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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by ladylight on March 7, 2002, at 19:37:42
Hi, I haven't been on this site in a long, long time. But I remember how much it helped me when I first was trying Effexor XR.
I've been taking Effexor for 2 years. The first year at 150mg and the second year I needed to up the dose to 225. I also take 50mg of Trazadone to help me sleep.
I'm a bit frightened about being on a medication for such a long time. I have a history of depression and have in the past been helped by Prozac and Wellbutrin. But I also tend to get to a point where I don't want to take my medication anymore and will spontaneously quit.
Obviously this is a poor choice and my Pdoc has been good enough to continue to tx me with the understanding that I won't wander off again to quit cold turkey.
Has anyone been on Effexor for more than 2 years? I'm frightened of having been on this for so long, but am more frightened of going off. Each time I have stopped taking anti-depressents, I've eventually relapsed. Each time the relaps seems to come sooner and the severity of the depression seems much much greater than it ever has before.
Has anyone here made peace with being on meds for the rest of their life? If so, how? and what meds are you taking?...Thanks for listening and for your support
Beth
Posted by Willow on March 7, 2002, at 20:05:14
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
Beth
I'm sorry but I'm getting mixed signals from you. Do you want to stay on the effexor? Myself I've been on it for about a year and a half, like yourself I came up with an excuse to lower my dosage. As a result I think I had a minor relapse, but doctors immediately asked about my compliance with my med.
This time I did a little searching into my own history trying to make a chronological listing of all the depressions I've been through. Sure enough a pattern showed up, less than every two years my life was significantly disrupted by the symptoms of depression. And even though emotionally my moods aren't affected as much anymore, my ability to think and rationalize is more so affected and the physical symptoms are more dominant.
(The only time I had any respite from it was when I was either pregnant or nursing. Strange thing is that it seemed to be my saving grace. Gave me a six year sabbatical. Though when I stopped it hit me with a vengenace.)
So yes I'm happy to have found effexor and like the comparison made so many times this medication is as neccessary for me as insulin is for a diabetic. It could be worse. My father has schizophrenia and for many years took the older anti-psycotics. His medications haven't been able to help him function at the same level as myself but then his illness is a whole different ball game.
Whispering Willow
Posted by maximillian on March 8, 2002, at 3:49:10
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
sorry for jumping in...but you said two years on. how are or what are still the side effects from this drug? i'm on 150 effex and 150 wellbutrin twice a day for both. been steady on both for three months now. prior i bounced around and back and forth from one to another. been seeing a neuro. do you or anyone think i should switch to a pdoc? my worst effect is the libido thing. i feel both have helped in their own ways, but thinking about cutting back on dosage. anyone?
Posted by NikkiT2 on March 8, 2002, at 8:36:18
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
I'm sort of usd to ideas I'll probably be on meds for most of my life.
Having bn thinking about this lots as my husband and I are thinking of starting a family next year, and he wants me med free for pregnancy and subsequent breast feeding...
Nikki
Posted by HMK on March 8, 2002, at 10:52:45
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
I've been taking Effexor XR for the past 3 years and am happy to continue taking it. It is the only antidepressant I've found which has so few side effects. As a bipolar II, I have resigned myself to the fact that I will have to take medication for the rest of my life. I have a very demanding profession, so it's vital that I am always at my very best. I simply cannot be at my best unless I treat my illness. I think of it as a plain ol' brain disorder- my illness is very physical if you know what I mean. My brain does not make the correct balance of neurotransmitters so I take things to correct this. I also take medicine for my hypothyroidism too- this will probably be for life also.
The only thing is I get really cranky about how expensive these medicines are. It costs me a forture every month to afford all my drugs- I spend about $500 each month which is only reimbursed at 80% by my insurance.
Best of luck to you and I think we should be thankful to have found a medicine that works so well. Don't focus on the fact that you're going to be taking it for so long- focus on its benefits.
Posted by Mark H. on March 12, 2002, at 17:09:24
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
> Has anyone been on Effexor for more than 2 years?
