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Dr. Bob is Robert Hsiung, MD,
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Posted by Dim_Light_Shining on August 20, 2006, at 22:51:50
In reply to Problems with Effexor XR and alcohol?, posted by Aciel on August 20, 2006, at 19:33:40
Hi Aciel,
I just read your post and there's a few things that really jumped out at me. I should start by saying I'm not any kind of health professional, but personal experience has taught me some things about depression and self-medication.
To me, it sounds like you may have two issues: alcohol, and the alcohol interacting with the Effexor, which indeed lowers tolerance. I find it concerning that you crave alcohol on a daily basis and recently drank a dangerous amount when no one was around to stop you, and that you don't feel you can stop drinking. May I ask why you feel you can't stop; is it a social thing, like related to friends, or is it something you feel that you yourself need? I completely know how easy it is, when you're depressed, to grab hold of anything that makes the pain go away for awhile. Unfortunately, this is also how many people find themselves in over their heads!
Again, this is only my opinion; I'm offering it in the spirit of helpfulness, not to boss or judge you. My suggestion is to speak to your doctor or psychiatrist without delay and tell them about your experiences with alcohol. There may also be programs for teenagers who are concerned about their alcohol use; you can usually find them in the phone book, or your doctor or guidance counsellor can refer you. You're well-spoken and clearly intelligent, and you were strong and self-aware enough to get help for your depression. You can use these same qualities to address your drinking before you come to harm. Please take good care of yourself, and lots of good wishes your way.
Posted by Dim_Light_Shining on August 20, 2006, at 23:09:58
In reply to Re: Horrible drug, posted by BB1969 on August 12, 2006, at 8:50:31
Hello all,
I was on Effexor a few years ago for about 12 months and it worked wonderfully, with no side effects whatsoever. I was able to discontinue it with no immediate problems; however, I've had several episodes of depression since then and finally decided to go back on meds.
I've been back on Effexor (only 37.5 mg. at this point) for only a few days now, so I'm not noticing any change in my mood yet, but instead a number of side effects. I'm dizzy, lightheaded, have restless legs (always did, but I'm really dancing now) and sexual side effects (a little more info than I wanted to share, but alas!).
I really don't want to get into switching medications around searching for a suitable one...it is a bit frustrating, as it worked so well for me the first time around. Does anyone know why this might be, or have a similar experience? Any suggestions for coping with restless legs or the lack of normal "appetites"? Might these effects improve or go away once I've gotten used to having the drug in my system?
Thanks very much.
Posted by dancing fool on August 21, 2006, at 9:28:02
In reply to Problems with Effexor XR and alcohol?, posted by Aciel on August 20, 2006, at 19:33:40
Hi Aciel,
I've been on Effexor for a few years (75 or 150mg). I also drink. I also feel a lowered tolerance and lowered self control, but not to the extent that you describe. Then again, I'm 46 years old and have been drinking all my life ...
I wonder if you've felt that you had issues with alcohol before you were on Effexor. The reason I ask is that maybe the drug in combination with your changed social environment brings out something that was there in the first place. Social pressure to drink is a terribly dificult thing to handle if you have some kind of a drinking problem - I know I have and I know I've never really been able to deal with it - except from quitting altogether.
If you're seeing a shrink, I would definitely bring it up. If you're not, please be careful and know that there are many who are having a hard time to deal with the social context of drinking. Some people find occasional AA sessions helpful. Finding additional friends who don't pressure you into drinking could also be an option. I'm not saying you should drop your drinking buddies, just find a few that don't, or at least don't find it important ... or something (just caught myself preaching there, sorry :-))
I'm pretty confident that you'll find some kind of solution - just the fact that you recognize it is pretty big. I doubt that the effexor has a whole lot to do with it, except that it blows up something that was there already. Then again, I've come across quite a few posts that claim that alcohol and effexor don't mix, period.
please keep in touch
dancing fool
Posted by antigua on August 21, 2006, at 12:26:42
In reply to Problems with Effexor XR and alcohol?, posted by Aciel on August 20, 2006, at 19:33:40
yes, I've heard of this. When I was on Effexor before I quit drinking, it had quite an effect on my drinking. I've since quit and switched to Cymbalta.
