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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Ricardo on May 1, 2003, at 21:22:53
Hi!
I've been on Effexor for 10 days now, and I feel great. No side-effects and I already feel better from my dysthimia + depression bouts + OCD. Previously, I had tried Paxil, Wellbutrin and Tofranil, but so far Effexor has been the best one for me. However, I'm scared! I've been reading so many negative posts on how terrible the withdrawal is that I'm a little afraid of thinking that I'll sure have to go through it sooner or later. I'm definitely NOT asking my doctor to put me off it. It's been working for me, so I want to keep trying. One questions crossed my mind: if withdrawing from it is so terrible, why do doctors keep prescribing it, and why are there so many people (even here, in this forum) on it? Wouldn't it be more logical just to try and prescribe other ADs? Or maybe the success stories still outnumber the negative ones and, regarless of how difficult the withdrawal is, Effexor is still more effective than most other ADs... Just some points that crossed my mind.
Best wishes,
Ricardo
Posted by ace on May 1, 2003, at 22:02:30
In reply to Why Effexor?, posted by Ricardo on May 1, 2003, at 21:22:53
> Hi!
>
> I've been on Effexor for 10 days now, and I feel great. No side-effects and I already feel better from my dysthimia + depression bouts + OCD. Previously, I had tried Paxil, Wellbutrin and Tofranil, but so far Effexor has been the best one for me. However, I'm scared! I've been reading so many negative posts on how terrible the withdrawal is that I'm a little afraid of thinking that I'll sure have to go through it sooner or later.IMO, I believe your worry is warranted. All these newer drugs are known to have the capacity to have terrible w/drawal syndroms. I went through Zolodt w/drawal - I had to pull out of uni, and my world turned black. I'm sure sooner or later you will stop Effexor. But if you start up another soon this should obviate the w/drawal probs from Effexor. BUT, if you want to go from Effexor to nothing...well, I would say be prepared.
I'm definitely NOT asking my doctor to put me off it. It's been working for me, so I want to keep trying. One questions crossed my mind: if withdrawing from it is so terrible, why do doctors keep prescribing it, and why are there so many people (even here, in this forum) on it?
That's simple: It is market immensly, everyone thinks newer=better, which is NOT true. TCAs, in many clinical, double blind placebo controlled studies, have been shown superior, sometimes greatly, to SSRI and drugs like Effexor. In addition, sure, sometimes it would be good for someone. Every serious doctor knows MAOI drugs to be very potent AD's. And, in addition, they have very little in terms of withdrawal. Recently I read Nardil (MAOI) has a w/drawal rate of 32%, and Paxil up in th high 70's%. If you w/drawal very slow with MAOIs and TCAs, very rarely will you have a problem. Not so with the newer AD's.
Wouldn't it be more logical just to try and prescribe other ADs? Or maybe the success stories still outnumber the negative ones and, regarless of how difficult the withdrawal is, Effexor is still more effective than most other ADs...THAT IS NO TRUE. And contrary to what others have said, it does not act greatly like MAOIs.
Just some points that crossed my mind.
>
> Best wishes,
> RicardoHope my thoughts help. Of course we are all different. If you suffer severe depression, try an MAOI. They blow the ass off depression. I mean BIG TIME!
Good Luck!,
Ace.
Posted by Dragonslayer on May 1, 2003, at 22:29:30
In reply to Why Effexor?, posted by Ricardo on May 1, 2003, at 21:22:53
While your concerns may be certainly warrented, I think there is the bit of caution to be exercised when you find the real life experiences found on med boards. I find them really helpful and I have gained ALOT of knowlegde, but they are a small slice of the picture of folks who use these catagories meds. Everyone is different and have very different experiences. I would not be so bold to advise others on what they should or should not take. I will relate things that worked for me. The personal experiences are helpful, but my advice is to work with a doc you have an open and honest relationship with. Truely research your concerns and bring them to your prescribing person. I have made big mistakes not going with felt right for me and ok with my doc. I thought I was so better informed - maybe I was, just wasn't smart about my decisions.
I was on a benzo and have experienced NONE of the pitfalls. Had I heeded all the information that was out for me to digest, I honestly think I would not have gotten better.
The is much to be made of "why" the choice of a particular drug. The good thing is you admit this choice is helping you.
Posted by justyourlaugh on May 1, 2003, at 23:02:51
In reply to Why Effexor?, posted by Ricardo on May 1, 2003, at 21:22:53
ric,,
i think the fact you have such a possitive attitude about it working is great...
i was on it for 2 months@300...no
"side effexors at all"...you cant truely take 1 persons bad experience..and judge...,if you remember anything..people that are on effexor and""well"are way too busy getting"on with it"...
dont let ,online loniness,(negative posting)be all you look at...
j
Posted by Caleb462 on May 1, 2003, at 23:04:38
In reply to Re: Why Effexor? » Ricardo, posted by ace on May 1, 2003, at 22:02:30
> That's simple: It is market immensly, everyone thinks newer=better, which is NOT true. TCAs, in many clinical, double blind placebo controlled studies, have been shown superior, sometimes greatly, to SSRI and drugs like Effexor. In addition, sure, sometimes it would be good for someone. Every serious doctor knows MAOI drugs to be very potent AD's. And, in addition, they have very little in terms of withdrawal. Recently I read Nardil (MAOI) has a w/drawal rate of 32%, and Paxil up in th high 70's%. If you w/drawal very slow with MAOIs and TCAs, very rarely will you have a problem. Not so with the newer AD's.
