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

Posted by scs3371 on July 3, 2004, at 12:36:56

In reply to Re: Larry, Effexor Withdrawal and SJW???? » KaraS, posted by Larry Hoover on July 3, 2004, at 9:40:37

DISCLAIMER: I am the one who posted the original post and have been doing research myself. I am in NO WAY offering medical advice - just stating what my feelings are after reading literature.

I have to agree that it seems likely that the risk of serotonin syndrome is extremely low with the 37.5 dose of Effexor. The risk of StS (serotonin syndrome) is increased with multiple therapeutic doses of SSIs...if you are on more than one SSI (Effexor AND Zoloft as an example - I don't even know if these are usually combined, but this is just hypothetical). The treatment for SSI is to remove the causative agent (the drug) so just be familiar with the signs and symptoms of StS and get medical treatment if you feel like you are experiencing any of those symptoms. (However some of the symptoms do mask withdrawal symptoms so that is where it gets tricky). From reading pharmaceutical info, it seems Effexor has a half life of about 5 hours and it's metabolite has a half life of about 11 hours. I have been off of Effexor for about 36 hours now (was on 75 mg) and plan to start taking SJW this afternoon. That is my choice...I am not in any way saying it's right for everyone or anyone! I just wanted to let you know what I was going to do after doing some research. The person who posted to NOT take SJW while you are trying to get off of Effexor did not say if she was on other meds, but said she was on, I believe, Celexa (? - I may be wrong about that). I am not discrediting her experience at all, just saying that for me, I am going to take the chance. I am an RN (again DISCLAIMER: I am NOT offering medical advice) and after reading the literature, I feel that I will take the chance on taking SJW. My e-mail address is scs3371@yahoo.com if anyone wants to chat/support each other, etc! Good luck!

Stacy :o)


> > 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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