But I have heard of Effexor making someone crave alcohol. Talk to your pdoc.
antigua
Posted by Aciel on August 21, 2006, at 14:45:56
In reply to Re: Problems with Effexor XR and alcohol?, posted by antigua on August 21, 2006, at 12:26:42
Wow, I definitely wasn't expecting such a response - and so soon. Thanks.
I never had anything more than one drink here or there before I was on the medication - just something my parents would let me have on special ocasions. I only began drinking because of the guy I was going out with and the new crowd that it brought. I've since made tons of new friends that I've met from parties, and at my school, drinking and partying is like the "cool" thing to do. The whole school is filled with wealthy, spoiled kids of high status parents, and when we get bored...we drink. I know people who drink much more than I do, it's just never affected them as bad.
But what you all have said is true, lately I have been turning to booze to numb the pain - it's just leaving me feeling even more depressed than I was before I drank. Real bright idea, right?
Just been a little freaky, since I never had the same thoughts about alcohol a year ago - I was in fact, terrified of drunks. Now I am one.
I'm going to try and cut back from now, and if it doesn't turn out how I hope, I'll definitely be seeing my doctor even sooner.
Thanks again, guys.
Posted by invisibleman15010 on August 21, 2006, at 16:08:46
In reply to Re: Problems with Effexor XR and alcohol?, posted by Aciel on August 21, 2006, at 14:45:56
Hi,
I had to get my two cents in on this one, as I too self medicated before I realized I had depression, have been on Effexor and am thinking of possibly going back on it. Anti depressants, benzos, alcohol don't mix. Especially if you are not able to control yourself. You are opening up a bottomless pit. One or two beers might not hurt you. But, on the other hand it may send you off to la la land and I don't mean Los Angelos. I remember having a few beers and some shots while on a long stressful business project. Next thing I knew, I was in bed. I was told that I was babbling, speech slurred, made a real *ss of my self, very unprofessional, but I learned a lesson. I havn't touched alcohol in almost two years and when I did, I was at home and made sure I only had a little bit and basically it just put me to sleep. Don't be like Jimi Hendrix, young, some much talent and life ahead, the musical world at his feet......a bottle of wine, sleeping pills and a grave...Sometimes, anxiety, severe depression, alcohol abuse, alcoholism, medication abuse just all rolls into one major life crisis that is hard to break out of........Good luck all.
e
Posted by dancing fool on August 22, 2006, at 4:22:45
In reply to Re: Horrible drug, posted by Dim_Light_Shining on August 20, 2006, at 23:09:58
Hi,
I suspect these side effects will pass. Give it a couple of weeks. If they're not over by then, consult your doc.
good luck
Posted by invisibleman15010 on August 22, 2006, at 8:13:53
In reply to Re: Horrible drug, posted by dancing fool on August 22, 2006, at 4:22:45
Aciel,
If you are only 17 and know that you are dealing with anxiety issues and alcohol abuse issues, dig your heels in and deal with it now. It can ruin your life. I don't remember any anxiety issues until I was a junior in college ...then out of the blue...I started having panic attacks while doing speeches or even just sitting in a class room. Without knowing what to do, I ran and started avoiding socail situations when I could. As my professional career kicked in the anxiety issues got worse,I started using alcohol to self medicate, then depression hit in my 30's. I really had no clue what was happening to me.
I have worked in post secondary education for years and saw the kids that were abusing alcohol and pot and other drugs daily. A little fun can all of a sudden become the monkey on your back.Find the best help that you can and take it. College and life thereafter can be a great experiance or it can be hell. Make it a wonderful experiance. God Bless, good luck.
E
Posted by inshadeoftree on August 22, 2006, at 12:38:15
In reply to Re: /Hey to Aciel!!!!, posted by invisibleman15010 on August 22, 2006, at 8:13:53
MY Goodness....I'm on my second day of Venlafaxine (Effexor X R ) and boy oh boy...what a bunch of information to sift..social anxiety disorder-general anxiety disorder-depression-leg twitching,lightning in my head...my my So I turn on my computer and google the drug and find a group of people discussing teenage drinking and depression and suicide and side effects--and dosage adjustments and their potential....my my what a wonderful world it is here today...a man in my position can feed the nervous cells in my head with usable information with almost no strings....
