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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 143. Go back in thread:
Posted by Devastated Mother on January 23, 2006, at 7:07:59
In reply to Re: Suicide on Effexor, posted by Racer on January 22, 2006, at 20:52:57
"That's the strongest warning the FDA has, and it's being used. It may not be what you want to hear, but that black box warning is adequate.
Effexor has been a life saving drug for many people, including a number of people here. "
I do not dispute any of this. However, I wonder if I have possibly misunderstood the black box. Is the patient expected to warn his/her family about the potential problems? Is this a reasonable expectation from someone who is depressed?
Posted by linkadge on January 23, 2006, at 11:44:59
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 22, 2006, at 18:00:13
I am about the age of your son, and I can't help but relate. I am very sorry. I took effexor, and unfortunately it did make me more suicidal.
The doctors don't understand the drugs they are dealing with. They don't know how they can make people feel. On the one hand they don't trust the patient, but on the other hand the doctor trusts that the patient is going to tell the doctor that they are more suicidal? Not likely. I just lied. I was so tired of failed attempts at making me feel better, that I just lied about how I felt. I felt like saying, if you're only going to give me 5 minautes of your time, you don't deserve to know how I feel.
My heart goes out in support. If only there were some way I could help to make the whole system more safe.Linkadge
Posted by linkadge on January 23, 2006, at 11:49:48
In reply to Re: Suicide on Effexor, posted by Racer on January 22, 2006, at 20:52:57
I would agree, the black box warning is definately *NOT* adequate.
They can do more. Certain drugs, for instance, require stricter monitoring, in order to insure their safety. There are no guidelines on how the patient is monitored. Like I said in the above post. Do you think that a doctor can tell, in 5 minautes, weather or not a drug is making somebody suicidal. Not likely.
Linkadge
Posted by Devastated Mother on January 23, 2006, at 12:02:30
In reply to Re: Suicide on Effexor, posted by linkadge on January 23, 2006, at 11:44:59
Thank you, particularly for your honesty and your support.
I am glad you are not now taking the drug, and I am grateful you did not suffer the same fate my son did.
Posted by Devastated Mother on January 23, 2006, at 12:03:47
In reply to Re: Suicide on Effexor, posted by linkadge on January 23, 2006, at 11:49:48
Additionally, suicidal is not a linear thing. You can be fine one part of the day and then an hour later be overwhelmed.
Posted by nicky847 on January 23, 2006, at 13:27:58
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 23, 2006, at 7:07:59
i am deeply sorry to hear about your loss...
how long had your son been taking effexor for?
i too think that these side effects are real...i am wondering though if this is something that goes away over time...both times i started taking lexapro i noticed for the first couple of months i would get very scary thoughts and feelings that i did not normally have even when depressed...but after about 8 weeks they became less intense and then eventually disappeared..
effexor is a powerful drug...my therapist told me its usually the med of last resort due to the bad withdrawal effects it has..
Posted by Devastated Mother on January 23, 2006, at 15:42:56
In reply to Re: Suicide on Effexor, posted by nicky847 on January 23, 2006, at 13:27:58
Not long -- maybe three weeks, he was on it, before his death. Yes, I definitely think it should be the drug of last resort. It was the second one they tried with him. I think his doctor just believes in it for some strange reason.
Posted by Devastated Mother on January 24, 2006, at 2:57:14
In reply to Re: Suicide on Effexor, posted by summerflowers on January 23, 2006, at 5:38:49
summerflowers,
Thank you for the link to the summaries of the studies on psychiatric drugs. I checked it out and find it absolutely reasonable and helpful in some ways. I suspect that there are many instances that do not get reported. Do you have any idea how one would go about finding out if adverse effects of drugs have been reported to the FDA?
