![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 925 to 949 of 10407. Go back in thread:
Posted by Iris on May 7, 2001, at 21:00:21
In reply to Re: New to Effexor, posted by RJC on May 7, 2001, at 18:13:19
> Thank's to all of you for answering me!!!
I am still very scared and I don't know if I should keep taking the pills or stop them right now.RC, are you in Therapy also or just on medication?
Does anyone know if Therapy alone helps? Iris
Posted by Michele on May 7, 2001, at 21:03:18
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 21:00:21
Iris,
I've had some few posts previous if you want to hear my detailed story.
If your uncomfortable with it.... scared, whatnot.... try another AD. There are so many out there... one's that have been around a long time that are more "trustworthy" to newcomers.I am in therapy alone and it's helped me greatly. Good luck....
Posted by Seraphim on May 7, 2001, at 22:22:16
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
> Hi,I am new to this and I was wondering if anyone could tell me how long it takes for the side effects to go away - will they at all? I started taking Effexor a week ago and I am taking 75mg a day. So far I'm having the following side effects:Trouble sleeping (I sleep for about three to four hours wake up and I'm wide awake,can't go back to sleep) plus I can't remember my dreams anymore.My jaw feels very tight with pain going into my ears.I am very! constipated :-( My arms and legs are falling asleep and I get this tingly feeling in my whole body.I constantly have sweaty palms. I did fell a little nausea for the first couple of days but that went away. I don't have much appetite. If there is someone out there who knows how long it takes for it to go away, please let me know.I am very scared taking this drug, like I said I am new to this. Thank's a lot to anyone who will answer me
For me, it took a few weeks for the side effects to start to subside. They will go away for the most part. I've read the other posts and I agree that you should really talk to your doctor about other alternatives. I don't know your whole situation, but either buspar or xanax work well for a lot of people in dealing with anxiety, and there are many others. After what I have been going through with side effects and now withdrawal (it is as bad as everyone says it is, even with help) I suggest seeking another alternative first and Effexor as a last resort. By the way, therapy has helped tremendously, but I am a true believer in that you get from therapy what you put into it. It is not always easy, but can be enlightening and powerful. I wish you well.
Seraphim
Posted by light on May 7, 2001, at 22:29:45
In reply to Re: beginning effexor xr--LIGHT, posted by Michele on May 7, 2001, at 20:36:28
hi, michele
gosh, hearing what you went through makes my problems seem like peanuts. i'm sorry that efexor worked out so badly for you. ya know, it's not a bad idea to print out some of these posts to show my doctor--especially since he literally goes and gives talks on how wonderful it is. i also clicked on a link earlier today that showed some FDA descriptions of efexor that supposedly had been recently revised to include severe withdrawal symptoms. as of right now, i am still flip-flopping. i spoke to a guy tonight who is on efexor now and hates it. he is one of those people who has taken drug after drug, and feels it's bset to just get off of everything--that the government is trying to control us, etc. etc. he doesn't seem to be thinking too straight, but that's scary, too...one thing he did suggest, though, which i plan to heed, is to start meditating and doing yoga again. those kinds of things can only help, and maybe if i try alternate avenues intensively, i won't even feel the need for "medication". we'll see. i think i'm going to go the natural way for now, but who knows what tomorrow will bring...
thanks--
light
p.s. yes, i'm in therapy, and my therapist is wonderful. two weeks ago when i saw her, and mentioned that i might want to get back on an AD, she said she was going to recommend it...(!!!!!)
Posted by RJC on May 7, 2001, at 22:32:40
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 21:00:21
Hi Iris,
I'm not in therapy.I've been seeing a psychologist every few months, but at the beginning I actually checked myself into a clinic and I was there for about a week.
I remember pacing the house all anxious and panicky knowing that something was wrong but not knowing what.
Thats when I went to the clinic for a week.I was embarressed at first but then thought bugger everyone if they think anything, and in hindsight nobody really cared anyway.They were just worried.I remember doctors saying that I'd get better and I didn't beleive them, but you do get better.
All I did was sleep and then I had 3 months off before returning to work.The tablets definately helped me but now that I'm stronger I have to get of them.
> > Thank's to all of you for answering me!!!
> I am still very scared and I don't know if I should keep taking the pills or stop them right now.
>
> RC, are you in Therapy also or just on medication?