>
> Has anyone here made peace with being on meds for the rest of their life? If so, how? and what meds are you taking?...Thanks for listening and for your support
> BethHi Beth,
In May, I'll have been on Effexor continuously for 5 years (plus one additional year before that). I'm Bipolar II and have two fairly distinct cycles a year (two troughs, two mild peaks). The "one additional year" reflects the fact that I, too, decided to quit after that first year.
The first year I took Effexor, I required an ever-increasing dosage. By the time I quit, I was getting withdrawal symptoms within 6 hours of taking my last dose for the day.
Between my first trial with Effexor and finding the "mix" that worked, I tried about 25 different anti-depressants and adjunctive medications, all the while growing increasingly worse.
Finally, my doctor and I hit upon the following daily regimen that works well for me: upon awaking, 25mcg Cytomel (thryroid), 2.5mg Pindolol, and either 40mg methylphenidate (Ritalin) or 10mg dexedrine. After breakfast, I take 150mg Effexor (not XR). At bedtime, I take 2.5mg Pindolol and 0.25mg clonazepam (for Periodic Limb Movement Disorder -- also helps with sleep).
The key for me was finding the adjunctives that countered my over-production of adrenaline and also potentiated the effects of Effexor, enabling me to stabilize at a fixed dosage of 150mg/day (instead of needing to increase it continuously). My depression is also atypical, which means I tend to eat and sleep all the time (hence the need for stimulants to stay awake during the day).
This mix, however physically taxing, has enabled me to benefit from renewed therapy, hold down a difficult job, regain joy in my marriage and in such ordinary activities as gardening and listening to music, and permitted me to undertake a serious spiritual path. I'm tremendously grateful that I have such a good medication regimen to follow, for however long it is available to me.
Having been to the absolute bottom and back, I can say that the quality of life I have regained in the last 5 years has been completely worth it even if I keel over tomorrow at the age of 52. In fact, this is the first time in my life that I've even *considered* that I might live into old age!
I think HMK and I both mention our bipolar conditions in part because we recognize wanting to go off of medications during an upswing as one of the symptoms we experience too. I'm not trying to diagnose you; just suggesting that you look at the possibility that you may "cycle" as well.
Be gentle and forgiving with yourself, and take each good day for the treasure it is. There's nothing wrong with taking medication, and if it improves the quality of your life, it is a very good thing indeed.
Best wishes,
Mark H.
Posted by maribeth on March 12, 2002, at 17:25:00
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
> Hi, I haven't been on this site in a long, long time. But I remember how much it helped me when I first was trying Effexor XR.
>
> I've been taking Effexor for 2 years. The first year at 150mg and the second year I needed to up the dose to 225. I also take 50mg of Trazadone to help me sleep.
>
> I'm a bit frightened about being on a medication for such a long time. I have a history of depression and have in the past been helped by Prozac and Wellbutrin. But I also tend to get to a point where I don't want to take my medication anymore and will spontaneously quit.
>
> Obviously this is a poor choice and my Pdoc has been good enough to continue to tx me with the understanding that I won't wander off again to quit cold turkey.
>
> Has anyone been on Effexor for more than 2 years? I'm frightened of having been on this for so long, but am more frightened of going off. Each time I have stopped taking anti-depressents, I've eventually relapsed. Each time the relaps seems to come sooner and the severity of the depression seems much much greater than it ever has before.
>
> Has anyone here made peace with being on meds for the rest of their life? If so, how? and what meds are you taking?...Thanks for listening and for your support
> BethBeth,
I can give you a "half yes answer"--I have accepted being on SOMETHING for the rest of my life. Now let me explain. I like you kept trying to come off the meds. And I am a professional who should know better. I too have been on Effexor for over two years. However, here is where I am so to speak -- My pdoc has been tapering me off the Effexor and on to Celexa at my request, no my INSISTANCE, due to massive weight gain. 50 lb over 5 years -- I simply will no longer put up with it!! The good the anti depressant may have done was about obliterated by my depression over my size.
I WANT MY BODY BACK.!!
