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sunnysideup69: what can I do to stabilise on venlafaxine

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sunnysideup69

Hi there,

Am hoping you can advise me.

I have made a bit of a boo boo, I think.

To cut a very long story short, have been on and off citalopram since 2008, tapered up and down, usually jumps of 5mg at a time.

In the winter of 2017 I had gotten down to 5mg. Foolishly, I dabbled in alcohol and recreational drugs at that time and caused a fairly major wobble, which then righted itself. Did the same in May 2018 and that time it didn't. I then wobbled around at various doses of citaolpram until finally titrating up to 20mg  this year, but it gave me really bad diarrhoea and unlike when I've taken it before, just seemed to turn me into a zombie with occasional anxiety and panic.

I assumed the problem was the drug and so switched to Venlafaxine 75mg XR in August this year. However, it's been 6 weeks and I'm not yet stable. Mostly, I have anxiety which is worse in the mornings and gradually eases through the day. GP and psych are saying I need an updose, but my hunch is that I probably need to hold and wait for stability, being as I've been all over the place with drugs over the last 18 months.

I'm wondering what you would recommend? I'm nowhere near thinking about tapering, but I know your site is big on stabilisation so any thoughts appreciated.

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Gridley

Welcome to SA, sunnysideup69.

 

It sounds like you're dealing with withdrawal from the Citalopram.  Every time you stop and restart a drug, as well as changing doses, sensitizes the system more and more each time you make a change.  This is known as kindling.  Drugs and doses that worked before fail to work and even have negative effects.  

 

 
 
Anxiety in the morning that gradually eases, known as cortisol spikes, is a common withdrawal symptom.  Do you have other symptoms?
 
What is your daily symptom pattern now? Do you feel better or worse in the hours after you take Venlafaxine? Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.  Please post this here in your Introductory topic for several days.
 
This is an example:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep
 
As you said, you've made many changes over the past several months, and we recommend holding where you are at 75mg and stabilize there.  This will give us an opportunity to see how you are reacting to that dosage through your daily symptom pattern entries.  Six weeks is not a long time in terms of stabilizing, especially given your previous history with Citalopram.
 
We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.
 
This is your Introductory topic, where you can answer my questions, post your daily symptom notes and ask your own questions.  We're glad you found your way here.
 
 

 
 
 

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Erell

Hello Sunnysideup

I presume you already know but I would hardly recommand To completely stop alcohol. Every time I have drunk alcohol during my benzo WD, every time I loose time because of strong symptoms.

 

I'm telling you without jugements, I made this mistake in the past too. 

Quitting entirely alcohol when you're on meds is a very very important thing To do for your health. Same thing with recreative drugs.

 

Have a good night.

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sunnysideup69

@Gridley, great, thank you, will keep a note of my symptoms over the next few days. Had a decent day today, and I do feel some 'lift' from the Venlafaxine. Also, how do I do my drug signature please?

 

 

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sunnysideup69
2 hours ago, Erell said:

Hello Sunnysideup

I presume you already know but I would hardly recommand To completely stop alcohol. Every time I have drunk alcohol during my benzo WD, every time I loose time because of strong symptoms.

 

I'm telling you without jugements, I made this mistake in the past too. 

Quitting entirely alcohol when you're on meds is a very very important thing To do for your health. Same thing with recreative drugs.

 

Have a good night.

 

 

Thanks Erell,

I know, it was really stupid. I have stopped alcohol completely since April. Even one glass of wine was making me feel depressed. And as for anything else....no way am I gonna chance it again. Am going to concentrate on getting better and then holding for a very very long time.

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Gridley
7 minutes ago, sunnysideup69 said:

Also, how do I do my drug signature please?

 

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  A list is a good format rather than paragraphs.  Use the following link:
 
 

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sunnysideup69

@Gridley feeling a bit scared now....do you think it's possible to stabilise on the Venlafaxine, even though I didn't on the Citalopram? Feeling worried that I've done some permanent damage, now. Also, I'm not young ....I'm 50. Hoping it's still possible to recover.

 

I'm due back at work in the next couple of weeks, I work part time so it's not too heavy, three days per week. Had to take time out because the first two weeks of the switch to Venlafaxine was rough....I was very agitated, thankfully that has gone now. Now I have plain old anxiety, on and off.