>
> Does anyone know if Therapy alone helps? Iris
Posted by Michele on May 8, 2001, at 0:18:58
In reply to Re: beginning effexor xr--LIGHT, posted by light on May 7, 2001, at 22:29:45
Hi again,
Ya know what's funny? My therapist recommended going on Ad's also.... then after about 5 sessions she realized I didn't need it... and actually expressed that she was glad I didn't give in..... medication just isn't for anybody. Sometimes the anxiety of it... which I can tell your feeling.... makes it very rough to even work.
Probably something to definately consider... if you decide to do the effexor route... or any AD for that matter(hint,hint.... sorry)... then your valium will probably help the anxiety you'll be getting my taking them ya know? I would think.
I know what you feel like with that flip flop feeling... it's awful, and stressful.I like that you thought of meditation and yoga. I do both... I do many things that people would probably laugh at...but hey, these little things work. The two you mention, excersise, FORCING myself to hang out with friends(that one is tough when I mostly want to be alone).. and really silly things... like for instance, I write a letter to God on my computer every night. But.. no matter how strange, these things work for me.
My therapist is wonderful at giving me written exercises to figure things out about myself and my feelings. They really work. She's good. I'm glad your happy with yours.. that's very important.
Anyway.... good luck! I'll be thinking of ya, and hoping for the best, whatever you decide. Remember... there is advice.... but do what you feel is right..... drugs or no drugs. You know yourself best!
Posted by Iris on May 8, 2001, at 6:32:37
In reply to Re: New to Effexor » Iris, posted by Michele on May 7, 2001, at 21:03:18
> Michele,
yes I would like to hear details. I really do appreciate everything you guys do. Iris
Posted by SLS on May 8, 2001, at 8:18:39
In reply to Effexor: MY Conclusions, posted by kid47 on May 7, 2001, at 14:43:15
Hi Kid.
Don't worry. No sh_t coming your way. :-)> Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression.
Just a few thoughts. Some facts. No absolute advice.Some physicians would classify you as being treatment-resistant. You would indeed qualify if you have tried 7 different antidepressants, having fully explored high dosages and allowed for a clinically sufficient time period to evaluate each. You might be at a greater risk of relapse given your treatment history. If your medical history of depression is one of chronic recurrence, this risk becomes greater still. Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective. For the average person with the average depression (unipolar and not bipolar), 13 months is a reasonable amount of time to remain well on an antidepressant before stopping. In my opinion, the key phrase is "remain well". I would not count the period between initiating medication and reaching full improvement as part of this 13 months. The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months. It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
> I don't think this is a drug that should be given as a first line AD.This will be an issue of debate, as it has been the experience of many doctors that Effexor is better than any of the SSRIs. A recent study that included between 1000 and 2000 patients has recently concluded the same. Not only does Effexor get more people well, but it gets these people more well.
> I think a discontinuation strategy should be discussed with your doc before being rx'd FXR.
...or any other antidepressant, along with the possible side effects. Withdrawal phenomena and treatment-emergent side effects occur with almost ALL of the antidepressants currently available. Of course, these occurences are variable for different drugs. I don't believe that Effexor can reasonably be singled-out. Perhaps Effexor is more visible now because it is becoming more frequently chosen as the "first line" by physicians.
> I think there should be comprehensive studies on discontinuation & a protocol established for it.
I agree, both aspects of your statement are happening right now. Unfortunately, the psychiatric community has been woefully neglectful of these things.
> But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.Since 1992, Effexor (venlafaxine) has shown a tendency to be somewhat superior to the SSRIs when treating treatment-resistant depression (TRD). However, MAOIs might have a better record still.
> 13 days med free & loving it!!!
13 months - 13 days.I hope you are not superstitious. :-)
- Scott
> PS As always your mileage may vary.With the prices of gas and psychiatric care on the rise, it is probably best to move ahead with careful planning.
Posted by Irene on May 8, 2001, at 14:26:16
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
When I started Effexor 3 years ago, it took me weeks to adjust to it. I also had trouble sleeping (Trazodone at bedtime helped a lot); very dry mouth, constipation; anxiety -the tingling in extremities, waking in the early morning, sweaty palms, and nausea, low appetite (Klonopin eased the anxiety. I stopped the Klonopin after a few months when Effexor finally kicked in). All of these symptoms happen as your body adjusts to the increasing dosage. These side effects were hard for me for a few weeks and then I noticed improvement over another few more weeks. It was a couple of months before we worked out the correct dosage for me, and then it really took care of my depression. I had tried Paxil and Zoloft before finding Effexor. Every one's body is different. It might work for you, or it may not - the hard part is waiting the couple of months to find out if it's the right one.
