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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by AnneL on March 14, 2001, at 23:16:02
My primary care doctor prescribed Effexor XR 37.5 mg to start with for one week then to increase if tolerated to 75 mg for a situational depression. I did inform him that I had tried all of the SSRI's about 2 years ago with the same result - night panic attacks starting after 2 or 3 days resulting in discontinuing the meds. Sure enough it's happened again with the Effexor. By the second night I had a panic attack that was pretty well controlled by Xanax, but by the third night I was pretty much unnerved by the whole situation that I discontinued the med. It was very disapointing because it was so well-tolerated during the day. My doctor wants me to try Remeron next. Should I completely abandon the Effexor idea and try Remeron? Or can this particular side effect be managed?
Posted by tina on March 15, 2001, at 7:54:15
In reply to Effexor xr causing panic attacks, posted by AnneL on March 14, 2001, at 23:16:02
I've heard this before and also have personal experience with this problem. Apparently this side effect improves with time. Perhaps your body just doesn't tolerate a hig dose in the beginning. Have you tried taking a really tiny amount for a couple of weeks and increasing slowly > I'm what the docs call a 'low-dose responder' maybe you are too. Every new one I take causes me severe panic attacks so I always have to start out with a dose way smaller than is recommended by my doc. Give this a try.
wishing you good luck with the FXR
t> My primary care doctor prescribed Effexor XR 37.5 mg to start with for one week then to increase if tolerated to 75 mg for a situational depression. I did inform him that I had tried all of the SSRI's about 2 years ago with the same result - night panic attacks starting after 2 or 3 days resulting in discontinuing the meds. Sure enough it's happened again with the Effexor. By the second night I had a panic attack that was pretty well controlled by Xanax, but by the third night I was pretty much unnerved by the whole situation that I discontinued the med. It was very disapointing because it was so well-tolerated during the day. My doctor wants me to try Remeron next. Should I completely abandon the Effexor idea and try Remeron? Or can this particular side effect be managed?
Posted by Lorraine on March 15, 2001, at 10:30:10
In reply to Re: Effexor xr causing panic attacks, posted by tina on March 15, 2001, at 7:54:15
Effexor is known for initially making anxiety worse and then later making it better. It might be worth hanging in there.
Posted by Eric on March 15, 2001, at 13:07:41
In reply to Effexor xr causing panic attacks, posted by AnneL on March 14, 2001, at 23:16:02
> My primary care doctor prescribed Effexor XR 37.5 mg to start with for one week then to increase if tolerated to 75 mg for a situational depression. I did inform him that I had tried all of the SSRI's about 2 years ago with the same result - night panic attacks starting after 2 or 3 days resulting in discontinuing the meds. Sure enough it's happened again with the Effexor. By the second night I had a panic attack that was pretty well controlled by Xanax, but by the third night I was pretty much unnerved by the whole situation that I discontinued the med. It was very disapointing because it was so well-tolerated during the day. My doctor wants me to try Remeron next. Should I completely abandon the Effexor idea and try Remeron? Or can this particular side effect be managed?
If you stay on the Effexor or SSRIs for several weeks, there is a good chance those panic attacks will dissipate and give way to an antidepressant effect. I think you may be confusing straight forward panic attacks(which are not usually caused by drugs) with SSRI and Effexor "activation" which oftentimes includes feeling extreme anxiety and nervousness, which includes "feeling weird." This SSRI/Effexor activation lasts a couple weeks in the beginning with some people, then as the body adjusts to the med it goes away, giving way to an antidepressant effect which usually actually fights the anxiety and panic attacks you complain of.Giving an SSRI or Effexor only a few days or even a week does not give it a chance. I would be willing to bet that you are simply panicking at the extreme activation feelings these meds often cause when you first start them. It would be easy to confuse "panic attacks" with the SSRI/Effexor activation...this is very common and a big reason why many quit their antidepressant in the first two weeks...they get scared from the early stage activation.
Eric
Posted by danf on March 15, 2001, at 15:11:04
In reply to Re: Effexor xr causing panic attacks, posted by Eric on March 15, 2001, at 13:07:41
early on, during first 4 to 6 weeks, ssris & effexor induce panic attacks & increased anxiety.
This gets much better at the 4 wk or so time frame....