Anyway, I will keep my notes for the next few days. Thank you.

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Gridley
6 hours ago, sunnysideup69 said:

do you think it's possible to stabilise on the Venlafaxine,

Yes, I think you can.  Just give it time and make no changes. The plain old anxiety is a typical withdrawal symptom caused by destabilization from all the changes you made.  It too will stabilize in time.  The damage is not permanent.  The brain has remarkable abilities to heal itself, known as neuroplasticity.

 

Healing from antidepressants: The power of neuroplasticity video (7.5 minutes)

 

Take a look at my first post to you about magnesium and omegas.  The have a calming effect.  Epsom salt baths are also calming.

 

Here are some techniques that are helpful in coping with anxiety:

 


Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

 

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sunnysideup69

Daily notes for 27/09/19, I should say this was a pretty good day for me, has made me feel more hopeful

 

 

5 30 woke with low anxiety

7 10 took Venlafaxine

7 25 ate breakfast

7 50 2200mg fish oil plus 150mg magnesium citrate

8 10 ice cold chills for about 5 minutes

8 15 warm bath with Epsom salts

8 50 slightly jittery, lasted ten minutes

9 30 ice cold chills again 5 minutes

11 00 sudden burst of happiness, then back to neutral

*All morning* low grade anxiety, very conscious of thoughts and how I feel

 

12 30 lunch

12 40 low anxiety because I have to call boss this pm

15 00 took a nap for half an hour

18 00 ate evening meal

21 00 screens off

21 30 really sleepy, went to bed

23 30 woke to use bathroom

*All afternoon* have gradually slipped into feeling normal, not constantly monitoring thoughts and feelings, just engaged in life.

 

Will be continued .....

 

 

 

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sunnysideup69

Another good day today....wow, I might be detecting a shift.....

Saturday 28th September   daily notes

 

3 45 am woke from intense dream, fell back to sleep immediately

 

4 30am woke too early but no anxiety

 

6am low anxiety, slight headache, ate breakfast

6 45 took 2200mg fish oil 150mg mag citrate, had epsom salts bath

7 00 took venlafaxine 75mg xr

7 20 slight anxiety beginning to rise

8 am headache gone but got body jitters

8 30 leave to go to Park Run some anxiety, fluttery heart

9 am did 5k park run, every now and again felt slight dizziness so had to slow down

10 am endorphins kicking in and i feel elated, also anxiety has been much better this morning

 

13 00 ate lunch and felt really relaxed, anxiety gone, just engaged in eating and listening to music, persisted all afternoon

18 00 hours slight fatigue but still feeling good, no strange dips in mood today

18 00 ate evening meal

 

will continue this tomorrow, .....

 

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Erell

Whouah what a terrific news! So happy you can relax in your day! 😄

Enjoy it ! :)

 

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Gridley
1 hour ago, sunnysideup69 said:

Another good day today....wow, I might be detecting a shift.....

That's great news, sunnysideup!

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sunnysideup69

Forgot to add to Saturday 28th that I went to bed at 10 20pm and slept straight through. Will do today's notes, tomorrow.

@Erell and @Gridley, thank you!  Cautiously reporting that I've had three increasingly good days. Cautious because I know this doesn't mean I'm stable. My third week on Venlafaxine was also good, and I crashed the next week BUT this run of good does feel lighter, and it's making me believe that I can stabilise.

 

Gonna keep the notes up for a week. I'll be here for the long haul anyway because after the changes of med over the last 18 months, I know I'm not ready to taper for a good while.

 

I'm booked for a massage this morning and am gonna ask the masseur to be really gentle and give a relaxing treatment. Tried acupuncture before and it was just too much.

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Erell

Hi Sunnysideup!

Whouah, I'm so happy To read about your good days! Even if you think you're not stable, enjoy these good days, they must have a sweet taste! 

 

I'm curious about massage : wanted To try To help me relax but too afraid of my NSC not linking it ! Tell us how it goes for you ;)

 

Hoping you're having a good day! (Or night, don't know what time it is for you :)

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sunnysideup69
9 hours ago, Erell said:

Hi Sunnysideup!

