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Re: Larry, Effexor Withdrawal and SJW???? » KaraS

Posted by Larry Hoover on July 3, 2004, at 9:40:37

In reply to Re: Larry, Effexor Withdrawal and SJW????, posted by KaraS on July 2, 2004, at 22:09:54

> Larry,
> I've been taking 37.5 mg. of Effexor and added 300 mg. of SJW in order to help me withdraw completely from the Effexor. So far it has been working out well but I just read a posting by "Linkage" on the regular P-B board. He claims it's very dangerous to mix them - that he ended up in the hospital from serotonin syndrome while he was taking 10 mg. of Celexa and an unspecified amount of SJW. Could you please advise or give me more guidelines for using SJW for this purpose?
>
> Thanks,
> Kara

What's missing from what you carry forward from Linkage is another key variable, dose.

In crude terms, you can estimate the likelihood of serotonin syndrome from therapeutic dose levels. You are at 37.5 mg Effexor, which is roughly one quarter of the smallest therapeutic dose. You are at 300 mg SJW, which is about one third of the minimum therapeutic dose. Add those together, and you get less than 60% of a therapeutic dose.

Now, that said, everyone has there own unique threshold for serotonin syndrome. Some people are especially sensitive to serotonergic meds, and get serotonin syndrome at recommended therapeutic doses. Usually, though, serotonin syndrome involves therapeutic doses of one med, plus therapeutic doses of another similar med, or even overdose of one or the other or both. But you are not even close to therapeutic dose.

You might want to use half a 37.5 Effexor for a while, instead of dropping straight to zero, but I do not foresee a problem with your combination.

Lar

 

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poster:Larry Hoover thread:362556
URL: http://www.dr-bob.org/babble/alter/20040613/msgs/362771.html