![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 658 to 682 of 10407. Go back in thread:
Posted by Sammy Shuford on March 27, 2001, at 23:00:11
In reply to Re: 7 WEEKS--EFFEXOR FREE, posted by Pamela on March 25, 2001, at 17:48:17
> > I am now 1 week free, dropped from 150mg to ZERO. Major headaches, vertigo, sinus type problems, and a little hot headed. All signs that I NEED to be free of this drug. No real depression. My depression stopped after my blood sugar dropped from 300mg/dl to normal 85-90. But the "good" doc insisted that we increase, it s good stuff.
> >
> > Ha
>
> Dear Sammy,
> I don't knowh ow youa e doing it going from 150mg to zero. I went from 75 mg to 37.5 then to alf that and half that etc. When I finally went completely off, all of the symtoms you describe (except the sinus) plus dizziness (severe) and pain (incredible). I wish you well and I totally agree, read my Back to the Urgent Care thread if you're interested in our wonderful doctors. If you get too bad I would suggest going at least to 37.5 for awhile, I found keeping at least a little bit in my system for a short period of time, helps. I know i wanted to quit cold turkey too, thinking the weaning was about depression coming back, Yeah I am drepressed allright..... because I feel physically terrile.
> Prayers are with you,
> PamelaAfter reading a lot here, I would also go back on a LOW dose, but all I have are 150mg caps.
Posted by Sammy Shuford on March 27, 2001, at 23:06:59
In reply to Re: Effexor Free--Pamela, posted by Seraphim on March 25, 2001, at 21:20:48
> Pamela,
>
> Please tell me more, and update me on your progress. I've gone from 300mg - 150mg in two weeks. I'm having a very hard time maintaining. I too thank God I found this site. I decided to get the Effexor out of my system after a few nightmare days of unintentional withdrawal. I'm trying to work, continue to be Mom and Wife, and maintain some semblance of normalcy. I've never been so sick and tired, I am living in a constant state of discomfort, nausea and abdominal pain. I know many out there have spoken of taking other medications to help counteract the symptoms of this one, but I'm having a real hard time trying to justify putting more drugs into my system and having to think about the potential side effects and withdrawal symptoms from the new ones. It does help to hear that I'm not alone. No one else in my life understands what I'm going through, and to tell you the truth, I'd rather they not. Probably a little pride speaking there. Anyway, I would like to hear more from you. Thanks.
>
> SeraphimNO, Seraphim, you are NOT alone. There have been many times in the last 10 days I though of going back, just to relive the current withdrawal. But God has blessed, and I have stayed free of this poison.
I personally will never trust a doctor’s word on a medicine. I fell betrayed by my “ex” doctor. And look forward to the day when I am free of the withdrawal effects.
Posted by Michele on March 27, 2001, at 23:08:07
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Sammy........
It's probably posted on here somewhere.... but... can I ask why you are getting off effexor?
Posted by Sammy Shuford on March 27, 2001, at 23:10:22
In reply to effexor side effects/withdrawl, posted by kckboxgrl on March 25, 2001, at 23:15:03
> Hi everyone! Just starting effexor xr, 37.5 mg. Up to 75 next week. I've read some really horrible things about side effects and withdrawl, has anyone had positive results? Also, since starting the effexor, i've had a headache (of migraine proportions) every morning--does anyone know if this is a side effect?
> Thanks for any help!
> Lisa
POSITIVE RESULTS, for family and coworkers, I was less apt to say what I really though while on thie medicine.
Posted by Julie L on March 28, 2001, at 0:57:45
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Posted by Canuck on March 28, 2001, at 1:52:45
In reply to Re: Another satisfied customer!, posted by Pamela on March 27, 2001, at 9:50:12
> >
> >
> > Just a quick note to say that I have had great results with Effexor XR. I did have a few side effects in the first three days. I had nausea for the first few hours after taking the drug. I also had a hard time sleeping for the first few nights, but I was having a hard time sleeping before the med anyway. And then there was the constant yawning that I could not control. (That could be guite comical depending on where I was.) But I am happy to say that all of that has ended now and I am feeling great. I am feeling more and more like my old self every day. I don't pretend to think that this drug will have the same effect on everyone, but it has done wonders for me. I do wonder, however; if the reason that there are far more unhappy people than happy ones posting on this web sight is because the happy ones aren't looking for a forum to sing Effexor XR's praises. If you are taking the medication and are having good results, why would you bother looking for a sight on the internet? I only found this sight purely by chance one night when I first started taking the med. Let me say, had I read many of the postings before I started taking the drug, I would not have taken it. This would have done me a great disservice. I have always just checked in on this sight and read the postings, but today I feel compelled to share my "good" Effexor XR story. Thank you for your time.
> >
> > Canuck
>
> Canuck,
> Once again, you are talking about FXR while you are "on" it, please don't be fooled it is the scariest thing I have experienced "GOING OFF" it. I loved it while on it, it did wonders for me. Information is good and you are right about this site with no one reporting good stuff. I would love to read just "ONE" positive about the withdrawals's.... JUST ONE! It might give me hope, but in the meantime, keep reading so you become aware. Our society likes the quick fix (as did I) so we tend to hide our head in the sand if it does the job, quickly. My life will never be the same (knowledge and appreciation for my previous good health)) as for my health, I pray everyday for a full recovery from this drug. I have other detailed info if yo haven't already read. Please don't dismiss what you read, these are real people, with real suffering going on. This site helped me tremedouly knowing that I wasn't the only one and wasn't going crazy.
> God Bless and I will pray for your success,
> PamelaI do not believe that I am being "fooled". My head is not hidden "in the sand". I spoke at length with my physician before starting this medication and she was very clear that I would experience side effects when coming off of the drug. I also spoke to a friend and also a co-worker who have both been on the med and are now both off of it. Both complained of extreme headaches when tapering off, but have had no other adverse reactions. I don't pretend to say that there are not patients who go through extreme withdrawl, but to be back to my old self again, I was willing to take the chance. I did not make this decision blind folded. I am extremely comfortable with my decision and when I feel strong enough to go off Effexor XR, I will do so with an open mind and a positive attitude knowing that I made my decision with my eyes wide open. Thank you for your time.