Whouah, I'm so happy To read about your good days! Even if you think you're not stable, enjoy these good days, they must have a sweet taste! 

 

I'm curious about massage : wanted To try To help me relax but too afraid of my NSC not linking it ! Tell us how it goes for you ;)

 

Hoping you're having a good day! (Or night, don't know what time it is for you :)

 

Oh my gosh, Erell, they do! I have not felt happy since the beginning of this year, just awful really, and it's so good to have some good feelings coming back. 

Massage should be okay but I would go for something gentle. When you have a 'deep ' massage, it can actually make you a bit emotional afterwards...and we're already emotional. So I just explained today that my nervous system was in a bit of a state and I need just gentle and soothing. She concentrated on neck and upper back and shoulders, which was great- all my tension sits there. It's night now,going to bed soon. xxx

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sunnysideup69

Sunday 29th September daily notes - today was another good day, this is a really good run. The Ven is definitely kicking in, but I've been taking 2200mg fish oil every day over the last two weeks and I think it's rally helping calm my system

 

5 20 awoke after an intense dream, slept straight through since 10.20pm last night

6am ate breakfast, slight fatigue

7am took 75mg XR Venlafaxine

7 15 warm epsom salts bath

7 30 2200mg omega 3, plus 150mg magnesium citrate

8am feeling slightly restless, anxiety 3 out of 10, slightly dizzy, gone after about 30 mins

9 15 left to go for a massage

10 30 massage feeling sleepy and relaxed

1300 ate lunch, anticipating friend coming over, she is often a bit depressive so am hoping she's in good spirits

1400 to 1600 tea and cake with friend, it was fine, i felt relaxed, very tired by the end though

1800 did strength exercises, listened to music, am enjoying music again

2100 quietly reading my book, winding down for bedtime

2200 Bed, fell asleep quickly

 

 

 

 

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sunnysideup69

Bit late with this update, which in itself is a good sign.....since last Tuesday (24th) There has been a real shift in mood and stability. I think I am beginning to stabilise on the Venlafaxine, and I'm pretty sure the Omega 3s are really helping me to calm down. To say I am pleased is an understatement, I've literally been suffering continuously with really bad anxiety all year, and it's such a relief to wake up feeling 'normal' and for the wobbles to be minor. I am having fluctuations in the day, but they are so small and almost insignificant. Here's my diary for Monday 30th and Tuesday 1st October.

 

Monday 30th

0315 woke fom intense dream but straight back to sleep

5am woke up in a good mood

7am 75mgXR Venlafaxine, with breakfast

735am 2200mg omega 3s, 150mg mag citrate

8am slight agitation, a bit 'high' but not difficult to manage

9am headache (didn't drink enough water after massage yesterday)

10am leave for counselling 

1300am ate lunch, headache has shifted

                slight obsessing over someone

1800 snack, not very hungry

 

2200 bed

 

 

Tuesday 1st October

3 00 woke but went back to sleep

400 woke but went back to sleep, both times vivid dreams woke me up

520 fully awake, no anxiety

630 breakfast

710 75mg xr Venlafaxine

715 more food, hungry

730 2200mg omega 3 plus 150mg magnesium citrate

1000 out for 5k run, feeling quite 'heavy' in body but completed it slowly

1300 lunch

1400 snack

1500 fatigued, went for a nap- woke up with some anxiety/disorientation but it passed

1600 got up

1800 ate supper and spent evening peacefully listening to online workshop

2200 bed

1100 warm

 

 

 

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sunnysideup69

So even though I seem to be stabilising, I realise I need to work on keeping myself stable- this is going to be the challenge for me. I tend to feel better and then try to dash into my normal routine. Need to keep an eye on that. But it's good to feel like I'm stabilising :)👊

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sunnysideup69

I'm stopping with the daily notes for now, because finally, after 7 weeks on the Venlafaxine, I seem to have stabilised. However, I realise I'm still fragile. Am making myself a mental weelness plan for work even as we speak.

I'm wondering @Gridley....given that I've actually really been wobbling around for a good 17 months, I'm wondering if I should now hold for the same length of time before I attempt to ever taper again?

 

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Gridley
1 hour ago, sunnysideup69 said:

'm wondering @Gridley....given that I've actually really been wobbling around for a good 17 months, I'm wondering if I should now hold for the same length of time before I attempt to ever taper again?

