Posted by Elroy on May 6, 2006, at 12:22:45
In reply to Re: OK now I am afraid, posted by Bonnie_CA on May 6, 2006, at 0:45:01
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> > Don't be scared off by the horror stories. Keep in mind that there are also plenty of people who have come off of Effexor without incident, but you don't hear about those people. Don't let this kind of stuff hold you back from a possibly effective treatment.
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> You know, I wish those people would post. I'm on Effexor for GAD, so I read the horror stories and I get freaked out.
Bonnie-CAI had NO problem coming off of Effexor. But then I was only on it for about a week. I too was / am suffering from GAD when I was put on Effexor. Not only did I develop fairly immediate "prostatitis like symptoms" that were very painful (one of the male side effects less heard about), but my anxiety levels went through the roof. By the end of the week it was unbearable. So I was taken off of it and put back on Xanax XR (1mg daily). Which helped a light amount.
A few months later I was then put on Cymbalta. Being very similar to EDffexor, I had the SAME reactions - it just took about 3 weeks too become unbearable instead of 1 week. Then back to Xanax XR only dose increased to 1 mg twice a day. (Which helped a bit more but still didn't seem to deal with the background anxiety completely - nor do hardly anything for the periodic spikes of sharp anxiety).
I was then at NIH Hospital for 2 weeks of testing in December (this last year) and part of my "Team" of doctors including a couple of psychiatrists.
They absolutely could not believe that there are doctors out there prescribing SSNRIs like Effexor and Cymbalta for any type of anxiety disorder. Both increase the circulating levels of norepinephrine and higher NE translates into higher anxiety levels. Even if your NE leves are tested at low, that low level is what your body / brain has adjusted to and "boosting" those levels causes severe anxiety.
They weren't even too enthusiastic about using SSRIs in anxiety situations, though they did say that certain ones did help mildly in certain types of anxiety.
Their medication of choice with most anxiety situations was Benzos. They specifically felt that for my condition that I was " severely under medicated" and recommended that my daily dosage be increased to 4 mg daily and then 6 mg daily. They also found out at NIH that my P450 enzymatic system - which metabolizes many things, including Xanax - was very much more efficient than the norm and as a result I was excreting the Xanax XR out of my bloodstream quicker than normal, so recommended that I go to 2 mg of Xanax XR three times a day. So far, my background anxiety is completely gone about 90% of the time and my "spikes" of severe anxiety are not only much less severe, but less shorter time periods and are further apart.
The theory expressed by NIH is that my anxiety is caused by my HPA Axis being hyperactive and dysfunctional (not reading feedbackl that I have plenty of cortisol so sending signals to produce more cortisol - and in a vicious cycle, the elevated cortisol levels cause increased anxiety which further hypers the HPA Axis). By being medicated at appropriate dosage levels, it should (hopefully) allow the HPA Axis a chance to rest and then re-set itself so cortisol secretions return to normal. Once we're sure that has happened and there has been no more anxiety, then we startt tapering off the Xanax XR. They were adamant if mental or physical symptoms of anxiety return that those are NOT withdrawal symptoms, it's just a sign that you're still not ready to come off of the Xanax XR. If you are ready to come off the Xanax (i.e., the anxiety is all gone), then the withdrawl will go smoothly. In fact, they felt that a good 50% of individuals taking even higher level therapeutic levels of Xanax can stop "cold turkey" and experience not one bit of withdrawal.
In fact, one of the psych docs specially mentioned at one point that she has patients who have much, much moer problems withdrawing from Effexor than she ever has had with withdrawing from Xanax.
So much for the horror story myths about Benzo withdrawals (where one thinks that anyone who ever took even the smallest dose of a Benzo has become an addict for life and will go through hellish withdrawal... maybe those rumors were started by Pharmaceutical company salesmen back when they first started pushing Prozac and other anti-depressants as also being good for anxiety!).
Elroy
poster:Elroy
thread:13781
URL: http://www.dr-bob.org/babble/20060504/msgs/640599.html