I take my last Effexor tomorrow. I was on 325mgm at the top. Yes, Effexor was a wonder for the depression, but was it worth it?? Frankly, I just do not know. We shall see how Celexa does Wellbutrin is next in line. I shall keep in touch
maribeth
Posted by SLS on March 12, 2002, at 18:39:11
In reply to Re: 2+ years on Effexor...., posted by Willow on March 7, 2002, at 20:05:14
Hi Willow.
> This time I did a little searching into my own history trying to make a chronological listing of all the depressions I've been through. Sure enough a pattern showed up, less than every two years my life was significantly disrupted by the symptoms of depression. And even though emotionally my moods aren't affected as much anymore, my ability to think and rationalize is more so affected and the physical symptoms are more dominant.
Is the decreased ability to think a side effect of Effexor or is it due to depression?I have been taking 300mg of Effexor along with imipramine and Lamictal in an attempt to resolve bipolar depression. However, I think Effexor might be reducing my drive and motivation. Have you experienced this sort of thing? Does it dissipate over time? I'd like to get a better idea of how these things persist over time to help me decide whether to continue with it or switch to Nardil.
Any input would be greatly appreciated.
One caveat that you probably already know: Discontinuing an effective antidepressant brings with it the risk that the same medication will not work in the future should one relapse. If one has a history of multiple recurrences of depression, has experienced a very long period of depression, or has demonstrated treatment-resistance to many medications, it probably makes sense to consider continuing treatment indefinitely.
- Scott
Posted by Willow on March 12, 2002, at 20:34:54
In reply to Re: 2+ years on Effexor.... » Willow, posted by SLS on March 12, 2002, at 18:39:11
Hey Scott
After re-reading what I posted I can see that it wasn't too clear. Unfortunately I'm not at my best right now, but perhaps some good will come of this little bump, though at the moment I can't imagine it.
What I meant by this, "And even though emotionally my moods aren't affected as much anymore, my ability to think and rationalize is more so affected and the physical symptoms are more dominant." ... is that over the years the emotional aspect hasn't governed my depression, more just apathy, fatigue and the mental fog that drifts in. Effexor has helped enormously for me with the thinking problems without giving the usual emotional problems that so many ADs have.
>
>
> Is the decreased ability to think a side effect of Effexor or is it due to depression?This is due to my "condition" mostly. The effexor though has decreased my anxiety so much that I don't have any real what if solutions. When I first started it I use to space out and now uping the dosage again I notice these moments but know they too will pass.
>
> However, I think Effexor might be reducing my drive and motivation. Have you experienced this sort of thing? Does it dissipate over time?Yes it did pass. May I ask how long have you been on the effexor? I think it was around the four month period that it went away, mind you I had to make an extra effort on my own to get to bed at a reasonable hour, (the med flipped my days and nights around) and to get off the couch. Now that you mention it I remember a period where I was quite overly content just to veg. Thank goodness I wasn't working at the time, though I was taking a course at the local college and was very close to losing the credit.
> One caveat that you probably already know: ... it probably makes sense to consider continuing treatment indefinitely.
Oh but even so it's worth repeating over and over to get through this thick skull of mine. Funny thing is before I wrote down the dates I would have said I had suffered with depression on three different occassions, when in reality there has been eight distinct bouts that I seeked treatment for. So yes I'm a lifer. Thank goodness my gp right away picked up on the fact that I had lessened my dosage.
I believe with patience on our parts, having supportive family and close friends, plus a knowledgeable doctor/s will help us get some normality back into our lives.
BEST WISHES
Weeping Willow
Posted by SLS on March 14, 2002, at 7:44:59
In reply to Re: 2+ years on Effexor.... » SLS, posted by Willow on March 12, 2002, at 20:34:54
Dear Weeping Willow,
Thanks for responding.> After re-reading what I posted I can see that it wasn't too clear. Unfortunately I'm not at my best right now, but perhaps some good will come of this little bump, though at the moment I can't imagine it.
I empathize with you. I hope the road smooths out for you soon.
