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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by Cybil on July 5, 2000, at 18:06:15
Thanks for everyone's emails on Effexor XR. This is such a great forum and I have learned so much over the past year reading people's posts!
I have been on Effexor XR 150 mg 5 months, for depression and anxiety. I chose it as an alternative to Zoloft 50 mg, which worked well for my unipolar depression but caused weight gain, diminished libido and sluggishness.
At first the Effexor was energizing as I had been a lethargic, atypical depressive. So energizing, in fact, that I had trouble falling asleep. Trazadone 25mg at bedtime did the trick. My problem is that for the past month or two, I have noticed that I have become EXTREMELY drowsy during the day, to the point of falling asleep. Luckily, I am not working right now as I am returning to school in a month for my masters. I am concerned about this lack of energy when I need to ramp up again in the fall. I am happy as can be otherwise, so I do not think the fatigue is a result of untreated depression.
I'm sure it's the Effexor because I've experimented pushing the dose by 37.5 w/increased drowsiness, and one day 37.5 less w/ a resulting increase in stamina, only to become drowsier immediately when I took the 37.5 later in the day. What's odd, however, is that even though I'm drowsy, if I try to take a nap, I can't fall asleep and I still get insomnia and some small hand tremors.
I'm making an appt. with my pdoc to explore possible augmentation to counteract this side effect, although JohnL's posts on adrafinil and other people's on Provigil intrigue me. I'm thinking a stimulant might reverse some Effexor-induced fatigue as well as have some AD effect independently. In the meantime, I'm going to try to verrrrry graduallllly titrate down to 75 mg of Effexor. When I first started taking Effexor, I noticed a positive boost at 37.5, so I'm hoping 75mg is effective for maintenance.
Any other suggestions/recommendations/ideas about what to do here would be most appreciated!P.S. Also, a philosophical thought: it seems like with both Zoloft and Effexor XR, I got a boost of energy when I first started on them (as compared with the depression/anxiety I was feeling prior). After a few months, however, the lethargy became more pronounced. Do you think that when the serotonin system gets returned to normal, continued depression-treatment-level doses give the body a surplus of serotonin (i.e., sleepy mellowness?) Just a thought...
Posted by SLS on July 6, 2000, at 16:34:34
In reply to Effexor XR Recent Sleepiness:Adrafinil/Stimulants?, posted by Cybil on July 5, 2000, at 18:06:15
Just a few ideas...
I think Ritalin deserves a look at first if you are to go with the stimulant strategy. Adding Wellbutrin may be something to consider in its place. Lastly, I get the impression that Celexa may not cause the type of late-onset fatigue that you describe. I'm not sure. I found it interesting that someone here (female) who experienced a loss of libido at a low dosage of Celexa recovered it upon raising the dosage.
Effexor and Wellbutrin is a pretty good combination.
Good luck.
- Scott
> P.S. Also, a philosophical thought: it seems like with both Zoloft and Effexor XR, I got a boost of energy when I first started on them (as compared with the depression/anxiety I was feeling prior). After a few months, however, the lethargy became more pronounced. Do you think that when the serotonin system gets returned to normal, continued depression-treatment-level doses give the body a surplus of serotonin (i.e., sleepy mellowness?) Just a thought...A good one IMHO.
This is the end of the thread.
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