Canuck
Posted by Pamela on March 28, 2001, at 9:15:23
In reply to Can't decide. PLEASE help!, posted by Michele on March 27, 2001, at 13:20:29
> Hi everybody,
> I am trying to make a desion. I have been on effexor xr for 3 weeks. 37.5,75,150. I have not felt any POSITIVE from this yet.... but many side effects that are scaring the *#*# out of me. Is it possible to tell if a drug is going to work for you in this amount of time? I've never taken an AD before... and I think if I want to stop them, now is the time, before I'm on it too long? I'm pulling hair out of my head trying to decide what to do. I can stop now, with hopefully minimal effects... or hang on and see what happens? If it's not the drug for me, I'd rather stop now and get it over with, since I'm out of work for 2 weeks. Any advice would be GREATLY appreciated. I'm sooo tired of these side effects.. they are messin' with my mind!!!! Thanx guys....... MicheleHi Michele,
You are getting strictly an "Opinion" here. Doctors say it takes at least 2 months to really take effect, but I disagree, I was feeling better in a matter of weeks. I loved the drug at that point.
I have a very sensitive system and I can take a sip of wine and feel it in a matter of seconds. So I feel it is different for everyone. I didn't have any side effects on it, but if I had, I would have stopped immediately, even not knowing what I know now. To me a side effects is a warning that your body does not like what you are putting in it. I for one cannot do "Caffeine"! Once again, if I drank a half of a cup of coffee I would be up for days, mean as H___ and have diarhea. Therefore I do not injest anything with caffeine in it.
I am sure you have read about some of the side effects getting off, too, so the final decison will need to be your. My prayers will be with you.
Pamela
Posted by Pamela on March 28, 2001, at 9:47:28
In reply to Re: 7 WEEKS--EFFEXOR FREE, posted by Sammy Shuford on March 27, 2001, at 23:00:11
> > > I am now 1 week free, dropped from 150mg to ZERO. Major headaches, vertigo, sinus type problems, and a little hot headed. All signs that I NEED to be free of this drug. No real depression. My depression stopped after my blood sugar dropped from 300mg/dl to normal 85-90. But the "good" doc insisted that we increase, it s good stuff.
> > >
> > > Ha
> >
> > Dear Sammy,
> > I don't know how you are doing it going from 150 mg to zero. I went from 75 mg to 37.5 then to half of that and half that etc. When I finally went completely off, all of the symtoms you describe (except the sinus) plus dizziness (severe) and pain (incredible). I wish you well and I totally agree, read my Back to the Urgent Care thread if you're interested in our wonderful doctors. If you get too bad I would suggest going at least to 37.5 for awhile, I found keeping at least a little bit in my system for a short period of time, helps. I know i wanted to quit cold turkey too, thinking the weaning was about depression coming back, Yeah I am drepressed allright..... because I feel physically terrile.
> > Prayers are with you,
> > Pamela
>
> After reading a lot here, I would also go back on a LOW dose, but all I have are 150mg caps.Dear Sammy,
Are you on Effexor XR (time released)? If so, what I did was just dump out the capsules a little at a time. I was doing it with the 75 mg.. I also got some 37.5 from my doctor. Your doctor should help you with this re: prescription Ask him for "samples" they have plenty!
I am literally down to abut 7 mg. if I were to guess, which almost scares me more... showing me just how potent this drug really is.
I also hear people on this site who are weaning down by great amounts in 1 weeks time frame. I weaned 2-3 weeks at a time and not large quantities. I was only on 75mg, so those who are on 150 and up,I would suggest doing it MORE slowly than from 150 to 75 in one fell swoop or 150 to zero, that is suicide (not literal). Maybe 150 to 125 then 100, then 75, etc.
Your body needs to get used to each lower doage and that will probably take more than a week.
Good Luck
Pamela
Posted by Pamela on March 28, 2001, at 10:00:56
In reply to Re: Withdrawal after 6 YEARS, posted by Julie L on March 28, 2001, at 0:57:45
>
> hi ... I've been on Effexor for 6 years. I'm currently 21 yrs old, you do the math. This med seems to work for me , but I want to get off of it. So I decided to slowly decrease my dosagefrom 37.5 to half a pill, to nothing. I've been free of it for a week now. I've gained 40 lbs over the past three years.
> I just got done with a panic attack (its 2 AM), and a fit of rage. i hit my roommate and regret doing so.
>
> I'm relieved to see that other people are having withdrawal symptoms too. I had the "medicine head"/vertigo feeling for about a week, now I cry almost every hour, and take everything the wrong way. I'm beginning to think that I'm NOT going crazy.
>
> I had the medicine bottle in my hand and was going to start taking them again. I think I'll wait it out with the rest of you...
>
> Thank you all,
> Julie
Hi Julie,
I take it you have been on quite a low dose for 6 yrs? 37.5 is the lowest on the time relased. Of course they did not have that 6 yrs ago, it is fairly new. I went back on to 12mg ish and now at about 7mg. I will wean until I'm down to 1 little granule. It is a potent drug, be careful!
We are with you,
Prayers and Blessings,
Pamela
Posted by Pamela on March 28, 2001, at 10:05:21
In reply to Re: Another satisfied customer!, posted by Canuck on March 28, 2001, at 1:52:45
> > >
> > >
> > > Just a quick note to say that I have had great results with Effexor XR. I did have a few side effects in the first three days. I had nausea for the first few hours after taking the drug. I also had a hard time sleeping for the first few nights, but I was having a hard time sleeping before the med anyway. And then there was the constant yawning that I could not control. (That could be guite comical depending on where I was.) But I am happy to say that all of that has ended now and I am feeling great. I am feeling more and more like my old self every day. I don't pretend to think that this drug will have the same effect on everyone, but it has done wonders for me. I do wonder, however; if the reason that there are far more unhappy people than happy ones posting on this web sight is because the happy ones aren't looking for a forum to sing Effexor XR's praises. If you are taking the medication and are having good results, why would you bother looking for a sight on the internet? I only found this sight purely by chance one night when I first started taking the med. Let me say, had I read many of the postings before I started taking the drug, I would not have taken it. This would have done me a great disservice. I have always just checked in on this sight and read the postings, but today I feel compelled to share my "good" Effexor XR story. Thank you for your time.
