![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 788 to 812 of 1313. Go back in thread:
Posted by Raggy on May 1, 2004, at 19:29:09
In reply to Re: are these posts representative?, posted by SLS on May 1, 2004, at 8:04:49
I read the other day where Wyeth lost a case for fen-phen and the jury awarded the family of the women who died 3 billion dollars, which they are going to fight. In the same article it said that Effexor sales are up 31 % this year.
Posted by seeknsolace on May 1, 2004, at 20:35:23
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » Douglas T., posted by chemist on May 1, 2004, at 18:57:54
> > I have been through the withdraral period (13 weeks of hell)
> > after 5 years on Effexor. I was in a fog for all of that time.
> > I am still not myself after almost a year. My site, dougtyler.com
> > has a lot of information and a way to get involved if you're like me
> > and want the idiots who make this stuff to pay us all back for what
> > we've been through. I am NOT selling anything.
> > Go to Effexor link at the bottom of the page. thanks and be well.
>
> ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist
I agree with you chemist but at the same time understand the underlying anger doug has. However, monetary settlement isnt going to give any justice to the withdrawl hell we have endured or for those to have yet go thru with it.Life isnt fair for the healthy minded or for us, chronically depressed. Money isnt going to deliver any of us, taking effexor off the market isnt going to solve anything either.
I'm sure no dr maliciously gave us effexor so that we would suffer its effects, they are human too and even if Wyeth knows of the withdrawal reactions, in some sense they have done a good thing in creating the drug. I mean it did help most of us right? Even if it was only in the beginning.. at least for a passing moment, we got to embrace life.
I know in truth, if it wasnt for effexor, taking the edge off of being bipolar, having anxiety disorder/panick attacks and seasonal effective disorder, I wouldnt have gained the strength and knowledge I learned in understanding myself, my emotions, ways to cope, especially now with the dark seasons approaching, being that bipolar is forever and it hits worse come the late fall season.
Ok just rambling now. To wrap this up, just saying there is no monetary value that give the dream and hope of being free from depression and I would give a billion dollars to know what it is to feel alive.. consistantly.
Posted by TanyaJean on May 1, 2004, at 21:14:37
In reply to Re: please be civil}}Dr Bob » maxziggy2002, posted by SLS on May 1, 2004, at 13:48:17
> Bye the way, what did you think of the links I posted regarding the relative efficacy of Effexor to the SSRIs?
>
>
> - Scott
I don't know if you're talking to Dr. Bob or to another post-er. I'm still reading through them a little at a time. Ok, so this is probably my second to last post. This caught my attention:
"Venlafaxine was significantly more effective than SSRIs in improving depression, perhaps due to enhancing both serotonin and norepinephrine."
My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then? I'd say it was twice as bad as when I missed the PAXIL. I also found it interesting that people with major depression fared pretty well on EFFEXOR.Thank you so much for the post-er asking "Hey Scott, are you married?" That was funny. There needs to be some levity in here and I was thinking the same thing.
Posted by TanyaJean on May 1, 2004, at 21:18:32
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » Douglas T., posted by chemist on May 1, 2004, at 18:57:54
> > I have been through the withdraral period (13 weeks of hell)
> > after 5 years on Effexor. I was in a fog for all of that time.
> > I am still not myself after almost a year. My site, dougtyler.com
> > has a lot of information and a way to get involved if you're like me
> > and want the idiots who make this stuff to pay us all back for what
> > we've been through. I am NOT selling anything.
> > Go to Effexor link at the bottom of the page. thanks and be well.
>
>" ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist"**What was that??
Posted by seeknsolace on May 1, 2004, at 21:22:38
In reply to Re: please be civil}}Dr Bob » SLS, posted by TanyaJean on May 1, 2004, at 21:14:37
> > Bye the way, what did you think of the links I posted regarding the relative efficacy of Effexor to the SSRIs?
> >
> >
> > - Scott
>
>
> I don't know if you're talking to Dr. Bob or to another post-er. I'm still reading through them a little at a time. Ok, so this is probably my second to last post. This caught my attention:
>
> "Venlafaxine was significantly more effective than SSRIs in improving depression, perhaps due to enhancing both serotonin and norepinephrine."
>
> My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then? I'd say it was twice as bad as when I missed the PAXIL. I also found it interesting that people with major depression fared pretty well on EFFEXOR.
