Altruist replied: "These are questions only your Dr. can answer properly, however, if I were in your shoes, I would do some research on the different meds available for what you're experiencing. There are mainly 3 neurotransmitters involved in treating depression, where one of the three needs to be regulated about 80% of the time to fix you. They are neuropinephrine, dopamine and serotonin. Effexor is a multiple reuptake inhibitor, which effects the reuptake of two neurotransmitters, namely dopamine and neuropinephrine. At this point, if it's not making you feel better after 10 months 1) You're not targeting the right neurotransmitter (you may need to switch to a serotonin reuptake inhibitor like lexepro) or 2) The reuptake in Effexor is not working for you, which is not uncommon and you may need to switch to another MRI like Cymbalta or Wellbutrin. The constant fatigue is a normal side effect for Effexor, however, you should get past it in 2 weeks to a month. If it's come back 10 months into taking it, chances are it stopped working. Again, this is common for reuptake inhibitors. From what I've researched, Effexor is the hardest antidpressant to get off of. 75mg is a very small dosage, where you can take up to 375mg/day. It may be a good idea to quit now and try something else. The discontinuation dosage is 35mg per week; so if you increase the dosage and it still doesn't work, it will take you longer to get off of it. However, you may need a stronger dose, based on what you discussed, but that is for you and your Dr. to decide. These are just all theories, based on some research I've done on antidepressants - I always research drugs before I take them, based on my diagnosis. At this point, you haven't described your diagnosis, aside from depression and anxiety. In most cases a simple SSRI combined with a theraputic does of a benzodiazepine (Ativan, Xanax, Klonopin) usually do the trick. If you have Unipolar/Bipolar, schitzoafective, BPD, it's a whole nother ball game. I hope this helps and good luck."

I_Love_McRedneck replied: "I think sometimes that happens. I take Cymbalta, but when I upped my dose to help with anxiety, it made things worse. Call your doc and see what he suggests but it's possible that you need to lower your dose."