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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 Shenandoah on February 16, 2008, at 20:39:48
I am new & just found this site.
I am thinking about asking my new Dr. about switching back from Effexor to Prozac. I believe Prozac is probably best for me, but will certainly take ANY suggestions.
I am in my 50's & have a Depression & Panic issue. My FABULOUS first Dr. (of 15 + years) saved my life from continuous panic attacks with Xanax. Then she recommended Zoloft to me for depression. It was fine & helped me immensly. I was concerned about weight gain especially & began taking Prozac. I liked it just as well & my weight was not perfect but much better.
I am trying a new Dr. that I am very disappointed with & hope for a change at some point. [He has Zero personality & Zero sense of humor].
Anyway............I began having terrible nightmares & little motivation, so the Dr. said that probably I was not getting the benefits after being on Prozac for so long, & was switched
to Effexor. It was OK for a while, but I do not like the sick withdrawal symptoms I get if I forget my medication for one day. & my weight has climbed.I have not been on Effexor for a full year yet, but wonder if changing back to Prozac will give me the same benefits I had when I began long ago--& how difficult it will be to switch back ??????
I do not like the side effects of constipation & occasional nausea with Effexor either.
Also I will never try Welbutrin (sp?) again. It made me feel extremely aggitated with angry feelings. If I felt this way, then I wonder how a troubled teen might react on this drug. It should be seriously studied, as it is not right for everyone & a young person may not realize what is happening to them.
Any feedback appreciated.
Posted by Phillipa on February 16, 2008, at 23:23:41
In reply to Prozac vs Effexor, posted by Shenandoah on February 16, 2008, at 20:39:48
Well first let me welcome you to babble where you will find a wealth in information probably not from me but others. I can only reiterate what you said in your thread that prozac worked for you and love that pdoc but for some reason had to change you did mention anger but not the prozac not continuing to work as an antidepressant and help you anxiety. But for some reason changed docs and he put you on effexor and you have gained a lot of weight and would like to return to prozac if it will once again work am I right so far if not correct me please and are afraid of effexor withdrawal. I am not positive but prozac being a long acting antidepressant may help with effexor withdrawal so you may have good luck switching back to prozac. Also check the withdrawal board for things others have used or google withdrawal effexor on Dr Bob side of site and the best of luck to you as you seem to do well on SSRI's. Phillipa
Posted by jms600 on February 17, 2008, at 16:30:36
In reply to Prozac vs Effexor, posted by Shenandoah on February 16, 2008, at 20:39:48
I have read on here recently that going back onto an SSRI after a long break can achieve the same antidepressant effect the patient got when he/she first went on the drug.
Not sure how this works or why - perhaps it has something to do with the brain becoming almost 'tolerant' to the drug, and so going back onto it after a break can 'reset' things (if you know what I mean)? Some of the other posters on here are far more knowledgeable about all this than me so maybe they could advise..?
Posted by Shenandoah on February 17, 2008, at 16:55:04
In reply to Re: Prozac vs Effexor, posted by jms600 on February 17, 2008, at 16:30:36
You phrased it so much better than I did! Thanks! I do believe that is exactly what the Dr. meant. I am not sure what a long break should be. Also don't know what is new, different & safe on the market in SSRI's.
I hope the same thing does not happen with my Xanax generic. I am very careful with those & try to take as little as possible.
Re antideppresants: I have a friend on Paxil who is doing well- Another on Welbutrin & doing well, though I can't take that one. Suppose going back to Prozac is my best bet, though I welcome suggestions & advice.
Hope this goes through. A different set-up & search method than I am used to. Great information though. I am impressed.
Posted by bleauberry on February 17, 2008, at 18:26:25
In reply to Prozac vs Effexor, posted by Shenandoah on February 16, 2008, at 20:39:48
Going back to a former medication is a mystery. Sometimes it works just like the first time. Sometimes it doesn't. Sometimes there are strong side effects that were not there the first time.