 

You should certainly hold.  I don't know if 17 months is necessary.  I would say to hold for at least  six months and then let's reappraise.  It will depend on how you're feeling at that point.

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sunnysideup69

@GridleyOk, so, I maybe spoke a bit too soon. The last three days I have woken again with anxiety which resolves as the day progresses.

 

Was nice to get a little window of that not happening, was anxiety free on waking for a good few days, now back to anxiety on waking again.

 

So I will make notes again for the next few days, especially as I'm heading back to work this week. Maybe that is kind of creating a bit of anxiety for me.

 

I've noticed a bit of obsessive thinking about someone creeping in as of Thursday, and my mood has dropped. I really need to tackle that as it's something I've always struggled with a bit....need to learn some techniques.

 

Also, days here in the Northern Hemisphere are getting shorter. Decreasing light can make me wobble a bit.

 

Keep plodding forward, I guess.

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Gridley
6 hours ago, sunnysideup69 said:

I have woken again with anxiety which resolves as the day progresses.

I have found that the morning anxiety/cortisol spikes come and go with me. The fact that your anxiety resolves during the day is a very good sign.  .

 

Good idea to contiue the notes.  And we keep plodding forward.

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sunnysideup69

@Gridley oh dear, have actually had a really bad day today, all day, so obviously got a little wave going on. Got a bit of general anxiety and a racing heart a lot of the day. Also a kind of weird low pitch humming in my ears.

The last time I had an all-day anxiety was twelve days ago, though, so that's not too bad. Also seem to have a bit of an unsettled stomach with this general feeling.

 

Forgot to take hour by hour notes today, will start that up again tomorrow.

Feeling a bit discouraged by having a bad day.....

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Gridley
26 minutes ago, sunnysideup69 said:

Feeling a bit discouraged by having a bad day....

Yes, it is discouraging.  I'm sorry you're having these difficult symptoms.   Really, though, you seem in general to be doing well.

 

Does the magnesium seem to help with the anxiety?

 

Here's my anxiety toolkit.  The last link, feet-on-wall, has really helped me.  If you can't manage feet on the ll, just hooking your lower legs over a chair works also.

 

 
 

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sunnysideup69
3 minutes ago, Gridley said:

Yes, it is discouraging.  I'm sorry you're having these difficult symptoms.   Really, though, you seem in general to be doing well.

 

 

 

Thank you, needed someone to say that. I'm about to pop a bit more magnesium to see if it helps my anxious body.

I'm really noticing the shift in daylight this week and I bet my nervous system is, too.

I think the Epsom salts baths were really helping but I've run out...need to get some more tomorrow.

 

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sunnysideup69

Had a really anxious sleep, ugh. Kept waking, alternating between being drenched in sweat and shivering. Did keep getting back to sleep though, so that's good.

Have to keep reminding myself that last week I had a run of seven good days, so am definitely beginning to stabilise on the Venlafaxine.

 

Will keep notes of symptoms today, will be more helpful to do so in a wave I think to see what's going on.

I'm just going to have to learn to manage the anxiety in the meantime.

 

 

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Erell

Hi Sunnysideup!

 

I'm in a middle of a wave too after having expérienced improvments,  so I totally understand what you're going through!

As you had 7 days of good,  you must remind that nothing lasts forever,  as this wave :)

 

About anxiety, I think the best way is To find distractions. What are yours?

 

Keep believing !

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sunnysideup69
2 minutes ago, Erell said:

Hi Sunnysideup!

 

I'm in a middle of a wave too after having expérienced improvments,  so I totally understand what you're going through!

As you had 7 days of good,  you must remind that nothing lasts forever,  as this wave :)

 

About anxiety, I think the best way is To find distractions. What are yours?

 

Keep believing !

 

Mine is about to be, do a meditation, have a bath, do some housework, go to counselling. What do you do to distract yoursel?

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Erell

When anxiety is too High, I try To distract with really simple things: sudoku, watching silly vidéos on YouTube, acting (like cleaning my flat)...

I should try To take a bath! 

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sunnysideup69
On 10/7/2019 at 7:04 AM, sunnysideup69 said:

 

Weird, can't seem to get rid of that box above.....

