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    What causes lack of appetite while on Venlafaxine?

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Posted on Mon, 14 Aug 2017 in Mental Health
Question: I have been put on Venlafaxine for the second time. 225md, but cut it to 220 approximately. I also take quetine and diazepam, which now don't touch my anxiety. My anxiety is worse than ever. My psychiatrist was the third locum I have seen and now he's gone! I feel like I need to get myself off the Venlafaxine as soon as possible as life is unbearable. Tried Sertraline, but that didn't work either, but much worse now. Difficulty in eating as I have no appetite.
doctor
Answered by Dr. Seikhoo Bishnoi 21 minutes later
Brief Answer:
Dose of Venlafaxine can be reduced.

Detailed Answer:
Hello thanks for asking from HCM

I can understand your concern. Venlafaxine is a SNRI drug and if you are not well even on 225 mg then this can be stopped. The dose should be reduced gradually over 4-6 weeks and in the same time another antidepressant drug like Escitalopram or Citalopram can be added. The drugs should be cross tapered. Venlafaxine should be reduced by 37.5 mg every week and at the same time Escitalopram can be started in dose of 5 mg and increase the dose by 5 mg every two weeks. The final dose should be 15-20 mg per day.

The drug should help in your depression and should control panic symptoms. Quetiapine can be continued as you are taking. For episodic control of anxiety Diazepam can be used.

You can discuss with your doctor for drug change.

Thanks and Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Seikhoo Bishnoi 41 minutes later
What if I don't want to go on another antidepressant?
doctor
Answered by Dr. Seikhoo Bishnoi 1 hour later
Brief Answer:
Lorazepam can be used on SOS basis

Detailed Answer:
Hello again

In that case you can continue to take Venlafaxine in your prescribed doses. The drug will control the depressive symptoms and if you had any panic attacks then you can use Diazepam on SOS basis.

Diazepam is relatively longer acting and if that doesn't help then low dose Lorazepam or Ativan can be added to your prescription. The drug will effectively control panic attacks.

Thanks and Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Seikhoo Bishnoi 6 minutes later
I still want to come off the Venlafaxine. Thanks for your help.
doctor
Answered by Dr. Seikhoo Bishnoi 3 minutes later
Brief Answer:
Gradual dose reduction can be done

Detailed Answer:
Hello again

In that case as I mentioned you can gradually reduce the dose of Venlafaxine over 6-8 weeks. Reduce the dose by about 37.5 mg every week and you can stop the drug completely over 6-8 weeks. Gradual dose reduction will not cause any withdrawal.

Thanks and Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Seikhoo Bishnoi

Psychiatrist

Practicing since :2007

Answered : 5181 Questions

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