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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by nancyjoyandamber on October 26, 2006, at 21:19:10
I am a middle age woman (in my 50's)who has been on 475mg of Effexor XR for several months. My Dr. says that in parts of California this is a perfectly ok dose. I live in Ma. He only gives me a script for 300mg and gives me samples for the other 175mg. When I have asked others who are familiar with this drug, they all say the max. dose should be around 275 to 300mg.. Even once when I was in a hospital the staff there would not give me the dose that I was on then which was only 375mg, as they said that I must mean 37.5 as NO ONE takes 375mg of EffexorXR a day.. I am concerned that I may be harming my body by taking this much..I have mentioned this to my psych dr. who prescribes this and he just seems to get annoyed that I am questioning him. Please if anyone has had experience with taking this much can they share it with me, and also anyone who thinks that this is way to much could you also share your thoughts.. Thanks.
Posted by sleepygirl on October 26, 2006, at 22:59:07
In reply to Is 475mg of Effexor XR a day way to much????, posted by nancyjoyandamber on October 26, 2006, at 21:19:10
the most I've ever taken is 300mgs, never heard of such a high dose before
how's your blood pressure?
that's always something my pdoc checks
good luck,
sg
Posted by Tomatheus on October 27, 2006, at 1:19:58
In reply to Is 475mg of Effexor XR a day way to much????, posted by nancyjoyandamber on October 26, 2006, at 21:19:10
> I am a middle age woman (in my 50's)who has been on 475mg of Effexor XR for several months. My Dr. says that in parts of California this is a perfectly ok dose. I live in Ma.
I am not familiar with Effexor's dose range, but if your doctor seriously told you this, I think it would be a good idea to switch docs asap. I wouldn't trust my mental health to anyone who says that a medication can be tolerated in higher doses in one part of the country, as opposed to somewhere else.
On a more positive note, welcome to Psycho-Babble.
Tomatheus
Posted by yxibow on October 27, 2006, at 3:42:17
In reply to Re: Is 475mg of Effexor XR a day way to much???? » nancyjoyandamber, posted by Tomatheus on October 27, 2006, at 1:19:58
> > I am a middle age woman (in my 50's)who has been on 475mg of Effexor XR for several months. My Dr. says that in parts of California this is a perfectly ok dose. I live in Ma.
>
> I am not familiar with Effexor's dose range, but if your doctor seriously told you this, I think it would be a good idea to switch docs asap. I wouldn't trust my mental health to anyone who says that a medication can be tolerated in higher doses in one part of the country, as opposed to somewhere else.
>
> On a more positive note, welcome to Psycho-Babble.
>
> TomatheusOne should be cautious about telling someone point blank to switch their doctor. I've seen posts like this and we all on here except for occasional posts from medical professionals are armchair psychopharmacologists.
What I think the doctor meant is that in his extended range of patients (psychiatrists frequently have journal clubs where they anonymously describe their patients and medication) there exists a protocol for a higher dose.
Nonetheless, that is a fairly high dose and yes, I would discuss it with your doctor point blank. In the short term it is probably not harmful but may raise your pulse or blood pressure, I suggest you monitor your pulse -- anyway one can tell if that is in an uncomfortable range physically fairly quickly.
Normally the dosage is 225 but I suppose some push to 300. Maybe your doctor has a reason for 475 but that seems much beyond the mean of pushed ranges. I know I couldn't stand Effexor period, but I'm different from you obviously. Cymbalta seems to be a better match, at least at the moment.
The XR format, besides extending patents, may increase the time that the drug enters the system so you're not getting all 475 at a rush. Nonetheless I dont see why there cannot be a two way street of communication with your doctor. I wouldn't be afraid to speak up and say, do your peers regularly prescribe (x) dose? California, wherever, it's irrelevant, its a doctor's license on the line and his peers and what they as a group feel comfortable with.