Devastated Mother
Posted by summerflowers on January 24, 2006, at 3:39:20
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 24, 2006, at 2:57:14
> summerflowers,
>
> Thank you for the link to the summaries of the studies on psychiatric drugs. I checked it out and find it absolutely reasonable and helpful in some ways. I suspect that there are many instances that do not get reported. Do you have any idea how one would go about finding out if adverse effects of drugs have been reported to the FDA?
>
> Devastated Mother
>Im so sorry for your loss.It angers me .Coverups,lies,neglect,its all there.It is estimated more people have died in psychiatry than in all the wars put together.It is also estimated psyciatry only helps 1% of people.I sent a report in on a near fatal severe reaction.But I allways wonder how many others-in our neighborhood,town,city,country have been reported,or just swept under the carpet.Maybe a true investigation would reveal something shocking.Its devestating.
Posted by nicky847 on January 24, 2006, at 10:44:32
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 23, 2006, at 15:42:56
i think that there needs to be MUCH closer monitoring of patients on antidepressants for the first month they are on them...the period that the body adjusts to the meds can be very scary..
i think after a while they are helpful, and they have helped me.. but in the short term they are dangerous
but it's not feasible to hospitalize every person that goes on a/d's until they adjust to the meds..so there has to be some other solution that can provide closer monitoring and counseling during the adjustment period
Posted by nicky847 on January 24, 2006, at 10:49:55
In reply to Re: Suicide on Effexor » Devastated Mother, posted by summerflowers on January 24, 2006, at 3:39:20
> > summerflowers,
> >
> > Thank you for the link to the summaries of the studies on psychiatric drugs. I checked it out and find it absolutely reasonable and helpful in some ways. I suspect that there are many instances that do not get reported. Do you have any idea how one would go about finding out if adverse effects of drugs have been reported to the FDA?
> >
> > Devastated Mother
> >Im so sorry for your loss.It angers me .Coverups,lies,neglect,its all there.It is estimated more people have died in psychiatry than in all the wars put together.It is also estimated psyciatry only helps 1% of people.I sent a report in on a near fatal severe reaction.But I allways wonder how many others-in our neighborhood,town,city,country have been reported,or just swept under the carpet.Maybe a true investigation would reveal something shocking.Its devestating.
>people do die in psychiatry...but you have to remember that in alot of those cases its the disease that kills and not the cure....people die in oncology too but its not because of the chemo in most cases, its because of the cancer..depression is a serious illness! and the worst part is that people who suffer from it are ashamed of it and dont want to talk about how they are feeling..
in my opinion, the problem is that we desperately need to improve our research of mental health issues..advances have been made but we as a society need to drag this disease into the light, remove the stigma, and begin finding more effective and less dangerous treatments...antidepressants are a start but we can do much, much better!
Posted by Racer on January 24, 2006, at 12:59:46
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 23, 2006, at 7:07:59
>
>
> However, I wonder if I have possibly misunderstood the black box. Is the patient expected to warn his/her family about the potential problems? Is this a reasonable expectation from someone who is depressed?And therein lies the rub...
I think the theory is that doctors monitor their most vulnerable patients closely enough to ensure their safety, and let parents or caregivers know that there is some danger during the adjustment phase.
And pigs fly through the air on great multicolored wings.
All I meant is that the FDA has *very* limited means to ensure the safety of people taking these drugs. The Black Box is the strongest thing they have. Beyond that, the doctors who prescribe these drugs are the ones who really have to step in to ensure the safety of their patients.
In a perfect world, there would be a therapist monitoring the patient and coordinating care with the psychiatrist. In the world of HMOs, of course, this doesn't always happen, and pdocs often don't see patients frequently enough during the adjustment phase, and in many cases GPs are prescribing these drugs rather than pdocs. All of those contribute to the problem.
