![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6199 to 6223 of 10407. Go back in thread:
Posted by zinya on January 27, 2004, at 14:49:36
In reply to Re: Anyone had success on Effexor XR?, posted by meds4life on January 27, 2004, at 14:33:45
Greetings, all!
I've been completely offline lately, which has been -- thank goodness -- a *good* sign. I've had a recovery of energy which -- get this -- was triggered by an antibiotic i had to take for a dreadful flu back at NY Eve time... There's a whole theory now about this which i THINK i wrote about here a couple of weeks ago -- about yin and yang -- and made me realize that maybe, given my own 15 yr history of being "restored" each time i had to take an antibiotic and suddenly having an energy level i'd been craving for months if not years ... that i once again posed this query and my chiropractic/guru who knows both eastern and western medicine too knew to tell me that antibiotics are a 'yang' phenom ... and i already know i have an almost exclusively 'yin' body -- super low body temps, low b.p., cold hands and feet, and more ... anyway, i'm now adding ginseng to my daily repertoire since the end of the antibiotic (bactrim) since ginseng is a 'yang' phenom too (i'm using the real thing, not packaged 'tea' packets, to brew into a daily drink)
anyway, meanwhile, i've returned to an active "life" (LIFE!!! imagine!!! it feels like a dream!) and am almost never even able now to keep up with some of the e-mailing and posting i wish i could also still do,... and never forgetting what a lifesaver this place was in its hour of need for me...
anyway, here's an article that appeared Sunday a.m. and , as an example, i was going to post it right then ... and it's only taken me 48 hrs to do so ... but for a change, that isn't becuz i was too depressed to follow thru but rather cuz i was too active! ... [but not manic either, just active -- minor miracle here ... and from current point of view, for me at least, the A-D route was a digression which for me wound up being more of a "ruling out" cuz at this point i don't think effexor honestly made any positive contribution ... BUT, nothing ventured, nothing gained...
wishing you ALL well...
warmly,
zinyaTruth: a Bitter Pill for Drug Makers
Greg Critser
January 25, 2004
LA TimesGreg Critser is the author of the forthcoming "One Nation Under Pills" and "Fat Land: How Americans Became the Fattest People in the World," recently out in paperback.
Next month, an advisory committee of the Food and Drug Administration will meet to discuss what might arguably be the most tendentious issue in modern psycho-pharmacology: the use of antidepressants to treat childhood and teen depression and the drugs' possible role in teen suicide. This comes on the heels of Britain having banned the prescribing of Paxil for children under 18 and advising against most other commonly prescribed antidepressants for that age group.
But the FDA should really be debating bigger issues, including the role these drugs have come to play in society, and the ways the drug companies have distorted the truth about their products.
The current crop of antidepressants, mostly selective serotonin reuptake inhibitors, or SSRIs, have become, in a sense, cultural products as well as medical products. We have embraced them as a society, yet we are intensely conflicted about them. They are not just pills but stories we tell ourselves about how we should feel and how life should be lived — pills as movies if you will. This may well be the reason we have such mixed feelings about antidepressants: We simply don't know how to assess them objectively, independent from the tales we have told ourselves.
One reason for that is the speed with which these drugs were launched out of the corporate womb and into the patient population. In the old days, before medicines were marketed directly to consumers, prescription drugs took years to gain a foothold and hence become profitable. Doctors stuck to the tried and true and were slow to embrace new drugs. But after Congress passed a law in the 1980s making generic drugs easier to get, brand-name companies had to become entrepreneurial; they realized they could no longer afford long waits for profitability.
This change led directly to a whole new marketing strategy at the big pharmaceutical companies: Rather than marketing to the relatively small pool of potential prescribers with psychiatric training, they cast a wider net: focusing on building demand among general practitioners — and later, more directly, among patients themselves. To help general practitioners unfamiliar with antidepressants explain the drugs to their patients, the manufacturers created easily understood stories, maintaining that SSRIs, such as Prozac (made by Lilly), Paxil (GlaxoSmithKline) and Zoloft (Pfizer), were not like the previous generations of psych meds. They were not uppers or downers or tranquilizers that turned patients into zombies but more sophisticated compounds that simply reestablished our "natural" neurotransmitter balance. It was a powerful message to a generation of patients inclined toward the natural.
The balance story is not exactly a lie, but it's not exactly the truth, either. When pushed, in a lawsuit against his company, Alan Metz, vice president for clinical development at Glaxo, admitted in court papers, "It's not possible really to measure total serotonin." He added that "we do not know with absolute certainty about how any of the antidepressants work." If the drug companies can't really measure what normal serotonin levels are, and they don't know really how the drugs work, then how can we say they restore balance?
A more accurate version of the message would be this: Varying levels of various neurotransmitters, including serotonin, are associated with varying levels of depression. But that doesn't make as good a story, and so the industry has aggressively and successfully promoted the notion of neuro-balance. SmithKline, before its merger with Glaxo, explained Paxil's effects with animations of a pool table, on which balls ricocheted madly until they were put back in order by Paxil. Pfizer, the largest pharmaceutical company in the world, sponsors "Brain: The World Inside Your Head," a traveling show for science museums in which the company tells children that depression may be caused by, you guessed it, "an imbalance in neurotransmitters."
