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Dr. Bob is Robert Hsiung, MD,
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Posted by Elizabeth on February 15, 2002, at 8:47:28
In reply to Effexor is a bad drug!! i need help!!!, posted by kimberly ann on February 14, 2002, at 16:36:39
Hi. I can think of a couple of ways to taper off Effexor XR.
One way is to switch to plain Effexor, which comes in tablets that you take several times a day. The total daily dose should be the same to start. The lowest strength is 25 mg, and because they are scored tablets, you can break them in half.
The other way is to switch to Prozac. Prozac is a very long-acting drug with an even longer-acting metabolite (norfluoxetine). As a result, Prozac self-tapers and most people don't experience withdrawal symptoms. The main problem here is figuring out the equivalent dose. I'd expect about 20 mg of Prozac to be okay if you're on 75 mg of Effexor, but that might not be enough. Get the Prozac in 10 mg caps so you can reduce the dose. You shouldn't need to take it for more than a few days.
There are also things you can take that can help with the withdrawal symptoms. Benadryl seems to be used a lot for the weird dizzy feelings, nausea, and perhaps urinary and GI problems; Dramamine should work too if you prefer that. Beta blockers might ease the cardiac effects and perhaps some of the agitation. Benzodiazepines should ease the agitation/jitters. You can use clonidine for the hot-cold flashes and cardiac stuff.
You can also combine these strategies. I hope that this information helps you. Definitely talk to the doctor who prescribed the Effexor about the trouble you're having; besides the fact that a lot of the ideas I've suggested require a prescription, I think it's important for doctors (not just patients!) to be informed about the withdrawal syndromes that people often get with the newer ADs.
-elizabeth
Posted by sjb on February 15, 2002, at 8:53:08
In reply to Re: Effexor is a bad drug!! i need help!!!, posted by ann on February 14, 2002, at 20:48:43
Ann,
I had a similar experience with the weight. When I was first on it w/Tompomax, I lost some weight and life was wonderful, well, relatively speaking. After about month, the appetite suppression started wearing off and I was binge eating much more frequently. We tried to chase the initial lift by upping the dosage but it did not work. I eventually was up to 450mg a day and coming off was horrible. I wish you luck but it is not rare for a lot of SRRI's to have initial appetite suppresion that eventually wears off and often times increasese appetite with continued use.
Posted by SusanG on February 15, 2002, at 13:37:59
In reply to Re: Effexor discontinuation » kimberly ann, posted by Elizabeth on February 15, 2002, at 8:47:28
Hi Elizabeth,
I think you have some good ideas about weaning off Effexor. I am almost off mine completely at this point and have gone through some hell but I think I am over the worst of it. Using the capsules and not being able to divide them was a problem for me. The nurse's suggestion to go every other day, then every third day just doesn't seem to make as much sense as a daily dose gradually lowered. Getting a blast (my capsules were 75 mg), then nothing, then a blast again can't the preferred way to go. But I am almost there and my symptoms of dizziness, random crying attacks, etc., have subsided and I hope they don't return. On to Wellbutrin in a week and I hope I find success with that.One more thought about the issue of weight gain. As others have said, I initally had no weight gain with Effexor XR but after about a month or so I started putting it on and ended up gaining about 25 pounds since November. NOT OK WITH ME! But I have noticed a pattern with my weight: when severely stressed and depressed I can't eat and my weight drops or stays down. When my stress/depression is lessened somewhat but not gone, I tend to eat too much as a coping mechanism and I gain. Maybe when I began to gain with Effexor it was because I was less depressed but not entirely ok and therefore went into Munch Mode. Maybe I really needed MORE Effexor to lessen the depression to the point that I don't eat to compensate. Who knows? I'm sure the fatigue I felt on Effexor also contributed to my decreased exercise which just exaserbated the weight issue. I will give Wellbutrin a try but I'm nervous about the earlier post stating that if one AD causes weight gain, it is likely that other AD's will as well.
