![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 913 to 937 of 10407. Go back in thread:
Posted by hf on May 7, 2001, at 0:23:05
In reply to Re: Wean slowly..very, very, slowly......., posted by mstar on May 6, 2001, at 14:48:44
> I just changed insurance companys (they cover meds!! with only a $7 copay!!)
> >
>
> hf,
>
> can I ask what insurance company? I am going to be changing jobs soon and will have to change from a 100% coverage of everything and 10$ co-pay for meds. Any help would be appreciated!
> MsMy husband started working for Intel and they have their insurance with Cigna. :)
Posted by Iris on May 7, 2001, at 10:33:44
In reply to Re: effexor xr and side effects - Ann and Judy, posted by Cam W. on April 23, 2000, at 23:08:36
Hi,I am new to this and I was wondering if anyone could tell me how long it takes for the side effects to go away - will they at all? I started taking Effexor a week ago and I am taking 75mg a day. So far I'm having the following side effects:Trouble sleeping (I sleep for about three to four hours wake up and I'm wide awake,can't go back to sleep) plus I can't remember my dreams anymore.My jaw feels very tight with pain going into my ears.I am very! constipated :-( My arms and legs are falling asleep and I get this tingly feeling in my whole body.I constantly have sweaty palms. I did fell a little nausea for the first couple of days but that went away. I don't have much appetite. If there is someone out there who knows how long it takes for it to go away, please let me know.I am very scared taking this drug, like I said I am new to this. Thank's a lot to anyone who will answer me
Posted by mtm on May 7, 2001, at 13:34:11
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
> Hi,I am new to this and I was wondering if anyone could tell me how long it takes for the side effects to go away - will they at all? I started taking Effexor a week ago and I am taking 75mg a day. So far I'm having the following side effects:Trouble sleeping (I sleep for about three to four hours wake up and I'm wide awake,can't go back to sleep) plus I can't remember my dreams anymore.My jaw feels very tight with pain going into my ears.I am very! constipated :-( My arms and legs are falling asleep and I get this tingly feeling in my whole body.I constantly have sweaty palms. I did fell a little nausea for the first couple of days but that went away. I don't have much appetite. If there is someone out there who knows how long it takes for it to go away, please let me know.I am very scared taking this drug, like I said I am new to this. Thank's a lot to anyone who will answer me
> Hi Iris,
I had some of the same symptoms: trouble sleeping, not remembering my dreams, constipation. Felt energetic and
and more alert though so it was worth it. After a few weeks the trouble sleeping changed to trouble
staying awake and the 'good' feelings dissipated. Plan to get off it soon and hope the horror stories
that I'm reading on this site don't happen. Personally speaking, if the side-effects to a drug make me
worried and anxious, what's the point in taking it? So it goes....
MTM
Posted by mstar on May 7, 2001, at 13:39:08
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
Did your doctor start you out with 75mg? It sounds like you are probably taking too much too soon. I had mild side effects, but I increased very slowly. You need to start out at 37.5 and take that until you feel the side-affects have gone away. That's what my doctor told me, to be comfortable before you take a larger dose.Are you taking it for major depression?
ms
Posted by kid47 on May 7, 2001, at 14:43:15
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression. I don't think this is a drug that should be given as a first line AD. I think a discontinuation strategy should be discussed with your doc before being rx'd FXR. I think there should be comprehensive studies on discontinuation & a protocol established for it. But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.
13 days med free & loving it!!!
PS As always your mileage may vary.
Posted by Iris on May 7, 2001, at 15:15:22
In reply to Re: New to Effexor, posted by mstar on May 7, 2001, at 13:39:08
>
> Dear mstar & mtm,
thank's for answering me.Yes, he my Doctor started me on the 75mg dose. I am taking it for my Anxiety attacks.I am also starting therapy in a couple of days. My Doctor told me I should take Effexor at least for 6 months before getting off it. I guess that's when the therapy kicks in? Since reading the messages on this bord I am really concerned taking this.My question is what happens after the drug, after the withdral symptoms? Will I have to take another drug instead and so on for the rest of my life or will I be medication free at last? I guess I have to talk to my Doctor about all this but my next appointment isn't for a while and this board is the next best thing - if not even better with all the experience. Thank's again
Posted by Light on May 7, 2001, at 15:47:08
In reply to Re: beginning effexor xr » Light, posted by Michele on May 3, 2001, at 0:38:55
> Hi.....