So does this mean that the big pharmaceutical companies are evil, as the Church of Scientology and other conspiracy buffs have suggested? Of course not. It simply means that Pfizer, Glaxo, Lilly and the rest are doing what they are supposed to do: make money. If they have gained in recent years far too much cultural power, it is because we have given it to them.
Are the drugs evil? Again, not at all. They are, at least in the short run, quite valuable, if monitored closely. Even the foremost critic of SSRI overuse, the British specialist David Healy, still prescribes antidepressants other than Paxil to patients.
The chief myth is that SSRIs — being restorers of "natural" balance — are safer than previous generations of psychiatric meds and, therefore, OK for family doctors to prescribe. They are not necessarily safer, and they should be prescribed only by people trained in their use who will closely monitor patients.
Closely monitor means weekly follow-ups for the first three months — something almost impossible in the modern managed-care environment where general practitioners average about eight minutes per patient to diagnose and prescribe. Follow-up appointments are tough to get. Yet nearly every study that has found SSRIs safe and effective looked at patients who received intense follow-up care. In the real world, most people who are prescribed SSRIs today are on their own.
This does not mean that only psychiatrists should prescribe them, but it does mean that any general practitioner who does so needs to have had substantial training in their use and a commitment to providing the necessary follow-up. That would not only make the process safer all around, it would free the general practitioner from simply endorsing a patient's self-diagnosis and request for treatment, which often happens. Better training would also provide doctors with the tools to resist the animated messages of the drug companies about these powerful psychiatric drugs. It also might make them consider providing a more accurate message to their patients, something like this: These drugs will stimulate some parts of your brain and tranquilize others. But you must report to me regularly, which is the only way I can make sure that the side effects don't turn into something harmful.
Those side effects can be major. Consider Paxil, approved in the early 1990s. Its biggest drawback is that going off the drug suddenly can cause serious withdrawal symptoms (or, as the company's legal staff insists on calling it, "discontinuation syndrome"), including suicidal despair. This was clear as early as 1996, when both the company and the FDA knew that the withdrawal syndrome — flulike symptoms, depression, anxiety and other fun experiences like "brain zaps" (a feeling sort of like an electrical charge in the head) — was, statistically speaking, Paxil's leading problem. Yet the company refused to put withdrawal syndrome on the drug's precautions label until 2001.
I once asked Jan Leschly, until 2000 the head of SmithKline, Paxil's maker, why that was so. We were sitting in a conference room of a large New York communications agency. Leschly, a charming onetime tennis pro from Denmark, was not surprised at the question. He said all the right things — that the company would never purposely endanger patients, that it would be bad for business as well as morally wrong, and that "we may press [advertising regulations] but we would never, never go beyond it." But why, I asked, when withdrawal syndrome was clearly the leading adverse event reported to both the company and the FDA, did he not put that warning under the precautions section of the label, where general practitioners might comprehend its gravity? Why, in fact, did the company spend millions to justify not doing so? Leschly then made it clear he had had enough of me. "Some people will never have enough information," he said, sticking out his hand for a conclusive handshake. "That's it. I've got an attorney sitting down there waiting to see me. I've got to go."
The public is still waiting for an answer.
Posted by flyingdreams on January 27, 2004, at 17:37:49
In reply to Re: Anyone had success on Effexor XR?, posted by meds4life on January 27, 2004, at 14:33:45
There is information on the weight gain issue at:
http://www.prozactruth.com/weight.htm
The fact is you can run 5 miles a day for a month straight and not lose a lb. I'm proof of that. This is because these drugs lower our metabolism, this is why we gain weight. Shame of the drug companies for denying it! All they want is $$$.
Never heard of synthroid, read up on the side effects and withdrawals from actual people who have been on that drug first! I'd ask about natural ways to fix it first.
Posted by flyingdreams on January 27, 2004, at 17:56:31
In reply to fwd new article about anti-depressants, posted by zinya on January 27, 2004, at 14:49:36
THANK YOU for posting this article! It says everything!
If everyone would post this article as often as they can in other groups and to friends and family, PLEASE get the word out there! Save some people from the pain I'm in now getting off these drugs!
Posted by EFFEXED on January 27, 2004, at 19:40:15
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
LIKE I SAID BEFORE I TOOK THE 37XR FOR 2 WEEKS NOW I AM ON THE 75XR WAS MOODY FOR THE FIRST 2 DAYS BUT NOW DAY 4 IS HERE AND TODAY IS THE BEST I HAVE FELT IN YEARS THIS STUFF IS GREAT I REALLY WAS ABLE TO GET UP THIS MORNING GO TO SCHOOL ON TIME AND AT THE END OF THE DAY I DID NOT FEEL LIKE I WAS GOING TO PASS OUT ON THE WAY TO PICK UP MY KIDS FROM SCHOOL MY DAUGHTER EVEN ASKED WHY I COULD NOT PLAY WITH HER LIKE THIS EVERY DAY I FEEL GREAT THANKS TO THE EFFEXOR
PS.I KNOW THIS IS ONLY DAY 4
HOPE IT LASTS.THANK YOU.( EFFEXED )
Posted by omegon on January 27, 2004, at 20:59:37
In reply to Re: Anyone had success on Effexor XR?, posted by flyingdreams on January 27, 2004, at 17:37:49
> [efexor, prozac, SSRI's in general]
> http://www.prozactruth.com/weight.htm
>
> The fact is you can run 5 miles a day for a month straight and not lose a lb. I'm proof of that. This is because these drugs lower our metabolism, this is why we gain weight.Some people gain. Others lose it. Prozac has destroyed my appetite completely in the last few weeks.