> > >
> > > Canuck
> >
> > Canuck,
> > Once again, you are talking about FXR while you are "on" it, please don't be fooled it is the scariest thing I have experienced "GOING OFF" it. I loved it while on it, it did wonders for me. Information is good and you are right about this site with no one reporting good stuff. I would love to read just "ONE" positive about the withdrawals's.... JUST ONE! It might give me hope, but in the meantime, keep reading so you become aware. Our society likes the quick fix (as did I) so we tend to hide our head in the sand if it does the job, quickly. My life will never be the same (knowledge and appreciation for my previous good health)) as for my health, I pray everyday for a full recovery from this drug. I have other detailed info if yo haven't already read. Please don't dismiss what you read, these are real people, with real suffering going on. This site helped me tremedouly knowing that I wasn't the only one and wasn't going crazy.
> > God Bless and I will pray for your success,
> > Pamela
>
> I do not believe that I am being "fooled". My head is not hidden "in the sand". I spoke at length with my physician before starting this medication and she was very clear that I would experience side effects when coming off of the drug. I also spoke to a friend and also a co-worker who have both been on the med and are now both off of it. Both complained of extreme headaches when tapering off, but have had no other adverse reactions. I don't pretend to say that there are not patients who go through extreme withdrawl, but to be back to my old self again, I was willing to take the chance. I did not make this decision blind folded. I am extremely comfortable with my decision and when I feel strong enough to go off Effexor XR, I will do so with an open mind and a positive attitude knowing that I made my decision with my eyes wide open. Thank you for your time.
>
> CanuckI wish you well!
Pamela
Posted by Seraphim on March 28, 2001, at 10:14:33
In reply to Re: Effexor Free--Pamela, posted by Sammy Shuford on March 27, 2001, at 23:06:59
Posted by Seraphim on March 28, 2001, at 10:36:48
In reply to Re: Another satisfied customer!, posted by Canuck on March 28, 2001, at 1:52:45
Posted by Seraphim on March 28, 2001, at 10:48:36
In reply to Re: Can't decide. PLEASE help!, posted by Pamela on March 28, 2001, at 9:15:23
Michele,
Please speak to a doctor, any doctor, if you are still experiencing the awful side effects. It looks like you increased your dosage very, very quickly. Maybe too quick for your system. Everyone of course is different, but aside from the side effects I experienced, I could tell a positive difference in my mental state within two weeks. If you are concerned, talk to a doctor, and if you decide to stop taking Effexor, be very careful and taper off. Even though you have only been taking it for three weeks, you will probably experience some of the withdrawal symptoms. Good Luck.
> Hi everybody,
> > I am trying to make a desion. I have been on effexor xr for 3 weeks. 37.5,75,150. I have not felt any POSITIVE from this yet.... but many side effects that are scaring the *#*# out of me. Is it possible to tell if a drug is going to work for you in this amount of time? I've never taken an AD before... and I think if I want to stop them, now is the time, before I'm on it too long? I'm pulling hair out of my head trying to decide what to do. I can stop now, with hopefully minimal effects... or hang on and see what happens? If it's not the drug for me, I'd rather stop now and get it over with, since I'm out of work for 2 weeks. Any advice would be GREATLY appreciated. I'm sooo tired of these side effects.. they are messin' with my mind!!!! Thanx guys....... Michele
>
> Hi Michele,
> You are getting strictly an "Opinion" here. Doctors say it takes at least 2 months to really take effect, but I disagree, I was feeling better in a matter of weeks. I loved the drug at that point.
> I have a very sensitive system and I can take a sip of wine and feel it in a matter of seconds. So I feel it is different for everyone. I didn't have any side effects on it, but if I had, I would have stopped immediately, even not knowing what I know now. To me a side effects is a warning that your body does not like what you are putting in it. I for one cannot do "Caffeine"! Once again, if I drank a half of a cup of coffee I would be up for days, mean as H___ and have diarhea. Therefore I do not injest anything with caffeine in it.
> I am sure you have read about some of the side effects getting off, too, so the final decison will need to be your. My prayers will be with you.
> Pamela
Posted by Amy 5452 on March 28, 2001, at 18:37:53
In reply to Re: starting effexor... keep posting.. success/dosage?, posted by Racer on October 25, 1999, at 19:54:13
Today is my first day on Effexor XR. I only took the 37.5mg pill, but i am so dizzy and nauseaus it is unbelievable. How long will this last for?
Posted by Michele on March 28, 2001, at 20:28:04
In reply to Starting Effexor, posted by Amy 5452 on March 28, 2001, at 18:37:53
Amy,
Hi.... I was just posting recently, regarding the side effects. Yesterday I almost went off after 3 weeks(150mg) and I've never taken ADs before. And these posts terrified me. I had horrible, horrible side effects myself.... all the sudden this morning.... poof, they were gone.... and I feel terrific! Better than I have in years. Hopefully this isn't a fluke....and it'll last... but it does end.(And I questioned that it ever would.) Good luck.... and keep in touch with your progress, Michele
Posted by Voski on March 29, 2001, at 8:14:23
In reply to Re: Another satisfied customer! » Canuck, posted by Seraphim on March 28, 2001, at 10:36:48
Efferox XR, YES!!! It has helped me!!! After taking Zoloft with side effects and then Prozac, yet more side effects with muscle spasms, it was Efferox XR that helped with no side effects. Struggling with depression is no fun for yourself or your family. After a year of feeling out of touch with myself and out of control, I went to my doctor. The results are wonderful with the help of counseling. The hell I put my children and husband thru. I am currently up to twice a day taking Efforox XR with fantastic results. That's 150 mg. 75mg. each time. I was having a mid day crash, as I call it. Crying and feeling useless is not fun. Now I am smiling and laughing again with slight bouts of crying, etc. What great news!!!! I am still in couseling and probably will be for a while, which is fine with me along with med help. At least now, I can get through the day. I still have trouble sleeping nights, but with Ambien, I now have a night with sleep and not waking to my mind wondering.... Feel free to comment. Good luck with all!!