> I'm glad to hear you decided and feel good about your decision. So you took your last one huh? How many days have you been on it? You should be fine... if not.... don't hesitate to use the tips on here.
> You sound completely like me. I felt just like you do.... and coincidentaly... that's what I take.... valium when it gets tough(about 2 a week)... Ive been finding other ways of dealing with my depression, and am thankful that I'm able to do it without meds. I'm one of the lucky ones. Hope it works for you... Thinking of you,
> Michele
< < <
<
>
>
hi---
ok, the saga continues...
i had decided to NOT take the effexor. i took only the first 4 doses of 37.5 mg and then stopped. no problems at all with stopping, which was great, because i did feel some side effects when starting. anyway, it's been about a week, and i am having huge personal problems that are leaving me feeling so drained every day, and i have been just crying uncontrollably every day, and unable to move on after "resolving" things. truthfully, it is all about my relationship with my boyfriend. there are extenuating circumstances that will never change, so i either deal with those things, or not. but there are other issues that have to do with the way we relate to each other, and fundamental human decency, and respect--as far as i'm concerned. basically, we are just too different, i'm afraid. i used to think that our relationship could thrive because of our differences--particularly in the way we grew up, and thus, how we treat others--but this is just so much work. so i don't even now how i feel, really, about taking medication if i look at the real reasons why--but at the same time, i feel like the way things are now, i may actually need something. here's another thing--i finally talked to my doctor today, and told him what was going on. he could not believe what i had heard about side effects and how hard it supposedly is to get off of effexor. he said it is totally different from ssri's (?) like paxil, and that it should be very easy to get off of...(again, i know this stuff is always different for everybody)but he happens to go around and give talks on effexor--says he knows the medication inside and out, and has never been more pleased with a drug. of course this is what happens when i have finally made my decision after flip-flopping a million times. so now, i feel like maybe i should just try it. i've been feeling so terrible lately, and really unable to function the way i need to. it's just this dilemma about the real reason for my problems pretty much being my boyfriend--so i should just quit HIM! for whatever reason(s) i'm not ready to do that (yet) and the issue really is my mental/emotional health, which is awful right now. so i think i'm going to call my doctor back and try this shit out. i feel insane....
Light
Posted by mtm on May 7, 2001, at 15:47:45
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 15:15:22
> >
> > Dear mstar & mtm,
> thank's for answering me.Yes, he my Doctor started me on the 75mg dose. I am taking it for my Anxiety attacks.I am also starting therapy in a couple of days. My Doctor told me I should take Effexor at least for 6 months before getting off it. I guess that's when the therapy kicks in? Since reading the messages on this bord I am really concerned taking this.My question is what happens after the drug, after the withdral symptoms? Will I have to take another drug instead and so on for the rest of my life or will I be medication free at last? I guess I have to talk to my Doctor about all this but my next appointment isn't for a while and this board is the next best thing - if not even better with all the experience. Thank's againIris,
I started out on 37.5mg. 75 might be too much. Interesting that he/she prescribed it for anxiety. It has never helped my anxiety but the occasional xanex gets me over the rough spots. My pdoc hasn't said anything about needing to take it for 6 months
either. A second opinion might be a good idea.
MTM
Posted by Iris on May 7, 2001, at 16:08:39
In reply to Re: New to Effexor, posted by mtm on May 7, 2001, at 15:47:45
Mtm,
I just got diagnosed with Anxiety a while ago.He started me out on Paxil.I felt really bad taking it.I went back and he put me on Effexor.I would love to get a second opinion but my husband is in the army and I have to see certain doctors -none of my choice- and frankly I don't think to highly of them.I am not an American and not very up to date when it comes to the medication over here.I really don't know what to do.I did ask him if I could just do the Therapy but he told me it was the combination of both that will bring results.I've been taking Effexor for a week now, maybe that's not long enough for any withdrwal symptoms if I stop right now??? Iris
Posted by RJC on May 7, 2001, at 18:13:19
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 16:08:39
G'day Iris,
I was put on EFXR for anxiety and for major depression (both of which I had never ever dreamed could happen to me) and told that I would have to be on it for at least 6 months and maybe even a year. It's now been 13 months.
But I am well over due to seeing my Dr, and when I see him, I hope to start cutting back.