Posted by AnneL on March 15, 2001, at 21:06:28
In reply to Re: Effexor xr causing panic attacks, posted by Eric on March 15, 2001, at 13:07:41
> >
> If you stay on the Effexor or SSRIs for several weeks, there is a good chance those panic attacks will dissipate and give way to an antidepressant effect. I think you may be confusing straight forward panic attacks(which are not usually caused by drugs) with SSRI and Effexor "activation" which oftentimes includes feeling extreme anxiety and nervousness, which includes "feeling weird." This SSRI/Effexor activation lasts a couple weeks in the beginning with some people, then as the body adjusts to the med it goes away, giving way to an antidepressant effect which usually actually fights the anxiety and panic attacks you complain of.
>
> Giving an SSRI or Effexor only a few days or even a week does not give it a chance. I would be willing to bet that you are simply panicking at the extreme activation feelings these meds often cause when you first start them. It would be easy to confuse "panic attacks" with the SSRI/Effexor activation...this is very common and a big reason why many quit their antidepressant in the first two weeks...they get scared from the early stage activation.
>
> EricThank you very much, Eric. I saw my doctor today who recommended that I resume Effexor xr at starting dosage and use Klonopin at night for anxiety relief and sleep. I am very motivated to give the Effexor a very fair trial, but need help with the "ativation" as you call it. Xanax is much too short-acting to have any real benefits during a long, scary night. Any suggestions on the use of another medication to help me while I get used to the medication? Thanks, AnneL
Posted by Eric on March 16, 2001, at 10:17:50
In reply to Re: Effexor xr causing panic attacks, posted by AnneL on March 15, 2001, at 21:06:28
> > >
> > If you stay on the Effexor or SSRIs for several weeks, there is a good chance those panic attacks will dissipate and give way to an antidepressant effect. I think you may be confusing straight forward panic attacks(which are not usually caused by drugs) with SSRI and Effexor "activation" which oftentimes includes feeling extreme anxiety and nervousness, which includes "feeling weird." This SSRI/Effexor activation lasts a couple weeks in the beginning with some people, then as the body adjusts to the med it goes away, giving way to an antidepressant effect which usually actually fights the anxiety and panic attacks you complain of.
> >
> > Giving an SSRI or Effexor only a few days or even a week does not give it a chance. I would be willing to bet that you are simply panicking at the extreme activation feelings these meds often cause when you first start them. It would be easy to confuse "panic attacks" with the SSRI/Effexor activation...this is very common and a big reason why many quit their antidepressant in the first two weeks...they get scared from the early stage activation.
> >
> > Eric
>
> Thank you very much, Eric. I saw my doctor today who recommended that I resume Effexor xr at starting dosage and use Klonopin at night for anxiety relief and sleep. I am very motivated to give the Effexor a very fair trial, but need help with the "ativation" as you call it. Xanax is much too short-acting to have any real benefits during a long, scary night. Any suggestions on the use of another medication to help me while I get used to the medication? Thanks, AnneL
One thing that helps to dissipate SSRI/Effexor "activation" a lot is daily aerobic exercise. It helps to burn up that activation feeling a little bit and calm you down. Do anything aerobic everyday when you start feeling activated from the meds and that helps somewhat to dissipate those nasty anxiety activation feelings. Just twenty to thirty minutes a day of ANY aerobic exercise will help.The Klonopin idea is good also. You might find if you can "suck it up" for a month or more, those bad activation feelings you describe as panic attacks will probably dissipate and you will actually feel better. In short, you might find you have to go thru a period where you actually feel worse in order to feel better long term.
Posted by louxloux on October 3, 2001, at 7:18:30
In reply to Re: Effexor xr causing panic attacks, posted by Eric on March 15, 2001, at 13:07:41
I have been on Effexor XR for a little over two months now... My Doc bumped me up to 75 mg. about 3 weeks ago... the only changes that I have noticed are: tremors when I first get up in the morning, and that it is much easier to get up in the morning. No positive effect on my mood, in fact, I recently had a depressive episode which was much worse than those I have experienced previously. Stopped eating altogether, obsessing about my low, withdrawn... locked myself in my house literally for days which is something that I have never done before. I have always managed to go to work, etc. even during episodes until this last one. Felt like I was absolutely going crazy. Has anyone had this sort of reaction from Effexor XR?? Have an appointment today with my Doc... this last episode really scared me, so I am opting to get off the med.
Also prior to Effexor XR... I took Paxil for nearly a year. It took around 6 weeks to finally kick in and boy did it. It was wonderful for several months before it seemed to lose its efficacy.. like taking nothing at all. Has anyone had this type of reaction from Paxil? Is it possible to build a tolerance? My Doc bumped me up in dosage and continued on the med for another two months. All the increase did was make me want to sleep 24/7, so he took me off of it, and then I was started on Effexor. Any information about these two would be greatly appreciated.
Thanks,
louxloux
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