The body and brain are not constant. Change, adaptation, environmental toxicity, genetics, aging, illnesses, stresses, life changes...all this stuff makes today different than a year ago.
It probably does make sense to go to something that did work in the past. Whether it will work again is not predictable. Based on witnessing others posting on this topic for years, and my own experiences, results are quite variable. Sometimes very good, sometimes disappointing.
No matter what you switch to, there will be a transition period where withdrawals from one med are ongoing while startup side effects from the new med are mixed in. The new med should lessen withdrawals and sometimes cover them up completely. But still, the transition could be weird, but hopefully smooth.
Posted by Shenandoah on February 17, 2008, at 18:59:48
In reply to Re: Prozac vs Effexor, posted by bleauberry on February 17, 2008, at 18:26:25
These comments are particularly interesting:
"The body and brain are not constant. Change, adaptation, environmental toxicity, genetics, aging, illnesses, stresses, life changes...all this stuff makes today different than a year ago.
It probably does make sense to go to something that did work in the past. Whether it will work again is not predictable. Based on witnessing others posting on this topic for years, and my own experiences, results are quite variable. Sometimes very good, sometimes disappointing."
My life is the same as a year ago-do have some stress & more on the way with a major project.
Can you help with experiences-either your own or what you have read?& PS: Phillipa-I tried to write back to you & did something wrong & it went into cyberspace-thanks for the Welcome & tips.
Posted by Phillipa on February 17, 2008, at 19:38:33
In reply to Re: Prozac vs Effexor » bleauberry, posted by Shenandoah on February 17, 2008, at 18:59:48
You're welcome. If you wish to contact another and their name is in blue click on the name and babblemail will show up. You then type a message like an e-mail and at the bottom is a click post to send them. The person intended for will get them. Try one and see. Phillipa ask the person to write you back so you know if you did it correctly.
Posted by Jay_Bravest_Face on February 18, 2008, at 14:10:19
In reply to Re: Prozac vs Effexor, posted by jms600 on February 17, 2008, at 16:30:36
> I have read on here recently that going back onto an SSRI after a long break can achieve the same antidepressant effect the patient got when he/she first went on the drug.
>
> Not sure how this works or why - perhaps it has something to do with the brain becoming almost 'tolerant' to the drug, and so going back onto it after a break can 'reset' things (if you know what I mean)? Some of the other posters on here are far more knowledgeable about all this than me so maybe they could advise..?
>
>
>I don't know...I have tried this, and found it of no value whatsoever. In fact, in the book "Noonday Demon" the author strongly urges against this. Going back and forth constantly between medications on a rotating basis does not seem healthy.
I think the best bet is to get the SNRI effect going. So, you want to look at:
a)switching to meds like Effexor, Cymbalta
b) combo of SSRI + Stimulant
c) tricyclic + SSRI
d) possible combo of SSRI + Wellbutrin
e) if you can afford weight gain, add RemeronAnyhow, just IMHO, but I unfortunately waited too long in between meds and gave away years accepting that I just had to live "sub-satisfactorily" with just an SSRI.
Best,
Jay
Posted by Shenandoah on February 18, 2008, at 19:34:52
In reply to Re:Prozac Vs. Effexor SSRI's }}}Shenandoah and » jms600, posted by Jay_Bravest_Face on February 18, 2008, at 14:10:19
Thanks Jay for suggestions. Interesting, helpful & curious....What is SNRI & IMHO?
"I think the best bet is to get the SNRI effect going. So, you want to look at:"
"a)switching to meds like, Cymbalta"I am Already on Effexor. Will look up Cymbalta.
"b) combo of SSRI + Stimulant"
Like What stimulant?
c)tricyclic + SSRI
Will look up tricyclic?
"d) possible combo of SSRI + Wellbutrin"
Wellbutrin made me feel awful & haven't heard of combo with SSRI. Good question to ask though.
