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thenadetthenade Posts: 137
edited 06/11/2012 - 8:45 AM in Pain Medications

Has anyone taken effexor and has it helped with nerve pain and the depression that can come with chronic pain? Any personal experiences would be appreciated. I know we aren't doctors and everyone reacts differently to meds. I tried Cymbalta and didn't tolerate it. Low dose but still very nauseated.


  • My doctor says anything with Norepinephrine action will have some impact on pain, and Effexor is an SNRI, although they've never marketed or tested it for pain. I hope it works for you!
  • Effexor and Cymbalta are similar because they are both serotonin norepinephrine reuptake inhibitors. The difference is that Effexor has a stronger serotonin affinity compared to norepinephrine, whereas Cymbalta is more equal for serotonin and norepinephrine (ie- the Effexor increases serotonin levels more than it increases norepinephrine levels, while Cymbalta increases both about equally). As Happy said, it is thought that norepinephrine is what has pain reducing qualities (hence why traditional SSRIs that don't affect norepinephrine have not been shown to have much effect on pain). So, both drugs affect norepinephrine and both should have pain reducing qualities, while the drug that increases norepinephrine more (the Cymbalta) should theoretically be better for pain. But, everyone reacts differently to meds and since both increase norepinephrine they both are potential pain reducers so the Effexor is certainly worth a try. Also, the increased serotonin action of the Effexor should help in the depression area, so if that is considered equally with pain relief the Effexor could really be a great choice.

    That being said, how long did you stick it out on the Cymbalta? It is notoriously hard to start and stop. I threw up my first 2 weeks on it, but after that was fine. I just say that so if the Effexor doesn't help and you didn't make it through the initial few weeks on the Cymbalta it might be worthwhile to give the Cymbalta another shot before completely eliminating it as an option. I did well on Cymbalta and got about 10% pain relief and it prevented me from getting depressed on the narcotics, so it ended up being a good thing for me even though those first few weeks were miserable.

    Another thing to look at is Savella, which is the newest SNRI to hit the market. It has a 3 to 1 affinity for norepinephrine compared to serotonin, so it is supposed to be even better than Cymbalta for pain relief (but I don't believe it has been very effective as an antidepressant). If the Effexor doesn't work you could ask your doctor if Savella is an option to try. It's a taper starter pack and I found it a lot easier to start than Cymbalta (still had nausea and vomiting, but not nearly as severe and just a few days compared to weeks on the Cymbalta).

    Good luck. I think there are a lot of us on the boards on an SNRI so hopefully someone with experience with Effexor will be able to share their experience.

    P.S. I also wanted to mention that it might be helpful to talk to your pharmacist, too. My pharmacist has been a big resource for me in figuring out the meds, so if you like your pharmacist it could be worthwhile to spend some time discussing what to expect with the Effexor. As I've been changing up my meds my pharmacist has been good to help me know what to expect as I try different meds and giving me feedback as far as what he has heard from other patients on the drug.
  • Savella didn't fall out as an antidepressant in the trials, so if you want antidepressant activity you'd have to add something else. I guess Cymbalta is the only one that is FDA approved to treat both depression and pain? Pristiq isn't, is it?

    I just bumped up to 120 mg on Cymbalta, which is twice the dose recommended for antidepressant treatment (pain doses are higher, as Cymbalta tends to more NE activity at higher doses). I'll have to let you all know how that works :)

    Lala, you have a heck of a time with the SNRIs don't you? I've been on all of them and never had that problem!
  • very careful if you get on Effexor and then try to get off of it. I followed my docs exact advice of tapering over one month and still ended up deathly ill and admitted to the hospital after a very scary health crisis resulting in an ambulance ride and ER visit. Read online about how hard it is to wean off. Due to my experience, it scares me to think of folks not given very extended wean down periods. Who would have thought one month wasn't long enough?