My theory on why TCAs are often more superior... because the anti-histaminic and anti-chollinergic effects contribute to the anti-depressant effect! Blocking of the H1 histamine receptor, for instance, has been shown to induce dopamine release.
Posted by justyourlaugh on May 1, 2003, at 23:17:31
In reply to Re: Why Effexor? » Ricardo, posted by ace on May 1, 2003, at 22:02:30
ace,,
sorry to hear your ass is all "blown out"..lol
just wanted to add ,,they way these meds work.,,,
any med..is different..
i do not believe there is any proof that any single "med" will "cure" the masses..the way it is marketed...
i want to say something so horrible and inappropriate,
about religion and science.....
be content ace
j
Posted by Snoozy on May 2, 2003, at 3:33:08
In reply to Why Effexor?, posted by Ricardo on May 1, 2003, at 21:22:53
Hi Ricardo -
It's great that the Effexor is helping you. I was on Effexor when it first came out (great name, don't you think :) and I'm one of those that lived through a horrendous withdrawl, *BUT* the reason mine was so horrible, and I think for others here as well, was that I *was not warned* about coming off the drug. If you do need to stop taking it, you at least will know to be careful and have a plan for tapering off. It would be interesting to see if anyone here did ok coming off Effexor, with adequate preparation and a dr who was aware of the impact.
Someone suggested here earlier this week that people taking Effexor should keep a few doses in an "emergency" stash, in case you ever have trouble getting a refill or getting to the pharmacy, etc. I think this is a great idea.
I would think most of us are here because we're having problems with medication, thus there are more negative than positive posts.
I hope it keeps working for you!
> Hi!
>
> I've been on Effexor for 10 days now, and I feel great. No side-effects and I already feel better from my dysthimia + depression bouts + OCD. Previously, I had tried Paxil, Wellbutrin and Tofranil, but so far Effexor has been the best one for me. However, I'm scared! I've been reading so many negative posts on how terrible the withdrawal is that I'm a little afraid of thinking that I'll sure have to go through it sooner or later. I'm definitely NOT asking my doctor to put me off it. It's been working for me, so I want to keep trying. One questions crossed my mind: if withdrawing from it is so terrible, why do doctors keep prescribing it, and why are there so many people (even here, in this forum) on it? Wouldn't it be more logical just to try and prescribe other ADs? Or maybe the success stories still outnumber the negative ones and, regarless of how difficult the withdrawal is, Effexor is still more effective than most other ADs... Just some points that crossed my mind.
>
> Best wishes,
> Ricardo
Posted by Ricardo on May 2, 2003, at 14:10:01
In reply to Re: Why Effexor? » Ricardo, posted by Snoozy on May 2, 2003, at 3:33:08
Well, guys, I'll keep all that in mind! Thanks a lot! Another point... Do the withdrawal problems depend on how high your dose is? I'm on just 37.5. Since I guess my major problem is dysthimia rather than depression, I guess it's a little harder to figure out whether the medicine is really working, since it's natural for me to have good and bad days. That's why currently I'm more worried about side-effects than the good ones! Since I'm on a low dose with no serious condition to treat right now, I've been hoping that I'll be able to stay at it. Can 37.5 be effective in the long run?
Again, many thanks,
Ricardo
Posted by Janelle on May 2, 2003, at 14:53:38
In reply to Re: Why Effexor? And what about the dose?, posted by Ricardo on May 2, 2003, at 14:10:01
I was on EffexorXR (but you do NOT want to hear my negative experiences!) for quite some time and from what I understand 37.5mg/day is not even a therapeutic dose - it is the starting dose. Then you go up to 75mg/day which is the lowest therapeutic dose.
My guess is that since you have dysthymia, you may *only* need the 37.5 or 75 at most.As for withdrawal, I think it IS dose-related in that the higher the dose you're on (I got up to 150mg/day) the LONGER it takes to do the taper because you have a higher amount to lower down from if you know what I mean.
Let's say you remain on 37.5, well, then your taper would be quicker and easier - perhaps your pdoc would have you take it every other day for a week or two, then every two days, then go off it. Whereas if you were at 75 or 150, you'd go down to the next lowest dose (e.g. from 150 to 75 for like a week, then down to 37.5 for a week, then every other day, then off it).
I tapered off in this manner - slowly and gradually and had NO withdrawal problems whatsoever.
However, when I was on Paxil (the WORST for withdrawal), my pdoc didn't even know about its problems had me go off it very fast and I got extremely sick from that rapid withdrawal.
So, the key with any med that requires a gradual taper is GRADUAL, SLOW and PATIENT!
Don't worry about it now; I think you should probably remain on it for 3-6 months anyway. That's what the professionals say for a-d's. Even when you feel *better* you need to REMAIN on them for awhile - kind of like letting an antibiotic run its course even though you feel relief after a couple of days.
Good luck 2 U.
Posted by Katia on May 3, 2003, at 4:06:32
In reply to Re: Why Effexor? » Ricardo, posted by ace on May 1, 2003, at 22:02:30
HIRicardo,
Effexor did not work for me; BUT it has worked for a good friendof mine- terribly so! I'dsay if it works for you evenfora brief period- it's totally worth thew/drawalsif you one day have to go through them!
good damnluck!
katia
Posted by Dr. Bob on May 4, 2003, at 11:45:36
In reply to Re: Why Effexor? » Ricardo, posted by ace on May 1, 2003, at 22:02:30
> If you suffer severe depression, try an MAOI. They blow the *ss off depression.
I'm sorry to be such a prude, but please don't use language here that could offend others, thanks.
Bob
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