Before anyone gets any ideas about weight loss, this is not necessarily a good thing, especially as the main reason for the change is that I feel too sick to eat most of the time. I am well underweight for my height already: male, 23, 178cm, under 60kg before I started it.
(Other SSRIs I've tried didn't make me gain weight either - though they certainly destroyed any fitness I had, due to the absolute apathy and inertia they produced.)
> Shame of the drug companies for denying it! All they want is $$$.
Well, yes. That's why they are called companies, and why they have managed to develop the few drugs they have at costs of hundreds of $million each. It's what they do and it's why their staff work for them. A non-profit company might have an outside chance of discovering a useful drug, but getting it through the (necessary) regulatory systems, and then actually marketing it enough so that it reaches patients? no chance.
The current systems work for the most part - it's just that they need a bit of (necessarily forcible) adjustment of the profit<->people balance, to sort out the side-effects that profitability doesn't notice, like making the people you're "helping" feel suicidal when you stop "helping" them.
Despite this, I see lots of posts on here slating "the drug companies" for releasing drugs that help some people but not others / not giving the side effects and withdrawal symptoms enough emphasis / not giving out free medicine to everyone / making any money at all. (For the record, I am a victim [perhaps only partially an unwitting victim] of paxil, effexor, and (increasingly) prozac - see earlier posts - so I'm not entirely biased towards those drug companies.) Again, who would develop these drugs in the absence of vast profits, especially given the current culture of litigation? The regulatory process (which is entirely necessary for new drugs) is inevitably very expensive to get through.
Obviously if you look at the whole system, and the devastating damage that these drugs can inflict on an individual human level when they are not used carefully enough, it it looks shaky under any moral scrutiny. Unfortunately, big companies don't work like that, for much the same reason as why one country can go to war against another and sanction the killing of people they've never seen: self-interest, tribe instinct. People in those companies will settle for helping some people, some of the time, and getting paid. The people who are hurt are someone else's problem.
If anyone is to blame, I think it is precisely those various governmental regulatory systems (much the same in any country, from what I've read): surely their primary purpose is to rationalise (humanise?) and keep this kind of thing in check while maintaining the advantages of opening the drug development sector up as a commercial market? Those agencies should be placing far more emphasis than they are effectively managing to do on sparing patients/victims the adverse effects of these drugs, which in many cases could be easily avoided or at least greatly reduced. Clearly the human cost of this is vast, and should be enough for those supposedly human-focussed governmental thingums to sort things out.
Of course, this is rarely enough unless the mainstream press happen to jump on the bandwagon. Taking the cynical point of view, the economic cost is huge as well, inevitably greater than the drug company profits! And it's likely that, even if you don't offset the economic losses directly against those profits, the latter will get zapped eventually when the aforementioned litigation gets going and produces multi-billion class-action lawsuits. They need to encourage cautious dosage changes, warn about withdrawal symptoms, potential for mood changes if misdiagnosed, and so on into hell for the patient. This information is widely available, seems to be well supported by studies as well as anecdotal evidence (admittedly I have not formally researched this, and my viewpoint may be biased) and is readily found if you research on the web, whether focussed on research or on patient experiences. Yet despite this, it is emphatically NOT getting to many of the doctors who prescribe these drugs, until their better-informed patients go through it and report back to them!
So what can we do?
Well, since most of us "victims" only have access to the doctors who put us through this, and to peers who might have to go through this later, the most useful thing is just to tell those people.
And of course if it might help you feel better, or satisfy your moral sense to some extent without actually having to engage in any conflict with those who might disagree, you could do worse than to post a long, unnecessarily detailed rant to an internet board where most people won't even read it.
Posted by Dr. Bob on January 27, 2004, at 21:22:18
In reply to Long rant: drug profits, regulation, patients, posted by omegon on January 27, 2004, at 20:59:37
> > Shame of the drug companies for denying it! All they want is $$$.
>
> Well, yes. That's why they are called companies...I'd like to redirect follow-ups regarding drug profits, etc., to Psycho-Social-Babble. Here's a link:
http://www.dr-bob.org/babble/social/20040120/msgs/306241.html
Thanks,
Bob
Posted by omegon on January 27, 2004, at 21:48:25
In reply to Re: Anyone had success on Effexor XR yes !!!!!!!!, posted by EFFEXED on January 27, 2004, at 19:40:15
I hope it works for you as well! Great that it helps you relate to your kids better.