Hang in there.
Also, I started with 37.5mg. I wonder starting at 75mg might have been too much of a jolt to your body. Tell your doctor everything. Good rapport with your doc is important.
Irene
> Hi,I am new to this and I was wondering if anyone could tell me how long it takes for the side effects to go away - will they at all? I started taking Effexor a week ago and I am taking 75mg a day. So far I'm having the following side effects:Trouble sleeping (I sleep for about three to four hours wake up and I'm wide awake,can't go back to sleep) plus I can't remember my dreams anymore.My jaw feels very tight with pain going into my ears.I am very! constipated :-( My arms and legs are falling asleep and I get this tingly feeling in my whole body.I constantly have sweaty palms. I did fell a little nausea for the first couple of days but that went away. I don't have much appetite. If there is someone out there who knows how long it takes for it to go away, please let me know.I am very scared taking this drug, like I said I am new to this. Thank's a lot to anyone who will answer me
Posted by Irene on May 8, 2001, at 14:34:02
In reply to Effexor: MY Conclusions, posted by kid47 on May 7, 2001, at 14:43:15
How long after completely coming off Effexor did you feel well again? Is your depression really over? That's such good news.
I myself weaned off last week, but started Serzone two days ago because I was still moody and had anxiety. I still wonder if it's the underlying depression I'm feeling or if I gave myself enough time after coming off the Effexor.
Irene> Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression. I don't think this is a drug that should be given as a first line AD. I think a discontinuation strategy should be discussed with your doc before being rx'd FXR. I think there should be comprehensive studies on discontinuation & a protocol established for it. But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.
>
> 13 days med free & loving it!!!
>
> PS As always your mileage may vary.
Posted by kid47 on May 8, 2001, at 14:36:13
In reply to Re: Effexor: MY Conclusions » kid47, posted by SLS on May 8, 2001, at 8:18:39
Hi Scott. Thanks for your input. Yes, unfortunately I have tried lots of psycmeds & with the exception of Celexa, which seemed to trigger a psychotic rage I gave them all at least a 6 week trial.They did little to deal with my depression & anxiety which was eventually dx'd (although I believe incorrectly) as Bipolar II. Cocktails with Lamictal, Neurontin, Topamax, etc. were introduced with little improvement. Klonopin was the only thing that made me feel better temporarily, but it seemed to aggrevate my depression if I took very much. I was concerned/ nervous about taking MAOI 's but was considering a TCA. Then about a year ago my new pdoc suggested FXR xr & I noticed improvement after about 4wks. This continued till I felt well enough to stop all psycmeds & succesfully weaned off FXR w/little or no discontinuation fx! (Prozac @20mg/day I think was the key).
I wish I could find info on how many rx's for FXR are written annually to get a better handle on the % of people who have problems with FXR. Any ideas? Also is FXR xr always what is rx'd?. I think the xr version is less likely to cause problems.
The reason I am not convinced that FXR should be a first line AD is the fact that it has the potential to effect more brain chemistry. You can make a short leap & say it also has a greater range for side fx potential. For those of us who have tried enough meds to be aware of what to expect (& are desperate enough) side fx might not be as traumatic as would be to the newly initiated. I agree that FXR has a greater potential to be more effective....than say an SSRI, but in some cases it might be considered overkill.
I am cautiously optomistic (which is quite a feat in itself) but am always ready for the other shoe to drop. I would not hesitate to resume a regimine of meds should I or my pdoc think it necessary. I was hospitalized initially when this all began at the tender young age of 46 & I do not wish to repeat that experience.
If you have read any of my pevious posts, you know I have tried to provide some balance to the very negative & sometimes hysterical anecdotes concerning FXR. I would hate to know that someone who might have been helped by FXR was disuaded from considering it after reading some of the frightening posts at PB. I have even been accused of being a drug company undercover agent.....Bond...Kid Bond...lol
Once again I appreciate your response. I have found you to be one of the very knowledgable & considerate posters on this list & I always read your comments.
I hope you are having success with your treatment. Take care.
14 (whew!! I am a little superstitious) days Med free & still pretty dogone happy about it.
Kid
> Hi Kid.