Those side-effects are very familiar, especially the tingly feeling, and lasted about 2-3 weeks for me.The only ones I have now are that I sweat a lot, occasionly get dizzy and wake up with a huge headache after drinking.(Self inflicted)
I'm not an American either and it does seem that most people here are, so it's sort of comforting knowing thats it's a worldwide problem.
Hope you get over the initial side-effects soon.
RC
> Mtm,
> I just got diagnosed with Anxiety a while ago.He started me out on Paxil.I felt really bad taking it.I went back and he put me on Effexor.I would love to get a second opinion but my husband is in the army and I have to see certain doctors -none of my choice- and frankly I don't think to highly of them.I am not an American and not very up to date when it comes to the medication over here.I really don't know what to do.I did ask him if I could just do the Therapy but he told me it was the combination of both that will bring results.I've been taking Effexor for a week now, maybe that's not long enough for any withdrwal symptoms if I stop right now??? Iris
Posted by Michele on May 7, 2001, at 20:29:17
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 16:08:39
Iris,
You really shouldn't have any problems if you decide to stop after one week. If that is your definate decision ... I would stop as soon as possible.... the longer it's in your system, obviously the more withdrawal. Most people I know that took it less than 2 weeks had very little or no withdrawal symtoms. Good luck!!!!
Posted by Michele on May 7, 2001, at 20:36:28
In reply to Re: beginning effexor xr » Michele, posted by Light on May 7, 2001, at 15:47:08
'm sorry kiddo for what your going thru. I completely understand... I've been there too.... and I still have a lot of emotional scars for very similar reasons.
I felt the exact same way you do... that I need some help... even if just temporary. I went back and forth... drugs? Yes. no. yes. no. Maybe you can talk to him about Prozac or celexa? I realize how easy it is to trust and believe your doctor....but that's the thing with this drug.. as soooooo many on this board can testify too. The doctor's don't seem to understand the withdrawal and blow it off.... check out some of the archives and see what they say. I'm not at all trying to persuade you from taking effexor.. by all means, if you trust in it.... go for it. I was just pointing out that there were so many other drugs on the market and you seemed afraid of it,with good reason. Are you also seeing a therapist? I find that helps me GREATLY in dealing with situational issues. Where do you live?
Again.... I'm sorry your going thru all this... man, life is painful isn't it? But I'll tell you... About 2 months ago.... due to various problems, mostly medical(a doctor commited major malpractice on me that has caused some permanent deformaties)and my fiance was killed in a motorcycle accident.. I tried to kill myself. I spent every day... 24/7 crying. I woke up crying.. fell asleep crying... paced my house, barely knew my name, etc. I couldn't do anything, I felt utterly hopeless. That's when I tried effexor for 8 weeks and it just made everything worse. Since I've been off it I feel great. I do see a therapist twice a week... but I can actually smile, laugh and have a good time. I had hit bottom..... I was so afraid of taking that drug that that become a challenge....to help myself without drugs... and I didn't think it was possible. But I'm back now.... after about 6 months of some serious depression. If you ever want to talk more personally, let me know and I'll give you my e-mail address. Take care and hang in there. P.s. Talk to your doctor about some possible other options.... or what a lot of people on this post are doing is printing out some posts on the withdrawal. Believe me... they are very real. Michele--------------------------------------------------------------------------------
If you want to change anything, please do so in the box into which you typed it.
Posted by Iris on May 7, 2001, at 21:00:21
In reply to Re: New to Effexor, posted by RJC on May 7, 2001, at 18:13:19
> Thank's to all of you for answering me!!!
I am still very scared and I don't know if I should keep taking the pills or stop them right now.RC, are you in Therapy also or just on medication?
Does anyone know if Therapy alone helps? Iris
Posted by Michele on May 7, 2001, at 21:03:18
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 21:00:21
Iris,
I've had some few posts previous if you want to hear my detailed story.
If your uncomfortable with it.... scared, whatnot.... try another AD. There are so many out there... one's that have been around a long time that are more "trustworthy" to newcomers.I am in therapy alone and it's helped me greatly. Good luck....