A friend of mine has recently increased her dosage of Effexor from 150mg to 300mg. She had done well on Effexor (combined with Wellbutrin SR 300mg) for quite a few years. However, depression began to reappear two or three months ago. It took two or three weeks before she felt improved at the increased dosage.
Are you scared? The few times I have had medication produce an improvement, I was scared to death each day that I would be pushed back into the pit.
> What I meant by this, "And even though emotionally my moods aren't affected as much anymore, my ability to think and rationalize is more so affected and the physical symptoms are more dominant." ... is that over the years the emotional aspect hasn't governed my depression, more just apathy, fatigue and the mental fog that drifts in.
What you have described here is probably the rule rather than the exception. As one ages with depressive illness, the features of the depression change. Most often, the trend is towards dementia and away from depressed mood or melancholia. Dementia is a generic term with the following definition:
----------------de·men·tia Pronunciation Key (di-men'-sha)
n.
Deterioration of intellectual faculties, such as memory, concentration, and judgment, resulting from an organic disease or a disorder of the brain. It is sometimes accompanied by emotional disturbance and personality changes.
(Source: The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2000 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.)
--------------
Ring a bell?It is no coincidence that depression in the elderly has so often been misdiagnosed as senile dementia. This is where the term "pseudodementia" comes from.
> This is due to my "condition" mostly. The effexor though has decreased my anxiety so much that I don't have any real what if solutions. When I first started it I use to space out and now uping the dosage again I notice these moments but know they too will pass.
A friend of mine has recently increased her dosage of Effexor from 150mg to 300mg. She had done well on Effexor (combined with Wellbutrin SR 300mg) for quite a few years. However, depression began to reappear two or three months ago. It took two or three weeks before she felt improved at the increased dosage. It seems to be "sticking".
Are you scared? The few times I have had medication produce an improvement, I was scared to death each day that I would be pushed back into the pit.
> > However, I think Effexor might be reducing my drive and motivation. Have you experienced this sort of thing? Does it dissipate over time?
> Yes it did pass. May I ask how long have you been on the effexor?
I have been taking 300mg for about nine months. I recently discontinued it because I thought it might be responsible for making me feel worse when combined with the tricyclics I was taking (nortriptyline and imipramine). When I was able to identify nortriptyline as the culprit, I switched to imipramine and restarted Effexor. It has only been three days since I added it, and I plan to return to 300mg.
> I think it was around the four month period that it went away,
I couldn't tell if my lack of motivation and libido were side effects of Effexor or due to a worsening of my depression resulting from nortriptyline. If these things are persistent and due to Effexor, I might elect to go to Nardil sooner.
> > One caveat that you probably already know: ... it probably makes sense to consider continuing treatment indefinitely.
> Oh but even so it's worth repeating over and over to get through this thick skull of mine. Funny thing is before I wrote down the dates I would have said I had suffered with depression on three different occassions, when in reality there has been eight distinct bouts that I seeked treatment for. So yes I'm a lifer. Thank goodness my gp right away picked up on the fact that I had lessened my dosage.
It wasn't until recently that I realized depression emerged in me before age 10. It was relatively mild, but it definitely impacted negatively upon my social development.
> I believe with patience on our parts, having supportive family and close friends, plus a knowledgeable doctor/s will help us get some normality back into our lives.
I wish I had more patience. I had enough in the beginning. I don't know why I don't have it now. It's like having your hand placed over a flame. You can't help but to do immediately whatever you can immediately to stop the burning. You'll do anything, even make unauthorized changes in your medication. That's the way it is for me, anyway, particularly when a new medication produces side effects or makes me feel worse.
Sorry for the length of this post. Thanks again.
> BEST WISHES
> Weeping Willow...and my best wishes to you. I would wish you good luck, but I don't think you'll need any. The increase of your Effexor dosage should do the trick.