I will give you my limited advice: I was on this drug recently for around three months. It worked well some of the time, but caused major problems at other times - so I can't be objective! (not that I think anyone can, really)
I did get several weeks of feeling better than I did on any of the other antidepressants I've tried - I actually enjoyed dealing with people for the first time in years.
I found I got a rapid decrease in effect after a couple of weeks at each dosage level. However, my doctor "fixed" this by increasing the dose, 75mg each time. At 225mg/day this "tolerance" decreased to some extent, but was replaced after a few weeks by extreme sleepiness, then mood swings (further in both directions than I'd been before starting ADs) bad enough that I had to switch to another drug.
If you find that the effects decrease after another week or so, you should probably wait a couple of weeks before you increase the dose - you might find it changes again, for the better. From many reports I've seen on here, it can take several weeks at the same dose for things to stabilise, despite the short half-life. Be very careful about sticking to the same time each day and don't miss any doses: I think that being somewhat variable in dosage time may have made things worse for me. Also, lots of people (and me) seem to report being moody, very irritable, anxious, unable to sleep, having nightmares etc. for a few days each time you increase the dose; but it should be controllable and get less each day, otherwise go straight back to your doctor! I found that, once I'd got used to the high dose I ended up on, it actually reduced my anxiety a lot for several weeks, though in the end I had problems.
> LIKE I SAID BEFORE I TOOK THE 37XR FOR 2 WEEKS NOW I AM ON THE 75XR WAS MOODY FOR THE FIRST 2 DAYS BUT NOW DAY 4 IS HERE AND TODAY IS THE BEST I HAVE FELT IN YEARS THIS STUFF IS GREAT I REALLY WAS ABLE TO GET UP THIS MORNING GO TO SCHOOL ON TIME AND AT THE END OF THE DAY I DID NOT FEEL LIKE I WAS GOING TO PASS OUT ON THE WAY TO PICK UP MY KIDS FROM SCHOOL MY DAUGHTER EVEN ASKED WHY I COULD NOT PLAY WITH HER LIKE THIS EVERY DAY I FEEL GREAT THANKS TO THE EFFEXOR
>
> PS.I KNOW THIS IS ONLY DAY 4
> HOPE IT LASTS.
>
> THANK YOU.( EFFEXED )
Posted by Katies1 on January 27, 2004, at 22:20:56
In reply to Re: Anyone had success on Effexor XR?, posted by flyingdreams on January 27, 2004, at 17:37:49
I am responding to the comment about using synthroid. Synthroid is for people with hypothyroidism. It is used to help restore normal hormones produced by the thyroid. Taking it with a well functioning thyroid can be dangerous. It can produce symptoms that mimic hyperthyroidism - nervousness, weight loss, increased heart rate, possible arrythmias (abnormal heart rhythm), and in severe situations death - a thyroid crisis or storm. Patients taking synthroid for hypothyroidism must have blood levels checked periodically and their dose adjusted. It is not a pill for weight loss. As a nurse, I would definately question anyone who tries to prescribe it to you without providing you with clinical evidence it can be used in the manner he/she is suggesting.
Posted by Embers on January 28, 2004, at 0:18:14
In reply to fwd new article about anti-depressants, posted by zinya on January 27, 2004, at 14:49:36
I first had trouble with depression and anxiety and was hospitalized about 22 years ago (at age 30). At that time I was given Elavil and found the side effects too awful to continue on that med. 12 years ago (after being without any medication for 8 years) I had severe depression with panic attacks and could no longer function. I was in hospital for one month, outpatient for another 6 months, and therapy for 8 years! During that time I was either on Prozac, Zoloft, Lithium, Zoloft again, Wellbutrin and now Paxil. Paxil seems to work the best for me. I'm still on a low doseage and it seems to keep the anxiety level down better than the other meds I was on, and my depression is at a manageable level. I work full time and 6 months ago got married for the first time at 51 years old! If you suffer from "clinical depression" I advise you NOT to give up if the first med doesnt work for you. Work closely with a pharma-psychiatrist. Some psychiatrists are more up to speed on drugs than others I've found. I do NOT recommend getting these drugs prescribed to you the first time by a general physician. Unfortunately my 85 year old father did, had side effects and the physician had him stop the Zoloft immediately. He committed suicide 2 weeks later. In our era of specialists, physicians should prescribe in their own fields
Posted by Zellie on January 28, 2004, at 9:05:32
In reply to Re: Anyone had success on Effexor XR yes !!!!!!!!, posted by EFFEXED on January 27, 2004, at 19:40:15
I began Effexor back in May, and my pdoc titrated me up in baby, baby steps, allowing lots and lots of time between the increases. It was torture on me at the time, but looking back, I am very glad. I have found him to be an excellent physician (I do not feel that way about many docs at all who prescribe psychotropic drugs). He specializes in the very disorders we all talk about here, and he is very into biochemistry. He does thorough research, and shares it with his patients faithfully.