Posted by Seraphim on May 7, 2001, at 22:22:16
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
> Hi,I am new to this and I was wondering if anyone could tell me how long it takes for the side effects to go away - will they at all? I started taking Effexor a week ago and I am taking 75mg a day. So far I'm having the following side effects:Trouble sleeping (I sleep for about three to four hours wake up and I'm wide awake,can't go back to sleep) plus I can't remember my dreams anymore.My jaw feels very tight with pain going into my ears.I am very! constipated :-( My arms and legs are falling asleep and I get this tingly feeling in my whole body.I constantly have sweaty palms. I did fell a little nausea for the first couple of days but that went away. I don't have much appetite. If there is someone out there who knows how long it takes for it to go away, please let me know.I am very scared taking this drug, like I said I am new to this. Thank's a lot to anyone who will answer me
For me, it took a few weeks for the side effects to start to subside. They will go away for the most part. I've read the other posts and I agree that you should really talk to your doctor about other alternatives. I don't know your whole situation, but either buspar or xanax work well for a lot of people in dealing with anxiety, and there are many others. After what I have been going through with side effects and now withdrawal (it is as bad as everyone says it is, even with help) I suggest seeking another alternative first and Effexor as a last resort. By the way, therapy has helped tremendously, but I am a true believer in that you get from therapy what you put into it. It is not always easy, but can be enlightening and powerful. I wish you well.
Seraphim
Posted by light on May 7, 2001, at 22:29:45
In reply to Re: beginning effexor xr--LIGHT, posted by Michele on May 7, 2001, at 20:36:28
hi, michele
gosh, hearing what you went through makes my problems seem like peanuts. i'm sorry that efexor worked out so badly for you. ya know, it's not a bad idea to print out some of these posts to show my doctor--especially since he literally goes and gives talks on how wonderful it is. i also clicked on a link earlier today that showed some FDA descriptions of efexor that supposedly had been recently revised to include severe withdrawal symptoms. as of right now, i am still flip-flopping. i spoke to a guy tonight who is on efexor now and hates it. he is one of those people who has taken drug after drug, and feels it's bset to just get off of everything--that the government is trying to control us, etc. etc. he doesn't seem to be thinking too straight, but that's scary, too...one thing he did suggest, though, which i plan to heed, is to start meditating and doing yoga again. those kinds of things can only help, and maybe if i try alternate avenues intensively, i won't even feel the need for "medication". we'll see. i think i'm going to go the natural way for now, but who knows what tomorrow will bring...
thanks--
light
p.s. yes, i'm in therapy, and my therapist is wonderful. two weeks ago when i saw her, and mentioned that i might want to get back on an AD, she said she was going to recommend it...(!!!!!)
Posted by RJC on May 7, 2001, at 22:32:40
In reply to Re: New to Effexor, posted by Iris on May 7, 2001, at 21:00:21
Hi Iris,
I'm not in therapy.I've been seeing a psychologist every few months, but at the beginning I actually checked myself into a clinic and I was there for about a week.
I remember pacing the house all anxious and panicky knowing that something was wrong but not knowing what.
Thats when I went to the clinic for a week.I was embarressed at first but then thought bugger everyone if they think anything, and in hindsight nobody really cared anyway.They were just worried.I remember doctors saying that I'd get better and I didn't beleive them, but you do get better.
All I did was sleep and then I had 3 months off before returning to work.The tablets definately helped me but now that I'm stronger I have to get of them.
> > Thank's to all of you for answering me!!!
> I am still very scared and I don't know if I should keep taking the pills or stop them right now.
>
> RC, are you in Therapy also or just on medication?
>
> Does anyone know if Therapy alone helps? Iris
Posted by Michele on May 8, 2001, at 0:18:58
In reply to Re: beginning effexor xr--LIGHT, posted by light on May 7, 2001, at 22:29:45
Hi again,
Ya know what's funny? My therapist recommended going on Ad's also.... then after about 5 sessions she realized I didn't need it... and actually expressed that she was glad I didn't give in..... medication just isn't for anybody. Sometimes the anxiety of it... which I can tell your feeling.... makes it very rough to even work.
Probably something to definately consider... if you decide to do the effexor route... or any AD for that matter(hint,hint.... sorry)... then your valium will probably help the anxiety you'll be getting my taking them ya know? I would think.
I know what you feel like with that flip flop feeling... it's awful, and stressful.I like that you thought of meditation and yoga. I do both... I do many things that people would probably laugh at...but hey, these little things work. The two you mention, excersise, FORCING myself to hang out with friends(that one is tough when I mostly want to be alone).. and really silly things... like for instance, I write a letter to God on my computer every night. But.. no matter how strange, these things work for me.
My therapist is wonderful at giving me written exercises to figure things out about myself and my feelings. They really work. She's good. I'm glad your happy with yours.. that's very important.
