BlueDay: Night urination - Effexor

[BlueDay]

Hi, I'm so glad I found this forum as I have been struggling alone with Effexor side effects for 20 years. I have assumed for a long time that it was just me, middle aged female after two pregnancies. I have since discovered the bladder/nocturia problems are a side effect. It has been like being tortured, not sleeping because I've always been up and down, up and down all night so I am totally exhausted. Travel and staying at people's homes has been hard to the point where I carry a plastic  container I can use at night instead of traipsing through campgrounds/bushes/hotels/family homes half a dozen times at night. My whole life seems to revolve around it! Also, over the last 6 months I have experienced terrible incontinence when out walking or just as I get near a bathroom. I feel like I am just a bladder with a person attached.

 

Recently I have had to increase  from 225 to 300 and the nocturia went into overdrive. My new psychiatrist says if you aren't getting a good night's sleep then that is as damaging as depression so lets try another drug. He seems to know what he's doing, or, I trust him at this stage. My previous psychiatrist was incredulous when I suggested the nocturia was a side effect. Frustrating to say the least. New Psychiatrist has me tapering to 75 before switching to another, as yet unnamed drug.

 

My problem is this ..... At 225 the nocturia is maybe 3 times a night. Manageable. Not perfect but manageable. So now I have dropped to 150. I thought that logically the nocturia would settle down to the 2-3 times a night level. But it seems to have gone up again, to almost the 5 to 6 times a night I experiences at 300. How could this be? Is this exacerbation of this side effect part of the tapering experience?  

[Altostrata]

Welcome, BlueDay.

 

It's too bad you've had to cope with this for so long. These drugs are widespread disruptors of all kinds of body functions.

 

Why did you "have" to increase to 300mg? How long did you take 300mg? How did you get from 300mg to 225mg? Did you have any withdrawal symptoms along the way?

 

The drugs have adverse effects, and tapering can have adverse effects in the form of withdrawal symptoms.To minimize withdrawal symptoms, we recommend a very gradual taper, see

 

Why taper by 10% of my dosage? 

 

Tips for tapering off Effexor (venlafaxine)
 

If you have had withdrawal symptoms, you may wish to hold at 150mg for a month or more and give your nervous system a rest. This may help the urination problem.

[BlueDay]

I increased from 225 to 300 after an upsetting incident that brought back debilitating depressive symptoms.  My choice to do so.  I dropped back to 225 because I could not tolerate the night urination. The my doctor suggested that maybe I should try switching to Cymbalta as it is a newer drug and may not affect my bladder as badly. So I dropped to 150 just over a week ago. The first three or four days were a bit rocky, with fatigue, loss of concentration and increased nocturia one night. The depressive symptoms have not returned, except that every day I have a crying time where I feel wretched, then I feel okay after a cry.

 

My doctor has suggested I drop to 75, stay there for five days then introduce 30 Cymbalta and stay there for five days then drop the Effexor all together, I guess. But I feel okay at 150 and I'm thinking I might just stay on this level for another few weeks, If the depressive symptoms are not overwhelming.

 

I read about Cymbalta causing nocturia and other bladder problems and wonder if I will get the same side effects with it as I am with Effexor. If so, I may as well stay on Effexor. I know this devil and how to monitor it, how it affects my bladder, etc. Cymbalta is an unknown.

[Altostrata]

5 minutes ago, BlueDay said:

fatigue, loss of concentration and increased nocturia one night

 

Those are withdrawal symptoms. It's possible that the adverse effects of Effexor for so long have caused that particular hormonal system -- the one that controls night-time urination -- to forget how to function, and the upset of withdrawal confused it more.

 

I have no idea if Cymbalta is going to solve your problems. We don't really deal with drug switches here, except for the purpose of going off the first drug, this being a site for tapering and withdrawal. But the nervous system is not made of rubber, and yours has been dealing with adverse effects from Effexor for many years, so if I were you, I'd treat it gently, it's vulnerable.

 

At any rate, I would stay at 150mg for a good while. I would also have the same reservations about Cymbalta. Why is your psychiatrist so interested in a newfangled drug?

[BlueDay]

I don't know why he's interested. He's a good man but you know, he probably feels he has to 'do' something, fix it or at least try to. He is not focused on meds as a 'cure', he is training to be a psychoanalyst, (very unusual in my country, and a good sign as far as I'm concerned), and I see him every week for psychotherapy after a traumatic bereavement.

 

He beleives in whatever works and using a variety of approaches. But, that said, because I'm suffering from complicated grief I believe he doesn't want to take any chances with my recovery.

If I go and tell him what I have decided - stay on 150 for now - he will be ok with that. If he's not, then we can talk about it. I will definitely raise my queries with Cymbalta  with him.

 

Also, Cymbalta has other medical issues that he has not checked with me over, ie. blood pressure and liver function. I am pretty healthy but before I change over, (if I change over) I will want to have a base line BP and liver function test so we all know where we are. It will mean seeing a different doctor and running around but if these side effects are known, then I should be alert for them, because no one else is going to be! That much I have learned. My previous psychiatrist, the one who put me on Effexor didn't believe the nocturia was a side effect of the drug. She thought I was imagining it. Well, I wasn't and I'm not and it is a recognised side effect. The only way todeal with these people is to be as educated as you can be about these things, and I am so glad sites like this exist!

[ChessieCat]

Hi BlueDay and welcome from me too.

 

So that you can make an informed decision, please consider this.  If you change from Drug A to Drug B you can end up experiencing withdrawal from Drug A plus start up, side effects and possibly a bad reaction to Drug B.  You will not be able to tell what is causing what.

 

Generally side effects of a drug are dose related, so holding for the time being to stabilise and then tapering Effexor will hopefully reduce the side effect.

[Altostrata]

23 minutes ago, BlueDay said:

I will want to have a base line BP and liver function test so we all know where we are.

 

Brilliant!

 

I can see you are appropriately cautious. Please let us know if we can help you taper anything.

[BlueDay]

8 minutes ago, ChessieCat said:

Hi BlueDay and welcome from me too.

 

So that you can make an informed decision, please consider this.  If you change from Drug A to Drug B you can end up experiencing withdrawal from Drug A plus start up, side effects and possibly a bad reaction to Drug B.  You will not be able to tell what is causing what.

 

Generally side effects of a drug are dose related, so holding for the time being to stabilise and then tapering Effexor will hopefully reduce the side effect.

Thank you, I hadn't thought of that issue of simultaneous withdrawal and start-up side effects. That could be a recipe for disaster! 

 

As I say I like and respect my doc, but it's not him doing the hard yards here, it's me. I will definitely talk this over with him and stay right where I am for now. A slow taper down to even 37.5 might be best.

[BlueDay]

7 minutes ago, Altostrata said:

 

Brilliant!

 

I can see you are appropriately cautious. Please let us know if we can help you taper anything.

 

Well, I have learned over the years that one has to case manage one's self, as doctors, no matter how well intentioned, are simply too time poor to do everything that needs to be done. I don't like the old medical model of Big Doctor handing down information to Little Patient. We are the ones who have to deal with the consequences, so I like to find doctors who I can work with. I am open to their expertise, of course, but they must learn to listen to and respect their patients. Particularly when strong psychiatric medicines are involved.

[Altostrata]

Very, very true, BlueDay.