I'm not capable of being able to judge the value of the information offered here,but I recognize things like need and human warmth,and good oldfashiond heart felt words......onward we go..
Posted by BB1969 on August 22, 2006, at 16:02:31
In reply to Re: /Hey to Aciel!!!!, posted by inshadeoftree on August 22, 2006, at 12:38:15
> MY Goodness....I'm on my second day of Venlafaxine (Effexor X R ) and boy oh boy...what a bunch of information to sift..social anxiety disorder-general anxiety disorder-depression-leg twitching,lightning in my head...my my So I turn on my computer and google the drug and find a group of people discussing teenage drinking and depression and suicide and side effects--and dosage adjustments and their potential....my my what a wonderful world it is here today...a man in my position can feed the nervous cells in my head with usable information with almost no strings....
> I'm not capable of being able to judge the value of the information offered here,but I recognize things like need and human warmth,and good oldfashiond heart felt words......onward we go..
Don't be discouraged - just be armed with information to talk to your doctor about. Some have had no side effects - others, like me, a different story. I feel this medication is killing me and I'm slowly getting off of it.
Posted by invisibleman15010 on August 22, 2006, at 16:22:29
In reply to Re: /Hey to Aciel!!!!, posted by BB1969 on August 22, 2006, at 16:02:31
Why can't it be as easy as choosing Tylenol or Advil...prior posting talks about Effexor with the same symptons I had on Paxil and Zoloft. Paxil was like a bad acid trip.....Are each of our brains wired so differently that these meds have such different effects.....seems like so few posting say....wow I feel wonderful.....I am ready to start a new life......is there something more here?? Are we having the proverbial wool pulled over our eyes? I am only addressing anxiety and depression, OCD, Bi Polor, Schizophrenia I can't even touch on....though I have seen the results......but I am very familiar with the effects, side effects, non effects of these anti depressant/anti anxiety meds.........I think we and the insurance industry are all being taken for a major ride.......Mine are in the toilet......well sewage plant by now.......How about a shot and beer........these meds are seeming to be much worse as I read more reports, visit more sites and try more med cocktails........
e
Posted by invisibleman15010 on August 22, 2006, at 16:26:15
In reply to 90%Negative Postings..9%Some Help....1% Great???, posted by invisibleman15010 on August 22, 2006, at 16:22:29
Are there any live saved by medication stories?
Posted by Elroy on August 22, 2006, at 16:53:42
In reply to Can someone post a true hands down meds saved me, posted by invisibleman15010 on August 22, 2006, at 16:26:15
> Are there any live saved by medication stories?
In my case, yes.Situation: Anxiety which developed from severe stress into mild anxiety and then into moderate anxiety and then went into a condition of Pseudo Cushing's accompanied by severe anxiety and a number of physical symptoms.
Xanax XR saved my life. A minor dose (1 mg twice a day) was enough to keep the edge off to keep me from going completely nuts - and helped stem the tide of the super elevated levels of cortisol that my conditionwas causing. After a 2 week stay at NIH Hospital (where extensive testing was done - in December of 2005) they confirmed the Pseudo Cushing's diagnosis and recommended that my anti anxiety meds (Xanax XR) be significantly increased. On my return it was increased to 2 mg three times a day (around late January of 2006). Since then my condition has slowly but steadily continued to improve.
Elroy
Posted by invisibleman15010 on August 22, 2006, at 18:46:55
In reply to Re: Can someone post a true hands down meds saved » invisibleman15010, posted by Elroy on August 22, 2006, at 16:53:42
The stress then fall into major anxiety sounds very familiar. What is Pseudo Cushing's? I know Xanax helped me. NO med has really helped me at all with depression symptons. But, the benzos, now klonopin does provide me with relief from anxiety and the depression seems to lift a little. I feel almost normal.But it does not last. Glad you got good help. You are a lucky man.
e
Posted by Dim_Light_Shining on August 22, 2006, at 20:37:24
In reply to Re: Can someone post a true hands down meds saved, posted by invisibleman15010 on August 22, 2006, at 18:46:55
Hi,
I'm sorry to hear your experiences with meds have been disappointing overall. But don't give up, as new drugs are always under development...I really hope that something turns up to help you find lasting peace in your life.