Posted by neko on February 15, 2002, at 15:31:35
In reply to Effexor is a bad drug!! i need help!!!, posted by kimberly ann on February 14, 2002, at 16:36:39
I have had almost all the same problems on Effexor XR as you have. One of the big draw backs of it was the heart palpitations. My heart would race all the time and it started to impact my sleeping. I am about 25lbs heavier than usual and my menstrual cycle has been completely messed up since I started Effexor last July. I still have that weird electric shocky feeling sometimes and find that I often stop mid-sentence and forget what the hell I was talking about. Boo to Effexor! j/k, but I would seriously recommend thinking twice before taking Effexor XR...
Posted by JANNBEAU on February 15, 2002, at 15:48:19
In reply to Re: Effexor discontinuation, posted by SusanG on February 15, 2002, at 13:37:59
>Hi, SusanB and Elizabeth (E,we've talked before):
This is Jannbeau. I posted a comment that weight gain on one psychotrophic medicine is a good predictor for weight gain on others. I just did a search on the www for "psychotrophic antidepressant weight" and, based on this (admittedly nonscientific) search, I stand by that statement. I also stated that those who were very thin to start or who lost wt with depression with were more likely to maintain or to lose wt on these meds. This seems to be a minority response however. The material I read today suggests that weight gain is a common effect of these medications. Personally, I've noticed a craving for high carb, high sugar foods on Effexor (saw this mentioned with regard to AD's, Antipsychotics, AntiBiPolar meds on my www travels, too). I am not gaining weight presently--haven't lost any either!
Now - finally - to the gist of this post: as you probably know, Welbutrin (bupropion) seems less likely to cause weight gain than some other AD's. There is another drug that might not cause as much weight gain: SERZONE or (nefazodone--sp?). BUT--the FDA recently announced (MedWatch) that the mfgr of Serzone must add a "Black Box" Warning to the physicians insert for Serzone. Apparently, there have been several instances of liver failure leading to death or liver transplants in persons taking Serzone. In most cases (?) the patients had NO indentified predisposing factors for liver failure nor did they have active liver disease when they started Serzone. Therefore, before you try Serzone, you may wish to talk with your physician about this risk. If you decide to take Serzone, you might wish to have liver function tests before you start and at regular intervals thereafter (perhaps 3 to 4 times/year).
Good Luck!!
Cheers,
Jannbeau
Hi Elizabeth,
> I think you have some good ideas about weaning off Effexor. I am almost off mine completely at this point and have gone through some hell but I think I am over the worst of it. Using the capsules and not being able to divide them was a problem for me. The nurse's suggestion to go every other day, then every third day just doesn't seem to make as much sense as a daily dose gradually lowered. Getting a blast (my capsules were 75 mg), then nothing, then a blast again can't the preferred way to go. But I am almost there and my symptoms of dizziness, random crying attacks, etc., have subsided and I hope they don't return. On to Wellbutrin in a week and I hope I find success with that.
>
> One more thought about the issue of weight gain. As others have said, I initally had no weight gain with Effexor XR but after about a month or so I started putting it on and ended up gaining about 25 pounds since November. NOT OK WITH ME! But I have noticed a pattern with my weight: when severely stressed and depressed I can't eat and my weight drops or stays down. When my stress/depression is lessened somewhat but not gone, I tend to eat too much as a coping mechanism and I gain. Maybe when I began to gain with Effexor it was because I was less depressed but not entirely ok and therefore went into Munch Mode. Maybe I really needed MORE Effexor to lessen the depression to the point that I don't eat to compensate. Who knows? I'm sure the fatigue I felt on Effexor also contributed to my decreased exercise which just exaserbated the weight issue. I will give Wellbutrin a try but I'm nervous about the earlier post stating that if one AD causes weight gain, it is likely that other AD's will as well.
Posted by Reneeb on February 15, 2002, at 19:04:05
In reply to Re: Effexor discontinuation, posted by JANNBEAU on February 15, 2002, at 15:48:19
> Hi Jannbeau, Thanks for the information. I have just lowered my dose of effexor now I am on 37.5mg and I see my doc of Monday. I am also on wellbutrin 300mg right now. I only had a problem with it the first two weeks after that I was fine.