 

Anyway @Gridley, wanna say thank you for all those links above. I'm gonna explore them properly today. I especially like the yoga 'legs up the wall' idea, I've just started yoga and that's something I can fit in every day.

I'm tentatively going back to work tomorrow, being phased in for two weeks. So, three mornings. I kind of feel I need to try getting back out into the world a bit more now, I'm not bed bound, I'm able to socialise, so I'm finding my way gently back into life again. Anyway, here are my notes for yesterday, am gonna keep it up for at least seven days this time, and probably for whole of October. Yesterday was difficult but not as awful as Sunday, which was a stinker.

Gridley, I'm a bit worried about the cortisol/anxiety spikes in terms of causing damage? Are they harmful?

 

Notes for 7/10/2019

3 a.m. woke with palpitations and body chills

5.30 a.m. Awake , anxiety is a 6 and I have palpitations

6.30 a.m. Ate breakfast, did meditation for ten mins

7 a.m. took Venlafaxine 75mg XR, noticing that dip in mood coincides with digestive symptoms, feeling some nausea/ a bit gurgly

7.30 a.m. Hot bath, too hot, was really sweaty after

9.00 a.m. 2200mg fish oil, 150mg Magnesium Citrate

9.20 a.m. Heart palpitations

11 a.m. leave for counselling, still feeling bodily anxiety especially tight chest and arms, slightly short of breath. Counselling was great, talked thru the rigger for my anxiety this weekend, was very soothing.Anxiety around a 6 all morning.

14 00 Ate lunch. Took another 150mg magnesium citrate. I'm feeling anxiety beginning to subside.

15 00 spoke to friend on phone, feeling quite relaxed

16 30 briefly feeling miserable for ten mins but it passes, have been very tired all afternoon as anxiety subsides

17 00 from here on, feeling pretty 'normal', anxiety about 1 or 2

18 30 Ate supper, watching tv

21 30 Fell asleep on sofa

22 30 woke and went to bed

 

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sunnysideup69

I LOVE the legs-up-the-wall-yoga....gonna add that to my daily routine. 10 mins sitting meditation, 10 mins restorative yoga.

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Gridley
6 hours ago, sunnysideup69 said:

Gridley, I'm a bit worried about the cortisol/anxiety spikes in terms of causing damage? Are they harmful?

I don't know the answer to this.  I've brought your question to the attention of the other mods.

 

Glad you like the leg-up-the-wall yoga!

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Altostrata

Hello, sunnyside.

 

From your earlier few daily notes, it looked like you were getting activation (variously agitation, headache, palpitations) shortly after taking Effexor. This indicates the dosage might be too high for you. The nighttime sweating might also be an adverse reaction.

 

Your more recent report, from October 7, was confounded by the hot bath after you took Effexor.

 

We need to see more daily notes, to identify possible adverse reactions to Effexor.

 

The cortisol spikes in the morning can be very uncomfortable and unsettling, but we have many people who have recovered from them. You might be able to lessen them by minimizing stimulation from the morning light with blackout shades and curtains and using a sleep mask to shield your eyes.

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sunnysideup69

Thank you @Altostrata

I'll continue with the daily notes.

 

October 8th

Woke at 2 a.m. back to sleep quickly

Woke at 4a.m. back to sleep quickly

5am woke properly anxiety at about 3 or 4, slightly jittery

6 30 a.m. breakfast, anxiety at about 3 or 4

6 50 2200mg fish oil, 150mg mag citrate

7am Venlafaxine 75mg XR

9 am Went for a 5k jog anxiety about 3

9 45 warm bath

12pm ate lunch , anxiety is about a now

12 30 took another 150mg magnesium

1300 did 'legs up wall' yoga

14 00 doing some artwork

15 30 feeling a bit 'flat', a slight depression at about a 1

16 30 quick pre yoga snack

all afternoon, depression has been around a 1

1800 feeling normal again, off to yoga

18 40 hatha yoga

2020 back from yoga, relaxed

2130 bedtime for me

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sunnysideup69

@Altostrata

Should also add that I'm postmenopausal, and the night sweats are quite common for me, hard to know if its the venlafaxine or my hormones

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Altostrata

That latest report is an improvement, isn't it?

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