With a diagnosis of fibromyalgia, I want to know what is the maximum dosage of Effxr possible that can be beneficial if already using 225mg?
Can effexor be used for pain control / fibromyalgia and if so, at what dose?
Question posted by Anonymous on 17 March 2011
Last updated on 30 March 2013
Answers
LaurieShay
17 March 2011
Hey clyons,
You are at the theraputic dosage for Effexor. Clinical trails showed no significant increase in benefit on doses greater than 225mg of Effexor, though it can be prescribed as high as 350mgs.
As far as the pain control, it is not a labelled treatment for pain. It may help your pain some, but generally not prescribed for that. An antidepressant that is prescribed for nerve pain is Cymbalta which acts on the same neurotransmitters that the Effexor works on, so they are similar in that regard.
Since you have fibromyalgia, I really recommend you ask your doctor about Cymbalta. It will help the nerve pain and the depression. I have taken Cymbalta for years and had good results for pain and depression. You would have to taper off the Effexor and start the Cymbalta, but should have no ill effects if done slowly and concurrently.
Just my thoughts, wishing you the best,
Laurie
Inactive
17 March 2011
Great info! I would like to add that venlafaxine is used as an off label indication for fibromyalgia. It is quite common. There are reasons to choose Effexor over Cymbalta.
Brian PharmD Candidate
LaurieShay
17 March 2011
Hey tecknotard,
I would love to know more about the reasons to chose Effexor over Cymbalta, please share, honestly.
Laurie
Inactive
17 March 2011
Great question!
There are a lot of reasons and it involves lots of grey areas. I will give a few examples.
1) Getting the most obvious and easiest out of the way if you had side effects or intolerance to one you could switch
2) Depending on kidney and liver function you might want to choose one over the other. Both drugs are eliminated from the body and metabolized by both the organs but at differnet extents. They have different guidlines for when it should be stoped
3) Effexor works very well in patients with concurrent anxiety. In fact, effexor is consider a go to option.
4) You also have to consider which other medicines someone is on. Both medications are metabolized by 2D6 (an enzyme for breaking down chemicals) but cymbalta is also broken down by 1A2. Many other medications can decrease the ability of the enzyme to get rid of the cymbalta so you can get higher and dangerous levels of cymbalta.
Those are just a few abreviated reasons. If you would like more info or specifics I would have to look it up.
In the end choices for the appropriate agent can be trial and error. Blanacing side effects and efficacy. I wish I could say there was a black and white choice.
Hope that helps!
Brian PharmD Candidate.
LaurieShay
17 March 2011
Thanks teknotard, I love to learn this stuff, how bout you? It is really fascinating, lol. I know I'm a little weird but I do love medical stuff.
Inactive
17 March 2011
I am a natural born learner. I am a pharmacy student (soon to be pharmacist) and I love everything about drugs.
In fact, I love it so much I am going to do a residancy, specialize and hoepfully become a professor *fingers crossed* Then I can be a life long student.
If you ever have questions I would be more than happy to help you out or do some research.
Brian PharmD Candidate
finash
29 March 2013
Hi, ive just come across this post form a couple of years ago and am interested in anyones input. I have been on Effexor XR 600mg daily for about 12 yrs now (took about 6yrs of numerous other antidepressants and severe depression to get to it?) and have had relative success with it and a combination of other drugs along the way to help with down times??? I have been diagnosed with Lupus and Fibromyalgia about 8yrs ago and have numerous health issues related to it? However my psychiatrist of 18yrs retired a year ago and my new psychiatrist is younger and not comfortable with my dose of Effexor and says that I would be gaining NO additional benefit than if I was on 300mg.? I have come off my Effexor twice in the last 8yrs when pregnant for the duration of my pregnancies and life has been awful until I returned to the original dose of 600mg? Is it likely that there is any pharmacological basis for taking the 600 mg and WHY do I not get the benefit of a lower dose? is there any way of working out why I need the higher dose? Thanks in advance! Ta Fi
LaurieShay
30 March 2013
Not really, 600mg is almost double the recommended maximum which is based on clinical trial response to titrating the medication. No additional benefit was seen after the 350 max. Unlikely you are truly needing that much, but be sure to taper down slowly so to avoid withdrawal symptoms.
Related topics
effexor, pain, fibromyalgia, dosage
Further information
- Effexor prescribing info & package insert (for Health Professionals)
- Side effects of Effexor (detailed)
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