I am so confused about the weight gain issue. I exercise everyday and put on 10 pounds. I was on zoloft years ago and after 3 months blew up like a balloon. My girlfriend has been on paxil and celexia to name a few and never gained a pound. She is also on wellbutrin and just went from effexor to serzone because of her sex drive. She never gained an ounce on the wellbutrin/effexor mix.
I am going to visit the site you mentioned. I would like to bring some information with me when I visit the doc.
Thanks again for the info.
Renee
Posted by SusanG on February 15, 2002, at 19:10:20
In reply to Re: Effexor discontinuation, posted by JANNBEAU on February 15, 2002, at 15:48:19
Thanks, Jannbeau, for the information. You always have interesting and informative comments on your posts and I appreciate the feedback. As I am pretty fond of my liver, I think I will stay away from Serzone, especially if I have luck with Welbutrin. I am even hesitant to try Welbutrin considering the possible or probable weight issue, but I'm not so sure I can go without any medication at all. Again, thanks.
Posted by marlene on February 16, 2002, at 10:03:47
In reply to Re: Effexor discontinuation, posted by SusanG on February 15, 2002, at 19:10:20
TWO WEEKS FREE OF EFFEXOR, ONLY SYMPTOM IS FATIGUE, WHICH COULD BE FROM DEPRESSION. AM NOT HAVING ANY SHAKING, TINGLING OR NOISE IN EARS. I ACTUALLY SLEPT THE LAST TWO NIGHTS. HOPING THIS IS ALL OVER NOW. WILL TALK TO PCP ABOUT ZOLOFT, MAYBE, STILL THINKING. HAVE CONTINUED TO FEEL MORE IN CONTROL AND LESS EATING, WEIGHT IS STARTING TO COME OFF AGAIN. NO LONGER HAVE THAT FEELING OF NOT CARING. AGAIN, WANT TO STATE, COLD TURKEY NOT FOR EVERYONE, BUT AT LEAST IT IS SURVIVABLE. CAN'T REMEMBER WHO POSTED, BUT I HAVE ALSO HAD THE PROBLEM OF STARTING A SENTENCE, AND NOT REMEMBER WHAT I WAS SAYING. AND MY SPEECH PROBLEM I HAD WHEN I WAS A KID, WAS STARTING TO REAPPEAR. HUSBAND SAYS HE IS NOTICING LESS OF BOTH. JUST A UPDATE.
Posted by Launie on February 16, 2002, at 10:13:17
In reply to Re: Effexor discontinuation, posted by marlene on February 16, 2002, at 10:03:47
Just a thought about your problems with speech and remembering....have you ever been diagnosed with something
like Lupus or FM (fibromyalgia). Both of these can cause depression and can go undetected for a very long time until
they become truly noticeable, not only to you but to others. Ask your PCP if you can see a rheumatologist if you have other physical symptoms
that you can't explain. Effexor only seemed to make me more tired and that ear thing was annoying. I don't recall it causing me to have problems with
my speech. Oh yeah, in the FM world, we call not remembering a sentence or word, etc, 'BRAIN FOG OR FIBRO FOG'. It's a reality.Launie
Posted by Launie on February 16, 2002, at 10:20:14
In reply to Re: Effexor discontinuation, posted by marlene on February 16, 2002, at 10:03:47
OOOOPS! That message to Susan G was to be for Marlene! Sorry everyone. Also, another quick side note...
I feel really strongly that alot of us who suffer from all types of depression actually have other things wrong that the medical
doctors aren't testing for. I have had this happen to me. It's really disheartening to be diagnosed with depression without the doctors listening to you
about all the other things that you are plagued with. In my case, it took literally years before I found a doctor that would open his dang ears and listen!I hope this hasn't happened to you, and if so....make sure you keep shouting until someone listens. There are other ways to deal with depression that is caused by
physical ailments and diseases. Thanks and I'll shut up now.Launie
Posted by marlene on February 16, 2002, at 10:38:32
In reply to Re: To Marlene - Effexor discontinuation, posted by Launie on February 16, 2002, at 10:20:14
> OOOOPS! That message to Susan G was to be for Marlene! Sorry everyone. Also, another quick side note...