voski
Posted by Leo on March 29, 2001, at 8:43:32
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
IF YOU'RE ANGRY NOW..........WAIT UNTIL YOU READ THE INFORMATION......SUPPLIED BY THE FDA..... IN THE FOLLOWING. ANYTIME THE FDA HAS TO "FORCE" THE MANUFACTURER TO COME CLEAN, THERE IS A HUGE DEGREE OF UNDERLYING PROBLEMS. THIS IS JUST THE BEGINNING.................MORE TO COME
The text below is taken from the drug data sheet for Effexor XR (Venlafaxine HCI) which was approved in it's new form by the FDA on 12 July 2000. A full copy of the 20 page document in Adobe Acrobat format can be downloaded by clicking the link at the end of this page.
The first section, relating to the short term premarketing trials, confirms the link between the drug and many of the side effects which I have mentioned on this web site (and many of which are the symptoms of serotonin syndrome) including; amnesia, confusion, depersonalization, hallucinations, paranoia, gastrointestinal problems, increased depression and vision impairment.
The second section confirms that postmarketing reports have suggested links with serotonin syndrome, neuroleptic malignant syndrome-like events, involuntary body movements and shock-like electrical sensations subsequent to discontinuation or tapering of the dose.
Having regard to the Safety Related Drug Labelling changes forced by the FDA in March 2000, which confirmed the existence of a severe dose and time related withdrawal syndrome, I believe that everything that I have said about this drug has been proven; that patient's prescribed Venlafaxine are at risk of developing severe and potentially fatal side effects to the drug and that in many cases such patients are unable to discontinue the drug or taper withdrawal. Nevertheless I'm convinced that there is lots more to come.
The question which begs to be asked is, why weren't we warned!EFFEXOR & EFFEXOR XR (venlafaxine HCl) Tablets
[March 3, 2000: Wyeth-Ayerst]
DRUG ABUSE AND DEPENDENCE:
Physical and Psychological Dependence: New third paragraph -
"Discontinuation effects have been reported in patients receiving venlafaxine (see DOSAGE AND ADMINISTRATION)."
DOSAGE AND ADMINISTRATION:
Discontinuing Effexor (venlafaxine HCl): First sentence revised (new text in italics) -
"When discontinuing Effexor after more than 1 week of therapy, it is generally recommended that the dose be tapered to minimize the risk of discontinuation symptoms. Patients who have received Effexor for more than 6 weeks or more should have their dose tapered gradually over at least a 2-week period."
New second paragraph -
"Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine, to include prospective analyses of clinical trials in Generalized Anxiety Disorder and retrospective surveys of trials in depression. Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment. Reported symptoms include agitation, anorexia, anxiety, confusion, coordination impaired, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting. It is therefore recommended that the dosage of Effexor be tapered gradually and the patient monitored. The period required for tapering may depend on the dose, duration of therapy and the individual patient. Discontinuation effects are well known to occur with antidepressants."
Discontinuing Effexor XR:
"When discontinuing Effexor XR after more than 1 week of therapy, it is generally recommended that the dose be tapered to minimize the risk of discontinuation symptoms. In clinical trials with Effexor XR, tapering was achieved by reducing the daily dose by 75 mg at one week intervals. Individualization of tapering may be necessary. [The remainder of the paragraph beginning with "While the discontinuation effects of Effexor XR have not been systematically evaluated in controlled clinical trials, retrospective..." has been deleted] and replaced with -
"Discontinuation symptoms have been systematically evaluated in patients taking venlafaxine, to include prospective analyses of clinical trials in Generalized Anxiety Disorder and retrospective surveys of trials in depression. Abrupt discontinuation or dose reduction of venlafaxine at various doses has been found to be associated with the appearance of new symptoms, the frequency of which increased with increased dose level and with longer duration of treatment. Reported symptoms include agitation, anorexia, anxiety, confusion, coordination impaired, diarrhea, dizziness, dry mouth, dysphoric mood, fasciculation, fatigue, headaches, hypomania, insomnia, nausea, nervousness, nightmares, sensory disturbances (including shock-like electrical sensations), somnolence, sweating, tremor, vertigo, and vomiting. It is therefore recommended that the dosage of Effexor XR be tapered gradually and the patient monitored.
Posted by Leo on March 29, 2001, at 9:03:17
In reply to Re: Sammy.........., posted by Michele on March 27, 2001, at 23:08:07
RE VENLAFAXINE WITHDRAWAL REACTIONS
DATE CITATIONDRUG REPORT
1996 Benazzi VenlafaxineSingle case report of withdrawal symptoms after abrupt cessation of four week treatment with VFX 150mg/day. Patient experienced "brief 'bursts' of dizziness, which lasted for a few seconds and occurred numerous times throughout the day", also with headache, nausea, fatigue, sweating and worsening of depression. Symptoms cleared when VFX 75mg/day was restarted and did not reappear during the gradual drug tapering that followed.
1996 Farah & Lauer Venlafaxine Single case report of a 32-year old woman, originally on VFX 300mg/day, treated for eight months for depression. On each of three occasions she failed to withdraw from the drug, after abrupt discontinuation: she "experienced headache, gastro-intestinal distress, fatigue and other symptoms ... She remains on a regimen of venlafaxine, 100mg t.i.d."