>
>
> Don't worry. No sh_t coming your way. :-)
>
> > Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression.
>
>
> Just a few thoughts. Some facts. No absolute advice.
>
> Some physicians would classify you as being treatment-resistant. You would indeed qualify if you have tried 7 different antidepressants, having fully explored high dosages and allowed for a clinically sufficient time period to evaluate each. You might be at a greater risk of relapse given your treatment history. If your medical history of depression is one of chronic recurrence, this risk becomes greater still. Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective. For the average person with the average depression (unipolar and not bipolar), 13 months is a reasonable amount of time to remain well on an antidepressant before stopping. In my opinion, the key phrase is "remain well". I would not count the period between initiating medication and reaching full improvement as part of this 13 months. The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months. It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
>
>
> > I don't think this is a drug that should be given as a first line AD.
>
> This will be an issue of debate, as it has been the experience of many doctors that Effexor is better than any of the SSRIs. A recent study that included between 1000 and 2000 patients has recently concluded the same. Not only does Effexor get more people well, but it gets these people more well.
>
> > I think a discontinuation strategy should be discussed with your doc before being rx'd FXR.
>
> ...or any other antidepressant, along with the possible side effects. Withdrawal phenomena and treatment-emergent side effects occur with almost ALL of the antidepressants currently available. Of course, these occurences are variable for different drugs. I don't believe that Effexor can reasonably be singled-out. Perhaps Effexor is more visible now because it is becoming more frequently chosen as the "first line" by physicians.
>
> > I think there should be comprehensive studies on discontinuation & a protocol established for it.
>
> I agree, both aspects of your statement are happening right now. Unfortunately, the psychiatric community has been woefully neglectful of these things.
>
>
> > But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.
>
> Since 1992, Effexor (venlafaxine) has shown a tendency to be somewhat superior to the SSRIs when treating treatment-resistant depression (TRD). However, MAOIs might have a better record still.
>
> > 13 days med free & loving it!!!
>
>
> 13 months - 13 days.
>
> I hope you are not superstitious. :-)
>
>
> - Scott
>
>
> > PS As always your mileage may vary.
>
> With the prices of gas and psychiatric care on the rise, it is probably best to move ahead with careful planning.
Posted by Irene on May 8, 2001, at 15:19:20
In reply to Re: Effexor: MY Conclusions » kid47, posted by SLS on May 8, 2001, at 8:18:39
Scott, I read your post with much interest.
>Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective.
Do you know why returning to a previously effective drug is often unsuccessful?
>The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months.
I'm not clear on the above. Do you mean that if one feels well after stopping a drug, and if he/she is going to relapse, it most likely would happen within 4 months of stopping previous medication?
>It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
Now I'm concerned. Every time I decreased from 225 to 150; 150 to 75; 75 to 37, I always got well again after a few weeks of 'yuckiness', therefore believing my depressive episode was over - that my body was able to muster up the serotonin after all. I had no relief, however, decreasing from 37 downward. Does that mean that the 2 months of yuckiness I felt then meant it was the real depression and I should have gone back to increasing Effexor instead of waiting that long? and therefore Effexor will no longer be effective for me in the future? That would be awful, because Effexor worked wonderfully for me.
confused, Irene
PS, are you in medical field, or are you speaking from personal experience only?
Posted by kid47 on May 8, 2001, at 15:19:52
In reply to Re: Effexor: MY Conclusions, posted by Irene on May 8, 2001, at 14:34:02
Hi Irene.
> How long after completely coming off Effexor did you feel well again?
Actually after about 11 mos, on FXR I began to feel "normal." When I realized this was not a fluke (or hypomania) I decided to wean off FXR. I started slooowly tapering my dose over about 7wks. & have continued to feel pretty good. This is day 14 med free so keep your fingers crossed!!!>Is your depression really over? That's such good news.
God I hope so!!!!! I also am aware it could return but trying to be optomistic.
> I myself weaned off last week, but started Serzone two days ago because I was still moody and had anxiety. I still wonder if it's the underlying depression I'm feeling or if I gave myself enough time after coming off the Effexor.
> IreneGood question. I'm curious....how long were you on FXR. What dose. Why did you stop taking it?