> I feel really strongly that alot of us who suffer from all types of depression actually have other things wrong that the medical
> doctors aren't testing for. I have had this happen to me. It's really disheartening to be diagnosed with depression without the doctors listening to you
> about all the other things that you are plagued with. In my case, it took literally years before I found a doctor that would open his dang ears and listen!
>
> I hope this hasn't happened to you, and if so....make sure you keep shouting until someone listens. There are other ways to deal with depression that is caused by
> physical ailments and diseases. Thanks and I'll shut up now.
>
> LaunieLaunie,
My mom had FM, till her death in Nov, we had the same doc and both of us have talked to her about me having FM, but she says just depression. I do try to yell at docs, but it took them 20 yrs to diagnosed a stomach problem which was causing my being overweight. Now they just want to keep me on Effexor, that is why I went cold turkey. I am in the process of finding a different doc. I also have Chronic Fatigue Syndrom. Will keep yelling at docs, but sometimes, it is as senseless as yelling at my kids.
Marlene
P.S. Thanks!
Posted by Launie on February 16, 2002, at 10:47:22
In reply to Re: To Launie, posted by marlene on February 16, 2002, at 10:38:32
I knew it had to be something else! You poor thing. Email me at bluedog@mtaonline.net and I can get you in contact with so many
people who can help, your head will spin. There have been studies that PROVE that FM is hereditary and that there are too many
doctors out there who refuse to believe it is even a problem. I for one am trying to educate people. This is a real disease and it has medical
testing to prove it. I wish some of these doctors would quit being so lazy and learn 'new' things. Alot of FM patients also suffer from CFS. I don't personally
but I know alot who do. TTYL.
> Launie,
>
> My mom had FM, till her death in Nov, we had the same doc and both of us have talked to her about me having FM, but she says just depression. I do try to yell at docs, but it took them 20 yrs to diagnosed a stomach problem which was causing my being overweight. Now they just want to keep me on Effexor, that is why I went cold turkey. I am in the process of finding a different doc. I also have Chronic Fatigue Syndrom. Will keep yelling at docs, but sometimes, it is as senseless as yelling at my kids.
> Marlene
> P.S. Thanks!
Posted by JAG on February 18, 2002, at 11:45:56
In reply to Re: Effexor is a bad drug!! i need help!!!, posted by ann on February 14, 2002, at 20:48:43
Hello,
I have been out of the loop (thread) for awhile and I'm new to this site. I read the comments about effexor and, of course, I am worried. I just saw my doctor this morning because I feel like I am regressing. I was on Zoloft and was weaned off with effexor (37.5mg). I have been on effexor (75mg) for about 3 weeks and have been going backwards with my depression and anxiety. She increased my dose today to 150mg, I hope this works. She is telling me that I will not gain any more weight if my anxiety is under control, because that's why I was eating so much. I have also been very agitated and do not like myself these past weeks. The panic attacks returned and depression. My doctor told me that it was a result of going off zoloft fast and it is getting out of my system. She does not want me to go off effexor (she increased it), because I have not given it a good enough trial. I need to get everything under control, especially my weight. Any comments or suggestions from someone who went through or is going through the same thing. Thank you, Be Well. JAG
Posted by SusanG on February 18, 2002, at 20:34:37
In reply to Re: Effexor is a bad drug!! i need help!!!, posted by JAG on February 18, 2002, at 11:45:56
JAG, I want to put my previous comments in perspective. Overall, I was happy with the way Effexor helped with my depression. I felt much less overwhelmed by life, and less of that generalized sadness that at times seemed crippling. I didn't feel the sexual effects I had felt on other meds. I know I should have tried harder to address my weight gain with diet and exercise and stayed on the Effexor a while longer. But I suspected Effexor was contributing significantly to my weight gain and since I seemed unable to make any headway with losing, I am getting off of it. Now that I am almost Effexor-free I have noticed a clearheadedness I didn't realize I had lost while on the meds. Perhaps you will appreciate the Effexor as you get the correct dosage worked out for you and maybe you will be one who doesn't gain; it seems some don't. It does seem to be a better choice than some other meds and I hope it works for you. At least if you decide it isn't for you, you will have some ideas from this site about how to wean off of it. Good luck to you.
