I know you guys know tons of info about medications so I thought I would ask this. My husband has been on Effexor for sometime (a couple of years or so) and is taking 75mg a day for depression. Another doctor has prescribed Elavil 25 mg once a day for a pain issue. My husband has been taking this for a little over a week and I think in the past couple of weeks even before he started taking the Elavil that he was becoming quite moody. His Effexor was bumped up from 37.5mg several months ago so I wouldn't think he needed an increase in his dose. He is wondering if the Elavil is stopping the Effexor from working properly though as it has only been about a week I wouldn't think that it has even really started working properly yet. If I didn't think that he'd started to become more moody before he even started the Elavil I might wonder about that but he thinks since he started it that this is the case (that he is more moody). I am going to check with the pharmacist (our local drug store is closed on Sunday) but so far what I see on the internet is that they are not contraindicated. Any thoughts anybody?

Elavil is used for both pain and also mental disorders (such as depression). Any medication taken for depression on average takes approximately 4-6 weeks to reach a therapeutic level in your system. At that point a dosage change may be needed. Often during the first 1-3 weeks of a new med you're going to experience side effects which usually taper off as your body adjusts to the new medication.

If he is having problems severe enough that either of you are worried, I would definitely call the doctor and discuss these issues with them. You are paying for their services after all.

...first what "type" of elavil is he taking? Look on the bottle, do you happen to see the words Amitriptyline, Allopurinol, or Perphe****ne anywhere?

Secondly, Effexor (also known as venlafaxine) is a pretty neat drug. Moodiness is definitely one of the side effects though. What happens when you begin taking antidepressants is really amazing (but really confusing and very hard to deal with, unfortunately). Your brain takes about 4-6 (sometimes longer) weeks to adjust to the new drug. You hit a lower low before you begin to see results. The best way to find out if it works or not is to stick it out. ...but if you're really worried, I'd definitely give your doctor a call. :-D

mxgirl, all I can find on Elavil is that the generic name is Amitriptyline. I find nothing about any other "types" of this medications. There are different "types" of amitriptyline but not the Elavil name itself. I'm confused by what you mean, can you clarify please.

I would have to look it up at work again, I used micromedex ... It listed amitriptyline, allopurinol, and perphe****ne as all being generics for elavil--- one was like elavil plus ...I don't remember off the top of my head. Regardless, I would assume it is amitriptyline which is a tetracyclic antidepressant ...and effexor is an SSRI ---this would actually be somewhat concerning to me, now that I think about it, depending on dosage. Though Effexor and Amitriptyline are chemically different, they both stop the reuptake of serotonin and norepinephrine (not so much with amitriptyline---but very much so w/effexor). I would think that this combo would lead to increased side effects such nervousness, anxiety, nausea, insomnia... Not fun at all. ---but again it depends on dosage...other medications/health problems, and your doc/pharmacist (always get counsel!!!) are your best bets to answering your questions.

The time period it takes for a drug that works on the nervous system to kick in can be really rough, a lot of times people give up and stop taking their pills...but you're going thru something called tonic depolarization blockaide--which i realize probably means nothing to you---but again, its where the whole "lower lows before it gets better" thing comes in. --just has to do with how your cells react.

I'm not too great with the tetracyclics, but I know an awful lot about SSRI's... haha I studied them very in depth in college... I can even draw you the chemical pathways and explain how they work on the brain. Psychopharmacology/neuropharmocology are my passions---it's what I'm hoping to specialize in. ...but unfortunately I am not yet a doctor...so don't take what I say too seriously.

oh yes... i forgot... amitriptyline for pain...is it shingles? if that's to personal to answer, you don't have to, just curious...

Thanks, I was just curious. I'm on the lookout for a new medication since mine isn't working which is why I asked. Just trying to get things straight. Thank you.

He is taking the amitriptyline version, only 25mg and his Effexor is 75mg. It could be that this is the adjustment period before he starts to get used to the drug, yesterday he seemed a bit calmer. The amitriptyline is actually for nerve pain, he has been having this unusual pain in his upper abdomen which no test (and he's had them all) can seem to account for. His specialist is wondering if it is some kind of nerve pain. It is a chronic pain, mostly a dull constant pain not cardiac related or related to anything that anyone can see. He's had all kinds of tests, x-rays, ultrasounds, bloodwork, next month he has a CT scan scheduled. Anyway the doctor thought this might work as it is effective for pain relief. I don't think the doses are very high that he would have to worry about huge side effects but maybe this is just the breaking in period before things level out.

Hopefully he can ride out the next week or so. After that, usually most of the bad side effects start to calm down.

Tietze's Syndrome:
Inflammation and swelling of the cartilage between the rib and breastbone (costochondral or chondrosternal joints is known as Tietze's syndrome. Such chest pain tends to be superficial rather than deep, is aggravated by breathing, and is very tender if the area is pressed.
Just a thought to look into this, I'm a therapy nurse and see this rarely, but it would be great to rule this out... good luck

Purplepansy912 - thanks very much for the suggestion but this is not it. The pain is not aggravated by anything that we can find, definately not breathing, not any particular activity or anything he eats. It does not hurt with palpation. But thanks for thinking!!!

I talked to our local pharmacist who said that there should not be any interaction with the two meds other than that he may feel more drowsy than usual. He has been drowsier and has had dry mouth but I think both of these are improving. His mood seems a bit better but he says it is because he is trying harder not to fly off the handle and let things bug him. It would be nice if he could practice this all the time!

Its kind of a weird combination. Make sure if your using more than one doctor that everyone knows the meds. I would have questioned it before taking it.