I was on 37.5 mg for about 4 weeks. Then went to 75 for 5 or 6 weeks. Then 112.5 for 7 or 8 weeks. Then 150 since then. With each increment, I felt better for a few days, but then, at some dosage levels, the depression grew almost unbearable after a week or so. I realized at that point that, for me, the med was working on the anxiety first (as it is known to do), and leaving me to fight the depression without the help of my anxiety any more. I realized then that the anxiety, as unhealthy as it had been, had actually served the purpose of prodding me through the depression. Once it was taken away, wow! I felt rotten. By 112.5 I was feeling considerably better, but still on the cusp of feeling depressed after about 6 or 7 weeks. So my pdoc upped the level once more to 150, and I've been good there since.
I have ADHD in addition to anxiety and depression, so Wellbutrin was added in November (we tried Concerta...ritalin based...but I could not tolerate it....must be in our family, since our youngest (12) tried it at the same time, and he, too, couldn't tolerate it, so he went back to Dexedrine...also used to treat ADHD). We pondered my trying Dexedrine, but since it is more stimulating than Wellbutrin, we opted for the Wellbutrin, given my high anxiety. It has gone well, and has helped me stay a little better on task.
Anyway, it is a guessing game as to how your body and brain will react. Just be very patient, and titrate up SLOWLY...it will help you to tolerate the med better, and will give it time to settle in. By the way, if you discover any sexual side-effects (delayed or absent climax), then it may subside or at least decrease substantially after about 3 to 6 months. If not, Wellbutrin can sometimes also help with that. Most side-effects ought to subside, given time....if they do not (as in the case of a close friend of mine who became unbearably tired on Effexor), then it is not the drug for you.
Don't ever miss a dose, take it at exactly the same time every day if you can, and if you do ever have to come off it, titrate down at even a SLOWER pace than a snail moves at, to mitigate intense side-effects that seem to accompany abrupt decline from the med. (P.S. Carry a spare dose with you, in case you realize once at work that you forgot to take your meds.)
Kindest regards,
Zellie> LIKE I SAID BEFORE I TOOK THE 37XR FOR 2 WEEKS NOW I AM ON THE 75XR WAS MOODY FOR THE FIRST 2 DAYS BUT NOW DAY 4 IS HERE AND TODAY IS THE BEST I HAVE FELT IN YEARS THIS STUFF IS GREAT I REALLY WAS ABLE TO GET UP THIS MORNING GO TO SCHOOL ON TIME AND AT THE END OF THE DAY I DID NOT FEEL LIKE I WAS GOING TO PASS OUT ON THE WAY TO PICK UP MY KIDS FROM SCHOOL MY DAUGHTER EVEN ASKED WHY I COULD NOT PLAY WITH HER LIKE THIS EVERY DAY I FEEL GREAT THANKS TO THE EFFEXOR
>
> PS.I KNOW THIS IS ONLY DAY 4
> HOPE IT LASTS.
>
> THANK YOU.( EFFEXED )
Posted by Zellie on January 28, 2004, at 9:23:34
In reply to Re: Anyone had success on Effexor XR?, posted by meds4life on January 27, 2004, at 14:33:45
Keeping weight off is a life-long battle for most of us! I am not overweight, but not because I am a lucky one who just seems to stay slim (I'm not slim, either, but a reasonable weight for my age and height). I must work at it all the time. I have found that the glycemic index of foods has a whole lot to do with how much weight my husband and I either gain or don't gain. As it goes, foods we eat will cause the pancreas to secrete insulin in proportion to the amount of carbohydrate that the food makes readily available to the body. If the carbohydrate is a complex one, the body has to work harder to turn it to energy, and less insulin is secreted in response to it. The simpler the carb, the easier it is for the body to grab hold of, and the more insulin is secreted. This same insulin will gather up and store excess energy that is not needed at the time, and stores it as fat.
So the idea is to eat only foods with a low glycemic index. These foods keep the insulin from being dumped into the bloodstream, but rather, cause it to trickle out. (This is the gist of it, although you'll notice the lack of medical jargon in my description!!)
There are many very excellent books out on the matter to educate you. They have indicies/charts that tell you the G.I. (Glycemic Index) value of various foods. Take the book you get with you to the grocery/health food store, until it becomes second nature for you to know what the G.I. is of most foods.
My husband and I have lived by this for 2 years now. Initially he took off 35 pounds (which he needed to) and I took off the 5 or so that had crept up over the years. Now that we are at a more optimum weight, we do not continue to lose, nor do we gain, unless, of course, we fall off the G.I. wagon and indulge in my personal favourite, Baskin Robbins Jamoca Almond Fudge!
Effexor has definitely made me hungrier at times (ravenous sometimes), so I eat pre-peeled and washed carrots dipped in a little light ranch dression. I munch on apples (that always have their skins on to keep the G.I. low). Nuts, and whole grain products that have fructose as a sweetener rather than any other sugars (fructose, incidentally, is NOT fruit sugar. It is available in pretty much all health food stores, and has a G.I. of 20, compared to sugar, which is 100! It is 1.8 times sweeter than sugar, so you require less of it, and it tastes excellent).
That's how I fight the weight....lots of only low G.I. foods. As long as I stick to the low ones, I don't gain. And if I go off the plan and indulge and gain weight, then I know exactly what to do to take it off again!
Hope it goes well for you.