Posted by Reneeb on February 18, 2002, at 21:18:48
In reply to Re: Effexor is a bad drug!! i need help!!!, posted by JAG on February 18, 2002, at 11:45:56
> Hi Jag, I agree completely with Susan except for one thing. I execrise everyday and watch what I eat and I still gained weight. That is the reason I am getting off it too. I didnt realize how much of a haze I was in til I started to wean myself to a lower dose. I had so much more energy. I have been on effexor for 1 year and thought it worked well if you just want to exist.
I hope it does better for you.
Renee
Posted by Willow on February 19, 2002, at 7:44:56
In reply to Re: Effexor is a bad drug!! i need help!!! » JAG, posted by Reneeb on February 18, 2002, at 21:18:48
"I have been on effexor for 1 year and thought it worked well if you just want to exist."
For myself effexor has been the first AD that worked for my symptoms without altering my mood/feelings. I am better able to cope with major events and the everday bumps. I do still get upset by events, but am able to balance myself quickly.
Treatment of "Generalized ANXIETY" it has been a gem! It took about seven months for me to feel the whole benefits of this medication.
I had given up on medications, but have been pleasantly suprised with this one. We each are individuals, our symptoms affect each in varying degrees, plus add the different treatment options; there is no answer for all, but more importantly what hasn't worked for one doesn't mean that it will not work for another and vice versa.
Whistling Willow
Posted by Dinah on February 19, 2002, at 8:14:18
In reply to Each person is unique., posted by Willow on February 19, 2002, at 7:44:56
Posted by Mandy L on February 19, 2002, at 10:12:38
In reply to Re: Effexor discontinuation, posted by marlene on February 16, 2002, at 10:03:47
My 16 year old daughter was on Effexor for about 6 months. We had to discontinue because of lack and sleep and she began to hear voices, in addition to other unpleasant side effects. It has now been 3 weeks of cold turkey. 3 days ago she became tired and slept normally for the 1st time in six months. We have had a horrible time with withdrawal, but are pleased that the worst is behind us. This web site has been a blessing because what we were not alone in what we were experiencing. She still has bad times, but they are shorter and farther apart. We now have had two days of normalacy. If I had known then, what I know now our family would not have done this in the beginning. I hope this is encouragement for others. It will get better.
Posted by Reneeb on February 19, 2002, at 11:40:08
In reply to Each person is unique., posted by Willow on February 19, 2002, at 7:44:56
Hi Willow, I agree with you that everyone is different. I was talking about my unique experience with effexor. I was really disappointed that it didn't work for me. I have been searching for a long time to find the right mix. I am very glad it is working for you.
Take care,
Renee
Posted by Maria Warren on February 19, 2002, at 12:16:05
In reply to Re: Each person is unique. » Willow, posted by Reneeb on February 19, 2002, at 11:40:08
> Hi Willow, I agree with you that everyone is different. I was talking about my unique experience with effexor. I was really disappointed that it didn't work for me. I have been searching for a long time to find the right mix. I am very glad it is working for you.
>
> Take care,
>
> ReneeHi Renee,Mandy,Willow, and everyone,
Well I did it. I saw my pdoc Monday and convinced him to take me off the Effexor XR. Thats the good news. Now for the rest of it-- He wants to knock me down to 300mgm right away (I an currently on 375 mgm) and continue the "taper" by about 75 mgm a week . Meanwhile he refused to have me go off AD's totally given my "history"; so while I am cutting the Effexor, I will be slowly building up Celexia until that reaches 20 mgm. Now I really like this guy and have been seeing him for over three years. How ever he was recently made department head and I now feel he rushes me through my appointments more than he used to. I don't want to switch docs, with all that entails. Am I off base to string out the taper a bit more? A little help here guys? Maria Warren
Posted by IsoM on February 19, 2002, at 13:02:56
In reply to Re: Each person is unique., posted by Maria Warren on February 19, 2002, at 12:16:05
Maria, you may take months tapering down from your Effexor only to find that you were one of the people who could discontinue it reasonably quickly without suffering bad effects. You'll know how you react from the initial change from 375 mg to 300 mg. If you're going to suffer discontinuation effects, you'll feel it that first week.
