At the urging of my therapist, I agree to antidepressant treatment for mild to moderate depressive symptoms, rages, and anxiety. The MD recommends extended release venlafaxine hcl. The dose is tapered up: the first week starts with 37.5 mg / day, the second and subsequent weeks are 75 mg / day.
I was at first doubtful about the whole pharm thing -- the SSRI drugs have been undergoing a public backlash, which is no wonder, simply because the pharm companies were pushing volumes of scantily tested chemicals as cure-alls (depression, shyness, and anxiety) to a largely nervous and work stressed society. Stories abound about SSRI over-dosages causing psychotic breaks, lost jobs, lost marriages et al. It took alot of prodding on my therapist's part before I realized: holy shit, I'm willing to overdose on cough syrup (blecch!) just to feel a little better, but I'm scared to sign up for an antidepressant? Hell, I like drugs!
I've been using venlafaxine for 4 weeks now, and I sure would love to tell you what's it's been like.
Week 1: on the first day, I popped a 37.5 mg capsule. At about T+1h I noticed slight stomach upset (more burning than nausea). At T+3h, there is a slight euphoria, much like the beginning of an E trip, but it never progresses beyond a nervous anticipation and a floaty and vague happy feeling. T+4h it still feels like E, but its taking hours to come on, god I'm happy! My jaw is clenched, my palms sweaty. I drink alcohol, but notice no effect (3 glasses of wine + 1 beer). Already, my wife notices an appreciable calm about me, and so she unloads months of pent up frustration on me -- 'why you've been an intolerable asshole blah blah blah...' -- and the funny thing is it doesn't anger me, it upsets me a bit but not overwhelmingly so, and I keep a level head, and I apologize. We kiss and make up.
That night I slept about 3 hours. Could not fall back to sleep. I'm jumpy as hell.
Day 2, and the euphoria does not come on as strong. The stomach burn is hardly noticeable. My jaw is clenched tight, however, and my palms sweat to no end. These symptoms + insomnia keep up for the next several days.
Week 2 -- I begin the 75mg dose. At about T+2h I start clenching my jaw even tighter, and my legs start shaking. Wow, I'm tense, but then the euphoria comes on strong and for the next 7 hours I'm just feeling really nervously good! Followed by the usual insomnia and sweaty palms and afternoon fatigues for another week!
I'm also aware of a slight discomfort -- It's a vague nervous kind of feeling, maybe just all the side effects combining to form a general malaise. But I'm becoming aware that I have control of my mind: instead of wandering around through avenues of imagined fears, dwelling on the unimaginable future or the dread mistakes of the past, I am able to stay present, attend to present duties.
Week 3 -- the malaise is increasingly diminished. I am able to sleep through the night (well, it helps to smoke some bedtime weed : )
[on the subject: venlafaxine in conjunction with marijuana has no noticeable effects for me outside of decreased paranoia -- the herb comes on just as strong, but I am able to keep a positive mind. The two interact well with each other.]
By the end of week 3, there are no more euphoric episodes, and either the body load is diminishing or I am growing accustomed to it; I suspect a bit of both.
I also notice a nagging inability to concentrate. It takes alot of effort to think, which is critical for my job (software engineering). Fortunately, I find that a large volume of coffee helps.
The sexual side effects seem to work to my advantage: my libido is actually increasing as my depression subsides, plus I last much much longer, thereby remedying my 'other problem'. :)
Week 4: I suddenly find a new clarity of thought and being; my concentration is way up and I'm able to do my work again. The body load is negligible, and I feel reasonably content -- not euphoric or high, but just plain ordinary, which is a great fucking way to feel if you have been feeling blue for years.
'So this is how you ordinary people feel... goddamned this is nice!'
I hope to continue this treatment until I have fleshed out how to exist in this baseline state, learn how to react normally to things, just basically get a working handle on my life again, at which point I will taper off, see if I can make it without pharmaceuticals.
