# Effexor and creepy crawly

**URL:** <https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074>\
**Category:** Erythromelalgia 101\
**Created:** [March 9, 2018, 4:46pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074 "2018-03-09T16:46:35Z")\
**Posts on this page:** 12\
**Page:** 1

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**Author:** ![Cherry](https://avatars.discourse-cdn.com/v4/letter/c/da6949/32.png) [@Cherry](https://forum.livingwitherythromelalgia.org/u/Cherry)\
**Post date:** [March 9, 2018, 4:46pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/1 "2018-03-09T16:46:35Z")

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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.

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**Author:** ![standing\_cat](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@standing\_cat](https://forum.livingwitherythromelalgia.org/u/standing_cat)\
**Post date:** [March 9, 2018, 6:42pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/2 "2018-03-09T18:42:31Z")

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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.

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**Author:** ![penny](https://avatars.discourse-cdn.com/v4/letter/p/8baadc/32.png) [@penny](https://forum.livingwitherythromelalgia.org/u/penny)\
**Post date:** [March 12, 2018, 3:40am UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/3 "2018-03-12T03:40:44Z")

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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.

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**Author:** ![Cherry](https://avatars.discourse-cdn.com/v4/letter/c/da6949/32.png) [@Cherry](https://forum.livingwitherythromelalgia.org/u/Cherry)\
**Post date:** [March 12, 2018, 2:32pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/4 "2018-03-12T14:32:20Z")

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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]

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**Author:** ![standing\_cat](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@standing\_cat](https://forum.livingwitherythromelalgia.org/u/standing_cat)\
**Post date:** [March 12, 2018, 7:59pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/5 "2018-03-12T19:59:02Z")

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> **[69bf656a6036ebf2da1a69ab8b5473178762.pdf](https://pdfs.semanticscholar.org/e31a/69bf656a6036ebf2da1a69ab8b5473178762.pdf)**
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> 15.35 KB

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](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](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).

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**Author:** ![penny](https://avatars.discourse-cdn.com/v4/letter/p/8baadc/32.png) [@penny](https://forum.livingwitherythromelalgia.org/u/penny)\
**Post date:** [March 12, 2018, 9:12pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/6 "2018-03-12T21:12:54Z")

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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.

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**Author:** ![standing\_cat](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@standing\_cat](https://forum.livingwitherythromelalgia.org/u/standing_cat)\
**Post date:** [March 14, 2018, 7:56pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/7 "2018-03-14T19:56:57Z")

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Hi Penny good luck at your doctor’s appt today, hope he is helpful. keep us posted.

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**Author:** ![penny](https://avatars.discourse-cdn.com/v4/letter/p/8baadc/32.png) [@penny](https://forum.livingwitherythromelalgia.org/u/penny)\
**Post date:** [March 15, 2018, 12:31am UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/8 "2018-03-15T00:31:18Z")

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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! 😩

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**Author:** ![Cherry](https://avatars.discourse-cdn.com/v4/letter/c/da6949/32.png) [@Cherry](https://forum.livingwitherythromelalgia.org/u/Cherry)\
**Post date:** [May 20, 2018, 12:18am UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/9 "2018-05-20T00:18:29Z")

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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!

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**Author:** ![standing\_cat](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@standing\_cat](https://forum.livingwitherythromelalgia.org/u/standing_cat)\
**Post date:** [May 25, 2018, 7:27pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/10 "2018-05-25T19:27:23Z")

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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.

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**Author:** ![Cherry](https://avatars.discourse-cdn.com/v4/letter/c/da6949/32.png) [@Cherry](https://forum.livingwitherythromelalgia.org/u/Cherry)\
**Post date:** [June 2, 2018, 7:23pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/11 "2018-06-02T19:23:38Z")

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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

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**Author:** ![standing\_cat](https://avatars.discourse-cdn.com/v4/letter/s/e56c9b/32.png) [@standing\_cat](https://forum.livingwitherythromelalgia.org/u/standing_cat)\
**Post date:** [June 2, 2018, 9:24pm UTC](https://forum.livingwitherythromelalgia.org/t/effexor-and-creepy-crawly/3074/12 "2018-06-02T21:24:05Z")

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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!