As you probably know It could take at least 6 weeks before you notice any improvement from the Serezone. In my case Serezone helped my anxiety but did little for my depression. It did make me very sleepy. But as u know everyone is different in their response to meds. Because of FXR's short half life & the time it might take for the Serezone to work you might be suffering from both a recurrence of depression & some discontinuation fx from the FXR. Geez....it's never easy is it. At any rate if you still feel lousy after a bit be sure & ask your doc about it. Good luck!! Take care
Posted by mstar on May 8, 2001, at 15:38:54
In reply to Re: Effexor: MY Conclusions » Irene, posted by kid47 on May 8, 2001, at 15:19:52
I take very few over the counter medications but I have a terrible back ache and I need to take some ibuprofen. I took 600 mg this morning (with food) and then 2 hours later my 150 mg effexor (again with food, I hate that eating thing, it's such an annoyance ;). I got several effects, an upset stomach, hot flashes and sweating and fatigue.
Has anyone else had problems when they've taken over the counter drugs and Effexor XR?
Ms
Posted by Irene on May 8, 2001, at 15:43:18
In reply to Re: Effexor: MY Conclusions » Irene, posted by kid47 on May 8, 2001, at 15:19:52
kid47,
I took Effexor for anxiety and clinical depression for 3 years (varying between 187.5 - 225 mg.), the last 9 months of which I finally had no depressive symtoms at all. Prior to that I had mild lows and fatigue here and there. But when I finally was truly well for 9 months straight, my doc and I decided to see if the depressive episode might be over, and began the tapering process 5 months ago.
Wow, your 7 weeks seems short to me! My doc wanted me to take a month with each step decrease to make sure I feel well for a while before doing another decrease.
What dosage were you at on Effexor, and Serzone? you mentioned you were being treated for anxiety and clinical depression. Was it that alone, or was there menopause, etc involved (sorry, I don't know your age).
Irene> Hi Irene.
>
> > How long after completely coming off Effexor did you feel well again?
>
> Actually after about 11 mos, on FXR I began to feel "normal." When I realized this was not a fluke (or hypomania) I decided to wean off FXR. I started slooowly tapering my dose over about 7wks. & have continued to feel pretty good. This is day 14 med free so keep your fingers crossed!!!
>
> >Is your depression really over? That's such good news.
>
> God I hope so!!!!! I also am aware it could return but trying to be optomistic.
>
>
> > I myself weaned off last week, but started Serzone two days ago because I was still moody and had anxiety. I still wonder if it's the underlying depression I'm feeling or if I gave myself enough time after coming off the Effexor.
> > Irene
>
> Good question. I'm curious....how long were you on FXR. What dose. Why did you stop taking it?
> As you probably know It could take at least 6 weeks before you notice any improvement from the Serezone. In my case Serezone helped my anxiety but did little for my depression. It did make me very sleepy. But as u know everyone is different in their response to meds. Because of FXR's short half life & the time it might take for the Serezone to work you might be suffering from both a recurrence of depression & some discontinuation fx from the FXR. Geez....it's never easy is it. At any rate if you still feel lousy after a bit be sure & ask your doc about it. Good luck!! Take care
Posted by Irene on May 8, 2001, at 15:50:09
In reply to Effexor and advil?, posted by mstar on May 8, 2001, at 15:38:54
MS,
I experienced tinnitus, heart palpitations, hot flashes when I took Advil a long time ago when I was on Effexor. I called my doctor, and she said ibuprofen can do that, as well as antihistamines. Therefore, she recommended Tylenol for pain relief, and nasal spray for colds. I have since then taken some Advil once in a while (lower than 600 mg, though) because Advil works better than Tylenol for me.
Irene> I take very few over the counter medications but I have a terrible back ache and I need to take some ibuprofen. I took 600 mg this morning (with food) and then 2 hours later my 150 mg effexor (again with food, I hate that eating thing, it's such an annoyance ;). I got several effects, an upset stomach, hot flashes and sweating and fatigue.
>
> Has anyone else had problems when they've taken over the counter drugs and Effexor XR?
>
> Ms
Posted by mstar on May 8, 2001, at 16:11:31
In reply to Re: Effexor and advil?, posted by Irene on May 8, 2001, at 15:50:09
that's good to know, thanks. I always take Ibuprofen because my pain is always muscles (although I avoid taking it when I can). Did your doctor say why?