Frankly I wouldn't be afraid to speak up about any medication questions at a psychiatrist/psychopharmacologist's appointment. Its your 15(+) minutes depending on what kind of insurance and what country you're in. If necessary take a pencil and pad and write all you need to know. Then you don't feel like you have to wait for the next appointment and stew in some dose of medication or confusion about something. Some doctors have email these days as well. Use your options. Its your copay if not your dime on the line.
-- tidingsJay
Posted by christophrejmc on October 27, 2006, at 3:58:02
In reply to Is 475mg of Effexor XR a day way to much????, posted by nancyjoyandamber on October 26, 2006, at 21:19:10
No, it's not way too much. There are many people who take more than that and do quite fine. The theory is that higher doses have a stronger effect on dopamine reuptake.
If you are having side-effects or if your blood pressure is high (that can be a problem at higher doses) you should discuss it with your doctor. If this is your first time taking medication, you may want to try other options, but high-dose Effexor has been quite helpful for a number of people with treatment-resistant/refractory depression.
Posted by Tomatheus on October 27, 2006, at 9:59:00
In reply to Re: Is 475mg of Effexor XR a day way to much???? » Tomatheus, posted by yxibow on October 27, 2006, at 3:42:17
> One should be cautious about telling someone point blank to switch their doctor. I've seen posts like this and we all on here except for occasional posts from medical professionals are armchair psychopharmacologists.
>
> What I think the doctor meant is that in his extended range of patients (psychiatrists frequently have journal clubs where they anonymously describe their patients and medication) there exists a protocol for a higher dose.Jay,
I feel accused by your statement. I think that there is a difference between telling someone else what I would do in their situation and telling that person to do something "point blank." I was doing the former, not the latter. Nancyjoyandamber obviously knows more about her doctor than I do, so yes, she's clearly in a better position to decide whether or not she should switch docs than I am. I may have taken her doc's statement out of context, and if I did, I apologize. I was clearly making a judgment based on one statement from Nancyjoyandamber's post, but I was by no means "telling [her] point blank to switch [her] doctor." If I wanted to do that, I would have said, "get a new doctor." I was saying what I would have done if I were in Nancyjoyandamber's situation based on her doctor's statement, which is a lot different from dictating what she should do. I don't mind if others disagree with me, and I certainly respect Nancyjoyandamber's choices when it comes to her mental health treatment. But it bothers me when others accuse me of saying something that I never said. I would never tell anyone to "point blank switch their doctor."
I'm also sorry if I didn't make it clear in my post that I'm a patient and that I'm not making myself out to be a medical professional of any sorts. I thought that I was making this obvious by starting one of my sentences by saying, "I wouldn't trust my mental health to anyone who says..." but I realize that it's possible that a medical professional could say the same thing. So, I apologize for not making it more clear that I'm also a patient.
Tomatheus
Posted by yxibow on October 28, 2006, at 1:12:52
In reply to Re: Is 475mg of Effexor XR a day way to much???? » yxibow, posted by Tomatheus on October 27, 2006, at 9:59:00
> > One should be cautious about telling someone point blank to switch their doctor. I've seen posts like this and we all on here except for occasional posts from medical professionals are armchair psychopharmacologists.
> >
> > What I think the doctor meant is that in his extended range of patients (psychiatrists frequently have journal clubs where they anonymously describe their patients and medication) there exists a protocol for a higher dose.
>
> Jay,
>
> I feel accused by your statement. I think that there is a difference between telling someone else what I would do in their situation and telling that person to do something "point blank." I was doing the former, not the latter. Nancyjoyandamber obviously knows more about her doctor than I do, so yes, she's clearly in a better position to decide whether or not she should switch docs than I am. I may have taken her doc's statement out of context, and if I did, I apologize. I was clearly making a judgment based on one statement from Nancyjoyandamber's post, but I was by no means "telling [her] point blank to switch [her] doctor." If I wanted to do that, I would have said, "get a new doctor." I was saying what I would have done if I were in Nancyjoyandamber's situation based on her doctor's statement, which is a lot different from dictating what she should do. I don't mind if others disagree with me, and I certainly respect Nancyjoyandamber's choices when it comes to her mental health treatment. But it bothers me when others accuse me of saying something that I never said. I would never tell anyone to "point blank switch their doctor."
