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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Janelle on June 8, 2003, at 16:16:47
Ritch, I keep seeming to come up with follow-up questions for you (sorry!) -- you said you are taking a "tiny" dose of EffexorXR from samples so I'm wondering just what you mean by TINY -- do you take the smallest capsule available which is 37.5mg (/day) or do you open that one up and take approximately half? Just curious, since I had been on EffexorXR (far too long) and could not tolerate more than 75mg without hypomanic side effects! I tapered off it quite easily, thank goodness.
Thanks.
Posted by Ritch on June 9, 2003, at 10:08:51
In reply to RITCH - re your dose of EFFEXOR XR ..., posted by Janelle on June 8, 2003, at 16:16:47
> Ritch, I keep seeming to come up with follow-up questions for you (sorry!) -- you said you are taking a "tiny" dose of EffexorXR from samples so I'm wondering just what you mean by TINY -- do you take the smallest capsule available which is 37.5mg (/day) or do you open that one up and take approximately half? Just curious, since I had been on EffexorXR (far too long) and could not tolerate more than 75mg without hypomanic side effects! I tapered off it quite easily, thank goodness.
>
> Thanks.Oh no, I don't take 37.5mg XR every day, I would probably self-combust! The highest dose I ever took was a whole 37.5mg XR capsule, ONCE. I was manic in about 2-3 hrs., and it lasted for about 3 hours or so. I take just a few of the waxy spheroids out of the capsule every morning. I counted the quantity of spheroids in a few of the capsules to get an average number. From what I rememember I got an avg. of about 108 spheroids per capsule. Whenever I get into my seasonal depressions the dose goes "up" to a max. of 36 spheroids (12.5mg approx.), and it works quite well. In between depressions I take much less to keep anxiety/panic under control, and it only takes about six to twelve spheroids to do the trick. I like to keep it to six if I can. If I get to about 9 nuggets I start to sweat too much. I get definite increases in blood pressure when I get to about 18 nuggets. Talk about med-sensitivity, HUH!
Posted by Janelle on June 9, 2003, at 18:51:35
In reply to Re: RITCH - re your dose of EFFEXOR XR ... » Janelle, posted by Ritch on June 9, 2003, at 10:08:51
Ritch, you crack me up (in a GOOD way) with the way you express yourself! You are very articulate!
Anyway, finally, someone (you!) who is as sensitive to meds as I am! I have to take pediatric doses or below the minimal therapeutic dose on just about all my meds!
Can you help me with the math you were talking about - I'm bad with it.
You wrote that you got an avg. of about 108 spheroids (is that the actual term for those tiny balls in a capsule?) per capsule.
Then you said you take a max. of 36 spheroids which is 12.5mg approx. How do you get the conversion, so to speak. I get that 108 spheroids equals 37.5mg, but how then do you get that 36 spheroids equals about 12.5 mg? THANKS!
HOLY COW - you get high blood pressure when you get to about 18 nuggets! That is incredible, most people (well, I should say the average person, if one exists!) get high BP on 300mg or more. Many folks can actually tolerate 225mg which is the recommended maximum dose! That's the level where EffexorXR hits all three key receptors (serotonin, norepinephrine, dopamine)
I got up to a whopping 75 mg before I got the hypomanic stuff (and didn't realize it at the time - accccck.)
Posted by Ritch on June 9, 2003, at 21:51:17
In reply to SPHEROID conversion ... » Ritch, posted by Janelle on June 9, 2003, at 18:51:35
> Ritch, you crack me up (in a GOOD way) with the way you express yourself! You are very articulate!
>Thanks, I find the term "spheroid" to be funny (albeit accurately descriptive) as well.
> Anyway, finally, someone (you!) who is as sensitive to meds as I am! I have to take pediatric doses or below the minimal therapeutic dose on just about all my meds!
>
> Can you help me with the math you were talking about - I'm bad with it.
>
> You wrote that you got an avg. of about 108 spheroids (is that the actual term for those tiny balls in a capsule?) per capsule.
>Hi, I believe that is the naming that the manufacturer used to describe them.
> Then you said you take a max. of 36 spheroids which is 12.5mg approx. How do you get the conversion, so to speak. I get that 108 spheroids equals 37.5mg, but how then do you get that 36 spheroids equals about 12.5 mg? THANKS!Take 108 and divide by 3 and you will get 36. Take 37.5mg and divide by 3 and you will get 12.5mg.
