Has Effexor for Pre-Menopause Symptoms Caused These Changes in Personality?

Reader’s Question

My wife was prescribed Effexor 37.5 mg for her pre-menopause symptoms. Her doctor told her that it would be safe, and she should not experience any significant side effects. The first few months were fine, however the next few months things began to change. She started to doubt her love for me, then within the year, she suddenly proclaims she doesn’t and hasn’t been in love with me for some time.

I have read and heard stories about the “Emotional Blunting” side effects of this SNRI, and read many horror stories about how it has been responsible for ruining otherwise good relationships. I have also read about the “Aural Halucinations”. These symtoms seem to be what’s going on in our lives. Her attitude toward me, and her personallity overall, seem to be the opposite of what they were before starting the Effexor. She is a deeply spiritual, religious person, but in the last six months has turned to cursing, and generally ignores the scriptures that she once loved. Am I losing my mind here, or is there really something happening to her that she cannot control? She has always been so critical of friends and co-workers who have turned to and depended on anti-depressants.

We have now been separated for two months. She went so far as to tell me she stopped the Effexor, cold turkey, six weeks ago, but I found out, from her, that she couldn’t take the withdrawal side effects and started back again after two days. My wife has never been a liar, but these lies seem to be becoming quite easy for her. Please, any advice you have will be appreciated.

Our Consulting Clinical Psychologist’s Reply

In mental health assessment, a dramatic change in personality tells us something has happened. Regarding the medications, there are reports of antidepressant-induced hypomania (abnormally elevated mood, agitation, talkativeness, physical hyperactivity, reduced need for sleep, etc.). If this has occurred, she will likely appear hyperactive and “wired”. There are also cases of emotional blunting with some medications although her current dose of Effexor is not a high dose.

Another possibility is the presence of depression despite the use of an antidepressant medication. Your wife may have been moving into a depressive state for over a year, the small dose of Effexor only prolonging the arrival of the depression. We often seen this situation when the antidepressant medication is used as a “bandaid” treatment by a family physician or OB/GYN. Patients are placed on the antidepressant at a low dose with the hopes of helping the patient during a rough time such as menopause, post-hysterectomy, and a variety of syndromes such as “empty nest” and “mid-life crisis”. It’s very possible that her depression may be stronger than the medication and that what was viewed as “pre-menopause symptoms” were actually the early signs of a severe depression.

The description of dramatic personality change, emotional numbness, and detachment from family and her religious faith are often found in depression. The addition of possible auditory hallucinations is very important here.

If possible, I would recommend that your wife obtain a consultation with a psychiatrist. Many of her symptoms suggest changes in her neurochemistry, especially hallucinations and emotional blunting. I would also suggest that you focus on her feeling better, not going to a psychiatrist to return to the marriage. When depressed, people become fixated on issues and marriage is a common fixation — one that ruins many relationships as you mention. Our goals should be to improve and stabilize her emotional state first. When she feels better, she can then obtain a better picture of her marriage and related situations. Keep in mind she may still want to leave the relationship.