Kindest regards,
Zellie> Hi! I have been on effexor xr for 4 months now due to deep recurring depressions and anxiety. I was hospitalized for a brief period. I realize now that I will be on medication for life to prevent a relapse. I don't like the idea, but realize that my life depends on it. I take 150 mg. of effexor xr. I started on effexor,klonopin, and ambien (for sleep) I feel great now. I have no anxiety or depression. I also discontinued klonopin and ambien without any problems. My concern is the weight gain. I have only gained 10 pounds, however when on paxil for my last depression I gained 40 pounds. My psychiatrist has talked about adding synthroid or something else to offset the weight gain side effect for me. Does anyone have any comments? Other than the weight gain, effexor has been highly effective!
Posted by Zellie on January 28, 2004, at 9:46:35
In reply to Re: fwd new article about anti-depressants, posted by Embers on January 28, 2004, at 0:18:14
I am so sorry for you, as I read of the death of your father. I don't know how long ago it was, but it doesn't matter. It is very devastating.
We must get the message out to general physicians...these drugs are a huge responsibility for them to take on....we must get through to them that they MUST learn all they can about them BEFORE prescribing them, and they must educate their patients THOROUGHLY on all possible side-effects. They must tread very, very carefully when decreasing or stopping any of these drugs.
Again, I feel for you. I am glad, though, that you are now able to cope with your own illness. I wish you well for the future.
Kindest regards,
Zellie
> I first had trouble with depression and anxiety and was hospitalized about 22 years ago (at age 30). At that time I was given Elavil and found the side effects too awful to continue on that med. 12 years ago (after being without any medication for 8 years) I had severe depression with panic attacks and could no longer function. I was in hospital for one month, outpatient for another 6 months, and therapy for 8 years! During that time I was either on Prozac, Zoloft, Lithium, Zoloft again, Wellbutrin and now Paxil. Paxil seems to work the best for me. I'm still on a low doseage and it seems to keep the anxiety level down better than the other meds I was on, and my depression is at a manageable level. I work full time and 6 months ago got married for the first time at 51 years old! If you suffer from "clinical depression" I advise you NOT to give up if the first med doesnt work for you. Work closely with a pharma-psychiatrist. Some psychiatrists are more up to speed on drugs than others I've found. I do NOT recommend getting these drugs prescribed to you the first time by a general physician. Unfortunately my 85 year old father did, had side effects and the physician had him stop the Zoloft immediately. He committed suicide 2 weeks later. In our era of specialists, physicians should prescribe in their own fields
Posted by Zellie on January 28, 2004, at 9:54:31
In reply to Re: fwd new article about anti-depressants, posted by Embers on January 28, 2004, at 0:18:14
Okay. I now know what it is like to have my brain not be able to keep up with my motions! I felt so oddly dizzy this morning, kind of like when you feel spacey when you have a head cold, only without any of the other cold symptoms. Every time I moved around the kitchen I had this weirdest feeling in my head, like when the computer can't quite keep up with the click of the mouse.
At breakfast, I stopped dead in my tracks when I realized Tuesday's meds were still in the pill box. I NEVER forget my meds, because I've read of such wicked symptoms that result from missing a day. I carry a dose with me at all times. How did I miss taking them yesterday?
Who knows. Maybe just so that I could now understand the weird feeling. I am SOOOO glad that I didn't get the brain zaps that so many of you have shared about.
From now on, I will check, check and double-check that I have taken my meds each morning!
Kindest regards,
Zellie
Posted by PoohBear on January 28, 2004, at 10:46:24
In reply to YIKES! Forgot my Effexor yesterday...DIZZZZY now!, posted by Zellie on January 28, 2004, at 9:54:31
Zellie:
I think your advice of stashing extra capsules around is sound.
For me, I generally take my 75mg XR capsule at the same time each week day, perhaps two hour later on weekends with no problem. I have also found that I can go back and forth between 75's and 150's without much problem...
I also agree that given the marketing efforts of the big drug companies (I'm not condeming them for that, that's how they survive), many doctors are prescribing these meds with very little idea of what they really do or what the side effects can be.
I am glad now that after deciding to go back to my psychiatric group for care, my psychiatrist had moved on to private practice. The nurse practicioner I'm seeing in his place is an expert in psychiatric pharmachology, what the meds do and also their attendant side effects.
You take care,
Tony
Posted by Dirtylowdown4 on January 29, 2004, at 10:05:25
In reply to Re: Sex life and Effexor...Help!!, posted by Ed O`Flaherty on November 3, 2002, at 14:55:22
I am a male who has been on 75mg of Effexor XR for several weeks. Has anyone had any experience with increased dosage and the effects on sexual orgasm? Since being on Effexor I have personally experienced delayed orgasm and to a lesser extent the inability to ejaculate. Since I have been plagued with premature ejaculation my entire adult life the delayed ejaculation is a very desirable side effect. I am considering asking my doctor to increase my dosage to combat my depression but am concerned that the increased dosage may result in increased frequency of no ejaculation. Desire and ability to obtain and maintain erection has not been a problem since being on the medication. Any comments would be greatly appreciated!