>
> HOLY COW - you get high blood pressure when you get to about 18 nuggets! That is incredible, most people (well, I should say the average person, if one exists!) get high BP on 300mg or more. Many folks can actually tolerate 225mg which is the recommended maximum dose! That's the level where EffexorXR hits all three key receptors (serotonin, norepinephrine, dopamine)
>
> I got up to a whopping 75 mg before I got the hypomanic stuff (and didn't realize it at the time - accccck.)
>
>It's potent stuff. I get hypomania from all SSRI's, so it's not too surprising. It is just easy to regulate the dosage of Effexor in this manner. I can't say that about the others. You have to get the liquid and spend $$$ and then dilute that-what a hassle. The MAIN thing is that I can increase the Effexor and get relief from depression I can't say that for Celexa, Luvox, Paxil. I could get some relief by bumping Zoloft or Prozac.
Posted by Janelle on June 9, 2003, at 22:26:57
In reply to Re: SPHEROID conversion ... » Janelle, posted by Ritch on June 9, 2003, at 21:51:17
You are right - EffexorXR IS potent stuff. Within the last year only I started to get hypomania from the SSRI's, starting with Paxil after being on it for about 8 years with NO hypomanic behavior whatsoever.
I've now gone down to a MICRO dose of Celexa because the higher dose (which was by no means high for the average person!) induced bad, bad hypomanic episodes. Tried Luvox but it was too sedating and I didn't give it enough of a chance to do anything!
No luck with Zoloft (hit a plateau); haven't tried Prozac.
So far, so good on the micro dose of Celexa along with a bunch of other stuff. I feel like a walking drugstore, as one poster on here put it and I "adopted" that phrase!
Posted by Caleb462 on June 10, 2003, at 1:21:11
In reply to Thanks RITCH, more ...! » Ritch, posted by Janelle on June 9, 2003, at 22:26:57
> You are right - EffexorXR IS potent stuff. Within the last year only I started to get hypomania from the SSRI's, starting with Paxil after being on it for about 8 years with NO hypomanic behavior whatsoever.
Interestingly... of all the SSRIs/SRIs... effexor has the LEAST affinity for the serotonin reuptake site.
You sure are a weirdo Ritch. No offense intended.
> I've now gone down to a MICRO dose of Celexa because the higher dose (which was by no means high for the average person!) induced bad, bad hypomanic episodes. Tried Luvox but it was too sedating and I didn't give it enough of a chance to do anything!
>
> No luck with Zoloft (hit a plateau); haven't tried Prozac.
>
> So far, so good on the micro dose of Celexa along with a bunch of other stuff. I feel like a walking drugstore, as one poster on here put it and I "adopted" that phrase!
Posted by Ritch on June 10, 2003, at 11:41:50
In reply to Thanks RITCH, more ...! » Ritch, posted by Janelle on June 9, 2003, at 22:26:57
> You are right - EffexorXR IS potent stuff. Within the last year only I started to get hypomania from the SSRI's, starting with Paxil after being on it for about 8 years with NO hypomanic behavior whatsoever.
>
> I've now gone down to a MICRO dose of Celexa because the higher dose (which was by no means high for the average person!) induced bad, bad hypomanic episodes. Tried Luvox but it was too sedating and I didn't give it enough of a chance to do anything!
>
> No luck with Zoloft (hit a plateau); haven't tried Prozac.
>
> So far, so good on the micro dose of Celexa along with a bunch of other stuff. I feel like a walking drugstore, as one poster on here put it and I "adopted" that phrase!
Janelle, what's your "microdose" of Celexa? Just curious. I found that anywhere from approx. 1.25mg-2.5mg was plenty (most of the time), when I was taking Celexa.
Posted by Ritch on June 10, 2003, at 11:47:36
In reply to Re: Thanks RITCH, more ...!, posted by Caleb462 on June 10, 2003, at 1:21:11
> > You are right - EffexorXR IS potent stuff. Within the last year only I started to get hypomania from the SSRI's, starting with Paxil after being on it for about 8 years with NO hypomanic behavior whatsoever.
>
> Interestingly... of all the SSRIs/SRIs... effexor has the LEAST affinity for the serotonin reuptake site.
>
> You sure are a weirdo Ritch. No offense intended.Yes I know! :) I just got back from a pdoc appointment, and we were talking about this. Evidently I must have a very high density of 5-HT receptors. I've taken larger doses of SSRI and Effexor, but they make me unstable. If I quit 'em I start to get panic disorder symptoms returning. There has also been some speculation that (higher doses of) serotonergics provoke some kind of epileptiform activity in my right temporal lobe.