>
> Thank you so much for the post-er asking "Hey Scott, are you married?" That was funny. There needs to be some levity in here and I was thinking the same thing.That came from me tonyajean, but he still hasnt answered *sniff*! ;)
Posted by chemist on May 1, 2004, at 22:04:44
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS, posted by seeknsolace on May 1, 2004, at 20:35:23
> > > I have been through the withdraral period (13 weeks of hell)
> > > after 5 years on Effexor. I was in a fog for all of that time.
> > > I am still not myself after almost a year. My site, dougtyler.com
> > > has a lot of information and a way to get involved if you're like me
> > > and want the idiots who make this stuff to pay us all back for what
> > > we've been through. I am NOT selling anything.
> > > Go to Effexor link at the bottom of the page. thanks and be well.
> >
> > ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist
>
>
> I agree with you chemist but at the same time understand the underlying anger doug has. However, monetary settlement isnt going to give any justice to the withdrawl hell we have endured or for those to have yet go thru with it.
>
> Life isnt fair for the healthy minded or for us, chronically depressed. Money isnt going to deliver any of us, taking effexor off the market isnt going to solve anything either.
>
> I'm sure no dr maliciously gave us effexor so that we would suffer its effects, they are human too and even if Wyeth knows of the withdrawal reactions, in some sense they have done a good thing in creating the drug. I mean it did help most of us right? Even if it was only in the beginning.. at least for a passing moment, we got to embrace life.
>
> I know in truth, if it wasnt for effexor, taking the edge off of being bipolar, having anxiety disorder/panick attacks and seasonal effective disorder, I wouldnt have gained the strength and knowledge I learned in understanding myself, my emotions, ways to cope, especially now with the dark seasons approaching, being that bipolar is forever and it hits worse come the late fall season.
>
> Ok just rambling now. To wrap this up, just saying there is no monetary value that give the dream and hope of being free from depression and I would give a billion dollars to know what it is to feel alive.. consistantly.
>
i concur. for those who have not picked up on my personal history, i have been on the development end and the receiving end of psychopharmaceuticals. and i don't mean marketing. improperly diagnosed as unipolar depression with agoraphobia and GAD over 10 years ago, i ran the gamut from luvox to remeron to celexa to parnate to paxil, and not in that order. additionally, there was tegretol, trileptal, topamax, neurontin, depakote. and then there were (concurrently) ambien, xanax, restoril, dalmane, halcion, klonopin, valium, and ativan. i am certain i missed a few, but it took a psychotic break while on parnate and a visit to a leading authority on bipolar (details for anyone who wants to know; involved with DSM-III and is a proponent of verapamil) to get things kind of straight. did i mention geodon and dexedrine? probably not.....or ritalin, come to think of it....you and the rest of us are not alone. and as you point out, effexor and countless other meds have helped many, and the last thing any drug manufacturer wants is for their product to fail, and that is for financial reasons. we, their target audience, also want success, because our lives can be (at least) marginally better if the right combination is found. it is not to anyone's benefit to go after drug companies, and citing a dearth of long-term studies is usually because the drug has not been on the market for long-term, randomized, controlled longitudinal studies. want a target? health insurance companies. preexisting conditions ranging from ``have you seen a mental healthcare practicioner in the past five years?'' to ``do you have high cholesterol?'' put you in the high-risk category. i am looking at the recent insert from a script i had filled yesterday for 60 2 mg generic alprazolam (xanax) tablets from a common pharmacy in a grocery store: my savings vs. the brand-name was $173.48, and i do not have prescription coverage. instead of being on the hook for $196.56, i strolled out for $23.08. yet i digress: doug's anger is misdirected, and i am no stranger to anger, but i know where to draw the line. if you don't like your therapist, try another. if your shrink is predisposed to prescribing for you a drug that is ineffective, try another. the greatest realization we have within ourselves is the ability to instigate change and not feel victimized by an industry that, on the whole, has done more good than harm. all the best, chemist
Posted by chemist on May 2, 2004, at 0:06:14
In reply to Re: relative efficacy of Effexor to the SSRIs }} S, posted by TanyaJean on May 1, 2004, at 21:18:32
> > > I have been through the withdraral period (13 weeks of hell)
> > > after 5 years on Effexor. I was in a fog for all of that time.