1966 Louie et al VenlafaxineThree cases are reported of VFX withdrawal, following both abrupt (2 cases) and very gradual cessation. Main symptoms were dizziness and G-I distress, but one patient also experienced auditory hallucinations and bizarre dreams. It took her ten weeks from the initial attempt at withdrawal to discontinue VFX. Neither of the two other patients was reported to have achieved withdrawal.
1996 Rauch et al VenlafaxineFour out of nine patients involved in an open 12-week trial of VFX for OCD "developed a troublesome withdrawal syndrome", in spite of gradual withdrawal of medication over four days to two weeks. Symptoms included "a flu-like syndrome with muscle aches, fatigue, headache, nausea and dizziness. In three cases, symptoms were relieved by resuming venlafaxine, followed by a more gradual discontinuation. Interestingly, the fourth patient developed withdrawal symptoms despite having initiated fluoxetine."
1997 Agelink et al. VenlafaxineTwo cases reported, both involving elderly women. In one case, patient was taken off VFX venlafaxine after 26 days because of persistent insomnia. Withdrawal symptoms included confusion, nausea, agitation, sweating, anxiety, visual hallucinations and fluctuation of blood pressure and heart rate. The severity of symptoms required close monitoring for eight hours in the psychiatric intensive care unit; symptoms resolved 24 hours after last dose. In the second case, VFX was stopped after 42 days because of lack of efficacy and unwanted effects. Withdrawal symptoms included nausea, feelings of abdominal distension, headache, restlessness, agitation, sweating and also visual hallucinations. Symptoms resolved within two to three hours after VFX was reinitiated. Thereafter, the drug was gradually withdrawn over four days, with no recurrence of symptoms.
1997 Cunningham Venlafaxine & Venlafaxine XRThis Wyeth-Ayerst sponsored study included measurements of withdrawal reactions in 127 patients treated with VFX but did not report them. Remarkable. Patients had been treated for 12 weeks with VFX (either the usual or Extended-Release version) in a double-blind, placebo-controlled trial, following which "study medications were tapered over a period of up to two weeks". The report states that patients were evaluated 4 to 10 days after medication was discontinued, but results are not reported.
1997 Fava et al Venlafaxine XRTwenty adult outpatients were randomly assigned to receive either an extended-release formulation of VFX or placebo. After eight weeks of double-blinded treatment, doses were tapered or stopped (tapered by 75mg/week for patients taking 150mg/day or 225mg/day - but not for patients on 75mg/day, or on PBO). Seven of the nine patients previously on VFX (78%) reported adverse effects on withdrawal (and became significantly more depressed), compared with two out of nine patients (22%) on placebo. The relationship between frequency and severity of effects and dosage of VFX was not recorded, but severity of withdrawal effects was significantly greater in the VFX group than for the group on placebo. See also: Cunningham, 1997.
1997 Giakas & Davis Venlafaxine FluoxetineThree consecutive cases reported of 26-35 year old women who experienced severe withdrawal after discontinuing venlafaxine, following treatment ranging from a week or two to seven months: "Repeated attempts at gradually tapering the dosage were unsuccessful and led to intolerable withdrawal sensations." In these and other cases, authors noted appearance of withdrawal symptoms within a few hours of patient missing a dose. Although, symptoms they saw "are not identical to a fully-fledged psychedelic experience or a true migraine headache, similarity is evident..." In all cases, venlafaxine was eventually discontinued under cover of fluoxetine, which itself was later withdrawn uneventfully in one of the three cases.
1997 Moore Venlafaxine"The investigators who were testing Effexor observed that 'clusters of symptoms sometimes occurred at or shortly after the discontinuation of Effexor treatment'. As a result, Wyeth-Ayerst did a survey of all the patients in the clinical trial's testing program. Overall, 35 per cent of the Effexor patients experienced withdrawal symptoms ranging from a flu-like syndrome to insomnia, nausea, nervousness and loss of energy. In five patients, Wyeth-Ayerst reported, withdrawal symptoms were so severe and prolonged that medical treatment was required. Two patients could not be withdrawn from the drug, and treatment was resumed. One patient was hospitalised. Two others had to be treated with another antidepressant. These five cases suggest a risk of severe addiction in some patients." Click for Moore
1997 Thase Venlafaxine XRReport of a manufacturer-sponsored, randomised, double-blind, placebo-controlled, multicentre evaluation of venlafaxine (extended release version) versus placebo. In this 8-week study, 91 patients were treated with VFX-XR and 100 with placebo. The medications were then tapered for up to two weeks, with a post- study evaluation made 4-10 days after discontinuation. In the 'Results' section of the paper, author noted: "Importantly, no clinically significant withdrawal syndromes were observed during double-blind discontinuation of study medications". However, the term "clinically significant" is not defined, and this finding was not considered sufficiently important to be mentioned in the Abstract of the paper.
1997 Wolfe Sertraline Venlafaxine Review including brief reports of two patients who had experienced withdrawal symptoms on discontinuing SRN and VFX respectively. The patient on VFX experienced severe restlessness (akathisia) which abated within hours of restarting the drug. The drug was later gradually tapered and withdrawn.1998 Boyd Venlafaxine
Brief review of the 13 reports of withdrawal reactions to VFX received by the Australian Adverse Drug Reaction Advisory Committee (ADRAC) between early 1996 and early 1998. "Four of the 13 patients recovered from their symptoms within two weeks and two required return to venlafaxine and a tapered withdrawal. Three patients had not recovered at the time the report was submitted to ADRAC and information on time to recovery was not available for three patients, while outcome was unknown for one patient."
1998 Dallal & Chouinard VenlafaxineLetter reports that, on completion of an 8-week open label study of venlafaxine, six of eight patients required gradual dose reduction (over 7-15 days, mean 11 days) because of severe withdrawal symptoms. In addition, two patients in the study had complained of a withdrawal symptom (nausea) shortly after missing a single dose. Authors advise: "clinicians should be aware of the potential for serious psychiatric and physical sumptoms that should not be confounded with the original illness when venlafaxine is abruptly discontinued".