Anyway.... good luck! I'll be thinking of ya, and hoping for the best, whatever you decide. Remember... there is advice.... but do what you feel is right..... drugs or no drugs. You know yourself best!
Posted by Iris on May 8, 2001, at 6:32:37
In reply to Re: New to Effexor » Iris, posted by Michele on May 7, 2001, at 21:03:18
> Michele,
yes I would like to hear details. I really do appreciate everything you guys do. Iris
Posted by SLS on May 8, 2001, at 8:18:39
In reply to Effexor: MY Conclusions, posted by kid47 on May 7, 2001, at 14:43:15
Hi Kid.
Don't worry. No sh_t coming your way. :-)> Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression.
Just a few thoughts. Some facts. No absolute advice.Some physicians would classify you as being treatment-resistant. You would indeed qualify if you have tried 7 different antidepressants, having fully explored high dosages and allowed for a clinically sufficient time period to evaluate each. You might be at a greater risk of relapse given your treatment history. If your medical history of depression is one of chronic recurrence, this risk becomes greater still. Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective. For the average person with the average depression (unipolar and not bipolar), 13 months is a reasonable amount of time to remain well on an antidepressant before stopping. In my opinion, the key phrase is "remain well". I would not count the period between initiating medication and reaching full improvement as part of this 13 months. The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months. It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
> I don't think this is a drug that should be given as a first line AD.This will be an issue of debate, as it has been the experience of many doctors that Effexor is better than any of the SSRIs. A recent study that included between 1000 and 2000 patients has recently concluded the same. Not only does Effexor get more people well, but it gets these people more well.
> I think a discontinuation strategy should be discussed with your doc before being rx'd FXR.
...or any other antidepressant, along with the possible side effects. Withdrawal phenomena and treatment-emergent side effects occur with almost ALL of the antidepressants currently available. Of course, these occurences are variable for different drugs. I don't believe that Effexor can reasonably be singled-out. Perhaps Effexor is more visible now because it is becoming more frequently chosen as the "first line" by physicians.
> I think there should be comprehensive studies on discontinuation & a protocol established for it.
I agree, both aspects of your statement are happening right now. Unfortunately, the psychiatric community has been woefully neglectful of these things.
> But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.Since 1992, Effexor (venlafaxine) has shown a tendency to be somewhat superior to the SSRIs when treating treatment-resistant depression (TRD). However, MAOIs might have a better record still.
> 13 days med free & loving it!!!
13 months - 13 days.I hope you are not superstitious. :-)
- Scott
> PS As always your mileage may vary.With the prices of gas and psychiatric care on the rise, it is probably best to move ahead with careful planning.
Posted by Irene on May 8, 2001, at 14:26:16
In reply to New to Effexor, posted by Iris on May 7, 2001, at 10:33:44
When I started Effexor 3 years ago, it took me weeks to adjust to it. I also had trouble sleeping (Trazodone at bedtime helped a lot); very dry mouth, constipation; anxiety -the tingling in extremities, waking in the early morning, sweaty palms, and nausea, low appetite (Klonopin eased the anxiety. I stopped the Klonopin after a few months when Effexor finally kicked in). All of these symptoms happen as your body adjusts to the increasing dosage. These side effects were hard for me for a few weeks and then I noticed improvement over another few more weeks. It was a couple of months before we worked out the correct dosage for me, and then it really took care of my depression. I had tried Paxil and Zoloft before finding Effexor. Every one's body is different. It might work for you, or it may not - the hard part is waiting the couple of months to find out if it's the right one.
Hang in there.
Also, I started with 37.5mg. I wonder starting at 75mg might have been too much of a jolt to your body. Tell your doctor everything. Good rapport with your doc is important.
Irene
> Hi,I am new to this and I was wondering if anyone could tell me how long it takes for the side effects to go away - will they at all? I started taking Effexor a week ago and I am taking 75mg a day. So far I'm having the following side effects:Trouble sleeping (I sleep for about three to four hours wake up and I'm wide awake,can't go back to sleep) plus I can't remember my dreams anymore.My jaw feels very tight with pain going into my ears.I am very! constipated :-( My arms and legs are falling asleep and I get this tingly feeling in my whole body.I constantly have sweaty palms. I did fell a little nausea for the first couple of days but that went away. I don't have much appetite. If there is someone out there who knows how long it takes for it to go away, please let me know.I am very scared taking this drug, like I said I am new to this. Thank's a lot to anyone who will answer me
Posted by Irene on May 8, 2001, at 14:34:02
In reply to Effexor: MY Conclusions, posted by kid47 on May 7, 2001, at 14:43:15
How long after completely coming off Effexor did you feel well again? Is your depression really over? That's such good news.