I have had a really great experience with Effexor in the past. When I was in my first year of university, I was deeply depressed and at times suicidal. I started taking Effexor and over the next few weeks it was like watching a miracle unfold...I felt so much better, even though I was on a low dose. Whether it was the drug, the cognitive-behavioural therapy I was doing or a change in my circumstances is hard to say, as all happened around the same time...I like to think it was a combination.
I just started taking Effexor again...I'd been off it for a few years and then everything came back. But I try to remind myself how well things turned out last time and try to stay hopeful.
Please try to stay hopeful too - I know how frustrating and discouraging it is. If you haven't already, you may want to look into counselling or cognitive-beahvioural therapy, as this has really helped me.
Hopefully this has provided some encouragement, or whatever else you need to hear right now. Please take good care of yourself and hang in there!
Posted by HOPEFULL on August 23, 2006, at 6:34:17
In reply to Re: Can someone post a true hands down meds saved, posted by Dim_Light_Shining on August 22, 2006, at 20:37:24
Hello, to everyone,I will tell you one thing,yesterday was my 2 day with EFF and I feel tension on my neck because I was only able to sleep 5 hours. But I can say I was able to feel a tiny bit better...of course and no offense to noone, I pray and keep on having Faith... that someday we all WILL,Wake up and SAY WHAT A WONDERFUL DAY, HAVE A BLESS DAY TO ALL
Posted by HOPEFULL on August 23, 2006, at 6:46:29
In reply to Re: Problems with Effexor XR and alcohol?, posted by Aciel on August 21, 2006, at 14:45:56
Posted by Elroy on August 23, 2006, at 7:50:07
In reply to Re: Can someone post a true hands down meds saved, posted by invisibleman15010 on August 22, 2006, at 18:46:55
> The stress then fall into major anxiety sounds very familiar. What is Pseudo Cushing's? I know Xanax helped me. NO med has really helped me at all with depression symptons. But, the benzos, now klonopin does provide me with relief from anxiety and the depression seems to lift a little. I feel almost normal.But it does not last. Glad you got good help. You are a lucky man.
> eIt is a form of Cushing;s Disease. There is actual Cushing's Disease where the body produces excessive cortisol due to a pituitary tumor. Then there's Cushing's Syndrome which is caused by either an adrenal gland tumor or an ACTH-secreting small-cell cancer. Then there's Exogenous Cushing's where a doctor has prescribed excessively strong levels of artificial cortisol (prednisone, etc.)... and then there's Pseudo Cushing's where the body produces highly excessive cortisol for any one of a number of reasons. Excessive obesity. AIDS. Active stage HIV. Acute, chronic alcoholism. And either chronic and/or acute depreession or anxiety.
In the latter case, endocrinologists call it Pseudo Cushing's, while neuropsychiatrists simply refer to it as a psychological disorder accompanied by excessive secretion of cortisol. Interestingly, while Endos are doing much research on "regular" Cushing's, they pretty much ignore Pseudo Cushing's - while the neuropsychiatrists are doing some quite serios research on psychological disorders accompanied by excessive secretion of cortisol (which is in fact MY version of PC).
An interesting article - from NIH Hospital - on that aspects of PC (psychological disorders accompanied by excessive secretion of cortisol) can be found at:
http://www.nih.gov/news/pr/sep2002/nichd-09.htm
Posted by flipsactown on August 23, 2006, at 8:26:47
In reply to Re: HAS ANYONE USE CYMBALTA (nm), posted by HOPEFULL on August 23, 2006, at 6:46:29
Currently on Cymbalta 60mg, Wellbutrin 400mg for sexual side effect of Cymbalta and Trazodone 150mg for insomnia side effect of Cymbalta. Have been on this combo for at least 5 months with great success. I have had unipolar depression and have been taken numerous AD's with great success for over 20 years. I am male.