> > > I am still not myself after almost a year. My site, dougtyler.com
> > > has a lot of information and a way to get involved if you're like me
> > > and want the idiots who make this stuff to pay us all back for what
> > > we've been through. I am NOT selling anything.
> > > Go to Effexor link at the bottom of the page. thanks and be well.
> >
> >" ...and the fact that you were taking effexor for 5 years and did not discontinue earlier makes you a victim of idiots? you are selling something: it's called a class-action lawsuit and publicity, both which would benefit you - monetarily. regardless of whether effexor has helped you (and others) or not helped you (or others) does not let you off the hook for continuing to ingest it for 5 years and then suing your doctors and wyeth. do you smoke cigarettes. too? maybe you can get some $$$ from the tobacco companies....with the most sincere wishes for your crusade, chemist"
>
> **What was that??hi tanyjean, chemist here...in response to ``what was that?,'' it was my take on doug's vendetta that is way beyond the limit of ``it's your fault, not mine.'' if you take a drug for 5 years - and we are not getting the full story, naturally (e.g., alcohol use, other meds, etc.) - and post 3 messages to enjoin a person in proceeding with legal action against doctors, therapists, and pharmaceutical companies, you are being asked to be part of a money-making scheme. and that is all there is to it. all the best, chemist
>
Posted by Carlos C on May 2, 2004, at 1:40:51
In reply to Re: TELL OPRAH YOU HATE EFFEXOR, posted by Bill LL on April 29, 2004, at 9:09:12
Along with about 7 other ADs that have not helped me but made things worse.
Posted by seeknsolace on May 2, 2004, at 6:13:19
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS » seeknsolace, posted by chemist on May 1, 2004, at 22:04:44
I applaude you chemist.. I've only been on about 4 antidepressants: zoloft, buspar, topamax, lithium, and lastly effexor.. ok thats more than four.
Now I understand only the past few years that I'm bipolar and been diagnosed as such, realized I've been so since adolescence.
I'm not being sarcastic towards you either, I could never endure as much as you have. I do not plan on returning to any meds.. maybe its the mania speaking :) Actually life has been so difficult, dont have many manic times, at least during those times, life was "great"!
Your a strong and very intelligent person. Theres a bible scripture that says "those who endure to the end, shall be saved". I think its appropriate to apply it towards our condition.
I had a hard time reading your post, maybe cuz its so early in the morn, but wanted to say.. my doc once told me, bipolar people are some of the smartest people in the world! :) So I conclude with, maybe thats our problem.. we're just too damn smart! ;)
> i concur. for those who have not picked up on my personal history, i have been on the development end and the receiving end of psychopharmaceuticals. and i don't mean marketing. improperly diagnosed as unipolar depression with agoraphobia and GAD over 10 years ago, i ran the gamut from luvox to remeron to celexa to parnate to paxil, and not in that order. additionally, there was tegretol, trileptal, topamax, neurontin, depakote. and then there were (concurrently) ambien, xanax, restoril, dalmane, halcion, klonopin, valium, and ativan. i am certain i missed a few, but it took a psychotic break while on parnate and a visit to a leading authority on bipolar (details for anyone who wants to know; involved with DSM-III and is a proponent of verapamil) to get things kind of straight. did i mention geodon and dexedrine? probably not.....or ritalin, come to think of it....you and the rest of us are not alone. and as you point out, effexor and countless other meds have helped many, and the last thing any drug manufacturer wants is for their product to fail, and that is for financial reasons. we, their target audience, also want success, because our lives can be (at least) marginally better if the right combination is found. it is not to anyone's benefit to go after drug companies, and citing a dearth of long-term studies is usually because the drug has not been on the market for long-term, randomized, controlled longitudinal studies. want a target? health insurance companies. preexisting conditions ranging from ``have you seen a mental healthcare practicioner in the past five years?'' to ``do you have high cholesterol?'' put you in the high-risk category. i am looking at the recent insert from a script i had filled yesterday for 60 2 mg generic alprazolam (xanax) tablets from a common pharmacy in a grocery store: my savings vs. the brand-name was $173.48, and i do not have prescription coverage. instead of being on the hook for $196.56, i strolled out for $23.08. yet i digress: doug's anger is misdirected, and i am no stranger to anger, but i know where to draw the line. if you don't like your therapist, try another. if your shrink is predisposed to prescribing for you a drug that is ineffective, try another. the greatest realization we have within ourselves is the ability to instigate change and not feel victimized by an industry that, on the whole, has done more good than harm. all the best, chemist
Posted by SLS on May 2, 2004, at 8:22:20
In reply to Re: please be civil}}Dr Bob » SLS, posted by TanyaJean on May 1, 2004, at 21:14:37
> My doctor had told me I was crashing so hard when missing a dose of PAXIL because it was just enhancing the serotonin. He put me on EFFEXOR because he said it enhanced both the serotonin and norepinephrine pathways. He said if I missed a dose, I wouldn't have such ill effects. So I wonder why I did then?
Your doctor is wrong for two reasons:1. He is wrong.
2. He is wrong.
:-)
1. The tendency for a withdrawal syndrome to occur upon missing doses has been observed for both Paxil and Effexor and is well known.
2. There is no medical foundation for concluding that Effexor will not produce this phenomenon simply because it inhibits the reuptake of norepinephrine (NE) in addition to serotonin (5-HT).
I am really appalled that this kind of ignorance and misinformation still exists. Even if a doctor doesn't want to read the most current medical literature, he must certainly come in contact with doctors who do.
The following is a citation on Medline from 1997. The authors are from Harvard / Massachusetts General Hospital. They are by no means obscure. Nor is the journal that published them, J Clin Psychiatry.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9219493
Here is something that can easily be found on the Web:
http://remedyfind.com/rem.asp?ID=3948&lPageNum=3
"
However, as Venlafaxine has a short half-life (approx. 5 hours), compared to say, Fluoxetine (2-3 days), sudden discontinuation or missed doses can result in serious side-effects. Withdrawal side-effects may include fatigue, nausea, dizziness, headache, insomnia, and nervousness. Venlafaxine withdrawal symptoms can be so significant that in March 2000, the U.S. FDA required manufacturer Wyeth-Ayerst to add additional labeling which states, “Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment..... It is therefore recommended that the dosage of Effexor be tapered gradually and the patient monitored. The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
"The labelling of the drug manufacturer is unambiguous.
- Scott
Posted by chemist on May 2, 2004, at 11:53:58
In reply to Re: relative efficacy of Effexor to the SSRIs }} SLS, posted by seeknsolace on May 2, 2004, at 6:13:19
well, thanks!...i think your stance in re: not taking any more meds is refreshing, as i, too, limit the regimen to the least amount of meds for the most effective response...an interesting thing about bipolar is that it goes for years undiagnosed or misdiagnosed, and this is in a way a ``fault'' of the malady itself: if you're manic/hypomanic, you don't feel any need to seek out help - everything is fine. when you get dysphoric/depressed, then you go see a psychiatrist, and naturally you present with those symptoms. so, out you go with a script for an antidepressant. then the cycle begins. the antidepressant makes you manic/hypomanic and insomnia, anxiety, and agitaton set in. so back you go, and come away with a less-activating antidepressant, a benzo, and maybe some ambien for sleep. and that combo brings you back down. as so on and so forth...as for enduring, on my part it largely has to do with self-education and taking matters into my own hands: instead of blaming the (admittedly lousy) healthcare system, the doctors, and the pharmaceutical companies, i switch therapists/psychiatrists. i also have a passion for my work, and have no intention of letting bumps in the road get in the way, no matter how large. it sounds to me like you are that kind of person, too(?). forums like this one are exceptionally good outlets for discourses like this one, i.e., to hear how others have dealt with their condition in a proactive way....all the best, chemist
> I applaude you chemist.. I've only been on about 4 antidepressants: zoloft, buspar, topamax, lithium, and lastly effexor.. ok thats more than four.
>
> Now I understand only the past few years that I'm bipolar and been diagnosed as such, realized I've been so since adolescence.
>
> I'm not being sarcastic towards you either, I could never endure as much as you have. I do not plan on returning to any meds.. maybe its the mania speaking :) Actually life has been so difficult, dont have many manic times, at least during those times, life was "great"!
>
> Your a strong and very intelligent person. Theres a bible scripture that says "those who endure to the end, shall be saved". I think its appropriate to apply it towards our condition.
>
> I had a hard time reading your post, maybe cuz its so early in the morn, but wanted to say.. my doc once told me, bipolar people are some of the smartest people in the world! :) So I conclude with, maybe thats our problem.. we're just too damn smart! ;)
> > i concur. for those who have not picked up on my personal history, i have been on the development end and the receiving end of psychopharmaceuticals. and i don't mean marketing. improperly diagnosed as unipolar depression with agoraphobia and GAD over 10 years ago, i ran the gamut from luvox to remeron to celexa to parnate to paxil, and not in that order. additionally, there was tegretol, trileptal, topamax, neurontin, depakote. and then there were (concurrently) ambien, xanax, restoril, dalmane, halcion, klonopin, valium, and ativan. i am certain i missed a few, but it took a psychotic break while on parnate and a visit to a leading authority on bipolar (details for anyone who wants to know; involved with DSM-III and is a proponent of verapamil) to get things kind of straight. did i mention geodon and dexedrine? probably not.....or ritalin, come to think of it....you and the rest of us are not alone. and as you point out, effexor and countless other meds have helped many, and the last thing any drug manufacturer wants is for their product to fail, and that is for financial reasons. we, their target audience, also want success, because our lives can be (at least) marginally better if the right combination is found. it is not to anyone's benefit to go after drug companies, and citing a dearth of long-term studies is usually because the drug has not been on the market for long-term, randomized, controlled longitudinal studies. want a target? health insurance companies. preexisting conditions ranging from ``have you seen a mental healthcare practicioner in the past five years?'' to ``do you have high cholesterol?'' put you in the high-risk category. i am looking at the recent insert from a script i had filled yesterday for 60 2 mg generic alprazolam (xanax) tablets from a common pharmacy in a grocery store: my savings vs. the brand-name was $173.48, and i do not have prescription coverage. instead of being on the hook for $196.56, i strolled out for $23.08. yet i digress: doug's anger is misdirected, and i am no stranger to anger, but i know where to draw the line. if you don't like your therapist, try another. if your shrink is predisposed to prescribing for you a drug that is ineffective, try another. the greatest realization we have within ourselves is the ability to instigate change and not feel victimized by an industry that, on the whole, has done more good than harm. all the best, chemist
>
>
Posted by TanyaJean on May 2, 2004, at 12:01:40
In reply to Re: please be civil}}Dr Bob » TanyaJean, posted by SLS on May 2, 2004, at 8:22:20
"The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
I would have thought 4+ months of tapering and being on a low dose for over a month would be sufficient enough to not have all the side effects listed. Then I can assume the thought is that my body was just not creating seratonin?
Posted by SLS on May 2, 2004, at 14:51:17
In reply to Re: please be civil, posted by TanyaJean on May 2, 2004, at 12:01:40
Regarding the discontinuation of Effexor:
> > "The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
> I would have thought 4+ months of tapering and being on a low dose for over a month would be sufficient enough to not have all the side effects listed.
Me too.
How much were you taking during that last month before you discontinued it? How much did you take as your very last dose? How would you describe your experience during those several months that you were tapering?
> Then I can assume the thought is that my body was just not creating seratonin
Well, actually, the reverse might have been true. There might have been a temporary increase in the production and release of serotonin. However, being exposed to artificially elevated concentrations of serotonin through reuptake inhibition can lead to a decrease in the sensitivity of receptors along the cell membrane. Neurons try to regulate themselves by changing the settings of their "thermostats". I really don't know what the dynamics are that produce the withdrawal syndrome and which variables take precedence in producing it.
If, while looking up at the stars in a planetarium, someone were to shine a bright flashlight in your eyes, you would no longer be able to see the stars immediately after the light is removed. The sensitivity of your eyes has been decreased in response to having been exposed to the bright light. In order to see the stars again, either the planetarium projector would have to make the stars shine brighter or one would need to allow the passage of a certain amount of time before the eyes adjust to the dark again. The variables would be things like how bright were the stars, how bright was the flashlight, how long was the flashlight on for, and how much time it takes for the sensitivity of the eyes (rods and cones of the retina) to adjust.
