Posted by Cam W. on March 8, 2001, at 7:04:30
In reply to If you have ever used Effexor ..., posted by willow on March 7, 2001, at 23:17:44
Willow - I sincerely doubt that Effexor will be withdrawn from the market. I am not sure that the company is aware of the extent of the backlash against it. You can still find psychiatrists (but mainly GPs; who BTW, treat a majority of depressions) who still do not know of that the Effexor's short half-life is causing problems (in a majority of people, it is not - really).
There is a problem with withdrawl symptoms only if the withdrawl is not handled properly. It is up to the drug company (Wyeth-Ayerst) to launch an education campaign for the physicians (and possibly the patients, as well), on how to watch for and treat serotonin withdrawl. Effexor withdrawl symptoms are far less severe, less dangerous and less common than withdrawl from long term use of a short acting benzodiazepine (eg Xanax™ - alprazolam), especially when Xanax is used at higher doses. MAOIs and TCAs are far more toxic and potentially lethal, with far more side effects, than Effexor.
While real, the Effexor withdrawl phenonmenon has blown out of proportion on the internet, with websites being created to feed the frenzy. I would like to see a study done that actually determines the true extent Effexor withdrawl; 1) separated from rebound bouts of depressive symptoms and depressive disorder; 2) psychosomatic symptoms; 3) primary depressive symptoms that never abated but some of the symptoms were masked by the secondary side effects of Effexor, 4) scapegoat-finding instead of working on the real issues behind the depression; 5) copycat withdrawers; 6) etc.
Don't get me wrong, serotonergic withdrawl is a real phenomenon, but is no where near as dangerous as withdrawl from the long term use of benzodiazepines, opiates, amphetamines, nor cocaine. In this sense, Effexor is not addictive, does not cause drug-seeking behavior, and does not produce dependence (outside of the case of any antidepressant causing a syndrome a person worrying that they will not be able to function without the antidepressant, which is a different syndrome altogether). There have not been, to my knowledge, any deaths directly related to the serotonergic withdrawl effects of Effexor (to severe serotonin syndrome, yes there have, but this is different).
Most people who do post on the serotonergic withdrawl symptoms do so within the first week of removal of the offending antidepressant (be it Effexor, Paxil, Zoloft, or Luvox). Why especially with Effexor? It has a shorter half-life than any of the other agents AND it is being used very extensively, at the moment. With the efficacy and widespread use of Effexor, it is not going to be taken off the market any time soon.
Willow - I'd have liked to have e-mailed you directly on this because I am sure a backlash will ensue (which is not my intention). If emotion could be left out of the discussion of Effexor withdrawl, perhaps we could arrive at a consensus of the best ways to monitor for and treat this phenonmenon. Perhaps we could find a way to get the word out to Wyeth-Ayerst and the media about the need for public awareness of serotonin syndrome, so that it will not take people by surprize. Perhaps Wyeth-Ayerst should begin a physician education campaign.
Effexor is too valuable a medication to be removed from the market. Until the next generation of mood-modifiers/HPA stabilizers hits the market, antidepressants (and ECT) are really the only treatments we can offer to augment the psychotherapies (esp CBT & IP) in treating major depressive disorder (and some other mood disorders).
Sincerely - Cam
poster:Cam W.
thread:55894
URL: http://www.dr-bob.org/babble/20010302/msgs/55906.html