Posted by invisibleman15010 on August 23, 2006, at 8:34:48
In reply to Re: Can someone post a true hands down meds saved, posted by Dim_Light_Shining on August 22, 2006, at 20:37:24
Dim lite shining,
Thanks for the post. It home for me. I am thinking about going back on Effexor??? As I have stopped all of my other med cocktail which was not working and never really did. Hey, let me know how you do. I have to decide before mid September when I go back into the Dr. He is pushing for ECT and then back on another med. I am leaning towards Effexor, or the natural route, via St. Johns Wort, Sam E, etc. none of the others have done anything for my depression.
e
Posted by invisibleman15010 on August 23, 2006, at 8:38:47
In reply to Re: Pseudo Cushing's » invisibleman15010, posted by Elroy on August 23, 2006, at 7:50:07
How do they know if your body is producing to excessive amounts of cortisol?
E
Posted by invisibleman15010 on August 23, 2006, at 8:51:12
In reply to Re: Pseudo Cushing's » invisibleman15010, posted by Elroy on August 23, 2006, at 7:50:07
Very interesting article, seems to fit in parts. But with a limited understanding of chemistry,endochonology etc.(I was a business major) I find a lot of it questionable, as many of us can find parts of the studies that fit some of our conditions. So how are we to know, when most of our GP or Psy Dr. are out in left field to, except for what the drug reps. are pushing. I have been to a number of well respected(at least in my general area) Psy docs and Gps and they never get past, yes you have severe anxiety and or depression, who, why or what doesn't enter the picture. But, thanks again for the article. Good food for thought as I contimplate my next Psy. move.
e
Posted by Crazy Horse on August 23, 2006, at 9:48:25
In reply to Re: Pseudo Cushing's » Elroy, posted by invisibleman15010 on August 23, 2006, at 8:51:12
Posted by Elroy on August 23, 2006, at 11:13:58
In reply to Re: Pseudo Cushing's » Elroy, posted by invisibleman15010 on August 23, 2006, at 8:38:47
The most accurate test is called a "24-hour Urinary Free Cortisol Test". A blood test or a saliva test takes just a momentary "snapshot" of what your cortisol levels are at that exact moment, whereas the 24-hr UFC gives you a more accurate picture of the TOTAL daily output. As cortisol secretion - and therefore the levels on the blood / saliva - vary during the course of the day. You could therefore have highly elevated cortisol levels in general, but just happen to have a blood draw done at the one time of the day where your secretion levels just happened to be just within range. So the doctor says that you're fine. But erally you might be 2 - 3 times (or higher) the maximnum of the reference range for that hormone.
If your levels are in fact elevated, then the next follow-up step would be to have either a Late Night Serum Cortisol draw (blood test) or Late Night Salivaery Cortisol test (saliva test). Because now you DO want a "snapshot picture" of where your cortisol levels are at... if you have PC version then your cortisol levels will be not only within range, but in the lower levels of the reference range). If your late night levels are elevated above range, then it is likely that you have one of the "regular" versions of Cushing's (test is done between 11 PM and Midnight).
Posted by Elroy on August 23, 2006, at 13:53:36
In reply to Re: Pseudo Cushing's » Elroy, posted by invisibleman15010 on August 23, 2006, at 8:51:12
Don't get me wrong. Neither I - nor that article - is saying that ALL conditions of anxiety or depression is caused by or in turn causes elevated cortisol levels.
That's the problem with this field, is that there are so many numerous causes of anxiety / depression... some purely traumatic experiences, some chemical imbalances, some hormonal imbalances (a field - like with this stuff with cortisol that is just starting to get investigated).. and some conditions that are a combination of those causations.
For example, PTSD patients tend to have LOW levels of cortisol (though not usually below the reference range levels... if they do develop such low levels, then they would be developing Addison's Disease which, like Cushing's, is a very serious medical disorder). Not all, but many sufferers of Panic Attacks have low cortisol levels in between attacks - but during the attacks their cortisol levels will sjyrocket and remain elevted for many hours afterwards.
What is being said is that there ARE certain psychological disorders that are characterized by highly elevated cortisol levels and therefore are in fact the same disorder that Endos refer to a very specific form of PC.
As the 24-hr UFC is a quite simple - and fairly inexpensive test - I believe that if it was me that I'd play it safe and check out having the test performed. If nothing else, to rule out that possibility.
In fact, since hormones can have such a great deal of play on our psychological wel-being, I would also strongly request a full range of hormone testing to see if anything was too low, too high or simply out of balance with another hormone.
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Dr. Bob is Robert Hsiung, MD,
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