If you are unfamiliar with planetariums, then just substitute the planetarium with a dark night sky and the projector with God. :-)
Cast of characters:
stars = serotonin
retina = postsynaptic neuron (receiver) membrane
rods and cones of the retina = serotonin receptors
flashlight = reuptake inhibition (Effexor)
projector = presynaptic neuron (sender) serotonin synthesis and release
- Scott
Posted by seeknsolace on May 2, 2004, at 14:56:46
In reply to Re: relative efficacy of Effexor to the SSRIs » TanyaJean, posted by SLS on May 2, 2004, at 14:51:17
Scott your so cute, still havent answered my question tho! Yes, I'm wacky.. that goes without saying! :) Tanya, if its any encouragement, I took my first dose of 5-htp last night, from what I understand, its some herbal thing that comes from africa, so its natural and less then ten bucks for a months supply, anyways, I feel in some ways better today even after just one dose, the down side is, woke up with a head cold so cant say how I truly feel, been more functional today, but also feeling a bit cloudy.. a fair compromise. Maybe give it a shot.. you been suffering too severly for too long, I know it takes time, but four months is just too damn long.
> Regarding the discontinuation of Effexor:
>
> > > "The period required for tapering may depend on the dose, duration of therapy and the individual patient.”
>
> > I would have thought 4+ months of tapering and being on a low dose for over a month would be sufficient enough to not have all the side effects listed.
>
> Me too.
>
> How much were you taking during that last month before you discontinued it? How much did you take as your very last dose? How would you describe your experience during those several months that you were tapering?
>
> > Then I can assume the thought is that my body was just not creating seratonin
>
> Well, actually, the reverse might have been true. There might have been a temporary increase in the production and release of serotonin. However, being exposed to artificially elevated concentrations of serotonin through reuptake inhibition can lead to a decrease in the sensitivity of receptors along the cell membrane. Neurons try to regulate themselves by changing the settings of their "thermostats". I really don't know what the dynamics are that produce the withdrawal syndrome and which variables take precedence in producing it.
>
> If, while looking up at the stars in a planetarium, someone were to shine a bright flashlight in your eyes, you would no longer be able to see the stars immediately after the light is removed. The sensitivity of your eyes has been decreased in response to having been exposed to the bright light. In order to see the stars again, either the planetarium projector would have to make the stars shine brighter or one would need to allow the passage of a certain amount of time before the eyes adjust to the dark again. The variables would be things like how bright were the stars, how bright was the flashlight, how long was the flashlight on for, and how much time it takes for the sensitivity of the eyes (rods and cones of the retina) to adjust.
>
> If you are unfamiliar with planetariums, then just substitute the planetarium with a dark night sky and the projector with God. :-)
>
> Cast of characters:
>
> stars = serotonin
> retina = postsynaptic neuron (receiver) membrane
> rods and cones of the retina = serotonin receptors
> flashlight = reuptake inhibition (Effexor)
> projector = presynaptic neuron (sender) serotonin synthesis and release
>
>
> - Scott
Posted by SLS on May 2, 2004, at 15:03:16
In reply to Re: relative efficacy of Effexor to the SSRIs, posted by seeknsolace on May 2, 2004, at 14:56:46
> Scott your so cute, still havent answered my question tho!
:-)
No. <flattered and embarrassed>
- Scott
Posted by seeknsolace on May 2, 2004, at 15:07:03
In reply to Re: relative efficacy of Effexor to the SSRIs » seeknsolace, posted by SLS on May 2, 2004, at 15:03:16
> > Scott your so cute, still havent answered my question tho!
>
> :-)
>
> No. <flattered and embarrassed>
>
>
> - Scott
>aww embarrassed.. that makes you even more cute! ;)
Posted by TanyaJean on May 2, 2004, at 17:04:52
In reply to Re: relative efficacy of Effexor to the SSRIs » TanyaJean, posted by SLS on May 2, 2004, at 14:51:17
"How much were you taking during that last month before you discontinued it? How much did you take as your very last dose? How would you describe your experience during those several months that you were tapering?"
By the way, the planetarium analogy was excellent. Made total sense.
I had been up to 150 mg but didn't take that for long (I was taking EFFEXOR XR). The last 4 months, I was taking...what was it, 75 mg? After 1 month of taking the 75, I broke the capsule in half and would dump out the "dots" and count them. So basically I was taking 37.5 mg for 1 1/2 to 2 months. Then I would half that. So I took half of 37.5 for about a month and then every day would lessen the dose and lessen the dose. I didn't realize that's what a lot of people were doing, at least from what I've read on here. I came searching for information because I was so sick 1 week after I completely stopped.
