go on antidepressants and have these thoughts do they ever go away?
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Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Thank you very much for your question. I remember answering a question of yours previously. I've read over your history, and hope I can be of help to you.

For all antidepressants, the FDA issued a black box warning after a study showed a small but statistically significant increase in suicidal thoughts for adults aged 18-24 in the first two months of treatment. You fall outside this age range, but more importantly, this warning by the FDA is controversial, because after it was issued, antidepressant prescribing rates fell, and suicide rates increased. The bottom line is that antidepressants TREAT suicidal thinking.

I mention all of this because I believe that depression, rather than Effexor, is contributing to these suicidal thoughts you are having. I think you need to call your prescribing doctor as soon as possible, preferably in the morning, and report these symptoms, and together you should make a decision. I would expect these symptoms to go away as your body habituates to this current and eventual higher doses, and I would lean towards keeping you on the antidepressant, with this major caveat: If you are currently having thoughts about suicide that you are considering acting on in any way, you need to visit an emergency room immediately, and the antidepressant should be temporarily stopped. Suicide is something we take very seriously, and if you are having urges to act on any of these thoughts, you need to be in a hospital environment where we can help you quickly.

I see you have asked many premium questions on this site. In the future, for continuity of care, you can ask me a direct question at my private link below. I would be happy to be your private doctor on this site.

My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States. For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Suicidal Thoughts After Increasing The Dosage Of Effexor XR?

Brief Answer: Consultation Detailed Answer: Thank you very much for your question. I remember answering a question of yours previously. I've read over your history, and hope I can be of help to you. For all antidepressants, the FDA issued a black box warning after a study showed a small but statistically significant increase in suicidal thoughts for adults aged 18-24 in the first two months of treatment. You fall outside this age range, but more importantly, this warning by the FDA is controversial, because after it was issued, antidepressant prescribing rates fell, and suicide rates increased. The bottom line is that antidepressants TREAT suicidal thinking. I mention all of this because I believe that depression, rather than Effexor, is contributing to these suicidal thoughts you are having. I think you need to call your prescribing doctor as soon as possible, preferably in the morning, and report these symptoms, and together you should make a decision. I would expect these symptoms to go away as your body habituates to this current and eventual higher doses, and I would lean towards keeping you on the antidepressant, with this major caveat: If you are currently having thoughts about suicide that you are considering acting on in any way, you need to visit an emergency room immediately, and the antidepressant should be temporarily stopped. Suicide is something we take very seriously, and if you are having urges to act on any of these thoughts, you need to be in a hospital environment where we can help you quickly. I see you have asked many premium questions on this site. In the future, for continuity of care, you can ask me a direct question at my private link below. I would be happy to be your private doctor on this site. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States. For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX