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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 mission7 on January 14, 2010, at 23:13:39
I've been on Effexor for over 10 years and it's worked pretty well and also take Lorezapam-PRN. I want to ask my doctor to add something to Effexor, such as, Paxil or Prozac. Can anyone suggest what to add?
In general I function pretty well, but looking back at the last 5 years, or so, I've been pretty miserable, suffering from depression and anxiety.
What I've tried:
Prozac: Made me think of suicide
Wellbutrin: I became very angry and aggressiveI would like to stay on Effexor because I relieves many symptoms. Such as no social phobia, etc.
I'd like to try something older--less pricey--because I just had cancer and it killed me financially.
Posted by mission7 on January 15, 2010, at 0:01:15
In reply to What should I add to Effexor, posted by mission7 on January 14, 2010, at 23:13:39
Or, is it time to switch from Effexor to something else?
ps One thing I forgot to mention is that when I up my Effexor dosage, I get angry and snap at people.
Posted by janejane on January 15, 2010, at 11:38:06
In reply to Re: What should I add to Effexor, posted by mission7 on January 15, 2010, at 0:01:15
I'm not nearly as knowledgeable as others here, but since nobody else has said anything yet, I thought I'd chime in...
So your remaining symptoms are depression and anxiety? It seems like something that works on serotonin would be a good choice, especially given what happened with wellbutrin. Maybe paxil? Just thought of that one it's supposed to be pretty calming (compared to say, prozac which is supposed to be more activating, and which we already know disagreed with you). Paxil is now generic, so it'd be cheap. It does seem like you should keep the effexor since it's working on some of your symptoms. Hopefully others will drop by with more suggestions soon.
By the way, congratulations on beating cancer. That's pretty amazing.
Posted by detroitpistons on January 15, 2010, at 12:56:58
In reply to Re: What should I add to Effexor, posted by mission7 on January 15, 2010, at 0:01:15
> Or, is it time to switch from Effexor to something else?
>
> ps One thing I forgot to mention is that when I up my Effexor dosage, I get angry and snap at people.Sounds like maybe you get a little hypomanic when you increase the dose. That's what happened to me with Effexor. The doctor added Lamictal to it, and ever since it seems to have worked. It's been about 4 years now. It basically prevented the "poop out" that I had experienced the first time around with Effexor.
I've had a couple rough patches here and there, but the Lamictal seems to keep me on an even keel over the long term. Lamictal is also generic now - Lamotrigine. It's worth asking about.
Posted by bleauberry on January 15, 2010, at 17:56:57
In reply to What should I add to Effexor, posted by mission7 on January 14, 2010, at 23:13:39
Considering how long you've been on effexor, and that it is helping in certain ways, it would probably be rocking the boat too much to think about stopping it. The withdrawals would be hell and longlasting, just for starters.
Five ideas. I thought of a bunch of different meds, but these were the ones I felt had the most potential to fit your particular story. Any of these would not replace effexor, but would be added to it.
Remeron
Nortriptyline
Zyprexa
Low dose Lexapro
LDNSome ideas to work with. I think doing a complete switch away from effexor after a decade on it is just too risky at this point.
Posted by polarbear206 on January 15, 2010, at 23:03:36
In reply to Re: What should I add to Effexor » mission7, posted by detroitpistons on January 15, 2010, at 12:56:58
> > Or, is it time to switch from Effexor to something else?
> >
> > ps One thing I forgot to mention is that when I up my Effexor dosage, I get angry and snap at people.
>
> Sounds like maybe you get a little hypomanic when you increase the dose. That's what happened to me with Effexor. The doctor added Lamictal to it, and ever since it seems to have worked. It's been about 4 years now. It basically prevented the "poop out" that I had experienced the first time around with Effexor.
>
> I've had a couple rough patches here and there, but the Lamictal seems to keep me on an even keel over the long term. Lamictal is also generic now - Lamotrigine. It's worth asking about.