Posted by casisill on January 29, 2004, at 11:37:08
In reply to Re: Glad to be OFF EFFEXOR!! » melley, posted by tetheredcat on January 8, 2004, at 21:52:47
HI
in response to tetheredcat i hope to god you managed to stay off this drug - its extremely dangerous. I've been on it nearly 2 years and am going cold turkey at present to get off it - i was on 225mg per day and am into my 7th day of withdrawal - i have dizziness, nausea, violent mood swings, depression, rages beyond belief and much more! i'm trying to hang in but the urge to go back on is unbelievable. I have researched the effects of this drug and its withdrawal and will be taking all of this to my shrink in march to show him i shouldn't have even been on this drug as i suffer bipolar ii and should have been on a mood stabiliser such as lithium. People have compared coming off effexor to heroin cold turkey - jesus if this is what its like i feel sorry for heroin addicts! I reckon i could easily have killed someone today with the raging mood i've been in - luckily i went back to bed to sleep it off. I don't know as yet how long this cold turkey lasts but i can't take much more of this - reckon i'll have to build an underground bunker and seal myself in if this dosent get much better!
Damn all the doctors for prescribing such an addictive dangerous drug! wonder what they get out of it - a holiday in the caribbean?
good luck to all coming off i'll let u know if and when i come through the other side!
cas
Posted by PoohBear on January 29, 2004, at 12:43:59
In reply to Re: Glad to be OFF EFFEXOR!!, posted by casisill on January 29, 2004, at 11:37:08
>in response to tetheredcat i hope to god you managed to stay off this drug - its extremely dangerous...> cas
Actually... It's my opinion that hyperbole like this is what's dangerous.
There are a lot of people, myself included who have been greatly helped by this medication. I do no deny for one minute that Effexor is often dispensed by GP's or others who have little knowledge about it's effects, either on or post medication other that the supplied pamphlets, but that's typical of many meds.
That said, sweeping generalizations and inflamatory remarks are not helpful. Let's just stick with the facts. There are people who are reading the comments that are posted disparaging whatever the drug du jour is, who are being helped be Effexor, etc, and are now fearful of continuing on the drug.
The more we can stick to encouragement, the better off we'll all be. I didn't say cover up, but there are ways to describe withdrawal effects without refering to a drug as "dangerous"
If it was "dangerous", the FDA would not not have allowed it to be marketed.
TR
Posted by Alittle Lost on January 29, 2004, at 13:51:13
In reply to YIKES! Forgot my Effexor yesterday...DIZZZZY now!, posted by Zellie on January 28, 2004, at 9:54:31
My doctor has taken me off of Effexor and will start me on Zoloft - which I'm happy with - when I get some of this Effexor out of my system. I have missed a dose of Effexor before and get terrible feelings like; dizzy, electrical shocks, uncontrolable shaking just name a few. Very scarey feeling. This is day 3, my hands and feet are so cold, my head hurts and all I want to do is stay in bed. I'm shakey, sick to my stomach, emotional roller coaster. I feel like a junky would coming off crack. I think Effexor should be banned along with Xanax!
Posted by Trish77 on January 29, 2004, at 14:15:54
In reply to Re: Anyone had success on Effexor XR? , posted by Jennzie on July 18, 2001, at 15:09:07
For anyone on Effexor Xr, and Xyprexa,
I am 26 and have been on a number of meds since i was 20, I have delt with my mental Illnesses nearly all my life and now I am on the E-X combo, they help but are not a miracle of cource, I still feel my illnesses, and the xyprexa has made me have night sweats and weight gain, (cause I am so hungry) since i am an adult I have began to take Dexatrim natural, to curb my hunger. I had lost allot fo weight last yr so the weight gain isn't making me over weight but it still makes me uncomfortable.Trish
Posted by pscho on January 29, 2004, at 15:04:12
In reply to Coming Off of Effexor, posted by Alittle Lost on January 29, 2004, at 13:51:13
Hi, I was on effexor for about 2 years and noticed the same "electrical shocks" that would start 12-24 hours after missing a dose. The effexor worked great for a year or so, but when I started trying to quit the electric shock feeling was so intense that i kept taking it for a second year, even though it wasnt doing me any good.
I finally weaned myself off of it slowly, and it was pretty rough for a couple of months or so, but I lived through it.
It has been about 18 months now, and i still get maybe one shock a day or so, or maybe less.
So it is a pain in the arse to quit, but it can be done
Posted by KFRAN on January 29, 2004, at 15:11:48
In reply to Re: fwd new article about anti-depressants, posted by Embers on January 28, 2004, at 0:18:14
I wholeheartedly agree. It is sad how very little knowledge some Drs(including some psychiatrists!!) have about meds and our diseases. I was very successful on prozac for many years until it stopped working. am now on effexor and keeping my fingers crossed. so far it is OK. I have a drinking problem though and feel the alcohol is preventing it from doing its best work.