"e) if you can afford weight gain, add Remeron"
Can't afford this one.
"Anyhow, just IMHO, but I unfortunately waited too long in between meds and gave away years accepting that I just had to live "sub-satisfactorily" with just an SSRI."
Interesting comment & I would like to hear more.
Wonder if I am living sub-satisfactorily with just SSRI. Can you give more info about combos you have experienced? & what IMHO is & what you did that helped?
Many thanks- really need help understanding what worked for you. Excellent feedback & some new stuff to look at. Please reply if you have time.
Sincerely, Deb (or Shenandoah, my home..)
Posted by Jay_Bravest_Face on February 19, 2008, at 7:05:20
In reply to Re:Prozac Vs. Effexor SSRI's }}}Shenandoah and » Jay_Bravest_Face, posted by Shenandoah on February 18, 2008, at 19:34:52
> Thanks Jay for suggestions. Interesting, helpful & curious....What is SNRI & IMHO?
>Just internet shorthand..lol. SNRI is a Serotonin Norepinephrine Reuptake Inhibitor (That is what Effexor and Cymbalta are.) They work on both Norepinephrine and Serotonin. Prozac, Paxil, Celexa, Lexapro, et al, are SSRI's, because they mainly work on just serotonin. (But, there is a lot of argument over all of this lately though, so really, don't give it much value.) IMHO is In My Humble Opinion.
> "I think the best bet is to get the SNRI effect going. So, you want to look at:"
> "a)switching to meds like, Cymbalta"
>
> I am Already on Effexor. Will look up Cymbalta.
>Cymbalta, knock on wood, seems to be a fine ad for me, much less harsh then Effexor, I think.
> "b) combo of SSRI + Stimulant"
>
> Like What stimulant?Well, I think the couple of main ones out there are Dexedrine, Ritalin, and Adderall(sp?) From what I understand (and my personal bias...but not all true for everyone of course) is Dexedrine seems to be the "smoothest" of the stimulants. Especially the SR (sustained release formula).
But, it might take trial and error. I found them okay with Prozac...but JUST okay...that's all..no real improvement.> c)tricyclic + SSRI
>
> Will look up tricyclic?
>Ya, this would be my second, and first if Cymbalta wasn't around. Nortriptyline has both a bit of 'punch' and a bit of a relaxing quality. Amitrptyline is for sleep. Imipramine is good for both sleep and for that 'punch'.
> "d) possible combo of SSRI + Wellbutrin"
>
> Wellbutrin made me feel awful & haven't heard of combo with SSRI. Good question to ask though.
>Ya, the only time I ever did good on Wellbutrin was when I had Depakote (or Epival as called in Canada.) BTW...if you have any difficulty with mood swings and major anxiety with anger, there is a new form, Depakote ER or XR, taken once a day, that doesn't supposedly cause weight gain, and really help smooth the moods out.
> "e) if you can afford weight gain, add Remeron"
>
> Can't afford this one.
>
> "Anyhow, just IMHO, but I unfortunately waited too long in between meds and gave away years accepting that I just had to live "sub-satisfactorily" with just an SSRI."
>
> Interesting comment & I would like to hear more.
>Yeah, well, I stuck it out for almost 5 years with Prozac and all sorts of trial add-ons, then before that, about 5 years with Effexor, then a year or so with Zoloft, then before that only weeks at a time with the other SSRI's and such. But, I waited way too long on those 2 five year periods. I feel like I missed out on much. So, I say, be vigilant, and demand the best state of mind you can get from the meds. (Of course I know you have to do your bit....but it's hard to when you are curled up in bed and scared of the telephone ringing!..lol.)
> Wonder if I am living sub-satisfactorily with just SSRI. Can you give more info about combos you have experienced? & what IMHO is & what you did that helped?
>
> Many thanks- really need help understanding what worked for you. Excellent feedback & some new stuff to look at. Please reply if you have time.