Same with me. I take effexor and lamictal. Great combo. I would look into it.
Posted by mission7 on January 16, 2010, at 15:02:59
In reply to Re: What should I add to Effexor, posted by polarbear206 on January 15, 2010, at 23:03:36
I see that lamictal is a tricyclic. That's not an MAOI is it?
Some of the drugs listed by bleauberry were for treating Bi-Polar disorder. Because, I don't suffer from that, would it change your recommendation?
Posted by detroitpistons on January 16, 2010, at 15:18:17
In reply to Re: What should I add to Effexor, posted by mission7 on January 16, 2010, at 15:02:59
Lamictal is not a tricyclic. It's an anticonvulsant that is also used as a mood stabilizer and/or to augment antidepressant therapy. I think it's better suited for bipolar II types rather than bipolar I.
These disorders aren't "black and white" and the drugs prescribed reflect that. For instance, some people with depression are prescribed antipsychotic drugs (in addition to antidepressants) even though they have no psychosis. Make sense? In other words, you don't have to have "textbook" bipolar disorder in order to be prescribed drugs that are used for bipolar disorder.
> I see that lamictal is a tricyclic. That's not an MAOI is it?
>
> Some of the drugs listed by bleauberry were for treating Bi-Polar disorder. Because, I don't suffer from that, would it change your recommendation?
Posted by mission7 on January 16, 2010, at 16:34:06
In reply to Re: What should I add to Effexor » mission7, posted by detroitpistons on January 16, 2010, at 15:18:17
I used to know which drugs were thought to do what, such as Effexor is a serotonin-norepinephrine reuptake inhibitor. What do these drugs do???
Remeron
Nortriptyline
Zyprexa
Low dose Lexapro
LDNIs there a Dopamine Reutake inhibitor?
Posted by mission7 on January 19, 2010, at 11:30:09
In reply to Re: What should I add to Effexor, posted by mission7 on January 16, 2010, at 16:34:06
OK! So, I set up an appointment with my PDoc to ask about adding something to EffexorXR. I have been really feeling like dirt for the last few months and can't stand it anymore. I'm pretty worried about it.
On this thread I got a few suggestion as for what to add to Effexor:
Remeron
Nortriptyline
Zyprexa
Low dose Lexapro
LDNI looked up the descriptions of these drugs and I'm pretty confused. Most of them seem to be things like bi-polar treatments, anti-psychotics etc., which isn't me. Does that matter? Or, is it a case of, "when we add this to EffexorXR it just seems to work."
Wish me luck. I meet with her on Tuesday.
Sorry, I need to vent: I own my own business and trying to tell my employees that I'm not feeling well only goes so far. For the most part Effexor was working for years, but I still feel like there is this impending doom. This horrible thing that is going to happen. And if I don't get everything done I'm going to be a horrible failure. When I try to work I get agitated and worried like there is something very important that I'm not getting done. I can't just relax and concentrate. When I'm awake I want to sleep. When I'm in bed I can't sleep. I'm a miserable wreck and need it to stop!
Have a Nice Day.
Posted by mission7 on January 19, 2010, at 11:35:23
In reply to Re: What should I add to Effexor, posted by mission7 on January 19, 2010, at 11:30:09
Man that last post felt great. I know things will get better. I've been through the "trying out new meds" thing before and as nail biting as it is, it can be a little fun.
Posted by janejane on January 19, 2010, at 11:43:46
In reply to Re: What should I add to Effexor, posted by mission7 on January 19, 2010, at 11:35:23
> Man that last post felt great. I know things will get better. I've been through the "trying out new meds" thing before and as nail biting as it is, it can be a little fun.
>I'm glad venting helped. Good luck with your appointment!
Posted by mission7 on January 19, 2010, at 12:52:57
In reply to Re: What should I add to Effexor » mission7, posted by janejane on January 19, 2010, at 11:43:46
Thanks for listening. Venting does provide some temporary relief.
This is the end of the thread.
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