I myself weaned off last week, but started Serzone two days ago because I was still moody and had anxiety. I still wonder if it's the underlying depression I'm feeling or if I gave myself enough time after coming off the Effexor.
Irene> Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression. I don't think this is a drug that should be given as a first line AD. I think a discontinuation strategy should be discussed with your doc before being rx'd FXR. I think there should be comprehensive studies on discontinuation & a protocol established for it. But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.
>
> 13 days med free & loving it!!!
>
> PS As always your mileage may vary.
Posted by kid47 on May 8, 2001, at 14:36:13
In reply to Re: Effexor: MY Conclusions » kid47, posted by SLS on May 8, 2001, at 8:18:39
Hi Scott. Thanks for your input. Yes, unfortunately I have tried lots of psycmeds & with the exception of Celexa, which seemed to trigger a psychotic rage I gave them all at least a 6 week trial.They did little to deal with my depression & anxiety which was eventually dx'd (although I believe incorrectly) as Bipolar II. Cocktails with Lamictal, Neurontin, Topamax, etc. were introduced with little improvement. Klonopin was the only thing that made me feel better temporarily, but it seemed to aggrevate my depression if I took very much. I was concerned/ nervous about taking MAOI 's but was considering a TCA. Then about a year ago my new pdoc suggested FXR xr & I noticed improvement after about 4wks. This continued till I felt well enough to stop all psycmeds & succesfully weaned off FXR w/little or no discontinuation fx! (Prozac @20mg/day I think was the key).
I wish I could find info on how many rx's for FXR are written annually to get a better handle on the % of people who have problems with FXR. Any ideas? Also is FXR xr always what is rx'd?. I think the xr version is less likely to cause problems.
The reason I am not convinced that FXR should be a first line AD is the fact that it has the potential to effect more brain chemistry. You can make a short leap & say it also has a greater range for side fx potential. For those of us who have tried enough meds to be aware of what to expect (& are desperate enough) side fx might not be as traumatic as would be to the newly initiated. I agree that FXR has a greater potential to be more effective....than say an SSRI, but in some cases it might be considered overkill.
I am cautiously optomistic (which is quite a feat in itself) but am always ready for the other shoe to drop. I would not hesitate to resume a regimine of meds should I or my pdoc think it necessary. I was hospitalized initially when this all began at the tender young age of 46 & I do not wish to repeat that experience.
If you have read any of my pevious posts, you know I have tried to provide some balance to the very negative & sometimes hysterical anecdotes concerning FXR. I would hate to know that someone who might have been helped by FXR was disuaded from considering it after reading some of the frightening posts at PB. I have even been accused of being a drug company undercover agent.....Bond...Kid Bond...lol
Once again I appreciate your response. I have found you to be one of the very knowledgable & considerate posters on this list & I always read your comments.
I hope you are having success with your treatment. Take care.
14 (whew!! I am a little superstitious) days Med free & still pretty dogone happy about it.
Kid
> Hi Kid.
>
>
> Don't worry. No sh_t coming your way. :-)
>
> > Hello.I have just successfully weaned off of 13 mos. @ 300mg/day of FXR xr. I tried 7 different AD's & countless "cocktails" but FXR xr was the only one that actually "cured" my depression.
>
>
> Just a few thoughts. Some facts. No absolute advice.
>
> Some physicians would classify you as being treatment-resistant. You would indeed qualify if you have tried 7 different antidepressants, having fully explored high dosages and allowed for a clinically sufficient time period to evaluate each. You might be at a greater risk of relapse given your treatment history. If your medical history of depression is one of chronic recurrence, this risk becomes greater still. Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective. For the average person with the average depression (unipolar and not bipolar), 13 months is a reasonable amount of time to remain well on an antidepressant before stopping. In my opinion, the key phrase is "remain well". I would not count the period between initiating medication and reaching full improvement as part of this 13 months. The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months. It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
>
>
> > I don't think this is a drug that should be given as a first line AD.
>
> This will be an issue of debate, as it has been the experience of many doctors that Effexor is better than any of the SSRIs. A recent study that included between 1000 and 2000 patients has recently concluded the same. Not only does Effexor get more people well, but it gets these people more well.