  • i am currently on Effexor and have found no side effects and am very satisified with the medication. :D i am now a little frightened to go off the medication on my own, which is how i usually stop. i have no plans to do this anytime soon, but like others who start to feel well, i would like to stop it and see how i am doing now... good luck as you try different medications... they all work differently for each of us! your doctor or pharmacist is your best source for advice as always.. Jenny :)
  • SNRI/SSRI are like some of the other meds we take in that they can have significant discontinuation effects. I have been on Cymbalta for a very long time and REALLY do not look forward to ever going off of it, as even missing for a few days results in serious symptoms.

    Cherish, sorry you had such a hard time :( It sounds like your doctor chose a strict weaning schedule rather than one based upon your symptoms. I'd hope my doctor would choose the latter!
  • Thank you all for your comments. My doctor did not tell me how hard it is to get off effexor but now I know. I am taking 37.5 mg to start, see how that goes. I am hoping it will lift my mood and provide some pain relief. Side effects that I am hoping I don't get are nausea, weight gain and not being able to sleep. My doctor did say I could take a small dose (10 mg) of elavil(for sleep). I am going to try and not do that. The pharmacy made me aware of serotonin syndrome. My doctor did say this med was not quite as bad for weight gain as some. What have all of you found regarding this?

    Lala329 I only tried Cymbalta for 1 week, so thanks for the info that your nausea went away after 2 weeks.

    Lulusheart What is your current dose of Effexor? If I can tolerate it my doctor will be monitoring my increases.
  • but has anyone heard Tramadol and Effexor are chemically similar to one another? This makes no sense to me and I will bring this up with my PM doc. If you do a google search, there seems to be something to this. (Yes, I know the net can be a source of good and bogus info) It just scares me that someone said they had a horrible experience tapering off Effexor. I'm on Tramadol at the moment for pain and don't plan to discontinue anytime soon. Just curious.
  • Tramadol has some effect on serotonin, as does effexor. So, there is some risk of interaction.

    You should ask your own doctor to be sure, but mine told me the risk was minor. I was on tramadol and Cymbalta for a long time. He did keep me down to 100mg Tramadol, but said that was probably overkill, as the actual incidence of serotonin syndrome was very, very rare.
  • I watched a friend go through a horrific withdrawal after weaning off Effexor. She was deathly ill for at least 10 days - probably close to two weeks. Prior to this, it really did make a huge difference with her mood and pain levels, but she had to stop taking it for some reason.

    When I attended a residential pain program a few years ago, I was weaning off the drug Celexa. The nurse there advised me to "shave" a tiny piece off each tablet for a week at a time, then shave another tiny bit off for another week, so on and so on until you are literally taking a crumb. I l"weaned" off Celexa for about four months. This is difficult to do when you're dealing with capsules; I'm not sure if it is recommended to open them and reduce the dosage that way, but it would certainly be worth checking with a pharmacist.
  • this conversation is making me so afraid. I've been on several antidepresents in my adulthood...and with all I've had either a bad experience starting or weaning. Well, I just let my doctor talk me into prozac to hopefully elevate my mood and energy level. What I take come in capsules only so I will definately check with the pharmacist about opening the capsules to wean (will not be weaning anytime soon). The worst one I've ever weaned was lexapro...and I did it over 3 months or so by "shaving" bits off for a week at a time. Antideppresants really scare me and I fear the dependance issue about as much as I do the narcotics I'm taking.

    Anyone on prozac and what have your experience been with it? I havent' seen an increase in energy yet :(
  • another drug I was put on to help with insomnia was trazadone. I did no research on this med and did not even realize it was in the "antideppresant" category. I didn't research it until I had been off for about 6 days and started having major withdrawl symptoms. I felt so stupid that I had not properly researched this med and took it for several months. As soon as I took one when I was feeling so ill, I felt completely fine in about one hour...then I did a proper wean. Good lesson learned.

    It's so important to do your due diligence with each med you are prescribed...good job.
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