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Well if 1 month has elapsed since the last use of mdma then you can now restart on Venlafaxine XR but at low dose of 37.5 mg / day which is to be taken for 1 week , followed by raising the dose to 37.5 mg twice a day ( total 75 mg/day) and maintaining on it for 2 weeks.
From there on you can raise the dose of venlafaxine XR as per the need by increments of 37.5 mg every 1 week until you each a maximum dose of 225 mg / day, beyond which you shall not go. However it is often seen that most of the users respond well to the dose of 75-150 mg / day , taken in 2 divided doses.
Kindly do this drug restart and dose changes under the guidance of your doctor.
I hope this helps.
Wish you all the best.
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also is it possible that i need different treatment? because i spend alot of time brooding over guilt and negativity which i dont particularly enjoy. i have no energy some days and even after long hours of sleep i feel tired. i have had recurring thoughts of suicide when i feel trapped by my thoughts im in constant fear and feel my guilt makes me believe i am worthless i also get many panic attacks, should i be on a different medication?
Well i was answering your query in detail when you relisted your question, in the wake of which my answer was never sent to you.
If you have stopped mdma on 16 march , so it has been roughly 3 weeks that you have been off it , so you can actually start on venlafaxine xr but at a low dose of 37.5 mg / day to be taken in morning as a single dose for 1 week and then further raise the dose to 37.5 mg twice a day and after 2 weeks on this you shall decide on raising the dose further as i have explained above.
You have asked about using any different medication , well on this i will say that since you have previously reaped benefits from the use of venlafaxine then it should be given the preference as it is a tried and tested formulation which gave some good results but was terminated too early , so i reckon you shall stick to this winning drug regime.
Yes you may ask your doctor to add an anti anxiety agent to venlafaxine such as ativan ( lorazepam ) or rivotril ( clonazepam ) at a modest dose of 0.5 -1 mg to be taken twice a day for brief period of 2-3 weeks only , this will kick start your recovery by providing relief to your anxiety and calming you down besides it will buy some time for the main drug venlafaxine to get settled in your system so as to produce the desired effects on your underlying condition and when this happens this anti anxiety agent can be withdrawn.