currently taking effexor … 70mg ish
maybe it’s helping with the flares… maybe it’s the weather turning, i don’t know
however i am now overwhelmed with pins and needles in my feet and hands. a creepy crawly tingle that overwhelms my thoughts. tho sometimes i just imagine it’s the feeling blood flowing properly instead of pooling and burning and/or raynauds.
Hey Cherry - I’ve never noticed the sensation you describe w/ effexor. I know I had pins/needles feeling when I was low in b12 though at one point.
Is Effexor used to treat erythromelalgia? I have been on it for 10 years (for anxiety) and was just (possibly) diagnosed with EM. I take 150 mg/day. I get the pins and needles feeling when I miss a dose. The withdrawal is horrible. I’m new to EM so I don’t know much about it or the treatments. But Effexor doesn’t seem to help me. I get burning red feet when I’m hot, but get cold blue/purple feet when I’m cold. My rheumatologist (I have celiac and psoriatic arthritis) saw my blue toes at my last appointment and said “you have Raynaud’s.” I told him I also get red burning feet and he said, that may be erythromelalgia. That’s all he said… nothing more! I definitely feel like my lower legs and feet have vascular issues even though my circulation is fine.
Venlafaxine (brand name Effexor) is approved for the treatment of depression, general anxiety disorder, social phobia, panic disorder, and vasomotor symptoms.
“Vasomotor” refers to actions upon a blood vessel which alter its diameter.
Uses for Venlafaxine:
Vasomotor Symptoms
Management of vasomotor symptoms in women with breast cancer and in postmenopausal women; improved both frequency and severity of vasomotor symptoms (hot flushes [flashes]
Describes 3 patients with EM, 2 of which responded to effexor, 1 which did not respond to prozac but did respond to zoloft. Seems like the relief is at least sometimes observed only a few hours/days after starting treatment. The doses of effexor are low making it more of an “SSRI” than “SNRI” (is my understanding anyway … “SNRI” doses of effexor are 150 mg or higher?) Usually cymbalta or effexor or tricyclics are given to EM patients for their pain-modulating effects – which come from the “N” or norepinephrine effect, but there seems to be (from case studies, and reading anecdotal stuffs from forums/groups) a benefit that can happen due to the serotonin’s actions on blood vessels/ “warm congested extremities”/temperature regulation.
However the serotonin can be hit or miss (SSRI’s like prozac can help Raynaud’s, can help Raynaud’s but send the patient to EM, help someone’s Raynaud’s + EM simultaneously, can help EM, can worsen EM, …, can help someone’s migraines, can make migraines worse, etc) From the paper just above: “5-HT is a vasoactive substance involved in central and peripheral neurotransmission
and platelet function. It may cause vasoconstriction or vasodilation depending on the
vessel involved and the integrity of the endothelium.”
And from the paper below: "The
reported side-effects of sweating and subjective feeling
of warmth are well known effects of SSRIs. There is evidence that
serotonin is involved in the temperature regulation
in the central nervous system. Moreover, the crucial role of serotonin in the regulation
of the vascular tonus in several distinct areas of
the body, thus contributing to the pathophysiological
changes in Raynaud’s phenomenon, has been well
known for many years "
https://www.researchgate.net/publication/8158899_Treatment_of_Raynaud’s_phenomenon_with_escitalopram
The below excerpt is interesting too. The last sentence says that the variability “may be partly explained by differences in serotonin metabolism”. https://academic.oup.com/rheumatology/article/42/4/601/1788213
FWIW after spending way too much time perusing the interwebz + consulting dr. google haha, my sense is that the serotonin activity is more likely to help the EM flaring frequency than worsen it, but you just never know. I was on a high dose cymbalta for many years prior to EM onset, and while a single antidepressant (paxil, cymbalta, effexor, zoloft, doxepin, mirtazapine) never affected it, things seem slightly better when I’m stacking mirtazapine + effexor (known to work well together).
Wow, thank you for sharing – very interesting information! No wonder EM is so difficult to treat… everyone responds differently. I see my doctor on Wednesday and plan to ask him more about my vascular symptoms.
Hi Penny good luck at your doctor’s appt today, hope he is helpful. keep us posted.
Thank you for asking. My appointment was at 3:30, I didn’t see the doctor until after 5. By then I was in a hurry to leave! He is a rheumatologist with a specialization in psoriatic arthritis, so most of our time was spent talking about that. He and the nurse practitioner both noticed that my toes were blue, and said I have Raynaud’s. I mentioned the red hot feet I get in warm temperatures and he said “you definitely have vascular issues - Raynaud’s for sure.” That was it. I forgot to ask what to do or who to see about it! 
i upped my effexor
more creepy crawlers. apparently it’s called formulation. driving me crazy
it’s ancommon symptom of lupus and fibromyalgia too. it’s aerik!
Cherry, I’m curious if the effexor helping you at all with your burning / symptoms?
I hope the “creepy crawlers” feeling ends up lessening with time.
Best wishes.
still creepy crawly! it’s driving me crazy. my hair is just about all gone too… which does nothing for my mood - think i losing it from stress/effexor or adalat
my burning has changed significantly but it’s due to the weather changing. the burning is everyday but much less severe and shorter duration.
i think i will ween off effexor. i’ve had enough of the side effects
sorry the effexor didn’t work out for you – it makes me wonder what effexor could possibly be doing to the nerves actually, if inducing creepy / crawlers is a potential side effect.
i’m switching from effexor to zoloft myself in a few weeks (I never had the creepy crawlers from it, just having a hunch that the norepinephrine is too stimulating for me).
i’m glad the weather changing is working in your favor!