When I was down to the 37.5 and then the half of that, I would feel fine during the day and about 5PM, I would start to feel really lousy. That lasted the entire time I was on the low dosages. 5pm rolled around and I was on the couch feeling dizzy and nauseous. The awful sound in my ears was there a lot even when I was still on the EFFEXOR. As if a small helicopter was following me around the house. It was hard to hear. I have 3 daughters and the 9 and 10 year old were wondering what in the world was wrong with me. They still wonder. I have to wonder if it's something to do with the Rheumatoid Arthritis. Before I was diagnosed, and was JUST on EFFEXOR, I had the exact symptoms if I missed a dose (dizzy, nauseous). There were times I didn't have the money for my copay and would miss 3 days. That was the worst.
I've probably written this too many times. My physician thought that because I was chronically in pain, that I was probably depressed, even though I didn't feel that way. I've had depression in my early 20's and my head just didn't have that depressed feeling. He also thought the anti-depressant would help control the pain issue. It never did. On or off it, there is no difference.
Scott, are you a student or psychologist or teacher? I missed it if you've ever said.
Posted by TanyaJean on May 2, 2004, at 17:10:10
In reply to Re: relative efficacy of Effexor to the SSRIs, posted by seeknsolace on May 2, 2004, at 14:56:46
"I took my first dose of 5-htp last night, from what I understand, its some herbal thing that comes from africa, so its natural and less then ten bucks for a months supply, anyways, I feel in some ways better today..."
I'm glad you're feeling better! Very sorry about the cold!! I had read a few weeks ago about 5-htp for something entirely different. A few weeks ago someone wrote about "Nux Vomica" and the name makes me want to do just that. It sort of helps. I guess. I can't stand to even look at the name. So I don't take them that often. I had taken Dramamine at the beginning of all this because I had the same feeling as with motion sickness. It took a slight edge off.
Posted by seeknsolace on May 2, 2004, at 21:01:01
In reply to Re: relative efficacy of Effexor to the SSRIs » seeknsolace, posted by TanyaJean on May 2, 2004, at 17:10:10
I'm feeling more icky and whiney about my cold then I am about the withdrawals.. it just sucks just a simple head cold always turns into some head/chest infection and I have no health insurance, but anyways, I had diff things on 5 htp too.. both good and bad. I thought maybe its just a matter of adapting and level of dosage, so by trial and error. Maybe it will work, maybe it wont.. but worth a shot (i'm speaking for myself.) Life wasnt very beautiful the first few weeks of being on effexor either, took time to adjust, but with this.. there shouldnt be the severity of the withdrawals.
One remarkable difference I noticed since taking it, my body didnt hurt even half as much today as it did all the days prior.
I did the dramamine too, I'm not sure if it helped.. maybe a little. I think the best medicine is rest, but having children we need to take care of, esp at the pre-teen rebelious stage, who can rest. I know I felt better this weekend (doing nothing) then as I did all last week while working and having unnecessary tension. I also notice when 'tension triggers' happen, I feel at my worst then too.. maybe something to all that..
>
> I'm glad you're feeling better! Very sorry about the cold!! I had read a few weeks ago about 5-htp for something entirely different. A few weeks ago someone wrote about "Nux Vomica" and the name makes me want to do just that. It sort of helps. I guess. I can't stand to even look at the name. So I don't take them that often. I had taken Dramamine at the beginning of all this because I had the same feeling as with motion sickness. It took a slight edge off.
Posted by Dr. Bob on May 3, 2004, at 3:04:33
In reply to Re: relative efficacy of Effexor to the SSRIs }} S » TanyaJean, posted by chemist on May 2, 2004, at 0:06:14
> doug's vendetta
> if you take a drug for 5 years ... and post 3 messages to enjoin a person in proceeding with legal action ... you are being asked to be part of a money-making scheme. and that is all there is to it.
I appreciate all the information and support you provide here, but but I also need to ask you please not to post anything that could lead others to feel accused or put down. Just because something may make someone some money doesn't mean that's all there is to it.