>
> I'm also sorry if I didn't make it clear in my post that I'm a patient and that I'm not making myself out to be a medical professional of any sorts. I thought that I was making this obvious by starting one of my sentences by saying, "I wouldn't trust my mental health to anyone who says..." but I realize that it's possible that a medical professional could say the same thing. So, I apologize for not making it more clear that I'm also a patient.
>
> Tomatheus
Oh I understand you're a patient, almost all of us are on here or have been or know they are about to enter another episode of a biological imbalance. It wasn't meant to.. well it was a sort of mild accusation or comment, but it wasn't meant to hurt your feelings in any way.
I took "...I am not familiar with Effexor's dose range, but if your doctor seriously told you this, I think it would be a good idea to switch docs asap.." to mean that I don't know about Effexor and you should get a new doctor.
As I've said, I've seen postings like this, "switch your meds immediately", "dump your doctor", and there is not enough contextual explanation for something that could get someone in a pickle if they are easily persuaded. Ultimately it is their health on the line and the doctor-patient relationship.
But you have explained here more, and I'm satisfied and it was a random interjection so there's no real need to overexplain yourself. I try not myself to point blank say something but as you are describing, "in their shoes", and so a little more information is necessary.
But don't worry, I'm not on a tirade or against you. It was just an interjection and I apologize if it came off as curt.-- tidings
Jay
Posted by Tomatheus on October 28, 2006, at 1:58:28
In reply to Re: Is 475mg of Effexor XR a day way to much???? » Tomatheus, posted by yxibow on October 28, 2006, at 1:12:52
Jay,
Thanks for your post. In retrospect, I think that my original statement ("I think it would be a good idea to switch docs asap") was a knee-jerk reaction to part of Nancyjoyandamber's post that I ended up taking out of context. I apologize to everyone here for making the statement. I don't know enough about anyone's doctor here to be able to reasonably determine whether or not it would be a good idea to switch docs, and I'm sorry for making such a snap judgment without thinking more thoroughly about what I was writing. You're correct. I should have been more cautious.
My issue with your post was that you seemed to imply that my statement was more of a demand than a suggestion. I think that I overreacted to your post, and I thank you for not overreacting to mine.
Tomatheus
> Oh I understand you're a patient, almost all of us are on here or have been or know they are about to enter another episode of a biological imbalance. It wasn't meant to.. well it was a sort of mild accusation or comment, but it wasn't meant to hurt your feelings in any way.
>
>
> I took "...I am not familiar with Effexor's dose range, but if your doctor seriously told you this, I think it would be a good idea to switch docs asap.." to mean that I don't know about Effexor and you should get a new doctor.
>
>
> As I've said, I've seen postings like this, "switch your meds immediately", "dump your doctor", and there is not enough contextual explanation for something that could get someone in a pickle if they are easily persuaded. Ultimately it is their health on the line and the doctor-patient relationship.
>
>
> But you have explained here more, and I'm satisfied and it was a random interjection so there's no real need to overexplain yourself. I try not myself to point blank say something but as you are describing, "in their shoes", and so a little more information is necessary.
>
>
> But don't worry, I'm not on a tirade or against you. It was just an interjection and I apologize if it came off as curt.
>
> -- tidings
>
> Jay
>
Posted by Colleen D. on October 30, 2006, at 20:20:25
In reply to Is 475mg of Effexor XR a day way to much????, posted by nancyjoyandamber on October 26, 2006, at 21:19:10
with careful monitoring of blood pressure. I was on 300mg tops, and now am on 150mg. I may go higher, but I'm doing well except for a total lack of interest in sex. Luckily, I'm unmarried and don't have a partner. I also get a "dried up" feeling from it. Dry nose, dry mouth and constipation. Drink lots of water!
Check your BP every time you go to the pharmacy if they have one of those monitors. I have never had higher than normal blood pressure while on it even though I went up to 300mg.
Good luck,
Colleen
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