1998 Johnson et al VenlafaxineCase report. Patient was a 42-year old man, successfully treated for depression with VFX 75mg/day for six months. Dosage was then halved (for an unspecified period) and stopped. Within 36 hours of stopping, patient "developed positional vertigo, which caused him significant incapacity, in addition to nausea and light- headedness". Symptoms soon resolved on reintroduction of drug. Dosage was reduced to 18.75mg/day for three weeks and then discontinued: "He had ongoing symptoms of vertigo which resolved slowly over three weeks. The patient's determination enabled him to discontinue ... but he did so with difficulty."
1998 Macbeth and Rajagopalan VenlafaxineCase report: After two year's unsuccessful treatment for depression, Mr Y (51) was tried on venlafaxine, to 300mg/day. "After four weeks on this dose, depressive symptoms continued unabated and Mr Y began to make active suicidal plans". A course of ECT was therefore planned, so the VFX was rapidly reduced, over two days. After 72 hrs, Mr Y developed severe nausea, anorexia, dizziness, unsteady gait, tinnitus and headache - all new symptoms which resolved when VFX was restarted at 75mg.day. Shortly after, Mr Y was withdrawn uneventfully from this dosage, over one week.
1998 Parker & Blennerhasset VenlafaxinePaper describes withdrawal problems associated with abrupt and tapered withdrawal of VFX and documents withdrawal symptoms occurring after missing a single dose. Two cases are discussed, including one where severe symptoms (including hallucinations) were experienced during slow tapering. Authors conclude that withdrawal "make make cessation of the drug extremely difficult", and they consider two strategies for addressing the problem.
1998 Raby VenlafaxineCase report in which odansetron was successfully used to relieve somatic symptoms (but not anxiety) of venlafaxine withdrawal. Patient (29 year old woman with 12-year history of bipolar I disorder) had been treated with VFX for 10 weeks without response. Dosage was decreased with difficulty: "when receiving less than 75mg/day of venlafaxine, Ms. A would experience nausea, headaches, diarrhea, and anxiety so severe that she was forced to remain at home" and "this proved to be a dose below which the tapering schemedule could not be continued".
1999 Goldstein et al , venlafaxineManic symptoms following antidepressant withdrawal have mainly been reported in unipolar depression. These cases involved bipolar patients, treated for an average 6.5 months, before taper (average 20 days, range 1-43). The first manic symptoms emerged, on average, 2 weeks into the taper period (range 1-23 days), and mean length of manic episode was 28 days (range 12-49 days).
1999 Sierra Santos et al VenlafaxineIn Spanish. Single case-history of severe reactions experienced in spite of gradual withdrawal and brief review.
2000 Pinzani et al VenlafaxineIn French. Short report of six cases of withdrawal reactions and a brief literature review. Authors conclude that "physicians must be aware of the frequency, rapidity and potent severity of these withdrawal syndromes".
2000 Patients' reports VenlafaxineSee this well-established, much visited US website operated by Belynda Warner at http://members.tripod.com/bwarner/effexor.html
Posted by Leo on March 29, 2001, at 9:13:01
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Withdrawal reaction associated with venlafaxine
H Johnson, W P Bouman, J Lawton.
Nottingham Healthcare NHS Trust, Wells Road Centre, Nottingham NG3 3AA
We report an apparent withdrawal reaction to venlafaxine, a recently introduced serotonin noradrenaline reuptake inhibitor antidepressant whose use is increasing.
A 42 year old man with a first episode of major depression was treated with venlafaxine after unsuccessful trials with fluoxetine and imipramine. He fully recovered over four weeks while taking a dose of 37.5 mg twice daily. This dose was maintained for 6 months and his mental state was stable. The dose was reduced to 37.5 mg once daily, which he tolerated well. However, within 36 hours after stopping venlafaxine treatment he developed positional vertigo, which caused him significant incapacity, in addition to nausea and light headedness. The symptoms resolved rapidly on reintroduction of the drug. The dose was reduced to 18.75 mg daily for three weeks and then discontinued. He had ongoing symptoms of vertigo, which resolved slowly over three weeks. The patient's determination enabled him to discontinue taking the drug, but he did so with difficulty. He had no previous history of adverse drug reactions or withdrawal symptoms.
At the time of writing, three reports had been published about five similar cases, but the patients in all five cases were taking higher doses of venlafaxine before treatment was discontinued. The possibility of a withdrawal reaction is mentioned in the manufacturer's data sheet, but it implies that such reactions are observed with doses of 150 mg daily and above. Given the possibility of a withdrawal reaction with low doses of venlafaxine, we suggest that this drug is used with caution and that care is taken to gradually taper any dose before discontinuing treatment.
Posted by Leo on March 29, 2001, at 9:30:41
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
Other Adverse Events Observed During the Premarketing Evaluation of Effexor and Effexor XR
During its premarketing assessment, multiple doses of Effexor XR were administered to 705 patients in phase 3 depression studies and Effexor was administered to 96 patients. During its premarketing assessment, multiple doses of Effexor XR were administered to 476 patients in phase 3 GAD studies. In addition, in the premarketing assessment of Effexor, multiple doses were administered to 2897 patients in phase 2-3 depression studies. The conditions and duration of exposure to venlafaxine in both development programs varied greatly, and included (in overlapping categories) open and double-blind studies, uncontrolled and controlled studies, inpatient (Effexor only) and outpatient studies, fixed-dose, and titration studies. Untoward events associated with this exposure were recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of untoward events into a smaller number of standardized event categories.