If you have any questions or comments about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
or redirect a follow-up to Psycho-Babble Administration.
Thanks,
Bob
Posted by chemist on May 3, 2004, at 3:10:59
In reply to Re: please be civil » chemist, posted by Dr. Bob on May 3, 2004, at 3:04:33
done....my opinions got the better of me...all the best, chemist....no more bashing....
Posted by Dr. Bob on May 3, 2004, at 3:20:45
In reply to Re: please be civil » Dr. Bob, posted by chemist on May 3, 2004, at 3:10:59
Posted by seeknsolace on May 3, 2004, at 6:01:27
In reply to Re: please be civil » Dr. Bob, posted by chemist on May 3, 2004, at 3:10:59
hey chemist, just seeing if you're doing alright, your posting time was 3 something am. I'm not sure what time zone your in or what time zone this board is set for. Seeing the time reminded me of the good old days of NOT SLEEPING. Before I knew I was bipolar/depressed.. just a few yrs ago. I had insomnia for 2 freakin yrs. I would wake every 15 mins to half hour, fully awake and alert. And that was waking to panick attacks and crying bouts, just to wear myself out then would go back to sleep.. fun times I tell ya! I didnt know that I was so ill, I thought it was just me.. how I am, tho I woke in tears with cause.. heartache.. (dam men!) I do know the heartache only manifested the root of the problem.
I went thru therapy to learn to sleep, to learn to love myself enough to relax and allow myself to sleep.. just took alot of strength to do this. Now, even still being bipolar, I dont suffer any more from insomnia. I look at the clock and tell myself I'm gonna sleep because I dont wanna feel like crap.. feel like I once felt. I dont know where your at, but hope you can get something out of this. Most of the time, I cant even stay awake during a nine o'clock movie!
Today is day 2 of being on 5-htp, woke with more mental clarity, still sick tho.. took some otc medicine last night, use to cause me to go into anxiety mode, but it didnt, so maybe getting better.
If I'm annoying anyone with writing too much.. good, I'm just gonna write even more! ;) I am a woman after all :P
Posted by SLS on May 3, 2004, at 10:09:27
In reply to Re: relative efficacy of Effexor to the SSRIs » SLS, posted by TanyaJean on May 2, 2004, at 17:04:52
Hi TJ.
> Scott, are you a student or psychologist or teacher? I missed it if you've ever said.
Car salesman. :-)
That sounds so funny, but it's true. I was a straight A student through my sophomore year of college, where I was working on a biology major. At that point I could no longer read, learn, and remember. I had to quit. After that, I floundered from job to job. Not pretty, but not unique. There are so many stories like that here. I had such a passion for medicine. I had to give up on that calling once I realized that even if I were brought into remission, medication breakthrough relapse was almost a certainty with the stresses of medical school and internship. I couldn't afford to take that chance.
I don't know how to account for the difficult time you had coming off of Effexor. It reminds me of what it felt like to discontinue Klonopin. But even that did not involve residual symptoms beyond one week. To come off of Effexor, I dosed myself as many times during the day as was necessary to stave off withdrawal symptoms. I would swallow a few grains here and a few grains there. I would purposely wait for symptoms of withdrawal to return and manifest briefly before taking a dose to alleviate them. It made sense to me intuitively that this would encourage the system to change by exposing it to the stimulus of withdrawal. I was able to go longer and longer periods of time before needing to dose again. To dose only once a day in the morning would not allow me to prevent a withdrawal syndrome from appearing by evening. I simply dosed whenever I needed to. I kind of did it by "feel". I know that I am susceptible to Effexor discontinuation withdrawal syndrome because I had to experience it several times prior to my using this flexible dosing schedule. I find that I can now get off of Ativan and Paxil the same way when necessary. I would like to think that this method of discontinuation would work for everyone, but I guess that is just wishful thinking. What you and some others describe as long-term residual effects of Effexor is scary. I don't know if a flexible dosing taper would prevent it.
- Scott
Posted by omi1 on May 3, 2004, at 12:49:48
In reply to Does it ever end? When?, posted by seeknsolace on April 30, 2004, at 5:33:17
I have been on and off effexor several times. I find coming off it to be like having a flu for a couple weeks-- nothing compared to the psychological agony of depression. Thats just my experience, which I thought I should add to the debate.
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