>
> > I've now gone down to a MICRO dose of Celexa because the higher dose (which was by no means high for the average person!) induced bad, bad hypomanic episodes. Tried Luvox but it was too sedating and I didn't give it enough of a chance to do anything!
> >
> > No luck with Zoloft (hit a plateau); haven't tried Prozac.
> >
> > So far, so good on the micro dose of Celexa along with a bunch of other stuff. I feel like a walking drugstore, as one poster on here put it and I "adopted" that phrase!
>
>
Posted by Janelle on June 10, 2003, at 18:59:09
In reply to Re: microdoses » Janelle, posted by Ritch on June 10, 2003, at 11:41:50
Ritch, I must stand (or sit!) corrected; I apparently do NOT take microdoses of all meds, at least NOT Celexa. YOU have that dubious honor!! LOL!
I was at 30mg of the stuff and man, it gave me hypomania BIG TIME for long periods of time before I'd crash, literally and wind up bedridden for days.
The pdoc knocked me down from that to a "mere" (well to me it's a mere) 10 mg! That is half of the lowest dose pill. And in my opinion, from all the meds I've been on over the years, Celexa is the EASIEST to just BREAK in half! At least the 20mg pretty pink ones are. There is a great score in them that breaks perfectly!
So, tell me HOW ON EARTH do you get down to that TRUE microdose that YOU take of Celexa? Is it available in capsule or liquid form that I'm not aware of? I just can't imagine getting it down as low as you do in pill form?? Hmmmmmm ...!
The one med I KNOW I started at micro/pediatric dose on cuz you have to because of a deadly rash it can cause if started at too high a dose was Lamictal - I began that at only 2 mg, worked up to 100mg but it didn't do the trick. Then again, it might have been in conjunction with the cocktail I was on at the time rather than the Lamictal itself. I may never know. But I do know that 2mg of Lamictal IS considered a micro/pediatric dose!
I suppose I should say that my other med doses are LOW (below the minimum therapeutic dose) not necessarily micro, based on what you take of Celexa!
I'm dying to know how you get it that low!
Thanks.
Posted by Ritch on June 10, 2003, at 22:47:50
In reply to RITCH: you're gonna FREAK OUT re micro of Celexa! » Ritch, posted by Janelle on June 10, 2003, at 18:59:09
> Ritch, I must stand (or sit!) corrected; I apparently do NOT take microdoses of all meds, at least NOT Celexa. YOU have that dubious honor!! LOL!
>
> I was at 30mg of the stuff and man, it gave me hypomania BIG TIME for long periods of time before I'd crash, literally and wind up bedridden for days.
>
> The pdoc knocked me down from that to a "mere" (well to me it's a mere) 10 mg! That is half of the lowest dose pill. And in my opinion, from all the meds I've been on over the years, Celexa is the EASIEST to just BREAK in half! At least the 20mg pretty pink ones are. There is a great score in them that breaks perfectly!
>
> So, tell me HOW ON EARTH do you get down to that TRUE microdose that YOU take of Celexa? Is it available in capsule or liquid form that I'm not aware of? I just can't imagine getting it down as low as you do in pill form?? Hmmmmmm ...!
>
> The one med I KNOW I started at micro/pediatric dose on cuz you have to because of a deadly rash it can cause if started at too high a dose was Lamictal - I began that at only 2 mg, worked up to 100mg but it didn't do the trick. Then again, it might have been in conjunction with the cocktail I was on at the time rather than the Lamictal itself. I may never know. But I do know that 2mg of Lamictal IS considered a micro/pediatric dose!
>
> I suppose I should say that my other med doses are LOW (below the minimum therapeutic dose) not necessarily micro, based on what you take of Celexa!
>
> I'm dying to know how you get it that low!
>
> Thanks.Mortar and pestal! I crushed 10mg Celexa half tabs of 20mg and mixed them with *small* amounts of vodka and water (citalopram is soluble in ethanol, but not water), and used a liquid medication syringe and added the correct amount to some juice in the morning to make the small dosage.
Posted by Emme on June 11, 2003, at 0:11:54
In reply to RITCH: you're gonna FREAK OUT re micro of Celexa! » Ritch, posted by Janelle on June 10, 2003, at 18:59:09
Hi. They make liquid Celexa. Get a syringe made for dispensing liquid medicine to children. The stuff tastes like Scope.