Posted by mercedes on January 29, 2004, at 15:17:06
In reply to Re: Glad to be OFF EFFEXOR!!, posted by casisill on January 29, 2004, at 11:36:32
Hi Cas,
I feel for you, going off Effexor "cold turkey". It has to be horrible. I know, I've been through it, but didn't go cold turkey as you are. It's important to titrate down. I had most all the withdrawal symtoms you describe (except nausea). The violent rages (glad I live alone)cursing, etc. I actually got in my car a couple of times and drove like a maniac, feeling invincible, not caring if I crashed. Luckly I live in the country with not much traffic. These are not normal behaviors and should be monitored by a professional.It took me 5 weeks to finally withdraw. And that was following dr's order's, titrating downwards from 300mgs to finally 37.5. It was after the last 37.5 that it took five weeks to finally withdraw. That was me...I've read other's post that their withdrawal experiences were not so bad.
I hope you consider calling you doctor for advice on how to get 'off' effexor. What you are going through is awful.
merc
> HI
>
> in response to tetheredcat i hope to god you managed to stay off this drug - its extremely dangerous. I've been on it nearly 2 years and am going cold turkey at present to get off it - i was on 225mg per day and am into my 7th day of withdrawal - i have dizziness, nausea, violent mood swings, depression, rages beyond belief and much more! i'm trying to hang in but the urge to go back on is unbelievable. I have researched the effects of this drug and its withdrawal and will be taking all of this to my shrink in march to show him i shouldn't have even been on this drug as i suffer bipolar ii and should have been on a mood stabiliser such as lithium. People have compared coming off effexor to heroin cold turkey - jesus if this is what its like i feel sorry for heroin addicts! I reckon i could easily have killed someone today with the raging mood i've been in - luckily i went back to bed to sleep it off. I don't know as yet how long this cold turkey lasts but i can't take much more of this - reckon i'll have to build an underground bunker and seal myself in if this dosent get much better!
>
> Damn all the doctors for prescribing such an addictive dangerous drug! wonder what they get out of it - a holiday in the caribbean?
>
> good luck to all coming off i'll let u know if and when i come through the other side!
>
> cas
Posted by KFRAN on January 29, 2004, at 15:17:32
In reply to Re: Glad to be OFF EFFEXOR!!, posted by casisill on January 29, 2004, at 11:37:08
I am so sorry to hear that. I hope it is better very soon. I have been on effexor xr for about a month and am now at 15O mil a day it is ok ...
is your advice to just run from it ? did it ever work for you?
just seeking knowledge, thanks
Posted by omegon on January 29, 2004, at 16:42:17
In reply to Effexor Dosage and sexual side effects, posted by Dirtylowdown4 on January 29, 2004, at 10:05:25
I am also male and was on efexor for something like 2.5 - 3 months. (Memory loss was one side effect for me.) I had somewhat delayed orgasm, but was never unable to get there; I actually considered it an advantage. I was on paroxetine before, which was much more of a problem; it made achieving orgasm an epic quest - took 50 minutes on occasion, which was extremely frustrating since it increased desire and _decreased_ pleasure!
The effect was much the same with all doses of efexor I was on. 225mg was the highest, and this actually increased desire several times compared to how I was without medication - though this probably says more about my depression than about the drug. No decrease in sensation/pleasure - if anything it was increased. It was almost worth putting up with the problems it was causing - primarily major mood swings, blurred thinking and lack of energy.
If it does cause you sexual problems, you might wait a few weeks before you abandon it if it's working well otherwise: I've seen quite a few reports that suggest the side effects, including the sexual effects, decrease after a few months at the same dose. (People have said anything from 2-6 months, which is admittedly not much of a comfort for something as urgent as sex!)
You might try (cautiously) taking 500mg of tyrosine. (Amino acid: a nutritional supplement available over-the-counter - in the UK at least - and a precursor of dopamine and noradrenaline.) This should help a lot with desire and pleasure. You should wait until any anxiety effects from the efexor have gone, though, since the adrenaline increase it causes can be very unpleasant otherwise.
> I am a male who has been on 75mg of Effexor XR for several weeks. Has anyone had any experience with increased dosage and the effects on sexual orgasm? Since being on Effexor I have personally experienced delayed orgasm and to a lesser extent the inability to ejaculate. Since I have been plagued with premature ejaculation my entire adult life the delayed ejaculation is a very desirable side effect. I am considering asking my doctor to increase my dosage to combat my depression but am concerned that the increased dosage may result in increased frequency of no ejaculation. Desire and ability to obtain and maintain erection has not been a problem since being on the medication. Any comments would be greatly appreciated!
Posted by helenag on January 29, 2004, at 17:05:13
In reply to Re: Effexor Dosage and sexual side effects » Dirtylowdown4, posted by omegon on January 29, 2004, at 16:42:17
This is a female perspective...when my dosage of effexor xr was increased from 225mg to 300mg, it definitely had increased sexual s/e's. You raised a good point about the depression being partly responsible for low libido, etc. It's good to keep that in mind.
However, when the dosage went to 300mg, I was still very interested in being with my husband and enjoyed our conjugal pleasures immensely, but had no drive or interest toward my own singular pleasure. It was quite vexing. And it lasted several several months.
Since then, it has improved, but there are times that the motor just doesn't turn over. So I would say that effexor does have sexual side effects that do render a person incapable, at times, of not being able to achieve orgasm.
It is frustrating. You have my empathy.
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