In the tabulations that follow, reported adverse events were classified using a standard COSTART-based Dictionary terminology. The frequencies presented, therefore, represent the proportion of the 4174 patients exposed to multiple doses of either formulation of venlafaxine who experienced an event of the type cited on at least one occasion while receiving venlafaxine. All reported events are included except those already listed in Tables 3 and 4 and those events for which a drug cause was remote. If the COSTART term for an event was so general as to be uninformative, it was replaced with a more informative term. It is important to emphasize that, although the events reported occurred during treatment with venlafaxine, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions:frequent adverse events are defined as those occurring on one or more occasions in at least 1/100.patients;
infrequent adverse events are defined as those occurring in 1/100 to 1/1000 patients;
rare events are those occurring in fewer than 1/1000 patients.
Body as a whole - Frequent: chest pain substernal, chills, fever; Infrequent: face edema, intentional injury, malaise, moniliasis, neck rigidity, pelvic pain, photosensitivity reaction, suicide attempt; Rare: appendicitis, carcinoma, cellulitis, withdrawal syndrome.
Cardiovascular system - Frequent: migraine, postural hypotension; Infrequent: angina pectoris, arrhythmia, extrasystoles, hypotension, peripheral vascular disorder (mainly cold feet and/or cold hands), syncope, thrombophlebitis; Rare: arteritis, first-degree atrioventricular block, bigeminy, bradycardia, bundle branch block, cerebral ischemia, coronary artery disease, congestive heart failure, heart arrest, mitral valve disorder, mucocutaneous hemorrhage, myocardial infarct, pallor.Digestive system - Frequent: eructation, increased appetite; Infrequent: bruxism, colitis, dysphagia, tongue edema, esophagitis, gastritis, gastroenteritis, gastrointestinal ulcer, gingivitis, glossitis, rectal hemorrhage, hemorrhoids, melena, stomatitis, mouth ulceration; Rare: cheilitis, cholecystitis, cholelithiasis, hematemesis, gastrointestinal hemorrhage, gum hemorrhage, hepatitis, ileitis, jaundice, intestinal obstruction, oral moniliasis, proctitis, increased salivation, soft stools, tongue discoloration.
Endocrine system - Rare: goiter, hyperthyroidism, hypothyroidism, thyroid nodule, thyroiditis.
Hemic and lymphatic system - Frequent: ecchymosis; Infrequent: anemia, leukocytosis, leukopenia, lymphadenopathy, lymphocytosis, thrombocythemia, thrombocytopenia; Rare: basophilia, cyanosis, eosinophilia, lymphocytosis.Metabolic and nutritional - Frequent: edema, weight gain; Infrequent: alkaline phosphatase increased, glycosuria, hypercholesteremia, hyperglycemia, hyperuricemia, hypoglycemia, hypokalemia, SGOT increased, thirst; Rare: alcohol intolerance, bilirubinemia, BUN increased, creatinine increased, diabetes mellitus, dehydration, gout, hemochromatosis, hypercalcinuria, hyperkalemia, hyperlipemia, hyperphosphatemia, hyponatremia, hypophosphatemia, hypoproteinemia, SGPT increased, uremia.
Musculoskeletal system - Frequent: arthralgia; Infrequent: arthritis, arthrosis, bone pain, bone spurs, bursitis, leg cramps, myasthenia, tenosynovitis; Rare: pathological fracture, myopathy, osteoporosis, osteosclerosis, rheumatoid arthritis, tendon rupture.Nervous system - Frequent: amnesia, confusion, depersonalization, emotional lability, hypesthesia, vertigo; Infrequent: apathy, ataxia, circumoral paresthesia, CNS stimulation, euphoria, hallucinations, hostility, hyperesthesia, hyperkinesia, hypotonia, incoordination, libido increased, manic reaction, myoclonus, neuralgia, neuropathy, paranoid reaction, psychosis, seizure, abnormal speech, stupor; Rare: akathisia, akinesia, alcohol abuse, aphasia, bradykinesia, buccoglossal syndrome, cerebrovascular accident, loss of consciousness, delusions, dementia, dystonia, facial paralysis, abnormal gait, Guillain-Barré syndrome, hypokinesia, neuritis, nystagmus, psychotic depression, reflexes decreased, reflexes increased, suicidal ideation, torticollis.
Respiratory system - Frequent: dyspnea; Infrequent: asthma, chest congestion, epistaxis, hyperventilation, laryngismus, laryngitis, pneumonia, voice alteration; Rare: atelectasis, hemoptysis, hypoventilation, hypoxia, pleurisy, pulmonary embolus, sleep apnea.
Skin and appendages - Frequent: rash, pruritus; Infrequent: acne, alopecia, brittle nails, contact dermatitis, dry skin, eczema, skin hypertrophy, maculopapular rash, psoriasis, urticaria; Rare: erythema nodosum, exfoliative dermatitis, lichenoid dermatitis, hair discoloration, skin discoloration, furunculosis, hirsutism, leukoderma, pustular rash, vesiculobullous rash, seborrhea, skin atrophy, skin striae.
Special senses - Frequent: abnormality of accommodation, mydriasis, taste perversion; Infrequent: cataract, conjunctivitis, corneal lesion, diplopia, dry eyes, exophthalmos, eye pain, hyperacusis, otitis media, parosmia, photophobia, taste loss, visual field defect; Rare: blepharitis, chromatopsia, conjunctival edema, deafness, glaucoma, retinal hemorrhage, subconjunctival hemorrhage, keratitis, labyrinthitis, miosis, papilledema, decreased pupillary reflex, otitis externa, scleritis, uveitis.