Posted by kid47 on May 8, 2001, at 17:03:31
In reply to Re: Effexor: MY Conclusions, posted by Irene on May 8, 2001, at 15:43:18
Hi Irene. I was taking 300mg/day of FXR xr. I think my adding Prozac 20mg/day helped me avoid discontinuation problems as I weaned of FXR. I think too I am lucky to not be as med sensitive as some. If I had felt uncomfortable I definately would of stayed at a particular dose longer or even titrated back up(I'm really a wimp). Along with the FXR I was taking 3200mg Neurontin 100 mg. Topamax& Klonopin as needed. My dx is Bipolar II. I am not conviced that is accurate but as long as it can be successfuly treated I don't care what the heck they call it. My max dosage on Serezone was 400mg in the pm. Even though I'm 48 I don't think menopause is a factor mainly because I am male. LOL. (Although my wife says I exhibit many of the symptoms) Male menopause?
Scott is correct (as always) about certain drugs sometimes not being effective the 2nd time around. The up side is sometimes a drug you have tried unsuccessfully in the past might work the 2nd time. But most of us don't retry a med that didn't work initially.
If you didn't have intolerable side fx with FXR & your mood does not improve after an adequate trial with Serezone u might want to chat with your doc about starting back on FXR. Hope this helps. Take care.
> I took Effexor for anxiety and clinical depression for 3 years (varying between 187.5 - 225 mg.), the last 9 months of which I finally had no depressive symtoms at all. Prior to that I had mild lows and fatigue here and there. But when I finally was truly well for 9 months straight, my doc and I decided to see if the depressive episode might be over, and began the tapering process 5 months ago.
> Wow, your 7 weeks seems short to me! My doc wanted me to take a month with each step decrease to make sure I feel well for a while before doing another decrease.
> What dosage were you at on Effexor, and Serzone? you mentioned you were being treated for anxiety and clinical depression. Was it that alone, or was there menopause, etc involved (sorry, I don't know your age).
> Irene
Posted by Irene on May 9, 2001, at 11:25:04
In reply to Re: Effexor and advil?, posted by mstar on May 8, 2001, at 16:11:31
Sorry, I didn't bother asking what kind of drug interaction happens on the chemical level when those are taken together.
Irene> that's good to know, thanks. I always take Ibuprofen because my pain is always muscles (although I avoid taking it when I can). Did your doctor say why?
Posted by SLS on May 9, 2001, at 18:01:31
In reply to Re: Effexor: MY Conclusions, posted by Irene on May 8, 2001, at 15:19:20
Hi Irene.
> >Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective.
> Do you know why returning to a previously effective drug is often unsuccessful?
No.
I might be tempted to try to create the "hypothesis of the day", except that it would give the false impression that the brain is so readily understandable. That is not to say that the workings of the brain are still the total mystery that they were only a few decades ago. However, far less is known than unknown, and even less is understood. What is known is that the brain, like many other components of our biology, can and does change in response to varying stimuli. When a drug is introduced to the brain for the first time, it reacts strongly to it. It is said to be "naive" to that particular drug. As time progresses, the brain and its neurons make adjustments in an effort to compensate for these new forces. They try to function in the way they think they are supposed to instead of in the way they are being forced to. Neuroscience has observed that some of these compensatory changes involve the numbers and "stickiness" of neuron receptors, increases or decreases in the amount of neurotransmitters, and the excitability of the neuron to receive and send messages.
When some drugs are discontinued, the brain does not return exactly to the same state it was prior to their introduction. I guess this can be a good thing if some of the changes produced means that it is "holding" the remission of depression. However, if the need arises for the reintroduction of the same drug, it is not encountering the same brain. There are residual changes to the brain that have been produced by its previous exposure to it. These changes may persist for years. The brain is no longer naive it, and might not react to it in the same way or as strongly. I guess you could say that the brain is less likely to be fooled by the same magic trick.
> >The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months.
> I'm not clear on the above. Do you mean that if one feels well after stopping a drug, and if he/she is going to relapse, it most likely would happen within 4 months of stopping previous medication?
Yes. Exactly.
> >It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
> Now I'm concerned. Every time I decreased from 225 to 150; 150 to 75; 75 to 37, I always got well again after a few weeks of 'yuckiness', therefore believing my depressive episode was over - that my body was able to muster up the serotonin after all. I had no relief, however, decreasing from 37 downward. Does that mean that the 2 months of yuckiness I felt then meant it was the real depression and I should have gone back to increasing Effexor instead of waiting that long? and therefore Effexor will no longer be effective for me in the future? That would be awful, because Effexor worked wonderfully for me.