As for why Effexor is not the last resort drug -- and it's not, because there are much more problematic ADs out there -- it's partly because it's generally well tolerated, and it's different from SSRIs. Doctors prescribing antidepressants go through a sort of protocol that starts with SSRIs because they're pretty benign drugs from a medical viewpoint. From there, they'll usually go to the SNRIs, of which there are two: Cymbalta, which is a bit of a disappointment, and Effexor. Effexoer has been around a while, Cymbalta has been out for about a year and a half. Most doctors will go for what they know a bit better first -- hence, Effexor is often a second choice, rather than last choice. How can I call them benign drugs? From a medical viewpoint, they are: no cardiotoxicity, no hypertensive crisis, no hypotension, no known LD50 in many cases, etc. And they tend to be effective for many people, and generally with far fewer side effects than the TCAs or MAOIs. The other newer drugs, Remeron, Wellbutrin, etc, have their own drawbacks, which make them somewhat less popular. So, most doctors will start with SSRIs and go on to Effexor.
I am sorry about your experience.
Posted by Devastated Mother on January 24, 2006, at 18:29:32
In reply to Re: Suicide on Effexor, posted by nicky847 on January 24, 2006, at 10:49:55
I guess I could accept this if my son had had depression issues for years. He did not. He had a couple of things happen in his life that would have depressed anyone, and a bad doctor decided effexor would help. Just a bad choice on her part not to assume that there would be a need for someone else to know about her decision and it's potential effects.
Posted by Smeegle on January 24, 2006, at 19:23:38
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 24, 2006, at 18:29:32
Sorry to hear about your loss. Your post struck a chord with me because I attempted suicide while weaning off Effexor. Fortunately for me, I just ended up in the psych hospital for a couple of weeks while it cleared my system and my new meds started working. I don't blame my pdoc even though he didn't warn me. I was taking it before we started reading about the "possible" suicide potential in children but not once did I ever read that it was a strong possibility for adults as well. I am 42 and never had a suicidal thought before then. Effexor seemed like a miracle drug when I first started taking it. I thought I had my life back. But then we started having to increase my dose about ever six months until I reached the maximum dose my dr would prescribe and my bp was high. It was only when I stopped taking it that there just didn't seem to be any other options. Looking back I can see how irrational my thinking was, but at the time it was so vivid and painful. It was no longer a matter of 'would I', but rather a matter of 'when'. I am now on Lexapro and though I still have depression, my thinking is rational and I fully believe in my current state of mind I would have the courage to ask for help. I would never recommend Effexor to anyone for any reason. It's not worth the risk.
Posted by summerflowers on January 25, 2006, at 0:24:37
In reply to Re: Suicide on Effexor » Devastated Mother, posted by Racer on January 24, 2006, at 12:59:46
> >
> >
> > However, I wonder if I have possibly misunderstood the black box. Is the patient expected to warn his/her family about the potential problems? The Black Box is the strongest thing they have. Beyond that, the doctors who prescribe these drugs are the ones who really have to step in to ensure the safety of their patients.>EXACTLY! Its like if you have an electrical problem say,in your house,you call in an electrician.You expect them to do their job safely,because it could be dangerous or lethal if it isnt.They get payd for their electrical expertise,Just like psychiatrists do.If the electrician causes a fire,they are liable for that,because they didnt do the job properly.People are warned about the dangers of electricity just as patients are warned of the dangers of these medications,but it is up to the experts to do their job-thoroughly!Just as an electrician or what have you.Man,I cant believe half of what goes on.
Posted by gardenergirl on January 25, 2006, at 22:57:53
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 24, 2006, at 18:29:32
> Just a bad choice on her part not to assume that there would be a need for someone else to know about her decision and it's potential effects.
Unless your son signed a consent for release of information, the doctor was not legally allowed to inform anyone about your son's being on psychotropic medications unless he directly expressed his intent to immediately harm himself to the doctor.
I'm sorry for your loss. I just wanted to clarify why a doctor might not inform an adult's parent about his care.
gg
Posted by Devastated Mother on January 26, 2006, at 1:47:52
In reply to Re: Suicide on Effexor » Devastated Mother, posted by gardenergirl on January 25, 2006, at 22:57:53
Yes, I know about the forms. Every other doctor he had, when he was asked, he willingly signed the form for us to be told. I don't think she asked him, because he would have signed it.