I was unable to tolerate even 4 mg of the stuff.
Emme
Posted by cybercafe on June 11, 2003, at 2:34:23
In reply to SPHEROID conversion ... » Ritch, posted by Janelle on June 9, 2003, at 18:51:35
more. Many folks can actually tolerate 225mg which is the recommended maximum dose! That's the level where EffexorXR hits all three key receptors (serotonin, norepinephrine, dopamine)
i'm really curious about this... do you mind if i ask where you guys found 225 effected 5ht, NE, and DA? .... cuz my doc says 225 effects 5ht, 225+ effects 5ht + NE
Posted by Ritch on June 11, 2003, at 10:06:35
In reply to Re: RITCH: you're gonna FREAK OUT re micro of Cele » Janelle, posted by Emme on June 11, 2003, at 0:11:54
> Hi. They make liquid Celexa. Get a syringe made for dispensing liquid medicine to children. The stuff tastes like Scope.
>
> I was unable to tolerate even 4 mg of the stuff.
>
> EmmeIf I ever went back to Celexa I would probably just go ahead and spend the $$$ and get one little jug of liquid Lexapro instead and put it in the fridge. It is a hassle to do all of that chopping and crunching and mixing.
Posted by Janelle on June 11, 2003, at 17:43:03
In reply to Re: SPHEROID conversion ..., posted by cybercafe on June 11, 2003, at 2:34:23
It's just me I think, who posted that EffexorXR at 225mg hits 5ht, NE, and DA and I heard it from the pdoc of a friend of my sister, this friend had been taking EffexorXR and increasing it, but developed blood pressure problems at a high dose (common).
I am pretty sure that at it does NOT take up to 225 to hit both 5ht and NE nor that you have to go HIGHER than that to hit all 3 because higher than 225 is when it usually raises blood pressure badly.
I suppose you could do a search on EffexorXR doses and the receptors it hits at various levels.
Posted by Janelle on June 11, 2003, at 17:45:13
In reply to Re: SPHEROID conversion ..., posted by Janelle on June 11, 2003, at 17:43:03
Posted by Janelle on June 11, 2003, at 18:01:58
In reply to Re: SPHEROID conversion ..., posted by cybercafe on June 11, 2003, at 2:34:23
Cybercafe,
I did a quick and dirty, so to speak, search on the question of dosing and receptors for EffexorXR and found that it apparently hits 5ht AND NE at levels between 75-150mg/day and then hits Dopamine at (quote) "higher doses" -- like around 225mg/day.
I also recall reading somewhere awhile back that EffexorXR technically is NOT one of the SSRI's (like Prozac, Zoloft, Paxil, Celexa, Lexapro) because it acts on BOTH serotonin AND Norepinephrine, whereas the others I listed act ONLY on Serotonin.
Whatever it was that I read said that EffexorXR is an SRI or SNRI, or something like that, which would indicate that it is a selective reuptake inhibitor or a Serotonin Norepinephrine Reuptake Inhibitor. The point being that it is technically and chemically NOT in the same exact category as those others, but is closely related! Hope this helps!
Posted by Caleb462 on June 11, 2003, at 22:07:41
In reply to More on EffexorXR dosing ... » cybercafe, posted by Janelle on June 11, 2003, at 18:01:58
Effexor, as a dopamine uptake inhibitor, is very weak... I highly doubt 225 mg has any noticeable effect on dopamine systems. 150 mg is usually the official dose given for signifigant NE uptake inhibition to begin, though I'm sure 75 mg has a weak effect. 225-300 mg is probably the range where Effexor acts most like an SNRI. This is just an assumption of course.
I'm curious as to what role dopamine plays in higher doses of Effexor... for example, some people take doses as high as 450 mg.. I wonder if there is any signifigant dopaminergic action going on at this point? My guess is not much... but who knows? There's been trials that have used as much as 600 mg of Effexor, I bet dopamine uptake inhibition does become a strong part of Effexor's action here... but having never experienced more than 225, I can't say.
Posted by cybercafe on June 12, 2003, at 2:20:32
In reply to More on EffexorXR dosing ... » cybercafe, posted by Janelle on June 11, 2003, at 18:01:58
Posted by Janelle on June 13, 2003, at 15:51:42
In reply to Re: More on EffexorXR dosing ..., posted by Caleb462 on June 11, 2003, at 22:07:41
This is the end of the thread.
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