I really don't think you placed yourself in a position of risk to qualify for the scenario I described above because you have not stopped taking Effexor completely nor for very long. If you and your doctor have become convinced that you need to continue treatment, everything should be peachy-keen once you return to your optimal therapeutic dosage.
Something that was mentioned by a smart person whose name I don't recall was that one must be careful not to confuse the withdrawal effects of drug discontinuation with the return of depression. I find that some drugs can exert a stimulatory or activating effect. As the drug is withdrawn, there might be a sort of stimulant let-down and fatigue with each reduction of dosage. I get the impression that the dopamine effects of Effexor are underestimated, and that such a let-down upon its discontinuation is possible.
If you are indeed relapsing into depression, raising the dosage of Effexor again will do the trick. Don't worry. :-)
> PS, are you in medical field, or are you speaking from personal experience only?
I consider myself as being in the medical field in so far as it is the field where the doctors are playing their football game. I'm only the ball.
- Scott
Posted by mvaureen on May 9, 2001, at 23:52:47
In reply to Re:Intractable Effexor Withdrawl , posted by wiley on September 2, 2000, at 19:22:01
Thanks to all of you who have submitted to this thread, I did not go to the emergency room today. I tapered the dosage, as instructed by my doctor, as I began to take Wellbutrin [I am up to 300 mgs of that]. Sunday, three days ago, I finished my last of the 37.5 mg doses of Effexor. Initially, the Wellbutrin made the trip down on Effexor easier. However, by last week I could hardly notice it working at all. I do believe that I could never have made it down to 37.5 mgs without it, though. I'm not sure that my doctor is up to date on the use of Zoloft or Prozac to assist tapering off of Effexor. My deeply traumatic depression of three years ago is still gone, even though I am experiencing ghastly withdrawal symptoms and have since two days ago when I had been off of Effexor for one day. Oddly, it is only after vomitting that the shock sensations and brain shivers are lessened to a tolerable level. While grateful that I am not in the mental and emotional state I was three years ago when I began Effexor, I had by this year developed an extraordinary lack of motivation, a need for 10-12 hours of sleep per day, a massive weight gain, and a general lethargy. I decided that the drug had sedated me too much for too long. Gone was the depression, but along came the stupor I lived in for two years. I knew that the symptoms of withdrawal were frightening and horrific, as I had missed a few doses over the last few years. I did not know, however, that without the last level of 37.5 mgs in my system, I would experience the symptoms you all have described here. My goal is to find an account of someone who has reported no withdrawal symptoms and find out how long it took for them to reach that state. If any of you know of someone like this, please post it. Like I said, I almost went to the ER tonight because I thought that I might die. Your notes helped me to realize that this might [I hope] be temporary. I have no doses of Effexor left. Strangely, I have no cravings for the drug itself -- only a desperate wish for this agony of withdrawal to be over. Much thanks, Maureen
Posted by kid47 on May 10, 2001, at 9:32:14
In reply to Re:Intractable Effexor Withdrawl , posted by mvaureen on May 9, 2001, at 23:52:47
Hi. Sorry you're having such trouble. Re: Successfull FXR discontinuation. See just about any Kid 47 posts.
