Venlafaxine - What is the highest dosage that can be given if 75mg isn't working anymore?
Hi plowdenslager! The maximum dose for moderately depressed patients is 225mg/day; the dose for severely depressed patients is 375mg/day.
Since you're taking a low dose of 75mg an increase to 100 or 150mg/day would be reasonable.
Good luck and let us know what you choose to do and how it goes, okay?
Venlafexine is sold in multiples of 37.5 mg. Most people get either 37.5 (base for neuropathic pain) or 75 (base for psychopharmacotherapy). 150 is as high as I'd feel comfortable with unless you're working with a psychiatrist. 300 is the highest most docs would go, but my fellow commenter talking about doses >400 is not terribly unusual. Effexor has an interesting pharmacodynamic profile. An increase in dose does not yield the linear bump in benefits some might expect. It's really more an exponential boost as higher doses begin to affect new and different neurotransmitters. 37.5 will yield GABA-geric effects (pain, anxiety), 75 will begin to see the serotonin reuptake inhibited, 75-150 sees some good norepinephrine activity and at 150 and above you'll see some effects on dopamine transport. Check the wiki entry for venlafexine for binding affinities and explanation of each neurotransmitter function.
I'm not a huge fan of big doses of Effexor due to the risk of insomnia. There's some really good drug combos that can give your venlafexine a boost. Mirtrazapine (Remeron) and Effexor can be combined with an SSRI (Zoloft, paxil, Prozac, celexa, Lexapro) or TCA - Tricyclic (Elavil) in what is known as California Rocket Fuel. If you swap out the SSRI or TCA for an SNRI like Cymbalta it is called Limerick Rocket Fuel.
Most family physicians and Internists have limited or no experience with these kinds of drug combos. You may want to consider a psychiatrist if your don't see one already.
- Venlafaxine Information for Consumers
- Venlafaxine Information for Healthcare Professionals (includes dosage details)
- Side Effects of Venlafaxine (detailed)
Search for questions
Still looking for answers? Try searching for what you seek or ask your own question.
Posted 13 Sep 2009 • 6 answers
Posted 6 Dec 2009 • 1 answer
I've been newly prescribed Venlafaxine 75mg for (mdd) and have been pleased so far but, I do however
Posted 17 Jun 2011 • 4 answers
Posted 29 Aug 2016 • 4 answers
Posted 8 Dec 2016 • 1 answer