Urogenital system - Frequent: metrorrhagia,* prostatitis,* urination impaired, vaginitis*; Infrequent: albuminuria, amenorrhea,* cystitis, dysuria, hematuria, female lactation,* leukorrhea,* menorrhagia,* nocturia, bladder pain, breast pain, polyuria, pyuria, urinary incontinence, urinary retention, urinary urgency, vaginal hemorrhage*; Rare: abortion,* anuria, breast engorgement, breast enlargement, fibrocystic breast, calcium crystalluria, cervicitis,* ovarian cyst,* prolonged erection,* gynecomastia (male),* hypomenorrhea,* kidney calculus, kidney pain, kidney function abnormal, mastitis, menopause,* pyelonephritis, oliguria, salpingitis,* urolithiasis, uterine hemorrhage,* uterine spasm.*
*Based on the number of men and women as appropriate..Postmarketing Reports
Voluntary reports of other adverse events temporally associated with the use of Effexor (the immediate release form of venlafaxine) that have been received since market introduction and that may have no causal relationship with the use of Effexor include the following;agranulocytosis, anaphylaxis, aplastic anemia, catatonia, congenital anomalies, CPK increased, deep vein thrombophlebitis, delirium, EKG abnormalities (such as atrial fibrillation, supraventricular tachycardia, ventricular extrasystoles, ventricular tachycardia), epidermal necrosis/Stevens-Johnson Syndrome, erythema multiforme, extrapyramidal symptoms (including tardive dyskinesia), hemorrhage (including eye and gastrointestinal bleeding), hepatic events (including GGT elevation; abnormalities of unspecified liver function tests; liver damage, necrosis, or failure; and fatty liver), involuntary movements, LDH increased, neuroleptic malignant syndrome-like events (including a case of a 10-year-old who may have been taking methylphenidate, was treated and recovered), pancreatitis, panic, prolactin increased, renal failure, serotonin syndrome, shock-like electrical sensations (in some cases, subsequent to the discontinuation of Effexor or tapering of dose), and syndrome of inappropriate antidiuretic hormone secretion (usually in the elderly).
There have been reports of elevated clozapine levels that were temporally associated with adverse events, including seizures, following the addition of venlafaxine. There have been reports of increases in prothrombin time, partial thromboplastin time, or INR when venlafaxine was given to patients receiving warfarin therapy.
Posted by Leo on March 29, 2001, at 9:40:37
In reply to Anyone had success on Effexor XR? , posted by jp on October 24, 1999, at 14:59:14
What I have just posted is the tip of an enormous iceberg. I could spend days posting the facts associated with the devistating effects of effexor. This drug makes Prozac look like an M&M.
In the future I will post the sources of information about the drug so that you can go to the sites and spend whatever time you feel i necessary navigating through all the information.
An excellent source to start with is:www.effexorfx.freeuk.com
This site will lead you to an abundance of sources and information about this "wonderful" drug.
Posted by JaneB on March 29, 2001, at 9:50:04
In reply to The Icing on the Cake............, posted by Leo on March 29, 2001, at 9:30:41
I took Effexor XR for over a year and experienced many of these symptoms. Tried to go without antidepressants at all and 10 months later had to start Celexa. Will I experience similar reactions upon discontinuation of Celexa? Scarey!
JaneB
Posted by Julie L on March 29, 2001, at 9:58:00
In reply to Is the same true of Celexa?, posted by JaneB on March 29, 2001, at 9:50:04
All of the studies that I'm reading only involve tests on people that have been on Effexor or Effexor XR for a year or less...
One of the studies that Leo posted mentioned breifly that the severity/intensity of the symptoms increased with the longer amount of time that the person was on Effexor.
Should I sue my doctor? Why did he leave me on this for so long if its not a common practice?
I'd really like to know when the withdrawal symptoms will stop...
Julie
Posted by McGuyver on March 29, 2001, at 10:38:25
In reply to Case Studies......More FACTS to come......, posted by Leo on March 29, 2001, at 9:03:17
Leo,
Ahh the light. I will continue to take my chances, as I've emntioned before I'm sure it's not as bad as other withdrawls I've had. But please note, I'm sure that I'm not alone in saying thanks. Backing up all the former bickering with something substansiated gained my respect immediatly. However, i will be taking it with a grain of salt, if you were to go into as much detial with something like asprin, I'm sure you could find similar results. Case studies and statistics are as good as the people who do them. Again, thanks.
Mc
>
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Posted by goofy on March 29, 2001, at 11:42:51
In reply to EFFEROX XR YES!!!, posted by Voski on March 29, 2001, at 8:14:23
> Efferox XR, YES!!! It has helped me!!! After taking Zoloft with side effects and then Prozac, yet more side effects with muscle spasms, it was Efferox XR that helped with no side effects. Struggling with depression is no fun for yourself or your family. After a year of feeling out of touch with myself and out of control, I went to my doctor. The results are wonderful with the help of counseling. The hell I put my children and husband thru. I am currently up to twice a day taking Efforox XR with fantastic results. That's 150 mg. 75mg. each time. I was having a mid day crash, as I call it. Crying and feeling useless is not fun. Now I am smiling and laughing again with slight bouts of crying, etc. What great news!!!! I am still in couseling and probably will be for a while, which is fine with me along with med help. At least now, I can get through the day. I still have trouble sleeping nights, but with Ambien, I now have a night with sleep and not waking to my mind wondering.... Feel free to comment. Good luck with all!!
> voski
voskiIam a 35 year old woman who had the same situation you discribed in your post. The only exceptions were, i was only on 75mg. and i was not seeing a counsler. I was excited with the results of this drug just like you. I did not have any side effects and was looking at this drug as a life saver. When I had been on the effexor for about a year, I started noticing some stange things gradually happening to me. The most noticable was I was having a hard time waking up. I started requiring 10-12 hrs. of sleep. Then i noticed my sex life was changing. I was becoming numb to any stimulation. Of course these are some of the signs of depression so my first thought was i had to increase my effexor dose. The fact that i was fine and great with my life one day and all of a sudden over a few weeks noticing these symptoms baffled me. I started investigating this drug and monitoring this board. all I can say is THANK GOD, I did not increase my dose at my dr. advise and that I startrd to take myself of this drug. I was able to get off this drug with very minimal side effects( check my previous post for details) I have now been effexor free for 19 days and all aspects of my life are great. I am glad you are doing great. I just felt compelled to share my situation with you because you reminded me of myself.
goofy
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