Sincerely,
Scott
Posted by nevergiveup1962 on March 15, 2002, at 17:29:53
In reply to 2+ years on Effexor...., posted by ladylight on March 7, 2002, at 19:37:42
Your post resonated!! I have been on anti-depressants for 10 years, and am now accepting enough that I can pop my pills every morning without even thinking about it. But I still occasionally have a major grief reaction and do stupido things - like last week I unilaterally decided to drop my Effexor SR from 300 to 225. Duh. I'm back up this week!
I finally decided to take my grief and anger at having this beast on my back seriously, so I bought a bunch of books that relate to coping with grief when you have a serious illness, or a chronic disability, or death or divorce.
I also found an article that suggests that psychiatrists and doctors quit kidding us "lifers" and start to treat us as patients with a chronic disease rather than with an acute illness that can be cured if only they find the right combo of meds (I got pissed off at the endless tinkering with combinations and milligrams)
Doing grief reading helped me re-frame my experience not just for myself, but also for my therapist and for my psychiatrist (who manages my meds). Depression is such a closeted illness; try not to buy into viewing it through a narrow lens that assumes cure. We have a massive, activity-limiting, life-threatening chronic disease.
If we lost a limb we'd get lots of support, and referral to grief groups, etc. I strongly recommend acknowledging grief as part of your life - just naming it can help put the anger into perspective. GRIEF. I HAVE LOST PART OF MY BODY AND IT WILL NEVER WORK RIGHT AGAIN WITHOUT DRUGS...BUT IT CAN WORK RIGHT AGAIN WITH DRUGS.
I feel grief, too, that nobody in the medical or scientific community finds it worthwhile to study the long-term effects. Tons of research is done establishing the safety and effectiveness of the drug on 47 patients who take it for 4 weeks...but after that, no one seems to care. Is it because permanent medication feels like a failure to a doctor? I am on the faculty at a medical school and have done a massive literature search on long-term effects. There is literally NOTHING on us lifers. Then I checked into NIH clinical trials of drugs to see if I was eligible - but if you have multiple diagnoses or complicating factors that may have contributed to the depression - you're not eligible!!
Maybe we should start a "Union Of Complicated Lifetime Depressants" and demand our rights!
Posted by Golf4 on October 15, 2002, at 13:24:49
In reply to Re: 2+ years on Effexor.... » ladylight, posted by HMK on March 8, 2002, at 10:52:45
> I've been taking Effexor XR for the past 3 years and am happy to continue taking it. It is the only antidepressant I've found which has so few side effects. As a bipolar II, I have resigned myself to the fact that I will have to take medication for the rest of my life. I have a very demanding profession, so it's vital that I am always at my very best. I simply cannot be at my best unless I treat my illness. I think of it as a plain ol' brain disorder- my illness is very physical if you know what I mean. My brain does not make the correct balance of neurotransmitters so I take things to correct this. I also take medicine for my hypothyroidism too- this will probably be for life also.
>
> The only thing is I get really cranky about how expensive these medicines are. It costs me a forture every month to afford all my drugs- I spend about $500 each month which is only reimbursed at 80% by my insurance.
>
> Best of luck to you and I think we should be thankful to have found a medicine that works so well. Don't focus on the fact that you're going to be taking it for so long- focus on its benefits.
>
HI,out of many interesting messages on this board,yours has been the most important for ME(having a similar problem,conception &eventually a similar way to handle it)
In case you still are "active"on this board,reading the newer messages,too(yours is dated March,2002) let's enable a correspondence ;
Posted by maximillian on October 18, 2002, at 5:28:04
In reply to Re: 2+ years on Effexor.... » HMK, posted by Golf4 on October 15, 2002, at 13:24:49
i'm on wellbutrin. been there a little over a year. i was on both effexor and wellbutrin. but effexor seemed to crush my sex life. wellbutrin is better it seems. 400 mg's. also my pysche has put me on pimezide(orap) and i have been on concerta for a while. taking seriquil to help me sleep. i didn't like effexor when i was on it. do you like the effexor and were you ever on wellbutrin? effexor didn't seem to crush my anger...the wellbutrin does or at least helps me to control it.
This is the end of the thread.
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