I have been on Effexor for about 2 months to help with my social anxiety disorder. My doctor started me on 35.5mg a day for a week, then eventually upped to 75.5mg a day. At this point I was feeling fine. Eventually, my doctor increased the dosage to 225mg and then 300mg. Oddly enough when the dosage increased, the effect was decreased. I am also taking Risperidone (2-4 tablets) before bedtime, could this be countering the effect of the effexor?
USICO Healthcare 
Hello and thank you for your question about whether Risperidone is countering the effect of the Effexor.
As I was trained as a psychologist, I first recommend non-pharmacological approaches to social anxiety disorder such as cognitive behavioral therapy.
Sometimes CBT plus medication temporarily can be helpful. But ultimately, as psychiatric drugs are so strong and unpredictable, I generally do not recommend them.
However, now as I am in medical school, and have experienced first-hand the positive effects of psychiatric medications with patients, I can admit their efficacy in certain severe cases.
If this is working for you, that is great. But I would like to ask you to become an expert on the medications you are taking. You can learn a great deal through certain web pages.
One great resource is the Rx list, where you can look at drug interactions:
http://www.rxlist.com/drug-interactions/risperidone-oral-and-venlafaxine-oral-interaction.htm
To learn more about the drugs you are taking and possible interactions through video, I recommend ‘Doctor of Mind’ Dr. Mark Viner in Nevada. He is so honest about the drugs that other psychiatrists have rejected him, but he is funny to watch, and you will learn a great deal that psychiatrists will not tell you.
1. Here Doctor of Mind talks about effexor Venlafaxine/Effexor
Please watch the whole video.
He says it can be a good antidepressant, but watch what he says about taking too much….never above 225.
it is not good for anxiety: 6:20 —
He says it can make you anxious…so that may explain the weaker anti-anxiety effect as the dosage becomes higher.
2. Doctor of Mind talks about why he likes Risperidone (it mixes well with other meds)
3. However please be aware that Risperidone can affect the heart rhythm. In the article below read about the drug interactions. it says that when mixed with Venlafaxine (Effexor) Risperidone can become more toxic.
I do not know whether you have tried SSRIs, but they are often the first type of medication for symptoms of social anxiety (eg Paroxetine (Paxil) or Sertraline (Zoloft)). Risperidone is usually used for antipsychotic medication…schizophrenia and symptoms of bipolar disorder (manic depression).
If this doctor is not prescribing the right balance for you, I recommend that you try another. You will find the right balance. However please be careful about altering the dosage of Effexor suddenly, make sure you have a psychiatrist’s guidance, for whatever changes you make.
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