If you don't feel bad, you probably can go with his tapering schedule. If you do feel bad, tell him you need to go much slower. By the way, 20 mg Celexa is pretty low. You may need 40 mg or even 60. Hopefully, adding the Celexa as you taper down from Effexor should quell the symptoms of discontinuing it.
I'm one of those who had to taper off SSRIs over months, a couple of mg at a time, & still felt sick every day & then even for months afterwards. My case is pretty rare, thank goodness. I'm taking adrafinil (Provigil's siter), Celexa, & synthroid now. I found, for whatever reason, that adrafinil's enabled me to stop Paxil this time with no problems whatsoever. I went from my 10 mg Paxil cold turkey (while taking the above combo too) to none. All other times I tried tapering off even a little, I'd get sick, woozy, etc. The only difference now is the adrafinil I take. Stopped the Paxil & never even noticed a difference.
Posted by NikkiT2 on February 19, 2002, at 16:36:10
In reply to Re: Each person is unique., posted by Maria Warren on February 19, 2002, at 12:16:05
I am tapering off Effexor (from 300mg) at 75mg a week. I am now down to 75mg and have had virtually no side effects. the best bet is cut down 75mg and see how you feel.. leave it, then do it again.. thats what I'm doing, just going at my own pace.
Nikki
Posted by Reneeb on February 19, 2002, at 20:54:39
In reply to Re: Each person is unique., posted by Maria Warren on February 19, 2002, at 12:16:05
> Maria, I am also tapering off effexor. I have gone from 150mg to 75mg and now I am on 37.5mg. My doc told me to stay on this for two weeks and then skip a day for another week. I haven't felt any bad withdrawal effects either. I listened to what people had to say here and took it really slow.
Good Luck,
Renee
Posted by Maria Warren on February 20, 2002, at 6:00:29
In reply to Re: Each person is unique. » Maria Warren, posted by Reneeb on February 19, 2002, at 20:54:39
> > Maria, I am also tapering off effexor. I have gone from 150mg to 75mg and now I am on 37.5mg. My doc told me to stay on this for two weeks and then skip a day for another week. I haven't felt any bad withdrawal effects either. I listened to what people had to say here and took it really slow.
>
> Good Luck,
>
> Renee
Hey Renee, Nikki,IsoM, and everyone,
you have no idea how much I appreciate your positive posts! I had read so much that was negative about coming off Effexor XR. It frightened me and caused me such saddness, because of all the AD's I had ever been on, Effexor had done the trick for me better than any other. Had it not been for the weight gain I probably would have stayed on it.
I like the title of this thread "everyone is unique" and I am trying to remember that. It is just so good to know that I have companions in this healing proccess. And thanks to you Dr. Bob for providing this site for us. Keep the support coming -- I have just begun to taper! Maria
Posted by SusanG on February 20, 2002, at 12:29:49
In reply to Re: Effexor is a bad drug!! i need help!!!, posted by JAG on February 18, 2002, at 11:45:56
Could any of you help me with a weird symptom I've been having? I'm not sure if it is Effexor related but could be. It sounds like the Brain Zaps that have been mentioned by others. I get these odd sensations like dizziness but not exactly. They are somewhat like the feeling you would get if you stepped off a curb unexpectedly or like the feeling off starting to nod off in a boring lecture, then catching yourself. I feel it just in my head, like little head hiccups and notice it mostly when sitting quietly. I have experienced them before but they have been worse lately and I wonder if this is due to weaning off the Effexor. I thought it could be due to dehydration or allergies so I tried to address these issues but no change. I just wish it would stop. Anyone recognize this?
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