Posted by Cam W. on February 23, 2000, at 7:23:12
In reply to Re: Too sleepy on Effexor, posted by Noa on February 23, 2000, at 4:58:39
> > Renee-
> I have had similar frustrations with my pdoc. His office is chaotic, the staff aren't the most professional, they are hard to reach, he is hard to reach. A couple of years ago I finally confronted him and said I couldn't work with him anymore if I can't reach him or get an appointment, etc. That is when he gave me his pager number and told me to page him to reach him. I said I was uncomfortable if I interrupted him at work, he said it was ok. I don't especially like the idea that he answers pages during sessions, but I have come to accept it. If I page him and he is with someone, he lets me know and then calls back later. Now I have figured out to page him right before his first appointment of the day, or right after his last (in fact I am going to page him this morning about my lab results). I have considered changing docs, but he is good at what he does, despite his awkward social skills, and poorly run operation. When I looked into changing, I found there were other docs who don't accept insurance, and their fees were way out of my affordability range.
>
> I think confronting your doc about this might be worth considering. Then, his response can be your final criterion about whether to continue working with him. If he gets defensive, or doesn't listen to your grievances, you'll know it is time to move on. Or, maybe he will respond appropriately and you'll get some changes.
>
> By the way, it took me a LONG time to muster up the courage to confront my doc about this. I am not great at confrontation. But I am glad I did it.
>
> Good luck.Renee - Effexor is a different antidepressant. At low doses (75-150mg) it acts like an SRI (eg Paxil) blocking serotonin reuptake ; at higher doses 225-375mg) it acts like the TCA Desipramine, blocking both serotonin and norepinephrine reuptake; and at still higher doses (600-700mg - very unlikely to be used clinically) it also starts blocking dopamine reuptake. Medlib is right. With each increase in dosage the side effects usually reappear for a week or so. Hang in there and see if your body will adjust to the higher dose (perhaps your doctor has been avoiding you because he has seen the sedation on dosage increases of Effexor and expects the drowsiness, etc. to go away. But he should tell you this). As for ADDerall; sorry, we don't have this drug in Canada, so I am not very familar with it clinically. I do know that the combination of Effexor and a drug like ADDerall can, in some people, increase blood pressure. Give it a few more days and see what happens. Keep us informed. Good luck - Cam W.
poster:Cam W.
thread:23255
URL: http://www.dr-bob.org/babble/20000220/msgs/23304.html