>
> Sincerely, Deb (or Shenandoah, my home..)
>Hey, no problem! You might want to look at exploring some of the above options (like consider Cymbalta.) I'd do that before adding on the other meds. Oh ya, may I ask what your diagnosis is? Depression? Anxiety? Both? There are lots of good meds out there, it's just a bit of try and see, and I know that does suck..heh. Anymore questions, please feel free to ask!
P.S.....my medications...
Cymbalta 60 mg 1x a day (I am in my 2nd week of it.)
Clonazepam 4mg a day
Topomax 200 mg at bedtime
Risperdal 1mg at bedtimeTake care, Jay
Posted by Shenandoah on February 19, 2008, at 8:02:23
In reply to Re:Prozac Vs. Effexor SSRI's » Shenandoah, posted by Jay_Bravest_Face on February 19, 2008, at 7:05:20
Jay-
Great. Great advice!
More questions & answers Please !!!!!!!!!!!!I go to the Dr. tomorrow & since he gives me little info. or feedback, I will need to ask informed questions. I think he would like to see me off Xanax-but he doesn't get what my old Dr. did (who had total trust in me)- & I have only seen him a few times.To answer one question-I believe my diagnosis is Chronic Mild Depression with Panic or Anxiety disorder. I just thought Effexor was another SSRI. It is OK with my depression, but don't like what I have read about it & if I just forget one night, I feel awful the next day! That didn't happen with prozac.
Re: the stimulants, I have only heard of this prescribed for people with ADD. I do not have this disorder- though do wish I was more motivated sometimes & had a normal sex life with libido.
Sounds like you did OK with the SSRI's too- but just felt eventually that they didn't do enough for you. Do you mind telling me your diagnosis too? & then maybe we could compare a bit better?
Will look up the Cymbalta after this note. Also, could you tell me about the other 3 meds you take & what they are for?
Re: my Xanax- My old Dr. (when my life was really stressful/ awful), she had me on 1 mg 3 times a day. It worked wonders for me. As time went on & I got out of a bad situation, I really cut down myself- though the scrip remained the same. Then my job & office moved home-from a less stressful atmosphere with the public & intense work----so I cut down even more. BUT, I have turned into somewhat of a Hermit! Probably not healthy. We run 3 + businesses & are getting ready to tackle a huge new venture. Public Meetings are heating up, newspaper will be interviewing & my office will go back to a busier location & I will be pretty involved with this stressful new business. Crazy? I suppose so! Anyway, I sure want to hold on to my Xanax scrip's, as time goes on & life gets wilder. Currently, I take as needed in partial amounts. Usually half or less than half of my original needs. Public speaking is "Out" for me & I am afraid I will be forced into some very soon? So part of the story............
Please reply & explain how the Cymbalta is going for you & how the other 3 combine & help you. & I soooooooo appreciate your HO, Humble Opinion!
Thanks, Deb
Posted by Jay-Bravest_Face on February 20, 2008, at 0:03:48
In reply to Re:Prozac Vs. Effexor SSRI's » Jay_Bravest_Face, posted by Shenandoah on February 19, 2008, at 8:02:23
Hi Deb:
> Jay-
> Great. Great advice!
> More questions & answers Please !!!!!!!!!!!!I go to the Dr. tomorrow & since he gives me little info. or feedback, I will need to ask informed questions. I think he would like to see me off Xanax-but he doesn't get what my old Dr. did (who had total trust in me)- & I have only seen him a few times.
>
> To answer one question-I believe my diagnosis is Chronic Mild Depression with Panic or Anxiety disorder. I just thought Effexor was another SSRI. It is OK with my depression, but don't like what I have read about it & if I just forget one night, I feel awful the next day! That didn't happen with Prozac.