>
> > I think a discontinuation strategy should be discussed with your doc before being rx'd FXR.
>
> ...or any other antidepressant, along with the possible side effects. Withdrawal phenomena and treatment-emergent side effects occur with almost ALL of the antidepressants currently available. Of course, these occurences are variable for different drugs. I don't believe that Effexor can reasonably be singled-out. Perhaps Effexor is more visible now because it is becoming more frequently chosen as the "first line" by physicians.
>
> > I think there should be comprehensive studies on discontinuation & a protocol established for it.
>
> I agree, both aspects of your statement are happening right now. Unfortunately, the psychiatric community has been woefully neglectful of these things.
>
>
> > But I do believe this drug for some, is the closest thing to a miracle cure we have for very treatment resistant depression, especially with comorbid conditions (IMHO). I know I will catch some shit for this statement. Just (as Dr Bob would say) Please be civil.
>
> Since 1992, Effexor (venlafaxine) has shown a tendency to be somewhat superior to the SSRIs when treating treatment-resistant depression (TRD). However, MAOIs might have a better record still.
>
> > 13 days med free & loving it!!!
>
>
> 13 months - 13 days.
>
> I hope you are not superstitious. :-)
>
>
> - Scott
>
>
> > PS As always your mileage may vary.
>
> With the prices of gas and psychiatric care on the rise, it is probably best to move ahead with careful planning.
Posted by Irene on May 8, 2001, at 15:19:20
In reply to Re: Effexor: MY Conclusions » kid47, posted by SLS on May 8, 2001, at 8:18:39
Scott, I read your post with much interest.
>Often, when someone in your position discontinues an antidepressant and relapses, the previously effective drug is no longer effective.
Do you know why returning to a previously effective drug is often unsuccessful?
>The risk of relapse can be significantly reduced by coming off an antidepressant very gradually. So too can be the withdrawal effects. Most people do not do this. The most likely time until relapse, should it occur, is during the first 4 months.
I'm not clear on the above. Do you mean that if one feels well after stopping a drug, and if he/she is going to relapse, it most likely would happen within 4 months of stopping previous medication?
>It might be best for you to remain wary, and perhaps keep a mood diary. If you see yourself beginning to slide back towards depression, you might want to consider returning to Effexor as soon as possible and titrate the dosage up as quickly as you can tolerate.
Now I'm concerned. Every time I decreased from 225 to 150; 150 to 75; 75 to 37, I always got well again after a few weeks of 'yuckiness', therefore believing my depressive episode was over - that my body was able to muster up the serotonin after all. I had no relief, however, decreasing from 37 downward. Does that mean that the 2 months of yuckiness I felt then meant it was the real depression and I should have gone back to increasing Effexor instead of waiting that long? and therefore Effexor will no longer be effective for me in the future? That would be awful, because Effexor worked wonderfully for me.
confused, Irene
PS, are you in medical field, or are you speaking from personal experience only?
Posted by kid47 on May 8, 2001, at 15:19:52
In reply to Re: Effexor: MY Conclusions, posted by Irene on May 8, 2001, at 14:34:02
Hi Irene.
> How long after completely coming off Effexor did you feel well again?
Actually after about 11 mos, on FXR I began to feel "normal." When I realized this was not a fluke (or hypomania) I decided to wean off FXR. I started slooowly tapering my dose over about 7wks. & have continued to feel pretty good. This is day 14 med free so keep your fingers crossed!!!>Is your depression really over? That's such good news.
God I hope so!!!!! I also am aware it could return but trying to be optomistic.
> I myself weaned off last week, but started Serzone two days ago because I was still moody and had anxiety. I still wonder if it's the underlying depression I'm feeling or if I gave myself enough time after coming off the Effexor.
> IreneGood question. I'm curious....how long were you on FXR. What dose. Why did you stop taking it?
As you probably know It could take at least 6 weeks before you notice any improvement from the Serezone. In my case Serezone helped my anxiety but did little for my depression. It did make me very sleepy. But as u know everyone is different in their response to meds. Because of FXR's short half life & the time it might take for the Serezone to work you might be suffering from both a recurrence of depression & some discontinuation fx from the FXR. Geez....it's never easy is it. At any rate if you still feel lousy after a bit be sure & ask your doc about it. Good luck!! Take care
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