Hi there ,

I have been taking desvenlafaxine for nearly 3 weeks for panic attacks and depression. So far I am not noticing any effects and I feel really desperate. I am not going to work and I feel really unwell. Is this normal ? Previously I was on paroxetine for two years but it stopped working and the doctor asked me to switch.

Many thanks
Dr. Richard Fry
Dr. Richard Fry
Child and adolescent psychiatrist, Psychiatrist
Just looking at the drug treatment in isolation may not be enough. What else has changed? If nothing (unlikely as things change all the time!) and it really is just about the biology alone you might like to discuss with your doctor any other alternatives, dual therapy, resistant depression treatments and the contribution of other factors, like inflammation. Coming off paroxetine after being on it for so long is also likely to be hugely relevant in terms of withdrawal, and the timescales on resolution of that are very variable.

Dr. Usman Anjum
Dr. Usman Anjum
Psychiatrist, Mental health specialist
I fully agree with Richard in above reply that drug treatment in isolation may sometimes be not enough and other factors need to be looked at possibly in form of psychological therapies. Saying that in the initial trials of desvenlafaxine Approx 40% of patients responded to the drug only at or after 8 weeks of treatment and complete therapeutic response was not always achieved in 8-week acute-phase clinical trials. Perseverance with medication might be the key if side effects are not unbearable.

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