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abray1115, Doctor
Category: Mental Health
Satisfied Customers: 10226
Experience:  Primary care with particular care and experience in managing common psychiatric problems.
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My daughter recently started having increased anxiety and panic

Customer Question

My daughter recently started having increased anxiety and panic attacks. She was taking 150 of Effexor, her family medicine Dr switched her to paxil- she has taken this for a mon. She felt calmer but lethargic, and very depressed, today the doctor said she should stop the paxil and increase her Effexor to 300mg 150 in the am 150 pm.

I take Effexor and have for years, my psychiatrist increased my dose to 37.5mg. I know 300mg is not the recommended increase with this drug. Can you advise?
Submitted: 3 years ago.
Category: Mental Health
Expert:  abray1115 replied 3 years ago.

Anthony Bray, MD : Hello!
Anthony Bray, MD : With Effexor the most common dose after the first few weeks of titration is 75md/ day....
Anthony Bray, MD : The usual max for this medicine is 225mg / day....
Anthony Bray, MD : So I would consider your dose to be low dose ( lowest effective dose is the guiding principle..)
Anthony Bray, MD : I have seem the dose used to be up to this level rarely but it is above the recommended max so risk if side effects could be increased.
Anthony Bray, MD : Effexor helps depression and anxiety via working in two neurotransmittors. --- serotonin plus norepinephrine--- the Paxil by comparison works to increase levels of serotonin only...
Anthony Bray, MD : I would suggest that further evaluation for her via a psychiatrist may be beneficial. The treatment of her depression and anxiety may benefit from counseling in addition to medication...
Anthony Bray, MD : if she still has problems with anxiety still ( panic attacks) then it may be that she might have benefit of medicine more directed at anxiety...this would depend on her response to her current medication...
Anthony Bray, MD : If the high dose of Effexor had bee
Anthony Bray, MD : ....has been a concern with side effects then having her take a lower dose of 150mg/ day and follow up with psychiatrist would be reasonable,,,,
Anthony Bray, MD : I hope this information helps! Let me know if you have further questions and I will be happy to get back with you! If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. Thank you and best regards,
Anthony Bray, MD : Anthony Bray MD

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