Hope this helps. Take care
> Thanks to all of you who have submitted to this thread, I did not go to the emergency room today. I tapered the dosage, as instructed by my doctor, as I began to take Wellbutrin [I am up to 300 mgs of that]. Sunday, three days ago, I finished my last of the 37.5 mg doses of Effexor. Initially, the Wellbutrin made the trip down on Effexor easier. However, by last week I could hardly notice it working at all. I do believe that I could never have made it down to 37.5 mgs without it, though. I'm not sure that my doctor is up to date on the use of Zoloft or Prozac to assist tapering off of Effexor. My deeply traumatic depression of three years ago is still gone, even though I am experiencing ghastly withdrawal symptoms and have since two days ago when I had been off of Effexor for one day. Oddly, it is only after vomitting that the shock sensations and brain shivers are lessened to a tolerable level. While grateful that I am not in the mental and emotional state I was three years ago when I began Effexor, I had by this year developed an extraordinary lack of motivation, a need for 10-12 hours of sleep per day, a massive weight gain, and a general lethargy. I decided that the drug had sedated me too much for too long. Gone was the depression, but along came the stupor I lived in for two years. I knew that the symptoms of withdrawal were frightening and horrific, as I had missed a few doses over the last few years. I did not know, however, that without the last level of 37.5 mgs in my system, I would experience the symptoms you all have described here. My goal is to find an account of someone who has reported no withdrawal symptoms and find out how long it took for them to reach that state. If any of you know of someone like this, please post it. Like I said, I almost went to the ER tonight because I thought that I might die. Your notes helped me to realize that this might [I hope] be temporary. I have no doses of Effexor left. Strangely, I have no cravings for the drug itself -- only a desperate wish for this agony of withdrawal to be over. Much thanks, Maureen
Posted by mvaureen on May 10, 2001, at 10:10:33
In reply to Re:Intractable Effexor Withdrawl » mvaureen, posted by kid47 on May 10, 2001, at 9:32:14
Thanks, kid. I realize that the withdrawal symptoms were probably at their most severe yesterday [the third day]. I will not take it now! Reading more of what you and others posted, I must remember to state that I was what I thought was irretrievably depressed before Effexor. So, to those who wonder if the drug itself works -- it does. While I do not like the side effects, I must say it probably saved my life. No one who is as depressed as most patients who start Effexor should attempt simply a chemical recovery, in my opinion. My therapist changed my life dramatically for the better. I read last night that at least one user of Effexor among other drugs concludes that Effexor should be the choice as a last, not first, strike against the chemical imbalance associated with depression. I think my doctor assumed I knew how bad these withdrawal symptoms can be. Anyway, I have had to take a few days off at work. This is not the most pleasant vacation, but I realize that Effexor is a strong measure and thus is given to a strong effect during stoppage. Thanks again! Maureen
Posted by battygoth on May 10, 2001, at 17:49:24
In reply to Re: New to Effexor, posted by mtm on May 7, 2001, at 13:34:11
Seems that different people have different side effects, and oddly enough sometimes they are opposites. Really makes you wonder. Anyway, I am also new to Effexor. I have been on it 2 wks and 3 days. It is recommended to wean into this drug as well as out so I started at only 37.5mg for the first week. I felt nothing happen at this dose. Then I started the 75mg. Still no change for about another week. But the last 3 days have been hell. I have absolutely no improvement in anxiety and if anything, I'm worse. I was given this for anxiety, not depression, but I think it is making me depressed! I cannot get out of bed in the morning and I have trouble staying awake once I finally do. I have missed 2 days of private computer school which costs thousands of dollars and I cannot go on like this. I could hardly fix myself breakfast this morning and was so tired that I had to eat it in bed, put the plate down beside my bed and go back to sleep for 4 hrs. I think it is like what someone else wrote on a post I came across that was from last year. Someone mentioned having more dreams and having more vivid dreams. I have noticed past couple of days also that I am having upsetting dreams and that I am waking up in the middle of this dream stage and I think that when the brain is disturbed during this dream stage of sleep you end up feeling exhausted and not well rested and I think that is why I keep going back to sleep including sleeping for several hours in the afternoon the past few days. I took this drug with positive expectations and did not look at possible side effects so that my interpretations of how I felt would not be biased. I only started to look up possible side effects of sleepiness after I noticed this change in myself. I am really disappointed that this drug is not working out for me. I am afraid to even try other meds as I will have no idea what negative effects they will have on me and I cannot afford to miss more days of school. I injured my back and my leg from competing in bicycle racing while having scoliosis. I have permanent damage and am in chronic pain for which I am prescribed pain meds. The FXR was given to me by the pain clinic I go to. I have been unable to ride a bicycle for about 4 years and it was my whole life, it was everything to me. Now with this FXR I am having vivid dreams of trying to ride a bike again and it is immensely disturbing and upsetting. Anyone else experiencing side effects of vivid and upsetting dreams and inability to stay awake feel free to contact me at intheflatfields@hotmail.com .
Posted by Craftnkidz on May 11, 2001, at 8:32:10
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
I have been taking Effexor for about 1 year. I have been experiencing my hands shaking so badly that I can hardly hold onto things and when I go to pick something up I often knock it over. I am a painter and this just can't go on any longer. Effexor seems to be working fine if I stay on 300mg daily. I do not drink any caffeine, and I lead a pretty dull life. I have tried to come down on my mg. but my depression and fatigue get worse as my shakes get better. Help! I need the medication but it is putting a damper on my work. I also experience extreeme vertigo with the lower doses, it is too much to walk at times.
Any suggestions would be appreciated.
Thanks
Angela
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.