Yeah, just a mistake on her part. And it only cost him his life. Oh well...
Posted by summerflowers on January 26, 2006, at 2:37:38
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 1:47:52
> Yes, I know about the forms. Every other doctor he had, when he was asked, he willingly signed the form for us to be told. I don't think she asked him, because he would have signed it.
>
> Yeah, just a mistake on her part. And it only cost him his life. Oh well...
>Two years ago,my partner of 16 years who I love and are so close to,(and the father of our 5 children) went through a rougth patch.Nothing he couldnt usually deal with.In the past,he had tackled problems,got through them,he also spent time in a rehab,a place where he came out stronger,so much healing went on.They didnt just deal with the alcaholism,they also dealt with everything deeper,including a chilhood of severe abuse.For 6 years he held onto the strength they gave him,and the skills taught,in how to survive in life.So,this time,he was advised by someone to see a therepist.When he went to the place he was given a psychiatrist,we didnt know the difference.This lady started bringing up his past,the past which he had dealt with allready in rehab.It all got dragged up again,and all the emotions with it.She diagnosed him PTSD,and gave him drugs to help,aropax and epilim.Each day went by and his whole character seemed to become possesed,rage came into the picture,character changes where he started acting really narrsistic.I told him I was scared,told him he had to stop taking the drugs,4 weeks he was on them,then he attempted suicide.He tried 4 ways but he amazingly survived.He has permanant damage to his brain,liver,and emotions.They dont seem to care.They also didnt involve me in anything,I was just nothing to this woman,she thought she knew him better than me for some reason.My heart goes out to you.I dont know if I should submit this,because the words you said above should be the last said,it is that sad.
Posted by Devastated Mother on January 26, 2006, at 5:55:35
In reply to Re: Suicide on Effexor, posted by summerflowers on January 26, 2006, at 2:37:38
summerflowers, and all of you here,
It does help to know I am not crazy, so your sharing here is helping me. I am grateful, especially since I can see you are sharing times that were incredibly difficult for you as well. For me, life will go on, as I know it must, but I am driven to try to do something to change our system that allows these sorts of things to happen to people. This is so wrong.
Posted by shasling on January 26, 2006, at 7:08:21
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 5:55:35
> summerflowers, and all of you here,
>
> It does help to know I am not crazy, so your sharing here is helping me. I am grateful, especially since I can see you are sharing times that were incredibly difficult for you as well. For me, life will go on, as I know it must, but I am driven to try to do something to change our system that allows these sorts of things to happen to people. This is so wrong.--Mom,
As someone who has never faced anything like this, I found that I had little to offer other than my deepest condolences and wishes for your healing. I wished I could do more to make it better. However, as a mom of a son the same age, who can't even process the the horror, I had to recognize that I very well might only make it worse by inadvertently dragging you back to a place you have already travelled through.
When I see this morning that you have received a measure of comfort and relief from talking with the others I am so grateful. It brought surprise tears to my eyes. I just want so badly for you to find some comfort, and was frustrated that it wasn't something I could do. Thanks to the others, and I am sorry for all of your experiences and losses.
With hope for your continued healing,
Suzie
>
>
Posted by Racer on January 26, 2006, at 13:24:45
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 5:55:35
> but I am driven to try to do something to change our system that allows these sorts of things to happen to people. This is so wrong.
>
>Believe me, I can relate to that sentiment.
If you really do want to do something to improve the system, I highly recommend that you report the doctor involved to your state's medical board. You can get all the forms online, and it's not that difficult to get through the whole process. The benefit of doing this is that it's free -- AND, if the doctor gets any sort of consequence at all, it's a whole lot easier if you choose to sue at a later date.
The medical boards are an often overlooked resource, and the more reports they get, the better the chance that things will change.