>Yeah, Prozac stays in the system so much longer, it takes a long time even to tell when you adjust doses. I think what makes Effexor both sometimes good and for some bad, is its immediate action. As you say, you miss a dose, and you feel it! How does Effexor compare to Prozac regarding your depression and anxiety?
> Re: the stimulants, I have only heard of this prescribed for people with ADD. I do not have this disorder- though do wish I was more motivated sometimes & had a normal sex life with libido.
>Well, the stimulants are being used quite a bit for people with depression, in particular those with a more vegetative depression (i.e. Sleep, eat, too much, lack of social interest, etc.) As a particular side-note, the stimulants and Wellbutrin seem to have an excellent effect on womens sex drive and libido et al. They dont seem to work so great for men (cest moi ..lol. )
> Sounds like you did OK with the SSRI's too- but just felt eventually that they didn't do enough for you. Do you mind telling me your diagnosis too? & then maybe we could compare a bit better?
>
Well, I fall into that bipolar 2 or 3 gap. I have major depression and anxiety.
I just rapid cycle often between the two. I always take a mood stabilizer (risperdal) and (topamax) with my antidepressant to prevent the rapid cycling. The clonazepam helps too. The SSRIs just drain me too much. They give me serotonin overload, along with major fatigue, like a heavy weight. Effexor an SNRI like I said before, was a bit TOO energizing, and Cymbalta seems to be the right balance.
> Will look up the Cymbalta after this note. Also, could you tell me about the other 3 meds you take & what they are for?
>
I think I mentioned the Risperdal. It is an atypical antipsychotic (dont let that scare you..) It just helps keep the moods nice and smooth and even. The Topamax is an anti-convulsant but also a mood stabilizer, which I am not sure HOW well works, but again is supposed to help keep thing even and smooth. And the clonazepam is a benzodiazepine, like Valium(sp?), and is great for breaking those tense moments, and when you want to relax, and/or get to sleep.> Re: my Xanax- My old Dr. (when my life was really stressful/ awful), she had me on 1 mg 3 times a day. It worked wonders for me. As time went on & I got out of a bad situation, I really cut down myself- though the scrip remained the same. Then my job & office moved home-from a less stressful atmosphere with the public & intense work----so I cut down even more. BUT, I have turned into somewhat of a Hermit! Probably not healthy. We run 3 + businesses & are getting ready to tackle a huge new venture. Public Meetings are heating up, newspaper will be interviewing & my office will go back to a busier location & I will be pretty involved with this stressful new business. Crazy? I suppose so! Anyway, I sure want to hold on to my Xanax scrip's, as time goes on & life gets wilder. Currently, I take as needed in partial amounts. Usually half or less than half of my original needs. Public speaking is "Out" for me & I am afraid I will be forced into some very soon? So part of the story............
>
> Please reply & explain how the Cymbalta is going for you & how the other 3 combine & help you. & I soooooooo appreciate your HO, Humble Opinion!
>Hey, no prob! I hope I shed some light on the other meds. I am going to be looking at maybe trying some other meds for the sexual dysfunction and weight gain. On is Meridia, a weight loss drug. You arent supposed to take it when on Cymbalta, but I have heard others taking it. I am just going to try a small dose (5 mgs) I should be getting that stuff by next week. Ill let you know how I am doing then. Right now, I am fine, actually, I just dont want to push my luck..lol..:-) Thanks for the questionsand interest!
Best,
Jay> Thanks, Deb
Posted by daveuproar on February 25, 2008, at 9:51:39
In reply to Prozac vs Effexor, posted by Shenandoah on February 16, 2008, at 20:39:48
I was on Effexor XR for years. It NEVER worked, but I was literally addicted because I had gone through the withdrawals before, and NEVER wanted to do that again..
Thankfully, I went to a new doctor who prescribed Prozac to help with the withdrawals, and my depression and anxiety.
Needless to say, I love the Prozac-- it really works, and it's CHEAP! It's one of those $5.00 RX's here in Texas!
Dave
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