does leflunomide affect my antidepressant, venlafaxine?

[hazmatrec]

hello! i have just started a prescription of leflunomide two weeks and two days ago. i take a serotonin-norepinephrine reuptake inhibitor (snri) as well, that I've been on for... six years? and been very happy with. three days after starting leflunomide, i started getting similar symptoms to seratonin medicine withdrawal, that I've gotten before when reducing or changing antidepressant medication. i call it the zaps. i get them with my current venlafaxine medicine if I'm more than three hours late taking the tablets. but I've been fastidious about timing and water since i started zapping.

has anyone else had (anecdotal, i know) change in absorbing their antidepressant, or even their venlafaxine? I've got the rheumy hotline number I'm going to ring, but thought I'd ask people actually taking the stuff! 😁

thank ye

cath

[Bakerannie]

I'm sorry, I don't have experience with either drug, although your description of "zaps" was astonishing. I was in hospital many years ago for weeks and weeks, and on heavy painkillers, and when I went home the medications were cut down very quickly. I would get a zing or zap every time I turned my head quickly, and it went on for several weeks if I remember. Drove me absolutely bonkers, and no one would listen or believe me, they just stared at me blankly. The zaps were worse than the whole hospitalization, and I think I was clinically depressed for some time because of it. Thank you for acknowledging that this is actually a very real condition. All the best to you as you sort your meds.

[hazmatrec in reply to Bakerannie]

oh, they are so real. so debilitating. they make me not want to change medicine ever, now i change real slow in avoidance. i don't know why i get em so quick. I'm so sorry you had them and were disbelieved.we aren't alone with the zaps. this article talks about antidepressants (psychiatrist.com/news/study..., but i also take tramadol and codeine for pain and changing those medicines will set off zaps too.

thank you for your good wishes! ⚡

😌

[ruth_p]

I didn’t find any difference to my antidepressant medication when I was on leflunomide but I wasn’t on venlafaxine but mirtazapine. My husband is on venlafaxine and he gets the zaps when he misses a dose. It does sound like a good correlation between starting the lef and the zaps starting. Have you looked online for drug interactions? Definitely ring the rheumatology helpline because it’s no good if it is stopping the venlafaxine uptake.

[hazmatrec in reply to ruth_p]

hello! i did look online for interactions, and didn't find anything direct. one of the frequent side effects of the leflunomide is suggested as changes in bowel habits. I've already got whacked out digestion with strange results, and haven't noticed a particularly out of range change, but it's possible there is an absorption issue? any way, time to call the hotline. I'm disregulated enough! i hope hope hope it's temporary, because the better i "feel" the better I'll feel, ya know? i would like the leflunomide to be worth it. 🤞

[Susie-Q]

Hi I have been on both these meds at the same time a few years ago and do not recall any problems. The zaps are definitely real though 😂

[hazmatrec in reply to Susie-Q]

so real. there's a short story by Kurt Vonnegut, Jr called Harrison Bergeron. the premise is "nobody was smarter than anybody else. Nobody was better looking than anybody else. Nobody was stronger or quicker than anybody else." because every skill or quality was dampened down somehow. George, one of the main characters, had innate intelligence that was higher than was acceptable. he was fitted with a radio earpiece. "Every twenty seconds or so, the transmitter would send out some sharp noise to keep people like George from taking unfair advantage of their brains." it made me think of the zaps sooo much.

[tyncwmmarchhywel in reply to Susie-Q]

Hi Susie, short explanation as to what zaps are. Thank you

[Susie-Q in reply to tyncwmmarchhywel]

Hi good question 😊 Zaps are really difficult to explain to someone who has never had them. I have been on Venlafaxine for over 20 years and when I first started it the zaps were daily occurrence. They would occur a couple of hours after I took this drug. It’s basically as if an electric shock “zaps” you. At first it happened on my head around the temple areas. Years later it was in my arms and occasionally my torso. It can actually give you a real jolt - like someone has tasered you for a couple of seconds (not that I know what that feels like). These days hardly ever happens thank goodness. I did forget to take them one day though and the zaps returned with a vengeance! Won’t try that again 😂 If anyone else can explain this better than I perhaps have, please join in. It’s a tricky sensation to explain. Thanks 😊

[hazmatrec in reply to Susie-Q]

i have tried to describe it before as one second or so of this picture from the old joy buzzer advertisement. it also has the feeling to me of licking a nine-volt battery but stronger, and running in a wave, or a guess current, usually brain outward, for me.

not painful, but muscle twitching, unexpected, distracting, noisy... makes me dizzy sometimes when they come fast together.

two men shaking hands: 1 laughs, the other shows signs of electrocution from a joy buzzer

[tyncwmmarchhywel in reply to Susie-Q]

Thank you

[mld78]

I stopped venlafaxine a few years ago. However I used to suffer zaps when I took various medications and had to be careful. But I took leflunomide for 29 days and have suffered terrible itching. I’m now on a medication to wash out the leflunomide! A hospital pharmacist may be the person to talk to. They were really helpful to me as they had understanding about interaction of drugs that the various consultants were ignorant of!!

[hazmatrec in reply to mld78]

ooh, sorry about the itching! nothing so far for me to precipitate a washout, but also no therapeutic effect yet. patience, young padawan. yeah, about lost all mine. breathing, breathing... so much ow!

[hazmatrec in reply to mld78]

thank you for the tip. I'm back near the hospital for physio on Wednesday, maybe can pop in. trudge in.