Another thing to do is to contact your local representatives -- although it shouldn't be, health care is a political issue. Especially mental health care.
Also, you can contact your local chapter of NAMI -- the National Alliance of the Mentally Ill. They have a lot of information about how to get through the maze of getting help in this sort of situation -- whether that help is getting the doctor involved investigated to make sure she did everything she was required to do, or getting you counseling, or adding you to a list of people the legislators should know about for the next time something about this comes up.
I realize that I'm suggesting that you DO things at a time in your life when I very much doubt you feel up to it, and I regret that. Maybe you'd find the process therapeutic, but regardless of that I very much hope that you have found grief counseling for yourself.
Posted by Devastated Mother on January 26, 2006, at 13:42:53
In reply to Re: Suicide on Effexor » Devastated Mother, posted by Racer on January 26, 2006, at 13:24:45
Actually, it has been a little more than six months, and I am at a point where I do want to DO something. I will probably never need counseling in my life--I will probably never trust another shrink in my life. If I had been less trusting, this wouldn't have happened.
I will start the process of trying to contact the medical board. Thanks for the suggestion.
Posted by summerflowers on January 26, 2006, at 15:32:29
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 26, 2006, at 13:42:53
> Actually, it has been a little more than six months, and I am at a point where I do want to DO something. I will probably never need counseling in my life--I will probably never trust another shrink in my life. If I had been less trusting, this wouldn't have happened.
>
> I will start the process of trying to contact the medical board. Thanks for the suggestion.
> You have all of our deepest sympathy,and I really think people all over the world who have been through this should stand together,and let the truth be told,for those that we loved.
Posted by simon levane on January 31, 2006, at 8:52:20
In reply to Suicide on Effexor, posted by Devastated Mother on January 21, 2006, at 2:23:04
I lost my 20 year old daughter in May 2004 under very similar circumstances. She had been prescribed effexor by a highly rated specialist in a Mental Health and Addiction Foundation for Obsessive Compulsive Disorder and General Anxiety Disorder. I had no idea that the drug had risk. She had a long history of personality disorder "acting out" and some previous attempts with overdoses of tylenol, but never a "final act". Neither the specialist, nor a psychiatrist she was seeing, nor our family doctor who was prescribing the drug advised us of the risk. I had let the family doctor know that she was abusing her use of ritalin by stealing extra doses from me, but he was clueless about the real risks of ritalin addiction, and the potentially deadly combination of tranquilizers and ritalin and the effexor. My daughter killed herself in the subway the day after her dose of effexor was increased.
This whole ridiculous aspect of medical confidentiality is so stupid when facing an at risk young person whose judgement was completely questionable due to her illness. Doctors are supposed to provide information if there is a serious risk of safety. When we later saw her medical records and I understood the total picture which I did not when she was alive from emotional exhaustion (not uncommon with troubled kids) and because I could not have imagined the stupidity and lackadaisical attitude of doctors about prescribing mind influencing drugs.
The pain of losing a child is just beyond comprehension. I wish that my daughter's medical caregivers could experience my pain for one day -- they would never ever forget to look after their patients. My daughter was full of life in spite of her illness and had so much to look forward to. Now I live in an agony that she could never have imagined being inflicted on me. It is a wonder I have not actually killed myself.
Many parent survivors of loss of their children to suicide feel just like that.
Doctors simply do not want to be accountable for this unbelievable kind of disaster. They would rather rationalize that "depressed people kill themselves", instead of accepting their own failure to duly inform family members of risk of medications.
Posted by Devastated Mother on January 31, 2006, at 9:25:16
In reply to Re: Suicide on Effexor » Devastated Mother, posted by simon levane on January 31, 2006, at 8:52:20
I am incredibly sorry for your loss. It has indeed been a long uphill battle with my own feelings in the face of this loss. I am sure it is not over.
Did you report the doctor to anyone or take any other steps?
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Dr. Bob is Robert Hsiung, MD,
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